On Living with Pure O

Content Warning: Mental health and self-harm

I stand on the edge of Oblivion and nothing stares back.

It’s wide expanse pours forth from chipped white –

the jaws of consciousness,

demanding sacrifice;

                              of self

                                                of love.

Stepping forward, I offer myself up,

knowing no other way,

before the open waves,

that strip me bare.

The lid of my mind pried open,

words burn across my eyes,

a flood carrying away joy,

prisoner of this holocaust.

And what remains;

my skin ripped and torn,

at the ankles of my arms,

penance for crimes,

I have not committed.

I stare and am reduced


The swell of the waves rises higher,

licking my heels, climbing

my frame.

I am borne away,

lifeless vessel


I dip beneath that dark mass:

their tendrils close, cradling my scalp,

nurturing a piercing blackness,

of sacrificial ritual,

the everlasting heartbeat,

echoing softly in my ear:

sacrifice self,

sacrifice love.


But, for all this, all I am left with is cold coffee and a sense of doubt.


Old man crawls into his coffin and was buried on a Tuesday.

He probably built it himself - shaped it smooth out of wooden planks
put it onshore and was washed away under the sky,
a fabric pulled of all its dusty sequins.

My eyes open, I lay there, naked gasping for air,
watching as
the coarse beach drags him away.

The vicar, sighs, stands up, says his rites
and is buried

The waves inch along the shore.
Pure O Essay

Edited verison published by The University of Oxford

Content Warning: Mental health and self-harm

For men it is almost impossible to talk about depression and to be completely honest, its not much better for women. We find ourselves on the edge of a precipice that is slowly crumbling away from under our feet and yet we still don’t move away – we have recently witnessed around a 94% increase in female suicides since 2012 (BMJ), it’s nothing new and yet we still refuse to acknowledge the crisis we are in.[1] We turn away and keep it hush hush like children on a schoolyard for fear of being ostracised. Ironically it is this self-same isolation that contributes so greatly to these rising figures. Yet figures and statistics are skim read, quickly dropped and left, the stuff of passing comment: instead it is the personal experiences that need to be heard.

So, I’ll start. Hi. My name is Aaron, I’m 19 years old and I have suffered from severe depression and Pure O for around 7 years. I’m writing this from my bed at 3:28am on a Friday as I keep the tide of intrusive thoughts at bay.

The best way for me to explain Pure O (or Pure OCD – Obsessive Compulsive Disorder) is firstly to tell you is that organising your pens on your desk so they look pretty or being mildly irritated that someone didn’t fully clean their whiteboard does not mean that you have OCD. It’s all bullshit. No, OCD is not the luxury of being able to choose whether or not your stationary looks neat but an inescapable dread and anxiety when compulsions are not or cannot be fulfilled. It will reduce you to a one-track record, endlessly looping just at the moment when you think you’ve gained a few minutes solitude. Living with OCD is living with a permeant roommate playing the drums in your head, 24/7. It doesn’t care of you’re upset. It doesn’t care if you’re angry. It doesn’t even care if you’re at the point of suicide. It cannot be predicted, nor can it be easily satisfied. Ritual is the only method of protection: you’ll find yourself breathless every day, repeating the same walk to the fridge over and over (did I land on my left foot or my right? Does this mean my dad will die?) and you’ll turn the lights on and off to ensure that you don’t have AIDS. And that’s the scariest part – its completely irrational. 

I’m sat in a coffee shop on the edge of a road opposite a roundabout. The seats are a wet cherry red, squeaky plastic clone of an American diner and a tall thin lady with faded blonde hair takes our order. I turn from the window and look over at my friend, smile weakly at their story of a party the other night and look down at my menu. I don’t feel hungry. Again. I look at the waitress and ask for some coffee instead of food. She replies of course, it’s no bother but my friend slows down and looks confused. I look up and try to form another smile but its too much, so I just stare blankly at them. They stop talking and ask if I’m okay. Just a bit tired is all. I always think about how many times I must have said this by now, over and over stretching across the past like the bags under my eyes. Trying to fall back into distraction I turn back to look out the window again, toward the roundabout; I see two cyclists chatting side by side as drift by, a bus pulling up behind them, the hissing of its brakes cutting through the window. The bus pulls closer and begins to accelerate towards the rear wheel of the cyclist on the right. My heart beats. The bus crashes into the back of the cyclist crushing them in between the boot of the silver Nissan in front and the cuboid of the bus’s bonnet. Both are red now, crimson blood spraying over the car as bones crack and dislocate through the skin of the rider. All of this happens without me thinking, without even catching a breath, without permission. It can’t be more than half a second. The riders slip around the far side of the roundabout and disappear. My friend’s talking again, and our coffee is arriving at the table.

Pure O (OCD) is a variation of OCD that means the suffer lives with constant intrusive thoughts, and compulsions, that have no logical basis. They are a constant assault on the mind and leave those who suffer mentally fatigued and unsure of their own identity. Pure O is different for every sufferer so I will only talk about my own experience in a hope to encourage others to do the same. Having lived with Pure O for the past 7 years I am still significantly affected every day. As a quick game, try to picture the worst conceivable thing imaginable to you. Got it? Great, now I can imagine that was not a pleasant experience, even for that short period; but now try to imagine doing this involuntarily, over and over every minute of the day. Your mind becomes your worst enemy, generating images of the most despicable acts and situations humanly possible to torture you with. It brings you to the point where you begin to question your own sanity and beliefs. Am I going to die of cancer? Do I really want to jump off this bridge? On the page I can censor what I write, erasing content deemed too offensive or shocking – but in the mind of a Pure O sufferer there’s no such grace.
Yet, while it is such an unknown and taboo illness and causes such debilitating effects, there is support for those who need it. Cognitive therapy and medication are available for those who are able to gain access to a doctor. Sadly, this process will always rely on the individual wishing to seek out help and fails to support those that may have the illness and not even know it. It is within this category that pose the greatest risk of developing depression, further anxiety issues and ultimately risk suicide for lack of understanding of their own illness. That is why education is so important, why talking about Pure O, OCD and depression can begin to tackle the ingrained taboo that prevents so many from seeking help and help prevent so many from dying so tragically young. I hope from giving my experiences I am able to help others fight against the stigma against mental illness and pave the way for a brighter future.

[1] BMJ 2020;370:m3431

The Painter

Content Warning: Self-harm and wounds

I hold out my work,

scrutinise it at a distance

witness the deep blues, light mottled browns and rich crimsons

that stain the canvas

painting my chipped fingernails

a dripping bracelet around my wrists

blurred in incandescent light through


        and screams.