Pure O OCD

OCD Specialist

New York City

Anxiety Therapist

You are a good thinker.
That is part of the problem.

You can plan. You can strategize. You can think your way through almost anything. Overthinking probably landed you your degree, career, or other personal achievements. But there is a fine line between thinking through a scenario and compulsively overthinking it.

With Pure O OCD, overthinking is never enough. You may think you have your answer and then your brain finds the next "but" and the spiral takes over again. There is always a "but." "But what about if this happens? But what about this? But what if I didn't take this into account?"

Pure O OCD is often misunderstood because there are no visible compulsions. No checking, no hand washing, no rituals anyone else can see. The compulsion is the thinking itself. The mental spiral that tells you, if you just think about this long enough, hard enough, thoroughly enough, you will be safe. You will be certain. You will be sure.

But certainty does not work that way. No amount of overthinking can give you 100% control, certainty, or safety. The truth is, we cannot ever be 100% in control, certain, or safe. The spiral creates a temporary sense of relief and then the overthinking starts again. And while you are inside it, you are not living. You are exhausted, hopeless, tired, and feel trapped in the overthinking loop.

How Pure O OCD shows up

Pure O OCD looks like intrusive thoughts you cannot stop analyzing. Replaying conversations, decisions, worst case scenarios. Mentally checking and rechecking. Seeking reassurance, from other people or from your own thoughts, that everything is okay. The thoughts feel urgent and important. The thoughts feel like if you stop thinking about them, something will go wrong. Overthinking also does not feel good. You are anxious the whole time. You may think your mind is not your own.

What is actually happening is that your brain has learned that thinking equals safety. ERP is how we disrupt that learned pattern. A lot of clients hear this and think I will stop them from thinking altogether. Thinking through a scenario can be healthy or unhealthy depending on the context. We will work together to help you recognize when OCD is activated and when it is not. Part of this work is building the skills to check in with yourself. How much time have you spent on this topic, is this a compulsion, is overthinking serving you, and is OCD making your decisions for you?

Why standard therapy often misses Pure O OCD

Pure O OCD is frequently misdiagnosed as generalized anxiety or depression because there are no visible compulsions to point to. Talk therapy and cognitive reframing can actually make OCD worse by giving the spiral more material to work with. If you have been in therapy and keep talking about the same thoughts without getting better, this is often why. The reframe or talking about the topic in therapy is actually you completing a compulsion. You are just learning to overthink more. You may also think therapy is a waste of time because it is just you continuing to spiral, and what you actually want is someone to help you turn down the volume on your anxious thoughts and get you living again.

What The Work Looks Like

We start by mapping your specific anxiety spiral. What triggers your anxiety, what the core fear is underneath it, and what response prevention looks like for you specifically. Then we build the skills to catch the mental spiral sooner, unhook from the anxious thoughts, and sit with uncertainty and discomfort without following the spiral down.

This is not about thinking better thoughts. It is about learning that you do not have to have it all figured out to move forward. You can feel uncertain and still trust yourself. You can take a leap toward what you actually want without the spiral signing off first.

That is what life outside of Pure O OCD looks like. Not the absence of intrusive thoughts. The ability to let them be there without letting them run everything.

Having these thoughts or experiences occasionally is normal. What distinguishes OCD from occasional anxious thoughts is that the thoughts are persistent, feel completely out of character, and cause significant distress and disruption to daily life.

If you are unsure whether what you are experiencing is OCD, working with a psychologist who specializes in OCD and anxiety treatment is the best way to get clarity on whether you meet criteria for OCD or another anxiety presentation.

Ready to get out of the loop?
Learn more about Individual Therapy and Intensives.