Pure O Ain’t So Pure

More than half of the clients who come to see me for treatment struggle with what many refer to, colloquially, as “Pure O,” or “Pure/Primarily Obsessional OCD.” The term “Pure O” is meant to describe a subtype of OCD that exists largely in one’s head with little to no obvious, outward compulsive behaviors. Many clients who present for help describe their symptoms as “anxiety” or “feeling like I just can’t shut my brain off.” Few clients, prior to receiving treatment, actually recognize their internal thought struggles as a form of OCD. In this post, I examine the OCD subtype of “Pure O” and suggest directions for treatment.

On Uncertainty & Doubt

I’m a reformed perfectionist. It’s still a daily effort for me to back off my perfectionistic tendencies and welcome (gasp!) errors into my life. But, when I am able to open the door to imperfection, I feel more human and free. Even harder than welcoming imperfection has been coming to terms with uncertainty and doubt. Perfectionists live with the illusion of control and the false belief that if everything is ‘just so’ they can ward off unpleasant or negative experiences. The trap here, of course, is that perfectionism is, itself, an unpleasant experience.