Perfectionism or “Just Right” OCD is a subcategory of OCD and has to do with having things “just right” or perfect. A person with “Just Right” OCD has obsessions but also an internal sense that something is “off.” In their minds, the order, frequency, balance, or position of something is out of place and must be corrected. “Just Right” OCD can take any form but some of the common triggers are touch, sights, sounds, or personal expression.
Fear or worry is often the main driver of compulsive avoidance rituals in other forms of OCD. In “Just Right” OCD, the person experiences a sense of uneasiness or incompleteness as their main drive to perform compulsions.
Examples of behaviors seen in “Just Right” OCD:
- Rewashing hands or getting another shower due to a feeling of “incompleteness”
- Rearranging a stack of papers until it has a “just right” feeling
- Adjusting the volume dial until the volume is “just right”
- Turning on and off the faucet until the last time you turn it it feels “complete”
- Over explaining, re-writing, or editing due to a need to be “perfectly” or “thoroughly” understood. This can be with written word, text messages, emails, spoken language, or internal self-talk.
- Evening up behaviors where a person does something twice on their right arm feels as though they need to do the same to the left arm
Symptoms of “Just Right” OCD can be many and they can have very negative impact on a persons ability to live their life. It is thought that people with “Just Right” OCD have greater difficulty in day to day functioning compared to other types of OCD.
Symptoms of “Just Right” OCD:
- High need for orderliness, control, or predictability
- Ordering or arranging compulsions
- A feeling of a “broken record” brain with endless loops that never feel quite right
- Excessive slowness on even daily, routine tasks
- Counting rituals and repetitive checking
- Perfectionism with concern over making mistakes
It is completely normal for people to experience uncomfortable thoughts or discomfort. But, people with “Just Right” OCD experience these thoughts as intolerable or unacceptable. From a Cognitive Behavioral Therapy (CBT) standpoint, we want patients to learn that they can actually tolerate feelings of discomfort. When a person does avoidance compulsions they teach themselves the wrong lesson: that they can’t handle the distress or discomfort. Through CBT and Exposure and Response Prevention (ERP) therapy, people learn that they can tolerate their uncomfortable feelings. They learn that not having that “just right” feeling doesn’t last long and isn’t that bad after all. ERP helps patients to face their anxiety and discomfort about things not being “just right” and practice new ways of responding to anxiety. Getting practice facing discomfort is the key to wellness. With practice, a person will become less disturbed by the feelings of incompleteness and more able to cope with anxiety and urges.