Many people with Pure-O may also experience comorbidity with features of perfectionism. When a Pure-O sufferer’s brain lands on a thought or question that is unacceptable to the person having the thought, the fear network of the brain is alerted that something is wrong and needs to be done about it IMMEDIATELY. This fight or flight experience is what causes the sufferer a great deal of distress. Pure-O is rooted in the faulty assumption that humans have control over their thoughts, which we do not. The human brain has evolved to be constantly spinning around, trying to find interesting problems to solve, and to search for threats to our safety or existence. The brain is particularly interested in thoughts that contain uncertainty. It is the very act of trying to not to have a bothersome thought that guarantees its resurfacing. The more one dislikes experiencing the intrusive thoughts and tries to repress, control, or fight the thoughts, the greater the frequency of intrusive thoughts one will experience.
Thus, what ignites the symptoms of Pure-O is not the experience of intrusive thoughts but actually one’s reaction to them. Pure-O sufferers often report that their thoughts make them incredibly anxious and they can’t get them out of their head. What distinguishes Pure-O from a fleeting unwanted thought is the anxiety that becomes affixed to these thoughts which then creates a significant amount of distress to the sufferer. However, non-clinical persons, or those who do not have OCD, are able to easily dismiss the thoughts as uncomfortable, weird, or just something their brain does. It is important to distinguish Pure-O from a singular fleeting thought.
Pure-O obsessions often manifest as intrusive, unwanted, inappropriate thoughts, impulses or “mental images.” The compulsions for Pure-O mainly exist in the form of mental rumination and reassurance seeking. Intrusive thoughts and images tend to coalesce around specific themes including: safety and harm thoughts about self and others, worries about sexual orientation (Sexual Orientation OCD or Homosexuality OCD), worries about relationship decisions (ROCD), fears of doing something illegal, pedophilia (POCD), over-concern for honesty or religious purity, or existential fears. Pure Obsessional OCD ( Pure-O) is a type of Obsessive-Compulsive Disorder ( OCD) in which an individual reports experiencing obsessions without outwardly observable compulsions.
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