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Common themes
Primarily obsessional OCD has been called "one of the most distressing and challenging forms of OCD."[3] People with this form of OCD have "distressing and unwanted thoughts pop into [their] head frequently", and the thoughts "typically center on a fear that you may do something totally uncharacteristic of yourself, something ...potentially fatal...to yourself or others."[4] The thoughts "quite likely, are of an aggressive or sexual nature."[5] The nature and type of primarily obsessional OCD varies greatly, but the central theme for all sufferers is the emergence of a disturbing intrusive thought or question, an unwanted/inappropriate mental image, or a frightening impulse that causes the person extreme anxiety because it is antithetical to closely held religious beliefs, morals, or societal mores.[6] The fears associated with primarily obsessional OCD tend to be far more personal and terrifying for the sufferer than what the fears of someone with traditional OCD may be. Pure-O fears usually focus on self-devastating scenarios that the sufferer feels would ruin their life or the lives of those around them. An example of this difference could be that someone with traditional OCD is overly concerned or worried about security or cleanliness. While this is still distressing, it is not to the same level as someone with Pure-O, who may be terrified that they have undergone a radical change in their sexuality (i.e.: might be or might have changed into a pedophile or become homosexual), that they might be a murderer or that they might cause any form of harm to a loved one or an innocent person, or to themselves, or that they will go insane. They will understand that these fears are unlikely or even impossible but the anxiety felt will make the obsession seem real and meaningful. While those without primarily obsessional OCD might instinctively respond to bizarre intrusive thoughts or impulses as insignificant and part of a normal variance in the human mind, someone with Pure-O will respond with profound alarm followed by an intense attempt to neutralize the thought or avoid having the thought again. The person begins to ask themselves constantly "Am I really capable of something like that?" or "Could that really happen?" or "Is that really me?" (even though they usually realize that their fear is irrational, which causes them further distress)[7] and puts tremendous effort into escaping or resolving the unwanted thought. They then end up in a vicious cycle of mentally searching for reassurance and trying to get a definitive answer.[8] Common intrusive thoughts/obsessions include themes of: Responsibility: with an excessive concern over someone's well-being marked specifically by guilt over believing they have harmed or might harm someone, either on purpose or inadvertently.[9] Sexuality: including recurrent doubt over one's sexual orientation (also called HOCD or "homosexual OCD"). People with this theme display a very different set of symptoms than those actually experiencing an actual crisis in sexuality. One major difference is that people who have HOCD report being attracted sexually towards the opposite sex prior to the onset of HOCD, while homosexual people whether in the closet or repressed have always had such same sex attractions for lifelong.[10] The question "Am I gay" takes on a pathological form. Many people with this type of obsession are in healthy and fulfilling romantic relationships, either with members of the opposite sex, or the same sex (in which case their fear would be "Am I straight?").[11][12]
Primarily Obsessional OCD Violence: which involves a constant fear of violently harming oneself or loved ones or persistent worry that one is a pedophile and might harm a child.[13] Religiosity: manifesting as intrusive thoughts or impulses revolving around blasphemous and sacrilegious themes.[14] Health: including consistent fears of having or contracting a disease (different from hypochondriasis) through seemingly impossible means (for example, touching an object that has just been touched by someone with a disease) or mistrust of a diagnostic test. Relationship obsessions (ROCD): in which someone in a romantic relationship endlessly tried to ascertain the justification for being or remaining in that relationship. It includes obsessive thoughts to the tune of "How do I know this is real love?" "How do I know he/she is the one?" "Am I attracted enough to this person?" or "Am I in love with this person, or is it just love?" "Does he/she really love me?" and/or obsessive preoccupation with the perceived flaws of the intimate partner. The agony of attempting to arrive at certainty leads to an intense and endless cycle of anxiety because it is impossible to arrive at a definite answer.[15]
Primarily Obsessional OCD resolution. In another example, the spike would be, "Maybe I said something offensive to my boss yesterday." A recommended response would be, "Maybe I did. I'll live with the possibility and take the risk he'll fire me tomorrow." Using this procedure, it is imperative that the distinction be made between the therapeutic response and rumination. The therapeutic response does not seek to answer the question but to accept the uncertainty of the unsolved dilemma.[23]
External links
TheOtherOCD.com (http://theotherocd.com) Pure OCD Forum (http://stuckinadoorway.org/forums/forumdisplay.php?f=41) Am I Gay? Obsessive-Compulsive Disorder Takes Many Forms (http://www.brainphysics.com/yourenotgay. php) The International OCD Foundation (http://www.ocfoundation.org) http://www.ocdla.com/obsessionalOCD.html OCD Center of Los Angeles ROCD Research Unit (http://rocd.net/)
Books
The Imp of the Mind: Exploring the Silent Epidemic of Obsessive Bad Thoughts by Lee Baer, Ph.D. The Treatment of Obsessions (Medicine) by Stanley Rachman. Oxford University Press, 2003 Brain lock: Free yourself from obsessive-compulsive behavior: A four-step self-treatment method to change your brain chemistry by Jeffrey Schwartz and Beverly Beyette. New York: Regan Books, 1997. ISBN 0-06-098711-1. The OCD Workbook by Bruce Hyman and Cherry Pedrick.
License
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