Brief overview
- Therapy: Cognitive behavioral therapy with confrontation exercises, sometimes supported by medication.
- Symptoms: Recurrent acts of control such as checking objects (e.g., stove, doors) combined with anxiety and inner tension; sufferers know their behavior is irrational
- Causes: Interplay of biological (genetic) factors and environmental influences (such as traumatic childhood, unfavorable upbringing)
- Diagnosis: Taking of medical history with the help of special questionnaires
- Prognosis: Good prognosis if treated early by a trained therapist
What is a control compulsion?
The control compulsion is a very common form of obsessive-compulsive disorder. Sufferers often spend many hours of the day checking the stove, faucets, and doors. In the long run, the time-consuming rituals prevent them from participating in life and from accomplishing their everyday tasks. A pronounced compulsion to check therefore causes considerable suffering.
This form of obsessive-compulsive disorder relates to the control of objects. Obsessive-compulsive behavior that relates to control over other people is more indicative of a personality disorder. In dissocial personality disorder, for example, sufferers have little empathy for others and sometimes manipulate those around them.
Not leaving the house anymore, not cooking on the stove or not lighting candles are avoidance strategies that maintain or even aggravate the control compulsion. In therapy, therefore, precisely such strategies are uncovered and worked on. Psychotherapy in combination with medication, such as selective serotonin reuptake inhibitors (SSRIs), helps in this process.
Of the psychotherapeutic methods, cognitive behavioral therapy with confrontation exercises has proven particularly effective. Here, sufferers learn to confront their fears. In the case of the control compulsion, for example, this means leaving the house without checking the door several times.
In the course of therapy, with the help of the therapist, sufferers learn to limit themselves to a normal level of control, i.e. to trust in themselves. This is because people with control compulsions always doubt themselves. Although they have just locked the door, the next moment they are unsure whether it is securely locked. In therapy, those affected practice not giving in to the urge to control. Over time, they become increasingly secure, and the anxiety subsides.
How does a compulsion to control manifest itself?
The people concerned fear that a terrible disaster will occur through their fault. To prevent this disaster, they check the stove top over and over again, for example. They often say aloud to themselves, “The stove is off.” But they are never quite sure. As soon as they move away from the stove, fearful thoughts resurface and they have to check the stove again.
They have a similar experience with faucets, lamps, and doors. Leaving the house thus becomes a torment. When they make it out the door after much toing and froing and remove the key, they press the door handle several more times to make sure the door is really locked. Some have to turn back several times and check everything again, still others don’t want to leave their apartment at all because the fears are too strong.
A common fear of sufferers with control compulsions is also running someone over without realizing it. They therefore drive down the same path over and over again to reassure themselves that no one has been hurt by them.
People with control compulsions know that their behavior is irrational, but are unable to change it. The controlling acts are often repeated to the point of complete exhaustion.
What are causes and risk factors?
However, this alone is not enough to actually develop a compulsion to control. Other factors must also be involved, such as traumatic childhood experiences or an unfavorable parenting style. A general anxiety plays an important role: anxious people tend to take threatening thoughts very seriously. They want to prevent the thoughts from becoming reality at all costs.
Details on the causes, diagnosis and treatment of obsessive-compulsive disorders such as control compulsive disorder can be found in the article Obsessive-compulsive disorder. There you can also read more about self-help for obsessive-compulsive disorder. In self-help groups, for example, group members share experiences and tips for implementing planned behavior changes.
What tests and diagnoses are available?
A control compulsion is a special form of obsessive-compulsive disorder. A therapist uses special questionnaires to determine whether this is the case. The diagnosis is a first important step on the way to getting the illness under control and coping with everyday life again.
