Being controlled, controlling, trying to control, lack of control, impulse control, losing control, taking control—these small expressions are phrases we use constantly in our daily lives. Their usage may be conscious or unconscious, and for most of us, they have become habitual. In reality, this is an important concept for all of us. We use it in line with our own needs and try not to lose control. However, for some people, this concept is extremely important—even vital. In certain obsessive individuals, this control mechanism becomes deeply embedded in their minds, both consciously and unconsciously, influencing their relationships, behaviors, thoughts, and emotional responses, almost taking over their inner world.
Panic attack patients have three main fears during an attack or even when anticipating one: having a heart attack and being unable to control it (and therefore the fear of dying), the fear of losing control or “going crazy,” and the fear that something terrible will happen to someone they love and that they will not be able to prevent it. But ultimately, these fears all lead to one core fear: the fear of death. Death is the only thing that truly cannot be controlled and represents the final point. Everyone knows that one day they will die and accepts that there is no escape from this. Up to this point, there is no problem.
The real question is: Do we actually *feel* this truth?
As humans, we tend to repeat certain concepts so often that we strip them of their emotional weight. When we do this, there is nothing left to be afraid of, and a type of “false acceptance” appears—something that looks like acceptance but is actually empty. Because in reality, all of us fear death, nonexistence, the anxiety of disappearing, and being lost.
In daily life, we distract ourselves with small concerns, finding substitute thoughts that replace truly existential and anxiety-provoking ones. We assign exaggerated meaning and importance to things we secretly know are insignificant.
We do this because we need it.
The greatest fear of a panic attack patient is having a heart attack, experiencing it, and dying. They know very well that there is no negotiation with such a situation. Their mind is constantly preoccupied with the idea that death might strike them at any moment. Here I emphasize an important distinction: knowing about death and accepting death are two entirely different things. Knowing is simply informational; awareness is not the same as acceptance. Knowledge is collective and mechanical—but it is feelings that give it meaning. A thought or piece of knowledge carries real power only when it is emotionally processed and internalized.
Obsessive individuals are generally highly controlled people; their lives are built around control. Making decisions is difficult, letting go is difficult, and uneasiness and anxiety dominate their internal world. Their most frequently used expression is “distress.” The distress inside them. When something happens, their first reaction is to feel overwhelmed—they experience internal tension. It is as if they feel anxious when they are *not* anxious; distress has become a lifestyle. Imagining a life without distress is difficult. Yet at the same time, they complain about the distress—because it is an unbearable sensation. When we look at the symptoms of panic disorder:
Difficulty breathing,
Heart palpitations,
Fear of losing control,
Involuntary physiological reactions,
Increased heart rate—
we notice that most of these symptoms involve automatic bodily functions, which they truly cannot control. These are bodily reactions that cannot be consciously managed. For obsessive individuals, unless everything is under their control, they cannot feel at ease, and they believe the entire world will fall apart. They try to create a system of their own and control everything down to the smallest detail. This includes their relationships, inner life, emotions, and thoughts. Through their obsessions and need for order, they attempt to control others. They have a personal system, and this system must operate according to their own understanding of control. Rules and discipline are extremely important, and they rarely compromise—because rules and discipline define the boundaries of control.
So why do some people—perhaps even the majority—possess these personality traits? If a human desires freedom, free thought, and free emotional expression, why would they invest so much effort into controlling themselves? Why would someone put themselves under such mental and physical strain trying to control their environment?
One of the most important reasons is the fear of death and the impossibility of controlling it. To “control death” would require truly feeling its existence. Feeling the reality of death does not pull us away from life—on the contrary, it strengthens our bond with it. Let me give an example: one of my long-term psychotherapy clients initially sought treatment after experiencing a panic attack. She arrived already aware of her symptoms and was experiencing intense distress. For years, the only emotion she could name or describe was “distress.” She experienced disproportionate and unrelated distress in reaction to events. In addition to a severe fear of flying, she had other phobias as well. But above all, her primary concern was her internal distress. After a certain point—although she had mentioned it vaguely in the beginning—she realized that this distress was actually a mask for her fear of death. Becoming aware of death, recognizing that she would truly die one day, and confronting the existential impact of being mortal initially caused discomfort and even a depressive emotional state. But once she reconciled with the idea of death—or rather, the thought of death—her distress began to disappear. Her distress had been a barrier between her and the fear of death. Feeling distressed meant she was not dying. Accepting the existence of death is one thing; fearing the fear of death is another.
All this effort we put into maintaining control in our daily lives is, without realizing it, nothing more than an attempt to escape the thought of death and to mentally “control” our mortality. To be mortal feels like proof of our weakness and incompleteness. But we must remember: a person who accepts their weaknesses can grow and develop. Someone who is “complete” has no need to grow. Who is complete? Who is without flaws?
Of course, the dynamics of obsessive personality and panic disorder are very deep and cannot be explained simply. Yet beneath all of them lies the effort to escape the awareness of death. Adults, in an attempt to distance themselves from death, often use childish defense mechanisms—perceiving death through a childlike cognitive lens. We resist growing up and behave as if we were not yet ready for certain truths. Naturally, we use some defense mechanisms to cope with reality, and this is normal. But when we use these mechanisms excessively or inappropriately, they lose their effectiveness. And at that point, we are caught unprepared by the very truth we were trying to escape—this is when psychological disorders appear.
