Understanding OCD Subtypes: Personal Stories from Women Living with Lesser-Known Variations

OCD: More Than Just Cleanliness – Understanding ‘Pure O’ and relationship Subtypes

March 24, 2025

By Archyde News staff

Obsessive-compulsive Disorder (OCD) is often portrayed in media as a fixation on cleanliness and order. however, this narrow depiction fails to capture the diverse and often distressing reality for millions of Americans living with the condition. Today, we delve into two lesser-known subtypes of OCD: “Pure O” and Relationship OCD (rOCD), exploring their unique challenges and offering insights into effective coping strategies.

For many, the experience of OCD extends far beyond handwashing and arranging objects. It can manifest as intrusive thoughts, intense anxieties, and compulsive behaviors aimed at neutralizing those anxieties. These compulsions can be mental, rather than physical, making the disorder less visible but no less debilitating.

Consider the experience of Keagan and Lisa, who share a similar type of guilt despite it evolving from something that isn’t happening.

“I would check and recheck candles, stoves, you name it.”

According to experts, the common thread that connects these experiences is OCD. As one expert, Kastens, explains, “At the end of the day, it’s all OCD, and your themes can always change. If you have Pure O, that doesn’t mean you’ll never have rOCD.”

The Intrusive World of ‘Pure O’ OCD

“Pure O,” or Primarily Obsessional OCD,is characterized by persistent,unwanted,and intrusive thoughts without overt physical compulsions.Individuals with Pure O may experience disturbing images, ideas, or impulses that cause significant distress. To manage this distress, they often engage in mental rituals, such as reassurance seeking, mental reviewing, or thought suppression.

Unlike the stereotypical image of someone with OCD meticulously cleaning, a person with Pure O might be plagued by thoughts of harming a loved one, even though they have no intention of acting on those thoughts.The anxiety stems from the fear that they *might* be capable of such an act, leading to intense self-doubt and guilt. For example, someone might repeatedly analyze past conversations to ensure they didn’t say anything offensive, or mentally rehearse scenarios to prepare for potential triggers.

The impact of Pure O on daily life can be profound. It can interfere with work, relationships, and overall well-being. Individuals may avoid situations or people that trigger their obsessions, leading to social isolation and decreased quality of life.

Recent Developments in Pure O Treatment:

Cognitive Behavioral Therapy (CBT),particularly Exposure and Response Prevention (ERP),remains the gold standard for treating pure O. However, recent research has explored the potential benefits of Acceptance and Commitment Therapy (ACT) in helping individuals accept intrusive thoughts without engaging in mental rituals. ACT focuses on values-based living, encouraging individuals to pursue meaningful activities despite the presence of unwanted thoughts.Additionally, mindfulness-based interventions are being investigated for their ability to improve attention regulation and reduce reactivity to intrusive thoughts.

Relationship OCD: When Anxiety Targets Love

Relationship OCD (rOCD) is a subtype were obsessions and compulsions center around romantic relationships. Individuals with rOCD may experience doubts about the strength of their feelings for their partner, their partner’s feelings for them, or the overall suitability of the relationship. These doubts can trigger compulsive behaviors aimed at seeking reassurance or resolving uncertainty.

Common rOCD obsessions include:

• Doubts about love: “Am I really in love with my partner?” “Does my partner truly love me?”
• Focus on perceived flaws: “is my partner attractive enough?” “Do we have enough in common?”
• Comparison with others: “Am I settling?” “Coudl I find someone better?”

These obsessions lead to compulsions such as:

• Reassurance seeking: Constantly asking their partner for affirmation or testing their love.
• Mental reviewing: Analyzing past interactions for signs of incompatibility or lack of affection.
• Avoidance: Avoiding intimacy or emotional vulnerability to protect themselves from potential heartbreak.

Danielle, 33, knows this struggle all too well. When entering a new relationship, her anxiety escalates beyond the typical first-date jitters.She experiences rOCD,which fixates on her romantic life,prompting an intense thought spiral. “Did she say the wrong thing? Why did her partner take five extra minutes to text back? Does she even love them? Do they love her?” These questions loop endlessly, causing exhaustion.”When you have relationship anxiety, you might convince yourself that you’re not attracted to your partner, so you avoid sex with them,” says Kastens. “You might have retroactive jealousy and distressing images of their sexual past,despite having one of your own.” You might also be convinced they’re not in love with you, despite them being all-in.This was Danielle’s case, which ultimately caused her to seek internal and external reassurance.

One way to combat seeking reassurance is to not do it. According to Kastens,”sitting with that uncertainty is better than seeking reassurance…mental compulsions, like reassurance seeking (whether from others, the internet, or yourself), can worsen anxiety in the long term, especially when it involves others.”

rOCD in the Age of Social Media:

Social media can exacerbate rOCD symptoms. The constant exposure to idealized relationships and curated portrayals of love can fuel doubts and comparisons. Individuals with rOCD may spend hours scrutinizing their partner’s social media activity, looking for evidence of infidelity or dissatisfaction. The “highlight reel” effect of social media can create unrealistic expectations and intensify feelings of inadequacy.

“Listen, I’m the opposite of what most people think when they hear ‘OCD,’ My house is a mess. I’m not super tidy. I’m not particularly concerned about germs.”

Practical applications and Coping Strategies

Understanding the nature of OCD and its subtypes is the first step toward effective management. The following strategies can help individuals cope with Pure O and rOCD:

1. Seek Professional Help: A mental health professional specializing in OCD can provide an accurate diagnosis and develop a personalized treatment plan.
2. Exposure and Response Prevention (ERP): This CBT technique involves gradually exposing oneself to feared thoughts or situations while resisting the urge to engage in compulsive behaviors.
3. Cognitive Restructuring: Identifying and challenging negative thought patterns can help reduce anxiety and improve emotional regulation.
4. Mindfulness and Acceptance: Learning to observe thoughts and feelings without judgment can decrease reactivity to intrusive thoughts.
5. Limit Reassurance seeking: Resist the urge to seek reassurance from others or engage in mental rituals. Instead, practice sitting with uncertainty and tolerating discomfort.
6. Focus on Values-Based Living: Pursue activities and goals that are meaningful and align with your values, even in the presence of OCD symptoms.
7. Support Groups: Connecting with others who have similar experiences can provide validation, reduce feelings of isolation, and offer practical coping strategies.

US-Based Resources for OCD:

Organization	Description	Website
International OCD Foundation (IOCDF)	Provides facts,resources,and support for individuals with OCD and their families.	iocdf.org
Anxiety & depression Association of America (ADAA)	Offers educational materials, support groups, and a therapist directory.	adaa.org
The TLC Foundation for Body-Focused Repetitive Behaviors	While focused on BFRBs, they offer resources relevant to OCD and related conditions.	bfrb.org

Hope and Healing: rewriting the OCD Narrative

Living with OCD, whether it manifests as Pure O or rOCD, can be incredibly challenging. Though, with appropriate treatment and support, individuals can learn to manage their symptoms, reclaim their lives, and build fulfilling relationships. It’s crucial to remember that thoughts are just that – thoughts. They don’t define who you are or dictate your actions.

The important takeaway is to remember thoughts are just thoughts. “You’ll see all these social media posts like, ‘your thoughts are your reality!’ ‘Your thoughts manifest your destiny,’” For someone with OCD, Danielle says, that’s simply not the case: Don’t listen to that, she says.

By increasing awareness, reducing stigma, and promoting access to evidence-based treatments, we can empower those living with OCD to rewrite their narratives and embrace a future filled with hope and healing. The key to remember is to educate yourself and others with OCD, so that you recognize it, whether within yourself or someone you love.

On embracing discomfort, remember, as highlighted in Psychology Today, living with OCD can make it arduous to take the steps required to change one’s mindset. Though, various therapies can instill confidence in patients that they have the power to rewrite their own story.

What are some effective strategies for managing Pure O symptoms in daily life?

OCD: A Conversation with Dr.Evelyn Reed on ‘Pure O’ and Relationship OCD

interviewer: welcome, Dr.Reed, and thank you for joining us today to discuss Obsessive-compulsive Disorder, or OCD. We’re focusing specifically on “Pure O” and Relationship OCD, two subtypes that are often misunderstood. Can you start by explaining what “Pure O” OCD entails?

Dr. Reed: Thank you for having me. certainly. “Pure O,” or Primarily obsessional OCD,involves intrusive,unwanted thoughts and mental obsessions without the presence of obvious,outwardly visible compulsions.Individuals experience significant distress from these thoughts,wich can range from disturbing images to fears of harm,perhaps leading to intense anxiety and self-doubt.

Interviewer: That’s a stark contrast to the common portrayal of OCD. And what about Relationship OCD, or rOCD? How does that manifest?

Dr. Reed: rOCD is characterized by obsessions and compulsions specifically related to romantic relationships. People with rOCD might constantly question their feelings, their partner’s feelings, or the overall suitability of the relationship. These doubts trigger compulsive behaviors such as reassurance-seeking from their partner and obsessive mental reviewing of past interactions.

Understanding the Nuances of OCD Subtypes

Interviewer: It seems like both Pure O and rOCD can significantly impact daily life. are there any specific challenges unique to each subtype?

Dr. Reed: Yes, absolutely. With Pure O, the internal nature of the compulsions, such as mental reviewing or thought suppression, can make it challenging for others to recognize the disorder. This can lead to isolation and a lack of support.rOCD is exacerbated by social media, with its curated portrayals of relationships, fueling doubts and comparisons. This can create unrealistic expectations and intensify feelings of inadequacy.

Interviewer: What are the most effective treatments for these OCD subtypes?

Dr. Reed: Cognitive Behavioral Therapy, especially Exposure and Response Prevention (ERP), is the gold standard.ERP helps individuals confront their fears and resist compulsions. Acceptance and Commitment Therapy (ACT) is also proving beneficial by helping individuals accept intrusive thoughts without engaging compulsions, while recent research explores the potential benefits of mindfulness-based interventions. For rOCD specifically, learning to sit with uncertainty and reduce reassurance-seeking is vital.

Practical strategies and Long-Term Management

Interviewer: What practical advice would you give someone struggling with Pure O or rOCD?

Dr. Reed: First, seek professional help. A therapist specializing in OCD can provide an accurate diagnosis and personalized treatment plan. Secondly, consider exposure and response prevention. Lastly,practice techniques of cognitive restructuring and mindfulness to manage intrusive thoughts. Remember that thoughts are just thoughts; they don’t define yoru reality.

Interviewer: The role of social media in rOCD is something we touched on briefly. Beyond individual coping strategies,how can society at large better support those with these subtypes?

Dr. Reed: Increasing awareness and reducing the stigma associated with OCD is crucial. We need to promote accurate portrayals of the condition and ensure access to evidence-based treatments. Support groups and online communities can be invaluable for connection and shared strategies.

Interviewer: Dr. Reed,what message of hope would you offer to someone living with Pure O or Relationship OCD?

Dr. Reed: There is hope,and recovery is absolutely possible.With the right treatment, support, and a commitment to self-care, people can manage their symptoms, improve their quality of life, and build fulfilling relationships. Remember that you are not alone, and even if OCD makes it arduous, there are many ways to rewrite your story. What are your thoughts, readers? Share in the comments section how you’ve found ways to deal with intrusive thoughts.

Thank you for sharing your expertise with us today, Dr. Reed. This insights will make a difference to readers who struggle with these conditions.