The American Psychiatric Association

We the undersigned urge the DSM Task Force to to incorporate a new sub-category in the DSM to describe what has been casually dubbed "Purely-Obsessional OCD". 
It is time for the DSM to recognize a subset of OCD that is grossly unrecognized among the mental health community: obsessions without overt compulsions.
Dubbed "Purely-Obsessional OCD" or "Pure-O" - sufferers are plagued with misdiagnoses by competent, credible therapists who, by practice and schooling, simply focus on whether their patients are exhibiting observable compulsions to make a diagnosis of OCD. However, if a patient's compulsions are taking place internally in the form of mental checking, subtle reassurance-seeking, avoidance, or fear-based withdrawal or avoidance, a misguided therapist might not recognize OCD in their patients, and end up exacerbating their patients anxiety level by employing inappropriate therapeutic techniques. The terror of patients with Pure-O often lasts for years or decades before a proper diagnosis is made. Many never receive a diagnosis of OCD. Fortunately, once diagnosed, patients can make rapid progress. However, the lack of information about this manifestation of OCD among the psychiatric community, and specifically within the DSM, has hindered awareness and therefore the proper education of the clinical community in training.
We urge the American Psychiatric Association to expand the definition of OCD to include a subtype of OCD that spells out the nature of the thoughts and compulsions that plague this community of sufferers.
Many thanks for your time and consideration.