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PURELY OBSESSIONAL OCD (PURE-O)

UNDERSTANDING PURE-O

What is Pure-O OCD?
Pure-O also known as "Purely Obsessional OCD" or "Primarily Obsessional OCD," is a subtype of OCD where individuals experience primarily mental compulsions or rituals, such as mental reviewing, counting, or reassurance-seeking without outwardly visible compulsive behavior. Common Pure-O obsessions are violent obsessions, relationship obsessions, and sexual obsessions. 
Common Obsessions in Pure-O Include:

Excessive worry and doubt about a romantic relationship

Excessive fear of not being able not to notice a thought, sensation or an image

Inappropriate or offensive sexual thoughts/images

Fear that obsession would continue forever

Excessive doubts about moral, religious, or existential issues

Effective Treatment for Pure-O OCD

While they lack observable compulsions, individuals with Pure O do engage in covert mental rituals like ruminating, praying, reassurance-seeking, or trying to push away the thoughts. This is the mind's attempt to reduce anxiety and make sense of the obsessive thoughts.


Pure O can be incredibly distressing and impairing. Sufferers may avoid going out, isolate themselves, or quit jobs/relationships due to the uncontrollable, unwanted thoughts. At our practice, we specialize in treating Pure O using evidence-based approaches like:

Exposure and Response Prevention (ERP)

ERP stands out as most effective treatment method for OCD. This approach entails individuals willingly confronting the very triggers and thoughts (images) that provoke anxiety without engaging with rituals. Through consistent practice of exposure exercises, individuals will learn how to interact with their inner experiences and find new ways to cope with uncertainties. The goal is to help individuals live a fulfilling, values-based life while embracing uncertainty.

Cognitive Behavioral Therapy (CBT)

CBT helps individuals identify patterns of thinking that are often related to Obsessive-Compulsive Disorder (OCD), such as all-or-nothing thinking, mind reading, thought-action fusion, and intolerance of uncertainty. Tools such as cost-benefit analysis, externalization of voices, Socratic questioning, survey method, and others are implemented in the treatment process. One of the most important cognitive behavioral interventions while treating OCD is Exposure and Response Prevention (ERP).

Acceptance and Commitment Therapy (ACT)

ACT helps you develop psychological flexibility – the ability to be fully present, disengage from unhelpful thought patterns, and behave in ways consistent with your values. Our ACT-trained clinicians guide you in accepting difficult thoughts/feelings about OCD without becoming entangled with them.

Mindfulness Practices

Practicing mindfulness can help individuals develop a different relationship with their mind and learn how to observe their thoughts, feelings, and physical sensations without getting caught up in ideas and opinions. Being mindful means observing our inner experience non-judgmentally while staying present with what we have chosen to focus on.

READ MORE ABOUT OCD

"I've worked with Kulliki to help me manage my experience with OCD for 2+ years and have watched my life change for the better in so many ways. Dealing with a chronic condition like OCD can be exhausting and discouraging, but having Kulliki as a therapist has really helped me make great progress in the direction of recovery. Kulliki has a very warm and compassionate energy and has always been kind, patient, and understanding in our work together. I trust her deeply and having her guidance throughout my journey as a young man with OCD has been invaluable."

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