Call 07887 701 176 or email

Orderliness and Symmetry OCD

Obsessive compulsive disorder, also known as OCD, is a psychological disorder, which is characterised by a cycle of obsessive thoughts and compulsive behaviour. OCD can affect both males and females of any age. In most cases, symptoms become apparent during adolescence or the early years of adulthood, but sometimes, signs are detected much earlier.

OCD has many different “subtypes” which are mostly characterised by intrusive thoughts and compulsive behaviours.   Individuals who have OCD may experience very different thoughts and their compulsions can vary hugely. This is because there are several types of OCD. The most common types of OCD include checking, contamination and washing and cleaning, rumination and intrusive thoughts and symmetry and ordering. This guide will focus on the OCD subtype of orderliness and symmetry OCD.

What is Orderliness and Symmetry OCD?

People with orderliness and symmetry OCD often display compulsive behaviour linked to arranging and ordering objects and the visual presentation of specific items. If you have this type of OCD, you might spend a lot of time lining objects up, putting them in different positions and organising your belongings to ensure that they look right, and also, most importantly, that it feels right to you.

A person with OCD may become anxious or restless if orderliness is not achieved, and they will usually focus on getting the presentation just right before they are able to move on. Some people might say that this form of OCD is linked to being a perfectionist, but there’s a difference between liking things to look right and having obsessive thoughts about the way objects are presented and feeling like you have to act on these thoughts to make yourself feel better and the world seem like it’s spinning in the right direction. 

Symmetry OCD

Symmetry OCD is characterised by a fixation on the alignment and arrangement of objects. If you encounter a shelf full of tins or pots, for example, and everything is in disarray, this could upset, irritate or distress you, and your natural reaction will be to change the arrangement of the items on that shelf until it looks and feels right to you. Symmetry OCD is often linked to the positioning of items and objects, but this is not the only example. Another example is writing in a lined notebook. A person with symmetry OCD may get anxious or upset if the letters they write aren’t shaped properly, or the words don’t sit on the lines perfectly. Even autonomous actions, such as walking, can become a cause for concern. Somebody with symmetry OCD may deliberately focus on applying the same amount of pressure on the ball of each foot when putting one foot in front of the other.

When you have symmetry OCD, you don’t just become concerned with the presentation of objects or the visual display in front of you. Your thoughts are focused not just on the fact that the visual isn’t right, but also what could happen as a result of that perceived imperfection.

Orderliness OCD

People who have OCD are often preoccupied with tidiness and organisation, and this drives them to display compulsive behaviour in the form of repeatedly arranging things or changing the order of objects. If you have orderliness OCD, you may become very anxious or irritable if you see a pair of shoes that isn’t arranged neatly or a line of books that isn’t in the right order, for example. People with orderliness OCD will often spend a lot of time rearranging objects so that they can reach a point when they feel relieved and less anxious. Some people will become fixated on specific patterns or use counting methods to create a more balanced display, while others will strive to stick to set positions that they have become accustomed to. If the visual is disturbed, for example, somebody else moves an object in the individual’s home, this can cause upset.

Like symmetry OCD, orderliness OCD is not a matter of being a perfectionist. You may be more likely to develop OCD if you have this character trait, but there’s a significant difference between OCD and liking things to be in the right order and look tidy and neat. When you have OCD, your thoughts become intrusive and consuming, and you’re driven to act on them. If you spot a bookcase that is in disarray or a line of pairs of shoes that isn’t in order, your instinct will be to stop what you’re doing and rearrange those objects until the distress passes.

What keeps orderliness and symmetry OCD going?

As humans, we process hundreds of thoughts every hour. We have things drifting in and out of our brains on a continual basis. Some thoughts we give a lot of time and attention to, and others float by without us even really noticing. If you’ve never experienced OCD before, you might assume that somebody with OCD can just alter the way they behave by trying to block out obsessive thoughts. The difficulty is that these thoughts are incredibly powerful and all-consuming, and it’s very difficult to break the cycle that characterises OCD. If you have OCD, you can’t just stop yourself from checking if you’ve locked the back door if you suddenly think that there’s a risk that the door is open. You get into a cycle, which involves:

     A thought: the books on your shelf aren’t in order

     An emotional response: anxiety and worry

     An action: arranging the books so that they are perfectly displayed


 The fact that you achieve that sense of relief and contentment when you carry out the action acts as a positive reinforcement of negative behaviour. This means that you’ll continue to repeat this sequence. The aim of treatment for OCD is to try and break the cycle, so that you don’t need to go through these motions and processes to feel calm or prevent anxiety.

CBT treatment for orderliness and symmetry OCD

CBT (cognitive behavioural therapy) is a tried and tested treatment method for many types of OCD, including orderliness and symmetry OCD. Cognitive techniques are designed to encourage the individual to analyse their thought processes and appraise them in the hope that they can learn to ease anxiety and achieve that feeling of everything ‘being just right’ without having to engage in compulsive behaviour. There are different elements of CBT. One aspect that is often used for people with OCD is exposure and response prevention, or ERP.  


Exposure and response prevention


ERP is a technique, which is often described in very basic terms as facing your fears. It involves exposing the individual to their fears or to scenarios that make them feel anxious in a controlled setting. The idea is that repeated exposure will cause anxiety levels to fall. There are various approaches, including gradual exposure, and flooding, which is defined by facing your worst fears very early on in the treatment process.

Facing your fears can be incredibly scary and daunting, but with the right support and guidance, it can help you to become more confident, and to learn that your worst fears won’t be recognised if you don’t tidy up your shoes or line all the cans in the kitchen up in order. With ERP, you will work with a therapist and they will ask you to rate your anxiety levels as you’re exposed to different scenarios.

This form of treatment has very high success levels, especially when combined with other cognitive techniques. 

Theory A vs Theory B

Theory A versus Theory B behavioural experiments are an important part of CBT for people with OCD. They encourage you to think about your own assumptions and thoughts and come up with alternatives, which are likely to be less threatening and more realistic. Theory A represents what the OCD intrusion “says”. In the case of symmetry OCD, this may be something like “Bad things will happen if things aren’t organised right.”  a disaster occurring and somebody getting hurt because objects aren’t tidy and arranged properly in the bedroom, for example, somebody tripping and breaking their leg because a shoe is out of line. Theory A drives compulsive behaviour and would result in you engaging in your compulsive orderliness and symmetry behaviours until the threat is removed and until distress reduces.

Theory B encourages you to come up with a new more psychological theory about what your intrusions mean. In this case, it may be something like, “I worry about bad things happening if things aren’t organised right.”  Once you’ve got both theories in front of you, you can evaluate and analyse which is the most accurate.