Other Topics in OCD: Pure O, Transformation Obsessions, and Real Event/False Memory OCD
What is “Pure O”?
Despite it’s prevalence in certain corners of the internet (i.e. Reddit, other online forums), the term "Pure Obsessional" or "Pure O" is actually no longer considered a clinically relevant distinction in the world of OCD treatment. The phrase “Pure O” conveys the misguided idea that some individuals with OCD do not engage in compulsions. While it is true that not all OCD sufferers engage in outwardly observable compulsions (checking locks, repeated hand washing, ritualized grooming, etc), those who do not are all but certainly engaging in mental compulsions. Because these compulsions happen within the sanctuary of the mind, they are exhausting, often feeling like a 24/7 courtroom trial where the sufferer is simultaneously the judge, jury, and defendant.
Common Mental Compulsions
Mental Review: Replaying past events to ensure you didn't do something "bad."
Mental Undoing: Replacing a "bad" thought with a "good" or safe thought.
Rumination: dwelling on an obsessional doubt for hours and hours in an attempt to achieve certainty or get an answer.
Hypervigilance: Monitoring your internal thoughts to ensure no forbidden intrusion surfaces.
Repeated praying
Mental Counting
Memory Review: Going back over memories to check for certain feelings to either prove or disprove an obsessional doubt (i.e. looking back on a first date to see if you truly felt sparks for your partner, reviewing your childhood to look for evidence of violent urges, etc.)
Just because others cannot see your compulsions doesn't mean you don’t have OCD!
Transformation Obsessions
Transformation obsessions and morphing fears in obsessive compulsive disorder involve intrusive doubts that a person's body, identity, or essential nature is changing in ways that feel frightening, irreversible, or beyond their control. These experiences are not rooted in a genuine desire to transform, but in the intense uncertainty that accompanies OCD. Someone might become convinced that looking at a particular animal too often will cause them to gradually take on its characteristics, or they may fear that thinking about a fictional creature means they are somehow becoming it. Others worry that exposure to certain media, people, or ideas could alter their face, voice, personality, gender, age, or even species in a literal sense. The obsession is rarely about the transformation itself. It is about the inability to feel completely certain that it cannot happen, no matter how irrational the fear seems from the outside.
Because OCD treats uncertainty as danger, these fears often lead to compulsions that are designed to restore a sense of certainty but instead strengthen the obsession over time. A person may repeatedly study themselves in the mirror for signs that their appearance has shifted, compare old photographs to their current face, avoid television shows or artwork that feature transformations, mentally review memories to prove they have always been the same person, or seek reassurance that they still look or act normal. Some people become hyperaware of ordinary bodily sensations and interpret them as evidence that the feared change has already begun. Others avoid specific words, images, or topics because they worry that merely engaging with them could trigger the transformation. Even when reassurance provides temporary relief, the doubt eventually returns, often with a slightly different question or a new imagined possibility, keeping the cycle of obsession and compulsion going.
False Memory/“Real Event” OCD
False memory and real event obsessive compulsive disorder revolve around persistent doubts about past actions, conversations, or decisions, even when there is little or no objective reason to question them. In false memory OCD, the fear often centers on something that may never have happened at all, such as accidentally harming someone, behaving inappropriately, or committing a serious wrongdoing that the person cannot clearly remember. Real event OCD, by contrast, focuses on something that actually did happen, but the mind exaggerates its significance, endlessly questioning whether it was immoral, unforgivable, or evidence of being a fundamentally bad person. A brief awkward interaction, an insensitive joke from years ago, or a minor mistake at work can become the subject of relentless mental review because OCD insists that absolute certainty about the event or its meaning is necessary.
The compulsions in this subtype usually take place internally, making them difficult for others to notice. Someone may replay the same memory hundreds of times, search for tiny details that could confirm or disprove their fears, compare recollections with photos, messages, or calendars, confess to friends or family in hopes of hearing that they did nothing wrong, or repeatedly search online for stories that resemble their own experience. Many people become convinced that the fact they cannot remember every detail perfectly means they are hiding something from themselves, even though memory is naturally incomplete and changes over time. Instead of accepting ordinary uncertainty about the past, OCD turns every gap in memory into a potential threat, leaving the person trapped in an exhausting cycle of doubt, guilt, and reassurance seeking.
Ready to start?
I offer specialized treatment for “Pure O", “Transformation Obsessions, “Real Event”/False Memory OCD, and other Obsessive-Compulsive Disorder (OCD) presentations both in-person in Lake Charles, Louisiana, as well as online throughout Louisiana. Reach out now to schedule a free consultation.