What Is Pure O OCD? And How Can You Prevent It?

Trigger warning: This article contains information about violence, which may be triggering to survivors.

Have you ever felt like you were living a nightmare? Pure O sufferers feel like that all the time.

Pure O, also known as Pure Obsessional OCD, is similar to other forms of OCD with a few important differences. It involves obsessions and compulsions but are typically “unwanted, involuntary thoughts and images about taboo topics such as violence, sex and blasphemy,” Aaron Harvey, founder of IntrusiveThoughts.org tells HuffPost Canada.

These unwanted thoughts are experienced by 80 per cent of people, but can be more severe in people who already suffer from an anxiety disorder like OCD. For those with mental health issues, the intrusive thoughts can lead to debilitating obsessions and compulsions.


So, why do we get them?

Past studies suggest intrusive thoughts and OCD are linked to hyperactivation of the amygdala, a part of the brain which alerts us to danger. According to Dr. Steven Phillipson, that portion of the brain isn’t responsible for a lot of thinking, so its activation might be part of a misfiring mechanism.


And how is it different from the OCD we already know about?

“The mainstream media has taught us that a person with OCD is obsessive about germs, cleanliness and order. But OCD is an anxiety disorder characterized by unwanted intrusive thoughts that lead to debilitating compulsions,” says Harvey.

“For example, a person with obsessions about contamination may wash her hands until she bleeds. But for persons with Pure O (which is not a disorder, but a nickname for a manifestation of OCD), they may experience repetitive violent thoughts about killing their spouse. Because they have no desire to do this, they begin obsessively questioning their capability.”

They may avoid their spouse, avoid knives, perform endless Google searches to assess the characteristics of a murderer, and spend endless hours a day engaging in “checking” and “reassurance seeking” behaviours in an attempt to prove to themselves they are not capable of murdering the person they love most. All of these compulsive behaviours exacerbate the problem, strengthening the volume and intensity of the thoughts.

How can you stop these thoughts?

“First, we must accept that we should not try to stop the thoughts. This only makes them stronger,” says Harvey. Instead, as with other anxiety disorders, treatment is required. Treatment can range from mindfulness practices to exposure response prevention (ERP) to cognitive behavioural therapy (CBT).

Harvey also recommends focusing on mantras which can bring sufferers back to a calm, collected manner.

For Harvey, who suffers from intrusive thoughts, ERP exercises can include the following steps:

  • Repeating a phrase such as “I might be a murderer” 8x a day
  • Holding a knife to a willing partner’s neck until the anxiety passes
  • Looking at a photo of a child 8x per day

While these mantras may sound violent, they’re said in an effort to confront the fear head on, rather than burying it away.

ERP therapy is all about customization and graduation. Anxiety is measured and as the individual progresses through the treatment, lessened to the point in which the individual no longer performs the compulsions.


How can you ensure a loved one who experiences intrusive thoughts will not act on it? What do you do if they do?

“The only way to beat OCD is to let go of reassurance-seeking behaviours,” says Harvey. “Constantly seeking reassurance is what leads to debilitating compulsive behaviours.”

If you or a loved one suffers from intrusive thoughts, get educated. Understand that statistically, people with OCD are no more likely to act out on unwanted thoughts than anyone else.

If intrusive thoughts have turned into obsessions and compulsions, consult a medical professional immediately.