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Resources to Help Kids Thrive Newsletter

What Is “Pure O” OCD?

A weekly update of content from childmind.org featuring parenting advice, in-depth articles, and the latest thinking on children’s mental health and learning disorders.

March 22, 2022

Checking locks, washing hands, organizing objects — these kinds of behaviors are what a lot of people imagine when they think of OCD. Many children with OCD do repeat rituals like these, called compulsions, to tame distressing anxiety. But for some, the compulsions happen only in their minds. They may be counting, replaying memories or repeating words in their heads. This kind of OCD is sometimes called “pure O,” which is misleading. Kids who experience it do have compulsive rituals — they just aren’t visible.

This week on childmind.org we look at how to recognize and treat this easy-to-miss form of OCD. Kids with mental compulsions may appear distracted or withdrawn, but that’s because they’re preoccupied with rituals no one can see. We also have information on some common (and frequently misunderstood) obsessions among kids with OCD, including religious worries, sexual thoughts, and fears of suicide.

Related Resources

Mental Compulsions and “Pure O” OCD

Almost all kids with OCD experience compulsions, but some kinds are easy to miss.


How to Help Kids Worried About “Bad Thoughts”

Children sometimes feel guilty about disturbing thoughts and can’t stop confessing.


Understanding Religious OCD

When the motivation is anxiety, not faith.


Sexual Obsessions and OCD

Explaining an often misunderstood symptom of OCD.


When OCD Triggers Suicidal Thoughts

How a form of OCD can be mistaken for being suicidal.


What Is the Best Treatment for OCD?

Exposure with response prevention is the gold standard.