Intrusive thoughts and 'Pure O'
Therapy for distressing thoughts and images you'd never act on — and can't switch off.
Does this sound familiar?
A thought or image arrives that horrifies you — violent, sexual, blasphemous, or simply wrong. You'd never act on it. But it sticks, and the harder you push it away the louder it returns. Maybe there are no visible compulsions at all — just hours of silent checking, analysing and neutralising in your head. That's what people call 'Pure O'.
Here's what matters: everyone has intrusive thoughts. OCD isn't having them — it's how hard your brain fights them. The content of the thoughts says nothing about who you are; the distress they cause says everything about what you value.
How I treat intrusive-thought OCD
I use CBT with Exposure and Response Prevention (ERP), the NICE-recommended treatment for OCD — adapted for thoughts rather than visible rituals. We won't debate whether the thoughts are true; we retrain how your brain responds to them, so they pass through the way other people's intrusive thoughts do.
I know these themes are hard to say out loud. You will not shock me, and you will not be judged — helping people say the unsayable is a large part of this work.
What to expect
A typical course runs 12–16 weekly sessions. Early sessions map how your OCD works and build the case against it; then we practise, gradually and collaboratively — you'll never be forced into anything.
Preguntas frecuentes
Do my intrusive thoughts mean something about me? No. Intrusive thoughts are universal, and OCD targets exactly what you care about most — that's why they feel so threatening.
Do I have to tell you the exact thoughts? It helps, but at your pace. Many clients start with the theme in general terms and share more as trust builds.
Is 'Pure O' really OCD? Yes — the compulsions are simply mental (rumination, checking how you feel, neutralising), which is why it often goes unrecognised for years.
Can sessions be in Spanish? Yes — I offer therapy in English and Spanish.
¿Quieres dar el primer paso?
Envía una consulta y Gisela se pondrá en contacto contigo en un plazo de un día laborable.