Most people will have heard of OCD, but how many have never heard of ‘Pure O’? And what is it?
Pure O stands for ‘purely obsessional’. There is some dispute whether Pure O actually exists, or whether it is merely another name for certain symptoms of the mental health condition, Obsessional Compulsive Disorder more commonly known as OCD – so a form of Obsessive Compulsive Disorder, without the compulsive part. It is true that Pure O is not listed officially as a medical condition, but those who suffer from Pure O experience many of the same symptoms as those with OCD. It is therefore often referred to as just OCD.
For those suffering from Pure O, leading a normal life can be a real challenge. Sufferers experience intrusive thoughts, which can often be of a violent, sexual or shocking nature. The sufferer would never carry out such thoughts, but they can cause immense distress and doubt in the mind of the sufferer as they question where the thoughts have come from.
Unlike someone with full-blown OCD, who would react to these thoughts by undertaking obvious or visible rituals such as repeated hand washing or checking locked doors to compensate for these intrusive thoughts, sufferers with Pure O will undertake mental rituals which are invisible to others to ‘cancel out’ the thoughts that they are experiencing. These rituals may take the form of repeating certain phrases or numbers in their mind or checking how they feel about certain thoughts and whether the thought is still valid, questioning whether it is in fact part of who they are.
There is an argument that these internal rituals will inevitably also involve other compulsions, such as avoiding certain places, people or situations which may trigger the intrusive thoughts. This supports the view that the condition is actually a form of OCD, as it involves both the obsessional and compulsive symptoms shown in OCD. The way therefore to successfully treat the condition is to use the same treatments used for OCD.
Appropriate treatments can include Cognitive Behavioural Therapy (CBT) – a talking therapy which looks at the way we act and think when faced with problems; Exposure and Response Prevention (ERP) – a therapy which involves facing fears head on and developing ways of coping with those fears; or the prescription of SSRIs – medication which helps relieve the symptoms of anxiety.
Further information on OCD and on Pure O can be found on the OCD UK website.
Pure O is not officially listed as a separate diagnosis in diagnostic manuals like the DSM-5 or ICD-11. However, many clinicians and researchers recognize it as a subtype of OCD due to the presence of intrusive thoughts and mental rituals. It is often treated in the same way as OCD.
Intrusive thoughts in Pure O can include violent, sexual, blasphemous, or morally disturbing content. These thoughts are unwanted, distressing, and often go against the person’s values or character, which is what causes such intense anxiety and self-doubt.
Traditional OCD often involves visible compulsions like hand-washing, checking, or ordering. Pure O, on the other hand, primarily involves mental compulsions, such as internal checking, rumination, or reassurance-seeking, to cope with obsessive thoughts.
While there is no definitive cure for Pure O or OCD, many people experience significant improvement with the right treatment. Cognitive Behavioural Therapy (especially Exposure and Response Prevention) and medications like SSRIs are commonly effective in managing symptoms.
Yes. If you are experiencing persistent, distressing intrusive thoughts and find yourself engaging in mental rituals or avoiding situations because of them, seeking help from a qualified mental health professional can be an important first step toward recovery.
