View original article published in Psych Central–

Landon was a bright intelligent child. He had excelled academically and also enjoyed sports. However, OCD appeared to be getting in the way of his life. There were times when he could not get out of bed because the thought of having to get dressed overwhelmed him. His socks needed to feel just right as well as his shirt and pants. He would repeat the behaviors until he felt just right about it. He seemed to be late to school every day.

Things in his room had to be just so. He would be angry and become aggressive when he noticed someone had been in his room. New belongings were challenging as well. When his parents bought him new items such as a backpack, shoes, or clothes, he refused to use or wear them. He quit violin lessons because playing the wrong notes distressed him. His parents felt helpless and lost.

Parents may miss the “just right” OCD symptoms and misunderstand their child’s behavior as defiant and manipulative. It may not make sense that their child is refusing to get dressed or do anything because things just don’t feel right. Kids who experience this type of OCD may feel overpowered by the dreaded feeling they often can’t explain. They just know it doesn’t feel right, and they believe this discomfort and tension in their body will last forever.

Parents can watch for signs of “just right” OCD also known as symmetrical, organizational, or perfectionism OCD.

Possible worries or obsessions:

• Feeling overwhelmed and stressed when someone disturbs them in any way.
• Maintaining possessions perfectly.
• Being judged when performing and feeling incomplete.
• Not looking perfect — clothes, hair, overall appearance.
• Not being understood by others perfectly.
• Learning about a specific topic.
• Having said, done, or thought something imperfectly.
• Reading and understanding things perfectly.
• Not being perfectly honest.
• Having things out of order, messy, or imperfect.
• Worrying about feeling stuck forever.

Those worries are intense, and OCD sufferers feel like they need to do something to feel right or complete. They create rituals that provide relief.

Possible Compulsions:

• Arranging objects or possessions in a special order or symmetrical way.
• Insisting their new possessions stay intact and in a perfect way.
• Maintaining belongings and room in a perfect order.
• Saying, reading, writing, drawing, memorizing, or doing something perfectly.
• Learning everything possible about a particular subject.
• Maintaining perfect appearance such as hair and redoing it until it feels just right.
• Being perfectly honest and “good.”
• Procrastinating homework and chores to avoid feeling doomed.
• Difficulty making decisions for fear of making the wrong one.
• Repeating behavior compulsively, such as getting dressed until they feel just right.
• Purposely doing an activity extra slowly to avoid making a mistake.
• Avoiding places or things such as rooms, beds, drawers, closets, they have been done perfectly so they won’t feel out of order.
• Avoiding certain behaviors or activities to circumvent feeling incomplete.

Reminders:

• Children’s disruptive behavior may appear defiant or manipulative; however, it is most likely due to the overwhelming discomfort.
• Obtain professional help as soon as you notice your children’s behavior is getting in the way of school, friends, family, or other areas of their lives.
• When children feel too overwhelmed, they may let go of their perfectionism and their rooms may become chaotic. They may become depressed.
• Children’s tension and distress may paralyze them. Validate and acknowledge their feelings as needed.
• When they feel stuck, they’ll want your assistance. Be cautious and remember that it takes time to change their inflexibility.
• Become aware of your own rigidity and avoid going from one extreme to the other such as doing everything for your child to becoming an OCD sergeant.

Ideas to get you and your child started:

• During peaceful moments talk about how they can delay the rituals when Mr. “Just Right” OCD shows up. Teach them that they can do this by sitting quietly and noticing their breathing. Younger children can notice how their belly goes up and down as they sit quietly. Ask them how long they think they can do this activity. Make a note of their prediction and set your stopwatch. Sit quietly with them and when they start becoming restless, notice the time that they were able to sit still. Have fun establishing a daily routine of sitting still and noticing.
• During quiet times, talk about the activities they wish they could be doing if Mr. “Just Right” OCD weren’t bossing them around. Talk about the things they enjoy doing. Create a sense of hope and confidence as you talk about the things they can do and make a plan.
• When an OCD storm shows up, encourage them to be curious and find out what may happen when they practice sitting still. Remind them why they are doing this routine. For example, “Let’s see how long you can sit still and notice your breathing. Remember, Mr. “Just Right” OCD doesn’t have to stop you from going out to play with your friends and having fun. You can do this!” Praise their efforts even if they just sat still for 5 seconds. Remember it’s about the process.

When OCD begins to disrupt your children’s life and yours, remember the love and support you have from family and friends. They are waiting for your call. Don’t hesitate to ask for their assistance. You deserve and need time to recharge and come up for some fresh air. Don’t ever forget that while there is life there is always hope!