The Difference Between OCD and PerfectionismLet’s stop using these two interchangeably.
You’ve probably heard it before: a friend is joking about how spotless their house is or maybe it’s a person who’s particular about what they eat, or an artist agonizing over final details in an already impressive work.
“Sorry,” they say, “I’m so OCD about it.”
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There’s a big difference between having OCD and being a so-called perfectionist—although the two can sometimes overlap. Knowing the line where personal preference stops and OCD symptoms begin is important for getting help. But what exactly is the difference between OCD vs. perfectionism?
So, what exactly is OCD?
Obsessive-compulsive disorder (OCD) is a chronic mental health condition where a person experiences intrusive thoughts or images that cause them serious distress and anxiety, along with compulsive behaviors meant to alleviate those unwanted thoughts, according to the National Institute of Mental Health (NIMH).
Maria Fraire, PhD, clinical psychologist and program director of the OCD Institute for Children and Adolescents at McLean Hospital, gave this example: Imagine you’re driving past a cyclist and realize they don’t have much room on the road. You’re rightfully concerned for them and maybe note to yourself to give cyclists more room next time. Then you go on about your day.
A person with OCD might begin to spiral with excessive and intrusive thoughts, like: I should have given them more room. I wonder if I hit them. Did I hit them? I must have hit them. I need to turn around. They might then feel compelled to turn around and check, even though they have no evidence that they hit them. But then they worry, again, that they may have hit the cyclist, and so they have to drive by again.
This cycle of intrusive thoughts and compulsive behavior is a pattern for people with OCD. “They'll have this thought, they'll get really uncomfortable. They have this ritual that makes them feel better,” Fraire says. “But then the thought shows up again, and they have to do the ritual again.”
The experience of OCD can vary from person to person based on their unique obsessions and compulsions. In OCD, obsessions refer to the unwanted and recurring thoughts, while the compulsions are the rituals or habits that someone feels compelled to do in response to those obsessions. Some of the more common obsessions include: a fear of unintentionally harming yourself or others (like the example above), a fear of germs or contamination, intrusive thoughts involving unwanted or forbidden sexual or religious acts, thoughts of aggression toward yourself or others, or needing things to be in perfect order, according to NIMH.
And how these thoughts turn into compulsions is also different for everyone. The media portrays a lot of repeated touching of handles or multiple hand washings, but that’s only a slice of what people with OCD can experience. “Anything can become a ritual,” Dr. Fraire says. The rituals may not always be obvious, either. “Sometimes it's visualizing an object in a specific way. Sometimes it's, ‘I have a certain phrase I have to say over and over in my head,’” she explains.
“The really important thing to keep in mind here when we're talking about OCD is that the obsessions are unwanted,” says Liz McIngvale, PhD, LCSW, director of the McLean OCD Institute at Houston. “They cause them a lot of distress, a lot of anxiety, and they want to get rid of that thought.”
The desperation to get rid of unwanted thoughts is what leads to compulsions, like turning the car around to confirm they didn’t hit the cyclist or washing their hands repeatedly to make sure they’re clean. It’s also worth noting here that while compulsions might offer a little relief in the moment, it’s not an enjoyable experience like the accomplishment you feel after cleaning out the chaos under your kitchen sink. So even though most people can relate to some of the symptoms of OCD (like worrying about germs or cleanliness and tweaking your behavior around those concerns), being diagnosed with the condition means that these symptoms are excessive and are causing real distress and consequences in your daily life—like they’re messing with your work, relationships, or basic functioning.
Now let’s talk about perfectionism.
Perfectionism might seem like a throw-around term, but the American Psychological Association (APA) does actually have a definition for it: “the tendency to demand of others or of oneself an extremely high or even flawless level of performance, in excess of what is required by the situation.” Basically, you’re doing the most.
Society tends to use this word to describe anyone who is detail-oriented or high-achieving, but it’s an actual trait that researchers have studied. And it’s not as great as our bosses might make it sound. Perfectionism—particularly the kind that makes you think you’re only valuable to others if you’re perfect—is associated with higher rates of depression, anxiety, eating disorders, and suicide.
That said, exactly when perfectionism veers from good effort to a problem is hard to define, according to the APA. “Enjoying doing things well doesn’t mean you’re a perfectionist, but when striving for that perfection is causing exhaustion, stress, and unhappiness, it might be time to find a different way,” Dr. Fraire says.
So it’s TBD as to when you actually qualify as a perfectionist. But there is a clearer line between OCD and perfectionism (though it’s also possible to have both—they’re not necessarily mutually exclusive).
“The big difference would be: Do you feel that the behaviors are actually useful?” Dr. McIngvale says. She gave an example of liking to organize her daughter’s closet by type of clothing. It’s certainly detail oriented—but doing so makes getting her daughter dressed in the morning easier. When a person with OCD has intrusive thoughts about orderliness, their compulsions tend to make life harder, not easier.
Another example: a perfectionist might double-check an email to make sure it doesn’t have any typos. A person with OCD might check, re-check, and re-check, getting lost in making sure there isn’t an error—ultimately leading to poor work performance because they got stuck in a compulsion, Dr. McIngvale says.
The other main factor is how much distress not doing a “perfectionist” action causes. “People with OCD struggle and have very intense anxiety when they don't follow through on their compulsions. It's not a preference,” says Jessica Frick, LPC, NCC, counselor at Metamorphosis Counseling in Erie, PA. Whatever action they take is “completely pushed by the anxiety that they're feeling.”
A perfectionist might prefer to have their closet organized, “but if push came to shove and they just could not do things the way that they wanted to do them, they're generally not going to experience the same level of emotional upset as folks with OCD,” Dr. McIngvale explains.
There’s also obsessive-compulsive personality disorder.
If your perfectionist tendencies are excessive and are taking a serious toll on your life and relationships, that could be a sign of yet another related condition: obsessive-compulsive personality disorder (OCPD).
Let’s say you’ve been called a perfectionist. You like things your way. But it’s fine! You find it useful! In fact, it’s the right way to do things—it’s honestly frustrating that everyone else doesn’t see that. Oh, and it’s driving the people in your life up the wall. Then we might be talking about OCPD.
OCPD is sometimes confused as a form of OCD but it’s actually its own condition. With OCPD, people are extremely concerned with orderliness, completing tasks, and the “right” way of doing things, according to the International OCD Foundation. They have rigid rules about how things should be and can’t let others take over.
That might sound similar to certain types of OCD or even perfectionism. But perfectionists often lack the self-righteousness characteristic of OCPD, and they can ultimately let things go when called to.
Also, people with OCD don’t enjoy their compulsions—they can see there’s something troubling about them. “Folks with OCPD, generally speaking, don't want to change. The obsessions and compulsions that they have, they believe they’re the right way to do things,” Frick says. That’s part of what makes the condition challenging—people often don’t see any problem with their systems and wish everyone else would just comply. It’s usually not until their work or relationships take a serious hit that they seek out help.
The bottom line: OCD, perfectionism, and OCPD are not the same, even though they’re often lumped together in everyday conversations. But it’s definitely worth knowing the difference so we aren’t adding to the stigma, shame, and confusion around these topics.
If you’re experiencing any combination of these symptoms—intrusive thoughts that bring you a lot of anxiety, compulsions you feel you have to act on, or even a nagging inner voice saying you need to be perfect—it’s worth talking to a licensed mental health professional. “As clinicians, it's our job to help you get relief through appropriate interventions,” Dr. McIngvale says. “There's amazing treatment for really all mental health conditions and for whatever you're going through.”
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