“‘Just right’ OCD” is a nonclinical way to describe an urge to ensure things are symmetrical or “just right” that can occur in OCD. This condition can be treated with therapy or by addressing underlying guilt-related triggers.

“Just right” OCD is also commonly called perfectionist OCD, symmetry OCD, or Tourettic OCD (due to the tic-like behaviors it can involve). OCD does not clinically have subtypes, but people with OCD may use labels such as these to help define their symptoms.

The Dimensional Yale-Brown Obsessive Compulsive Scale distinguishes among the types of obsessions and compulsions that people with OCD experience, including:

  • symmetry/just right perception
  • harm
  • scrupulosity
  • contamination
  • hoarding
  • miscellaneous, such as superstitious beliefs

While this condition may feel distressing, there are ways to treat it. Here’s what to know.

Many people with OCD regularly have “not just right experiences” (NJREs), which involve the feeling or obsession that something is not quite right. As a result, they may have an overwhelming compulsion to “correct” the issue.

“Just right” OCD involves obsessive thoughts and compulsions that are driven by a sense that something is:

  • incomplete
  • asymmetrical or slightly off
  • not quite right

This type of OCD is typically accompanied by:

  • tension and discomfort due to the “off” trigger
  • a need to correct the circumstance until it’s “just right”
  • challenges identifying why something feels off (in some cases)

The “not quite right” situation could happen in response to sensory stimuli, such as smells or textures, or in response to feelings. Examples include:

  • needing to arrange objects until they’re perfectly aligned or symmetrical
  • feeling that an object is not in the right place and repeatedly adjusting it
  • needing to repeat words or phrases until they sound “right”
  • needing to think a thought in a specific way or a certain number of times
  • needing to repeat an action with each hand until it feels symmetrical
  • adjusting clothing until it feels “just right” on your body
  • feeling compelled to walk into a room several times until it’s “right”
  • feeling the need to end a conversation in a particular way

According to the International OCD Foundation, in children, the condition may manifest as:

  • insistence on wearing clothes in a certain way
  • severe distress when routines are disrupted
  • difficulty transitioning between activities

Unlike other types of OCD, “just right” OCD doesn’t always have an obvious trigger.

For example, while someone with harm OCD may wash their hands repetitively due to a fear of harm from germs, someone with “just right” OCD may wash their hands repeatedly until it feels “just right.” Someone’s exact definition of “just right” may be elusive, but it often involves a vague sense of symmetry, evenness, or perfection.

These habits may sometimes interfere with day-to-day activities.

According to a 2015 study, NJREs are mainly associated with OCD, but they may occur in other conditions that involve OCD-like symptoms. Examples include:

  • Hair-pulling disorder (HPD): HPD is considered an OCD-related condition. In the 2015 study, people with OCD had higher levels of NJRE severity than those with gambling disorder or eating disorders. However, those with HPD and OCD experienced relatively equal levels of NJREs.
  • Tourettic OCD: According to a 2022 review, Tourettic OCD is essentially a combination of OCD and Tourette syndrome. People with Tourette syndrome do not tend to have the “not just right” feeling when performing tics, but those with Tourettic OCD perform tics repeatedly due to feelings of incompleteness or imperfection.
  • Major depressive disorder (MDD): In a 2023 study, researchers found that people with OCD reported significantly higher numbers of NJREs than those with anxiety. However, people with MDD experienced NJREs at a roughly equal rate to those with OCD.

Commonly associated conditions with less evidence to support their relationship include:

  • Autism: According to a small 2017 study, there’s a lack of evidence to suggest that NJREs are a core facet of autistic traits. But this study had only 25 participants, so more research is necessary.
  • Anxiety: A small 2016 study found that people with OCD had significantly more NJREs than a control group with anxiety-related conditions and a neurotypical control group. But this study, too, had a small number of participants, and more research is necessary.

Older studies with small samples sizes have suggested that NJREs affect 63% to 92% of people with OCD. The International OCD Foundation reports that NJREs affect more than half of people who have OCD.

NJREs are considered a core driver of OCD, along with triggers such as harm avoidance. They may be treated with similar approaches, such as:

  • Cognitive behavioral therapy (CBT): CBT is a first-line treatment for OCD and can be effective at helping people identify and challenge the beliefs and thought patterns associated with NJREs.
  • Exposure and response prevention therapy: This is a form of CBT that involves facing feared “not just right” situations without engaging in compulsive behaviors.
  • Acceptance and commitment therapy: This form of therapy is particularly effective for helping manage obsessive thoughts.
  • Selective serotonin reuptake inhibitors: Doctors may prescribe these medications to treat OCD, often in combination with therapy.

Managing guilt and OCD

According to a 2023 review and some older research, guilt sensitivity plays a major role in both the development of OCD and NJRE severity. The review explains that “demanding parent mode,” which involves having a harsh, critical inner voice that sets unreasonably high standards or rigid inner rules, is commonly associated with OCD.

Demanding parent mode is linked to:

  • fearing guilt and experiencing more guilt
  • being more sensitive to disgust
  • experiencing more intense “not just right” feelings

For that reason, learning how to acknowledge, address, and heal from guilt may ease symptoms. Practicing self-compassion and being kinder to yourself may also help. Remember, you are not your obsessions or compulsions, and there’s life beyond them.

“‘Just right’ OCD” is a term that some people with OCD use to describe their experience, although “just right” OCD is not a clinical subtype of the condition. It may involve a desire for perfection or completeness.

If you have this experience of OCD, there are effective treatments that can help you manage it, including forms of therapy such as CBT and ACT.

Addressing underlying feelings of guilt that are common to NJREs may also help ease the symptoms. When in doubt, if possible, speak with a therapist who specializes in OCD.