Pure O: The Side of Mental Health We Don’t Discuss  

Nobody ever talks about how irresponsible it feels to sit with intrusive thoughts.

The aim of OCD treatment is to be able to sit with uncomfortable, intrusive thoughts and not act on compulsions to “put right” the intrusive thought. But imagine living with your worst nightmare happening inside your head every single day. 

Pure O is a name used to categorise a form of OCD which is ‘purely obsessional’, i.e. not involving visible compulsions such as handwashing. However, this term does not accurately represent the reality of the disorder. Diagnostic criteria for OCD requires an individual to suffer from both obsessions and compulsions: the two go hand in hand. 

Obsessions are intrusive thoughts which cause distress to the individual. They can include; fearing that something bad will happen, worrying that you did something wrong in the past, and fears regarding contamination. Everybody has the odd intrusive thought, though the majority of people are able to shake them off and don’t become obsessed with their meaning and what they reveal about us as a person. 

Compulsions are actions which the person performs to “put right” the intrusive thought. The individual knows, on some level, that they are not helpful, but they also feel intense distress by not performing them. These can include checking locks, turning off a light switch a number of times, or counting. 

Though the compulsions that come along with Pure O are mainly done inside the head of the individual, they are still very much present. 

Picture this: you’re loading the dishwasher and a thought pops into your head: you’re a sex offender, or a murderer, or you’re going to hell. The average person is able to dismiss this thought as ‘junk mail’ and carry on with their day. 

The person with OCD latches onto this thought and spirals into ruminating and mentally reviewing past memories. Were they capable of harming a family member, or even a child? They start to replay past memories of being around children in their head, searching for “clues” or signs that they may have harmed someone. 

They spend so much time trying to fill the missing moments that additional, false details are added. They have now convinced themselves that they are a monster, capable of things that bring them so much unease and disgust. They start to avoid spending time with children, retracing their steps to make sure they didn’t harm somebody, and doubting every fuzzy memory. This is one of the most common themes of obsessive compulsive disorder, though nobody talks about it. 

Opening up to others is so difficult due to the fact that people know so little about the disorder and its manifestations. The stigma surrounding taboo themes of obsessive compulsive disorder mean that so many people suffer in silence instead of accessing the support they need. Not trying to “put right” these thoughts feels irresponsible, like you’re accepting that you are capable of all of the terrible things that your brain has convinced you of. 

There is nothing scarier than not knowing what is real and doubting your own reality, morals, and intentions. Intrusive thoughts are ego-dystonic, meaning that they go against a person’s values and beliefs. The people who have these thoughts are the least likely to act on them. They are so horrified by the presence of them that they do everything to try and push them away. But who can you turn to when you are terrified that you’re a predator? Who do you turn to when you genuinely think that you are capable of causing harm?

This is just one example of the ways OCD can manifest. OCD also usually presents itself in lots of different themes at the same time. Scrubbing skin raw, checking, counting, praying- these are all common compulsions that millions of people do to try and find relief. 

An estimated 1.2% of the population has OCD, meaning that it’s likely that somebody close to you is suffering from violent intrusive thoughts that go against their values. Because this form of OCD is invisible to others with compulsions being mental instead of physical, the only way you would ever know is if they tell you, which due to stigma and shame, they are unlikely to. 

Too many lives are lost to OCD as a result of stigma and lack of education. Nobody should have to deal with a mental health condition alone. Please reach out to somebody if you are struggling, and know that you are not alone. 

Any student experiencing psychological or mental health difficulties does not have to struggle alone. Support is available through the University Open Door team.

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