Pure O OCD

Purely Obsessional, or Pure O, is a mental health condition in which individuals experience obsessions, such as intrusive and distressing thoughts, images, or impulses. It is a subtype of Obsessive Compulsive Disorder (OCD).

The term ‘Pure O’ may be misleading, as it implies that those with Pure O only experience obsessions (the “O” of Pure O). People with Pure O do also experience compulsions – that is, behaviors or rituals performed to neutralize the obsessions and associated distress.

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It is the nature of these compulsions that distinguishes Pure O from more traditional presentations of OCD – e.g., excessive hand washing, counting, and checking. Instead, the compulsions in Pure O are purely cognitive. These mental acts may take on several forms, such as:

These compulsions are often motivated by the intolerance of uncertainty.

Note: Experiencing intrusive thoughts is very common. In fact, the majority of people without OCD experience very similar types of thoughts as people with OCD. The difference is that for people experiencing OCD, those thoughts come with a false alarm signal. The thoughts may seem very important, imminent, and threatening.

The good news is that there are many research-supported strategies that can help manage these thoughts and feelings more effectively. Learning what these strategies are, and gaining expertise in using them, can allow people to lively freely from their OCD and make choices in line with their goals and values.

Learn more about OCD definitions, symptoms, diagnoses, and treatment options.

Prevalence of Pure O OCD

OCD affects between 1-3% of the population and is seen equally amongst adult men and women. (However, men tend to develop symptoms at a younger age than women.)

Symptoms of Pure O OCD

The overarching symptom of Pure O OCD is performing mental acts in an attempt to neutralize or undo an intrusive thought, image, or urge, and/or to obtain certainty and eliminate anxiety. These may include:  

This can lead to:

Themes and types of Pure O OCD  

There are many examples of Pure O themes that people experience. These may include thoughts about:

What to look for in a Pure O therapist

When looking for a therapist to treat Pure O, it is important to become an educated consumer and look for a therapist with particular expertise.

The treatment can be very different than the type of work that can help other mental health issues and at times can seem counterintuitive. In fact, there are some therapeutic techniques that may even fuel one’s obsessions and worsen symptoms.  

It is important to work with a mental health professional who practices cognitive behavioral therapy (CBT), particularly a technique known as exposure and response prevention (ERP/ExRP). It can also be helpful to look for someone who practices acceptance and commitment therapy (ACT) and/or mindfulness-based therapy. Look for someone who has expertise in treating Pure O specifically and knows how to apply therapeutic techniques when compulsions are not observable but purely mental.

Find therapists who treat OCD near you

Find therapists who treat OCD on Zencare. Search by insurance, fees, and location; watch therapist introductory videos; and book free initial calls to find the right therapist for you!

New to therapy? Learn about how to find a therapist here.