Pure Obsessional OCD, commonly referred to as Pure O, is categorized as a milder form of obsessive-compulsive disorder (OCD) having lesser overt symptoms in contrast with the more severe OCD types. Because Pure O is less severe in nature, cognitive behavioral therapy (CBT) and even self-help techniques will oftentimes reverse the disorder and do away with medications as much as possible.
Cognitive Behavioral Therapy and Pure O
Pure O, in essence, is not manifested by individuals with overtly compulsive rituals and behaviors such as persistent hand washing or bathing. Most of the time, such compulsions are limited within the person’s thoughts, although some individuals may also show subtle forms of compulsive rituals.
Treatment of Pure O involves cognitive behavioral therapy (CBT), which has also been found to be successful in the treatment of more severe cases of OCD. CBT suggests that a person’s actions, desirable or undesirable, are always influenced by his or her thoughts, and that the very thoughts associated with the targeted undesired behavior should be reversed to eliminate the recurrence of unwanted behavior. Among the many CBT techniques, exposure response prevention (ERP) and cognitive restructuring are commonly used.
Exposure Response Prevention and Cognitive Restructuring
Exposure response prevention (ERP) involves exposing the patient to the specific stimulus closely associated with the obsessive thoughts. An individual who fears suffocating their child with a plastic bag, for instance, may be presented with a plastic bag. The therapist then encourages the patient to touch and hold the plastic bag and rationalize or even resist his or her obsessive thoughts associated with suffocating someone with it.
Yet, in some instances in which it is inconvenient or impossible to present the patient with the stimulus, imaginal exposure is then used during the therapy. This method involves writing a story of the individual’s fears. These stories can be read or listened to while repeatedly exposing the individual to his/her obsession. The use of “Imaginal Exposure” can assist the individual by decreasing the frequency and sensitivity to their unwanted thoughts and images.
On the other hand, cognitive restructuring involves the process of rationalization as to the logical relevance of such obsessive thoughts and fears. During the course of the therapy, the psychiatrist engages into a series of questioning, asking a number of leading questions to help the patient arrive at a stage of realization regarding the logic of such thoughts. While proven effective, such approach is oftentimes used in conjunction with ERP.
Mindfulness-Based CBT and Pure O
Another new approach to the treatment of Pure O disorder is mindfulness-based CBT, which encourages the individual to begin to embrace or accept these obsessive thoughts without the need to perform any compulsive countermeasures to eliminate the obsession. Thus, the tug-of-war between the obsessive thoughts and having to respond compulsively will be greatly diminished.
Self-help methods have also been proven to show promising results, in which an individual begins to accept the intrusion of such thoughts and then begins to ignore such obsessions and accept the fact that certain aspects of life are normally unpredictable.