When most people, myself included, think of Obsessive-Compulsive Disorder, they tend to think about the type of OCD that involves cleanliness, fear of contamination and repeated hand washing, or the checking type of OCD, which involves someone checking and re-checking things, like locked doors or light switches. I learned about OCD that way in college, and so did my counselor. We didn't know what Purely Obsessional OCD, or Pure O, was so, in case anyone else out there might be trying to figure all this out like me, I'll explain it. (Or, I should say, I'll explain what I've figured out so far based on personal experience and research.)
Pure O is a subtype of Obsessive-Compulsive Disorder that seems to be a fairly new area of research from what I've been reading. Almost all the obsessive and compulsive parts take place inside a person's head, so that they might show very few (if any) behavioral compulsions that other people can see. Hence, the not-so-accurate name "Pure O", because other people, including a mental health professional, can't see the person performing the compulsions. That's why Pure O is often misdiagnosed as another anxiety disorder like Generalized Anxiety Disorder or, in my case, Panic Disorder (Wochner, 2012).
The compulsions are still present in Pure O, but they are actually mental rituals instead of observable behaviors. Some of the compulsive things I've noticed in myself include trying to figure out why I have the intrusive thoughts that I have, trying to forcefully control the thought, questioning my morality, repeating certain words and phrases in my head (like, "Please, God," over and over), excessively praying for forgiveness (because I'm sure I've sinned and can't remember it), overanalyzing my body language and behavior so I appear as normal as possible to everyone around (so no one can guess what's going on inside my mind), avoiding people/places/situations that make the obsessions and intrusive thoughts worse (I avoid movies about demonic possession and apocalyptic themed movies/books/shows), and I also seek reassurance from other people that I'm not evil, possessed, or going to Hell (Seay, 2011).
I've seen some other compulsive behaviors mentioned that I don't experience, like balancing the bad thoughts out with a "good" thought to neutralize it, repeating tasks because you had a "bad" thought while you were doing whatever the task was, so you have to do it over with a "good" thought, and reviewing your life to gain certainty of a memory in which you did "bad" things. I'm sure there is more, but this is the extent of my research at this point (Seay, 2011).
My obsessions are all related to religion, but that isn't the only Pure O obsession out there. Some other obsessions that I've read about include self harm or harming others, inappropriate or violent sexual thoughts, doubt about one's sexual orientation, and relationship doubt. These are the most common types of obsessions, but I'm sure there are more that I could add to the list (Wochner, 2012).
OCD is an anxiety disorder that results from a chemical problem in my brain. It doesn't sound so scary when I say it like that. Pure O is treatable, just like the form of OCD that everyone is familiar with. Pure O doesn't seem so scary now that I figured out that I can recover from it and actually be my "normal" again. Since I've figured this out, I don't have to carry all that shame around and hide it from people, because I know it's only the Pure O and not actually me (me = the rational Megan that exists when I'm not anxious or panicking).
I'll end with this: If something I've written about sounds familiar, maybe you should think about talking to a professional. Pure O, like all the other types of anxiety disorders, is treatable. You don't have to suffer in silence. If you're having intrusive thoughts, remember this: those thoughts don't mean anything, except that you have an anxiety issue caused by chemicals in your brain. If you're like me, and you're carrying all that guilt and shame because of all the "bad" thoughts rolling around in your head, you have nothing to feel ashamed of or guilty about because you can't control your brain chemistry.
Sources for the information in this post:
Seay, S. (2011, August 1). Pure-O OCD (Pure Obsessional OCD): Hidden Rituals. Retrieved September 30, 2015, from http://www.steveseay.com/pure-o-ocd-pure-obsessional-ocd/
Wochner, S. (2012). Pure Obsessional OCD-Symptoms and Treatment. Social Work Today, 12(4), 22-22. Retrieved September 30, 2015, from https://www.socialworktoday.com/archive/070212p22.shtml
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