The difference between Pure OCD and “Regular” OCD

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image from Pixabay (ColiN00B)

Pure OCD is a term used by individuals in the OCD community to describe symptoms when everything takes place in their head. There are no outwardly visible compulsions like counting, tapping or washing. Moreover, the obsessions often are taboo, violent, or blasphemous. What this has led to is a sort of divide between the “regular” OCD community and those with Pure OCD.

However, the difference between Pure OCD and “Regular” OCD is…virtually nonexistant.

They are both OCD. They both involve obsessions and compulsions. They are covered on the same page in the Diagnostic and Statistical Manual (DSM). They get the same diagnosis code for insurance purposes.

Do I have a problem with people using the term Pure OCD? Kind of. Here’s why.

The term was originally coined by Dr. Steve Phillipson. It’s taken on a life to stand for purely obsessional OCD. The idea is sometimes that these individuals have only obsessions, not compulsions. However, research has since shown that there are in fact compulsions. They just aren’t outwardly visible. They could include tasks like replaying an event in your head, repeating a word or phrase, praying compulsively, or trying to check a memory. The list of possibilities is pretty endless. Invisible compulsions are still compulsions. Still, the term Pure O stuck and a community within the OCD community has developed.

Yes, the term allows those with these types of obsessions and non-outward compulsions find one another. People who have been struggling can suddenly find out they aren’t alone. That is a good thing. But the problem is the term perpetuates myths that Pure OCD doesn’t involve compulsions, is different from “regular” OCD, and is treated differently than “regular” OCD.

I am not a medical professional, but according to the International OCD Foundation the gold-standard, research supported treatment for OCD is exposure and response prevention (ERP) therapy and/or medication. 

ERP can be applied to any obsessions and compulsions OCD throws at you. An ERP specialist will be able to help you with imaginal exposures, script exposures, etc. Please find an OCD/ERP professional in your area or willing to do Skype therapy.

In summary, let’s use this term with caution. And perhaps we should find a new term.

Note: The inspiration from this post came from watching a Facebook interaction in which someone asked how ERP is applied to Pure O, and someone replied that ERP doesn’t work for Pure O. Making Pure O it’s own thing can lead to this confusion.

For help finding an OCD specialist, visit:


For more information:

Does Pure O Exist?

ERP for Pure O (The OCD Stories)




  1. I could have done with this 10 years ago 🙂 great stuff. My compulsion is the mental argument which just fuels it like any compulsion does. Even if I ‘find an answer’ there’s only temporary relief, like a compulsion. Be well!

    Liked by 2 people

  2. There are typically two schools of thought on this (clinically). Those that care and want to abolish the term because it doesn’t align with a measurable scientific definition and those that don’t because they care more about relating to the patient/client population. The term ‘pure-o’ is so ingrained in google and in the minds of those that live with it and essentially saw that nick name as a life saver that there really wouldn’t seem to be a point in renaming it. All it takes is a quick google search and/or some psycho-education from a therapist to understand it’s simply a nickname. Those that choose not to do that education and would rather tout that Pure O doesn’t exist are probably more interested in serving their egos than their clients. #1 People would rather use the term Pure O than have to disclose their shameful and horrifying sexual intrusive thoughts…it’s way easier coming off the tongue that way. #2. I would have to search the internet high and low to truly find out that Pure O doesn’t have compulsions—which would probably be in itself a compulsion. It’s wishful and I think useless thinking to align with the view that we shouldn’t be using it. It normalizes, it helps people feel less alone, and it gives people hope. I certainly don’t see anything wrong with that.

    Liked by 1 person

    • I really like your point about being able to say “pure o” rather having to describe the thoughts. I’m still concerned about the distinction because I saw someone ask on Facebook how ERP would be applied to pure O, and someone replied that ERP doesn’t work for pure O. Granted, hopefully a professional would know that isn’t true.


      • I have seen these same comments. But I guess I liken that to just the need for education in general about OCD, not just Pure O. Many people STILL believe talk therapy is appropriate therapy or EMDR (ACK!), so I look at it as just another chance at educating people and dispelling the myths. What I have seen (obviously in my experience) as well as others is that they finally find a place in the world of OCD when they find out there is a ‘name’ for it and then they have hope that they are not alone and recovery is possible. Ideally there will come a day when we can do away with ALL ‘types’ and ‘names’ of OCD (HOCD/Contamination OCD/etc), and all it is is JUST OCD! But, I don’t see that happening at least in my lifetime!

        Liked by 2 people

  3. Not only do I not think that PURE O has relevance within OCD, I do not like labeling any aspect of the disorder because there is a method by which we can calm our obsessive thoughts and feelings down and lead the lives we wish to lead and it is recovery I prefer to label and concentrate on.

    Liked by 1 person

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