What Is “Pure O” OCD?
Published April 17th, 2025
4 min read
In the “Pure O” form of OCD, the compulsions are harder to spot. Rather than being physical actions, these compulsions are performed mentally.
Written by Simon Spichak
Obsessive-compulsive disorder (OCD) is one of the most common and misunderstood mental health conditions. People with OCD develop intrusive thoughts called obsessions that cause anxiety and distress. They perform compulsive behaviours to relieve the distress. Often the compulsions are physical actions, but with the “Pure O” form of OCD, these compulsions are mental.
How is “Pure O” different from other subtypes of OCD?
While not an official subtype of OCD, many mental health professionals are becoming increasingly cognizant of “Pure O.”
In other forms of OCD, people perform compulsions to relieve the anxiety or distress caused by obsessive thoughts. But rather than performing actions like cleaning, seeking reassurance, or other repetitive behaviours, the compulsions for “Pure O” occur in a person’s head.
Some people with “Pure O” might repeat words, phrases, or events in their head repeatedly. Others might argue with themselves or become hyperaware of their thoughts or physical sensations.
“Pure O” Obsessions and Compulsions
People with “Pure O” could have the same obsessive thoughts as people with other forms of OCD. the compulsions might manifest as internal prayer, arguments with intrusive thoughts, rewinding and ruminating on events from the day, or assurance-seeking.
Some examples of obsessions include:
Obsession: Wondering whether you closed the door and turned off the oven before leaving the house for work.
Compulsion: Rewinding and ruminating on your memories to reassure yourself that you locked the door and turned off the oven.
Obsession: You might experience intrusive thoughts about their social interactions. The thoughts might tell you that your friends secretly hate you or are laughing at you behind your back.
Compulsion: You might argue with yourself and try to prove that your friends do like you. You would ruminate over past events and repeat arguments in your mind to prove these thoughts wrong.
Obsession: You get repetitive feelings that something horrible, like a car crash, will occur unless you act to stop it with a mental compulsion.
Compulsion: You might pray, count, or repeat the same few words over in your mind so that the bad thing or catastrophe doesn’t occur.
Treating “Pure O” OCD
The frontline treatment for OCD is exposure and response prevention (ERP) therapy. ERP progressively exposes you to distressing situations that trigger your obsessions while preventing you from acting out the compulsions.
For “Pure O”, this could mean learning to welcome the intrusive thoughts, rather than trying to suppress them. Learning to focus on these thoughts without avoiding them, no matter how distressing they may feel in the moment, helps rewire the brain and desensitize it.
ERP won’t stop intrusive or obsessive thoughts. But instead of derailing your day, causing anxiety, and affecting your day-to-day life, ERP will help you get desensitized to them. Eventually, you’ll be able to have the same obsessive thoughts without causing you substantial distress.
How Resolvve Can Help
Resolvve’s therapists are trained to treat OCD and can help you reduce your symptoms. If you’re ready to take the next step toward treatment, you can book a free consultation with one of our therapists.
You can read more about OCD and ERP here:
Please note that this post is written for educational purposes; it is not therapy. If you need to talk to a professional, please book a consultation with a psychotherapist through Resolvve.
