The dimension of control in psychological disorders: from hypercontrol to loss of control

"Whoever does not restrain the will with beasts should accompany"

(Leonardo da Vinci)


The idea of ​​control in our culture is much older than Leonardo's time, as Herodotus testifies about two thousand years earlier: "Of all human miseries the most bitter is this: knowing so little and having no control over anything".

Man has always tried to exercise his ability to control the world and himself, as a strategy of adaptation and survival. He tried to do it with different tools, with magical and propitiatory rites, just think of the rain dance, with religion, as in the case in which one prays for someone to heal, with science and technology, which have progressively established themselves as the knowledge of excellence to control the phenomena.

The attempt at control has always oscillated between belief and reason. Even today, where rational control struggles to reach, we pass to the attitude of propitiatory and fideistic control: when medicine decrees that there is nothing more to be done to save a person we love, we easily cling to any hope to try to avert the unfortunate outcome.

Since ancient times and, even more so with the age of enlightenment, reason has become our resource for exercising control over the world and over us. This has involved and still involves a sort of hierarchy between emotion and reason, in which rationality is commonly considered superior to emotions, as a way to approach the world. Leonardo's sentence quoted at the beginning underlines this distinction. On the other hand, it is common experience to hear "Try not to lose control", "You must learn to control yourself", "Analyze things rationally", "Think!"

The cultural belief that these sentences imply is that reason, rational logic, can also govern the emotional impetus, the domain of emotional experience. This translates into how we manage and learn to manage our emotions. This is true in the field of education, but also in the context of the therapy of psychological problems. Cognitive-behavioral therapy, for example, places a strong emphasis on the importance of rational control of dysfunctional thoughts, to regulate emotional expressions. Pharmacology, on the other hand, through specific molecules, tries to regulate emotional responses. Here, too, the implicit idea is to control emotions in order to regain rational guidance.

In reality, if a hierarchy is to be found, phylogenetically it appears exactly the opposite. From an evolutionary point of view, the brain structures that mediate emotional experience are the oldest, while those that underlie the dominion of rationality are the most recent. Furthermore, in terms of activation of the organism in the adaptation responses, it is the emotions that are activated in a very short time, to allow the individual the best adaptation to the contingent situation that must be faced. When, while driving the car, we see a dog crossing the road suddenly, it is fear that immediately alerts us and allows us to brake promptly.

The reasoning comes only after: first we hear, then we think. Therefore rational control can only come after the emotional experience has unfolded its effect and, precisely for this reason, it is often ineffective in regulating it.


The dimension of control is central to the formation and maintenance of numerous psychological disorders.

Panic Disorder

The research-intervention carried out in the last thirty-five years by Giorgio Nardone and his collaborators on the panic disorder he highlighted how it is the attempt to voluntarily control one's physiological reactions that leads to the loss of control that causes panic. In this disorder, trying to calm down voluntarily without success feeds the emotional explosion that leads to panic. As Cioran notes, "the subterfuges of hope are just as ineffective as the arguments of reason" in this situation.


Obsessive Compulsive Disorder

Rigid control, which can never be disregarded, is the underlying mechanism of obsessive-compulsive disorder. In these cases the control modality is ritualized and the compulsive ritual becomes the fulcrum of the problem. Whether it is done to remedy a possible mistake, for example continuously cleaning a surface for fear that it will become dirty, whether it is done to prevent a future problem, such as repeatedly checking that the gas is closed, or to propitiate a favorable outcome , wearing a certain garment so that the examination goes well, the ritualized control becomes the cage in which the person closes himself, thus finding himself a prisoner of the rite. The control is so successful that it cannot be done without. Too bad it is an illusory control that confirms itself and imprisons the person.


Sleep disorders

Equally different sleep disorders they imply control as the determining factor. Here we find those who voluntarily make an effort to fall asleep, take sleep preparations and drugs, take precautions and rituals to promote sleep and, invariably, find themselves with their eyes open staring at the ceiling or, even worse, looking at the smartphone. As well as those who, as Federica Cagnoni explains, report in the night a way of managing reality adopted in daytime life, the constant control of reality through thought, which leads to continuous awakenings and difficulties in falling asleep, due to the mental work that the person perseveres to do even during the night. Instead of letting himself be cradled in Morpheus's arms, he sleeps with one eye open.


At Strategic Therapy Center of Arezzo for more than thirty years Giorgio Nardone studies and intervenes on these mechanisms that invalidate people in their life. In his long research and intervention work on psychological and relational disorders, assisted by the team of his collaborators, he developed effective and efficient treatment protocols for the resolution of most of the problems that people suffer from in the psychological field. His work has produced some of the most effective treatment techniques for the therapy of panic, phobias, obsessive-compulsive disorder, sexual disorders, sleep disorders, eating disorders. The Brief Strategic Therapy formalized by Giorgio Nardone is today an original model of therapeutic treatment exported all over the world.

In our culture and in contemporary society, the idea of ​​control is central and the illusion seems to be that everything can be controlled. We constantly strive to exercise as much control as possible and often feel the weight of this effort, it is no coincidence that stress is one of the most used words today. The chimera of absolute control is pursued, raising rational thought to a single instrument of knowledge, rather than learning to manage the share of uncertainty present in any phenomenon. The highest level of control, as Giorgio Nardone recalls, is reached when one is able to move smoothly between loosening control and regaining control, just like the champions of each discipline do.


Instead of clinging rigidly to the illusion of absolute control, it is appropriate to learn to dance flexibly between certainty and uncertainty, between reason and emotion, accepting blurred boundaries and contradictions and remembering that, as Nietzsche wrote, "everything that is absolute belongs to pathology" .


Dr. Carlo Eugenio Brambilla

Official Psychotherapist of the Strategic Therapy Center



Reference Bibliography


Cagnoni, F. (2016). Insomnia.

Cioran, EM (1993). Syllogisms of bitterness. Milan: Adelphi.

Marinoni, A. (1974). Literary writings. Milan: Rizzoli.

Nardone, G. (2013). Psychotrap. Milan: Ponte alle Grazie.

Nardone, G. (2016). Panic Attack Therapy. Milan: Ponte alle Grazie.

Nardone, G. (2019). Emotions. Instructions for Use. Milan: Ponte alle Grazie.

Nardone, G. & Portelli C. (2013). Obsessions compulsions manias. Milan: Ponte alle Grazie ..

Nardone, G. & Salvini, A. (2013). International Dictionary of Psychotherapy. Milan: Garzanti.

Nietzsche, F., (1977). beyond Good and Evil. Milan: Adelphi.

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