CBT for Orderliness and Symmetry OCD In Kent, London and Online by Video Session

Obsessive Compulsive Disorder (OCD) is a psychological health condition characterized by persistent and unwanted thoughts, obsessions and repetitive behaviours or mental compulsions.

Whilst OCD manifests in several different forms depending on the individual’s context, one of the most clinically prevalent OCD subtypes involves obsessions and compulsions relating to orderliness and symmetry.

We provide specialist Cognitive Behavioural Psychotherapy for Orderliness and Symmetry OCD, including metacognitive therapy (MCT), Acceptance and Commitment Therapy (ACT), Inference Based Therapy (IBT) and Exposure and Response Prevention (ERP).

To organise a free 15 minute consultation to talk about the problem and therapy options for Orderliness and Symmetry OCD, you can email This email address is being protected from spambots. You need JavaScript enabled to view it. or complete our contact form.

What is Orderliness and Symmetry OCD?

Orderliness and Symmetry OCD, also known as “Just So” or Perfectionism OCD, involves anxiety and discomfort when things are out of sequence, symmetry or balance. This is characterised by intrusive and obsessional thoughts about disorder and compulsive arranging, organising or visual alignment behaviours.

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Orderliness and symmetry OCD often stems from a need for control and predictability in an inherently unpredictable world. Individuals experiencing this form of OCD may feel overwhelming anxiety if certain items or tasks are out of place or asymmetrical.

This projected need for order is linked to how some OCD sufferers interpret ambiguous or unpredictable situations as threatening, unsafe, uncomfortable or out of control The preoccupation with things being out of balance or asymmetrical, leads to an intolerable sense of uncertainty, incompleteness, volatility, disequilibrium, frustration and anxiety.

The compulsive check and correct behaviours that follow; such as rearranging objects, sequencing or excessive adjusting are used as substitute coping mechanisms to alleviate feelings of uncertainty, disorder and distress .

Individuals struggling with Orderliness and Symmetry OCD logically understand that their compulsive check and correct behaviours are irrational and ineffective, however orderliness behaviours provide a short term proxy for relief and deflect feelings of disorder and ambiguity. Research into Orderliness and Symmetry OCD indicates that the obsessions can be less explicit than other forms of OCD, rather presenting as tacit and intense feelings of discomfort, fear or foreboding. Never the less, Obsessional themes can include:

An overwhelming urge for objects to be arranged in a specific sequence or order, such as items needing to match in size, shape, or colour. Worrying or fixating about visual alignment, excessive detail and precision.
A preoccupation with the aesthetic look or feel of objects such as ornaments, pictures or clothing.
Feeling distracted or frustrated if items are moved or rearranged.
Obsessing about body sensations, feelings of balance or physical imperfections.
Fixating on matching behaviours, for example feeling the same tension or pressure in each foot when walking or on both sides of the body when altering posture.
Worrying and ruminating on feelings of dread, misfortune, insecurity or danger if things do not feel “just right”.

Whilst obsessions are mainly experienced as feelings of discomfort, frustration or fear, Orderliness and symmetry Compulsions tend to be more explicit and easier to observe. These include:

Counting and recounting items repeatedly to ensure that objects feel organised or symmetrical.
Continuously checking to ensure that objects or possessions such as books, clothes, shoes, utensil’s, pictures or ornaments are precisely placed in their correct position.
Visually checking that items are aesthetically symmetrical and continuously making fine adjustments. Constantly moving or arranging items until they are perceived as perfectly aligned or orderly.
Counting behaviours, such as counting the number of items or ensuring that they meet a specific numerical pattern.
Adjusting objects so they are perfectly straight or aligned with one another, such as aligning books on a shelf or ensuring picture frames are level.
Excessive or ritualised cleaning to avoid feelings of disorder or incompleteness. (This can overlap with contamination OCD, where the compulsion is based on the fear of infection, pollution or mental corruption).
Avoiding places or situations that might trigger feelings of disorder or chaos, such as cluttered or disorganised environments.
Systematically organizing, categorising or labelling belongings based on specific criteria such as colour, size or purpose.
Engaging in certain repetitive actions such as locking and unlocking doors or closing cabinets repeatedly until it feels “just right.”

These compulsions, while intended to alleviate anxiety caused by obsessions, often interfere with daily life and may consume significant time and energy. In addition to the emotional distress associated with Orderliness and Symmetry OCD, individuals also feel that their ordering and checking behaviours undermine their own sense of intelligence, integrity and common sense.

How is Order and Symmetry OCD Maintained

Order and Symmetry OCD involves a three-part processes. perfectionistic doubts lead to obsessions and high levels of anxiety and frustration. corrective and control behaviours are performed in an attempt to escape or suppress the obsessions and anxiety. Whilst this provides temporary relief, it also reinforces the vicious cycle of Harm OCD.

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How is Orderilness and Symmetry OCD Treated Using CBT?

The gold standard psychological treatment for Orderliness and Symmetry OCD is Cognitive Behavioural Psychotherapy. In particular, a combination of cognitive, meta-cognitive and behavioural strategies drawn from mainstream CBT, Acceptance and Commitment Therapy (ACT) and Inference Based Therapy (IBT), have been found to be highly effective in the treatment of Orderliness and Symmetry OCD.

In the UK, Exposure and Response Prevention (ERP), is always incorporated into the behavioural component of the CBT process. Whilst some therapy providers recommend ERP as a stand-alone treatment, recent research studies shows that this can limit access to other evidence based cognitive change and defusion strategies.

Other forms of talking therapy including interpersonal, psychodynamic and psychoanalytic therapy, is less effective in the treatment of Obsessive Compulsive Disorder and in some cases may contribute to further deterioration.

The term “Refractory” OCD is used to describe particularly complex and treatment resistant forms of Orderliness and Symmetry OCD. At GoodCBT.com we therefore integrate schema based CBT to identify and alter the individual’s relationship with early formed maladaptive beliefs that may act as precursors for Orderliness and Symmetry OCD.

How Many Therapy Sessions to Treat Orderliness and Symmetry OCD?

Whilst it’s difficult to state precisely how many sessions of Cognitive Behavioural Therapy will be required to address Orderliness and Symmetry OCD, the process typically involves as few as eight sessions and can involve up to twenty.

The number of therapy sessions will always follow a full psychological assessment of the problem and the production of a therapy plan.

At GoodCBT.com we always write to our clients following the first session, with a full psychological assessment and treatment plan. Every session is followed by detailed session notes, summarising the key learning points and the agreed actions. All sessions are 60 minutes long, rather than the 50 minutes or less offered by most other private providers. This means that our clients can spend more time engaging in the therapy process, without being distracted by time constraints or detailed note taking. Sessions may also be recorded for future reference where the client wishes.

To talk to us about specialist Cognitive Behavioural Psychotherapy for Contamination OCD, complete our contact form or email This email address is being protected from spambots. You need JavaScript enabled to view it.