Pure Obsessional OCD

Pure Obsessional OCD


Pure O is a type of OCD characterized by intrusive, unwelcome, and uncontrollable thoughts. Pure O is sometimes referred to as purely obsessional OCD (or obsessions). While someone with Pure O may not carry out overt actions like washing their hands, counting, or organizing things, the disease is instead accompanied by covert mental rituals.

Sometimes people wrongly believe that Pure O is a "less severe" version of OCD. The typical intrusive thoughts associated with this condition can be quite upsetting and unpleasant for those who experience its symptoms.

While those without compulsions are occasionally referred to as having "pure O" or "purely obsessional OCD," the diagnostic guide used by many doctors, psychiatrists, and Counseling psychologists does not list this variety as a separate diagnosis.

Obsessive-compulsive disorder symptoms include recurrent obsessions and obsessive actions (compulsions). For instance, someone with OCD might experience uncontrollable thoughts about germs and hygiene that cause them to feel the need to repeatedly wash their hands.

Despite the absence of the evident compulsions, individuals with a "purely obsessional" type of this illness nonetheless experience a variety of OCD symptoms. Obsessions and/or compulsions are characteristics of OCD, according to the DSM-5.

Recurrent, invasive, unwanted, and persistent thoughts, visions, or urges that create discomfort or suffering are known as obsessions. Obsessions frequently involve physical, sexual, aggressive, or religious impulses, as well as worries about symmetry and contamination.

Researchers discovered in a 2011 study that people who have "pure obsessions" (also known as "taboo thoughts" or "inappropriate thoughts") also practise mental rituals to cope with their distress.

These rites could consist of:

  • Mentally going through the past or knowledge

  • Repeating words in your head

  • Reversing or undoing specific actions in your mind

People who are troubled by obsessive thoughts might frantically look for comfort. Because many patients might not even recognize it as a habit, this can be troublesome. Such assurance-seeking could entail:

  • Seeking validation from others

  • Avoiding things or circumstances that make you nervous

  • Looking for reassurance from oneself

  • Online researching

This symptom's additional issue is that relatives and friends may grow weary of or annoyed by the persistent demands for assurance, which some people may mistake for neediness.

Pure O still contains compulsions, but because they are virtually exclusively mental in origin, they are far less evident.


Despite the paucity of study on the precise origins of pure O, numerous studies have looked into OCD and its causes. These may consist of:

Factors of a biological nature: MRI brain scans reveal structural and functional variations in the neuronal (nerve) circuits in our brains that "censor" or filter the countless thoughts, ideas, and impulses we experience each day.

Family history: Because "pure" cases of OCD are hard to find, research has proved challenging. However, research has shown that those who have relatives with OCD are five to seven times more likely to develop pure O. 

Genetics: Although no specific "OCD gene" has been identified, the illness may be influenced by mutations in some gene families.


Medication is frequently used in conjunction with psychotherapy, which may include cognitive-behavioral therapy (CBT), support groups, and psycho-education, to treat OCD, particularly pure OCD.


According to research, cognitive-behavioral therapy can effectively treat pure O. Therapists and other mental health professionals must, however, be aware of how crucial it is to address the underlying mental processes that underlie this subtype of OCD. 

Treatment won't be as thorough or efficient if the therapist thinks the patient merely has obsessions and ignores the mental rituals that go along with these cognitions.

Researchers looked at individual trials in 2011 to determine whether specific symptom subtypes of OCD reacted better to specific therapeutic modalities. They discovered that, in the majority of studies, OCD is characterized by non-compulsive religious and sexual obsessions (also known as "pure O") and was linked to a subpar response to SSRI and exposure and response prevention treatments.

A type of behavioral therapy used to treat different OCD manifestations is exposure and response prevention therapy, or ERP therapy. It entails a qualified therapist assisting a client in approaching a fear object devoid of any compulsive behaviors.

Clients purposefully subject themselves to the triggers of their compulsions or obsessions while being restrained from indulging in compulsive behavior or obsessive thoughts. Teaching patients how to manage their symptoms without acting on compulsions is the aim of this type of therapy. In the near term, this causes more discomfort, but with time, symptoms and behaviors may improve.

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Medication Medications may include tricyclic antidepressants like Anafranil or selective serotonin reuptake inhibitors (SSRIs) (clomipramine). Atypical antipsychotic drugs, commonly referred to as second-generation antipsychotics, are also used to supplement SSRIs. According to one review, 20% to 40% of patients have a reduction in OCD symptoms when taking SSRIs, which corresponds to 40% to 60% of people.

The particular treatment (or combination of treatments) is determined by the needs of the patient. If a patient cannot or does not want to take medication, for instance, a therapist may choose to employ CBT alone. If a patient lacks the motivation to seek exposure-based treatments or does not have access to a CBT therapist, they may also recommend drugs alone. For that you can search for the Best therapist near me.

Coping with Pure O

Although seeking the advice of a licensed mental health professional, and looking for the Best psychologist in India is typically required for OCD treatment, there are a number of OCD self-help techniques that you may use right now to assist you or a loved one in managing the disorder's core symptoms.

Relaxation techniques: Learning and using relaxation methods like deep breathing, mindfulness meditation, or progressive muscle relaxation are among the greatest ways to cope with stress, which is a primary cause of pure O symptoms.

Workout: There is mounting evidence that aerobic exercise might lessen OCD symptoms.

Support groups: Pure O patients (as well as their loved ones) can greatly benefit from both in-person and online support groups by receiving resources, knowledge, or just a listening ear.

Pure O might not involve the external actions that people typically associate with OCD. Even though they may be disguised, the secret mental rituals that characterize the disorder's solely obsessional form constitute a form of compulsion.

Consider speaking with a psychologist by searching for an Online counsellor if you discover that you have upsetting obsessions and/or mental compulsions that are interfering with your daily life. They may assist you in comprehending your symptoms and selecting the most appropriate course of action. Even though it's not always simple, talking about your feelings is the first step in seeking the support you might require to feel better.

Contributed By- Dr. (Prof.) R.K. Suri & Ms. Varshini Nayyar