Chronic pain, OCD, and letting go

For many, chronic pain, disordered eating, obsessive-compulsive tendencies, and emotional distress can feel like unrelated, mysterious struggles. Yet beneath these experiences often lies a common thread: a deep-rooted need for control. This need emerges as a way to manage life’s unpredictability, especially when early experiences left us feeling powerless and unsafe. 

That urge to control can show up in many ways: physically, through chronic pain or disordered eating; mentally, in obsessive thoughts, compulsions, or phobias; and emotionally, through anxiety, perfectionism, or the inability to let go.

The root of control: Childhood despair and helplessness

In nearly every client who struggles with control, whether it shows up as perfectionism, OCD, anxiety, chronic pain, or over-functioning, there is one thing I consistently find underneath: a profound and early sense of helplessness or despair.

Not just discomfort, not just stress, but a quiet, sometimes invisible kind of despair that began in childhood.

For some, that helplessness came from witnessing domestic violence, being small and terrified, unable to stop what was happening, unsure if anyone would protect them. 
For others, it was having a parent who was chronically unwell (emotionally or physically) and feeling like they should do something about it, but not knowing what to do.
Some describe growing up emotionally invisible, with a caregiver so consumed by another child or by their own pain that they grew desperate to be seen and heard.

These aren’t just difficult experiences. They shape how the nervous system wires itself for survival. When there’s no one reliable to regulate with, no place to safely fall apart, the child does the only thing they can: they take control in any way possible.

That might look like being the “good” child, the quiet one, the achiever, the one who never has needs or feelings. Or it might look like a child who starts to control their food, their routines, and their space,  not out of rebellion, but as an attempt to create safety in a world that feels unpredictable or an attempt to be perfect so they can be loved. 

As adults, that unresolved helplessness doesn’t disappear. It morphs into behaviours that look like overthinking, tension, compulsions, rigidity, or emotional shutdown. Not because we’re broken, but because those early strategies worked. They helped us survive.

But now, the same strategies that once protected us may be keeping us stuck.

A personal story: When control becomes a cage

I once worked with a man – let’s call him Daniel – who came to therapy because he was exhausted. Not in the way most of us say we’re tired, but a deep, bone-level fatigue that had followed him for years. On the surface, he was incredibly “together”: a successful professional, meticulous in his routines, always reliable. But underneath, he was drowning in anxiety, plagued by insomnia, chronic back pain, and a constant feeling that something terrible might happen if he ever let his guard down.

In one session, after months of gently exploring the roots of this tension, he finally said: “When I was little, I remember hearing my parents scream through the walls. I’d lie in bed, frozen, thinking if I just stayed quiet, maybe I could stop it.”

That moment broke something open. Daniel had spent his entire life trying to be the one who prevented chaos, the one who was trying to freeze or keep things still so nothing bad could happen. He was holding so much tension in his body from trying to keep things safe and in control. As a child, that strategy made sense. But now, as an adult, the very control that once protected him had become a cage. He didn’t know how to relax. How to trust. How to feel safe while moving, while living.

Together, we began the slow work of helping his body unlearn what it had been practising for decades. Not by forcing anything, but by offering small, consistent experiences of safety. Learning to feel without bracing. Learning to rest without guilt.

Daniel’s story is not rare. It's one I’ve seen in many forms: a story of children who become adults without ever having felt truly safe. And it’s a reminder that what looks like “over-control” on the outside is often a deep wound of helplessness on the inside, asking to be witnessed and softened, not judged or fixed.

Chronic pain: The body’s way of holding control

Chronic pain is often treated purely as a physical issue, yet many cases don’t have a clear medical cause. Instead, pain can arise from nervous system dysregulation. When your body feels threatened, whether by real or remembered dangers, it stays on high alert, holding tension that leads to inflammation and pain.

This need for control keeps the body locked in protective mode. People who struggle to relax or feel unsafe unless they’re constantly “doing” something often carry pain as their body’s way of guarding itself. Trusting the body to rest and heal can feel impossible.

OCD and anxiety: Trying to control the uncontrollable

Obsessive-compulsive behaviours are the mind’s attempt to impose order on uncertainty. Intrusive thoughts, rituals, and rigid routines give a fleeting sense of safety from chaos. But underneath, there’s often a deep fear of uncertainty and a belief that life is too unpredictable to handle.

Michael, another client, spent years trapped by compulsive handwashing. He knew his hands weren’t really dirty; the compulsion was about control. Growing up with a critical and unpredictable father, Michael learned that mistakes weren’t allowed. His rituals were his way of preventing judgment and rejection.

The harder we try to control, the more trapped we become in these mental loops.

The emotional toll: Perfectionism and the fear of letting go

Control doesn’t always show up in obvious ways. For many, it’s perfectionism, over-responsibility, or the fear of disappointing others. This constant stress drains your energy and makes letting go feel unbearable.

Letting go means facing that childhood helplessness head-on. If unpredictability once meant pain, your mind will naturally avoid anything that triggers it. But avoiding that discomfort comes with a cost: exhaustion, anxiety, and feeling stuck.

Healing through trust and release

The path out isn’t about giving up responsibility but about shifting from rigid control to flexible trust.

• Nervous system regulation: Practices like intense breathwork that mobilise the stress system and shut down the freeze mode, or meditation and movement, help signal safety to your body.
• Facing uncertainty: Small steps toward embracing unpredictability build resilience, whether it’s allowing a little mess or saying “yes” to spontaneity.
• Processing trauma: Somatic therapies and inner child work help heal the roots of control.
• Self-compassion: Recognising that your need for control comes from a place of protection, not weakness, creates space for healing.

Embracing life beyond control

Control was never the answer; it was a survival tool born from past pain. True freedom begins when you learn to trust yourself and life’s natural flow. In that trust, chronic pain, obsessive thoughts, and emotional distress lose their hold, making space for ease, growth, and genuine peace.