What Is “Just Right” OCD?
Have you ever felt like something isn’t quite right? Maybe it’s your shirt collar that doesn’t sit perfectly, or your handwriting that isn’t as neat as it could be. For most people, these moments come and go. But for individuals with “just right” OCD, the need for things to feel “just right” is overwhelming and persistent. “Just right” OCD isn’t about fear of harm or contamination, as with other common types of OCD. Instead, it’s about achieving a feeling of completeness or perfection that’s often hard to put into words.
Characteristics of “Just Right” OCD
“Just right” OCD often revolves around an intense discomfort or “off” feeling when things aren’t aligned with an internal standard. It’s not always about appearance; it could involve actions, sounds, or even thoughts. For example, someone might feel compelled to touch an object with both hands to achieve a sense of balance or symmetry.
Common obsessions
Obsessions in “just right” OCD often focus on:
- Symmetry: Everything must look or feel symmetrical.
- Order: Items must be arranged in a specific way.
- Sensory “rightness”: Sounds, textures, or movements must feel perfect.
For example, a student might rewrite their notes multiple times because the lines aren’t perfectly straight.
Common compulsions
To reduce their discomfort, people with “just right” OCD might engage in compulsive behaviors such as:
- Repeating actions: Tapping, blinking, or walking in a certain way until it feels “right.”
- Rearranging objects: Moving items repeatedly until they meet a specific standard.
- Undoing: Reversing actions to “correct” something that feels wrong.
How “Just Right” OCD Differs from Other Disorders
Distinction from other types of OCD
OCD can take many forms. Unlike contamination OCD, which involves a fear of germs or illness, or harm OCD, which includes intrusive fears of hurting oneself or others, “just right” OCD is less about avoiding specific threats and more about uncomfortable sensations or the feeling that something is “off.” For example, someone with contamination OCD might wash their hands repeatedly out of fear of getting sick, while someone with “just right” OCD might wash their hands over and over until they feel like they’ve done it the “right” way, even if they’re not afraid of germs. The motivation behind the compulsions is different, even if the behavior is similar.
Distinction from perfectionism
While perfectionism and “just right” OCD may seem similar, there’s a key difference: perfectionists often focus on outcomes (“This has to look flawless”), while individuals with “Just Right” OCD are driven by internal discomfort (“It doesn’t feel right”).
Distinction from Tourette’s Syndrome
Some tics in Tourette’s syndrome, such as repetitive movements or sounds, might resemble OCD compulsions. However, Tourette’s tics are typically involuntary, whereas OCD compulsions are usually intentional.
Causes and Risk Factors
Biological factors
Research suggests that OCD (including “just right” OCD) is linked to over-activity in certain parts of the brain, particularly in areas that regulate decision-making and emotional responses. When these areas are over-active, they may trigger repetitive thoughts and behaviors. Imaging studies have shown that successful OCD treatment (either with therapy or medication) can reduce this over-activity. Some research also suggests that genetics may contribute to the development of OCD, since OCD can sometimes run in families, though the exact genes involved are still being studied.
Environmental factors
Stress, upbringing, or learned behaviors might also play a role. For example, stressful life events, and specifically childhood trauma, may cause a higher risk of OCD. Growing up with caregivers who were overprotective or who emphasized orderliness or perfectionism might also make the development of OCD more likely. In addition to stress and upbringing, environmental factors like infections or inflammation (e.g., strep throat in childhood) may contribute to OCD symptoms.
Effective Treatment Approaches
Exposure and Response Prevention (ERP)
Exposure and response prevention is a type of therapy that’s considered the gold standard for treating OCD. It is based on the idea that the avoidance of the uncomfortable feeling that comes up when something is not “just right” actually makes those uncomfortable feelings worse in the long-term. ERP involves learning to approach the situations that trigger the obsessions (e.g., placing items slightly out of alignment) and resisting the urge to perform their usual compulsions. Over time, ERP helps reduce the anxiety tied to those triggers.
Cognitive therapy
This therapy technique helps people challenge and reframe the thoughts fueling their obsessions. For instance, a therapist might help someone recognize that their discomfort won’t last forever, even if they resist a compulsion.
Medication options
Selective serotonin reuptake inhibitors (SSRIs), a type of antidepressant, are an effective treatment for OCD symptoms. Medications can be especially helpful when combined with therapy.
Coping Strategies
Mindfulness techniques
Mindfulness can help individuals observe their thoughts without judgment. Simple exercises like deep breathing or grounding techniques can also reduce overall anxiety levels. Slowly, people can learn through mindfulness practice to observe and accept that the obsession or the urge is present without them needing to act on it, and that the obsession or urge does not last forever.
Using support systems
Connecting with others who understand OCD, whether through support groups or online communities, can make a meaningful difference. Friends and family can also help by learning about “just right” OCD and offering understanding and encouragement without enabling compulsions. For example, they can say things like, “I can see how tough it is for you, and at the same time, I believe you can do it.”
Seeking professional help
If you think you or someone you love might have “just right” OCD, know that effective treatments are available and you can reach out for help. With the right tools and support, it’s possible to take back control and live a life that feels “just right” without the burden of compulsions.
