Episode 26

Just Right OCD

In this episode of Purely OCD, show hosts Lauren Rosen, LMFT, and Kelley Franke, LMFT, discuss “Just Right” OCD. They discuss related obsessions (they could be anything!), compulsions and exposures. As always, they answer questions at the end.

Lauren and Kelley reflect on Goldilocks’ insistence that she get things “just right.” This is not wholly dissimilar from what people with Just Right OCD are after.

This desire for getting that “just right” feeling can come up in all sorts of different subtypes. For instance, people with this subtype might think they must:

• Get the “Just Right” feeling when praying in order to continue with other activities.
• Write a word just right or something will to happen to a family member.
• Finish whatever task is being done (walking around the block, eating a meal, folding a towel) before the phone rings, or else something bad will happen.
• Check something until it feels “just right” (e.g. checking the door knob until you hear it click in the right way)
• Do something just “right or else” they’ll feel “off” forever.

There’s a lot of magical thinking related to Just Right OCD.

The obsession could really be about anything. The “just right” is about the goal of the compulsion.

Exposure and Response Prevention for Just Right obsessions could involve:

• Making it “Just wrong” (i.e., a little bit off)
• Sitting with the uncomfortable feeling
• Writing an imaginal exposure that something bad will happen because a person didn’t do something “Just Right”

Kelley and Lauren talk about how guilt and moral scrupulosity can get involved when it comes to resisting compulsions. Oftentimes people reason that it’s not such a big deal to check something one more time if it could save a person’s life. The trouble is it rarely stays at that one more check.

Kelley: “If it’s in my control to check one more time then isn’t it worth it because I could save that person?” … It’s like some moral obligation.

Lauren: [OCD says] “Gotta go back because otherwise I’m a jerk. Because I can’t bothered to go back for 5 seconds and save my mother’s life. Which of course is not true… but you have to be wiling to embrace that maybe you are.”

Kelley: You know what I would do if it were me… and what I have done, is been like “Well, I’m really excited today about killing everybody in the house” and then just walk out that door with my shoulders back and my stomach…to the floor.

Viewer Question: Does OCD cause black and white thinking?

“I think OCD is very black and white. I don’t know if there’s any in between. It’s either good or bad or – and that’s the whole thing is we’re trying to teach people how to do middle path… maybe there’s a little good or a little bad.”

Kelley Franke, LMFT

Black and white thinking can encourage compulsive overthinking. For example if you think “I’m a bad person” you may want to churn over the circumstance to make sure you didn’t do something offensive.

Life causes black and white thinking… everyone engages in black and white thinking… It’s very evolutionarily beneficial to be able to think efficiently, to be able to make snap judgments. It’s just that efficient doesn’t mean accurate.

Lauren Rosen, LMFT

Lauren mentions the book Thinking, Fast and Slow in which Daniel Kahneman talks about Type 1 and Type 2 thinking. Type 1 is very black and white and it’s efficient but not necessarily accurate. Type 2 is more thorough but takes more energy. Having the capacity for both types of thinking is important, but the black and white thinking would have been selected for given that being able to make snap decisions is a skill that promotes survival.

Someone asks a question about good and bad foods, chemicals, and diet. Lauren talks about the fact that this comes up in Eating Disorders generally and also in Orthorexia specifically. There is a lot of all or none thinking in our culture regarding food “Good foods” versus “Bad foods.” While some foods are more nutrient dense or less so, foods aren’t inherently moral.

Question: How to describe symptoms to a psychiatrist when the content of thoughts are shameful.

Unfortunately sometimes people have to educate their providers about OCD. With some of the more taboo themes, opening up can be challenging under the best of circumstances. Understandably, people can be more reticent to share these thoughts if someone isn’t super familiar with OCD. If you’re seeing a therapist who specializes in OCD, you can ask your provider to educate your psychiatrist if they are not well informed.

Question: Is it normal to have a flood of OCD thoughts after a night of drinking or getting drunk. What if I did this and I don’t remember?

Kelley: Oh my God I hate this one!

It’s challenging because if you do black out then the concern of not remembering whether you’ve done something makes some degree of sense. And reconsidering your behaviors so that you might act more responsibly in the future might be beneficial, given that blacking out is unlikely to be helpful.

But this can come up for people who don’t black out. If you don’t have an explicit, autobiographical memory about a situation, you may question what happened – like with locking a door while sober. This also applies when substances are involved.

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Disclaimer: This information is meant to be general information not unique to any individual. Before following any guidance or advice found on this site or in the Purely OCD Podcast a visitor or listener should always consult with their own licensed healthcare practitioner. The Purely OCD Podcast and Website are not therapy or intended as a replacement for therapy. They are for educational purposes only.