Just Right OCD: Obsessions, Compulsions, & Treatments

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, incomplete, or just not quite right. 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.¹ One study found that 57% of those with just right OCD 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 with magical thinking, in the same 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 OCD guilt may also accompany just right OCD.³ People feel a sense of responsibility surrounding their OCD 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 & 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:^4,5

• 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.⁴

Tics Vs. Just Right OCD

Just right OCD and tics, usually related to Tourette’s disorder or tic disorder, may appear to have some overlap of symptoms. With closer inspection, though, tics are quite different from OCD. Tics tend to be a quick and automatic behavioral symptom that includes movement or vocalization. Just right OCD leads to compulsions, which are behaviors that are more elaborate and intentional.

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 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 Symptoms

OCD symptoms consist of obsessions and compulsions. Those with just right OCD may obsess about things being incomplete or causing harm to those around them, then practice compulsions like ordering and rearranging items in their home or mentally reviewing every aspect of their day.

Common Just Right Obsessions

Most people with just right OCD cannot identify a specific intrusive 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

OCD compulsions 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.”

Avoidance

Someone with Just Right OCD may develop the compulsion of avoidance to cope with the distress caused by obsessions. Avoidance generally shows up as someone intentionally staying away from people, places, or situations which might trigger their obsessions. Avoidance can also involve using distractions to avoid the distress caused by the obsession. When avoidance becomes a common compulsion, it can cause someone with OCD to live in isolation.

Just Right OCD Examples

Just Right OCD may look different for everyone. In general, it involves obsessions and compulsions centering around something that feels “off,” incorrect, or incomplete and efforts to “correct” the trigger. Obsessions also tend to be triggered by the five senses.

Here are a few examples of what just right OCD could look like:

• Someone is the last person to leave work and they are responsible for locking the front door. They feel compelled to lock and relock the office door until the sound the lock makes seems “correct.”
• Someone develops an obsession that something is “off” about the food at a neighbor’s holiday function. They decide to go into the kitchen and monitor how things are being prepared and stored. If someone tries to do something they are uncomfortable with, they offer to do the task for them.
• Someone writes a handwritten note to a friend but feels that their letters are “different” than last time. They become convinced the last note they hand-wrote was “correct” and attempt to replicate the experience through writing and re-writing the note until it feels “right.”

How Are Just Right OCD Symptoms Triggered?

Just right OCD symptoms can be triggered by any of the senses. It typically starts with a feeling that something is undone or not right, and feeling the need to complete a specific task to eliminate the feelings. It is often triggered by a feeling of fear, driving all the obsessive and compulsive behaviors, actions, and thoughts.

Here are some potential just right OCD triggers based on the five senses:

• Sight: Sight related triggers might include certain numbers, incomplete or uneven things, or dirty objects. Sight triggers generally cause a person to feel the need to clean, order, arrange, straighten, or monitor.
• Sound: Sound triggers may become obsessions when they feel incomplete or incorrect. Sounds, or songs, may also become stuck in a person’s mind who has just right OCD, and they may feel compelled to re-listen until the sound feels “correct.”
• Smell: Smell triggers may become obsessions when a person ruminates on “why” something smells “off” or “incorrect.”
• Touch: Touch triggers generally have to do with a feeling of asymmetry or incompleteness. For example, someone may brush against your right arm and you may feel compelled to “even out” sensations by touching your left arm.

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.

Common signs of just right OCD include:

• 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)

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.

What Causes 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.⁶ Usually the sense of touch, vision, hearing, and internal and external physiological sensations are involved in the experience.⁷

Causes of OCD are typically a combination of:

• Genetics: Genetics is potentially the biggest risk factor for OCD. Having a close family member with OCD greatly increases the odds of having OCD, especially if that family member showed symptoms during childhood.
• Personality: Temperamental risk factors of OCD include being inhibited, showing more depression and anxiety, and internalizing mental health symptoms.
• Trauma & life changes: Trauma and high stress increase the risk of OCD. With high levels of abuse, neglect, or other life changes, OCD possibility increases.
• The development of another condition: People with OCD tend to have other mental health conditions, especially anxiety disorders, like panic disorder, social anxiety disorder, and generalized anxiety disorder.

Just Right OCD Treatment

The key treatment for OCD is exposure and response prevention, and many people with OCD also experience relief from medication.

Exposure and Response Prevention

Just right OCD is treated the same way other types of OCD 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 sessions for OCD, and are coached to keep going in spite of the strong urge to stop and “fix” the feeling.

Examples of Exposures for Just Right OCD

The best ERP treatments will be specific to the form of obsessions and compulsive behaviors. Some possible types of exposures could be:

• For a person who touches a door lock numerous times: Encouraging them to only touch once.
• For a person who flips a light switch over and over: Encouraging them to only flip once.
• For a person who counts aloud: Asking them to avoid counting.
• For a person who steps or walking a certain way: Asking them to walk with a different pattern.
• For a person who blinks or moves eyes compulsively: Focusing on building time between blinks.

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.”

Acceptance & Commitment Therapy

ACT for OCD focuses on helping someone become more accepting of their experience of intrusive thoughts, images, and urges instead of constantly avoiding and pushing away obsessions. ACT comes from the basic notion that anxiety and distress are parts of life that don’t have to be avoided in order for positive change to occur.

ACT helps OCD sufferers learn how to mindfully accept obsessions without attaching meaning to them, learning to live life despite the distress. ACT sessions help someone develop psychological flexibility through learning to embrace core values and commit to living a purposeful life through these values, despite the content of their obsessions.

Medication

ERP is the first line treatment for OCD, but OCD medications can help make the process speedier and more effective for many. Selective serotonin reuptake inhibitors (SSRIs), specifically, are a class of antidepressants that have a track record of improving OCD symptoms.⁸

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. You can also utilize online OCD resources like NOCD to get started from home.