Watching Channel 4's Pure tonight? Here's everything you need to know about 'Pure O' OCD

13th Feb 19 | Lifestyle

This lesser talked about mental health issue manifests itself as intrusive thoughts that can often be sexual or violent.

One of the great things about the fact that people are generally more open about mental health these days, is that we now feel comfortable discussing all different types of fears, phobias and compulsions in our music, books, art and TV programmes.

Take Channel 4’s groundbreaking new show Pure, for instance, which tells the story of Marnie – a 24-year-old woman who has a very specific form of OCD called ‘Pure O’.

Marnie leaves her hometown in Scotland to start a new life in London after battling with daily intrusive and sexual thoughts, which make her wrongly believe that she’s a sex addict.

During the six-part series, she learns that her mental rituals are actually down to the lesser-known form of OCD, and endeavours to learn more about her undiagnosed issue. The show, which is both sharp and intelligent, is based on the real-life experiences of author Rose Cartwright, who penned a novel of the same name.

So what exactly is Pure O? Ahead of episode two (which airs at 10pm tonight), we asked Dr Wiktor Kulik MRCPsych, a consultant psychiatrist at London Doctors Clinic to explain…

First off, what exactly is OCD?

“Let’s start by defining what ‘obsessions’ and ‘compulsions’ mean,” says Dr Kulik. “These words can be used commonly, like ‘I’m obsessed with my shoes’ or ‘He is a compulsive liar’, but they have a different, and a very specific meaning, for mental health professionals.

“An obsession is an unwanted and unpleasant thought, image or urge that repeatedly enters your mind, causing feelings of anxiety, disgust or unease. These have to be recognised as one’s own thoughts, in which the person is unable to resist them.”

Kulik says that a compulsion, meanwhile, is a repetitive behaviour or mental act that you feel you need to carry out to temporarily relieve the unpleasant feelings brought on by the obsessive thought.

washing hands
Hand washing is a common OCD compulsion (Thinkstock/PA)

Common compulsions include excessive hand washing, cleaning or checking something repeatedly, such as a locked window or door. Compulsions are repeated again and again and are not inherently enjoyable or purposeful.

“The WHO’s International Classification of Diseases specifies that for a diagnosis of OCD to be made, obsessions, compulsions (or both) need to be present for at least two weeks and be a source of distress. Or they have to interfere with the person’s daily life,” explains Kulik.

“It’s then divided into more specific categories. Some people have predominately obsessional thoughts and others have mainly compulsive acts. The most common and recognised form of OCD though, is mixed obsessional thoughts and acts.”

What is the difference between OCD and ‘Pure O’?

Lucy’s character, who exhibits no observable compulsions to friends and family, but secretly battles with intrusive thoughts, highlights that when it comes to OCD, you can have ‘Pure O’, without the ‘C’.

An individual with Pure O may not display obvious physical reactions related to their thoughts, such as washing hands or double-checking locks, but is driven instead by hidden mental rituals. For this reason, Kulik says that Pure O is often more difficult to recognise.

Young sad mad sitting by the window
Friends and family may not notice any visible compulsions or rituals (Thinkstock/PA)

He says that diagnosis can be tricky, as obsessions and ruminations can be common in depression, so the diagnosis should be made by a medical practitioner when the obsessive thoughts arise or persist in the absence of clinical depression.

“Both OCD and Pure O are identified by taking a detailed history of symptoms and other elements of person’s history,” Dr Kulik adds. “A GP can exclude other causes and decide on the best treatment.”

What should you do if you are concerned that you or someone you know has Pure O?

“People with OCD often delay seeking help, because they feel ashamed or embarrassed,” says Kulik. “It’s always encouraged that they either speak to their GP or refer themselves directly to a psychological therapies service.

Psychotherapy session, woman talking to his psychologist in the studio
Don’t be embarrassed to seek help, urges Kulik (Thinkstock/PA)

“There are treatments that are effective for most sufferers. Typically, this would start from a course of psychological therapy called CBT (cognitive behavioural therapy) where you look into your thoughts, feelings and behaviours in more detail. This is completed with the help of the therapist and would typically be accompanied by exercises to do at home,” says Kulik.

A 2008 study also found that ERP therapy, or ‘exposure and response prevention’, can be helpful in treating OCD. ERP is when you gradually expose yourself to the source of your fear, over and over again, without acting out any compulsive mental or physical rituals to neutralise the phobia.

If a patient does not respond to psychological treatment, or if the symptoms are very severe, Kulik says that a GP may prescribe antidepressants.

As well as seeking out professional treatment, he believes that it’s worth connecting with other people with OCD for advice and support.

Support groups are available in many locations, and online charities also offer meetups and message boards, like Mind, OCD-UK and OCD Action.

Pure continues tonight at 10pm on Channel 4.

© Press Association 2019