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I'm Ali Graymond. I'm an expert in OCD recovery because for the last 19 years, I've been helping people fully recover from OCD. If you would like to do personal coaching with me, all the information is on youhubocd.com you can sign up from there. Let's talk about correct way to do ERP for pure O. So if you have, let's say what kind of puro. For an example, say harm ocd and you don't have physical compulsions, but you're ruminating a lot, or false memory, OCD or relationship ocd, whatever. Let's. Let's pick these three. So you get a thought that comes in right. That thought, feeling, image sensation feels very real. And now you are at a crossroads. So that thought coming in right? The automatic thought that came in thought, feeling, image, sensation is the exposure. So that's E in the erp. So exposure done, check automatic. Now you are at a crossroads. Are you going to do response prevention or are you going to do response a lot? If you do response prevention, it means that you see this as an OCD thought. You choose. You choose to see this as an OCD thought, and from that point of view, you refuse reaction. So you're like, okay, this is my usual theme. This is how it usually comes in. Yes, it feels real scary, disturbing. But wait a minute, I need to be ignoring this. I cannot be trying to figure this out. So you're choosing to prevent your usual response of figuring it out. So that's response prevention. So that's emotional ERP for pure O. So the exposure was automatic or on purpose. If you're trying to bring up a thought on purpose. But for pure O, I don't think you need to bring up thoughts on purpose because they're there all the time anyway. So. But the thought came in, you refused reaction versus a thought came in, and you're like, oh, yeah, I'm gonna go online, figure it out, ask everybody I know. That's not response prevention. That's response a lot. So that's not erp, that's just exposure. And then let's make my OCD worse. So this includes talking to people online, research, asking ChatGPT, asking Google, trying to piece events together, trying to sort through your feelings. Are you a good person? Are you a bad person? What kind of person are you? All of this is response a lot. It's not response prevention. And with pure O, you need to do response prevention all day long. So this is not one off erp. No matter what your therapist who has no idea about rumination and all of that says if you have pure O, I guarantee you that your biggest problem is rumination. Because even with those reactions that I said, right, the, the research, the online checking, all of this, while you're doing that, you, you are ruminating. So if you are ruminating most of the time, most of the day about your thought, you are making that thought worse, it's going to get worse. So you need to make the active choice to do response prevention all the time, all day long. And you're not going to be successful all day long. But this is where tracking and reducing comes in. We're tracking how much active rumination we did, how much, how much we messed up basically. And tomorrow we're going to mess up a little less than today. We're not saying we're not going to mess up at all, but we're going to do a little less and less and less. And I'm telling you, I see this with clients all the time. Okay, they're my clients, so I'm working with them one on one. But their recovery is fast. Within a month they're going from level 8, 9 anxiety to level 1 0, 2, something like that. And I showed you tracking of the, these are my clients, these are actual people. They're recovering, they're doing good and fast. But one off exposures are not gonna cut it. Your little scripting techniques and whatever hierarchies are not gonna cut it with Bureau. You're gonna be stuck forever if you do it that way because it's simply not enough. It's an all day job. So anytime you are ruminating, you are doing damage to your recovery. You're choosing not to do response prevention and your job is to just keep catching it, keep bringing yourself into response prevention. And also I wanted to again remind you, you are building a completely new skill, a skill that you've never had before. So on one side you should be hard on yourself. You shouldn't be letting it slide like whoops, ruminated, whoops, ruminated again. You know, can't do that. But at the same time, I do want you to have some, some grace and some kindness for yourself when you do mess up and try to learn from the experience. So let's say you messed up today, went online, googled, ask for reassurance, all this, okay, once you start to feel better, once you're a little bit out of it, zoom back out, kind of go over it from a detached perspective and look at it where, why did you make those Choices. So not about the thought itself, but just what made me make that wrong choice? What made me choose response a lot versus response prevention and how can I fix that next time? Those should be the questions that you're asking. Not blaming yourself, not sitting there, oh, I'm so bad I'm never going to recover. Because then you'll just spiral into meta ocd. OCD about recovery, right? You don't want to do that because that's also a type of puro. We don't want to do that. What you want to do is you want to say to yourself, okay, what happened? Why couldn't I have made a better choice? Well, why did I make that choice? And it could be things like I was too stressed, I was too tired, it came out of nowhere, maybe the trigger was too high and you're just not equipped to deal with that level trigger right now. You know all kinds of things. But what can I learn from this for next time? And the number one thing you can learn is when I'm in that situation again, I'm going to make sure I'm going to disregard. When I get a similar thought to the one I got last time, I'm going to make sure I disregard. So, so that's, that's the way to do ERP for pure O in the way that you recover. And just wanted to add this in. If, let's say part of your pro is that you are avoiding something, then you can do on purpose exposures again. But on purpose exposure needs to be with the purpose of disregarding afterwards. So the exposure that you're forcing now, okay, fine, but the response prevention and that not ruminating post fact, that remains the same. That's the rule that stays. So if, let's say you're avoiding, sure, add on purpose exposures, but only doing on purpose exposures for puro will never get you to full recovery. It's a physical impossibility because most people with pure O ruminate all day long or most of the day when they're in the bad state and as they get better, it reduces. But it's yeah, and OCD morphs. That's, that's the reason why you cannot get away with just exposures for your current theme because that OCD is going to want to get fed. And if you're not buying this theme anymore because you, let's say, did a lot of exposures for your current thoughts, first of all, it can come up with different thoughts for the same theme, but if everything is exhausted completely, it will come up with a new theme and your anxiety level will be just as high. It won't be less. And usually people. Not usually, but I'd say sometimes half. Half and half. Maybe people cycle through a few different themes, including the recovery theme. Usually that's the last one that the OCD will throw at people is the OCD about ocd. So just be mindful of that and do recovery properly. You can do this. You can fully recover. My clients are fully recovering, so you can fully recover. Your brain is capable. I'm telling you, your brain is capable. Are you going to do it or not? I don't know, but your brain is capable. Thank you for listening. If you have not subscribed, please subscribe. If you would like to do private coaching with me, please sign up through. You have oct. Com. I'll see you tomorrow.
Host: Ali Greymond, OCD Specialist & Author
Date: December 20, 2025
This episode explores the correct way to implement Exposure and Response Prevention (ERP) for Pure-O OCD—a subtype of OCD characterized primarily by intrusive thoughts, images, or feelings, without visible compulsions. Ali Greymond emphasizes the importance of ongoing response prevention, specifically targeting rumination, which she identifies as the main compulsion in Pure-O cases.
| Segment | Timestamp | |--------------------------------------------------------------------|--------------| | Introduction and background | 00:00 - 00:29 | | What counts as "exposure" in Pure-O | 00:29 - 01:04 | | Response Prevention vs. Response A Lot | 01:04 - 02:41 | | The central challenge of rumination for Pure-O | 02:41 - 03:41 | | Why one-off ERP or hierarchies don't work for Pure-O | 03:41 - 04:17 | | Tracking, reducing, and self-assessment strategies | 04:17 - 05:16 | | On grace, learning from setbacks, & practical self-questioning | 05:16 - 06:13 | | On-purpose exposures & continuous response prevention | 06:13 - 07:14 | | The morphing nature of OCD themes & meta-OCD | 07:14 - 07:42 | | Parting encouragement & optimism | 07:42 - end |
"The exposure was automatic or on purpose... But for pure O, I don't think you need to bring up thoughts on purpose because they're there all the time anyway." (01:48)
Ali distinguishes Pure-O from other OCD types regarding the need for deliberate exposures.
"If you are ruminating most of the time, most of the day about your thought, you are making that thought worse, it's going to get worse." (02:38)
"One off exposures are not gonna cut it. Your little scripting techniques and whatever hierarchies are not gonna cut it with Pure O. You're gonna be stuck forever if you do it that way because it's simply not enough." (03:59)
"You are building a completely new skill, a skill that you've never had before. So on one side you should be hard on yourself... but at the same time, I do want you to have some, some grace and some kindness for yourself when you do mess up and try to learn from the experience." (04:36)
"Not blaming yourself, not sitting there, oh, I'm so bad I'm never going to recover. Because then you'll just spiral into meta OCD. OCD about recovery, right? You don't want to do that because that's also a type of Pure O." (05:16)
"OCD morphs. That's, that's the reason why you cannot get away with just exposures for your current theme..." (07:13)
"Your brain is capable. Are you going to do it or not? I don't know, but your brain is capable." (08:04)
This episode is essential listening for anyone working toward recovery from Pure-O or supporting a loved one on this journey. The practical, affirming advice cuts through confusion, offering a realistic path to lasting change.