Being in control of your life means you are more assertive when things don't go your way, so you are less likely to accept others trying to control you - hence the rise to the top. But if things stop going your way, or beyond your control, you find it difficult to cope.
Yale University psychiatrists have recently found that a need constantly to be in control makes you three times more likely to suffer a serious depression in the face of an adverse life event, such as a failure at work or a relationship breakdown. Other research has found that when under stress, you are much more likely than others to develop heart disease.
The biggest problem for a control freak is being faced with situations where there is an "effort-reward" imbalance - you put in a lot of effort but get much less reward than you were expecting, or none at all. Control freaks work hard because they assume they'll be rewarded for their effort.
But control freaks have never realised life isn't that predictable. And they can't stand it.
Recent research by psychologist Ann Zak and her colleagues in New York confirms, for instance, that control freaks blame their partners if things go wrong in a relationship. They reason that they've worked hard to make things succeed, so it can't be their fault when it goes belly up. As a result, there tends to be more conflict in relationships where a control freak is one of the partners. Compromise is difficult; their need for control arises out of a strong sense that they are right and everyone else is wrong.
Even more intriguing is the recent finding from a Tel Aviv research team that control freaks get worse when under stress. When they find themselves losing control in one sphere of their life - such as increased stress at work - they compensate by increasing their control of their partner. Or vice versa: for example, it could be that your head of department's increased need to control his or her area reveals a recent loss of control in a personal relationship.
Research has even suggested that women are more likely to be perceived as control freaks in intimate relationships, while men try to take over at work. The theory is that women need to compensate for their sense of less control outside the home - or perhaps for their perceived loss of control over their lives when they start a family.
Control freaks can also seem to get lost in a vicious spiral of control and stress. They attempt to deal with stressful relationships by trying to exert more control, which produces more stress, leading to more attempts to control. This continues until they lose their temper in a final attempt to regain control. So, paradoxically, those we know who are most prone to lose it completely and appear out of control through rage are most likely to be control freaks unable to cope with not always getting their way.
One cast iron guarantee of being awarded a season ticket to my clinic is to persist in trying to control the uncontrollable. When it comes to children in particular, don't make the dangerous assumption that you have more control than you really have.
Professor Raj Persaud is a consultant psychiatrist at the Maudsley hospital and senior lecturer at the Institute of Psychiatry in London. He is a fellow of University College London, and author of From the Edge of the Couch published by Bantam Press, pound;12.99. Email: firstname.lastname@example.org