OCD, OCPD and Perfectionism: Feeling seen, and what comes next

It’s late, and you’re scrolling. A well-known influencer is talking about her OCD. She checks the locks three times. She can’t leave a picture frame crooked. She rewrites emails until they’re perfect. Something in your chest loosens a little. That’s me, you think. Maybe there’s a name for this.

That moment matters. So does what you do next.

Feeling seen is real

There’s something powerful about watching someone describe your private habits out loud. For years you might have thought you were just a bit much. Too fussy. Too anxious. Too hard on yourself. Then an influencer you trust says the same things on your phone, and it turns out you’re not the only one.

We don’t want to brush that off. Feeling seen can be the first time someone takes a quiet struggle seriously, including you. It can open a door. This might be a real thing. There might be something I can do about it.

At the same time, we notice something else in our work with people at our practice. A label can start to feel like a membership card. It explains a lot, it connects you with people you admire, and it can feel like a relief to belong somewhere. Most people have done some version of this, us included. It’s very human.

The catch is that a label can become a place to stop. That’s just my OCD can quietly close the conversation, when it could have been the start of one. The more useful questions often come next:

• Is this name actually the right fit for what I’m living with?
• What does this pattern cost me, and the people close to me?
• What might I want to do differently, now that I understand it a little better?
• What strengths or good qualities are bound up in this pattern for me, and how can I hold on to those?

This post is our attempt to help with those questions. We’ll look at what OCD tries to capture as a diagnostic term, how it differs from the label OCPD, and how perfectionism fits in. Then we’ll step back from the labels altogether and look at the person underneath them.

OCD and OCPD: similar names, different experiences

This is one of the few places where we think it helps to start with the diagnostic categories. Diagnostic labels are names that people have created to describe patterns of human experience. They’re useful, but they aren’t things in themselves, and they can’t tell you who you are. Here, though, two very different experiences share almost the same diagnostic label and acronym, and mixing them up can send people looking for the wrong kind of help.

The current diagnostic manual used in Australia is the DSM-5-TR (American Psychiatric Association, 2022). Here’s what it describes, in plain words.

What OCD actually describes

Obsessive-compulsive disorder (OCD) has two parts.

Obsessions are thoughts, images or urges that keep pushing in, even though you don’t want them. They usually bring a rush of anxiety, disgust, dread or a sense that something is badly off. Common themes include fear of contamination, fear of causing harm, unwanted sexual or religious thoughts, and a strong need for things to feel “just right”.

Compulsions are things you feel driven to do to settle the obsession or stop something bad from happening. Washing, checking, counting, arranging, asking for reassurance, or going over things again and again in your head. They bring relief for a moment. Then the doubt comes back, often louder.

For it to be defined as OCD under the diagnostic criteria, this cycle takes up a lot of time (often more than an hour a day) or causes real distress or disruption to your life. People differ in how much they can see that the fears don’t quite add up. Some know it makes no sense and feel trapped anyway. Others feel quite sure the fear is real.

The key thing: OCD usually feels like an intruder. People with OCD rarely enjoy these repetitive behaviours, which are also known as rituals. They often feel ashamed of the thoughts and worn out by the rituals. I don’t want to think this. Why won’t it stop? How come I have so little control over stopping it myself? Why do I keep doing the same things over and over?

“Pure O” and relationship OCD

Two terms come up a lot online at the moment.

“Pure O” is a popular name, not a diagnostic one, for OCD where the obsessions are front and centre and the compulsions are mostly hidden. They happen inside your head: reviewing, analysing, checking how you feel, arguing with a thought, or quietly seeking reassurance. From the outside, it can look like nothing is happening. On the inside, it can be exhausting.

Relationship OCD (sometimes called ROCD) is when these obsessive doubts centre on a relationship. Do I really love them? Are they the right person? What if I’m with them for the wrong reasons? People might compare their partner to others, keep testing their own feelings, or ask friends for reassurance again and again. The doubts tend to feel urgent and distressing, even when the relationship itself is going well. We’ll be writing more about relationship OCD in upcoming posts.

What OCPD describes

Obsessive-compulsive personality disorder (OCPD) isn’t about intrusive thoughts and rituals. It describes a long-standing way of being, usually there since early adulthood, built around order, perfection and control. It shows up across work, home and relationships, and it costs a person flexibility, openness and ease.

The DSM-5-TR lists eight features. Four or more need to be present, in a lasting and pervasive way. In everyday terms:

1. Getting so caught up in details, lists, rules and schedules that the point of the task gets lost.
2. Perfectionism that gets in the way of finishing things, because it’s never quite good enough.
3. Work taking over, with little room left for rest, fun or friends (when it isn’t driven by financial need).
4. Being very strict and inflexible about right and wrong, beyond what your culture or faith asks.
5. Finding it hard to throw things out, even worn-out things with no sentimental value.
6. Struggling to hand tasks to others unless they’ll do it exactly your way.
7. Being very careful with money, holding it back for a future disaster.
8. Rigidity and stubbornness.

The key thing here: OCPD usually feels like me. It often feels like having good standards in a world that doesn’t always share them. There can be real pride in these traits too. Being reliable, prepared and thorough can feel like part of being a good, responsible person, and in many ways it is. The frustration, when it comes, tends to point outward. Why can’t anyone else do this properly? People often come to therapy not because of the traits themselves, but because of what they’re costing: burnout, a partner who feels criticised, a team that’s stopped trying, a life with no room to breathe.

What this might look like day to day

These aren’t neat boxes. Many people have some of both. In one Australian study of adults with OCD, almost half also met criteria for OCPD (Starcevic et al., 2013). And plenty of people have a few of these tendencies without meeting criteria for either.

So what’s in the social media reels?

We can’t diagnose anyone from a 60-second video, and that includes influencers. But a lot of what gets called “OCD” online (colour-coded wardrobes, a love of labelling, high standards, a strong preference for order) sits much closer to obsessional personality traits, or simply to personal preference. OCD itself is often less photogenic: hours lost to checking, thoughts people are too ashamed to say out loud.

Research has found that OCD is one of the conditions most often used casually or jokingly online (Pavelko & Myrick, 2015). One study of the most-viewed #OCD TikTok videos made by women found that more than half played OCD down, often using it to mean clean or organised (Woods et al., 2023). That can make it harder for people with OCD to be taken seriously. It can also make it harder for someone with obsessional personality traits to see what they’re really carrying.

Beyond the labels: what these patterns are really doing

Diagnoses are one way of making sense of a set of human experiences, but they’re not the whole picture. You don’t need to meet criteria for anything in the DSM for these patterns to matter in your life. So let’s put the categories down for a moment and look at the human experience underneath.

Obsession simply means the mind returning to something again and again. It won’t let it rest.

Compulsion means a strong pull to do something, so that the returning obsessions stop for a while.

Most of us know a gentle version of both. Rereading a text before sending it. Checking the oven once more on the way out. Lying awake replaying a conversation. The question isn’t whether you do these things. It’s how much room they take up, and what they’re protecting you from. It’s also worth asking how these behaviours might once have kept you safe, or helped you through painful times.

A way of handling feelings that seem too much

In our experience, obsessive and compulsive patterns are very often a way of coping with feelings that are hard to sit with. Uncertainty. Anxiety. Guilt. Anger. Grief. The sense of not being in control of what happens to you or the people you love.

These feelings don’t only live in your head. They show up in the body: a tight chest, a clenched jaw, shallow breathing, a restless buzz that won’t settle. Checking, ordering, planning and perfecting can bring that buzz down, at least for a moment. The relief is real. That’s why the pattern sticks.

The cost tends to arrive slowly. The world gets a little smaller. More things need to be just so before you can relax. And the feelings underneath never quite get a chance to be felt and pass through.

A way of staying safe with other people

These patterns often show up most in relationships. Being the organised one, the reliable one, the one who never drops the ball can feel safe. Nobody can criticise you if everything is done right. Nobody can let you down if you do it all yourself.

But control and closeness pull against each other. It’s hard to be close to someone while you’re managing them, or bracing for them to get it wrong. Partners and colleagues may feel judged. You may feel lonely and unappreciated, carrying more than your share.

None of this means you’re doing something wrong. These are clever, protective strategies. They usually made a lot of sense at a time in your life when some kind of coping strategy was needed. The question is whether they still serve you now.

Perfectionism is not OCD

“I’m such a perfectionist, I’m so OCD” might be the most common version of this mix-up. Perfectionism and OCD can overlap, but they’re not the same thing.

Perfectionism is less about intrusive thoughts and more about worth. It’s the sense that you’re only acceptable, lovable or safe when you get things right. The bar keeps moving. Reaching it brings relief, not joy. Missing it brings a harsh inner voice that can be hard to switch off.

Perfectionism isn’t its own diagnosis. It’s a thread that runs through many kinds of struggle: anxiety, low mood, burnout, difficulties with eating, and yes, OCD and OCPD too (Egan et al., 2011). Plenty of people live with intense perfectionism without it turning into any of those other things.

It can help to tell apart two things that look alike from the outside:

• High standards come with some flexibility. You care about doing good work. When it isn’t perfect, you’re disappointed, then you move on.
• Perfectionism comes with a price on your sense of self. A small mistake can feel like proof that you’re not good enough. Rest feels like something you haven’t earned yet.

If you’re one of our many clients working in a demanding, fast-paced job, you may know this well. Perfectionism often gets rewarded at work. It can be hard to see the cost until your body starts sending the bill: the tension headaches, the broken sleep, the Sunday-night dread.

The aim isn’t to stop caring or to drop your standards to zero. It’s to loosen the grip, so that your worth isn’t on the line every time you hit send.

A psychodynamic lens: where these patterns come from

Psychodynamic therapy asks a simple question. How did this make sense, back when you learnt it? Patterns that feel fixed today usually began as the best possible answer to a difficult situation we found ourselves in long ago.

Early learning

Some common stories we hear (and every person’s is their own):

• When love felt like it depended on being good. If praise came for getting things right, and coldness or criticism came with mistakes, a child learns that getting it right is how you stay close. The stakes of getting it wrong become very high.
• When home felt unpredictable. If things were chaotic, or a parent was unwell or stretched thin, order can become a way of creating some safety when nothing else felt safe.
• When some feelings weren’t welcome. If anger, neediness or sadness were met with discomfort, a child learns to keep those feelings tidy and out of sight. Being sensible, organised and in control is a lot safer than being messy and upset.

None of this is about blaming parents. Most were doing their best with what they had. It’s about understanding why your mind and body learnt to work the way they do.

How we keep feelings at arm’s length

Over time, these early lessons turn into automatic habits. They happen so fast we don’t notice them. Thinking and analysing instead of feeling. Doing something to “undo” a thought that scared us. Being extra careful, extra polite or extra good when part of us is actually angry. Keeping busy so there’s no quiet space for grief to arrive.

These are ways of protecting ourselves from feelings that once seemed too big. The trouble is, the feelings don’t go anywhere. They often show up instead as tension in the body, anxiety without a clear cause, or a flat, dreadful tiredness.

Attachment and relationships now

The way we learnt to stay close to the people we depended on as children is often called our attachment style. Research, including work by Australian researchers, has found links between insecure attachment and obsessive-compulsive patterns in adults (Doron et al., 2009).

You might notice this in your relationships today:

• If you tend to worry about being left or not being enough, you might seek reassurance again and again, or get caught in doubts about whether your relationship is “right”.
• If you tend to rely on yourself and keep people at a distance, control and self-sufficiency can feel like the safest option. Depending on someone else may feel risky, even irritating.

Here’s an everyday example. Your partner stacks the dishwasher “wrong”. You feel a flash of irritation, then a tightness in your chest. You say nothing, wait until they leave the room, and quietly redo it. On the surface, it’s about bowls. Underneath, there may be something much older: a fear of things going wrong, a habit of not trusting others to look after you, or anger that never felt safe to say out loud.

Psychodynamic work helps you notice these moments as they happen, feel what’s underneath them, and try responding in a new way. That might mean saying the thing. It might mean leaving the bowls where they are, and seeing what you feel.

What to do with a new understanding

So you watched the reel, and something clicked. What now?

Naming something is a good start. But understanding a pattern doesn’t change it on its own. Change usually comes from doing something a little differently, and staying with what that brings up. Here are some places to begin.

Get curious about the fit. Look back at the descriptions above. Does your experience feel like an intruder you’d love to be rid of? Or does it feel like you, and mostly frustrating because of other people? Maybe it’s some of both. Maybe neither label fits, and that’s useful to know too.

Ask what it costs, and what it gives. Think about your time, your sleep, your body, your relationships, your rest. What has this pattern taken from you? Then think about what it has given you, such as care, reliability or an eye for detail. Which parts would you want to keep, even as other parts loosen?

Notice the feeling before the urge. Next time you feel pulled to check, fix, redo or plan, pause for a breath. What’s happening in your body? Where is the tension? Is there a feeling there you can name? Anxiety, guilt, anger, sadness?

Try a small delay. If it feels manageable, wait a few minutes before you act on the urge. See what rises, and what happens to it if you let it be there. Feelings tend to come in waves. Often they peak and ease on their own.

Let one thing be good enough. Send the email with a typo you’d normally fix. Leave the cushions as they are. Let someone else do it their way. Notice what you feel, and notice that you got through it.

Tell someone. Shame grows in silence. Saying this is what I do, and it’s harder than it looks to someone you trust can take some of its weight away.

A word of care: if you think you might have OCD, trying to resist compulsions on your own can be really hard and sometimes discouraging. That isn’t a failure. It’s usually a sign that some support would help.

How can a psychologist help?

A psychologist can help you work out what’s really going on, and what you’d like to do about it. That’s often more useful than a label on its own.

Making sense of it together. We start by listening. What do these patterns look like in your life? When did they begin? What do they protect you from, and what do they cost? Where a diagnosis is relevant, we’ll talk it through openly. Where it isn’t, we won’t force one.

If it’s OCD. The approach with the strongest research behind it is a form of CBT called exposure and response prevention, or ERP (Öst et al., 2015). In plain terms, you and your psychologist slowly and gently move towards the situations that trigger your fears, without doing the ritual. You set the pace. Over time, you learn that you can sit with doubt and discomfort, and that the feeling passes without the compulsion. ACT (acceptance and commitment therapy) can sit alongside this, helping you make room for hard thoughts while you move towards what matters to you. For some people, medication is part of the picture too, and your GP or psychiatrist can talk that through with you.

If it’s more about personality, perfectionism or relationships. This is where psychodynamic therapy can be especially helpful. It has good evidence behind it, and its benefits often keep growing after therapy ends (Shedler, 2010). Rather than targeting a single behaviour, it looks at the whole person: the feelings underneath the need for control, how they show up in your body, and how old patterns play out in your relationships today. Several of our psychologists work psychodynamically, including with ISTDP (intensive short-term dynamic psychotherapy), which pays close attention to what you feel, moment to moment, in the room. You can read more in our ISTDP series. Schema therapy can also help with long-standing patterns like perfectionism and harsh self-criticism.

Both, often. Many people have a mix of OCD symptoms and obsessional personality traits. Good therapy can draw on more than one approach, shaped around you.

The work isn’t always comfortable. Letting go of control, even a little, usually brings up the very feelings it was holding back. That’s part of the work, and you won’t be doing it alone. Over time, many people find they can hold their standards more lightly, feel closer to the people they love, and have more room to rest.

Getting started. You can see one of our psychologists in person on Macquarie Street in the Sydney CBD, or online from anywhere in Australia. If you’d like to claim a Medicare rebate, ask your GP about a referral and a mental health care plan. You’re also welcome to book without one.

If a reel made you stop and think

If something you saw online made you think that’s me, it’s worth listening to. Treat it as an invitation to look a little closer, rather than the final word.

Whatever the name turns out to be, or even if there isn’t one, you deserve to understand what you’re carrying and to have more choice in how you respond to it. That work can be uncomfortable. It can also open up a life with more room in it.

When you’re ready, there are two easy ways to take the next step. If you’d like to talk it through first, give our friendly admin team a call on (02) 9235 3127, or send us a message through our contact form. They’ll answer your questions, help you feel at ease, and match you with a psychologist who suits what you’re looking for. If you’d rather get started on your own, you can book online yourself through our self-booking portal, at a time that suits you. Either way, we’d be glad to hear from you.

This article is general information only and isn’t a substitute for an individual assessment.