Pure-O, or Pure Obsessional OCD, is one of the murkier subtypes, and some experts say it doesn’t even exist. The symptoms must also not be due to the presence of some other medical condition. Pure-O is a special kind of OCD, in which the person experiences obsessive thoughts, without engaging in compulsive behaviors and ritualizing. Primarily Obsessional OCD Symptoms and Treatments, Ⓒ 2021 About, Inc. (Dotdash) — All rights reserved. Feel free to post! Pure Obsessional OCD – Symptoms and Treatment Obsessive-Compulsive Disorder or OCD is a mental health condition that is comprised of obsessive thoughts and compulsive behaviors that are employed to neutralize the anxiety created by distressing and intrusive obsessions. "[5] The thoughts "quite likely, are of an aggressive or sexual nature."[5]. They found that in the majority of studies, OCD characterized by religious and sexual obsessions without compulsions (i.e., Pure O) was associated with a poor response to treatments using SSRIs and exposure and response prevention.. Close. It is often mistaken for generalized anxiety disorder or typical cognitive distortions. Pure-O obsessions often manifest as intrusive, unwanted, inappropriate thoughts, impulses or “mental images.” First described by Baer in a 1994 article in the Journal of Clinical Psychiatry, Pure O was described as being composed of sexual, aggressive, and religious obsessions that were not accompanied by compulsions.. Primarily cognitive obsessive-compulsive disorder (also commonly called "primarily obsessional OCD", purely obsessional OCD, Pure-O, OCD without overt compulsions or with covert compulsions) is a lesser-known form or manifestation of OCD. Steketee, R.O. This reassurance-seeking can be problematic because many patients may not even recognize it as a compulsion. I want to create a safe place for people suffering with Pure Obsessional OCD! The Pure O Form of OCD The Pure O form of OCD (pure obsessional OCD) is not widely known and is especially likely to go unnoticed by family members and even the teenagers themselves. Frost, J. Rhéaume and S. Wilhelm, Cognitive theory and treatment of obsessive-compulsive disorder. ‘Pure O’ would be treated using standard traditional treatment methods, the same that are used for every other type of OCD, it said. While people who do not report engaging in compulsions are sometimes referred to as having "Pure O" or "Purely Obsessional OCD," this variant is not listed as a separate diagnosis in the DSM-5, the diagnostic manual used by many physicians, psychiatrists, and psychologists. Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. or "Could that really happen?" Pure-O obsessions often manifest as intrusive, unwanted, inappropriate thoughts, impulses or “mental images.” Avoiding anxiety-provoking objects or situations. [26], Those suffering from primarily obsessional OCD might appear normal and high-functioning, yet spend a great deal of time ruminating, trying to solve or answer any of the questions that cause them distress. While ritualizing and neutralizing behaviors do take pl… Treatment for OCD, including Pure O, often involves the use of medication in combination with psychotherapy, which can include cognitive-behavioral therapy, support groups, and psychological education. Very often, Pure O sufferers are dealing with considerable guilt and anxiety. While the compulsions are more noticeable, they are only one aspect of this disorder. What distinguishes Pure Obsessional OCD from classic OCD is that in Pure-O OCD, symptoms are predominantly obsessive (rather than compulsive) in … That's what matters. Pure-O OCD is a type of Obsessive Compulsive Disorder consisting of internal, covert compulsions. OCD symptoms are not better attributable to another mental disorder such as generalized anxiety disorder, body dysmorphic disorder, hoarding disorder, substance-related disorders, or major depressive disorder. The main type of therapy available for those with Pure O is cognitive behavioral therapy (CBT). While it may seem that the individual has obsessions without compulsions, a review of his/her symptoms almost always … Posted by 2 hours ago. September 13, 2019 Posted in Mental Health, OCD General Tagged flase memory ocd, Mental Health, OCD, OCD False Memories, Overcoming OCD, Pure O. I haven’t blogged solely about OCD for a while so I though it might be time. While ritualizing and neutralizing behaviors do take place, they are mostly cognitive in nature, involving mental avoidance and excessive rumination. The inclusion of this “either or” in the definition of OCD allows for the existence of an individual suffering from only obsessions (i.e., “pure obsessional, or “pure O”). This is the most common thing I see in therapy in cases of pure O. Oakland, CA: New Harbinger. Obsessive-Compulsive Disorder. OCD symptoms must not be due to the physiological effects of a substance (such as a side effect of a medication or illicit drug). In: Camprodon J, Rauch S, Greenberg B, Dougherty D, eds. According to the DSM-5, OCD is characterized by obsessions and/or compulsions. Depress Anxiety. This may sound like a less severe type of OCD, while in fact it is different in nature, but not in severity. New Harbinger Publications. Pure-O can be defined as, “a form of OCD in which a person experiences obsessive, unwanted thoughts without visible compulsions or rituals.”This means that while an individual may be diagnosed with OCD and struggle with obsessions, their compulsions tend to be carried out within their mind, rather than displayed outwardly. Pure-O is a misnomer as a stand-alone OCD subtype as it exists within many other OCD manifestations. The Pure O stands for ‘purely obsessional’ and while sufferers often also have the better-known symptoms of OCD, such as compulsive checking, this strand of the illness often focuses on intrusive and distressing thoughts rather than actions. They will understand that these fears are unlikely or even impossible but the anxiety felt will make the obsession seem real and meaningful. “Pure-O” OCD, or Pure Obsessional OCD, is a relatively less common form of OCD that seemingly differs from classic presentations of the illness. OCD symptoms are time-consuming, often taking more than one hour per day, or they must create significant distress or impairment in occupational, social, or other critical areas of life functioning. Pure O is a form of OCD marked by intrusive, unwanted, and uncontrollable thoughts (or obsessions). The frequency of these thoughts can vary, from a few times per day to greater than eight hours per day. The person begins to ask themselves constantly, "Am I really capable of something like that?" Pure-O OCD. Learn the best ways to manage stress and negativity in your life. Directed by W.M. This difficulty has also led to the false idea that there are some OCD sufferers who only experience obsessions and not compulsions. HBO Max's new show, Pure, follows a 24-year-old woman named Marnie who's constantly troubled by disturbing sexual thoughts. These obsessions often manifest as intrusive, unwanted, inappropriate thoughts, impulses or “mental images”. Pure Obsessional OCD (Pure O) is a term for a type of OCD in which an individual reports experiencing obsessions without observable compulsions. The distinction between the presence of subclinical symptoms and a clinical disorder requires assessment of a number of factors, including the individual’s level of distress and impairment in functioning. But a variant of OCD is a pure obsessional state. The American Psychiatric Publishing textbook of psychiatry, By Robert E. Hales, Stuart C. Yudofsky, Glen O. Gabbard, American Psychiatric Publishing, includes Purely Obsessional OCD in its definition of O.C.D. Exposure Therapy for Anxiety: Principles and Practice. Pure-O, or Pure Obsessional OCD, is one of the murkier subtypes, and some experts say it doesn’t even exist. These same obsessions may also be experienced by individuals with non-Pure-O forms of the disorder. Although resisting the need to reassure oneself and perform compulsions will initially cause anxiety to increase, refusing to practice compulsions over an extended period of time will eventually cause anxiety around the sufferer's intrusive thoughts to decrease, making them less prevalent (e.g. Pure-O is a misnomer as a stand-alone OCD subtype as it exists within many other OCD manifestations. Pure-O stands for Purely Obsessional OCD. Stewart SE. The Myth of Pure OCD. Examples of imagery include, unmotivated extreme violence, recurrent doubt over one's sexual orientation, or impulses revolving around blasphemous and sacrilegious themes. Kendra Cherry, MS, is an author, educational consultant, and speaker focused on helping students learn about psychology. What is 'Pure O'? Purely Obsessional OCD, also known as Pure O, is a type of OCD in which a sufferer engages in hidden compulsions. In this method of getting over Pure O OCD we are going to focus on getting rid of OCD thoughts by changing how you react to the thoughts. New York: Humana Press; 2016. doi:10.1007/978-1-59745-495-7_2, Williams MT, Farris SG, Turkheimer E, et al. Pure O OCD is a subtype of OCD in which the compulsive behaviours which usually characterise OCD are internal and mental rather than observable. "[2], Primarily obsessional OCD has been called "one of the most distressing and challenging forms of OCD. [3][30][31] People suffering from OCD without overt compulsions are considered by some researchers more refractory towards ERP compared to other OCD sufferers and therefore ERP can prove less successful than CT.[32][33], Exposure and Response Prevention for Pure-O is theoretically based on the principles of classical conditioning and extinction. or "Is that really me?" (2005). - Pure Obsessional OCD (Pure-O) is a type of Obsessive-Compulsive Disorder (OCD) in which an individual reports experiencing obsessions without outwardly observable compulsions. The term ‘Pure O’ may be misleading, as it implies that those with Pure O only experience obsessions (the “O” of Pure O). WHAT IF I committed a sin?). Obsessive Compulsive Personality Disorder, GAD and OCD Are Different Conditions With Similar Symptoms, How OCD Can Make Some People Have Suicidal Thoughts, Repetitive Behaviors or Compulsions Are a Symptom of OCD, Daily Tips for a Healthy Mind to Your Inbox, selective serotonin reuptake inhibitors (SSRIs), Myth of the Pure Obsessional Type in Obsessive-Compulsive Disorder, Factor Analysis of Symptom Subtypes of Obsessive Compulsive Disorder and Their Relation to Personality and Tic Disorders, Symptom Subtypes of Obsessive-Compulsive Disorder: Are They Relevant for Treatment, Repeated intrusive images, thoughts, and impulses that create a great deal of distress, Making attempts to ignore, suppress, or neutralize the obsessive thoughts, Repetitive actions, either behavioral or mental, that a person feels compelled to perform as a result of obsessive thoughts. As a follow-up to my previous post on Pure-O OCD, I thought it might be helpful to identify some obsessions that are commonly reported by individuals with Pure Obsessional OCD. ‘Pure O’ would be treated using standard traditional treatment methods, the same that are used for every other type of OCD, it said. 1 talking about this. I was a Pure O sufferer for about 35 years. & Clark, D.A. [27], The most effective treatment for primarily obsessional OCD appears to be cognitive-behavioral therapy. The name ‘Pure O’ comes from the term ‘purely. While some studies have suggested there may be different symptoms subtypes of the disorder, one study suggests that the term Pure O may be something of a misnomer. While people who experience these obsessions without any obvious behavioral compulsions, they do still engage in unseen mental rituals. The obsessional component tends to get overlooked. (3rd ed., pp 368-399) Chicago: Mosby. Current Clinical Psychiatry. If the therapist believes that the patient only suffers from obsessions and does not also treat the mental rituals that accompany these cognitions, the treatment will not be as complete or effective. These obsessions often manifest as intrusive, unwanted, inappropriate thoughts, impulses or “mental images”. Though talking about your thoughts isn't always easy, it is the first part of getting the help you may need to find relief. This method ensures that you get over your present OCD worries and at the same time not create any new thoughts. The name is slightly misleading as it suggests that there are no compulsions at all. So just … However, the hidden mental rituals that characterize the purely obsessional form of the disorder are a type of compulsion, even though they may go unseen. Exposure and response prevention, also known as ERP therapy, is a form of cognitive-behavioral and exposure therapy. It is often mistaken for generalized anxiety disorder or typical cognitive distortions. "[5] People with this form of OCD have "distressing and unwanted thoughts pop into [their] head frequently," and the thoughts "typically center on a fear that you may do something totally uncharacteristic of yourself, something... potentially fatal... to yourself or others. These people are erroneously referred to as having “Pure-O”. My Pure O – Unwanted and Out of Control – Part 1. Exposure and response prevention (ERP) therapy is the front line psychological treatment for all types of OCD, including Pure O. Medications may include selective serotonin reuptake inhibitors (SSRIs) or the tricyclic antidepressant clomipramine. They can help you understand your symptoms and find the best treatment to meet your needs. 2 hours CE Weikart. A recommended response would be, "Maybe I did. Pure Obsessional OCD (Pure-O) is a type of Obsessive-Compulsive Disorder (OCD) in which an individual reports experiencing obsessions without outwardly observable compulsions. Purely Obsessional, or Pure O, is a mental health condition in which individuals experience obsessions, such as intrusive and distressing thoughts, images, or impulses. Pure-O is supposed to stand for Purely Obsessive with no compulsions but people with Pure-O OCD have compulsions. Later, research further divided aggressive obsessions into fears over impulsive harm and unintentional harm. These people are erroneously referred to as having “Pure-O”. When people think of obsessive-compulsive disorder (OCD), they tend to focus on the most obvious compulsions, such as repetitive hand-washing, cleaning or checking on things, or an extreme need for symmetry. Aust N Z J Psychiatry. 1994;55 Suppl:18-23. What Is "Just Right" OCD and Tic-Like Compulsions? Close. Deep down, I must be a psychopath. Baer L. Factor Analysis of Symptom Subtypes of Obsessive Compulsive Disorder and Their Relation to Personality and Tic Disorders. Common intrusive thoughts/obsessions include themes of: There is no such diagnosis in DSM-5. 2009. People who experience a "purely obsessional" form of this disorder experience a range of OCD symptoms, although the obvious compulsions are absent. It may take on the form of many of the types listed here on this site such as Harm OCD or religious OCD. Pure O is a form of OCD that is misrepresented in literature and on the web and that is misunderstood by many people, including OCD sufferers. By understanding that such mental rituals exist, therapists and other mental health professionals can ask patients about these symptoms. Pure O OCD is essentially a broken pattern of attempting to battle thoughts that a person thinks of as bad. ), Obsessive-Compulsive Disorder: Theory and Management. Obsessions can center on somatic, sexual, religious, or aggressive thoughts as well as concerns with things such as symmetry and contamination. Nova Science Pub Inc. In: MA Jenike, L Baer and WE Minichiello (Eds. [2] According to DSM-5 compulsions can be mental, but they are always repetative actions like "praying, counting, repeating words silently". Quite often Pure O (which stands for Pure Obsession or Purely Obsessional), because of its definition, is described as a type of Obsessive Compulsive Disorder that does not have compulsions. How Therapy Can Help. Without such questioning and prompting, patients may be reluctant to describe the symptoms that they are experiencing or may not even be aware that they should discuss these symptoms. They then end up in a vicious cycle of mentally searching for reassurance and trying to get a definitive answer.[3][8]. Often people seeking treatment for Obsessive Compulsive Disorder (OCD) call my office asking if I have experience treating ‘Pure O’ OCD. [2] For people with primarily obsessional OCD, there are fewer observable compulsions, compared to those commonly seen with the typical form of OCD (checking, counting, hand-washing, etc.). Usually by the time someone calls me for OCD treatment they have read books, visited websites and seen numerous therapists. While those without primarily obsessional OCD might instinctively respond to bizarre, intrusive thoughts or impulses as insignificant and part of a normal variance in the human mind, someone with Pure-O will respond with profound alarm followed by an intense attempt to neutralize the thought or avoid having the thought again. These individuals are at the end of their rope. This reassurance-seeking ritual will provide no further clarification and could exacerbate the intensity of the search for the answer. Fordham University, Bronx, New York, http://www.ocdonline.com/articlephillipson1.php/, Am I Gay? [6] The fears associated with primarily obsessional OCD tend to be far more personal and terrifying for the sufferer than what the fears of someone with traditional OCD may be. Mindfulness-based stress reduction (MBSR) may also be helpful for breaking out of rumination and interrupting the cycle of obsessing. Pure O is a term made popular by the internet to describe a type of OCD that consists only of obsessive thoughts, without any of the typical compulsive behaviours. Pure O: The Invisible Side of Obsessive-Compulsive Disorder follows Chrissie Hodges, a typical eight year old whose life changed drastically with the onset of symptoms from Pure OCD. Ruminations may include trying to think about something 'in the right way' in an attempt to relieve this distress. But does ‘Pure O’ exist? Pure-O OCD. There are numerous corresponding cognitive biases present, including thought-action fusion, over-importance of thoughts, and need for control over thoughts. These affected persons are troubled by sudden thoughts or images of awful things, often of that person doing something awful. This type of OCD is referred to when one has primarily obsessive thoughts and does not engage outward compulsive behavior. The therapeutic response does not seek to answer the question but to accept the uncertainty of the unsolved dilemma.[34]. With Stella Singer, Carl G. Herrick, Danielle Vettraino, Lauren Paulis. Understanding and Treating Obsessive-Compulsive Disorder: A Cognitive Behavioral Approach, Lawrence Erlbaum Associates, Inc.; 1 edition (September 2, 2005). Keep in mind that some of these symptoms are quite common (when experienced in a limited form) and may or may … ‘Purely obsessional’ or ‘Pure O’ is a term commonly used to refer to a form of Obsessive-Compulsive Disorder which people mistakenly believe has no outward compulsions and only features distressing internal intrusive thoughts. Obsessive Compulsive Disorder Research, By B. E. Ling, 2005. Some individuals with OCD describe themselves as “pure obsessional” or “Pure O,” meaning they have obsessions without compulsions. This article looks at Pure O OCD and at how Cognitive Behavioural Therapy with Exposure and Response prevention (ERP) can help. Those thoughts centered on impulsive harm often focus on what is sometimes termed "taboo thoughts" related to sex, religion, and aggression. Abramowitz JS, Deacon BJ, Whiteside SPH. Some side effects associated with the use of SSRIs include, One review of the research has suggested that approximately 40% to 60% of patients respond to treatment with SSRIs with a 20% to 40% reduction in OCD symptoms.. Starcevic V, Brakoulias V. Symptom Subtypes of Obsessive-Compulsive Disorder: Are They Relevant for Treatment? An example of this difference could be that someone with traditional OCD is overly concerned or worried about security or cleanliness. Obsessive compulsive disorder By Frederick M. Toates, Olga Coschug-Toates, 2nd Edition 2000, Pages 111-128, The OCD workbook By Bruce M. Hyman, Cherry Pedrick, Pages 16-23, Obsessive-compulsive disorder By Frederick M. Toates, Olga Coschug-Toates, 2nd Edition 2000, Pages 94-96, http://www.ocdonline.com/articlephillipson2.php, http://www.brainphysics.com/research/HOCD_Williams2008.pdf, "Homosexual Obsessive Compulsive Disorder (HOCD): A Rare Case Report", "Sexual orientation obsessions in obsessive–compulsive disorder: Prevalence and correlates", "Treatment of Sexual-Orientation Obsessions in Obsessive-Compulsive Disorder Using Exposure and Ritual Prevention", The Treatment of Obsessions by Stanley Rachman. Page 128. Thought-Action Fusion Is When Thinking Seems the Same as Doing, OCD vs. One can have a Pure-O subtype and have overt compulsions connected to other subtypes. This course will teach you how to unmask this disorder, and treat it using evidence-based techniques. 1. No need to explain yourself to death. E.g., someone with primarily obsessive OCD might think, "If I don't remember what I had for breakfast yesterday my mother will die of cancer!" Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Myth of the Pure Obsessional Type in Obsessive-Compulsive Disorder. Mental health professionals can ask patients about these symptoms looks at Pure O may not even recognize it as stand-alone... Searching an answer for some question can be problematic because many patients may not involve the outward behaviors that come... ” or “ mental images that violate one 's own value/moral system in nature, but not in severity has... Obsessions may also be helpful for breaking Out of Control – Part 1 Inc. Dotdash... Or obsessions ) may take on the form of many of the search for the answer manage stress and in! And treat it using evidence-based techniques cognitive in nature, but not in severity reading numerous on. To answer the question but to accept the uncertainty of the unsolved dilemma. [ ]!, you need to fully understand the “ mechanics ” of Pure O, ” they! 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York: Humana Press ; 2016. doi:10.1007/978-1-59745-495-7_2, Williams MT, Farris SG, Turkheimer E, et.... V, Brakoulias V. Symptom subtypes of Obsessive compulsive disorder consisting of internal, covert compulsions Farris! Numerous articles on defining psychopathy baer and we Minichiello ( eds, reading numerous on. Me for OCD treatment they have obsessions without compulsions consultant, and treat it using evidence-based techniques aggressive... Be made between the therapeutic response does not have any information that searching an answer for some can! Ritualizing and neutralizing behaviors do take place, they are mostly cognitive in nature, but in... Of: there is no such diagnosis in DSM-5 is Obsessive–compulsive disorder related to the DSM-5, vs. Through trauma, abandonment, childhood relational problems, and issues pure o ocd.. They can help to see if certain Symptom subtypes of OCD, is an author, educational,! 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Reassurance-Seeking can be associated with OCD describe themselves as “ Pure O sufferers dealing., cognitive theory and treatment of obsessive-compulsive disorder the thoughts `` quite likely, are of an aggressive sexual! With pure-o OCD is a form of OCD responded better to certain treatment approaches get over your present worries. By sudden thoughts or images of awful things, often of that person doing something awful are more,! Example of this difference could be that someone with traditional OCD therapy ( CBT ) certain actions s, B. Certain actions sufferer feels would ruin their life or the tricyclic antidepressant clomipramine dilemma. [ ]... About something 'in the Right way ' in an attempt to relieve this distress form.email. Eight hours per day to greater than eight hours per day to when one has primarily Obsessive thoughts, or! Some dreaded event also led to the false idea that there are numerous corresponding cognitive biases,! Farris SG, Turkheimer E, et al attempt to relieve this distress over thoughts thoughts/obsessions! Worries and at the same time not create any new thoughts for up...