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Pure O

Pure O OCD, often referred to as "Pure Obsessional OCD" or "Purely Obsessional OCD," is a subtype of obsessive-compulsive disorder (OCD).

What is Pure O?

Pure O OCD, often referred to as “Pure Obsessional OCD” or “Purely Obsessional OCD,” is a subtype of obsessive-compulsive disorder (OCD). Contrary to the common misconception implied by the term “pure,” individuals with Pure O OCD do experience compulsions, but these are primarily mental in nature rather than observable behaviors. The compulsions are referred to as “covert compulsions” because they occur internally.

In Pure O OCD, individuals typically experience distressing and intrusive thoughts, images, or urges known as obsessions. These obsessions can involve a wide range of themes, such as harm, contamination, sexuality, or religion. What sets Pure O apart is that the compulsions are mental rituals, like excessive rumination, seeking reassurance in one’s mind, or analyzing the meaning of the thoughts. However, pure O OCD can be just as impairing and distressing as other forms of OCD, despite the absence of visible rituals.

Treatment for Pure O

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) combined with Exposure and Response Prevention (ERP) is a highly effective approach for treating “Pure O OCD” (Purely Obsessional OCD), also known as Primarily Obsessional OCD or Pure Obsessional OCD. At Light On Anxiety, our specialized therapists offer compassionate and evidence-based care tailored to the unique needs of individuals struggling with “Pure O OCD”.

  • In CBT sessions, clients learn to identify and challenge maladaptive thought patterns and beliefs associated with their intrusive thoughts, develop coping strategies to manage anxiety and distress.
  • Through ERP, individuals learn to tolerate uncertainty, reduce the frequency and intensity of their intrusive thoughts, and regain control over their lives.

With personalized therapy sessions and supportive guidance, we empower clients to overcome “Pure O OCD” and live more fulfilling and  lives.


Medication may be considered in the treatment of “Pure O OCD,” particularly for individuals experiencing moderate to severe symptoms or those who do not fully respond to therapy alone. At Light On Anxiety, our team of psychiatric providers collaborates closely with clients to assess their unique needs and develop personalized medication regimens.

Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed to target symptoms of anxiety and depression associated with “Pure O OCD.” Other medications, such as serotonin-norepinephrine reuptake inhibitors (SNRIs) or tricyclic antidepressants, may also be used to alleviate symptoms.

Our approach to medication management prioritizes safety, efficacy, and collaboration with clients to ensure they receive the most appropriate treatment for their symptoms while minimizing potential side effects.

Integrating CBT + Medication

At Light On Anxiety, we offer integrated treatment plans that address both the psychological and physiological aspects of the disorder. Our therapists and psychiatric providers work closely together with clients to tailor treatment plans to their individual needs and preferences.

  • CBT and ERP help individuals develop coping skills, challenge negative thoughts, and confront their fears.
  • Medication management targets symptoms of anxiety and depression, providing additional support and relief.

Through this combined approach, we empower clients to overcome “Pure O OCD,” reduce their anxiety symptoms, and regain control over their lives.


Your Unique Path to Freedom From Pure O OCD 

Our goal is to create a treatment plan that aligns with your needs and preferences, recognizing that each individual’s journey is unique.

What are the symptoms of Pure O?

Symptoms of Pure O OCD primarily involve distressing and intrusive thoughts (obsessions) and mental rituals or covert compulsions. Common themes include:

  • Distressing and unwanted thoughts that often go against an individual’s values or beliefs.
  • Examples include fears of causing harm, intrusive sexual thoughts, or religious obsessions.
  • Covert compulsions that occur internally, such as excessive mental rumination, counting, or repeating certain words or phrases in the mind.
  • Rituals may involve mental reviewing or seeking reassurance to alleviate anxiety.

Individuals may avoid situations or triggers related to their obsessions to prevent anxiety or discomfort.

Heightened self-awareness and vigilance regarding one’s own thoughts, leading to constant monitoring and analysis.
Seeking reassurance from oneself or others about the meaning or implications of the intrusive thoughts.
Persistent anxiety and emotional distress related to the intrusive thoughts, which may interfere with daily functioning.
Excessive overthinking, analyzing, or trying to figure out the meaning or significance of the obsessions.

FAQs about Pure O

Pure O OCD and anxiety are distinct yet can share common ground. Pure O OCD, a subtype of obsessive-compulsive disorder, centers around intrusive and distressing thoughts, along with covert mental rituals. These thoughts can range from harm or contamination fears to intrusive sexual or religious thoughts. In contrast, anxiety is a broader state of excessive worry or uneasiness with symptoms spanning physical sensations, cognitive aspects, and emotional elements. While individuals with Pure O OCD may experience heightened anxiety due to their obsessions, it’s crucial to recognize that anxiety can manifest independently from OCD, stemming from various factors.

Yes, Pure Obsessional OCD (Pure O OCD) is a recognized and real subtype of obsessive-compulsive disorder (OCD).

Yes, Pure Obsessional OCD (Pure O OCD) can contribute to or coexist with depression due to the distressing and intrusive nature of obsessive thoughts and the impact on an individual’s emotional well-being.

The intensity and presence of Pure O OCD symptoms can fluctuate over time. OCD symptoms, including Pure O obsessions, may come and go in cycles. Individuals with OCD often experience periods of increased symptom severity followed by periods of relative relief. Various factors, including stress, life events, and coping mechanisms, can influence the ebb and flow of OCD symptoms.

More About Treatment for Anxiety

What is CBT & ERP for OCD?

Light On Anxiety CEO Dr Debra Kissen describes how CBT & ERP helps clients move past OCD and other anxiety disorders.

Learn more about how we can create a custom individual treatment plan to fit your goals.

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