Last week Paradise singer, George Ezra spoke on the BBC podcast How Do You Cope? about his experience living with an OCD condition called ‘Pure Obsessional’ or 'Pure O'. It was the first time I had ever heard someone in the public eye chat openly about this particular strand of OCD. What struck me about the conversation on social media, was how many comments came from people who could relate to what the 27-year-old singer was saying, yet had never heard of ‘Pure O’. That there are people who believe they are suffering alone with this exhausting condition or who do not know that what they are going through is not their fault…
In its least complex definition, Pure O is a type of OCD, where people experience obsessional, intrusive thoughts without any visible, outward compulsions. The nature of these obsessional, intrusive thoughts can be extremely distressing and even debilitating. They typically play on a fear that you may do something completely uncharacteristic of yourself, to yourself or those around you. At their most distressing, they can come in the form of aggressive, violent or sexual obsessions that feature family, friends and strangers.
‘Pure O’ is not a medical term, but rather a nickname for this common form of OCD where the compulsions are not obvious. Often, people who live with Pure O discover that they have many hidden compulsions that they couldn’t quite put their finger on without the help of a professional. Most of us think of cleaning, disinfecting, rituals or even counting when we think of the ‘C’ part of OCD. However, those with Pure O tend to do things like sensation-checking, which is when a person studies their body’s reactions or their feelings to validate an intrusive thought. They might also avoid places, people, objects, activities or conversation topics that they know could trigger obsessional thoughts. This avoidance can also be seen as a compulsion. Many organisations such as OCD UK, do not recognise Pure O as a separate condition to OCD, as it can be harmful to ignore these silent but very real compulsions.
It is important to note that in most cases, this form of OCD cannot be ‘cured’ per se. However, Cognitive Behavioural Therapy and Acceptance Commitment Therapy is used to allow people with Pure O to manage the condition. Medication solutions are also used as treatment and a combination of medication and therapy is the most common approach.
A more helpful term for Pure O could be Primarily Obsessional OCD. Whatever you wish to call this strand of OCD, those who live with the condition can find relief in being diagnosed. In the episode of How Do You Cope? George Ezra spoke of how discovering a name for what he was experiencing helped him feel less alone. This highlights the need for a healthy conversation about intrusive thoughts and obsessions. The most important thing is to ask for help if these symptoms of Pure O resonate with you. Talk to your GP or even a trusted friend or family member if thoughts and obsessions are affecting your day to day or limiting you.