“Just right” obsessive-compulsive disorder (OCD) involves having obsessions and compulsions that concern the feeling that something is not quite right.
Most people are familiar with the feeling of something being “not quite right.”
Perhaps you walk into your kitchen and something seems “off,” and you realize it’s because your spouse moved your toaster to another counter. Or perhaps you get into your car and something doesn’t feel quite right, and you realize you’ve moved your seat too far forward.
Most of us feel a little uncomfortable when something isn’t quite right. But for people with “just right” OCD, this nagging feeling can be persistent and deeply distressing.
People with “just right” OCD have obsessions and compulsions about something being incomplete or incorrect.
For example, you might have obsessive thoughts about your floor not being totally clean, leading to a compulsion to clean the floor until it feels “just right.”
Or, you might feel like your stapler isn’t in the correct place on your desk, so you pick it up and place it down, repeating this compulsion until it feels “just right.”
“Just right” OCD can be disruptive to your daily life, but as with all kinds of OCD, it is treatable.
In many cases, OCD involves an overwhelming fear of something. You might, for example, fear that you’ll hurt someone or that your house will burn down. This fear might fuel your obsessions and compulsions.
However, not all types of OCD are fear driven. “Just right” OCD isn’t so much about fear as it is about the uncomfortable, nagging sense that something is:
- slightly off
- not quite right
The obsessions aren’t always about preventing a terrible outcome, but about shaking off that uncomfortable feeling.
“Just right” OCD involves obsessive thoughts and compulsions that are fueled by the feeling that something is incomplete or slightly incorrect. This type of OCD is also sometimes called Tourettic OCD (TOCD).
What’s the difference or link between perfectionism and ‘just right’ OCD?
Perfectionism is the idea that something can and should be perfect. Perfectionists often hold themselves and others to impossibly high standards, refusing to accept anything less than perfect.
OCD and perfectionism can be interlinked. Many OCD-related obsessions and compulsions are driven by the idea that something needs to be perfect. In particular, “just right” OCD can look like perfectionism.
Still, a key difference between OCD and perfectionism is that for people with OCD, intrusive, repetitive, and recurring behaviors and thoughts are unwanted and may cause significant distress, which is not typically the case for people with perfectionist tendencies.
Plus, people with perfectionist traits may expect others to follow the same high standards, while people with OCD tend to focus on their own behaviors.
Experts also differentiate between “healthy” (adaptive) and “unhealthy” (maladaptive) perfectionism. Adaptive perfectionism may motivate people to do well, while maladaptive perfectionism is focused on past mistakes and the expectations of others.
Maladaptive perfectionism is the type of perfectionism more frequently seen in people with OCD. It can be debilitating — especially if you feel that you can’t start or complete tasks because you fear they won’t work out perfectly.
Still, it’s important to keep in mind that perfectionism isn’t a mental health condition on its own, and not every perfectionist has OCD or vice versa.
What’s the difference between tics and OCD?
As mentioned, “just right” OCD is also called Tourettic OCD. It can be difficult to distinguish between tic disorders and TOCD.
Tic disorders are characterized by involuntary, repetitive actions (called tics). Vocal tics can include:
Motor tics can include movements like:
OCD — especially Tourettic OCD — might look like a tic disorder. Someone might repeat compulsions to get something “just right.”
For example, they might repeat a phrase over and over again until it sounds correct, or they might pick up a pencil and put it down again to shake off the feeling of it being in the wrong place.
Someone can have a tic disorder and OCD. The diagnostic criteria for OCD in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) includes a specification to describe if the person has a current or past diagnosis of a tic disorder.
However, tic disorders and OCD are not the same things. According to the International OCD Foundation (IOCDF), “just right” OCD is more thought-based than tic disorders. Tic disorders aren’t usually fueled by obsessive thoughts that something is “not right.”
Tics and OCD can become more intense during times of stress.
The exact symptoms of “just right” OCD can differ from person to person.
“Just right” OCD differs from typical OCD. Typical OCD is usually based on a fear that something terrible will happen, while “just right” OCD is about feeling like something isn’t totally correct.
So, while typical OCD can be driven by a fear or worry, “just right” OCD involves a distressing sense of incompleteness.
The symptoms of “just right” OCD can include:
- a nagging, persistent feeling that things are incomplete or simply not right
- distress about sights, smells, sounds, textures, tastes, or feelings that don’t seem right to you
- repeating words, movements, or actions until something feels right (for example, repeating a word that sounds “off” or touching the sleeve of your shirt repetitively because it doesn’t feel “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
“Just right” OCD can interfere with day-to-day tasks. You might find yourself stuck on certain tasks that you feel the need to repeat because they don’t feel right to you (such as rewriting the same email again and again).
Repeating tasks can take up time, attention, and energy, which can make it hard to function.
The causes of OCD are not always clear. A number of factors might increase your chances of developing OCD, such as:
- Genetics. Genetics can play a role. OCD is a heritable condition, which means you’re more likely to have it if a close relative has it.
- Personality. Certain personality traits, like neuroticism, might make you more likely to develop OCD.
- Life changes and trauma. Major life changes or trauma might trigger OCD.
- Other conditions. Other mental health conditions, like anxiety disorders, might increase your chances of developing OCD.
In children, strep bacteria can trigger an immune reaction called PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections), resulting in OCD-like symptoms.
Like other forms of OCD, “just right” OCD is treatable.
Other types of talk therapy, such as acceptance and commitment therapy (ACT) can also be helpful.
In some cases, a doctor might prescribe medications like selective serotonin reuptake inhibitors (SSRIs) to treat OCD.
According to the IOCDF, treating “just right” OCD can be more difficult than treating typical OCD. This is because it’s harder to address obsessions around the feeling of incompleteness than it is to address obsessions around harm and fear.
It’s also more difficult to identify the triggers of “just right” OCD, as it can be triggered by anything, while people with typical OCD usually have more specific triggers.
Nevertheless, while it may be more challenging, “just right” OCD is treatable.
“Just right” OCD can be difficult to identify and challenging to live with, but it’s important to keep in mind that it can be treated. It’s possible to live a happy and fulfilling life while having OCD.
A good first step is to find a therapist who has experience in treating “just right” OCD.