Primarily obsessional obsessive compulsive disorder

Primarily obsessional obsessive-compulsive disorder (also commonly called purely obsessional OCD, Pure-O, OCD without overt compulsions or with covert compulsions) is a lesser-known form or manifestation of OCD. For people with primarily obsessional OCD, there are fewer observable compulsions, compared to those commonly seen with the typical form of OCD (checking, counting, hand-washing, etc.). While ritualizing and neutralizing behaviors do take place, they are mostly cognitive in nature, involving mental avoidance and excessive rumination. Primarily obsessional OCD often takes the form of horrific intrusive thoughts of a distressing or violent nature. For example someone with Pure-O might be terrified they are gay despite only liking girls and explain that away be thinking they are an closet case. Or thinking there are a psychopath despite the evidence to the contrary such as caring for people and feeling sadness if someone gets hurt.