What is PureO OCD?

What is PureO OCD?

Obsessive-compulsive disorder is a very complex and challenging condition. It reaches far beyond excessive hand washing or counting. It is estimated that OCD occurs in around 1.1% of the general population in the UK. Many with OCD struggle with endless ‘What If’ thoughts, giving it the nickname of the doubting disorder.

OCD can also portray itself purely in the mind, without overt visual compulsive behaviours such as checking, washing or ordering. Diagnostically this is known as Obsessive Rumination but has recently been called Pure O, or purely obsessional OCD.

10% of people with OCD have the subtype Pure-O.

10% of people with OCD have the subtype Pure O, but there are usually covert mental compulsions such as counting, thought blocking, suppression or thought distraction that exacerbate intrusive thoughts. 

The topics of intrusive thoughts, particularly in Pure O, can cover a range of themes such as:

  • Harm
  • Sexuality
  • Health
  • Faith
  • Relationships


Below are some examples of common Pure OCD obsessions and compulsions:

Obsession: Fear of harming yourself, a loved one, or a stranger.

Compulsion: Guilt. Feeling deeply ashamed for having violent intrusive thoughts.


Obsession: Fear that your sexuality is the opposite of what you know it to be.

Compulsion: Research. Looking online to find the answer to your doubts.


Obsession: Fear that your partner may not be ‘the one’.

Compulsion: Reassurance. Asking family and friends if you seem happy together.


These are just a few situations that people with Pure OCD can struggle with. The truth is there are so many thoughts with so many compulsions, and several themes can present themselves at any given time.


How do I know if I have OCD?

Everyone gets intrusive thoughts. This does not mean you have OCD. The difference is those who have the disorder, feel extreme anxiety and discomfort as a result of these thoughts, which can be very debilitating. No matter how hard they try to get rid of them, they won’t go away.

It’s essential to know that just because you have unwanted intrusive thoughts, it does not mean anything about your character, or that your core beliefs are changing.

Living with OCD of any type can be very intense, but there are steps you can take to recover and manage it better, so it no longer disrupts your daily life.

CBT is the treatment choice for any subtype of OCD, as it’s an anxiety disorder, whatever the theme may be. For OCD, other elements such as ERP (exposure response prevention) are practised to face and get under the perceived fear.

“ERP is when you voluntarily expose yourself to the source of your fear over and over and over again, without acting out any compulsion to neutralise or stop the fear. By repeatedly facing something you’re afraid of, you force your brain to recognise how irrational it is.” www.madeofmillions.com

In the CBT treatment of OCD, the recovery plan is likely to be a combination of:

  • Psycho-education
  • Attentional focus training
  • Exposure and response prevention
  • Behavioural experiments
  • Cognitive restructuring
  • Graded cognitive exposure


We are delighted that 92% of our patients reach full recovery from OCD; if you are struggling, it’s never too late to seek help. We are here for you.

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