Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Fears or obsessions about symmetry

Nov 18, 20226 minute read

OCD focused on symmetry falls in the category of Just Right (Perfectionism) OCD. It involves noticing, fixating on, and feeling very uncomfortable in response to things that are out of balance or asymmetrical. This can include items in one’s visual field as well as feelings or sensations in one’s body. People with Just Right OCD related to symmetry become very uncomfortable or distressed when they see things that are unbalanced or uneven, or when they experience sensations in their body that are not the same on both sides. This obsession with symmetry goes far beyond a simple preference for having things arranged in an aesthetically pleasing way. It involves intense anxiety and a strong compulsion to correct or balance out asymmetry or imbalance.

“Symmetry” here refers to things having balanced proportions or being arranged such that their sides mirror each other exactly. For people with symmetry themes in Just Right OCD, literal symmetry may not always be required, but rather things must be lined up or ordered in a particular way that looks or feels “right” to them. People with OCD focused on symmetry may arrange decorative objects on a mantel or table in a way that is symmetrical or balanced, park their car such that it is perfectly centered between the lines, become preoccupied with facial features that are uneven or unbalanced, style their hair in a symmetrical way, arrange books according to height, perform an action on the other side of the body after it was done on one side, walk in a way that feels balanced, or chew equally on both sides of the mouth. 

People with symmetry themes in Just Right OCD may also mentally undo or rearrange things. They may experience fear that if things are not arranged or done in a balanced way, something bad will happen, but in many cases, they don’t fear a specific negative outcome, but rather experience intense anxiety or distress due to the feeling that something just isn’t quite right.
  • Feeling the need to match sensations or actions on one side of the body with the same sensations or actions on the other side
  • Feeling the need to arrange objects in a way that is very ordered, sometimes symmetrical in a literal sense
  • Feeling the need to arrange items on a desk in a specific, orderly way, perhaps such that items line up perfectly with the edge of the desk
  • Feeling the need to arrange books on a shelf according to height
  • Feeling the need to make drapes on either side of a window hang perfectly evenly, with both sides matching perfectly
  • Feeling the need for pillows on a bed or sofa to be perfectly symmetrical
  • Preoccupation with facial features such as eyes, ears, or nostrils that are not perfectly matched or even
  • Feeling the need to park a car so that it is perfectly centered between the lines demarcating a parking spot
  • Feeling the need to walk in a way that feels perfectly balanced

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Common triggers

People with OCD related to symmetry may be triggered by a wide variety of situations in which items are not precisely arranged in an orderly or symmetrical fashion or feel askew. These can include items being arranged unevenly on a mantle or table, facial features that are uneven, or a car parked unevenly in a parking spot. 

With OCD centered on symmetry that pertains to bodily sensations, triggers may include experiencing a sensation on one side of the body, being touched on one side of the body, brushing against something with only one side of the body, or walking in a way that feels uneven.

How can I tell if I’m experiencing Just Right OCD surrounding symmetry and not simply a preference for a particular aesthetic? 

OCD is distinct in that it consists of a cycle of intrusive and unwanted thoughts or urges called obsessions; persistent anxiety that results; and compulsions, which are attempts to neutralize the feelings and reduce the anxiety. Obsessions in OCD go far beyond a simple preference for how things are arranged or how they feel physically. Obsessive thoughts and sensations are persistent and result in significant anxiety. 

A person with OCD focused on symmetry may feel extremely anxious or uncomfortable when triggers are encountered. As with other forms of OCD, they become driven by anxiety to resolve the source of discomfort by urgently rearranging things or evening out unbalanced physical sensations. Attempts to do this become excessive and the relief achieved is fleeting.

Common compulsions

When people with Just Right OCD focused on symmetry experience intrusive thoughts, feelings, or urges that cause distress, they are driven by anxiety to engage in a variety of compulsions, whether mental or physical. Compulsions are done in an attempt to correct anything that does not look or feel balanced or symmetrical. 

Compulsions can take up hours of one’s day and make them feel highly uncomfortable, frustrated, or awkward in public or social situations.

Common compulsions performed by people with OCD centered on symmetry include:

  • Arranging and rearranging furniture or other objects in one’s environment
  • Creating arrangements of décor that are geometrically symmetrical
  • Mentally measuring or checking to see if things are even 
  • Ruminating on things that they can’t rearrange, trying to “solve” their discomfort
  • Making things feel balanced in their body by repeating actions done with one side of the body on the other side
  • Walking in such a way that both feet feel the same
  • Arranging books on a shelf according to height and facing the same direction
  • Painstakingly making sure drapes hang perfectly even on both sides of a window
  • Meticulously parking a car so that it is exactly positioned in the center of a parking spot

How to treat OCD focused on symmetry

Just Right OCD focused on symmetry can be debilitating for people who struggle with it, but, like any form of OCD, it is highly treatable. By doing exposure and response prevention (ERP) therapy with a trained therapist, you can overcome the debilitating cycle of OCD.

Exposures are planned activities that trigger fearful thoughts or sensations. In ERP, one also practices intentionally resisting their compulsions. When exposures are done consistently over time, one learns that a lack of balance and symmetry can be accepted, even when it’s uncomfortable—although unpleasant, anxiety can be tolerated. In time, the anxiety one feels in response to triggers becomes manageable, and sometimes negligible.

ERP therapy for symmetry themes in Just Right OCD would involve making things asymmetrical or unbalanced and resisting the urge to rearrange or balance them out. Essentially, exposures are designed by determining what OCD is dictating and doing the opposite.

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Examples of possible exposures done to treat OCD focused on symmetry include: 

  • Arranging pillows on a sofa or bed in an uneven way
  • Placing books in random order with heights mixed up
  • Parking a car unevenly in a parking spot
  • Touching the body on one side only
  • Asking someone to touch part of the body on only one side and not repeating the action on the other side
  • Walking with one foot on a rug and one on the floor

I encourage you to learn about NOCD’s accessible, evidence-based approach to treatment. 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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