Misaligned objects in OCD: when leaving something out of place is difficult

When something does not fit

A notebook is turned slightly, two objects are not equally spaced or a picture appears crooked. Another person may find the detail easy to ignore. In OCD, it can keep demanding attention and produce tension, irritation or an experience that is difficult to describe: ‘it is not right’, ‘it is not finished’ or ‘something is still missing’.

There is not always a fear that a disaster will occur. Some symptoms are connected with incompleteness or a not-just-right experience. The distress may feel more like pressure or discomfort than fear. Some people do link the misalignment to a consequence and fear that something bad will happen unless it is corrected. Others need only to remove the sensation.

What happens when it is corrected

The person moves the object and checks its position. Relief may be immediate, but the arrangement may still not feel right. They then shift it by a few millimetres, look again or restart the sequence. An objective measurement does not decide when the action is complete. It ends when a sense of closure arrives, which may take a long time or fail to arrive.

If somebody else touches the object afterwards, the process may begin again. When correction is not possible — in a classroom, a shop or another person’s home, for example — part of the person’s attention may remain fixed on the detail. Listening, reading, talking or completing another activity can become difficult.

Behaviours that may occur

• Aligning books, papers, cutlery, clothes or decorative objects.
• Judging distances visually or comparing the two sides of an arrangement.
• Putting something down and picking it up repeatedly until the action feels complete.
• Returning to a room to correct a detail that was left unresolved.
• Asking other people not to move particular objects or redoing what somebody else arranged.
• Reviewing mentally how something was positioned after it is no longer visible.

The same behaviour can have different purposes. Tidying a desk once to work comfortably is not the same as a compulsion. The urgency, rigidity, time involved, distress when trying to stop and effect on daily life all matter.

Not simply perfectionism or liking order

A preference leaves room for choice. A person may want an object to be straight and decide to leave it. With a compulsion, walking away may be extremely difficult even when the person knows that further correction is not useful. It does not necessarily mean that the whole room is tidy. One edge or one distance can be impossible to ignore within an otherwise untidy space.

Arranging can also occur for reasons other than OCD. It needs to be distinguished from enjoyable routines, a need for predictability, tics, perceptual difficulties and other conditions. One action cannot establish its purpose or a diagnosis.

Treatment and family life

Cognitive behavioural therapy with exposure and response prevention — ERP — is a recommended treatment for OCD. Here it might involve deliberately leaving a small misalignment in a planned way and practising continuing with the activity without correcting it immediately. The aim is not to cause distress or create disorder by surprise, but to learn that discomfort can be experienced without relying on the ritual.

At home, deliberately moving possessions to ‘prove’ that nothing happens can increase conflict and is not a substitute for treatment. Reorganising family life so that nothing ever changes position can also allow the problem to expand. A professional assessment with somebody experienced in OCD is advisable when corrections take substantial time, prevent study, work or leaving home, or cause frequent conflict.