Torturing Thoughts: Purely Obsessive OCD and How to Overcome It
You are standing on a subway platform waiting for your car to arrive staring blankly at the soulless corporate advertisement displays in front of you. Your eyes shift to the right and next to you stands a woman looking at her cellphone waiting for her train unaware of your glance. Randomly, you visualize yourself shoving her onto the train tracks below you. You look away and close your eyes, shaking your head as you have no desire to actually do this and goes against your character; the thought vanishes from your mind as quickly as it appeared. That is how these arbitrary thoughts are normally processed by your consciousness, much like a gust a wind that blows by you or a lightning strike. For a moment imagine that your mind, instead of dismissing the thought, ruminated on it and became stuck as you explored every reason you wouldn’t do something so horrendous. It doesn’t matter though, the more you explore and analyze the thought and why you wouldn’t do something like it, the stronger that thought becomes crippling you with a profound anxiety of “what if.”
What is it?
Pure obsessive OCD, Pure-O OCD, P-OCD has many unofficial names and acronyms and is not a clinical term or an official diagnosis in the DSM-V-TR. It is an anxiety disorder that falls under the purview of obsessive-compulsive disorder (OCD) which is a mental health diagnosis that is defined by obsessions and compulsions. The International OCD Foundation explains that, “Obsessions are unwanted, intrusive thoughts, images, or urges that trigger intensely distressing feelings. Compulsions are behaviors an individual engages in to attempt to get rid of the obsessions and/or decrease his or her distress.”
This variant of OCD, “Pure O”, exists solely in the mind and is invisible to outside observers as the obsessions and rituals are purely mental. You will most likely not see the stereotypical demonstrations of OCD such as obsessively washing one’s hands or flicking a light switch a set number of times. In a post by Dr. Spitalnick in the Anxiety Specialists of Atlanta he states that Pure-O is, “most commonly understood to consist of non-stop repetitive thoughts (obsessions) that are disturbing and overwhelming about topics that are existential, perverse, taboo, sexualized, or seemingly harm-focused.”
Many-Headed Hydra
The intrusive thoughts that can plague an individual are many, with no specific pattern or reason aside from being able to target one’s most personal fears about themselves. There is no logic to intrusive thoughts, just like there is no logic to where lightning will strike, here for a moment and gone the next. There are stories of those who suffer from ‘Pure-O OCD’ that detail ruminating and checking being attracted to the same sex, the opposite sex, violence, sexual assault, pedophilia, and many other examples as the list is as infinite as the thoughts we are able to conjure. Much like the hydra and cutting off one of its heads, you might have success conquering one thought only for many more to spawn in its absence.
These types of intrusive thoughts, for those with suffer from Pure-O OCD, may cripple and paralyze them through avoiding any situation or stimulus that may trigger these thoughts. This could resemble agoraphobia, hyper vigilance, and constant checking or reassurance from others to internally combat the intrusive thoughts. Paradoxically, the more you try to fight these thoughts through checking, avoidance, and ruminating the more overwhelming they become and increase the distress experienced by the body and mind. It also does not help that if someone seeks assistance for intrusive thoughts that therapists and other mental health professionals who are not aware that OCD can manifest in this fashion may misdiagnose their patient and attempt ineffective treatments.
Hope for the Future
If you or someone you know is experiencing what can be classified as Pure-O OCD it is important to know you are not alone and there are treatments available for it. Mindfulness based CBT, ACT, Exposure and Response, and other modalities have shown efficacy in decreasing symptoms and granting those who suffer from it some relief. It is important to connect with other online resources for support and identify mental health centers and therapists that are aware of this illness and competent in OCD treatment. A great place to start is the International OCD foundation to find a qualified professional or local support group near you, or contact local therapists to see if they specialize in OCD.
