Jump to content

Time to ditch the term 'Pure O'?


Recommended Posts

A couple of weeks ago a subject about the methods of private therapists was being discussed in the ‘members area’ of the forum, and somehow the topic moved on to a discussion about the term ‘Pure O’. Further to that discussion I am even more convinced of the belief that the term 'Pure O' needs to be resigned to the history books, and replaced with another term/phrase.   My reasons for this are not new, I have been harping on about it for some time now. But the primary three reasons are:

  • It’s technically inaccurate.
  • It’s not a medical term.
  • It confuses people into not recognising their own condition accurately.

Now don’t get me wrong, it may be helpful in helping people identify an aspect of OCD that they may not have been aware of  perhaps, but that’s not a good enough reason to continue with a factually inaccurate term, especially if a better and more appropriate phrase can be used instead.

The fact is, and this is backed up by lots of anecdotally evidence from people I speak to through the charity that they mistakenly think they only have purely obsessional thoughts, i.e. that it is Obsessive Disorder (OD) and not Obsessive COMPULSIVE Disorder (OCD). The problem here is if you are failing to recognise symptoms of your own condition, it’s going to make it incredibly more difficult to move forward, which is why I feel strongly about this.  

Whilst it’s not a medical term, most OCD specialists will understand what you mean, but for people going to their GP or local therapists and talking about ‘Pure O’, it’s more likely to have therapists confused and scratching their heads, and I am not sure we can blame their lack of training in OCD for not recognising a non-medical term!!!

I know my suggestion that we ditch the term ‘Pure O’ will not be popular with a lot of people, and I suspect some commercial therapists here and in the US will not buy into this, because for some it allows themselves to create a market for themselves by claiming to be ‘Pure O ‘experts. In fact going off subject slightly, my advice to anyone seeking therapy is if you come across any therapist claiming that they’re a ‘Pure O’ specialist and don’t declare on their website or within the first sessions of treatment that it is just standard OCD then I would give careful consideration to ditching them because they’re educating you and arguably they’re not being honest with you. And dishonest therapists should be avoided at all costs, and sadly there are a few of those about, but I will revisit that subject another day.

But going back to ‘Pure O’ there are too many sufferers that read articles online that are led to falsely believe they don’t suffer with any compulsions at all. The fact is it is simply not true, ok so they may not be ‘washing their hands’ but they will engage in at least one, if not most of these:

  • Checking things on Google
  • Checking for reassurance from loved ones or friends
  • Checking own body for arousal or other sensations
  • Physical ‘avoidance’ of people, places or objects
  • Attempt to force and check for ‘feelings’

See the trend here, there’s a physical action taking place, that’s right, a compulsion and if someone, anyone, with any form of OCD wants to recover they have to be able to identify and recognise their illness.  I once said that most forms of OCD include ‘checking’ as a compulsion, and the aforementioned badly and inaccurately named ‘Pure O’ is no different in the fact there is always 'checking' taking place. In fact, I might even argue on another day that the average person with what they call ‘Pure O’ will engage in more compulsions than people with other aspects of OCD.

So, a more factually accurate term fore 'Pure O'  might be Obsessive ‘with less obvious, but still there’ Compulsive Disorder. Now I grant you that’s not as catchy as ‘Pure O’, but it’s a lot more accurate.  I don’t have an answer for what it should be rephrased and renamed to, but maybe it shouldn’t be renamed at all and just ditched.  One of my forum moderators made a good suggestion on the previous discussion that should refer to all forms of the illness the same, i.e. ‘OCD with a theme of……’.  That's actually not a bad way to bring more awareness and recognition to ‘all’ aspects of OCD when we talk about the subject in the media.

But the bottom line is this, if people are being led to the false misrepresentation that ‘Pure O’ differs from others aspects of OCD, and they are made to believe they don't have any compulsions, then I am afraid they’re not being helped at all.  So maybe it’s time we drop the term ‘Pure O’.

Link to comment

I agree with everything you say Ashley. I suppose when I first googled my symptoms many years ago I could relate to the term "pure O" but once I found this place I was able to identify those mental compulsions, googling, scanning my body etc, so I've never actually said I have "pure O" just plain old OCD!xx

Link to comment
2 minutes ago, Wonderer said:

I agree with everything you say Ashley. I suppose when I first googled my symptoms many years ago I could relate to the term "pure O" but once I found this place I was able to identify those mental compulsions, googling, scanning my body etc, so I've never actually said I have "pure O" just plain old OCD!xx

Couldn't agree more Wonderer.

Link to comment

I agree that 'Pure O' is something of a misnomer and can be misleading, but I do think we need a term for this 'flavour' of OCD. Without a term/label, it's harder for sufferers to find others going through the same thing, and it's less likely that people will have those "yes! that's me!" lightbulb moments as happened with me when I first read about 'Pure O'. What to call it though... that's a tricky one. How about IOCD (for 'internalised' or 'invisible' OCD)...?

Link to comment
Guest ashipinharbor
2 minutes ago, Torsa said:

I agree that 'Pure O' is something of a misnomer and can be misleading, but I do think we need a term for this 'flavour' of OCD. Without a term/label, it's harder for sufferers to find others going through the same thing, and it's less likely that people will have those "yes! that's me!" lightbulb moments as happened with me when I first read about 'Pure O'. What to call it though... that's a tricky one. How about IOCD (for 'internalised' or 'invisible' OCD)...?

I second this.

Link to comment

No problem with that - I've long identified the term (as I think many have) as a misnomer ... qualified it as 'so-called'. It's a rough sketch and easy (and should always be qualified) way to describe OCD with less visible compulsions. 

Link to comment

I agree, Ashley. It's still OCD.

I have thought before that I sometimes have compulsions without obsessions. For example, needing to touch things with both hands. But someone here said there is an obsession even if I'm not aware of it, for example the need for things to be symmetrical is the obsession in this case. And no one calls that pure C!

Link to comment
51 minutes ago, Torsa said:

 I do think we need a term for this 'flavour' of OCD.

 

51 minutes ago, Torsa said:

How about IOCD (for 'internalised' or 'invisible' OCD)...?

 

I am not against another term (if a suitable one could be found), but I am not sure you have fully understood my post Torsa.

What I was trying to illustrate, and I accept perhaps I have not done that clearly, but it's that this form/flavour of OCD is no different, there's always physical and visible compulsions, so internalised or invisible OCD would not be accurate either.   i.e. Seeking reassurance is common, and a rather visible compulsion.  So I am still at the point where I simply refer to this has 'OCD', nothing more, nothing less.

I hasten to add this is just my opinion, but it's been something brewing for a while now and I really don't think I am wrong with this.

Link to comment

I do agree with you. I worry though that my own compulsions aren't enough to be considered compulsions. I have the same thought tracks all the time and doubt circles. When I first broke down I would ask the same questions again and again and would call every helpline etc.. I also did checking but my problem is that I'm not sure how regular it all was now that I've tried to stop most of it. There are moments where I do look up my disorder, or even go on here, just as a bit of a comfort and I talked to people about it a lot though not as much as I did. Whilst I'm not as panicky I still suffer quite a bit so I wonder what my compulsions are now? If ruminating is one it might be that, but as soon as a new doubt forms I will analyse it in my head and it will give me anxiety, but I don't really do anything to stop that anymore apart from talking to people. It just doesn't feel conclusive enough and makes me feel different from other sufferers, and I'm also worried there isn't enough evidence for when I talk to a therapist. I'm not sure why I'm dumping this all on this post but I'm just not really certain what my condition is. 

Link to comment
7 minutes ago, Chrids said:

There are moments where I do look up my disorder, or even go on here, just as a bit of a comfort and I talked to people about it a lot though not as much as I did. Whilst I'm not as panicky I still suffer quite a bit so I wonder what my compulsions are now? If ruminating is one it might be that, but as soon as a new doubt forms I will analyse it in my head and it will give me anxiety, but I don't really do anything to stop that anymore apart from talking to people.

I would very much say that is all still OCD (at the risk of giving you reassurance :a1_cheesygrin: )

You do mention some compulsions that you do now (and others in the past):

7 minutes ago, Chrids said:

I do look up my disorder

 

7 minutes ago, Chrids said:

I will analyse it in my head

Even coming on here for comfort could be a compulsion, if that's done for reassurance rather than a practical tool.

Link to comment

Ahh ok. I've said the same things before I think as well I just wish there a bit more conclusive evidence. But I already accepted it was OCD before so it's not point doubting it now. And I do think treating it all the same is better because it doesn't make people feel as singled out and gives the OCD itself a bit less power.

Link to comment
1 hour ago, Torsa said:

I agree that 'Pure O' is something of a misnomer and can be misleading, but I do think we need a term for this 'flavour' of OCD. Without a term/label, it's harder for sufferers to find others going through the same thing, and it's less likely that people will have those "yes! that's me!" lightbulb moments as happened with me when I first read about 'Pure O'. What to call it though... that's a tricky one. How about IOCD (for 'internalised' or 'invisible' OCD)...?

To me this is an argument that supports ditching the term rather than an argument to hold onto it. 

Once we start calling all the different themes OCD can cover simply 'OCD' it should make it easier for people to get directed to the right help.  Articles online and other places can then more easily explain the problem without resorting to stereotypes like hand washing or checking or 'purely thoughts'. For as long as OCD continues to be segregated and divided according to symptoms, the sources of help will also divide and confuse. It's not unusual see people arriving at the forum doubting if their experiences are OCD because their particular topic of worry isn't one of the better known themes and therefore wasn't listed specifically when they tried to research their symptoms.

It's only by unifying the disorder under a single title that we'll ever get past this problem of sufferers believing there are different 'flavours' of OCD. 

No disrespect to Torsa, or anyone else arguing for the term to be kept, but I think sufferers keen to hold onto the term also tend to hold onto the belief they don't do 'rituals'. Telling yourself 'I have pure O' maintains the belief that mental compulsions, because of their invisibility, are somehow different to more visible rituals even once they've been identified as compulsions. To me the use of the term is always an indicator that the sufferer is in the very early stages of self-education, treatment and recovery and has yet to fully grasp what their OCD is about and what they'll need to do to overcome it.

Holding onto the term 'pure O' is also to deny that there are behavioural responses (behavioural compulsions) such as googling or reassurance seeking or checking, as Ashley mentioned above. Calling it 'pure O' may therefore lead the sufferer to expect therapy to consist 'purely' of treating the thoughts and not the behaviours, which is going to make therapy unsuccessful.

I vote we ditch the term 'pure O' asap and call everything simply 'OCD'. :) 

Link to comment
49 minutes ago, Jessie_Loz said:

Its simply used to describe to people what ur OCD is. I have learnt so much about OCD yet if i want someone to know the ins and outs ill say Pure O so they get a better understanding

But it doesn't though does it?  I consider myself a tad knowledgeable about OCD, and if someone told me their OCD was Pure O I would not have a clue what type of OCD a person had. Somebody once told me they had Pure O because they had obsessive thoughts their house was contaminated, they said it was Pure O because they didn't really clean. That's not a typical Pure O story, but it's what the person mistakenly believed, and like all forms of Pure O the person did have compulsions.

Pure O could mean absolutely anything, it tells me nothing about what form of OCD you have, the term means nothing, it's a pointless term.

I hate the acronyms HOCD, POCD etc, etc but at least they give people in the know with OCD a rough idea what their form of the illness was. 

In the past I have had fears of inappropriately looking at children, of saying something racist when near a black person, of being contaminated, of needing to check the tap was off. I don't refer to those as Pure O, contamination OCD, checking OCD.... it's just OCD.  All of them have obsessions, anxiety and COMPULSIONS... it's OCD.

Link to comment
9 hours ago, Jessie_Loz said:

I dont know but it needs to be made as clear as possible so people who are scared and dont know what it is wil understand 

It is on our main website, but we need to drive people there in the first place.  I think this is where Snowbears original suggestion would be really useful (if we can get everyone supporting it), so that when we talk about OCD to the media or write online articles we refer the following, 'I suffer with OCD with a theme/fear of XYZ'.  A few extra words, but it covers both aspects, we are telling the public it's OCD and we are telling readers what form it takes (to raise awareness of the different types).

 

Link to comment
Guest ashipinharbor
8 minutes ago, Ashley said:

'I suffer with OCD with a theme/fear of XYZ'.  A few extra words, but it covers both aspects, we are telling the public it's OCD and we are telling readers what form it takes (to raise awareness of the different types).

 

:goodpost:

Link to comment

I like it too,  Bye Bye Pure O, you never were anyway.  

I refer to the way the disorder expresses itself in a person as the way it manifests itself. I think this gets nicely around the themes and flavours of gravy and brings us back to the point that its   functionality is the same whatever  the manifestation.

This simplifies things in the way Snowbear sought.  

Edited by taurean
amendment
Link to comment

As someone who suffers from intense mental checking that i have yet to get under control, i understand both sides of the argument here. It gave me a lot of comfort when i first heard about Pure O, because self help books about stopping physical compulsions were of no use to me. I wanted to get help, but could find nothing related to my mental compulsions until i realized there was something referred to as Pure O.

However, i agree that the term Pure O is not correct, as i've now realized that i do in fact perform compulsions in my mind. But if there wasn't a separate term for the completely MENTAL compulsions, i would have wondered if i had OCD at all. I think there does need to be some sort of classification between OCD with covert compulsions, and OCD with overt compulsions. I've had both types, and i can guarantee that it's harder to accept that you have OCD when everything is in your mind, i think in large part, because most people don't understand what they are actually doing. If they can't see and define their actions, it's hard to fix them.

Not trying to start something, just my point of view. I think a lot of OCD sufferers who have only ever suffered mental compulsions have an extra step in their recovery, because recognizing that mental compulsions exist and being able to identify them is something that OCD sufferers who have visible compulsions generally don't have to worry about.

Link to comment

Because of this discussion I did some googling of the term 'pure o' and read a few articles, and they taught me more about covert compulsions and as a result I ended up having a bit of a breakthrough today.  

I was diagnosed with OCD 8 months ago and had 20 CBT sessions and read several books but I've not made a lot of progress towards recovery despite really trying, but this evening I feel calm for the first time in months.  This is because I realised that a lot things which I do, and I thought were simply part of my personality, for example reading about science, checking the news every few hours etc. are actually compulsions.  So I tried cutting them all out, but at the same not actively avoiding them, and after an hour of intense anxiety this morning I now feel strangely rational. 

So, agreeing with mdlbrightchild, I do think there is a problem with insufficient info about recognising covert compulsions, and lack of understanding by some mental health professionals. 

 

Link to comment
11 hours ago, mdlbrightchild said:

I think there does need to be some sort of classification between OCD with covert compulsions, and OCD with overt compulsions.

I would not necessarily disagree with this, I don't have a suggestion other than for now perhaps it comes down to using Snowbear's suggestion again, so that when we talk about this we simply say 'I have OCD with covert compulsions, which are counting rituals in my head'. Only a few more words, but tells everyone what your compulsion is and that it is OCD.

Have you never had physical compulsions either? checking stuff with other people (reassurance), avoidances?

11 hours ago, Wren said:

I do think there is a problem with insufficient info about recognising covert compulsions, and lack of understanding by some mental health professionals. 

Agreed Wren, that I guess that's the job of OCD-UK and other anxiety charities to raise awareness about all aspects of OCD.  Just on that note, if anyone either now or in the future is willing to talk about their OCD to the media (any aspect of OCD) then please let me know and I will do what I can to generate opportunities to share your story and raise some awareness.

 

 

Link to comment

On a general note I just want to thank the forum for engaging in the discussion in a positive and construvice manner. I know it's an emotive subject for those with this type of OCD, so I thank you for listening to me and engaging in the conversation.

Link to comment

:thumbup:

The OCD entry on Wikipedia is interesting, they start by saying ...

"Primarily cognitive obsessive-compulsive disorder (also commonly called "primarily obsessional OCD", purely obsessional OCD, Pure-O, OCD without overt compulsions or with covert compulsions)[1] is a lesser-known form or manifestation of OCD."

they then go on to use the term 'pure o' exclusively and also use ROCD, HOCD etc. although it is otherwise well written.  Might be worth asking for it to be edited. 

Link to comment

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
×
×
  • Create New...