Perfectionism, Symmetry, Just Right OCD, and Sensorimotor OCD
OCD related to rigid standards, a need for balance and “just right” feelings, and neutral obsessions/Sensorimotor OCD
Just-Right OCD
You've probably heard someone say, "I'm a little OCD about my desk," or "I'm OCD about how my closet is organized." It's one of the most common misconceptions about obsessive-compulsive disorder. While some people with OCD do struggle with order and organization, the disorder isn't about liking things neat. It's about what happens when your brain gets stuck on something that feels profoundly wrong.
One subtype that illustrates this well is Just Right OCD, sometimes called Incompleteness OCD or Tourettic OCD. Unlike many other forms of OCD, this subtype often isn't driven by a feared consequence. There may be no "What if something terrible happens?" Instead, the obsession is an intense internal sensation that something is off, incomplete, uneven, or misaligned. People often describe needing something to "click" or feel settled before they can move on.
This can show up in a variety of ways. A word or sentence may not sound "right," leading someone to reread or repeat it until the feeling resolves. Physical sensations may feel unbalanced—if one arm brushes a doorway, the other arm suddenly needs to do the same. Objects may need to be arranged in a particular way, not because they're more organized, but because the arrangement provides temporary relief from an internal sense of incompleteness.
The compulsions are attempts to make that uncomfortable feeling go away. Someone may reread the same line several times, rewrite words, repeat a sentence, or walk back through a doorway until it feels right. Others engage in symmetry behaviors, such as touching something with the opposite hand after accidentally brushing it with the other. Some people experience strong physical urges that lead to repeated blinking, tapping, shoulder shrugging, or other patterned movements. This sensory-driven presentation is why you'll sometimes hear the term Tourettic OCD. Although Tourette syndrome and OCD are different conditions, they can overlap, and some compulsions are driven more by an uncomfortable physical urge than by fear.
Like every form of OCD, these compulsions provide short-term relief while reinforcing the disorder over time. Each time the brain gets relief after repeating or correcting something, it learns that the ritual was necessary, making the urge more likely to return.
Sensorimotor OCD
At first glance, the intrusive thoughts that characterize Sensorimotor OCD do not appear necessarily frightening or distressing in the same way that other OCD subtypes might be more viscerally striking (violent, sexual, or contamination-related obsessions). This is where the term “neutral” obsessions comes from, in the sense that the obsessions of this subtype are not overtly taboo or obviously ego-dystonic. However, a closer look typically reveals that the obsessions are not necessarily about the sensations themselves, but rather what the consequences of noticing (or being unable to stop noticing) might be. Sufferers fear that, should the unwanted awareness of these thoughts, feelings, or sensations persist, it could ruin their life in some way.
Here’s a list of some of the more common obsessions that occur in Sensorimotor OCD:
Intrusive thoughts about (and/or unwanted awareness of):
automatic bodily processes, such as heartbeat or yawning
Certain body parts (e.g. nose, tongue)
dual-control processes (body functions that are usually on autopilot but can be consciously controlled) such as swallowing, breathing, and blinking
Dissociative sensory experiences such as depersonalization and derealization
Compulsive behaviors designed to try and get rid of the anxiety that these obsessions cause can vary. Oftentimes Sensorimotor OCD sufferers will perform mental compulsions such as monitoring the sensation or process, checking their awareness of it, or trying to tune it out or ignore it.
A note on OCD, Perfectionism, and OCPD
"Perfectionism," "OCD," and "OCPD" are often used interchangeably, but they describe meaningfully different experiences. Perfectionism is a personality trait, and it exists on a spectrum. While it can cause real suffering, it isn't a clinical disorder on its own. OCD is something different entirely. It's characterized by intrusive, unwanted thoughts (obsessions) that cause significant anxiety, and repetitive behaviors or mental acts (compulsions) performed to relieve that anxiety. The key word is unwanted: people with OCD aren't chasing high standards. They're trying to escape distress. This can be tricky, but one example would be someone who "has to" reorganize their desk until it feels exactly right. They aren’t necessarily a perfectionist; they may be responding to an intrusive sense that something is wrong and won't release them until they fix it. (Which would make the behavior a compulsion within the context of OCD).
Obsessive-Compulsive Personality Disorder (OCPD) adds another layer of confusion. Despite the similar name, OCPD and OCD are distinct conditions that respond to different treatments. OCPD is a personality disorder marked by a pervasive need for orderliness, control, and perfectionism. A person typically experiences these as ego-syntonic. They believe their standards are right and others simply aren't meeting them. People with OCD, by contrast, usually recognize that their obsessions and compulsions are excessive. Furthermore, the thoughts feel foreign and distressing, not justified (ego-dystonic).
It's also possible to have OCD and OCPD at the same time, which can complicate both diagnosis and treatment. If you've been told you're "just a perfectionist," or you're not sure whether what you're experiencing is OCD, OCPD, or something else, a thorough assessment with a clinician trained in these conditions can bring some clarity.
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I offer specialized treatment for Perfectionism, Symmetry, Just Right OCD, Sensorimotor OCD, and other Obsessive-Compulsive Disorder (OCD) presentations both in-person in Lake Charles, Louisiana, as well as online throughout Louisiana. Reach out now to schedule a free consultation.