Pure Obsessions: a Variant of OCD
"Evil thoughts."
Posted Jul 04, 2012
Obsessive-compulsive disorder (OCD) involves intrusive, unwanted thoughts that usually imply some sort of action. (A compulsion.)
Some examples: The obsessional person has the thought that stepping on a crack in the sidewalk will cause some bad things to happen to a member of her family. Therefore, she feels compelled to avoid the crack.
The thought of germs contaminating everything requires the affected individual to wash continuously.
The thought that an intruder may enter through an unlocked door requires the obsessional person to check the door over and over.
Obsessions can be persistent and commanding. Hence, the ordinary meaning of an obsession: an overwhelming preoccupation.
But a variant of OCD is a pure obsessional state. These affected persons are troubled by sudden thoughts or images of awful things, often of that person doing something awful. These thoughts do not involve a compulsion to do anything. In fact, the thought of doing any of these things is repugnant and very upsetting. But the unwanted thoughts come repeatedly, nevertheless. They tend to fall into four categories:
- Violent thoughts, usually against someone who is loved or helpless. Examples: stabbing a child in the eye with a scissors. Picking up a knife and stabbing a stranger. Sometimes these images are gruesome beyond ordinary imagination.
A young woman came to see me with the story that she had become very depressed following the recent birth of her daughter. “I’ve been having evil thoughts,” she said, crying. “I’m the most terrible mother.”
“Wait, let me guess. You’ve been thinking of throwing the baby up against the wall or out the window.”
“How did you know?”
These thoughts are common. There was a time when new mothers imagined stabbing their baby with a safety pin, but that particular preoccupation disappeared when Velcro replaced safety pins as a way of fastening diapers. Another young woman was frightened by the phrase, “murder, murder, murder,” which came to her while she was baby-sitting. (footnote: This taunting thought is quite different than the “command hallucinations” sometimes experienced by paranoid schizophrenics. For one thing, the obsessional person understands that the phrase is coming from her and is not a voice coming from somewhere else.)
2.Shameful sexual thoughts, usually homosexual. “Wouldn’t it be awful ,” a man thinks, “if I suddenly kissed him while he was leaning over my desk.” These thoughts are not accompanied by sexual arousal, but by embarrassment and shame. A woman was troubled by a phrase that came to mind unbidden, “Cary Grant’s penis.” There was no meaning to these thoughts, she told me, although it was true that Cary Grant reminded her in some ways of her father. Or at least that was the explanation given to her by a previous therapist, a psychoanalyst.
3.Just plain disgusting thoughts. These are so ridiculous, commonly, that they seem funny to everyone, except the person who is having them. They even seem absurd to people who, themselves, have other obsessional thoughts. For instance, drinking urine out of a puddle with a straw, kissing someone’s pimply ass, and so on.
4.Sacrilegious thoughts. Picturing the Virgin Mary with a penis, or imagining Jesus in a sexual situation.
I do not know why people have these thoughts.
I remember a man who had two contrasting attitudes about a mentor: he admired and loved him; and he feared him. He had an obsessional thought of, literally, kissing the man’s ass. All right, that suggests some clever unconscious translation of his feelings towards his mentor, but does not explain why he expressed those ambivalent feelings through the medium of such detailed, intrusive fantasies.
I know, without question, that these varied obsessional thoughts are not due to an unconscious wish to engage in these behaviors. First of all, there is nothing else in the thoughts or actions, or other expressed feelings, of these people that are consistent with such morbid urges. Such behaviors are literally the last thing they would want to do. These thoughts seem to be chosen precisely because they are so contrary to that person’s wishes. They are the worst things that person can imagine.
I hesitate to generalize from my experience, which probably includes only at most a couple of dozen of these patients, but I notice that many of these affected individuals are especially proper and controlled people. Maybe these thoughts represent some wish to break out of confining ethical standards.
I saw a woman who had had a baby three weeks before. She told me, “This kid never sleeps. Sometimes I feel like bopping him or throwing him up against the wall.” No sense of horror or dismay. She felt comfortable expressing these thoughts, which she understood she would never act upon; and she did not feel embarrassed by them. Unlike the woman mentioned above, I would not expect this particular woman to express herself through obsessional thoughts.
Maybe pure obsessional thoughts are an expression of a “too up-tight” personality. This is the kind of explanation that gives psychiatry a bad name. I mention this thought only because I have had it. Even though I knew some of these people well, I would never have been able to predict that they would have developed this symptom.
Treatment:
Obsessive-compulsive disorder, when mild, is disruptive to ordinary life. When severe, it can have a devastating effect. These pure obsessions have no effect on the way the affected individuals live. They are important only because they frighten and dismay the person having them. They are uncomfortable. They do not lead to greater problems. Treatment, therefore, involves convincing the patient of three things:
- These ideas, in an obsessional person, never lead to action. There are people who do awful things, sometimes unimaginable things; but they are not appalled by the prospect of doing them. So much can be said also about homosexual obsessions. People who are homosexuals and engage in homosexual acts are not horrified by having homosexual thoughts. (Although in certain religious communities they are told that they should be horrified.)
- These ideas do not mean that the people having them are morally flawed. Quite the contrary.
- Talking to someone about these obsessions—like talking about fantasies in general-- tends to lessen their impact.
Usually, patients respond to treatment well. I try to be reassuring, -- I look bored, therefore, not concerned-- and sometime later, when I enquire about these thoughts, I am usually told they have gone away. (c) Fredric Neuman 2012 Follow Dr. Neuman's blog at fredricneumanmd.com/blog
yup
I would say that I have my "top on too tight" and I do have those obsessive intrusive thoughts. My sister and I both obsess on situations that we are wishing we could control. She actually has an OCD diagnosis,but she doesn't have typical compulsions.
She does have trichotillomania and has since about the time she was molested as a young child (by a neighbor). I have an Asperger's diagnosis. I perseverate, but I enjoy my perseverations.
I have intrusive thoughts that are basically random phrases that I would compare to the words or phrases that a Touretter blurts out. I don't ever say them aloud, though. These words or phrases suddenly pop into my head as I'm thinking about something else. They are intrusive, but not shocking or vulgar, usually. (Sometimes they are unusual English words or foreign language words that I had heard recently).
I also have intrusive thoughts that shock me, generally related to the private parts of a person I'm conversing with (as described in your article). The inappropriate thought disgusts me and I push it out of my head. It usually doesn't come back immediately.
A psychologist suggested that I have could OCD because of odd intrusive phrases, but I don't have the typical compulsions of OCD... which is why I find your article so helpful.
Thanks.
When was yet another label created for this?
I have this, but I have GAD. My mother also had this (we sometimes compare the intrusive thoughts we've had) and was diagnosed - on the basis of this particular symptom - with anxiety neurosis when that term was still used.
There's always been a fine line between GAD and OCD. If I stand at a train platform then the minute I hear a train I will see a vivid image in my mind of me running in front of the train and I'll take a step backwards "to stop myself" even though I know I won't do it. I've also had people hide all the knives in the house because I thought I might lose control and commit suicide (I wasn't suicidal). I've had to walk away from small children and animals because I thought I would kill them. I clutch my hands in the passenger seat of cars in case I grab the steering wheel and kill us all, I do the same to stop me from sending company-wide emails with embarrassing personal facts about myself in them, or to stop me taking my clothes off in public or masturbating in front of my boyfriend's parents. Obviously, I don't think I'll do any of these things. But the thoughts are strong enough and unexpected enough to make me want to protect myself in some way, just in case...
I've spoken to many doctors about this over many years, and my mother did the same when she had the problem, many doctors have said "ah yes, this is a common symptom of generalised anxiety disorder, loads of my patients have it".
My question is: Is it worth creating another category - this pure obsessional disorder - to distinguish the point where GAD starts to merge with OCD? Do we need another label when this symptom is so well known?
This may seem like a silly
This may seem like a silly question, but I noticed a seeming discrepancy in your article. In one paragraph you wrote: "I know, without question, that these varied obsessional thoughts are not due to an unconscious wish to engage in these behaviors." However, a couple of paragraphs down you noted, "Maybe these thoughts represent some wish to break out of confining ethical standards." I have mild OCD and have always found comfort in knowing that my obsessional thoughts are NOT because I want to engage in a behavior. However, from the second sentence it seems as though you feel that these thoughts could mean that somewhere deep down, I want to do the things I'm thinking about to "break free." As someone who ruminates relentlessly (at times) about what my thoughts mean, I find this incredibly anxiety-provoking to think that they COULD mean something.
(This post just probably goes to show how I ruminate too much over simple internet posts!)
I suppose my question is, do these thoughts actually represent any kind of wish to break out of a standard? I like to think that they don't.
Silly thoughts
Just wondering about the content of the thoughts when it comes to OCD. I was diagnosed with OCD about 13 years ago and have had every theme you could possible imagine. Now I am kind of having ridiculous thoughts where I might look at something or someone and straight away think something totally ridiculous like "imagine having sex with that or this person" and I will have to visualise this. It is extremely distressing because it does not even make sense and cannot be done anyway, so what I am asking is this, can OCD make you have absurd, imaginitive thoughts and even though you know they are ridiculous, they still seem to upset you?
silly thoughts contd..
I just thought i might add something here, it's almost like whatever I think about (whether it be something that I saw on the news, a memory, or just simple thoughts) I have to distort it but thinking something totally risiculous in relation to it. I have not had a response yet doctor, can you please shed some light on my question. many thanks..
Silly thoughts
I am not a doctor just someone who has the same problem has you and the answer is yes. OCD makes the thoughts seem real that they will upset you. Its a problem in thought processes. Everyone has strange thoughts for me I noticed I have more than most but I am also highly creative. I read once that people with OCD are very creative people. Which makes sense since your mind can make up so many things. If you need help look up the 4 steps in OCD it's very helpful. Remeber it's not you it's the OCD thinking process.
Silly thoughts
I am not a doctor just someone who has the same problem has you and the answer is yes. OCD makes the thoughts seem real that they will upset you. Its a problem in thought processes. Everyone has strange thoughts for me I noticed I have more than most but I am also highly creative. I read once that people with OCD are very creative people. Which makes sense since your mind can make up so many things. If you need help look up the 4 steps in OCD it's very helpful. Remeber it's not you it's the OCD thinking process.
do others have these thoughts?
hello. i am 3o years old and i have suffered with ocd since i was a child. i have been feeling very suicidal recently. i have had every thought you could think of,... sexual. germs, violence, religious etc. but recently i have been having thoughts about turning into something else, ie elephant or something like a fly or ant?. i have no idea why i keep getting these thoughts but it is extremley frightening.its not just the thought i get but the feeling and sensation too. i would like to know if anyone else has had these thoughts too?. if the thought is about god or cleaning etc, at least i know that others have those thoughts, but i feel very alone with the other thoughts. thank you.
This is me!
Hello. I am a 20 year old college student, and I struggle very much with Pure OCD. When I was a young child I began having unwanted thoughts that would come in waves, such as "Fuck you" . and over the past 10 years or so, the obsession has stuck with sexual themes, usually about having sex with a teacher, family member, or random stranger. At times I think about seeing people naked also. It's been so horrifying and frustrating, especially when i feel that these thoughts drown out all of my other normal thoughts. I haven't really told anyone about it, or when I've tried I've been met with vague responses. I've been able to "ruminate" or counter most of these thoughts with the phrase "having sex with my future husband" (I am a strong christian with a desire to save sex for marriage, and thinking this phrase doesn't give me as much anxiety). However, now I think this phrase dozens or even hundreds of times a day, whenever any anxious thoughts tend to arise. Any help would be much much appreciated, especially concerning how to tell my family/doctor/counselor about all of this. Thank you!
to everyone else who has shared on this page, thank you. You've helped me realize I'm not alone!!
obsessing over person
I don't know if this is a symptom of O.C.D.I used to obsess about my weight and was anorexic.Over the years,If I made a friend,I would get to the point where I would think about them every second of every day,despite being married and having children.I like this friend a lot and every chance I get to be around her,I take.Its almost to the point of being a stalker but not wanting to.I find myself going to her for advice constantly,its excessive,I won't intrude on her,her family,etc but I'm tired of having this one track mind and figuring out how to reduce this.
the cure to pure o and how i found it
http://pureoocdcure.tumblr.com/
Strange Thoughts
I have had intrusive thoughts for quite some time now and its not all the same thoughts. It always changes over time. I have worried that I might commit suicide someday, even though I would never do it. I had thoughts about me losing my religion. I worried that I was falling away from my faith. I still have worries that I will catch the stomach flu. I have special rituals during the flu season, including washing my hands until they bleed or not touching certain things. I am currently having intrusive thoughts that I could be gay even though I have been straight my whole life. These thoughts, when they happen, really cause stress and anxiety; to the point of feeling sick. I know i will never act upon these thoughts but they seem real to me at the time and my mind is consumed. It is a terrible feeling because i cannot get rid of them. These thoughts are ruining my life.
I have tried the three parts to his treatment and it seems to help a little bit. I just want these thoughts to end. All the others have passed in time and im sure this one will but for now it is taking over my life.
Pure OCD
Has anyone experienced masturbation as a ritual brought on my these sexual intrusive thoughts that have been seen on porn sites? My son starts masturbating but has to do it so many times (normally in threes) and then the OCD changes the goal posts and he cannot stop. My son has high functioning autism so he's highly intellegent but cannot stop doing this which has then caused other rituals too. Please get in touch if you have. I have get to meet anyone else who has the same type of OCD, and I'm wondering if it is Pure OCD or not?
ocd
Just wondering if we can still post questions about ocd on this forum. I am experiencing a relapse and need some reassurance.
Similar experiences
Dr Neuman:
This is an interesting phenomenon. I have seen three cases like this in our trauma program. What is interesting is that they all manifest in such similar ways, even though the thoughts are different. 2 of the clients responded well to OCD/Anxiety medication and one did somewhat better with psychotherapy, although his OCD was more pronounced and his pure obsessions were more subdued.
I hope people when they are seeking help for this can express all of their symptoms to their health care provider and ensure that everyone understands what they are experiencing. Even though these thoughts can be disturbing, embarrassing, and scary this is a rare enough problem that some might miss the diagnosis, or even misdiagnose.
Thanks for the insightful article.
Michael Allison
Marriage and Family Therapist
Similar Experiences
Hi, I found your comment to be very interesting from a Therapist's perspective. I am a textbook case of sometimes debilitating "Pure O". It started when I was 20 and I thought I was going crazy. I am now 47. It can be non existent for months and then all of a sudden out of nowhere the thoughts start and goes through several cycles, sometimes for days or weeks. Then one day I will wake up and it has all stopped. It is like you are fighting your own mind. I really believe it's a chemical imbalance or hormonally driven in some way. I take an anti-depressant and it seems to help about 75%. I have always had to be on one. I do get breakthroughs even with the meds but have the tools to fight the beast.
The only people that know are those I have told. You wouldn't know by talking to me that I may possibly be spiralling down hill. I do work. When it is bad it takes all that I have to get there but fighting through seems to be the key to success for me.
I agree that people have to be honest with their physicians so they are properly diagnosed and not to be ashamed. It is a very strange and real anxiety disorder that tortures the soul. On a positive note, I really do appreciate more than most people what a good day feels like!!
Thanks for Listening
Violent thoughts
I have been having violent thoughts for a long long time. Sometimes it used to be just torturing a good friend or sometimes killing parents in the most horrific ways ( which also felt artistic, adding to the horror), or killing people, soldiers ( sometimes of other countries), or killing people for hurting someone I love, etc... I'm not particularly bothered but I really want to know WTF is going on and if there's something needs fixing. I wouldn't claim to be nice (but brutally honest ) but I don't think I am highly motivated to act on any of those thoughts.