O is for Obsessional OCD
I know this sounds redundant…obsessional Obsessive Compulsive Disorder? The thing is, this form of OCD can be harder to diagnose because it’s really and truly “all in your head.”
Sometimes called “Pure O,” the compulsions in this form of OCD are all mental. So you do have both obsessions and compulsions as usual. THe difference, however, is that the compulsions are completely invisible.
So while somebody might see me obsessively rearranging my books on my bookshelf, or kicking pinecones in a certain manner as I walk, there’s no way to spot the compulsions in “Pure O.” It can also be hard to recognize these compulsions in yourself, because after all, they are completely mental. It’s easy to pass them off as “just thoughts.”
Examples of Pure O may be having a personally unacceptable thought, like stabbing somebody or doing a sexual act with somebody you shouldn’t have sex with, and then doing a ritual to counteract that thought. It could be saying a prayer, a certain phrase, or mentally “checking” to make sure that you are a good person or that you didn’t really mean to have that thought. In fact, this can intersect quite nicely with religious OCD when it comes to prayers.
Purely obsessional OCD can be treated in the same way as garden variety OCD, through CBT and ERP. (Gotta love that alphabet soup, yes?)
Did you know about Pure O before this post? I didn’t know about it before I started therapy!