Have all therapists heard of "Pure O" OCD?
April 18, 2017 6:56 PM   Subscribe

After hearing it described on a podcast and doing a lot of googling, I'm 99.9% sure that I have "pure obsessional" OCD. I'm currently seeing a therapist for anxiety, and I want to tell them about the OCD too – but they're a "mental health counselor" at a low-cost clinic. Is it possible they wouldn't have heard about this OCD variant?

To give you a little more background, they're a certified mental health counselor with a psychology degree who has been treating me with CBT.
posted by cookiedough to Health & Fitness (7 answers total) 1 user marked this as a favorite
Yes. They should have heard of this. They have a psychology degree and are a certified mental health counselor. That they work at a low cost clinic shouldn't really matter. If it was me, I wouldn't have any issues at all discussing this with any therapist with the background you mention, regardless of where they worked.
posted by ilovewinter at 7:16 PM on April 18

Psychiatrists do differentiate between obsessions and compulsions, if that's what you're asking.

I have not personally heard of "pure obsessional" OCD as a formal DSM diagnosis, but can understand that OCD may have more prominent obsessive symptoms rather than compulsive symptoms. The criteria for OCD (link is to the official DSM-5 online, but if you can't access it, here is another link that provides the same information) clearly states that patients may have either obsessions or compulsions. It also specifically defines both "obsession" and "compulsion".

I think that the rapport established between you and your counselor will ultimately matter more than the degree they hold.
posted by gemutlichkeit at 7:17 PM on April 18 [2 favorites]

Most therapists are probably going to refer to this as "obsessive thoughts", typically an indication of an anxiety disorder.

And, in answer to your question, I'm a therapist and had never heard of it referred to as pure obsessional OCD or, as the internet just told me, pure-O. Obsessive thoughts and obsessive thinking are common phrases in my office.
posted by HuronBob at 7:17 PM on April 18 [8 favorites]

I've never heard of the term pure O but as soon as you defined it I knew exactly what you were talking about (LCSW not working as a therapist).
posted by AlexiaSky at 8:19 PM on April 18 [1 favorite]

My friend was diagnosed with "Pure O OCD" when she was pregnant. She was seeing a psychiatrist. Sometimes psychiatrists will differentiate, even if the DSM V doesn't have a category. They might not write it up in a report with those words.
posted by shockpoppet at 8:42 PM on April 18 [2 favorites]

Did you see Harry Styles on SNL with Jimmy Fallon? Who knew he was so talented? You should watch this clip.

I know that is a non-answer and here's why I did that: worrying about whether or not your therapist is qualified and will know this term is your obsessive brain needing reassurance.

I have a kid who was diagnosed with Pure O OCD; he didn't demonstrate scrupulosity or handwashing or religiosity or any compulsive behavior except for reassurance seeking.

Reassurance seeking is tricky because there is a fine line between being responsible versus OCD-driven doubt, and your question is a manifestation of needing certainty. If my son was asking this, after years of treatment and family therapy I would know to immediately change the subject and refuse to answer him. This seems cruel, but I learned that the person with OCD has to and CAN manage living with uncertainty and every time one engages with what may be a perfectly normal question, they've just fed that OCD-brain that needs reassurance. Even an answer of, "I can't answer this" acknowledges the need for reassurance is there.

If you were my kid, I'd change the subject and refuse to respond. Since this is an AskMe, I suggest you tell your therapist about this question.

And CBT is the preferred treatment for OCD, so you're in good hands (which is not meant to reassure you but is a statement of fact.)
posted by yes I said yes I will Yes at 2:44 AM on April 19 [5 favorites]

Questioning whether your therapist is right for you based on the kinds of illness they have experience treating is a totally reasonable thing to do as a health consumer and isn't "reassurance seeking". Definitely ask them about this, and pursue other therapists if you both agree on this diagnosis and it's not something they have experience with.
posted by colorblock sock at 9:57 PM on April 20

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