How Does “Pure O” Develop?

How Does “Pure O” Develop?


Purely obsessional OCD, often called ‘Pure O,’ is a form of OCD in which a person experiences primarily intrusive or unwanted thoughts without performing outward compulsions or rituals.

For a long time, Pure O has been seen as a type of OCD that has been more difficult to treat than others. However, in my experience, people with Pure O almost always engage in compulsions, they are usually just less noticeable to others, especially if you don’t know what to look for. Most compulsions are unseen compulsions, such as mental rituals like mental checking, rumination, or other mental distraction techniques. 

People with Pure O will also engage in different, often subtle, physical compulsions, such as avoidance, checking, and reassurance seeking.

So in this episode, I discuss how ‘Pure O OCD’ develops, and I also offer some examples of different compulsions that people engage in.




All right. Hey there. And welcome to this episode where we're going to talk about how pure O OCD develops. And so, um, you know, if that's a new term to you that the idea of pure Oh, OCD means basically purely obsessional OCD, and really what we're talking about there kind of a sub category of OCD that really falls into three themes, right? You have the idea of OCD around harmful or violent thoughts, um, the around religious themes and then also OCD around sexuality and relationships. Right. And in the pure Oak category, what used to be believed was that OCD was just, just the obsessive component, right? There was no compulsive component. Right. And if, you know, in the last episode we talked about how it loosely develops. So you have the four components, right? You have the obsessive thought or the intrusive thought, and then that produces anxiety or guilt or doubt, right.


And then you do the compulsion and then you get relief. And when those four components kind of locked together, they basically formed this loop. And the more you do a compulsion, the more you reinforce the fear. So the worst fear gets in the worst, the compulsion gets in and just grows. Right. And so when we talk about, um, pure OCD, you know, it used to be thought that there were no compulsive behaviors and, you know, a person just struggled with the obsessions, right? The obsessive thoughts about, you know, harm, thoughts, religious thoughts, or relationships and sexuality. And so they thought, you know, for a long time that it was very difficult to treat, but what, um, what we've realized now, right. You know, as, as you know, there's been advancements in the field and obviously people have gotten better is that the compulsion's that people do are actually usually mental and they're usually happening just right in their mind.


And, you know, if you're not familiar with, with mental compulsion, so, you know, we can go into some of the ideas. Right. But, um, you know, the idea of pushing a thought out of your head, right. In thought suppression. Right. And what we need to realize is that's actually a behavior. Right. And so it's easy to see physical behaviors. Right. So in, in typical, what you might call typical OCD, I don't know that I even really believe in that, to be honest, but with, with traditional forms of obesity, like contamination, um, you know, you'll see the outward behaviors of washing hands, right. You'll see the outward behaviors of avoiding things that are contaminated or checking something or getting, you know, verbal reassurance again. And again, and again, with pure OCD or, you know, the, the forums that kind of fall under that category, right? Like relationship obesity, sexual orientation, or pedophilia, OCD, um, harmo city, cell pharma city, and then finally scrupulosity kind of any of the religious or existential forms of OCD.


What you'll see is that people do a lot of mental behaviors just right in their head, very I just to themselves, like you would never know. Right. So they could be, let's say in, in a meeting at work and they could be analyzing, right. Like, Oh, you know, if they had a relationship C they could be analyzing a conversation they had with a coworker and trying to analyze if they were, you know, attracted to the person. Right. And because it causes them anxiety. Right. So it's, it's very different than the idea of actually being attracted to someone. Right. It's, it's this fear that like, Oh my gosh, well, what if I was attracted to them and was I flirting with them? So they're analyzing and replaying the conversation again and again, and that's all just happening right. In their mind. Or they could be, you know, silently praying about something.


Right. So someone with more scrupulosity and religious form of OCT, which again, we have a whole series on that. And so we'll, uh, we'll definitely include that in the notes below the show, but, you know, with, with that particular form of, of OCD, right? A lot of times people just pray silently in their mind and it becomes, it becomes, um, again, tough because part of breaking that cycle is not doing the compulsive behaviors, which means, you know, foregoing, prayer, and, and, you know, that's where that conflict comes in. Right. You know, with, with treatment and, you know, someone will usually say like, well, my faith is very important to me and, and you know, we totally respect that, but when you're using it in a way that's reinforcing a fear that actually is, is not logical. And it's starting to impact your life to the point where maybe you're not going to work or maybe your relationships are, and work is getting damaged.


Right. That's when we really have to start challenging the difference between, well, what's your faith. And what's fear, you know, what's driven by fear and anxiety. And, and if this behavior of mental prayer right. Can get, can, can get people, you know, really caught in that loop a lot where they're praying about the same thing day after day, month after month, year after year. Right. I am. In fact, I've seen cases where people have prayed about something for, you know, 20 plus years, right. The same thing. And, um, and, and this can go on and on. So things like thought suppression, right? A thought replacement, mental blocking, a lot of, a lot of, um, a, a big compulsion that people do with pure is cognitive avoidance, meaning that the avoid trying to have a thought or image pop up in their head. And if it does pop up, you know, a lot of like, you know, kind of blocking techniques.


And what we need to realize is these behaviors are exactly the same as if you're doing physical behaviors. So if you're washing your checking, it might be easier for other people to spot it, but all the stuff you're doing in your head E avoiding songs or movies that trigger thoughts, right? Like these are just examples of, of little compulsion's that develop that pure O C D. And that's why, you know, I don't, I don't even really believe in that concept of Piero city because I've never seen it exists. I usually, after you talked to someone for just a few minutes, you'll be able to start seeing compulsions that they're doing. And, um, and that's why the treatment process is exactly the same. But when we talk about how pure O develops, it really is the same thing, right. You have the intrusive thought. And like I said, with Piero, it's generally in one of those categories, right.


With harm or violence, religion, or faith, and then sexuality or relationships. And when that thought happens, right. And then the person feels anxiety or doubt or uncertainty, or, you know, whatever that uncomfortable feeling is. And then they engage in a compulsion to neutralize that. And it's just important to realize that with Piero, you really, we really gotta look for those mental compulsions. Right. And, and the things you're doing mentally, or, or environmentally, just, just in your head, right. So you could be checking something mentally, you could be checking to see if you are aroused over a certain situation. Those are, those are examples of mental compulsions because they just happen right here. And no, one's the wiser. And that's the tricky part about PIRO CD is that while you might see that the person's in distress, you often won't see them doing these things. And so, um, you know, one of the reasons I wanted to make an episode about this is because just to kind of spread some awareness on this idea of mental compulsions and how they're the same thing as physical compulsions, because they still keep that loop going.


And that's really how that Piero OCD develops, right? It's you have the thought, the anxiety or uncomfortable sensation, and then the behavior and the behavior is just usually mental and that generates relief. And that reinforces the feared thought, which creates a harder, a bigger reaction emotionally. And then the loop just grows and grows and grows and grows. And that's how, you know, a little thought will turn into something that essentially is, is controlling a person's life. And so hopefully that was helpful. And, um, again, if you, if you found this helpful, please, um, we always appreciate if you'd subscribe and like, and share, uh, we also have some free resources available for, for any of you that are struggling with OCD and anxiety. And so down right below, um, there's a little link where you can click on that and, you know, we can send you those resources to help you as well. And that's [email protected] So thank you so much for taking the time to hang out with us today, and we will see you on the next episode, take care.


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