Intrusive thoughts: Courage, compassion, and the power of sharing

As a counsellor, I have the privilege of walking alongside individuals as they navigate some of the darkest and most misunderstood parts of their inner world. One such experience that I have witnessed is a rise in clients tormented by intrusive thoughts involving harm towards others, sometimes of a sexual nature. 

What is Pure OCD?

Not much is known about Pure ODC, or Pure O, and there is debate about whether it even ‘exists’. Pure O is a popular term describing a person who experiences mental obsessions, but doesn't seem, on first glance at least, to have any compulsions.

Pure O is about unwanted, intrusive, and highly distressing thoughts that often stand in stark contrast to the person’s values, character, and desires. These thoughts can include fears of harming someone, sexual thoughts possibly involving children, or religious blasphemy – all of which bring intense shame and anxiety. 

What sets Pure O apart is the internal struggle. Unlike more visible compulsions like handwashing or checking, individuals with Pure O tend to engage in mental rituals: mental checking, rumination, reassurance-seeking, avoidance, or trying to "cancel" a thought. This battle happens silently, which often leads to isolation. Many of my clients suffer for years without speaking a word of their torment, fearing judgment, rejection, or worse – being labelled as dangerous. 

How can counselling help people navigate these emotions? 

It is often in the counselling room, in a space of safety and trust, that these individuals take the painful and liberating step of speaking their thoughts aloud for the first time. I cannot overstate the courage this takes. Imagine living with a thought that horrifies you, that you might have judged yourself by for years, one you desperately wish you didn’t have, and then daring to tell another human being. 

But what happens in that moment of sharing can be profound. There is often a shift – a space opens up between the person and the thought. That thought, once tied so tightly with identity and shame, begins to lose its power. It becomes something that is happening to the person, not something that defines them. 

We begin to explore it together. With gentleness and clinical grounding, we look at what OCD does – how it targets what we care about most, when it started, when it is better and when it is worse. A thought is not an action. A thought is not a truth. A thought is a thought, albeit a painful one.  

The therapeutic process then becomes about learning to relate to thoughts differently, rather than eliminating them. Through compassion, space and psychoeducation, clients learn to tolerate uncertainty, to live alongside their intrusive thoughts without being governed by them. It is about helping them put language around their thoughts as a ‘thing’ or a disorder, not as a reflection of who they are. 

I have worked with many clients who have walked this path – some quietly, some in profound distress – and each one reminds me of the bravery it takes to seek help. I see in front of me deeply conscientious, caring individuals who are terrified of doing harm precisely because they do value kindness and safety so highly. 

My hope in writing this is twofold: first, to raise awareness about Pure OCD and offer language that might help those living with it better understand and articulate their experience; and second, to challenge the silence that so many are held in by fear and misunderstanding. You are not alone. Your thoughts do not define you. And speaking them aloud can be the beginning of healing. 

If you’re struggling with thoughts you can’t control, please know there is help. There is hope. Please reach out to a professional to learn more.