Just right OCD is obsessive compulsive disorder (OCD) without the obsessive thoughts causing harsh anxiety or fear response. People with just right OCD tend not to have intrusive thoughts in the same way as other types of OCD; instead, they experience a subjective feeling that something is wrong. It is treated with the behavioral technique called exposure and response prevention (ERP).
What Is Just Right OCD?
Just right OCD is a type of OCD in which a person has a heightened sense that something is wrong in that triggering moment without there being any observable evidence. Some people never know when they will be triggered or for how long they will be stuck until they achieve the “right” feeling. Some find that transitions such as moving from one place to the next or from one task to the next evokes this sensation.
Common feelings associated with just right OCD include:
- Mental & physical issues: Some have found that just right OCD is set off by visual, tactile, and auditory cues in the environment.3 One study found that 57% of OCD patients described the feelings as mental, and 42% said they experienced both mental and physical discomfort.2
- Superstitions: In trying to find meaning for why this happens, some people interpret just right OCD in the way we develop superstitions.Behaviors considered “lucky” may be performed due to an unlucky feeling. People also say they feel responsible for doing something that will prevent a bad thing from happening.
- Guilt: Feelings of guilt may also accompany just right OCD.4
People feel a sense of responsibility to ensure things are safe and are driven to perform compulsive behaviors. These can be physical acts (like tapping, repeating the behavior in the moment of being triggered, and visual checking) or mental (praying, seeking reassurance, and mentally reviewing the sequence of actions prior to the trigger).
Just Right OCD vs. “Typical” OCD
For the most part, just right OCD does not appear to have specific feared consequences from the feeling of incompletion, whereas other types of OCD like contamination, safety, sexually intrusive thoughts, or harm obsessions, have obsessive fear-based thoughts that drive compulsive behaviors meant to ward off negative feared outcomes.
With just right OCD, people want to “shake off” the feeling. Some describe it as a “tip of the tongue” experience that could be resolved in any second. Extraordinary effort is put into making the “just right” obsession go away, which is similar to other OCD subtypes.
“‘Just right OCD can differ from other forms of OCD in two ways:
- The obsessional thought(s) (e.g., one sock is lower than the other) may not signal harm so much as evoking the disruptive “not just right” feeling that the person believes will linger until things are put right
- There may not be the feelings of panic, fear, or even anxiety that we see in other forms of OCD; instead we see the ‘not just right feeling,’ and often irritation or frustration, particularly if the compulsion fails to correct
Most people with OCD have more than one type of obsession/compulsion; people with ‘not just right’ OCD may also have contamination obsessions and cleaning compulsions, or obsessional thoughts about harm and checking compulsions, or repugnant obsessions with cleaning/checking/reassurance overt and covert compulsions.” – Christine Purdon, Professor of Psychology and Director of Clinical Training of University of Waterloo
Just Right OCD & Perfectionism
It has been suggested that many perfectionistic OCD behaviors are attempts to match sensations with expected outcomes.
Some of the feelings that people attempt to reconcile include:5,6
- The feeling of having forgotten something
- A physiological feeling that you can’t explain
- The feeling that something hasn’t been done perfectly enough
- The feeling that something is unsafe or vulnerable for no recognizable reason
- Feeling that objects aren’t arranged in just the right way
There are some compulsive behaviors that appear related to other OCD subtypes such as checking that the stove is off for whom safety is not the primary concern, but rather to achieve a perfect state of completeness.5
Just Right OCD Symptoms
Common Just Right Obsessions
Most people with just right OCD cannot identify a specific obsessive thought that is causing their distress, but the sensation of incompleteness can evoke a sense of harm or danger for which they feel responsible.
Obsessions may be related to feelings of:
- Impending doom
- Causing harm
- Being harmed
- Bad luck
- Something wrong
- Being negligent, selfish, and uncaring if compulsions are not performed
Just Right Compulsions
Compulsions related to other OCD subtypes can be performed until the right feeling is achieved. For example, someone with contamination obsessions may wash their hands or take long showers until they feel clean enough, but when the reason is to feel right, they keep washing their hands or be stuck in the shower not because they feel dirty, but because they don’t yet feel able to move on. The same experience occurs with people who have safety concerns and check versus those who keep checking until the “not just right” feeling goes away.
Common just right OCD compulsions include:
- Ordering
- Arranging
- Washing
- Being stuck in place
- Counting
- Mental reviewing
- Cleaning
- Calling, emailing, texting or other forms of communication to others to make sure everything is OK
Monitoring
Purdon mentions, “In addition to obsessions and compulsions, people will also do a lot of monitoring of their environment so they can be on top of ordering/arranging. For example, people may monitor the movements of their family members so they can follow and put things that the family members may have disturbed back to rights. They may actually try to ‘corral’ their family members into one space and go get things for them so as to avoid having to follow their trail and correct things. People may scour the carpet for lint or to check that the vacuum lines are in fact straight. People will check that everything is in its place.”
How Are Just Right OCD Symptoms Triggered?
Just Right OCD symptoms can be triggered by any of the senses. It can be triggered by feelings that something is incomplete and feeling as though you need to achieve the task or complete the task to eliminate the feelings. It is often triggered by the feeling of fear, driving all the obsessive and compulsive behaviors, actions, and thoughts.
Outward Signs of Just Right OCD
People who suffer from OCD are often caught off guard by the sudden provocation of the feeling. People around them may not understand their behavior and it is often difficult for people to explain it. For some it may occur intermittently while for others it can be constant.
The common signs of just right OCD are:
- Being late to daily scheduled routine activities
- Repeating steps of random tasks (can be once or many times)
- Having things neatly arranged or ordered and being upset if they are moved out of position by others
- Need for symmetry (similar to Symmetry OCD)
“‘Just Right’ OCD obsessions and compulsions can appear virtually anywhere. From tapping knees to stepping on cracks while you walk, lining up toys, touching elevator buttons, saying prayers, combing your hair, or closing your car window–any of them can be a focus of ‘Just Right’ thinking.” – Mark A Reinecke, Professor Emeritus, Psychiatry and Behavioral Sciences at Northwestern University
How Does Having Just Right OCD Impact Someone’s Life?
Just Right OCD can make day-to-day life challenging. It can be hard to leave the house on time due to intrusive thoughts which can delay you if you need to do more rituals to cope. It can take time to make something feel complete even when you know your compulsions aren’t necessary. It can also pose challenges in relationships as a partner may feel overly watched or monitored.
Causes of Just Right OCD
Just right OCD results from a glitch in neurological sensory functions before and during triggering episodes that create urges to repeat behaviors.7 Usually the sense of touch, vision, hearing, and internal and external physiological sensations are involved in the experience.8
Neuroimaging and neurophysiological testing have identified the mechanism behind just right OCD is mediated by the frontal-subcortical circuits that signal response inhibition. Response inhibition is the suppression of actions that do not match the context that is expected in goal-oriented behavior.9
Another study found behavioral and neurophysiological evidence that action completion and the feeling of incompleteness were indicators of deficient response inhibition and may underlie action repetition and problems with controlling impulses which are normally attended to by attention and reason.1
Treatment for Just Right OCD
Just right OCD is treated the same way other OCD symptoms are treated, typically with exposure and response prevention (ERP). Since anything can trigger just right OCD, people mostly just have to perform functional tasks during ERP therapy sessions for OCD, and are coached to keep going in spite of the strong urge to stop and “fix” the feeling.
Reineke states, “As with other forms of OCD, it can be helpful to understand, on a moment-by-moment basis, the experience of the obsession or compulsion. What are the cues, emotions, and thoughts before, during and after the event? What’s the consequence if one doesn’t do it just right? How would you typically cope with the negative emotions which would arise? How can you inhibit the compensatory thought or action which follows? It can be a challenge, but Exposure and Response Prevention (the standard tools of OCD treatment) can be quite helpful with Just Right symptoms.”
Others have predictable situations that trigger the feeling (i.e., reading, writing, playing video games, watching movies) and practice moving fluidly with the task. The hardest part is the beginning phase of behavioral change. With consistent practice, the person develops the ability to keep moving and is better able to focus on the task rather than the feeling.
OCD Medications may also play a role in treatment.
Getting Help for OCD
It’s important to find a certified therapist with experience in treating OCD with ERP. You can ask your primary care doctor for a referral, or you can use an online therapist directory where you can sort by experience and insurance coverage.
Final Thoughts
Behaviors related to just right OCD can be challenging to control but with consistent practice people can accept and get used to the feeling as part of their daily experience. Once the feeling is accepted, people surrender the need to fix it in the way that someone with a low level chronic pain goes about her life not fighting it.
Just Right OCD Infographics
