Media usually presents obsessive-compulsives with very obvious compulsions: hand-washing is a favorite but also extreme organization and hoarding, as well as checking and counting. But not all compulsions are so easy to see.
In fact, some compulsions are so difficult to recognize that it lead to a misnomer– Pure Obsessional OCD. The name Pure-O leads some to believe that this type of OCD can essentially drop the “C” from its acronym. But that would be a mistake.
Pure-O’s still have compulsions– they are just harder for the public to notice. They include mental rituations like repetition, avoidance, and seeking reassurance.
For example:
I would have an intrusive, blasphemous thought– which would cause me to question my salvation. I would repeat a particular prayer over and over in my head to ward off this thought, and I would ask everyone if they thought I was going to go to hell (sometimes this would be active– “Do you think I’m going to hell?”– and sometimes passive, as in “I’m scared I’m going to go to hell” and waiting for that person to reassure me … “Why would you think that?! No way!”). I would also avoid certain things (Matthew 12 and Mark 3, for example, or movies with profanity, which would trigger my blasphemous thoughts).
Sometimes it was hard to really focus on a conversation I was having because there was another entire conversation happening in my head at the same time. It’s like listening to two tracks at once.
I wrote a poem to demonstrate it:
So … yeah. There are compulsions you would never know are there, except for the strange look in my eyes, the odd shake of my head as if I were erasing something dark and secret.