What is Pure OCD?

An Introduction to Pure OCD

What is Pure OCD? Seems like a good place to start for blog post number one. Pure OCD took me twenty years to self-diagnose. Why? Well, it wasn’t for lack of trying. I’m not special, I guess we are all on a journey of self-discovery of sorts; but, if I would have had the information I hope to share, this process would have been incredibly less arduous.

That’s the point of this blog: to spread awareness of Pure OCD, to create something that I wish I had known about. My planned writing is altruistic; however, I’m no saint, and I hope my thoughts will act as a catalyst for my continuing process of coping with Pure OCD. Docendo discimus – to teach is to learn – according to some clever Ancient Roman, and I think he was on to something.

Coping with Pure OCD

I chose the word coping in this blogs’ name deliberately. I could have chosen instead managing, beating, controlling, and although tempting to subtly sound more vitriolic – coping – at least for me, is what the process of living with Pure OCD entails. I don’t think suffering from Pure OCD is ever completely “beaten”, in the same way a broken bone can be healed. To an outsider to this mental illness, this may seem defeatist. I don’t. For anyone whose mind is constantly bombarded with uncontrollable thoughts relentlessly trampling over their consciousness, the idea there could be any respite at all would seem fantastic, at least that’s how I felt and am still grateful for.

Pure OCD – what’s with the name?

So what is ‘Pure OCD’? Confusingly, you may hear it called ‘Pure O’, ‘intrusive thoughts’, ‘Purely Obsessional OCD’ or other synonyms; however, I’ll just stick to Pure OCD for the sake of consistency. Pure OCD is controversial (a major reason why it often takes so long for people to be professionally diagnosed, if at all) in that some health professionals don’t recognise it as anything categorically different to “regular” OCD. I see this as a mistake as I believe it results in a lack of initial diagnosis and thus prolonged suffering.

Regardless, the semantics I don’t think are important, so long as sufferers are clear on their mental processes which are underpinning their Pure OCD – easier said than done, I know. I found it extremely difficult to find treatment without having the vocabulary to communicate the illness. Health professionals who don’t recognise the nuances of OCD are therefore unlikely to even recognise the illness, let alone actually offer any value.

Understanding Obsessions

To start with OCD (Obsessive Compulsive Disorder) more broadly then, we need to fully understand the two eponymous components. The obsessions and the compulsions. On one level, that’s all there is to it. A practically infinite myriad of seemingly unconnected behaviours and personality traits can be explained by these two things. Obsessions and Compulsions.

I can’t stress enough, Obsessive Compulsive Disorder is absolutely not just about cleaning; however, I’ll use this manifestation as a tangible example. Thinking that cleaning (as the media would have you believe0 is the bread-and-butter of OCD is a common misconception, and one I hope this blog will address.

However, we need to look closer at the nature of the obsession. It is an understandable, yet fatal mistake to assume the act of cleaning is in of itself an obsession. This is looking at the painful behaviour back-to-front. The obsession here is most likely* fear of germs, viruses, diseases…some kind of contamination with grave consequences. This is what the obsession boils down to….fear of something….in this case fear of contracting something horrible. This usually takes the form of endless ruminations as one searches fruitlessly for answers, that never satisfy the insatiable questions of: “But what if…?”

The obsession – avoiding disease for example – is the first component. The second is the compulsion. Usually, the compulsion in this example would then be cleaning. The compulsion is an attempt to resolve the obsession. Obsessions by their nature are relentless; therefore, neither are the compulsions…and so the cycle continues.

Understanding Compulsions

So why is Pure OCD different from ‘regular’ OCD? The difference is not necessarily** the obsession but the compulsion. The compulsion in the above example was zealous cleaning. The compulsions for Pure OCD sufferers are purely mental. The compulsions are mental gymnastics; thus, hidden from plain sight (another major reason why it takes so long to be recognised). Just like how physical compulsions can take many forms following their many physical obsessions, these mental compulsions can be similarly diverse. As these mental compulsions are by definition hidden and abstract in nature, it’s so difficult to communicate and recognise. That said, common examples include the compulsion to mentally count, to recite mantras, to playback situations (real or imagined) in the mind, to ruminate on previous or projected scenes. It’s all brain activity, but stuff that’s not manifested out in the physical world that can be readily observed.***

That, in a nutshell, is what Pure OCD is – any kind of obsession which results in an overwhelming need to be resolved in the form of a laborious mental process. Something this blog hopes to discuss in great detail; although not as an obsession…that would be too ironic :).

Footnotes

*There could be a finer analysis, but for blog post number one I didn’t want to get bogged down in super-fine detail.

**Although, often certain obsessional themes naturally align themselves to Pure OCD over regular OCD.

*** I think self harm is a grey area, on one level it’s a physical action that can be observed; however, it’s generally done privately, often kept hidden, and is resolved in a sense, in the mind (i.e. the feeling of pain in the mind is the goal, cutting oneself physically in the world is just the route to it).