Managing Purely Obsessional Obsessive Compulsive Disorder (Pure-O)

Purely Obsessional Obsessive Compulsive Disorder (“Pure-O”) is a form of obsessive compulsive disorder in which people experience “ego dystonic” thoughts and obsessions without observable compulsions. In other words, people who suffer from Pure-O experience intrusive thoughts or unwanted mental images without a compulsive reaction to these thoughts.

The thoughts are ego-dystonic because they are inconsistent with the person’s value system (they are often abhorrent to the sufferer) and bring about extreme anxiety. Often these obsessions are about committing immoral acts against others. Sufferers often experience extreme difficulty even talking about the obsessions so may suffer in silence and experience extreme fear and panic.


Symptoms of Pure-O

Each sufferer may experience different obsessions, however some common ones are:

  • Intrusive thoughts around physically assaulting, hurting, or killing someone
  • For religious sufferers: Sinful or blasphemous thoughts
  • Worry about running over someone in a car
  • Worry about sexuality or paedophilia
  • Concern and excessive worry about bodily sensations causing illness
  • Persistent worrying and excessive questioning around the nature of self and reality
  • Extreme fear of having written or said something inappropriate


Counselling and Therapeutic Approach

Cognitive behavioural therapy (CBT) has proven to be a very effective method for treating Pure-O. Schema, dialectical, mindfulness, acceptance and commitment therapy, existential and emotion focussed therapies can also be helpful. At Eucalyptus psychology, your psychologist will help to find the best treatment and management plan for your particular needs.