What Is “Pure O” OCD? Understanding This Misunderstood Type of OCD

“Pure O” OCD: If You Don’t See the Compulsions, Is It Still OCD? (Spoiler: Yes!)

When most people think of OCD, they picture hand-washing, checking the stove over and over, or organizing things in just the right way. These are the outward, visible signs of OCD that we often see portrayed in movies or talked about in everyday conversation.

But what happens when the compulsions aren’t something you can see? What if they’re happening entirely in your head?

That’s where the term “Pure O” comes in—and it’s often misunderstood.

So, What Is “Pure O” OCD?

“Pure O” is short for Purely Obsessional OCD. It’s a phrase people sometimes use to describe a form of OCD where the compulsions aren’t outward or physical—but mental.

Just like other types of OCD, “Pure O” involves intrusive, unwanted thoughts (obsessions). The difference is in how someone responds to those thoughts. Instead of checking a lock or washing their hands, someone with “Pure O” might:

• Silently repeat certain words or phrases to feel “safe”

• Mentally review memories or events over and over

• Try to “figure out” what a thought means about them

• Pray silently or count to feel better

These mental behaviors are called mental compulsions, and they’re a big part of what makes “Pure O” still very much OCD.

Wait—Is It Really OCD If There Aren’t Any Visible Compulsions?

Yes. 100% yes.

The term “Pure O” can be confusing because it sounds like someone has only obsessions and no compulsions. But here’s the truth: people with “Pure O” do have compulsions—they’re just happening silently, in the mind.

And that’s still OCD.

OCD isn’t defined by what the compulsions look like. It’s defined by the cycle:A distressing thought → an urge to do something to neutralize it → temporary relief → repeat.Whether that “something” is checking a door or replaying a conversation in your head 30 times, it’s still a compulsion.

Common Themes in “Pure O” OCD

Because “Pure O” is OCD, its themes overlap with common obsessional themes found in OCD. A few common themes people often struggle with are:

• Harm OCD: “What if I lose control and hurt someone I love?”

• Relationship OCD (ROCD): “What if I don’t really love my partner?”

• Sexual Orientation OCD (SO-OCD): “What if I’m not who I think I am?”

• Religious OCD (Scrupulosity): “What if I’ve committed a sin and don’t even realize it?”

• Pedophilia OCD (POCD): “What if I’m a danger to children?”

• 
  

These thoughts are not a reflection of your character. They’re intrusive, unwanted, and incredibly distressing—which is exactly why the mind tries to “solve” or “undo” them with mental rituals.

Why It’s So Important to Recognize Mental Compulsions

One of the hardest parts of “Pure O” is how invisible it can be. From the outside, no one sees the internal struggle. That can make it really confusing—not just for others, but for the person going through it.

You might wonder,

“Is this really OCD if I’m not doing anything on the outside?”“Am I just overthinking?”“What’s wrong with me that I can’t stop obsessing?”

If this sounds familiar, you’re not alone. You may be dealing with a form of OCD that’s just harder to spot—but very real.

Yes, “Pure O” OCD Is Treatable (And You Don’t Have to Do It Alone)

Here’s the good news: OCD is highly treatable, including “Pure O.”

Therapies like Exposure and Response Prevention (ERP), Acceptance and Commitment Therapy, and Inference based CBT are incredibly effective. With these treatment options, you’ll learn how to face the scary thoughts without doing the mental rituals and learn how to identify a thought as obsessional (and therefore irrelevant) or non-obsessional (relevant). It might sound intimidating at first, but with the right therapist and support, it’s absolutely doable—and life-changing.

The first step is simply understanding what’s going on in your mind. And you’ve already started that just by being here and reading this.

You Are Not Your Thoughts

If you’re caught in a cycle of unwanted thoughts and exhausting mental rituals, please know: this isn’t your fault. You’re not your thoughts. And you’re not alone.

There is help, there is hope, and recovery is possible.

Looking for Support with OCD or “Pure O” in Washington or Texas?

I specialize in helping women in Washington State and Texas who are navigating OCD—including those with mental compulsions that often go unseen. Whether you're in Seattle, Austin, or anywhere in between, you're not alone—and you don’t have to keep struggling in silence.

If you’re ready to feel less stuck and more in control, I’m here to help. Reach out today to schedule a free consultation, and let’s talk about what healing could look like for you.

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