OCD Series: Perfectionism OCD Treatment
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As a therapist who specializes in OCD therapy, I frequently work with clients whose struggles center around the need for things to feel “just right,” to be perfectly aligned, or to be completed without any errors. This subtype of Obsessive-Compulsive Disorder is often referred to as Perfectionism OCD or Symmetry/Ordering OCD, and it can cause significant distress and disruption. If you feel stuck in cycles of arranging, correcting, or repeating tasks until they’re perfect, this post is for you. I’ll explain how this form of OCD works, what it looks like in everyday life, and how therapy for OCD can help.
What Is Perfectionism (or Symmetry) OCD?
Perfectionism OCD is characterized by intrusive thoughts or discomfort related to things being uneven, imprecise, or incomplete. The individual may feel compelled to correct these perceived imperfections until they achieve a sense of internal “rightness.” Unlike high-achieving perfectionism (which is more about performance or achievement), Perfectionism OCD is often about relief from anxiety or internal tension rather than achieving external goals.
Common triggers include slightly misaligned objects, writing that doesn’t look “just right,” or completing tasks in an exact sequence. This OCD subtype can manifest in both physical and mental compulsions.
Common Obsessions and Compulsions:
Here are some of the most frequent ways Perfectionism OCD may appear:
Obsessions:
Distress about items being crooked, uneven, or asymmetrical
Feeling that something is incomplete or not done “the right way”
Fear that something bad will happen if things aren’t perfect
Intrusive thoughts that persist until something feels resolved
Compulsions:
Repeatedly arranging or straightening objects
Rewriting words or redoing tasks until they feel “just right”
Tapping, counting, or moving in specific ways
Mentally reviewing actions to ensure they were done perfectly
Although these behaviors may appear subtle or even productive to outsiders, they are often exhausting and deeply distressing for the person experiencing them.
The Challenges of Perfectionism OCD
This form of OCD can be particularly insidious because our culture often rewards perfectionism and attention to detail. As a result, people struggling with Perfectionism OCD may be praised for their efforts, even as they’re suffering internally. Many of my clients describe feeling trapped by their own standards, spending hours on tasks that should take minutes. The emotional toll includes anxiety, frustration, guilt, and a persistent sense of failure.
More than 1 in 100 people have experienced OCD in the past year, per NIH.
How Is Perfectionism OCD Treated?
Like other subtypes, Perfectionism OCD responds well to evidence-based treatments. Here’s how I typically support clients dealing with this challenge:
Exposure and Response Prevention (ERP): We’ll identify your perfectionism-related triggers and gradually work toward tolerating imperfections—whether it’s leaving a picture frame slightly crooked or sending a message with a minor typo. The goal is to break the association between imperfection and threat.
Cognitive Restructuring: I’ll help you identify and challenge rigid thinking patterns, such as “If it’s not perfect, it’s a failure,” and work toward more flexible, compassionate self-talk.
Medication: For some, SSRIs can reduce the intensity of OCD symptoms, especially when perfectionistic behaviors are severe.
Mindfulness and Acceptance: Mindfulness techniques help you observe your discomfort without immediately trying to “fix” it. These strategies can build your tolerance for uncertainty and reduce the urge to correct everything.
Moving Forward
Perfectionism OCD can be draining, but it’s also treatable. With the right support, you can learn to embrace imperfection, regain time lost to compulsions, and move through life with more ease.
Additional Support: Finding a Therapist in Philadelphia
At Philadelphia Talk Therapy, I offer specialized OCD treatment to help clients untangle from the grip of perfectionism and related compulsions. If this post resonates with you, I’d be honored to help you take the next step. Let’s work together to build a more balanced, self-compassionate way forward.
Matt Sosnowsky, LCSW, MSW, MAPP is the founder and director of Philadelphia Talk Therapy. For over a decade, Mr. Sosnowsky has provided psychotherapy services in agency and private practice settings, helping individuals overcome mental health challenges, manage life transitions, and find passion & meaning in life.
Want to learn more about Philadelphia Talk Therapy and how we can help you understand and treat Symmetry OCD? Get in touch today.
