The “Pure-O” is manifested by a two-part process: the originating unwanted thought (spike) and the mental activity which attempts to escape, solve, or undo the spike, called rumination. Steven J. Phillipson, PhD, OCDOnline.com

One subtype of obsessive-compulsive disorder (OCD) was coined “Pure O” as far back as 1988 by clinical psychologist Steven J. Phillipson, whose website is OCD Online.

And now the UK has a TV series called Pure based on the same-titled 2015 memoir of Rose (Bretécher) Cartwright.  Although the author’s intrusive thoughts manifested as primarily sexual, this is just one theme experienced by some of those with Pure OCD, otherwise known as pure obsessional OCD.

Stacey Kuhl Wochner, LCSW (Social Work Today), offers this list of possible manifestations:

• thoughts about harming oneself or others;

• thoughts about abhorrent sexual activity, such as pedophilia or incest;

• persistent doubt about one’s sexual orientation;

• persistent doubt about one’s romantic partner;

• antireligious thoughts; and

• thoughts about normally unnoticed somatic functions, such as blinking, swallowing, or breathing.

…And also explains an important point:

The label Pure O, in addition to the covert nature of mental compulsions, causes some clients to mistakenly believe they do not carry out their compulsions. With OCD, compulsions are always present, whether mental rituals or observable compulsions. Since individuals with Pure O fear the negative consequences of harmful, violent, or sexually inappropriate thoughts, they perform compulsive mental processes to neutralize fear. Mental compulsions function as a method of figuring out the meaning of thoughts and serve as a desperate attempt to reduce anxiety and distress many fear will never go away.

TV Pure‘s lead character is Marnie, played by Charly Clive. An intro to the series from Eva Wiseman, The Guardian: “The first episode opens in Scotland at an anniversary party while, mid-speech, she tries to fight the images that swell inside her head. The hall becomes a writhing mass of bodies: her mother, her father, her grandma, her friends, no longer politely sipping white wine in their best cardigans, instead heaving into each other in a sweaty orgy. She needs to escape.”

The series will likely show there’s hope for recovery. Per Eleanor Morgan, The Guardian, “Cartwright says she is in a good place now and that, although intrusive thoughts are still a part of her life, having therapy has helped her to manage and accept them. Being on hand to guide Marnie through her own experience was, she says, ‘almost like another kind of exposure therapy’.”

Exposure therapy, or exposure and response prevention (ERP), is actually the go-to treatment, say various experts, including mental health advocate Chrissie Hodges, who also has suffered with this condition and wrote the 2017 PURE OCD: The Invisible Side of Obsessive-Compulsive Disorder.