“Not just right” OCD is a category of OCD where individuals often experience an overpowering internal sense that the balance, order, place, frequency or position of something is disturbed and must be corrected. It can be a spoken or written word, touch, feel, sound, or smell of something that is not ‘just right.’ The individual with ‘just right’ OCD often performs endless repetitions of ordinary tasks out of frustration that they are not ‘perfect’ or ‘just right.’ Touching and tapping, symmetry, ordering, and arranging, perfectionism and counting can all be part of the rituals related to ‘just right’ OCD.
Although Exposure and Response Prevention is a useful for treatment of NJR OCD, variations of individual presentation may necessitate variants in goals of ERP.
For some individuals with NJR OCD, the feeling is not accompanied with any specific fear but rather difficulty tolerating feelings of discomfort/tension that are associated with skipping rituals. For these individuals, exposures may look more similar to habit reversal training with emphasis on the practice of tolerating difficult sensations.
Other individuals with “not just right” feelings may have associated beliefs that feeling less than “just right” will lead them to underperform in valued work or social functions, particularly with upcoming special events or other high-stakes performance situations. Cognitive-behavioral therapy examining perfectionistic beliefs and values clarification may be an important adjunct in order for exposures to be effective.
For other individuals, not just right feelings can be accompanied by distressing intrusive thoughts (e.g., thought of something bad happening to self or loved ones) and need to achieve a “just right” feeling through compulsions to prevent intrusive thought from coming true, even if logically they believe these events are not connected. Thought-action fusion exercises can also be a helpful way to address magical thinking and increase motivation for exposure.
DISCLAIMER: The content found here is intended to serve as educational content and is not intended to replace therapy. For treatment-related questions, please be sure to work with your local provider or contact a local clinician.