Control is not a neutered word. It is packaged energy. The word "control" is caged by modifiers. Self-control builds might. There is flood control or fire control. People speak of birth control, knowing its power over life.

Erase the niceties and control turns raw. There is military control, control by dictators and despots. Control is a style of management. Control says one person has another tied up in the strings of a marionette.

People of the world can be loosely grouped by their internal tension and their means of managing this emotional-physical force. Some will walk and others will run away from control. Others will freeze like a statue. Then there are those who must take charge. It is as though it is in their blood. In reality, it is in their brain.

The brain being in charge has several advantages. One is to avoid anxiety. Having large angst is over-stimulating anticipation. It is imagining the unknown around the next bend that is distressing. It is the unknown that drives up the hormones of self-preservation.

Exercising control ameliorates the discomfort of not knowing. Controlling others by whatever means is exhilarating. For many it is a need. There is a circle of control. Feeling that we are loved and competent is a human necessity. When we perceive we are missing one or the other or both, hurt follows. From the depths of pain, the body will frequently erupt in anger. It is through this emotional display that we feel stronger. This pseudo-strength is a means to intimidate and force the compliance of others. Control comes to the aid of the insecurity.

Control also is derived from those who struggle with relationships. Emotional neglect in childhood leaves blank the mental model of person-to-person interaction. It is easy to picture a well-intentioned and loving mother or father who was not taught how to emotionally engage another. When the child cries, the parent can’t interpret its needs. If this happens enough times, the infant learns to not send signals. The conclusion is "Why bother?" They will not be answered properly.

These infants grow up with the learned auto-dysregulation. Therefore, to feel calm, they have to become excited. They are at peace when they rule others. They are most comfortable doing everything because only they know how to do it right. Explaining something to others is difficult because they never had the experience as a child. Emotional absence taught the baby to keep quiet. Words are not part of their emotional tool kit.

Control therefore suits them just fine. They are in charge. They don’t have to explain or justify. They command. They do not lead. They point and expect others to jump. The internal sensation both calms and excites to make the cortisol go down and the testosterone go up.

Some people only know control. They know no other way, and they feel justified.

Therefore, if there is damage to one’s self-worth, what better way to cover it than by being the boss?

That is why there is never a shortage of dictators and bullies.

Now imagine those who are against control of others but big on self-control. They don’t need the credit for success. They are comfortable with ambivalence. For them, not everyone has to march to the same tune, especially a tune they didn’t pick out. They quietly, but effectively, go about their job. They don’t need the external attention because they are self-contained emotionally. They lead, not dictate. They seek the input of others and recognize them for their worth.

They don't yell or intimidate. They elevate, not suppress. They recognize there are others who have to be in charge to function. They let them.

They are not wimps. They are meek and long-suffering, but they will reprove at times with clarity, not anger.

It would be nice if the control freaks would chill out. They could use some self-control.

Joseph Cramer, M.D., is a board-certified pediatrician, fellow of the American Academy of Pediatrics, practicing physician for 30 years and a hospitalist at Primary Children's Hospital and the University of Utah. Email: jgcramermd@yahoo.com