As discussed in The Simplest Explanation of How OCD and Anxiety Work, people with anxiety and OCD are all afraid of failing to prevent an irreversible catastrophe; but exactly what each individual considers a catastrophe varies from person to person. Dr. Elna Yadin realized that each person with anxiety or OCD usually has a single core fear that underlies all of their various symptoms.
Identifying this core fear is essential to understanding and dismantling the thought process underlying the anxiety, and to designing effective exposures. So how do you figure out what your core fear is?
One method is to look at all the different triggers that make you anxious, and ask yourself: What’s the worst thing that could happen, and what would the worst part of that be? The goal isn’t to reassure yourself that it could never happen, but rather to explore what you fear could happen if everything did go as badly as possible. Once you’ve done this for each trigger, look for a common theme across all of them.
But what counts as a core fear?
Some time ago I had a realization that greatly enhanced my understanding of anxiety and OCD, and also made it easier to identify the core fear: These disorders are always based on a fear of making a mistake that you can’t take back. Therefore, the core fear must always be something that could be preventable and the consequences of which could be irreversible.
If you have a clear understanding of your OCD or anxiety, you will be able to identify the irreversible core fear and identify how all forms of avoidance and compulsion (including rumination) are aimed at preventing it.
If you think you know what your core fear is, but it’s not irreversible, it’s not the core fear. (Try asking yourself: What would the worst part of that be?)
Sometimes it can be hard to identify your own core fear, and this is one of the things a therapist familiar with this theory can help you with.
Once you have identified how all of your triggers relate to your irreversible core fear, and how all forms of avoidance and compulsion are aimed at preventing it, you will be in a great position to start dismantling the disorder.