Symmetry OCD is a subtype of OCD where people feel the need for perfect balance or order in their surroundings. Intrusive thoughts can cause anxiety when symmetry isn’t achieved—causing compulsions like rearranging objects, aligning items repeatedly, or engaging in rituals to restore a sense of “rightness.”
Many people have a natural preference for organization and neatness. Whether it’s having a tidy home, a well-arranged workspace, or an organized schedule, order and structure can create a sense of calm and control. Some people feel more comfortable when their surroundings reflect a certain level of balance and symmetry.
However, if you have symmetry OCD, a subtype of OCD, you might have an intense, uncontrollable need for perfect balance and symmetry. You may have thoughts like: “This is asymmetrical—if I don’t fix it, it feels incomplete” or “I can’t stop until everything feels balanced and symmetrical.”
When the need for symmetry becomes a cycle of obsessions and compulsions, it’s gone well beyond a personal preference for order, despite what the myths and media depictions of OCD may say.
Fortunately, symmetry OCD is highly treatable with exposure and response prevention (ERP) therapy. Read on to learn more about the symptoms of symmetry OCD, how it can affect your daily life, and the most effective way to treat it.
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What is symmetry OCD?
Symmetry OCD falls under the subtype “just right” (perfectionism) OCD, which involves noticing, fixating on, and feeling very uncomfortable in response to things that are out of balance or asymmetrical.
In this form of OCD, symmetry specifically refers to the idea that objects or sensations should mirror each other exactly, creating an ideal of balance where both sides are perfectly equal in appearance or feel. The need for order and symmetry can be so consuming that it interferes with daily life. This can include items in your visual field as well as feelings or sensations in your body.
Like other forms of OCD, “just right” (perfectionism) OCD is characterized by a cycle of obsessions and compulsions. Obsessions are recurrent and intrusive thoughts, sensations, images, feelings, or urges, typically center around a need for symmetry, balance, or order. When something feels “off,” it can trigger anxiety or and severe discomfort.
This might involve something as simple as a picture frame being slightly crooked, a stack of books that’s not perfectly straight, or even physical sensations, like feeling that one side of the body is different from the other. The anxiety triggered by unbalanced or asymmetrical objects and sensations can be overwhelming, making it difficult to focus or complete tasks without performing compulsions.
Common obsessions of symmetry OCD
Some common obsessions of symmetryOCD include:
- 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 an orderly way, sometimes symmetrical in a literal sense
- Feeling the need to walk in a way that feels perfectly balanced
- Becoming preoccupied with facial features (eyes, ears, nostrils, etc.) that are not perfectly matched or even
- Feeling the urge to have food in perfectly equal portions, the same number of items on each side of the plate, or having food look “balanced”
Common compulsions in symmetry OCD
These obsessions can be extremely upsetting. As a result, you might perform compulsions, which are repetitive behaviors or mental acts, in order to reduce anxiety or prevent something bad from happening.
Compulsions can take up hours of your day and make you feel highly uncomfortable, frustrated, or awkward in public or social situations.
Some common compulsions in symmetry OCD include:
- Arranging and rearranging furniture or other objects
- Arranging decorations or home decor in a geometrically symmetrical way
- 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 the 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
Community discussions
Do I have symmetry OCD, or is it just a preference for orderliness?
For many people, having things organized or neat is simply a matter of preference. Some people enjoy symmetry, whether it’s arranging items in their home, organizing their closet, or ensuring their workspace is orderly. These preferences are often just part of their routine, and they don’t interfere with daily functioning.
“A lot of people like things symmetrical, color-coded, or orderly,” says licensed therapist Tracie Ibrahim, MA, LMFT, CST. “That doesn’t mean you have OCD. A lot of people think of OCD as some kind of delightful order and symmetry disorder. However, OCD causes distress.”
For example, people with OCD don’t want to straighten a picture on the wall just because they “don’t like it that way,”” says Ibrahim. “They straighten it because they’re going to feel very uncomfortable until they’ve straightened it. They might even take longer than other people to straighten it and make sure it’s even really, really, really straight or really symmetrical.”
The good news is that with proper treatment, including exposure and response prevention (ERP), people with symmetry related OCD can manage their symptoms.
Exposure and response prevention (ERP) for symmetry OCD
ERP is a specialized form of cognitive behavioral therapy (CBT) that was specifically designed to break the cycle of obsessions and compulsions.
In ERP, you’ll work together with a trained therapist to gradually confront your intrusive thoughts and fears while resisting the urge to do compulsions to ease anxiety. You’ll start by identifying your core fears and creating an exposure hierarchy—a list of exposure exercises you can do ranging from ones that are least distressing to those that are more challenging. This allows you to start with manageable exposures and build your way up, helping you confront your fears step by step while learning to tolerate the discomfort without resorting to compulsions.
The response prevention part of ERP includes intentionally resisting the compulsive behaviors you typically perform in response to your obsessions.
“If we’ve got this whole order and symmetry happening in the bathroom, I’d say, take one item and put it out of place. That’s where we can get started,” says Ibrahim. “Then, take a couple of items and put them out of place. And then we can go a little bit larger: mess up all of the items and put them somewhere where you don’t normally put them.”
This process may be difficult at first, but over time, it teaches your brain that the anxiety caused by imbalance or imperfection is temporary and does not require immediate action.
Some other examples of exposures 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
Over time, through ERP, you’ll gain the confidence to face intrusive thoughts without performing compulsions to decrease distress. Instead, you’ll learn that you can tolerate discomfort and anxiety without needing to “fix” imbalance or asymmetry.
Bottom line
The distress caused by a lack of symmetry, order, or balance isn’t just about a preference for neatness—it goes much deeper. The discomfort is overwhelming, often creating a sense of unease, anxiety, or even fear when things feel “off.” This distress can be all-consuming, leading to compulsive behaviors that temporarily relieve the tension but never truly resolve the underlying anxiety. The constant need to restore balance can take up hours of the day, leaving little room for other activities or responsibilities
As a result, it’s important to find a therapist that specializes in ERP therapy who can curate a structured, tailored plan specific to your unique needs.
Key Takeaways
- Symmetry OCD is part of an OCD subtype called “just right” (perfectionism) OCD, where people have obsessions that cause an overwhelming need for balance, symmetry, and order in both their environment and their own body.
- In response to obsessions, someone with symmetry OCD performs compulsions, which can include the need to arrange objects symmetrically, match sensations or actions on both sides of the body, and avoid situations where imbalance or disorder could trigger distress.
- Exposure and response prevention (ERP) therapy gradually exposes you to your intrusive thoughts and triggers while you resist the urge to do compulsions to ease anxiety.