Categories of Obsessions
When you see a person who has pure obsessional OCD (Pure O), symptoms may vary. All people with Pure O have some sort of obsessions, but they do not act on those obsessions through outwardly noticeable compulsions. The main category that many Pure O obsessions fall into is that of a violent act. People with Pure O may obsess over the fact that they will commit a violent act (e.g., kill a person, molest a person), or they may obsess over the fact that they have already committed a violent act (e.g., physically assaulted someone, run over a pedestrian). Their obsessions may also be about a violent accident happening accidentally, due to their own negligence. For example, they might fear that they have exposed their family to toxic chemicals or that they will burn down their workplace one day.
Some people with Pure O obsess about completely non-violent topics. They might obsess about their health, or even about somatic physical acts, such as breathing or swallowing. They may obsess about whether they have a different sexual orientation than they always believed, or about whether they have destroyed a relationship with someone else (e.g., written a hate letter to a friend, used foul language in front of a boss). Religious people with Pure O may obsess about blasphemous thoughts, such as worshipping Satan.
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.
OCD Center of Los Angeles – https://www.ocdla.com/obsessionalOCD.html
The Other OCD – https://www.theotherocd.com/
OCD-UK – https://www.ocduk.org/1/pureo.htm