“Pure” obsessive-compulsive disorder is a mental health condition that can severely impact a person’s capacity to function. They can become entrapped by difficult emotions or uncertainties. This article will explain what it is like to have pure OCD and how specialized therapy can help those with this disorder.
What Is OCD?
Obsessive-compulsive disorder (OCD) is an anxiety disorder that causes a person to have disturbing thoughts and mental images. These can involve urges to act in irrational or socially unacceptable ways. Individuals typically recognize that their thoughts do not make sense. Nevertheless, they may come to believe they are bad people for having them. Despite their resistance to such urges, they often fear they will perform the act. The fear and self-disgust can be overwhelming.
Types of Compulsions
In response to these intrusions, compulsions are performed to alleviate the discomfort. For example, someone obsessed with order and symmetry may go to great lengths to ensure their home is perfectly arranged. Before leaving the house, they spend considerable time putting things in the right spots which can be exhausting.
Compulsions can also play out in the mind. Mental compulsions include thought processes like someone:
- thinking about certain phrases and ideas
- becoming consumed by “What If…?” questions
- replaying past events and conversations repeatedly
- imaging how they would respond if a disaster happened
- checking how they feel emotionally about a person or issue
- scanning their bodily sensations for signs of discomfort or asymmetry
Mental Moves, Avoidance, & Reassurance
Some people mainly have mental compulsions and perform behaviors that diverge from classical OCD. This subtype is known as pure OCD. In addition to excessive rumination and daydreaming, individuals with pure OCD can get stuck in a cycle of avoidance. They might decline an invitation to go to a party if they are consumed with the possibility of driving off the highway. Buildings taller than four stories might be off limits due to their concerns about getting trapped in a fire.
Reassurance-seeking behaviors can also occur which manifest as “the need to ask, tell, or confess” their distress, as well as:
- seeking self-assurance that their beliefs are untrue
- researching their issue on the internet
- asking others if they did the right thing
- oversharing details of an interaction
- excessive apologizing
It may not be obvious to friends and family that a loved one struggles to keep it together when pure OCD is at work.
Going Down the Rabbithole of Possibilities
Someone with pure OCD leaves no rock unturned when rationalizing through something emotionally triggering. They may start with a reasonable prompt like “Did I find that man attractive?” This train of thought can spiral into the major life consequences of cheating on his or her husband, and branch off into a series of distantly related events. In their attempt to relieve their anxiety, they imagine everything that could go wrong. The more they do this, the fewer answers they find.
Specialized Treatment for OCD
Because close examination and rationalization are key aspects of pure OCD, standard cognitive behavior therapy (CBT) is not helpful. CBT involves interacting with thoughts and behaviors contributing to a client’s distress to understand why they are happening. This can exacerbate mental compulsions. Exposure and Response Prevention (ERP) is a special type of CBT used to treat OCD. Medications are sometimes prescribed alongside therapy.
How Does Therapy Work?
There are three elements to therapy for OCD:
- educating the client about their condition (psychoeducation)
- modifying negative thinking patterns (cognitive restructuring)
- progressively exposing the client to their fears (ERP)
ERP is the cornerstone for pure OCD treatment. It works by teaching clients how to respond to symptoms in a new way. Instead of embracing their need to control overcomes, they learn to loosen their grip. Intrusive thoughts become background noise as the mind adopts new patterns of thinking. The alarming list of things that could happen is not given much attention. The client accepts that they may have scary thoughts without assigning significance to them.
An Example of Exposure
The therapist will expose the client to a particular obsession and ask them to do the opposite of whatever their urges are telling them to do. The specific techniques used depend on the client’s unique orientation.
For instance, if the client is terrified that the devil influences their actions, the therapist might ask them to draw the devil. The trained therapist will guide the client through this anxiety-inducing process and help them calm themselves without engaging in mental compulsions. When the client is ready, the therapist might go a step further and ask the client to take on the role of Satan and give him a voice.
Although this sounds counterintuitive and uncomfortable, CBT specialized for pure OCD can shatter a person’s beliefs about themselves and reduce the negative feelings they have about their obsessions.
Pure OCD can be debilitating. Disturbing thoughts swirl around the mind until they are temporarily “resolved” through mental compulsions. Seeking constant reassurance that you are safe or avoiding places your friends are going can be depressing. Substance abuse is often around the corner for those who don’t receive proper treatment. Avalon Malibu is a licensed addiction and mental health facility in beautiful Malibu, CA. We provide residential treatment for mental health and addiction, partial hospitalization, intensive outpatient, and medication management. Our dedicated and experienced team deeply understands mental disorders like OCD. Cognitive behavior therapy with Exposure and Response Prevention helps our clients realize that they don’t need to do anything about unwanted thoughts. They are safe even when they do not feel like they are. If you have been struggling in silence, please call (844) 857-5992.
