Although many people believe that Pure O does not manifest itself in any compulsions at all, this way of thinking is incorrect. Similar to the characteristics of people with OCD, people with Pure O have their own rituals they use to manage their obsessions, but these rituals are almost entirely in the mind. For examples, one of these compulsions is the act of "checking," or making sure that their obsession is false. For example, they may search the Internet over and over again for a news bulletin about a house that has been burned down, to deal with the obsession that they set fire to their own home. Even more simply, a person with pure O might have constant ruminations about whether something happened, describing each detail about what went on in the day - in his or her own head! - in order to feel more confident in the fact that the obsession is false.
People with Pure O may also feel compelled to avoid people, objects or situations related to their obsessions. Alternatively, they may constantly confess their obsessive thoughts to people, even complete strangers, to make themselves feel more secure. They may even repeatedly ask for reassurance from these people that the obsession is false. Other people with Pure O may perform superstitions in order to stop their obsessions from coming true.
These Pure O symptoms vary from person to person, but what unites them all is the fact that they include obsessions, but do not include extremely noticeable compulsions.