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Introduction
Obsessive-Compulsive Disorder (OCD) is a well-known mental health condition, but many people are unaware of a lesser-known variant: Pure O OCD. Pure Obsessional OCD, often called Pure O, presents without visible compulsions. This subtype can be challenging to identify, leading to delayed diagnoses and untreated symptoms. In this blog post, we’ll dive deep into what Pure O OCD is, how it differs from traditional OCD, and ways to manage it.
What is Pure O OCD?
Pure O OCD refers to a subtype of obsessive-compulsive disorder where the compulsions are mental rather than physical. The term Pure O implies that individuals experience intrusive, unwanted thoughts (obsessions) without the observable behaviors (compulsions) often associated with OCD. However, this can be misleading, as mental compulsions often occur but go unnoticed.
REMEMBER MANY MENTAL HEALTH PROFESSIONALS GET IT WRONG WHILE TREATING PURE O OCD AS COMPULSIONS ARE ALMOST ALWAYS PRESENT BUT ARE OF HIDDEN NATURE
For example, someone with Pure O may constantly engage in mental checking or rumination to relieve anxiety caused by intrusive thoughts. While they may not be performing visible rituals like hand-washing or door-checking, their internal battle is just as exhausting.
CAUSES
the exact causes of pure o ocd like many other mental illnesses is unknown but following factors contribute significantly to its development
Biological Factors
MRI brain scans reveal structural and functional differences in brain circuits responsible for filtering and censoring the many thoughts and impulses we experience each day of people with pure o ocd these circuits are defective
Psychosocial factors
the factors such as physical,mental,sexual abuse and neglect in childhood predisposes a person to pure o ocd and certain personalities such as perfectionists are more prone to it
Family History
Research shows that Pure O is five to seven times more common in individuals with a family history of OCD, although finding "pure" OCD cases for study has been challenging.
Genetics
While no single "OCD gene" has been identified, the disorder may be linked to variations in many gene groups, suggesting a genetic component to its development.
Common Obsessions in Pure O OCD
The intrusive thoughts experienced by individuals with Pure O OCD are often disturbing and anxiety-provoking. These thoughts are ego-dystonic, meaning they conflict with a person’s values and desires, which can lead to intense guilt or shame. These thoughts may be triggered by a particular cue in the environment but many times these thoughts are without any trigger they occur on their own
Common themes include:
Fear of harming others: Intrusive thoughts about unintentionally hurting someone. eg: thought of killing your child with a knife
Religious or moral scrupulosity: Obsessions surrounding religious practices, religious personalities or moral behaviors, fearing they may have sinned or acted immorally. eg; having recuurent blasphemous thoughts about some important religious figure.
Sexual obsessions: Inappropriate or taboo thoughts about sexual behaviors or orientation. eg ; having a thought that one is pedophile
Health-related obsessions: Constant fear of having a severe illness despite evidence to the contrary.
Relationship Obsessive-Compulsive Disorder (ROCD): involves obsessive doubts about one's romantic relationship, leading to constant questioning such as "Is this true love?" or "Am I attracted enough to this person?". These intrusive thoughts create anxiety as the individual seeks certainty, which is impossible to achieve, resulting in guilt, fear, and distress over perceived flaws or imagined infidelity.
These obsessions can occur without any actual desire to act on them, which makes them incredibly distressing for the individual.
Mental Compulsions
Even though Pure O may not have visible rituals, mental compulsions are often present and take many forms. These include:
Mental reassurance: Constantly telling oneself that they would never act on their thoughts.
Checking: Reviewing past actions to ensure they haven’t harmed someone or sinned.
Neutralizing thoughts: Countering intrusive thoughts with ‘good’ or neutralizing thoughts to cancel them out.
Avoidance: Steering clear of situations, people, or objects that could trigger intrusive thoughts.
Mental reviewing : people mentally review
Seeking reassurance : people disturbed by pure o thoughts may also seek reassurance from others about their thoughts being wrong
Researching online: this is a very interesting one as researching online although seem harmless but it is usually a compulsion thus strenghthning the obsession
These mental compulsions, although invisible, perpetuate the obsessive-compulsive cycle, making it hard to break free from Pure O OCD.
How Pure O OCD Affects Daily Life
The intrusive thoughts and mental compulsions of Pure O can have a profound impact on an individual’s daily life. Many people suffer in silence, afraid of being misunderstood or judged for their thoughts. This can lead to:
Isolation: Avoiding social situations or activities that might trigger obsessions.
Relationship Strain: Partners or friends may not understand why someone seems distant or preoccupied.
Work or School Impairment: Difficulty focusing due to constant ruminations and mental rituals.
Emotional Distress: Anxiety, guilt, and stress are common due to the nature of the obsessions.
Other mental illnessess : a person may also develop depression,eating disorders along with pure o ocd if not treated in time and properly
Self harm and suicide: it has been seen that some people commit suicide to get relief from suffering
Diagnosing Pure O OCD
Diagnosing Pure O OCD can be tricky because of the internal nature of the compulsions. A mental health professional typically looks for signs of recurrent, intrusive thoughts and the mental strategies used to neutralize or cope with them. It’s important to understand that having intrusive thoughts alone doesn’t mean someone has Pure O OCD; it’s the compulsive response to these thoughts that distinguishes it.
Many people with Pure O suffer for years before receiving a proper diagnosis due to the hidden nature of their symptoms, so seeking professional help early is crucial.
Treatment Options for Pure O OCD
The good news is that Pure O OCD is treatable, with several effective therapies available:
1. Cognitive Behavioral Therapy (ERP) ( gold standard and the best )
CBT is one of the most effective treatments for Pure O. A specific type of CBT called Exposure and Response Prevention (ERP) helps individuals confront their intrusive thoughts without performing mental compulsions. Over time, this reduces the fear and anxiety associated with these thoughts.
To explore how CBT can help you overcome intrusive thoughts, we recommend the book Overcoming Unwanted Intrusive Thoughts: A CBT-Based Guide to Getting Over Frightening, Obsessive, or Disturbing Thoughts.
The Mindfulness Workbook for OCD is an excellent resource for practicing mindfulness and CBT techniques.
2. Acceptance and commitment Therapy
Mindfulness practices help individuals become more aware of their thoughts and feelings without judgment. This approach, combined with Acceptance and Commitment Therapy (ACT), can help people accept intrusive thoughts without reacting to them, breaking the cycle of obsession and compulsion.
3. Medication
Selective Serotonin Reuptake Inhibitors (SSRIs) and a Tricyclic antidepressant clomfranil are often prescribed to help manage the anxiety and obsessions associated with Pure O. These medications can reduce the intensity of intrusive thoughts and help individuals engage more fully in therapy. The usual dosage of these medications is very high to treat ocd
4. Support Systems
Support from family, friends, and mental health professionals can make a significant difference. Online communities and support groups for OCD can also provide reassurance and understanding from others going through similar experiences.
Breaking the Stigma: It's Okay to Seek Help
One of the most significant barriers to treatment for those with Pure O OCD is the shame surrounding their intrusive thoughts. Many people are reluctant to seek help because they fear being judged or misunderstood. It’s important to remember that Pure O OCD does not define a person; intrusive thoughts are not a reflection of one’s true intentions or desires.
Final Thoughts on Pure O OCD
Pure O OCD is a challenging yet treatable condition. The internal nature of the compulsions can make it hard for others to understand, but it’s crucial for those affected to know they are not alone. By seeking professional help and using evidence-based therapies like erp individuals with Pure O can reclaim their lives from the grip of intrusive thoughts.
If you or someone you know is struggling with Pure O OCD, remember that help is available. Speaking with a mental health professional can provide the guidance needed to start the journey toward recovery.
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