Symmetry and ordering OCD

Obsessive compulsive disorder (OCD) is a mental health condition where a person has obsessive thoughts and compulsive behaviours. OCD-UK says symmetry and ordering is one of five main types of OCD that are traditionally described. It adds that themes often overlap.

In this type of OCD, you feel a strong need for things to be even, in order or ‘just right’. Arranging, counting or repeating until they feel that way is the compulsion. OCD-UK says the fear behind it may be about avoiding the discomfort of things not feeling right. Sometimes it is about preventing harm.

The NHS lists ‘a need for symmetry or orderliness’ as a common obsession. It lists counting, ordering and arranging as common compulsions.

Our guide to what OCD is explains how obsessions and compulsions work together.

For some people, the urge is mostly about a feeling. Things look or feel wrong, and that brings a strong sense of unease. Putting them right is the compulsion.

For example, you might straighten the things on your desk again and again until they feel exactly right. Or you might count, or redo something, until it feels ‘complete’.

Putting things right brings relief, but only for a short time. The NHS explains that the obsession and anxiety soon come back, so the cycle starts again.

For some people, ordering is tied to a fear of harm. You might feel that if things are not lined up, someone you love could have an accident or become ill.

Most people with OCD know their compulsions make no logical sense. But the NHS says they still feel they need to do them ‘just in case’.

Some people fear that just thinking about something bad will make it more likely to happen. OCD-UK calls this ‘magical thinking’. It is also sometimes called ‘thought-action fusion’. Arranging, counting or repeating can then feel like a way to cancel the thought out.

NHS inform gives the example of someone who fears causing harm to their family. They may feel the urge to repeat an action many times to ‘neutralise’ the thought. NHS inform says this kind of compulsion is particularly common in children with OCD.

Rituals can feel like they keep people safe. But NHS inform explains that they make OCD harder to manage. They stop you learning that the frightening thoughts are not real, and that you can cope with the anxiety.

Lots of people like a tidy desk or a neat cupboard. That on its own is not OCD. People sometimes say they are ‘a bit OCD’ when they like things neat. Mind says a common misconception is that OCD just means liking things to be tidy.

OCD-UK says small quirks that pass quickly and cause little distress are not OCD. OCD itself can leave a person struggling to function for hours at a time.

A key difference is how it feels. The Royal College of Psychiatrists says compulsions in OCD never give pleasure. They always feel like an unpleasant demand or burden. Putting things right may bring brief relief, but that is not the same as enjoying it.

It may be worth talking to a professional if:

• the urges cause you distress
• the rituals take up a lot of your time
• they get in the way of work, school, friends or family life

Children often have little rituals of their own. The Royal College of Psychiatrists says many children have mild compulsions, such as arranging their toys very precisely or avoiding cracks in the pavement. This usually goes away as they grow older. But it is worth getting advice if a child’s rituals upset them, take up a lot of time or affect school or family life. Our guide to OCD in children and young people explains more.