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Understanding “Pure Obsessional OCD”: It’s Not Just Obsessions
Effective Therapy for “PURE O” OCD in Orlando (& additional locations)

GroundWork provides in-person appointments in Central Florida, and virtual appointments for clients residing in Florida, Maine, Vermont, Montana and South Carolina.

What is “Pure O” or “Pure Obsessional OCD”?

Obsessive-compulsive disorder (OCD) affects millions of people worldwide, with symptoms ranging from physical rituals like handwashing to uncontrollable thoughts or obsessions. Among them, “Pure Obsessional OCD” has been commonly used to describe a type of OCD that allegedly involves only obsessions with no physical compulsions. However, research has shown that this label is a misnomer, and the disorder is more complex than its name implies. In this blog post, we will explore “Pure Obsessional OCD” and the possibility of mental compulsions as the primary rituals.

Role of Compulsions in “Pure O OCD”

Pure Obsessional OCD is a subtype of OCD that was previously considered to have a complete absence of rituals / compulsions. However, the trained eye of an OCD specialist can identify the rituals and compulsions that may otherwise go unnoticed. “Pure O” often involves primarily mental compulsions instead of overt physical rituals. People with this subtype of OCD may struggle with distressing, unwanted thoughts, images, or urges that revolve around themes such as harm, sexual, or religious obsessions. The person may engage in mental compulsions to neutralize the anxiety caused by these obsessions. For instance, they may repeatedly analyze or seek reassurance from others, mentally reviewing past events to check if they acted according to their values, pray to counteract intrusive thoughts, or analyze thoughts compulsively.

Intrusive Thoughts OCD vs Pure O OCD

Despite its name, research has shown that the “purely obsessional” character of this subtype of OCD is a misnomer. While people with Pure Obsessional OCD may not exhibit any observable physical compulsions, they do engage in covert compulsions. Mental compulsions are mental activities that aim to reduce the distress caused by obsessions. The problem is that instead of reducing anxiety, these activities maintain and even exacerbate it over time. For example, a person who fears hurting someone may count to a specific number repeatedly to counter the anxiety the obsession produces. This kind of activity can be so subtle that it may even go unnoticed by the person with OCD.

The reason mental compulsions can be so insidious is that they are more difficult to pinpoint and often go unnoticed if a therapist doesn’t specialize in OCD . The person with OCD may believe that obsessing and performing mental activities is part of their personality or that it helps them cope with anxiety. However, these activities can quickly become maladaptive, reinforcing the obsessions and increasing anxiety.

Specialized & Effective Therapy for Pure O OCD

“Pure Obsessional OCD” or “Pure O” is an inadequate label to describe the complexity of OCD. While people with this subtype may not engage in physical rituals, they do have mental compulsions, which can be as debilitating as their physical counterparts. It is crucial to recognize mental compulsions to avoid misdiagnosis and ensure that patients receive appropriate treatment. Identifying the covert activities related to Pure Obsessional OCD and addressing them through exposure and response prevention is an effective way of treating this condition. If you or someone you know is struggling with these types of unwanted thoughts and mental compulsions, don’t hesitate to seek professional help.

Have You Found Previous Therapy Minimally Effective, or Even Ineffective?

Studies confirm that people often believe that they are receiving Cognitive Behavioral Therapy (CBT) from their mental health professional when in fact they are not. Research repeatedly verifies that other types of therapy are less effective in treating anxiety and OCD and it is widely recognized that CBT is the most effective treatment for anxiety and OCD. OCD and Anxiety disorders are complex and require treatment from clinicians who have been specifically trained in CBT for these issues.


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