All About Pure O Treatments: Therapy and Self-Help Tips

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Pure O Treatments - CBT

In order to understand Pure O treatments, it is important to first recognize what exactly Pure O is. Pure O (Pure Obsessional OCD) is a form of OCD that does not typically manifest itself in rituals or other outward signs. Instead, Pure O exists almost completely in the sufferer’s mind. (There are, however, some mental rituals that exist even in Pure O).

The main type of therapy available for those with Pure O is cognitive behavioral therapy (CBT). It is used to treat traditional OCD as well, and is based on the premise that your thoughts can influence your actions, and that changing your thoughts can change your actions (even those “actions” that take place within the mind). There are two main CBT techniques that are used to treat Pure O: ERP (exposure response prevention) and cognitive restructuring.

Exposure Response Prevention

Exposure response prevention (ERP) consists of exposing people with Pure O to the events or circumstances that trigger their obsessions. For example, if a person constantly obsesses about suffocating a child when they see a plastic bag, a therapist would make them hold a plastic bag and challenge them to hold it firmly without trying to escape from it or even talk about it. This head-on approach is effective with many OCD sufferers in general, and with Pure O people in particular.

More specific to Pure O is a variant of ERP called imaginal exposure, in which the person with Pure O listens to a recording describing the obsession. The therapist then works with the client to avoid taking the normal steps they would take - such as checking, avoidance, or superstitious behaviors. Both of these techniques can reduce both the frequency and strength of obsessive thoughts.

Cognitive Restructuring

The process of cognitive restructuring, which is the second technique used in CBT, enables people with Pure O to question the assumptions that exist within their obsessions. The therapist asks them leading questions to help them recognize the fact that their obsessions are unhelpful and contain logical fallacies. This process must be paired with ERP and other coping techniques, but can motivate people with Pure O to overcome their obsessive tendencies.

Mindfulness-Based CBT

A newer development in the field of CBT is the creation of mindfulness-based CBT. This variation focuses on the fact that much of the psychological distress experienced by a person with Pure O stems from the lack of control over obsessions and the need to eliminate obsessive thoughts. Mindfulness-based CBT encourages people to accept their obsessions and experience them without feeling the need to control them. It emphasizes the importance of responding to them without resorting to mental rituals or other typical Pure O behaviors.

Self Help Tips for Pure O

People with Pure O can help themselves deal with their obsessions between therapy sessions by using certain techniques that are CBT-based. For example, if they obsess over a specific question (e.g., “Did I give my friend the wrong directions?"), they can avoid trying to answer question and instead focus on accepting the uncertainty (e.g., “Okay, worst comes to worst, he won’t make it to my house”). In more extreme obsessions, they can even over exaggerate the details of their obsessions so as to make them seem more ludicrous. For example, for people who obsess over the fact that they may abuse a child, they can go along with their obsessions by thinking, “And while I’m at it, I’ll go into the school across the street and run through the classes, hitting all of the kids in there too. And the police will come in and arrest me, and I’ll be on the front page of the newspaper tomorrow!”

People with Pure O can also schedule a specific time in their day for obsessions. That way, if they feel their obsessive thoughts stirring in the morning, they can shelve the obsessions and tell themselves that they will think about it more at their “scheduled obsession time.”

These Pure O treatments can be done at home, but nothing can substitute for true therapy from a professional who is experienced in treating this disorder.


OCD Center of Los Angeles,

The Other,


This post is part of the series: A Different Form of OCD: Pure O

Unlike typical OCD, Pure O (Pure Obsessional OCD) consists almost entirely of obsessions, with no visible compulsions. This series of articles discusses the definition, symptoms, and treatments for Pure O.

  1. Insight into Pure O Treatments: Therapy and Self-Help Techniques
  2. What is Obsessive Compulsive Disorder Pure O?