If you manage someone who asks for a frontal lobotomy as a workplace adjustment, they may be suffering from Pure OCD. They feel this way because their minds have become search engines on autofire. Every second of every day, they search for a cure to their intrusive thoughts, but the more they search the deeper they fall into the bottomless pit of this anxiety disorder.

From coast to coast, all over the globe, the internet has provided salvation and damnation for Pure OCD sufferers. The online communities and experts help them understand and treat their intrusive thoughts. Unfortunately, this reassurance becomes another form of checking to complete the vicious circle of carrying out compulsions to relieve the terror of the obsessions.

“These obsessions often manifest as intrusive, unwanted thoughts, impulses or “mental images” of committing an act they consider to be harmful, violent, immoral, sexually inappropriate, or sacrilegious. For individuals with Pure Obsessional OCD, these thoughts can be frightening and torturous precisely because they are so antithetical to their values and beliefs.” (OCD Center of Los Angeles)

The content of the obsessions may cause an impasse in supporting Pure OCD sufferers as they fear you won’t believe them, or you will believe them and push the panic button to make their nightmare public. 

Don’t push them for information as they have difficult conversations with their OCD every day in a futile attempt to prove their intrusive thoughts are false. The cruel twist is that if the obsession starts to subside, sufferers perceive that as evidence their fears are true.

It’s not real, it’s OCD. But what if it is real, and you don’t believe me? If it isn’t real, why can’t I stop thinking about it? I can’t take the chance, just forget about it. If only I could go back to the day before it all started, none of this would have ever happened. But you can’t go back. You have to fight back to get your life back or OCD will win.

Understanding more about OCD

OCD is ranked by the World Health Organization (WHO) in the top 10 of the most disabling illnesses by lost income and decreased quality of life. However, my earlier OCD article explained the difficulties in challenging the misconception that everyone “is a little bit OCD” because they like to be tidy and orderly.

Pure OCD is thought to be the hardest variant of OCD to treat as there are no physical compulsions like excessive handwashing or cleaning to overcome. It is all in your mind. You have to expose yourself to the thoughts and feel the fear until you’re not afraid any more.

Thankfully more people are sharing their stories on how they faced the fear, such as the writer Rose Bretécher who said: “I didn’t understand that the only way to treat pure O is to stop acting out compulsions and break the vicious cycle.” (The Guardian, 2013)

Breaking the vicious cycle is incredibly hard. It’s like swimming out too far from the shore and looking down to see a thousand hungry sharks. You either do nothing and drown because the sharks aren’t real, or take a deep breath and swim for your life. Whatever happens, happens. You have to live with the uncertainty to break free from the ‘what if’ nightmares.

Warning signs

While line managers and considerate colleagues are not expected to become OCD experts to help sufferers realise their thoughts are not real, they can look out for warning signs and offer the appropriate support.

Pure OCD sufferers may:

• act like they have 10 seconds to defuse a bomb on a regular basis
• seem preoccupied and distant because they are trying to solve the world’s greatest mystery
• behave like they are receiving devastating news through invisible headphones while talking to you
• seek reassurance on obsessive thoughts, but try to pass it off as casual conversation
• suddenly start laughing because of the stupidity of their obsessions, only to be miserable again a few seconds later
• scrutinise emails and documents for any “incriminating information” that may expose their OCD
• spend a lot of time surfing the web to prove they have OCD

What organisations can do

Organisations can start by following the Thriving at Work recommendations to support people with Pure OCD. Having an OCD-savvy occupational health provider can validate this misunderstood condition, enabling meaningful conversations on how to mitigate the impact it has on their career and the business.

This will be especially important if people are struggling to find a GP or counsellor who understands Pure OCD.

It’s about trusting people to manage their workload and illness, ensuring they are not subjected to banter, ridicule or discrimination.

Even if people choose not to disclose their condition, they may still need managerial and peer support to get through this difficult time. They know you know, but everyone acts like they don’t know until normal service resumes.

Surviving Pure OCD

It’s all psychological. You yell OCD, everybody says, “Huh? Order? Cleanliness?”

You yell about Pure OCD, you’ve got a panic on your hands you may never recover from. The good news is that you can get better without a frontal lobotomy, but it will be harder to recover and manage how those around you perceive your condition while the stigma and misunderstanding of Pure OCD still exists.

If you decide to search Doctor Google for information on Pure OCD, just be thankful you can log off and enjoy the rest of your day. About a million or so people in the UK are not so lucky.

You may want to start by checking out the Intrusive Thoughts site for info on Pure OCD.