Maybe you tap a surface until it feels "just right," or repeat a movement again and again because your body simply won't let it go. It looks like a tic, but it also feels like a compulsion. If that sounds familiar, you may have come across the term tourettic OCD. This post explains what the term means, how compulsions and tics usually differ, why they overlap and how OCD therapy can help with the urges behind them.
This post is general information, not a diagnosis or medical advice. Only a qualified professional can assess what you're experiencing.
Tourettic OCD, the short answer
Tourettic OCD is a term some researchers and clinicians use for repetitive behaviours that sit somewhere between OCD compulsions and tics. These behaviours are often driven by a physical urge or a nagging "not just right" feeling, rather than by a specific fear.
It's not a separate diagnosis in the DSM-5. Instead, it describes a pattern that shows up in some people with OCD, especially people who also have tics or a family history of tics. Researchers describe it as a distinct presentation that can be harder to recognize and treat, because it doesn't fit neatly into either box.
The good news is that understanding the pattern is the first step toward getting the right kind of help.
Compulsions vs tics, the usual differences
OCD compulsions and tics can look alike from the outside. Both are repetitive and both can feel hard to resist. But they usually differ in a few key ways.
What comes before. A compulsion usually follows an intrusive thought or fear, such as "If I don't touch this again, something bad will happen." A tic is usually preceded by a physical sensation, an itch or tension that builds until the movement or sound releases it.
Whether it has a purpose. Compulsions are typically done to prevent something feared or to reduce anxiety. Tics usually don't have a goal beyond relieving the urge.
How it feels after. After a compulsion, people often feel brief relief from anxiety, and then the doubt creeps back. After a tic, people often feel a release of physical tension.
According to the National Institute of Neurological Disorders and Stroke, tics are sudden, repetitive movements or sounds, often preceded by an urge, and OCD often occurs alongside tic disorders. The National Institute of Mental Health also notes that some people with OCD have a tic disorder.
In real life, the lines blur. Research suggests some behaviours sit right between the two, which is why a careful conversation matters more than a label.
What tic-like compulsions can look like
Tic-like compulsions vary, but some common examples include:
Touching or tapping objects until it feels right
Evening up, like touching with the left hand after the right
Repeating a movement, such as blinking or shrugging, until it feels complete
Repeating a word or phrase until it sounds right
Stepping, walking or sitting in a certain way until it feels "just so"
What links these is often the "not just right" feeling. It's not always about preventing harm. It's about an uncomfortable sense of incompleteness that won't settle until the action is done in a specific way.
Counting can play a part, too. If counting is a big part of your experience, our post on why people with OCD count explores that in more detail.
These patterns can show up in kids and teens as well. Our post on signs of OCD in children offers more on what parents may notice. We see children 6 and up, both online and in person.
Why the difference matters for treatment
Sorting out whether a behaviour is more like a compulsion, more like a tic or somewhere in between matters because it shapes what helps.
OCD therapy focuses on the urge and the "not right" feeling, helping people learn to tolerate discomfort without doing the behaviour. When the behaviour is driven mostly by that urge, OCD therapy can be a good fit.
A conversation with a therapist helps untangle what's happening. They'll ask about what comes before the behaviour, what you're hoping it does and how you feel afterward. That picture guides the plan. A free consult is an easy way to start that conversation, and an OCD assessment conversation can go deeper if it's helpful.
It also helps to know that both patterns can be present at once. Some people have classic compulsions, tic-like compulsions and simple tics all mixed together. A good therapist won't force your experience into one category. They'll look at each behaviour and what drives it, then focus therapy where it can help most.
You don't need to figure out the label before reaching out. That's part of what the first sessions are for.
How ERP can help with "just right" urges
Exposure and response prevention (ERP) is a type of cognitive behavioural therapy and one of the main treatments for OCD, as the NIMH describes. In ERP, you gradually face the things that trigger the urge, and practise not doing the compulsion in response.
For "just right" urges, ERP can be adapted. Instead of focusing on a feared outcome, the work focuses on the feeling itself. For example, a therapist might help you:
Touch something once and leave it feeling "wrong" on purpose
Delay evening up for a few seconds, then a little longer
Notice the discomfort, rate it and watch it change over time
Practise sitting with incompleteness without fixing it
Over time, many people find the urge gets weaker and less demanding. The "not right" feeling may still show up, but it no longer runs the show.
ERP is done step by step and at a pace that feels manageable. Your therapist will work with you to build a plan that starts small. Our OCD therapy page explains more about how we approach this work.
If tic-like compulsions are taking up time, causing embarrassment or getting in the way of school, work or relationships, it's worth talking with someone who understands OCD.
What we offer, and getting started
At Transformation Counselling, we offer OCD therapy, including ERP, for children, teens and adults. We also offer OCD assessment conversations to help understand what you're experiencing. We don't offer tic-specific treatment. During your free consult, our team can talk through what fits best for you.
Many people with tourettic OCD have spent years feeling misunderstood, told their behaviours are "just habits" or "just tics." A therapist who understands the overlap can help you make sense of it and work toward more freedom.
You can see us in Kitchener, Waterloo, Cambridge or Ottawa, or by secure video from anywhere in Ontario, and every location offers every service.
Cost, billing and your first step
Sessions with our therapists range from $130 to $200, depending on the clinician.
We accept Health Spending Accounts (HSAs).
We can direct bill many insurers, including for sessions with an RP (Qualifying). Desjardins is the exception: through TELUS eClaims, we can direct bill Desjardins for sessions with an RSW, RP or psychologist, but not for an RP (Qualifying).
Coverage depends on your plan, so check with your insurer before you start.
Book a free 15-minute consultation with our admin team, and they'll help you find a therapist who's a good fit.
If you're in crisis: if you or someone you love is in immediate danger, call 911. If you're thinking about suicide, call or text 9-8-8 any time, day or night.
Urges that feel like tics can still loosen their grip. With the right support, "not just right" can become something you can live with.
Last reviewed: October 2026
Sources
Katz TC, Bui TH, et al. Tourettic OCD: current understanding and treatment challenges of a unique endophenotype. Frontiers in Psychiatry, 2022
Szejko N, Muller-Vahl KR, et al. Challenges in the diagnosis and assessment in patients with Tourette syndrome and comorbid obsessive-compulsive disorder. Neuropsychiatric Disease and Treatment, 2021
Obsessive-Compulsive Disorder (OCD), National Institute of Mental Health (NIMH)
Tourette Syndrome, National Institute of Neurological Disorders and Stroke (NINDS)