Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Fear of disorder

By Scott Serpa, LICSW

Aug 30, 20225 minute read

Reviewed byTaylor Newendorp

What is ordering OCD?

Perfectionism can come in two forms. The healthier expression of perfectionistic tendencies is associated with goal-directed behavior, organizational skills and high standards for yourself. The much unhealthier form of perfectionism—which is very common with ordering OCD—can be characterized by fear of disorder and making mistakes, recurrent doubts that you are doing something correctly, preoccupation with past mistakes, and a persistent need to maintain a sense of control, all of which usually result in distress, anxiety, frustration, or poor self-esteem. 

If you have a near-constant need for things to be done or feel “just right,” that persistent desire for a feeling of certainty could be a product of OCD. Many people with ”Just Right OCD” experience obsessive feelings or worries that things feel “off,” and engage in compulsions related to order and symmetry to try and feel secure and in control. The problem is there is no true certainty or absolute “just right,” and doubts and bothersome feelings of imperfection will always be present in some form. 

Order-related rituals can involve the need to rearrange objects to make things look just right, lining things up over and over again, performing a task or action until it feels perfect, and counting objects in order to be sure of their number or to make sure they are divided into equal groups. 

OCD order and symmetry symptoms can involve organizing items in a certain way, feeling “incomplete” when items are not exact, and a need for symmetry in actions you undertake and/or how different areas of your body feel (for example, “I bumped my left arm on the desk, so I need to bump my right arm so it feels the same”). 

Organization rituals can also involve aligning objects to prevent something bad/unwanted from happening or trying to mentally “arrange” your thoughts in a certain way to make sure you are not a bad person. Someone struggling with ordering OCD tends to feel tremendous discomfort when something does not appear, think, or feel the way they need it to be in order to achieve a sense that it is perfect or just right.

Ordering OCD – Common obsessions

  • Experiencing intense anxiety due to asymmetry
  • Requiring extreme balance in all things such as exerting equal pressure on each foot when walking
  • Continuous fear or dread that something bad will happen if an item is out of place
  • Needing things to look or feel in balance such as books, papers or personal items
  • Hyper-focus on breathing, blinking, walking, or other sensations
  • Feeling a need to remember or account for small details (a road sign, license plate, number of steps, etc.)

Common triggers

People fear of disorder may be triggered by situations causing them to feel as if they are not in control of a situation, and that something bad may happen as a result. They may also experience distress when they have to make a decision or take action, which can lead to indecisiveness (also known as “decisional avoidance”). The pressure of having to provide the “right” or “perfect” answer can feel overwhelming. Others describe having intrusive thoughts or sensations that something in their mind, body, or environment is “not right,” which causes anxiety as well.

Triggers for people with ordering OCD include:

  • Situations that are hurried or intense
  • Seeing items that are not aligned correctly or appear incomplete
  • Writing, typing, walking, or other repetitive physical tasks
  • Thinking “What if I always feel this uneasy?” or “I can still fix it”
  • Entering new or unfamiliar places

How can I tell if it’s OCD fear of disorder, and not anxiety or relationship issues?

OCD will include obsessions and compulsions, in one form or another. Obsessions go beyond typical worries and are considered to be intrusive thoughts, images, sensations, or urges that cause undue anxiety and distress. Compulsions can be repetitive behaviors or mental acts where a person is compelled to act in response to their obsessions, in an attempt to resolve anxiety, prevent a negative outcome, or feel “just right.” 

Obsessions from OCD tend to be more intense than generalized anxiety disorder (GAD), and GAD will not involve overt compulsions such as ordering and arranging things excessively, or mental review and rumination, in order to feel better temporarily. Anxiety with GAD is more gradual day to day, whereas OCD hits hard and fast with specific fears or distress—in Ordering OCD specifically, you may feel that things need to be ordered and arranged to reduce anxiety as quickly as possible.

Common compulsions

When people with ordering OCD experience obsessive thoughts or feelings, they feel a need to resolve their anxiety or distress by doing compulsions, which can be physical or mental actions. These may include impeccably ordering objects, arranging clothes, food, shoes or any items in the environment, ensuring that there are no visible asymmetries in handwriting, writing or typing sentences until they feel “just right”, or reviewing their memory for specific details they may have forgotten.

Compulsions performed mentally or physically by people with ordering OCD include:

  • Repetitive arranging organizing or lining up objects until certain conditions are met 
  • Repeating actions until they feel just right
  • Counting objects or actions to feel in control
  • Reviewing memories to feel certain about details

How to treat fear of disorder

Fear of disorder in order and symmetry OCD can be debilitating for people who struggle with it, but it is highly treatable by doing exposure and response prevention (ERP) therapy with a trained OCD specialist. ERP exposes a person to situations related to their intrusive thoughts that cause them anxiety, then guides them while they resist engaging in compulsive behaviors. The goal of treatment is for people to learn that they can resist compulsive urges, causing the intensity of their discomfort to fade away on its own and decrease long-term. 

Everybody gets intrusive or unwanted thoughts or feelings from time to time, but for people without OCD, these thoughts and feelings don’t cause much or any distress. OCD, on the other hand, causes these thoughts and feelings to get “stuck” and bring distress. By repeatedly facing such situations without engaging in compulsions, people with OCD can learn that they are able to tolerate anxiety, and that discomfort can pass without performing compulsions that only make their anxiety worse over time.

If you’re struggling with OCD, you can schedule a free 15-minute call today with the NOCD care team to learn how a licensed therapist can help. At NOCD, all therapists specialize in OCD and receive ERP-specific training. ERP is most effective when the therapist conducting the treatment has experience with OCD and training in ERP.

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