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Living with "Pure O" OCD: The Thoughts That Haunted Me

A raw and honest look at purely obsessional OCD, the shame around intrusive thoughts, and how ERP therapy changed everything.
knowledge hub
Reviewed by the HeyPsych Medical Review Board
Board-certified psychiatrists and mental health professionals
Medical Review Board
Published: January 10, 2024
Last Updated: January 9, 2026
Last Reviewed: January 9, 2026

Article

11 min read

Overview

For years, I couldn't tell anyone about the thoughts that tormented me. Violent images. Horrible "what ifs." Thoughts so disturbing I was convinced I was a terrible person. I didn't have visible compulsions, so I didn't think it was OCD. Turns out, I had "Pure O"—purely obsessional OCD. Here's my story.

What Pure O Actually Is

Common misconception: "Pure O" means no compulsions. Reality: The compulsions are mental, not physical. My obsessions: Intrusive thoughts about harming people I loved. Fears I was secretly evil. Constant "what if" spirals. Disturbing sexual or religious thoughts. My compulsions (all mental): Mentally reviewing whether I'd acted on thoughts. Seeking reassurance from myself that I'm a good person. Mental checking, counting, praying. Analyzing every thought to prove I wasn't dangerous. From the outside, I looked fine. Inside, I was in constant turmoil.

The Shame Was Suffocating

I was terrified to tell anyone. What if they thought I was dangerous? What if saying the thoughts out loud made them real? What if a therapist reported me? I searched online: "having violent thoughts, am I evil?" I found forums full of people with OCD describing my exact experience. That's when I first learned about Pure O. But even then, I waited another year to seek help. The shame was that powerful.

Finally Getting Help

At 26, I hit a breaking point. The thoughts were constant. I couldn't concentrate at work. I avoided my niece because of intrusive thoughts. I knew this wasn't sustainable. I found a therapist who specialized in OCD. In our first session, I nervously described my thoughts. She didn't flinch. "That's textbook OCD," she said. "These are intrusive thoughts, and they're treatable." I cried with relief. I wasn't evil. I had a medical condition.

ERP Therapy: Terrifying and Life-Changing

ERP stands for Exposure and Response Prevention. For OCD, it's the gold standard treatment. How it works: You're exposed to your feared thoughts (exposure) without performing mental compulsions (response prevention). This teaches your brain the thoughts aren't dangerous. What it looked like for me: • Writing out my worst intrusive thoughts • Sitting with the anxiety without seeking reassurance • Accepting uncertainty instead of mentally checking • Gradually reducing compulsions It was terrifying. My brain screamed that I was making things worse. But slowly, the thoughts lost their power. My therapist was right: thoughts are just thoughts. They don't make me evil, and I don't have to engage with them.

What I Learned About Intrusive Thoughts

• Everyone has intrusive thoughts. People with OCD just get stuck on them. • Intrusive thoughts are the opposite of desires. They're ego-dystonic—they horrify you precisely because they go against your values. • Engaging with the thoughts (analyzing, seeking reassurance, mental checking) makes them worse. Acceptance makes them fade. • You can't control what thoughts pop into your head. You can only control how you respond. • Having a thought—any thought—doesn't make you a bad person or mean you'll act on it.

Life After Treatment

I still have intrusive thoughts. But now I recognize them for what they are: brain noise. Meaningless static my OCD throws at me. The difference: I don't spiral anymore. When a thought pops up, I notice it and move on. "Cool story, brain. Anyway..." I'm not cured, but I'm managing. I have flare-ups during stress, but I know my tools now. ERP. Medication (SSRI). Self-compassion. Acceptance. I can live my life. I can be around my niece without fear. I can enjoy moments without my brain hijacking them.

To Others Suffering in Silence

If you're reading this and recognizing yourself, please know: • Your thoughts don't define you • Intrusive thoughts are a symptom, not a character flaw • OCD lies. It tells you you're dangerous. You're not. • Treatment exists and it works • You're not alone. Millions of people have OCD. • A good therapist won't judge you—they've heard it all before • Telling someone about your thoughts won't make them real • You deserve help, even if your brain tells you otherwise Find an OCD specialist. Look for someone trained in ERP. The International OCD Foundation has a therapist directory. It's scary, but it's worth it.

Conclusion

Living with Pure O OCD was like having a bully living in my brain, constantly feeding me horrible thoughts and demanding I prove I wasn't a monster. ERP therapy taught me I didn't have to engage. The bully still shows up sometimes, but I don't give it power anymore. If you're suffering with intrusive thoughts, please reach out for help. You're not evil. You're not dangerous. You have OCD, and OCD is treatable.

What Pure O Actually Is

Common misconception: "Pure O" means no compulsions. Reality: The compulsions are mental, not physical. My obsessions: Intrusive thoughts about harming people I loved. Fears I was secretly evil. Constant "what if" spirals. Disturbing sexual or religious thoughts. My compulsions (all mental): Mentally reviewing whether I'd acted on thoughts. Seeking reassurance from myself that I'm a good person. Mental checking, counting, praying. Analyzing every thought to prove I wasn't dangerous. From the outside, I looked fine. Inside, I was in constant turmoil.

The Shame Was Suffocating

I was terrified to tell anyone. What if they thought I was dangerous? What if saying the thoughts out loud made them real? What if a therapist reported me? I searched online: "having violent thoughts, am I evil?" I found forums full of people with OCD describing my exact experience. That's when I first learned about Pure O. But even then, I waited another year to seek help. The shame was that powerful.

Finally Getting Help

At 26, I hit a breaking point. The thoughts were constant. I couldn't concentrate at work. I avoided my niece because of intrusive thoughts. I knew this wasn't sustainable. I found a therapist who specialized in OCD. In our first session, I nervously described my thoughts. She didn't flinch. "That's textbook OCD," she said. "These are intrusive thoughts, and they're treatable." I cried with relief. I wasn't evil. I had a medical condition.

ERP Therapy: Terrifying and Life-Changing

ERP stands for Exposure and Response Prevention. For OCD, it's the gold standard treatment. How it works: You're exposed to your feared thoughts (exposure) without performing mental compulsions (response prevention). This teaches your brain the thoughts aren't dangerous. What it looked like for me: • Writing out my worst intrusive thoughts • Sitting with the anxiety without seeking reassurance • Accepting uncertainty instead of mentally checking • Gradually reducing compulsions It was terrifying. My brain screamed that I was making things worse. But slowly, the thoughts lost their power. My therapist was right: thoughts are just thoughts. They don't make me evil, and I don't have to engage with them.

What I Learned About Intrusive Thoughts

• Everyone has intrusive thoughts. People with OCD just get stuck on them. • Intrusive thoughts are the opposite of desires. They're ego-dystonic—they horrify you precisely because they go against your values. • Engaging with the thoughts (analyzing, seeking reassurance, mental checking) makes them worse. Acceptance makes them fade. • You can't control what thoughts pop into your head. You can only control how you respond. • Having a thought—any thought—doesn't make you a bad person or mean you'll act on it.

Life After Treatment

I still have intrusive thoughts. But now I recognize them for what they are: brain noise. Meaningless static my OCD throws at me. The difference: I don't spiral anymore. When a thought pops up, I notice it and move on. "Cool story, brain. Anyway..." I'm not cured, but I'm managing. I have flare-ups during stress, but I know my tools now. ERP. Medication (SSRI). Self-compassion. Acceptance. I can live my life. I can be around my niece without fear. I can enjoy moments without my brain hijacking them.

To Others Suffering in Silence

If you're reading this and recognizing yourself, please know: • Your thoughts don't define you • Intrusive thoughts are a symptom, not a character flaw • OCD lies. It tells you you're dangerous. You're not. • Treatment exists and it works • You're not alone. Millions of people have OCD. • A good therapist won't judge you—they've heard it all before • Telling someone about your thoughts won't make them real • You deserve help, even if your brain tells you otherwise Find an OCD specialist. Look for someone trained in ERP. The International OCD Foundation has a therapist directory. It's scary, but it's worth it.

The resources and information provided are for educational purposes only. They are not a substitute for professional medical or mental health advice, diagnosis, or treatment. Always seek the guidance of qualified health professionals with questions about your health.