The Truth About “Pure O”
“Pure OCD” is a term that gets used a lot—but it’s often misunderstood. Many people assume it means a “milder” or “different” form of OCD because they don’t have obvious compulsions. In reality, the compulsions are still there—they’re just happening in your head.
The term “Pure O” (short for “purely obsessional”) gets tossed around a lot, but it’s actually misleading. Because here's the truth: there’s no such thing as OCD without compulsions. If there were, it wouldn’t be OCD.
What makes Pure O feel different is that the compulsions are often invisible. They're mental. Silent. Internal. Things like rumination, mental checking, replaying events, analyzing your feelings, praying in your head, attempting to neutralize your thoughts or avoid them all together. These are compulsions too—just harder to spot from the outside.
In this post, we’ll break down what “Pure O” really means, why it’s a common misunderstanding, and how recognizing your mental compulsions is actually a turning point in getting the right treatment.
What People Mean When They Say “Pure O”
Most people who use the term “Pure O” are trying to express that their compulsions don’t look like what people expect. And they’re right. OCD isn’t always visible. Not all compulsions involve checking the stove or avoiding door handles. Many take place entirely in your mind.
So when someone says they have “Pure O,” what they usually mean is:
They experience intense, distressing intrusive thoughts
They don’t perform obvious, physical rituals
Their compulsions are mostly mental, emotional, or subtle
In that way, “Pure O” is less of a diagnosis and more of a shorthand to describe a subtype of OCD that’s centered around internal processes.
Mental Compulsions Are Still Compulsions
Here’s the defining feature of OCD: you have an intrusive thought (obsession), and you do something to try to neutralize it or decrease the distress it causes (compulsion). That “something” doesn’t have to be physical.
Examples of mental compulsions include:
Replaying memories to “check” what really happened
Mentally reviewing whether you felt a certain way
Trying to logically figure out or “solve” a doubt
Silently praying or repeating a phrase to feel safe
Analyzing whether your reaction means something about you
Scanning for proof that you're a good or bad person
Mentally rehearsing how to act “just right” in the future
Trying to neutralize, suppress, or “undo” a thought you didn’t like
Trying to prevent or control what kinds of thoughts come into your mind in the first place
These compulsions can be exhausting and just as disruptive as visible rituals—sometimes more so, because they’re harder to recognize, and even harder to explain to others.
Why This Misconception Matters
When people believe they have “Pure OCD,” they often think, “I don’t do compulsions, so maybe this isn’t OCD.” That can lead to years of misdiagnosis, ineffective treatment, or feeling like a failure in ERP because no one addressed the mental rituals.
Understanding that your thinking itself has become a compulsion helps shift the goal of treatment. You’re not trying to control your thoughts or stop having them. You’re learning how to stop responding to them through mental rituals.
It also helps you catch the compulsions earlier—because they don’t always feel like something you're “doing.” They often feel like thinking, problem-solving, or getting clarity. But in OCD, that mental activity only makes the doubt stronger.
Why the Term “Pure O” Still Gets Used
To be fair, “Pure O” has stuck around because it’s a way for people to describe an experience that felt invisible and misunderstood for too long. For some, it was the first label that helped them realize what they were going through had a name—and that they weren’t alone.
So no shame if you’ve used the term. Most people do at some point. But as you learn more, it’s helpful to understand what’s underneath that label—and to use language that better reflects what’s actually going on. Because the more clearly you can identify the pattern, the more effectively you can change it.
Final Thoughts
“Pure O” doesn’t mean you’re not doing compulsions—it just means they’re happening behind the scenes. And once you can see them for what they are, you can learn to respond differently.
Mental compulsions are real, valid, and treatable. Whether you’re using ERP or I-CBT, recognizing those internal responses is key to breaking the cycle and rebuilding trust in your own mind.
