OCD's Evil Brother

         Most people have heard of Obsessive-compulsive disorder or OCD, and often the first thought is of someone who can’t stand germs or uneven numbers. Loveable, laughable figures like “Monk” or “Bob Wiley” come to mind that make us roll our eyes at neat-freak friends and say, “that’s so OCD”. What doesn’t come to mind is raping children, murdering parents, or mutilating yourself. But for many people, around eighty million in fact, that is what comes to mind. Meet the antagonist, a form of OCD called Pure Obsessive Obsessional Compulsive Disorder or “Pure-O." This type of OCD lives and thrives in the mind, caging its victims in fear by giving them a permanent front row seat to their worst horrors. It’s nearly unheard of, and yet people suffering from Pure-O are just as common and as harmless as those suffering from regular OCD.

         The first thing that should be addressed is the both the simplest and the most important: what is Pure-O? Dr. Steven J. Philipson Ph.D. describes it as such: “The "Pure-O" is manifested by a two-part process: the originating unwanted thought (spike) and the mental activity which attempts to escape, solve, or undo the spike, called rumination.” (Philipson). I like this definition for a lot of reasons, chief of them being that it doesn’t use the word “obsession” which, in my experience, immediately provokes strong and negative reactions in people. Instead, it focuses on what it is- thoughts that people don’t want and actively try to avoid. These thoughts commonly fall into three large categories: sexual (pedophilia, incest), sacrilegious (sex with God, etc.) and violence (self-mutilation, murder).

         For example: imagine that Suzy and her sister meet up to have lunch and Suzy’s sister brings an infant child with her. For the first few minutes, Suzy is smitten and coos and baby-talks to her niece non-stop. As takes her first bite of her sandwich however, she is suddenly overcome with images of stabbing her infant niece with the knife next to her plate. Extremely disturbed by the graphic images, she spends the rest of lunch unable to eat and barely hearing a word her sister says because she is so busy trying not to think about hurting her niece.

         These are all heavy and disturbing topics and it’s easy to understand why having them constantly on the front of one’s mind would be very upsetting. What’s not easy to understand for both the diagnosed and those who hear about it? They are just thoughts. The first thing that anybody who hears of or has this disorder has to accept is that just because you think something doesn’t make it so. So let’s be clear about what Pure-O is not. It is not like schizophrenia, where a person hears voices and will in some cases act on them. And it is absolutely not whispers of subconscious desires or wishes. To reiterate, the thoughts of Pure-O are exactly what the sufferer does not want.

         So now that we’ve we're clear on what Pure-O is and is not we have to ask the next question: why should we care? How common is this disorder in reality? According to The National Institute of Mental Health between about 2% of the population from 18-59 suffer from OCD. Of these, around 25% suffer from Pure-O; that is obsessions without compulsions (Christine Purdon). As aforementioned, though, Pure-O is an under-diagnosed mental disorder, due to the difficulty of the thoughts that people with it have, and the ignorance of those who hear these thoughts so these numbers are guesses. After all, who wants to tell their spouse that they can’t stop thinking about killing their children?

         But then, every parent must have these thoughts at some point, right? Who doesn’t have a moment they can point to where they thought had a stray violent, inappropriate or disturbing thought? Of course everyone has "stray thoughts". What everyone doesn’t have is constant thoughts of an extremely disturbing nature. As Miss Bretécher says in her article detailing her struggle with Pure-O: “Every minute of every day, I saw everyone naked.” This wasn’t something that “bothered” her, it was something that debilitated her. Pure-O is a disorder because it goes beyond just seeing something, it’s fearing something. The anxiety that comes from the thoughts are the crippling part, because the thoughts take up a majority, from 6-8 hours of a sufferer’s day. Imagine watching a horror movie featuring you or your loved ones for that long.

         My interviewees, who've both requested to remain anonymous, both described how Pure-O nearly destroyed them and their lives. Student A, a college junior diagnosed a year ago, told me when prompted, "I would sit in class and struggle not to pass out as I stared at the neck of whoever was ahead of me and saw myself ripping into it over and over again. Sometimes I would go entire periods not hearing a word the professor said because I was engrossed in the horror of my thoughts." Student B, a college sophomore diagnosed five years ago, said, "I would be on the floor begging God for mercy every night as I was constantly thinking about one of my younger siblings and I having sex. I remember some nights I'd spend the entire night in the bathroom rotating between throwing up and praying."

         Disturbing, isn't it? But as uncomfortable for as it is to hear, it is agony to live, they report. And for both of them, they believe they lived nearly a decade of their lives having these thoughts and believing that they were actually their desires because they never breathed a word of it to anyone else. And who can blame them?

         For those who still aren’t convinced that it even exists, you are not alone, though you are certainly in the minority. There are some, such as Dr. Bradley C. Riemann, who say that all obsessions come with compulsions. However, his general definition of compulsion tends to be more in the mind rather than the act, which is controversial. That is to say, even those who say Pure-O doesn’t exist do not say that obsessions don’t.

         So if it’s really that bad, how can you be sure that Pure-O people won’t act on their obsessions? There are more than a few stories where frightened children took their terrifying thoughts to teachers and ended up facing things like expulsion or even police as a result. I’ll say again- these obsessions are incredibly disturbing, not only to the ones who have them, but also to those they might tell. It’s a reasonable reaction for a teacher whose student tells them that they can’t stop thinking about stabbing a classmate with a pencil to report the child.

         But the reality is that people with Pure-O pose no more threat, and some argue less threat, than any other person out there. As Doctor Phenzel says in his article How I Treat OCD Killer Thoughts: Treating Violent Obsessions- “It should be noted that people who suffer from these thoughts have no history of violence, nor do they ever act out on their ideas or urges. (Phenzel).” To repeat: people often see exactly what they fear. A homosexual imagines being with the opposite sex, a mother imagines drowning her child, a missionary imagines God naked. The thought is the fear, not the desire. Furthermore, it’s not the thought that counts. As far as Pure-O goes at least, it’s not the content of the obsession that’s important, but rather the anxiety one feels because of it.

         In conclusion, Pure-O is a common and, to all but those who have it, harmless form of OCD. In media we often see the mentally disabled, disordered and diseased as the creepy bad guy, but in reality, it’s just not like that. People with this disease suffer, and they suffer more because others don’t take the time to try to understand. That can change, though, if people will just try.
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Works Cited
Bretécher, Rose. "Pure OCD: a rude awakening." The Gaurdian 2013: 1. 14 September 2016.
Christine Purdon, David A. Clark. Overcoming Obsessive Thoughts. Oakland: New Harbinger Publincations Inc., 2005. 14 September 2016.
National Institute of Mental Health. Obsessive Compulsive Disorder Among Adults. January 2016. <http://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml>. 14 September 2016.
OCD Center of Los Angeles. Pure Obsessional OCD (Pure O) – Symptoms and Treatment. 2016. 14 September 2016.
Phenzel, Fred. How I Treat OCD Killer Thoughts: Treating Violent Obsessions. n.d. 14 September 2016.
Philipson, Steven J. "Thinking the Unthinkable." OCD Online 2016: 1. <http://www.ocdonline.com/thinking-the-unthinkable>. 14 September 2016.
Riemann, Bradley C. Pure “O” - Fact or Fiction? 14 September 2016. 14 September 2016.
Wochner, Stacey Kuhl. "Pure Obsessional OCD — Symptoms and Treatment ." Social Work Today (2012): 22. 14 September 2016.
Wortmann, Fletcher. "The Danger of Doubt: The Ruthless and Frequently Misunderstood Logic of OCD." Children's Mental Health Network (2013): 1. 14 September 2016.