Why watching your own control makes it feel precarious
Checking whether you still feel in control is the compulsion at the centre of this theme. Attention aimed at control makes control feel unsteady, in anyone, like thinking hard about swallowing.
Try this. Think carefully about swallowing. Attend to it. Notice each part of the movement, and check that it is happening correctly. Within a few swallows, something that has worked automatically all your life feels effortful and slightly wrong. Now try walking down stairs while watching your feet and checking each step. The same thing happens.
Nothing was wrong with the swallowing or the stairs. What changed was that they were being watched. This is the mechanism at the centre of fear-of-losing-control OCD, and the self-monitoring is the compulsion people are least likely to recognise as one.
Control is automatic until it is inspected
Most of what you do runs without supervision. You do not decide to keep your hands on the wheel; they stay there. You do not decide not to shout in the library; the not-shouting is the default. Control, in the ordinary sense, is the absence of any impulse to do otherwise, running quietly in the background, rather than an effort being made.
Turn attention onto it, and it changes character. Am I still in control? Is my grip steady? Would I notice if it slipped? Now control is a thing being done, and things being done can fail. The feeling of precariousness is the ordinary effect of watching an automatic process, and it happens to anyone who tries.
How the loop tightens
In this theme, the monitoring is constant. Checking whether you still feel in control. Testing the grip. Watching for the moment it slips. And every check produces the feeling of precariousness, which gets read as evidence that the danger is real, which drives more checking. Within months, a person who never once thought about their own self-control has become someone who cannot stand on a platform without running a continuous diagnostic on their own restraint.
The diagnostic never returns a clean result, because the diagnostic itself is what makes the reading unsteady.
Thoughts and actions are different systems
Thoughts and actions run on different systems, and the mechanism is reassuring in a way that reassurance is not. Having an image of turning the wheel does not move your hands. Having the urge to shout does not open your mouth. The gap between a thought and an act is a structural feature of how brains work rather than a thin line held by willpower, and the self-monitoring is checking a barrier that was never in danger.
The horror you feel at the image is evidence that the thought is landing on somebody it is profoundly at odds with, which is exactly why it stuck to you and not to the person next to you.
The rest of the safety apparatus
Around the monitoring sit the other safety behaviours: standing further back on the platform, gripping the wheel harder, moving the knives, taking the longer route, avoiding being alone with the people you might hurt, avoiding the quiet room where an outburst would be unthinkable. Each tells your brain that the danger was real and that you only got through it because you were vigilant. Each prevents you from finding out what happens without the vigilance.
Stopping the watch
In CBT with exposure and response prevention, the self-monitoring is withdrawn like any other compulsion, and it is usually the hardest one, because it feels like the last line of defence. The practice is to stand on the platform, or hold the wheel, or be in the kitchen, and not check. To let the question "am I still in control?" arrive and go unanswered, and to put attention back on the world. The precariousness rises, because the check was holding it down. Then, given no check, it falls, and the automatic control that was always there resumes.
We are not going to try to establish that you are safe. Every time you have established it, it has expired within the hour. What we do is dismantle the apparatus that has been producing the feeling of danger, gradually, in an order you agree to, and get the ordinary things back.
Telling it apart
Part of assessment is separating an intrusive urge you find horrifying from genuinely wanting to harm yourself or someone else. If it is the second, say so straight away, including in a first email, and we deal with that first. If it is the first, there is more on how I treat fear of losing control, and the watching is where we begin.