What It Is like Living with the Pure-O Type of OCD

I have Primarily Obsessional OCD (Pure-O). My OCD isn’t fully like the OCD people understand best. Or even misunderstand best.

There are many types of OCD, mostly defined by the compulsions people have. It is true that people are obsessed with actions from the seemingly benign (for example, hand-washing) to what may seem odd (an example being avoiding getting body parts stuck in a door jam.) These are examples of real obsession and compulsion pairs. Those with OCD are known for drawing out future eventualities based on these fixations. We’re very good at eventualities. Those with these types of OCD will imagine that they have to control or prevent real-life events through these compulsions.

The universe of OCD is rather misunderstood in general (characters in popular culture that are “so OCD” don’t help the cause, because we with OCD are not merely quirky, we are living in a nightmare of thoughts we don’t want to have that we absolutely must act on.)

Pure-O is a type of OCD where the compulsions are rather muted. I like to explain it as the compulsions exist, but they are turned inward into my brain. I don’t obsessively wash my hands. In fact, if you must know, I wash my hands less often than one should. I do have tinges of thoughts about getting body parts stuck in the door, but those thoughts pass fairly easily.

My world is filled with obsession. That word—obsession—means so much. It defines me, and even those closest to me only see a percentage of it. The problem with not having compulsions as many do with OCD is that my obsessions have no outlet—not even the irrational.

One of the best examples of what I live with every day is my obsession with rewinding time. It is, in fact, this obsession—when explained to a psychiatrist—that my diagnosis of OCD was formed from the more generic “Generalized Anxiety Disorder.” I am in a constant battle with the past, only in my mind (as the past can only exist in one’s mind.) I am in a constant—and immensely strong—state of questioning everything I’ve ever done.

Should I have sent that email? Should I have said things differently in that email? Did the word “irritated,” used in the email I just sent, convey something that will come back and hurt me? Can I have that email back? Is there some way I could get to the computer of the recipient and delete the email from their inbox, so I can take a step back and re-send a further edited version of the email? Could I enlist a hacker to help do this? (I have never gone as far as actually acting on these thoughts—and there lies the crux of the war inside my head!)

I cannot rewind time (I am not a wizard.) But many times I absolutely, in my mind, need to. I have no compulsion at all I can act on, I can only obsess over the eventualities of what I’ve done in the past. And by “done” I mean almost every action that contains any discernable question as to the outcome. Anything that is not ritual—where the outcome is known—I obsess over.

This is why a good portion of my life is ritual. Because I know the outcome. Now, don’t throw a kink into my rituals, and I am pretty good. The purpose of these rituals is different than those with other forms of OCD. They are not compulsions per se, as they are not tied to external eventualities. I have a system of 48 towels used each for very specific things. Some are rotated, there is a whole methodology. This merely gives me comfort, it does not—in my head, and unlike in the heads of those with OCD where compulsion is king—affect how things will play out in my life and in the lives of others. It is merely a ritual for the sake of predictability.

Unfortunately, I can only live in the world of the ritual so much. I live in the world outside my head as well. Some who observe me would say I live inside my head more so than the average person, and they are right. But I do not live entirely inside my own head.

Because of this, I seek control over everything around me. Now, before you label me a sociopath, note that I do not actually take control over much around me. In fact, I am a rather non-confrontational, and almost diffident person. I am shy to enact any level of control of my surroundings. But I think it! Oh, that is a constant. And that is part of Pure-O.

I am obsessed with the minutiae of every single thing going on around me and how I see it playing out. I can see so many different endings to every single action, that it fills my head. I am often overloaded just thinking of all the various figurative tentacles of realities that could happen.

When I say minutiae, I mean minutiae. I am in a conversation, I am often not saying much. But I am listening to every word, and I am thinking of every synonym to every word, and how using those synonyms could better the outcome for everyone involved—of course including myself in this. Quite.

My brain is a thesaurus of realities.

Yet, with the “primarily obsessional” condition I have, the need to use this figurative thesaurus is almost always turned inward. I just think. And think. And think. I clench my fists, bite my lower lip, shake my leg to the point of cramping muscles. Often and in secret.

The energy I spend obsessing has no ground wire. I have no valve to release the tension caused. It just remains. That is quite literally it. It remains. That is Pure-O. It doesn’t have a tidy conclusion positive or negative. I leave you with nothing of a release with this sketch of my OCD because that is where I am left.

Obsessing. Compulsion, inward. Both utterly unsatisfied and held back from Doing Bad Things. But obsessing in secret. Always obsessing.

Christopher runs the site/blog Yeah OCD (https://yeahocd.com). Diagnosed with Generalized Anxiety Disorder for years, he worked with doctors to uncover his very atypical OCD, which he explores on his site. As well, he is an advocate for mental health issues and writes frequently about the world of mental illness.