When your child seems consumed by the need to have things a certain way—whether it’s aligning their books just so, rewriting a sentence until it feels perfect, or redoing tasks endlessly—you may wonder, What’s really going on here?
These aren’t just quirks or habits; they could be signs of Just Right OCD, a subtype of obsessive-compulsive disorder (OCD) that’s driven by an overwhelming need for perfection and symmetry.
Unlike typical OCD, which often stems from fears of harm, “Just Right” OCD centers on a deeply uncomfortable feeling of wrongness. It's not about external consequences but an internal battle for a sense of order or completeness. For children and teens, this can feel like being stuck in an endless loop where relief only comes after rituals—if it comes at all.
Take Jaime, for example. At first glance, she seemed like a perfectionist. But when I observed her in the classroom, the reality became clear: her relentless erasing and rewriting weren’t about achieving excellence but calming her brain’s demand for making it “just right.”
Understanding Just Right OCD in Children
Obsessive compulsive disorder (OCD) is when your child's brain gets stuck on the repeat button, obsessively replaying certain thoughts and behaviors. There are different kinds of OCD, and Just Right OCD is a specific manifestation where one can't tolerate feelings of imperfection.
In people with Just Right OCD, obsessive thoughts and compulsive behaviors are often centered around achieving a sense of things being “just right” or perfect according to a person's internal standards or rituals.
Put simply- it is an extreme form of perfectionism.
I recall working with Liam, whose struggle with “Just Right” OCD became evident during a school observation. At lunch, instead of sitting with his classmates, he meticulously arranged his food on his tray, cutting his sandwich into identical squares while the other kids chatted around him. His distress over getting things “perfect” overshadowed his ability to connect with peers or engage in typical activities.
Children with this type of OCD feel intense discomfort or anxiety if things are not arranged or done in a particular way. They might engage in rituals or repetitive behaviors to achieve a sense of perfection or to alleviate the distress associated with the uncomfortable feelings that something is not quite right.
Such mental acts could include repetitive checking, arranging objects in the right place or particular order, and performing specific actions until they feel right. (Coles & Ravid, 2016)
Just Right OCD vs. Perfectionism
While these two things can look similar on the surface, as both involve a desire for order and precision, however, the driving forces behind these behaviors are very different. Perfectionism is a personality trait focused on achieving high standards or avoiding mistakes, often tied to external goals or societal expectations. In contrast, “Just Right” OCD stems from an internal sense of discomfort or imbalance that compels individuals to perform repetitive actions until things feel “right.”
“Just Right” OCD | Perfectionism | |
What drives it? | Need for internal relief from discomfort or tension due to perceived “wrongness.” | Striving for excellence or high personal standards. |
What triggers it? | Intense anxiety or unease until things feel “right.” | Frustration or dissatisfaction with imperfection. |
What's the outcome | Compulsions, rituals, or repetitive behavior are performed to reduce distress. | Actions aim to achieve goals or avoid criticism. |
Flexibility | Rigid; difficulty stopping or ignoring the strong urge to “fix” things. OCD can affect one's psychological flexibility. | Flexible; able to adjust standards when necessary. |
What are the effects? | It can significantly disrupt daily life and relationships. | It may enhance or hinder productivity, depending on severity. |
Symptoms of Just Right OCD in Children
Are you worried that your child's odd behavior may be OCD? It's always a good idea to seek help from a mental health professional or have them take a Just Right OCD test for kids, but it's also important to observe your child's OCD obsessions and compulsions. As I always say, put your parent detective hat on!
Here's a quick list of Just Right OCD signs and symptoms:
- Feeling uncomfortable or anxious when things aren’t arranged, or not in the exact same length or done in a specific way.
- Repetitive behaviors such as adjusting items on a desk, rewriting homework, or reorganizing a backpack.
- Redoing actions over and over, like stepping on certain tiles, touching objects repeatedly, or retracing steps until it feel correct.
- OCD typing is when one spends hours retyping frustrated because it doesn’t feel “just right.”
- Seeking reassurance constantly, making sure they are not doing anything wrong
- Getting stuck on small details, like needing their clothes, artwork, or school supplies to be perfectly aligned or symmetrical.
- Struggling to move on from tasks because something feels incomplete or “off.”
- Avoiding certain activities, like games or group projects, to prevent triggers of discomfort or anxiety.
- Spending excessive time on routines, like brushing teeth, tying shoes, or arranging their room.
- Frustration or meltdowns when things don’t feel perfect or when rituals are interrupted.
- Difficulty making decisions because they fear choosing the “wrong” option
- Withdrawing from peers because of fear that their behaviors will be noticed or judged.
- Common obsessive thoughts include “I need to redo this. It feels wrong” and “This doesn't feel complete or balanced.” “This doesn’t look or feel even.”
- Common OCD compulsions include checking items (e.g., doors, light switch, or drawers) repeatedly to ensure they are in the “correct” position.
These common Just Right OCD examples can help you understand if your child’s behaviors are more than just quirks and could be signs of OCD. Recognizing these thought patterns is the first step toward getting the proper support.
What Causes Just Right OCD Symptoms?
The Just Right phenomenon is caused by a combination of factors, including genetics, brain chemistry imbalances, and nervous system dysregulation. These factors lead to heightened activity in brain areas responsible for processing fear and discomfort, making individuals feel an intense need to correct or complete actions to reduce internal distress. Stressful life events and environmental triggers can also exacerbate symptoms.
Holistic Ways to Treat Just Right OCD
Can just right OCD be cured or managed without medication? The answer is a big YES! It all starts with regulating the brain and the nervous system. Once your kid is calm and regulated, true healing occurs.
While “Just Right” OCD presents its unique challenges, there is hope and support available. Breaking the chains of perfection begins with acknowledging the nature of the disorder and seeking professional guidance.
Cognitive-behavioral therapy (CBT) is an effective therapy for just right OCD. Response Prevention therapy (ERP) is a CBT approach where the child is gradually exposed to stimuli until they can better manage their compulsions and obsessions. These exposures will help challenge and change their patterns of thought and behavior.
Finding a rumination focused ERP can also be helpful to help your child with intrusive thoughts and anxiety disorders that may come with OCD. Treatment and management continue at home, too, and this is why it's important to get the family involved, especially parents, so they can know how to manage Just Right OCD symptoms using self-regulation skills.
Mindfulness-based approaches, such as Acceptance and Commitment Therapy (ACT), can also be valuable in cultivating a more accepting and flexible mindset. Embracing uncertainty and learning to tolerate discomfort are pivotal steps in untangling the web of “Just Right” OCD.
Remember, there are simple ways to manage OCD. It all starts with a calm brain and a regulated nervous system. Even little things like using essential oils and taking herbs can make a difference.
OCD therapy should be combined with a healthy diet, supplementation, and a lot of behavioral therapy. Both Jaimie and Liam participated in my BrainBehaviorReset Program, which combines science-backed methods for Just Right OCD treatment. This program includes Neurofeedback, PEMF therapy, ERP, magnesium supplements, and brain tools that empower children to identify when OCD symptoms are taking hold, allowing them to counteract these with therapist-approved coping strategies and self-regulation techniques. Learn more about our program here.
Your child should be able to learn how to talk back to OCD. Parents should guide them on breaking free from the chains that bind them to the elusive quest for that just right feeling and make their day-to-day lives easier through natural therapies and solutions. Yes, there is hope!
Parent Action Steps
☐ Create a safe space for your child to share their significant distress and most common compulsions.
☐ Consult with mental health professionals specializing in obsessive-compulsive disorder.
☐ Consider natural treatments like ERP therapy to address common triggers.
☐ Cultivate a supportive home environment with every family member acknowledging the overwhelming fear related to different forms of OCD.
☐ Cultivate a mindset that embraces the feeling of incompleteness or imperfection and teaches children that mistakes are opportunities for growth and self-compassion.
☐ Take the OCD Quiz to get evidence-based treatments for your child.
☐ Use the Solutions Matcher for individualized solutions for Just Right OCD symptoms.
What is Just Right OCD?
Just Right is an obsessive-compulsive disorder (OCD) subtype characterized by an intense need for things to be aligned, symmetrical, or “just right” to relieve a sense of discomfort or imbalance. It bothers them if a thing seems unbalanced or feel incomplete. This often leads to repeat behaviors or the creation of rituals or mental acts to achieve a sense of order or completeness. It stems from feared outcomes that something bad will happen if things are not “right.”
Do SSRIs treat OCD?
The use of Selective Serotonin Reuptake Inhibitors (SSRIs) should never be the first line treatment for OCD symptoms or any other mental health conditions in a child. Watch my episode on SSRIs side effects.
At what age can a child start exposure therapy?
Exposure therapy can be tailored for children as young as 6 years old, depending on their ability to understand and engage in the process. A trained therapist will adapt the approach to suit the child’s developmental level and specific needs.
How does building pleasant experiences help with OCD?
Engaging in enjoyable activities can also create new, healthy neural pathways, making it easier for individuals to resist compulsive behaviors and their common obsessions.
These experiences can include activities that bring joy or relaxation, such as:
Creative hobbies: Painting, drawing, or playing music.
Physical activities: Playing sports, dancing, or yoga.
Mindfulness practices: Breathing exercises, meditation, or nature walks.
Social interactions: Spending time with friends, family, or pets.
Sensory activities: Gardening, baking, or engaging with soothing textures.
Such activities provide a healthy outlet for stress and help shift attention away from OCD-driven thoughts and behaviors.
Is perfectionism OCD the same as Just Right OCD?
Flawless OCD, also called Perfectionism OCD, involves frequent intrusive thoughts and compulsions to make things perfectly aligned or perfectly arranged, driven by a fear of mistakes or judgment. In contrast, Just Right OCD people are focused on relieving an internal sense of discomfort or imbalance, with repetitive actions aimed at feeling “just right” rather than achieving external perfection. Both disorder has perfectionist tendencies that may affect their day to day activities.
What are the common rituals around reassurance seeking OCD?
Asking repeated questions for confirmation (e.g., “Are you sure I’m okay?”).
Seeking validation about actions, thoughts, or decisions.
Confessing intrusive thoughts for reassurance.
Checking others’ reactions for approval or disapproval.
Researching excessively to confirm fears is unfounded.
These behaviors provide temporary relief but often reinforce the OCD cycle. A Rumination based ERP can help manage these symptoms.
Is there a Counting OCD test for kids, and how does it relate to Just Right OCD?
While there isn’t a formal Counting OCD test for diagnosis, parents can observe signs like repetitive counting, distress when losing track, or rituals involving specific numbers. These behaviors often overlap with Just Right OCD, where the need for balance or perfection drives counting rituals. If these patterns disrupt daily life, consulting a mental health professional is crucial to address both Counting OCD and related compulsions.
How to cope with OCD compulsive speech?
OCD compulsive speech involves repetitive or uncontrollable talking driven by intrusive thoughts or the need to feel “just right.” To cope, identify triggers, practice pausing before speaking, use deep breathing to manage anxiety, and consider Cognitive Behavioral Therapy (CBT) for effective support.
What is Health Concern OCD?
Health Concern OCD is a subtype of OCD focused specifically on obsessive worries about personal health.
Individuals may experience intrusive thoughts about having undiagnosed illnesses or physical symptoms, leading to excessive behaviors such as repeatedly checking their bodies for signs of disease, researching medical conditions online, or seeking constant reassurance from doctors, family, or friends.
For example, a child with this mental health condition may have ritualistic behaviors such as repeatedly checking their temperature or washing their hands excessively out of fear of germs.
What are other OCD subtypes?
Besides Just Right OCD, common OCD subtypes include:
Contamination OCD: Fear of germs, dirt, or illness leading to excessive cleaning or avoidance behaviors.
Harm OCD: Persistent thoughts about causing harm to oneself or others.
Checking OCD: Repeatedly checking things (e.g., locks, appliances) to prevent feared consequences.
Relationship OCD: Obsessive doubts about relationships or partner compatibility.
Health Concern OCD: Persistent fears about having undiagnosed illnesses.
Symmetry and Order OCD: A need for items to be perfectly arranged or balanced.
Citations
Coles, M. E., & Ravid, A. (2016). Clinical presentation of not-just right experiences (NJREs) in individuals with OCD: Characteristics and response to treatment. Behaviour Research and Therapy, 87, 182–187. https://doi.org/10.1016/j.brat.2016.09.013
Huey, E. D., Zahn, R., Krueger, F., Moll, J., Kapogiannis, D., Wassermann, E. M., & Grafman, J. (2008). A psychological and neuroanatomical model of obsessive-compulsive disorder. The Journal of neuropsychiatry and clinical neurosciences, 20(4), 390–408. https://doi.org/10.1176/jnp.2008.20.4.390
Kostek, N. T., Garcia-Delgar, B., Rojas, A., Luber, M., & Coffey, B. J. (2016). Approaches to the Diagnosis and Treatment of OCD with Comorbid Tic Disorders. Current Treatment Options in Psychiatry, 3(3), 253–265. https://doi.org/10.1007/s40501-016-0091-8
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Dr. Roseann Capanna-Hodge has three decades of experience in working with children, teens and their families with attention-deficit hyperactivity disorder (ADHD), autism, concussion, dyslexia and learning disability, anxiety, Obsessive Compulsive Disorder (OCD), depression and mood disorder, Lyme Disease, and PANS/PANDAS using science-backed natural mental health solutions such as supplements, magnesium, nutrition, QEEG Brain maps, neurofeedback, PEMF, psychotherapy and other non-medication approaches.
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