Our sense of control is a core psychological need that has been especially present in my therapy work with patients recently. As a practicing psychologist, I meet with about 25 people per week struggling with various manifestations of psychological distress in their lives. People come with common concerns (depression, anxiety, relationship concerns, trauma) and less common concerns (chronic pain).
Control is an underlying issue especially present with some presenting concerns like anxiety and disordered eating. However, I’ve noticed that the need for control in life may be a central conflict for us all, and may affect many or most periods of significant psychological distress for people.
Taking a broader view, philosophers have identified control as a central existential struggle for human beings. Yalom (1980) claims adult choice, or “freedom”, is one of four existential conflicts in life (the others being death, isolation, and meaninglessness). Specifically, he notes that our freedom involves thousands of forks in the road. There is always a tension between the prong in the fork we choose (and therefore exert our control or will toward) and the prongs we don’t choose (thereby relinquishing our control over these lost paths).
There’s an intense encounter with control and loss of control with each choice we make in life. As a result, there are times in life that anxiety prevents us from choosing. In other words, we give up the ability to choose because it’s too distressing. In an effort to control this aspect of our existence, we actually suffer the ultimate loss of control by refusing to choose.
It has been compelling recently to see the areas of psychological distress among my patients that include a battle with choice and control as an underlying dynamic. Many of my patients in their 20s face big choices in life, including career path, whether to deepen a romantic relationship, and, for some, how to continue with their education. They tend to have some sense of the path forward, but you also see behavior and events that hinder their progress. Although this relinquishment of control doesn’t explain the entire struggle or distress, you can see that part of the issue is the person’s fear of the vulnerability that choice presents. Choosing could mean they make the wrong choice. They could face failure, rejection, disappointment.
A well-renowned psychologist, Otto Rank (1917), said that “some [people] refuse the loan of life to avoid the debt of death” in his book Will Therapy, Truth, and Reality. He cleverly captures the notion that our time in life is a precious gift that some unintentionally squander due to the fear that they will die having “lived the wrong way”. The more this fear paralyses us, the more we play into this self-fulfilling prophecy. The more we refuse to make choices in life, the less we live at all; and the more we relinquish any control over our life.
In addition to existential anxiety, there are many other forms of anxiety that involve a struggle with control. Perfectionism, obsessional thinking/compulsive behavior, and restrictive eating behavior/over-exercise all typically involve significant anxiety and all involve an effort to control some area of vulnerability in the patient’s life. Perfectionism, for example, has the following rigid rule at heart: if I push to be perfect in all activities, I will avoid the vulnerability of being wrong or punished. Ironically, perfectionism often involves a high level of self-criticism. This may be another mechanism of control. If I control criticism by criticizing myself before others do, I won’t have to face the vulnerability of others’ criticism.
Similarly, obsessive thinking involves an effort to control a vulnerable event by constantly devoting mental energy to the feared experience. Among my patients, there are times when someone is attempting to control a feared outcome like the loss of a significant romantic relationship or eating too many calories in a day. Our thinking tends to be more rigid and absolute when we’re experiencing anxiety; therefore, patients struggling with obsessional thinking usually feel that they must stay with the same thought they’ve had hundreds of times. By obsessively focusing on the same thought, they man be able to keep the actual feared consequence from sneaking up on them and wrecking their life. Its a superstitious form of control.
How many of us feel the scary momentum of life’s events at times? How many times does it feel like each consequence and occurrence is unfolding in front of us like a heavy train going downhill? Maybe I can obsessively think my way through every turn. Maybe I can move that massive weight with mind over matter.
Again, this struggle with control comes down to vulnerability. Can I accept the loan of life and be vulnerable, with the fear that I will live the “wrong way”? Brene Brown masterfully addresses the issue of vulnerability in her research, writing, and presentations. She talks about all the ways that we numb our vulnerability: drinking alcohol, watching tv, buying endless gadgets, obsessing over our image, and watching pornography to name a few top examples.
In addition to this internal numbing, Brown talks about interpersonal efforts to avoid vulnerability. She elaborates on how we can take a protective, defensive position with other people in order to create strong external armor against vulnerability. To be fair, many people experience trauma in family, social, or romantic relationships. When we’re hurt by people, we have to protect ourselves. But, in doing so, the little or big injuries in life and the armor we build around us ends up blocking out the tender, affectionate, caring, kind experiences with others as well.
In the next part of this essay on control, I will talk about steps that help us balance control and vulnerability. I’ll outline the importance of fostering acceptance, mindfulness, and self-compassion in our lives. And I’ll provide a case example that highlights struggle with control and increased acceptance.
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