“Just Right” OCD, also sometimes called “Perfectionism OCD” or “not just right OCD”, is a common subtype of Obsessive Compulsive Disorder (OCD) characterized by ongoing intrusive thoughts and compulsive behaviors around organization, balance, perfection, symmetry, and order – making things feel “just right.”
Sufferers of Just Right OCD feel frequent intrusive thoughts, or obsessions, around a need for their physical surroundings to feel perfect.
As a result, sufferers will compulsively fix, rearrange, touch, or count things until they feel comfortable or certain. Some people will spend hours a day engaging in compulsive behaviors, and others might just avoid situations entirely so that they don’t have to deal with the time and stress required to make things just right.
In This Article
Differences Between Perfectionism and OCD
A key difference between being a perfectionist and having OCD is how one feels about their behaviors and rituals. For people with OCD, the intrusive, repetitive, and recurring behaviors and thoughts are unwanted and cause significant distress, while people with perfectionist traits do not typically experience the same degree of unease.
For example, while a perfectionist may appreciate an organized closet or a color-coordinated bookshelf, a person with OCD will feel anxiety or fear if they don’t organize their closet or bookshelf in a certain way.
However, OCD and perfectionism can be interlinked, and it is not uncommon for one can suffer from both perfectionism and OCD. Research has shown that perfectionist tendencies can even be a predictor of OCD.
Just Right OCD can manifest in a number of different ways. Some people with Just Right OCD may fixate on parts of their body, like making sure their fingernails are the exact same length, their hair is perfectly arranged, or their makeup is applied symmetrically.
Others might avoid stepping on cracks on the sidewalk or rereading every text or email repeatedly before and after they send it. Many people with Just Right OCD will feel anxiety from looking at a slightly crooked picture frame or an item not placed in its correct location.
Common Obsessions of Just Right OCD
People with Just Right OCD have an overwhelming need for things to look, sound, or feel “perfect” or “just right.” Common symptoms of Just Right OCD can include:
- Feeling anxious if a picture frame is slightly crooked, and being compelled to straighten it.
- Checking a text or email 20 times before sending it to be sure that there are no mistakes and the words are perfect
- Avoiding stepping on cracks in the sidewalk or making sure you are stepping on an even number of cracks.
- Touching your left shoulder if someone accidentally touches your right one to make it even.
- Touching or picking up items in a certain way or in a certain order
- Unlocking and relocking the front door a dozen times before leaving the house
- Tying the shoe on their right foot to match the tension of the shoe on their left foot
- Counting out the exact number of coffee beans when making coffee in the mornings
- A nagging, persistent feeling that things are incomplete or simply not right
- Repeating words, movements, or actions until something feels right
- Being unable to identify exactly why something feels off, incomplete, or incorrect
- A strong urge to rearrange objects so that they are symmetrical or organized in a particular way
- Distress about sights, smells, sounds, textures, tastes, or feelings that don’t seem right to you
- A fear of the consequences of making mistakes or anxiety that harm will come to oneself or others if things are not done perfectly.
Common Compulsions of Just Right OCD
Fixing
Fixing behaviors is one of the most common compulsions for this subtype of OCD. These compulsions result from obsessions with symmetry and order.
Some people will spend hours rearranging things in their environment so that they feel symmetrical or “perfect.”
Others might have a ritualistic compulsion to fix things, such as needing to turn a light switch on and off 5 times before leaving each room.
Checking
People with Just Right OCD will often engage in checking compulsions to make sure that things are just right, even after they have already fixed them.
For example, they might rearrange their fridge or pantry over and over again until it feels perfect and symmetrical. And then even after arranging it in a way that feels right, they might go back and check again to make sure that things are as perfectly arranged as they left them.
In another example, people might reread a text message dozens of times even after they have already sent it.
Reassurance Seeking
People with Just Right OCD may engage in compulsive reassurance-seeking with friends or family to be sure that something is perfect even though their OCD is telling them that it isn’t.
They might repeatedly ask friends for a second opinion on an email to ensure it sounds good and is grammatically correct.
Additionally, some people might ask those around them if they also feel like something is off to try to assure themselves that they are not the only ones who feel that something is not right.
Touching
People with Just Right OCD often compulsively touch things, especially in a specific pattern or with a particular frequency.
For example, if something bumps their left knee, some with Just Right OCD may have the intense urge to bump their right knee against something just so that things feel symmetrical.
Or, someone might feel the compulsion to touch a certain object or open and close a door a certain number of times before they feel like things are complete.
Counting
Another common compulsion is counting things to ensure that things are symmetrical or “perfect.” For example, someone with Just Right OCD might count their steps to ensure that they’ve stepped exactly the same amount of times with their right foot as with their left foot.
Or, they might count out the exact number of coffee beans each morning before making their coffee.
Avoidance
Because people with Just Right OCD experience high levels of anxiety and stress when things appear to be incomplete or uncertain, they might avoid certain situations or places where they know their OCD will likely be triggered.
For example, if sending a text message or email consumes hours of a person’s day because they have to read it repeatedly, they may decide it’s best to stop texting and instead call someone on the phone.
In other cases, someone may feel like the color red is “just wrong,” and thus compulsively avoid the color red by refusing to wear red clothing or eat red foods.
What is Exposure and Response Prevention (ERP) Therapy for OCD?
Like with most types of OCD, the best course of treatment for harm OCD is Exposure and Response Prevention (ERP) therapy.
ERP is a type of Cognitive-Behavioral Therapy that is considered the first-line psychotherapy for OCD. It has been found effective for 80% of people with OCD.
ERP has two main components:
- Exposure: purposely doing activities that are designed to elicit your anxiety
- Response Prevention: actively resisting the urge to complete a ritual
In ERP, patients are exposed to feared situations or objects meant to set off their compulsions. This therapy is intended to purposely invoke more anxiety in attempts to disrupt the neural circuit between the processing and action parts of the brain.
Over time, patients learn to resist the urge to perform compulsive rituals and manage their OCD thoughts and actions. By staying in a feared situation without anything terrible happening, patients learn that they don’t need their compulsions to cope, and their fearful thoughts have no power over them.
For example, someone with Just right OCD might be asked to look at or do something that feels wrong or off to them.
If they have symmetry obsessions, they might be guided by their ERP therapist to only touch their right shoulder without touching their left.
They would need to resist the urge of touching their left shoulder to balance things out and sit with the anxiety that this wrongness or incompleteness brings. For people who suffer from OCD, exercises like these can feel incredibly difficult and even physically painful.
You should only complete exposures if you are able to maintain good response prevention while doing so. Even the most challenging, high-level exposures will be ineffective if you are not maintaining good response prevention.
ERP takes time, effort, and practice, but patients learn to cope with their thoughts without relying on ritualistic behaviors.
The compulsion to avoid anxiety is a powerful driver of OCD. Still, ERP is one of the most powerful tools available for treating OCD because it directs the patient to live with the anxiety and see that nothing bad will happen.
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