Just Right OCD is a form of obsessive-compulsive disorder where people experience an overwhelming sense that something is "not right" or "incomplete." Unlike other OCD forms, it's not driven by fear of specific threats, but by an intolerable feeling of incompleteness that only subsides when things are "exactly right."
What Is Just Right OCD?
Just Right OCD, also known as "Not Just Right Experiences" (NJREs) or incompleteness OCD, is a specific presentation of obsessive-compulsive disorder characterized by a dominant feeling of incompleteness or that things aren't "quite right." Unlike other OCD forms where specific fears (such as contamination or harm) drive behavior, people with Just Right OCD are driven by an internal urge for things to be "exactly right."
According to the International OCD Foundation (IOCDF), over 50% of individuals with OCD experience "just right" obsessions and compulsions. Research by Coles and colleagues (2003, 2005) established that these "Not Just Right Experiences" represent a distinct phenomenon in OCD that can significantly impact daily functioning.
Uncomfortable sensory or psychological experiences characterized by a feeling that something is "not right" or incomplete, which drives repetitive behaviors aimed at achieving a "just right" feeling. Unlike fear-based OCD, NJREs are primarily motivated by discomfort and an urge for completion rather than anxiety about specific threats.
Sensory phenomena (SP) are uncomfortable feelings, including physical sensations, "just right" perceptions, and feelings of incompleteness, that have been identified as predictors of symptom severity in individuals with obsessive-compulsive disorder (Horncastle et al., 2022).
Just Right OCD Symptoms: How It Shows Up
Just Right OCD manifests in various ways. The core symptoms can be divided into three main categories:
1. Symmetry and Ordering Compulsions
An overwhelming need for symmetry, balance, and perfect arrangement defines this category. People may spend hours arranging objects until they are positioned "just right."
Pictures must hang perfectly straight and be exactly aligned
Objects on a desk or shelf must be arranged symmetrically
Books must be sorted by size, color, or alphabet—with precisely defined spacing
Clothing must be folded or hung in a specific way
Furniture must be positioned at exact distances from each other
2. Repetition Compulsions
Actions must be repeated until they "feel right." This process can make simple everyday activities extremely time-consuming.
Walking through doorways until it "feels right" (often a specific number of times)
Repeating, erasing, and rewriting words or sentences
Counting steps or performing activities a specific number of times
Starting homework or work assignments over and over until they appear "perfect"
Touching an object until the feeling is "right"
3. Completeness Compulsions
A pervasive feeling of incompleteness that only goes away when an action is completed in a very specific way.
Touches must be performed equally on both sides of the body (left = right)
Thoughts must be "finished" before moving on
Reading and rereading text until every word has been "fully absorbed"
Ritualized morning or evening routines that must be followed exactly
The feeling of having forgotten something "important," even when everything is objectively done
Just Right OCD is not about perfectionism in the traditional sense. While perfectionists strive for a high ideal and feel pride when achieving it, people with Just Right OCD experience an internal compulsion and intense tension that is only relieved by the "right" feeling. They experience no satisfaction, only temporary relief.
The Science Behind It: Sensory Phenomena
In research, Just Right Experiences are classified as part of so-called "Sensory Phenomena" (SP). These describe a group of unpleasant physical and mental sensations closely linked to OCD symptoms.
Understanding Sensory Phenomena
Sensory phenomena encompass various types of uncomfortable sensations:
Not Just Right Experiences (NJREs)
The feeling that something is "not right" or "not quite as it should be," without perceiving a specific threat or danger
Feelings of Incompleteness
A pervasive sense that an action or situation is "incomplete" and must be finished
Physical Sensations
Physical discomfort such as tension, pressure, or a "tingling" that compulsions are meant to relieve
Urge to Act
A compulsive internal drive to perform or repeat an action until a certain feeling is achieved
Prevalence and Clinical Significance
A comprehensive meta-analysis by Horncastle, Ludlow, and Gutierrez (2022) examined the relationship between sensory phenomena and OCD symptoms in both clinical and non-clinical populations. The findings reveal:
Robust effect sizes for both incompleteness feelings and Not Just Right Experiences in relation to OCD symptoms were confirmed. Interestingly, effect sizes did not differ significantly between clinical and non-clinical groups, suggesting that these sensory phenomena are a consistent feature of obsessive-compulsive symptoms—regardless of disorder severity.
Research findings suggest that sensory phenomena should be considered as an intervention target for individuals with clinical and subclinical OCD features.
Sensory phenomena are confirmed as markers for obsessive-compulsive symptoms in both groups. Findings suggest that sensory phenomena could be targeted as intervention for individuals with both clinical and subclinical obsessive-compulsive features.
— Horncastle, Ludlow & Gutierrez , Meta-Analysis 2022, Journal of OCD and Related Disorders
Neurobiological Basis
Neurobiological research has provided important insights into the mechanisms of Just Right OCD. While the exact causes are not yet fully understood, imaging studies show specific patterns in the brains of affected individuals.
The Cortico-Striatal-Thalamic Circuit
Research funded by the National Institute of Mental Health (NIMH) has found that OCD is associated with overactivity in the cortico-striatal-thalamic circuit. This neural pathway is responsible for:
Habit formation – the development of automatic behavioral patterns
Movement control – planning and executing actions
Reward functions – the sense of "rightness" or completion
In Just Right OCD, this circuit appears to signal incorrectly that an action is "complete" or "right." This leads to the overwhelming urge to repeat actions until the brain finally gives the signal that something "fits."
Brown and colleagues (2019), in NIMH-funded research, demonstrated that functional neural mechanisms specifically related to sensory phenomena show distinct activation patterns, providing neurobiological validation for the "just right" experience.
Imaging studies show that in people with Just Right OCD, certain brain regions—particularly the orbitofrontal cortex, the striatum, and the thalamus—exhibit altered activity. These regions are significantly involved in evaluating whether an action is "finished" or "right."
The Role of Serotonin and Other Neurotransmitters
As with other forms of OCD, the neurotransmitter system plays an important role in Just Right OCD. In particular, serotonin—a neurotransmitter that influences mood, impulse control, and the evaluation of actions—appears to be imbalanced in OCD.
This explains why Selective Serotonin Reuptake Inhibitors (SSRIs) can help relieve symptoms in many affected individuals. However, people with pronounced Just Right Experiences sometimes respond less well to medication alone than those with anxiety-based OCD forms—highlighting the importance of specific therapeutic approaches.
How Just Right OCD Differs from Other OCD Types
Just Right OCD differs from other OCD forms in several important aspects:
Feature |
Just Right OCD |
Other OCD Forms |
|---|---|---|
Primary Motivation |
Feeling of incompleteness; urge for "rightness" |
Fear of specific threats (contamination, harm, etc.) |
Emotional Driver |
Tension, discomfort, internal pressure |
Anxiety, panic, fear |
Compulsions |
Repetition until the "right feeling" |
Neutralizing a feared danger |
Relief |
Temporary, when something "feels right" |
When anxiety subsides or is neutralized |
Typical Areas |
Symmetry, ordering, repetition, balance |
Contamination, harm, morality, religion, sexual/aggressive thoughts |
These differences have important implications for treatment. While anxiety-based OCD treatment using Exposure and Response Prevention (ERP) aims to reduce anxiety, Just Right OCD treatment must focus on tolerating discomfort and incompleteness.
Impact on Daily Life
Just Right OCD can significantly impact life. The constant need to make things "right" leads to:
Time Loss and Slowness
Simple everyday tasks can take hours. Brushing teeth, getting dressed, or leaving the house becomes a time-consuming ritual. Some affected individuals report needing several hours to get ready in the morning because every action must be repeated until it "feels right."
This phenomenon is called "obsessional slowness" in the clinical literature and can lead to significant impairments in education, career, and social relationships.
Academic and Occupational Impairments
Schoolwork is rewritten, erased, and corrected over and over, even when content is correct
Deadlines cannot be met because assignments don't appear "perfect enough"
Workflows are interrupted by ritualized actions
Concentration difficulties because thoughts constantly revolve around "incompleteness"
Social isolation as appointments are canceled or avoided to make time for rituals
Emotional Burden
The constant internal tension and the feeling of never being "done" lead to:
Chronic stress and exhaustion
Frustration and self-blame
Feelings of shame because others can't understand the behavior
Depressive symptoms as a consequence of impairments
Social isolation as affected individuals hide their rituals from others
Studies show that nearly 90% of children with OCD report at least one significant impairment in functioning, with difficulties at school, home, and in social settings. Just Right OCD contributes significantly to this burden.
Diagnosis and Recognition
Diagnosis of Just Right OCD occurs as part of a comprehensive clinical evaluation by a psychiatrist or psychotherapist with OCD expertise.
Diagnostic Criteria
Just Right OCD meets the general criteria for OCD according to DSM-5 or ICD-11, with the following features being particularly characteristic:
Presence of obsessions or compulsions that are time-consuming (more than 1 hour per day) or cause significant distress
Compulsions are not primarily motivated by fear, but by a feeling of incompleteness or the need for "rightness"
Repetition, symmetry, or ordering needs are prominent
The person experiences overwhelming discomfort when things don't appear "right" or "complete"
Symptoms lead to significant impairment in important life areas (school, work, social relationships)
Assessment Tools
Various standardized instruments are used to assess and evaluate symptoms:
Yale-Brown Obsessive Compulsive Scale (Y-BOCS)
The gold standard for measuring OCD symptom severity, including time, impairment, and control over symptoms
Not Just Right Experiences Questionnaire (NJREQ)
Specific questionnaire developed by Coles et al. for assessing "Not Just Right Experiences" and incompleteness feelings
Dimensional Yale-Brown Obsessive Compulsive Scale (DY-BOCS)
Captures various symptom dimensions, including symmetry and ordering compulsions
If you notice that you:
- Spend more than an hour daily on rituals or repetitions
- Avoid or limit important activities (school, work, social contacts) due to compulsions
- Experience significant distress from feelings of incompleteness
- Notice impairments in relationships or daily life
...then it makes sense to seek professional help. The earlier OCD is treated, the better the chances of success.
IOCDF Therapist Directory: iocdf.org/find-help
NOCD: Online ERP therapy platform specializing in OCD at nocd.com
Psychology Today: psychologytoday.com
Crisis Support: 988 Suicide & Crisis Lifeline (call or text 988)
Just Right OCD Treatment
The good news: Just Right OCD is treatable. Current research shows that approximately 70% of people with OCD respond to evidence-based therapies. However, Just Right OCD often requires specific modifications to standard treatment.
Exposure and Response Prevention (ERP)
Exposure and Response Prevention (ERP) is considered the gold standard for OCD treatment. According to the IOCDF, ERP is the most effective psychological treatment for OCD. For Just Right OCD, however, ERP is adapted in special ways:
While exposure for anxiety-based OCD aims to reduce fear, Just Right OCD treatment focuses on tolerating incompleteness and discomfort. This means:
Create a Hierarchy
Together with your therapist, you create a list of situations that trigger the "not just right" feeling, sorted by difficulty level.
Begin Exposure
You deliberately expose yourself to situations that trigger incompleteness—e.g., intentionally hanging a picture crooked or leaving a text with "errors."
Prevent Response
The crucial step: You resist the urge to "correct" the situation or repeat until it "feels right."
Tolerate Discomfort
You learn to endure the uncomfortable feeling of incompleteness without reacting. Over time, the intensity of this feeling decreases.
Experience Habituation
Through repeated exposure, your brain becomes accustomed to the feeling of incompleteness, and the urge for compulsive behavior diminishes.
Research from the University of South Florida OCD Program shows that clinicians frequently modify ERP for Not Just Right (NJR) OCD because the standard form is often less effective. Modifications focus on training tolerance of incompleteness rather than anxiety reduction (Reid, Storch & Lewin, IOCDF Fact Sheet).
Cognitive Behavioral Therapy (CBT)
In addition to ERP, treatment also includes cognitive elements that help challenge dysfunctional beliefs:
"I must do everything perfectly, or it's worthless"
"If something doesn't feel right, I must fix it"
"Incompleteness is intolerable"
In therapy, you learn to recognize these thought patterns and develop alternative, helpful perspectives.
Acceptance and Commitment Therapy (ACT)
ACT has proven particularly helpful for Just Right OCD because it focuses on psychological flexibility and values-based action:
Acceptance: Learn to accept unpleasant feelings (like incompleteness) without needing to control or change them
Defusion: Create distance from your thoughts—"I'm having the thought that something isn't right" instead of "Something isn't right"
Values-based action: Consciously choose actions that align with your life values, even if that means discomfort
Medication
In many cases, psychotherapy is supplemented by medication, particularly:
Selective Serotonin Reuptake Inhibitors (SSRIs) such as sertraline, fluoxetine, or fluvoxamine
Clomipramine (a tricyclic antidepressant with strong anti-OCD effects)
Important to know: People with pronounced Just Right Experiences sometimes respond less well to medication alone than those with anxiety-based OCD forms. Therefore, combination with psychotherapy is particularly important.
Treatment |
Response Rate |
Special Considerations for Just Right OCD |
|---|---|---|
ERP (modified) |
60-80% |
Requires focus on incompleteness tolerance rather than anxiety reduction |
Cognitive Therapy |
50-70% |
Helpful for perfectionism and beliefs about completeness |
SSRI Medication |
40-60% |
Often less effective than for anxiety-based OCD; combination recommended |
Combination ERP + SSRI |
70-85% |
Best evidence for long-term improvement |
Self-Help Strategies and Daily Tips
In addition to professional therapy, there are several strategies that can help you cope with Just Right OCD in daily life:
1. Set Time Limits
Set fixed time limits for activities prone to rituals:
"I'm allowed a maximum of 15 minutes for getting dressed"
"I read a paragraph only twice, no more"
"I organize my desk for at most 10 minutes"
Use a timer to maintain these boundaries.
2. "Good Enough" Instead of "Perfect"
Consciously practice leaving things "good enough":
A picture doesn't need to hang exactly straight—"close enough" is sufficient
A text doesn't need to be perfect—mistakes are human
Objects don't need to be arranged with millimeter precision
Tell yourself: "This is good enough" and move on, even if it feels uncomfortable.
3. Intentionally Build in Incompleteness
Practice mini-exposures in daily life:
Intentionally leave a book tilted on the shelf
Position an object asymmetrically on your desk
Write a text and deliberately leave a small "mistake"
Touch something with one hand without using the other hand too
These small exercises train your brain to tolerate incompleteness.
4. Mindfulness and Acceptance
Mindfulness exercises help observe discomfort without reacting to it:
Notice the feeling of incompleteness: "I feel tension in my body"
Name it: "This is my Not Just Right feeling"
Accept it: "This feeling is uncomfortable, but not dangerous"
Let it be there without changing it
Over time, you'll notice that the feeling subsides on its own without you having to do anything.
These strategies can be supportive but do not replace professional therapy. If your symptoms significantly impact your life, seek help from an OCD-specialized therapist.
For Family Members: How Can I Help?
As a family member or friend of someone with Just Right OCD, you can play an important supportive role—but it's also important to know the boundaries:
What Helps
Educate yourself about Just Right OCD—understanding is the first step
Be patient—compulsions are not voluntary and cannot simply be stopped
Avoid criticism—"Just stop it" or "It doesn't matter" don't help and often increase shame
Support professional help—encourage therapy and offer to help find therapists
Don't participate in rituals—if you constantly make things "right" or check, you reinforce the compulsions
Praise progress—acknowledge small successes in coping with compulsions
What to Avoid
Providing reassurance—"Yes, that looks perfect" reinforces dependence on external feedback
Performing rituals—when you make things "right" for the person, you don't help in the long run
Showing impatience—"This is taking too long" creates additional pressure
Equating the person with OCD—your loved one is more than their disorder
The IOCDF offers resources specifically for family members, including support groups and educational workshops. These can help you better understand how to provide support without reinforcing compulsions. Visit iocdf.org/supportgroups for more information.
Prognosis and Outlook
The prognosis for Just Right OCD is overall positive when adequate treatment is provided:
Approximately 60-80% of affected individuals experience significant improvement through ERP or a combination of ERP and medication
Symptoms can be significantly reduced, even if complete "cure" is not always a realistic goal
Many people learn to manage their compulsions so that they no longer represent significant impairment
Early intervention significantly improves chances of success
It's important to understand: OCD is often a chronic condition that can occur in phases. Relapses are possible, especially during stressful periods. But with the right coping strategies and professional support, these phases can be managed well.
Research shows: People who receive specialized OCD treatment often experience life-changing improvements. Many report that after therapy, they feel "free" for the first time in years and can shape their lives according to their own values—not according to the rules of their compulsions.
Frequently Asked Questions
Summary: Key Takeaways
What is Just Right OCD?
A form of OCD where an overwhelming feeling of incompleteness or "not-rightness" is the primary driver—not fear.
Prevalence:
Over 50% of people with OCD experience "Not Just Right Experiences" to varying degrees.
Main Features:
Symmetry and ordering compulsions
Repetition compulsions until the "right feeling"
Completeness needs
Significant time loss and daily life impairments
Treatment:
ERP (modified for incompleteness tolerance)
Cognitive Behavioral Therapy
Acceptance and Commitment Therapy
Medication (SSRIs) often in combination with psychotherapy
60-80% response rate to evidence-based therapies—significant improvement is possible with professional help.
Final Thoughts
Just Right OCD can be an extremely distressing condition that significantly limits life. The constant feeling that something "isn't right" or is "incomplete" can be exhausting. But there is hope and effective help.
Research in recent years has significantly expanded our understanding of "Not Just Right Experiences." We now know that these sensory phenomena are an important and treatable aspect of OCD. With the right therapy—particularly modified ERP, cognitive therapy, and when appropriate, medication—most affected individuals can achieve significant improvement in their quality of life.
If you're affected: You're not alone, and your experiences are real and valid. It's not your fault, and you're not "too perfectionistic" or "too sensitive." You have a treatable neurobiological condition, and with professional support, you can learn to regain control over your life—not over your compulsions, but over your choices and actions.
The first step is often the hardest: seeking help. But this step can be the beginning of a new life—a life where "good enough" really is good enough.
This article is for informational purposes only and does not replace professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition. If you're experiencing a mental health crisis, please contact the 988 Suicide & Crisis Lifeline by calling or texting 988.
References & Sources:
International OCD Foundation (IOCDF). Just Right OCD Fact Sheet. Authors: Jeannette Reid, MS, Eric Storch, PhD, & Adam Lewin, PhD. University of South Florida OCD Program. https://iocdf.org/
Horncastle, T., Ludlow, A. K., & Gutierrez, R. (2022). Not just right experiences and incompleteness as a predictor of OC symptoms in clinical and community samples: A meta-analysis. Journal of Obsessive-Compulsive and Related Disorders, 35, 100762. https://doi.org/10.1016/j.jocrd.2022.100762
Coles, M. E., Frost, R. O., Heimberg, R. G., & Rhéaume, J. (2003). "Not just right experiences": Perfectionism, obsessive-compulsive features and general psychopathology. Behaviour Research and Therapy, 41(6), 681-700.
Coles, M. E., Heimberg, R. G., Frost, R. O., & Steketee, G. (2005). Not just right experiences and obsessive-compulsive features: Experimental and self-monitoring perspectives. Behaviour Research and Therapy, 43(2), 153-167.
Brown, L. T., et al. (2019). Functional neural mechanisms of sensory phenomena in obsessive-compulsive disorder. National Institute of Mental Health (NIMH) funded research.
Belloch, A., Fornés, G., Carrasco, A., López-Solá, C., Alonso, P., & Menchón, J. M. (2016). Incompleteness and not just right experiences in the explanation of obsessive-compulsive disorder. Psychiatry Research, 236, 1-8.
Summerfeldt, L. J. (2004). Understanding and treating incompleteness in obsessive-compulsive disorder. Journal of Clinical Psychology, 60(11), 1155-1168.
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Foa, E. B., Yadin, E., & Lichner, T. K. (2012). Exposure and response (ritual) prevention for obsessive-compulsive disorder: Therapist guide (2nd ed.). Oxford University Press.