In one scene in Channel 4's comedy drama Pure, a collection of perfectly ordinary commuters on the London Underground suddenly becomes a writhing mass of naked bodies and limbs and tongues and genitals. But it's nothing erotic or sexy; instead, it's the visual manifestation of an "intrusive thought" that horrifies our main character, Marnie.

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Marnie (Charly Clive) suffers from a form of OCD commonly known as "pure O", and her distressingly sexual "intrusive thoughts" are destroying her life. Based on the memoir by Rose Bretécher (real name Rose Cartwright), the six-part drama brings those intrusive thoughts to our screens as part of a groundbreaking (and hilarious) story.

Of course, that involved a whole load of extras getting naked.

Pure, Channel 4

Describing the experience of filming that scene on the tube, director Aniel Karia joked: "Distressing. Harrowing."

But, he added, "it was really interesting. It was logistically very difficult, obviously you've got a lot of naked people in a small space. There were about 50 extras, that's a lot of people just to wrangle in a short space of time."

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Speaking at a Bafta preview screening, he recalled: "That was quite hard work and then they're naked, and they're hot and naked, so they sometimes smell. In a contained space, a lot of hot people. They're not actors, of course, they're extras, they're nice but they don't necessarily know what they're doing. So there's having to work with that."

There was also the difficult line to tread between the reality of this mental illness – and what you're allowed to put on TV, even after the watershed.

"There are other challenges, like compliance," Karia said. "Turns out you can't show porn on primetime Channel 4.

"So you have to work around those limits, but still make it shock and have a true sense to it – even though it's right over there on the spectrum."

One vital element, screenwriter Kirstie Swain explained, was making sure these scenes of sex and nudity "weren't gratuitous."

"They're distressing for Marnie, and the audience should be distressed too," she told the audience. "And also we're very concerned with the discussion about the representation of women on screen as well, so we didn't want to just be gratuitous and show a tit when there was no need to see a tit.

"The tit had to be earned, which is a rule for life."

During filming, Cartwright had the surreal experience of seeing her own "intrusive thoughts" acted out on the streets of Shoreditch by a collection of nude (and very cold) extras.

"My most memorable moment was the first time I was on set," she told the audience at Bafta. "When I first moved to London, when I was in the state that you see Marnie in, in those episodes, I actually lived in Shoreditch – so that was very close to home for me."

She recalled: "It was during the Beast from the East, so it was snowing, which is terrible for naked extras. And I was like, 'What have I done?' And I turned the corner at Shoreditch, and I looked down the street and it was just floodlights, and 60 guys in hi-vis jackets."

When the moment for the 'intrusive thought' came and the cameras were ready to roll, "they pulled up these big privacy screens, and the guys in the salon down the alley had to be briefed that there might be some nudity happening outside just in case their clients get offended," Cartwright said, looking back on that unusual film shoot.

"It was like: 'What is my life?!'"

PURE

But after years of treatment and therapy, Cartwright said working on the Channel 4 drama and seeing her painful thoughts acted out in front of her was "definitely the best therapy I've ever had."

She explained: "It was such a privilege, because people pay hundreds of pounds for that kind of exposure therapy – and here I am!

"I had this thing I've kept secret and was so ashamed of, but going down to set and just seeing it discussed so openly and for storytelling to be such a healing tool – I was just like, 'This is alright, I don't regret this.'"

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Pure begins at 10pm on Wednesday 30th January at 10pm on Channel 4


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