Hey everyone! Before we chat about Pure O, it’s probably a good idea to make sure you understand how OCD works in general, what intrusive thoughts are and how they relate to OCD, so please check out the following posts first!
Done that? Awesome, let's go!
What is Pure O?
Pure O stands for 'Purely Obsessional OCD', which, at first glance, is a pretty confusing name because it implies that it is OCD without compulsions! It isn't, but we'll get to that in a minute. Pure O is a highly debated term so please make sure you read the little discussion on the pros and cons of its use at the bottom of this blog. It's pretty important information.
The History of the Term Pure O
Pure O, was coined by OCD specialist Dr Steven Philipson. Dr Philipson is a wonderfully experienced OCD specialist and has been treating people with OCD for decades. He noticed that some of the people coming to see him for treatment with OCD-style symptoms showed no outward compulsions. He realised that the OCD Loop was intact but that instead of seeing physical compulsions, such as checking physical objects or completing certain physical behaviours, they were completing the compulsions internally. For example, they reviewed memories (checking compulsion), tried not to think about certain things (avoidance compulsion), and repeated sentences or prayers (tried to neutralise and cancel out their distressing thoughts and obsessions). He came up with the term to represent those people and their needs. It was an important finding and brought relief and treatment options to many people.
Is PURE O, OCD?
Yes, Pure O is OCD. The mechanisms are the same, and the OCD Loop is still present, but to the untrained eye, it might look like compulsions aren't taking place because they are trickier to spot.
Pure O and Distressing Thoughts
Pure O often involves very upsetting obsessions (e.g. intrusive thoughts and fears). Many centre around sexual and physical violence and cause a lot of distress for those having them. It's so important to remember that in OCD, these thoughts are ego-dystonic - this means they go AGAINST the values and nature of the person experiencing them. The nature of these thoughts often adds another layer of shame to OCD and stops people from reaching out for help for fear that people won't understand. If you would like to know more about how to speak to people about distressing, intrusive thoughts, please read this post here. There is help available and so many people behind you, so please don't feel alone.
What is the Treatment for Pure O?
The treatment for Pure O is the same as it is for OCD, because it is OCD. The gold standard of treatment for OCD is Cognitive Behavioural Therapy (CBT) with Exposure and Response Prevention (ERP). Medications are often used alongside these. Supplementary and alternative therapies are available if you don't find these treatments helpful. Please remember that speaking to your medical professional about the treatment that best suits your needs is always best. I've chatted in more detail about getting help for OCD in this post.
Is using the Term Pure O Helpful?
Yes and no.
OCD has been subjected to many misunderstandings in the past, and on top of that, many medical professionals don't realise that OCD can have internal compulsions. This can leave people dealing with OCD and distressing intrusive thoughts frightened and feeling alone.
The term Pure O allows for knowledge of this distressing and isolating form of OCD to spread. It gives people experiencing this type of OCD a term they can use to find others who've been through the same thing. It has helped create a community, education, and support network. The term Pure O helps counteract feelings of isolation and shame, which is much needed and totally life-changing for many people.
The use of the term Pure O isn't without its downsides. OCD is a complicated enough condition to understand as it is, and the term Purely Obsessional OCD, without explanation, implies that you can have OCD without compulsions. This is incorrect. So the term can spread misconceptions. Another downside is that the term Pure O is rarely known outside of the OCD community in the UK (it's used more in the US), so the term can be an obstacle to getting help. People discussing Pure O, and not OCD, with their Drs are often met with blank stares and confusion.
The Future of the Term Pure O
I'm seeing the term used less and less as time goes by. As people get more used to making intrusive thoughts a part of the conversation around OCD, there seems to be less and less need to use the term Pure O. Whatever the future holds for the term Pure O, there is no denying that for a lot of people, the term was a life-changer and that is a brilliant thing.
And there we have it!
An overview of all things Pure O. I hope you found it helpful and please remember that if you are dealing with OCD, you are not alone.
Please let me know if you have any questions, and I'll do my best to answer them or direct you to the right place.
Sending loads of love,
Cat xx
Further Reading
Want to know why some obsessions feel like urges? Read our most-read blog here.
Want to know what I do when intrusive thoughts try to spoil something nice? Have a read here!
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