Everyone with obsessive-compulsive disorder is afraid of something. "Checkers" worry about leaving the stove on or forgetting to lock their door, for example. But there is one category that receives less attention, yet proves just as painful for the patient. This is "Pure-O" or "pure obsessions" OCD, and its symptoms--and effects--are largely hidden from the public.
The Nature of Pure-O Thoughts
Pure obsession patients often believe that their thoughts are harmful or reveal something horrible about them. Suppose that one has gruesome images about suffocating their wife. Whereas most would dismiss such thoughts as odd, yet not dangerous, a pure obsessions patient could see them as foreshadowing an actual attack or proving them to be a terrible person.
Another patient may have thoughts of cursing at God, renouncing faith or shooting Jesus. They would consider themselves horribly sinful, secretly evil or even damned by God because of the OCD symptoms.
Important to note is that, in both situations, the thoughts themselves are considered horrible--not just the actions or statements they represent.
Compulsions Related to Pure Obsessions OCD
Some feel that Pure-O patients have no compulsions at all; rather, they endure the pain that their obsessions cause without a response.
But it is the author's experience, and the view of many obsessive-compulsive disorder researchers, that compulsions for Pure-O do exist; their nature is simply hidden, or hard to notice, for friends and family.
For example, the husband with thoughts of suffocation might avoid making physical contact with his wife. He may avoid movies that show a choking scene, and hug her only at the waist. If the thoughts persist, he may even sleep in a separate bead for fears of smothering her in the night.
And the religious sufferer will have compulsions of her own. She will likely repent whenever one of the thoughts comes, often with tears. If she is a Roman Catholic, she might attend confession every day her church offers it--and repent for the same things each time.
Outward or inward, reactive or preemptive, compulsions do exist in Pure-O OCD.
Treating Pure Obsessive Patients
Education is a valuable step in treatment. Those with Pure-O need to learn that their thoughts are involuntary, and caused by a chemical imbalance rather than their own will. This is especially important in religious OCD cases, as involuntary thoughts are not sinful within the Christian tradition.
Second, anyone afraid of their thoughts can put exposure-response prevention. The idea is to expose oneself to the feared item, then withold any compulsions that might occur. The Pure-O patient with religious OCD would expose herself to the involuntary blasphemies in their head, but choose not to repent.
The goal is not to stop the obsessions, but rather to prevent the anxiety they create and the compulsions they result it. Once the effects of the thoughts are restricted, and the fear over them lessoned, the thoughts themselves will begin to ease.
Hope for Pure Obsessive Patients There is no reason for Pure-O paitents to despair about their mental condition. Those with intrusive thoughts must realize that their involuntary images and obsessions do not make them evil; inded, they often portray the opposite of the sufferer's beliefs, desires and intentions. Nor is there a likelihood of the patient breaking down and actually performing the actions depicted in their thoughts.
THose with Pure-O of a religious context should remember that God is not mad at them; rather, He wants them to recover even more than the OCD sufferer does.
Nobody should be afraid of their thoughts. With exposure-response theraypy, prayer and OCD medication, nobody need be.
Further Reading
If the subject of obsessive-compulsive disorder interests you, or if you’d like more help in your fight against OCD, try reading some of these additional articles on obsessive-compulsive disorder.
Fighting back against pure-o OCD—(an examination of treatment methods for those afraid of the thoughts and images in their head)
Differentiating OCD thoughts from real thoughts (A helpful resource for identifying OCD thoughts)
How does Exposure-Response Prevention work? (A guide to exposure-response prevention, geared towards a Christian audience)
