What is Pure OCD?

Summary

The video script delves into 'Pure' OCD, a form of obsessive-compulsive disorder characterized by intrusive, distressing thoughts rather than physical compulsions. Sufferers grapple with fears of committing heinous acts, despite having no actual intent. Treatment approaches vary, with psychotherapists emphasizing the root cause as self-esteem issues and shame, suggesting that overcoming this disorder involves repairing self-loathing and learning self-compassion.

Takeaways

• 🧠 'Pure' OCD, also known as Intrusive Thoughts, is a form of mental affliction where individuals experience distressing thoughts without any outward physical compulsions.
• 😨 Sufferers are tormented by unwanted thoughts of committing heinous acts, such as harming loved ones or children, despite despising these ideas.
• 🔍 The condition is internal, with no physical manifestations, making it a more隐蔽 and distressing form of OCD compared to the standard version.
• 🤔 The distress stems from a deep-seated fear that they might be psychopaths, rapists, or pedophiles, leading to a constant internal search for evidence of such tendencies.
• 🚫 The intrusive thoughts can be so overwhelming that individuals may avoid certain places, objects, or social situations to prevent acting on these thoughts.
• 💊 Psychiatrists often prescribe antidepressants to alleviate the general mood and reduce the compulsion to ruminate on these thoughts.
• 🧐 CBT psychologists engage in logical arguments with the intrusive thoughts to help sufferers recognize they have no actual intention to harm.
• 💭 Psychotherapists approach the issue by addressing the root cause, which they believe is tied to self-esteem and shame, rather than the thoughts themselves.
• 👤 The condition is often linked to a history of traumatic and degrading experiences, leading to a fundamental sense of unworthiness and self-loathing.
• 🔄 Pure OCD can manifest after positive life events, as the individual's self-esteem remains low and they seek to maintain a sense of inner equilibrium with negative thoughts.
• 🌟 The treatment involves repairing self-loathing and shame through a process of self-compassion and learning to be a friend to oneself, often facilitated by a supportive therapist.

Q & A

What is 'Pure' OCD, and how does it differ from standard Obsessive Compulsive Disorder?

Pure OCD, also known as Intrusive Thoughts, is a form of Obsessive Compulsive Disorder where the distressing thoughts and compulsions unfold purely in the mind without any outward, physical action. Unlike standard OCD, which involves repetitive actions like handwashing or checking gas pipes, 'pure' OCD does not have a physical component.

What kind of distressing thoughts do individuals with 'Pure' OCD experience?

Individuals with 'Pure' OCD are tormented by intrusive thoughts that they may want to commit heinous acts, such as murder, sexual assault, or harm to children, which they themselves despise and fear. These thoughts are often in direct conflict with their values and beliefs.

How does 'Pure' OCD affect the daily life of those who suffer from it?

The condition can severely impact daily life, causing individuals to avoid situations or objects that trigger their intrusive thoughts, such as avoiding children or sharp objects. It can also lead to social anxiety and a constant state of fear and self-doubt.

What is the current understanding of the treatment for 'Pure' OCD?

There is no foolproof treatment for 'Pure' OCD, but approaches include the use of antidepressants to lift mood and reduce rumination, cognitive-behavioral therapy (CBT) to challenge intrusive thoughts logically, and psychotherapy to address underlying issues of self-esteem and shame.

Why do psychotherapists believe that addressing self-esteem and shame is crucial in treating 'Pure' OCD?

Psychotherapists believe that 'Pure' OCD sufferers have a fundamental problem with self-esteem and shame, often stemming from traumatic childhood experiences. They feel undeserving and disgusting, and their intrusive thoughts are an attempt to reconcile this self-judgment with societal expectations.

How do psychotherapists approach the treatment of 'Pure' OCD differently from other mental health professionals?

Psychotherapists do not directly target or argue with the intrusive thoughts. Instead, they focus on the root cause, which is the sufferer's self-loathing and shame, and work on rebuilding their self-esteem through a process of witnessing and validation.

What role do societal judgments and religious beliefs play in the manifestation of 'Pure' OCD?

In societies where religious transgression is particularly condemned, 'Pure' OCD sufferers may be haunted by thoughts that they have offended a higher power. The content of intrusive thoughts can change based on societal definitions of what is considered 'awful' or taboo.

Can you achieve something positive and then develop 'Pure' OCD?

Yes, 'Pure' OCD can sometimes be diagnosed after individuals achieve something positive, like a promotion or a fulfilling relationship. The positive event may trigger intrusive thoughts as a way to maintain a low self-esteem, ensuring that their self-judgment aligns with their perceived worth.

What is the underlying cause of 'Pure' OCD according to the script?

The underlying cause of 'Pure' OCD is self-loathing and a deficit of love, often originating from traumatic and degrading childhood relationships, leading to a basic sense of self that is not deserving of existence or happiness.

How can an individual with 'Pure' OCD begin to heal according to the psychotherapeutic approach?

Healing begins with repairing self-loathing and shame through repeated positive interactions with an outsider who offers a generous and sympathetic perspective. This helps the individual learn that they are not the worthless being they perceive themselves to be.

What is the significance of the book 'What is Psychotherapy' in understanding 'Pure' OCD?

The book 'What is Psychotherapy' provides insights into the experience of going through therapy and emphasizes the importance of psychotherapy in treating mental health conditions like 'Pure' OCD by offering a deeper understanding of the therapeutic process.

Outlines

00:00

😨 Understanding Pure OCD

This paragraph delves into the distressing world of 'Pure' OCD, a form of Obsessive Compulsive Disorder that is characterized by intrusive thoughts rather than physical compulsions. Unlike standard OCD, which involves repetitive actions, 'pure' OCD is a mental struggle where individuals are tormented by unwanted, abhorrent thoughts that they fear they might act upon, despite having no intention to do so. These thoughts can lead to severe anxiety and avoidance behaviors, as sufferers become convinced of their potential to commit heinous acts. The paragraph emphasizes the psychological toll of this condition, with sufferers often starting their day burdened by self-loathing and a sense of being undeserving. The treatment approaches vary, with psychiatrists possibly prescribing antidepressants to elevate mood and reduce rumination, while CBT psychologists engage in cognitive restructuring to help patients logically dispute their intrusive thoughts. Psychotherapists, on the other hand, focus on the underlying issues of self-esteem and shame, suggesting that the condition is rooted in a deep sense of self-loathing and a need for internal consistency between self-perception and societal judgment. The paragraph concludes by suggesting that the key to recovery lies in addressing this self-loathing and shame, often through the compassionate witnessing of a therapist who can help the patient reframe their self-concept.

05:05

📚 The Role of Psychotherapy in Treating Pure OCD

The second paragraph shifts the focus to the therapeutic process, emphasizing the importance of psychotherapy in treating Pure OCD. It suggests that the intrusive thoughts associated with the condition are not expressions of desire but symptoms of deep-seated self-distrust. The paragraph underscores the significance of learning to be a friend to oneself, which is a critical aspect of the therapeutic journey. It also references a book, 'What is Psychotherapy', which is said to provide insights into the experience and value of undergoing therapy. The paragraph implies that through psychotherapy, individuals with Pure OCD can begin to challenge and reframe their self-perception, moving towards self-compassion and trust, which are essential for alleviating the symptoms of the disorder.

Keywords

💡Pure OCD

Pure OCD, or 'Pure' Obsessive-Compulsive Disorder, is a subtype of OCD where the obsessions are intrusive thoughts that cause distress without any associated compulsive behaviors. It is characterized by unwanted, distressing thoughts that the individual does not want to have but cannot control. In the script, it is described as a condition where sufferers are haunted by thoughts of committing heinous acts, which they fear and despise, leading to significant distress and a sense of self-loathing.

💡Intrusive Thoughts

Intrusive thoughts are unwanted, involuntary thoughts, images, or urges that cause anxiety or distress. They are a key feature of Pure OCD and are often related to themes of violence, harm, or sexual deviance. The script illustrates this with examples such as thoughts of harming a loved one or sexually assaulting a child, which the individual finds abhorrent but cannot dismiss.

💡Self-Esteem

Self-esteem refers to an individual's overall sense of self-worth or personal value. In the context of the script, it is suggested that individuals with Pure OCD have a problem with self-esteem, feeling fundamentally unworthy and disgusting. This internalized sense of worthlessness is seen as a root cause of their intrusive thoughts, as they seek to align their self-judgment with what they believe society would judge them to be.

💡Shame

Shame is a painful feeling of humiliation or distress caused by the consciousness of wrongs or foolishness. The script posits that shame is a central issue for individuals with Pure OCD, stemming from a deep sense of personal disgust and a belief that they are beyond societal acceptance. This shame can lead to a preoccupation with thoughts that confirm their negative self-image.

💡Psychopath

A psychopath is an individual with a personality disorder characterized by enduring antisocial behavior, diminished empathy and remorse, and bold, disinhibited, and egotistical traits. In the script, the term is used to describe the fears of Pure OCD sufferers who worry that their intrusive thoughts are indicative of being a psychopath, despite having no actual intention or desire to harm others.

💡CBT

Cognitive Behavioral Therapy (CBT) is a form of psychotherapy that aims to change patterns of thinking or behavior that are behind people's difficulties, by challenging and changing cognitive distortions and improving coping skills. The script mentions CBT psychologists who work with Pure OCD sufferers by arguing with their intrusive thoughts, helping them to logically understand that they have no real intention to act on these thoughts.

💡Antidepressants

Antidepressants are a class of medication used primarily to treat depression and other mood disorders. In the script, psychiatrists are described as prescribing antidepressants to Pure OCD sufferers to elevate their mood and reduce the tendency to ruminate on their intrusive thoughts, thereby providing some relief from their distress.

💡Self-Loathing

Self-loathing is an intense form of self-hatred or self-contempt. The script identifies self-loathing as a fundamental issue in Pure OCD, where individuals have a deep-seated belief in their own worthlessness. This self-loathing is seen as driving the intrusive thoughts, as a way for the mind to create a sense of internal consistency with the individual's negative self-concept.

💡Psychotherapy

Psychotherapy is the treatment of mental health issues through talking therapies. The script discusses how psychotherapists approach Pure OCD differently by not directly targeting the intrusive thoughts. Instead, they focus on addressing the underlying issues of self-esteem and shame, aiming to help sufferers develop a more compassionate and accepting view of themselves.

💡Self-Distrust

Self-distrust refers to a lack of confidence in one's own judgment, abilities, or worth. In the context of the script, Pure OCD sufferers are described as experiencing radical self-distrust, which manifests as intrusive thoughts that they fear may reflect their true, hidden nature. The treatment involves helping them learn to trust themselves and understand that their thoughts are not indicative of their character or intentions.

Highlights

Pure OCD is a distressing mental condition that unfolds purely in the mind without outward physical actions.

Individuals with Pure OCD are haunted by intrusive thoughts of committing socially abhorred acts.

Sufferers are convinced of their potential to commit heinous crimes despite despising such acts intellectually.

The fear of being a psychopath, rapist, or paedophile is a common intrusive thought in Pure OCD.

Sufferers are burdened by the need to constantly scan their minds for evidence of their dreadful apprehensions.

Pure OCD can lead to severe anxiety and avoidance behaviors, impacting daily life and social interactions.

Psychiatrists may prescribe antidepressants to alleviate the mood and reduce rumination in Pure OCD sufferers.

CBT psychologists engage in arguing with intrusive thoughts to help sufferers logically dismiss them.

Psychotherapists approach Pure OCD by addressing self-esteem and shame, rather than the thoughts themselves.

The root of Pure OCD is often traced back to a deep-seated sense of self-loathing and a history of traumatic relationships.

Sufferers may feel they do not deserve to exist, leading to a mismatch between their self-perception and societal expectations.

Pure OCD can be diagnosed following positive life events, as sufferers struggle to feel happiness due to low self-esteem.

In religious societies, Pure OCD sufferers may be haunted by thoughts of offending a deity and being exposed as sinners.

The treatment for Pure OCD involves repairing self-loathing and shame through compassionate witnessing and self-acceptance.

The book 'What is Psychotherapy' provides insights into the experience and importance of therapy for mental health conditions.

Pure OCD thoughts are symptoms of radical self-distrust rather than actual wishes or intentions.

Learning to be a friend to oneself is a vital step in overcoming the intrusive thoughts associated with Pure OCD.

Transcripts

Few mental afflictions are as humbling or as terrifying as what is known as ‘Pure’

OCD or, more colloquially, Intrusive Thoughts. In standard Obsessive Compulsive Disorder,

a person is haunted by a worry that compels them to repeat an often counterproductive

or fruitless action with manic intensity: handwashing, turning off gas pipes, checking

their pulse and so on. But in ‘pure’ OCD, there is no outward, physical action; the

problem unfolds – hence the name – purely in the mind, yet it is, if anything, an even

more distressing condition. Image result for Frank auerbach The Pure OCD sufferer is tortured

by thoughts that they want to do, or have done, some of the most censored and abhorred

acts in our societies, acts that they themselves despise and fear at an intellectual level.

They grow convinced of their wish, for example, to murder a loved one, harm a child sexually

or assault a stranger. They cannot shut out the idea that they may become, or have already

shown signs that they are, a psychopath, a rapist or a paedophile. They scan their minds

ceaselessly, looking for evidence to confirm their dreadful apprehension. So burdened are

they by these thoughts, they may not be able to go anywhere near children or may take fright

at the sight of a knife in a drawer. Left alone with a colleague, they may panic that

they could lose control and lunge inappropriately at them. At the station, they are flooded

with anxiety at the feeling that they may push their partner or their child under a

train. Having to think of oneself in these terms quickly drains life of any of its pleasure.

The Pure OCD sufferer wakes up every morning certain that they are one of the worst people

ever to have walked on the planet. There is not, as yet, a foolproof way of treating the

condition – but discussions of how to approach it reveal large differences in assessments

of how the mind operates. Psychiatrists tend to prescribe antidepressants, in order to

lift the general mood of sufferers and thereby lessen the tendency to ruminate to the point

of exhaustion. CBT psychologists will try to argue closely with the intrusive thoughts,

so that eventually sufferers can logically acknowledge that they truly have no intention

of harming anyone or doing anything obscene. But it is psychotherapists

who have what is perhaps the most imaginative and unexpected solution. They do not target

the thoughts themselves or argue with them directly. They don’t try to reassure people

logically that they are not about to murder a loved one or harm a child – because they

don’t believe that this is what is actually at stake and judge that offering reassurance

on these points only legitimates a pattern of thinking that has no basis in reality.

They locate the origin of the problem somewhere quite different: the sufferer of pure OCD

has, first and foremost, a problem with self-esteem and shame. The unfortunate person feels, at

some level, utterly disgusting and beyond the pale – and will in the background have

been feeling like this for a long time. Somewhere in their past, normally as a result of very

traumatic and degrading childhood relationships, they will have derived an impression that

they did not deserve to exist. Their current thoughts are not plans for the future, they

are attempts by the mind to find a match between their basic sense of self and what would be

needed by their society to concur with it. They are a move to bring about a form of dreadful

inner equilibrium, ensuring that the judgement of the world falls in line with the judgement

of the self. Cases of Pure OCD are sometimes diagnosed just after sufferers have achieved

something rather positive in the eyes of others: they have been promoted or begun a fulfilling

relationship or mastered a project. It should be a cause for celebration but happiness simply

feels unwarranted. By latching onto thoughts of complete illegality, one is assured that

one’s self-esteem will remain at rock bottom. Interestingly, in societies that find religious

transgression particularly abhorrent, Pure OCD sufferers will be haunted by feelings

that they have offended God and are about to be outed as sinners. Behind Pure OCD is

a person’s needs to find a reason to feel awful, it isn’t about this or that condemned

act – and as the definition of awful changes, so too will the manifest content of the intrusive

thoughts. The disease is anchored in self-loathing, not in blasphemy, incipient paedophilia or

murderous intent.This analysis opens the way to treatment. What the sufferer of pure OCD

needs, above all else, is to begin to repair their self-loathing and shame. They need to

learn, through repeated encounters with an outsider who casts a generous and sympathetic

eye on them, that they are not the worthless being they take themselves for. Their problem

began with a deficit of love – and needs to be healed by a loving act of witnessing.

Pure OCD thoughts are not wishes, they are symptoms of radical self-distrust – and

these will start to lift once the afflicted learn that most vital of arts: being a friend

to oneself. Our book what is psychotherapy tells us exactly what going through therapy

is like and why it is so important.