Sep 24, 2026 · 6 min · 8 segments
You finally start getting a handle on one OCD fear — and then suddenly it latches onto something completely different. The thoughts may change from contamination to driving, relationships, morality…
Patrick McGrathHost
So a core fear is really the deeper, often more universal fear that drives someone's specific emotions.
obsessions, right? The fear that someone might have with contamination OCD might initially seem that they're afraid of germs.
But when you look deeper, it could be around a core fear of death or dying, right? In some way.
And so a few other examples might be that they're alone or abandoned in some way that they won't be able to handle feeling certain experiences or that they'll just be trapped in this for the rest of their lives.
to find a core fear an erp therapist might ask what would that mean to you repeatedly this is uh something called the vertical arrow where we keep going from here's what you tell me and i say well and if that were to happen what would that mean to you and then they'll say this and if that were to happen what that mean to you and we kind of keep going on that until we hit a spot where there's either nowhere further to go or it might seem like it's starting to circle back up again right So we want to get to that core experience, that thing that people are ultimately afraid of.
So we can make sure that we're designing exposure and response prevention exercises that come at many angles at being able to hit that core fear instead of maybe just the idea of germs.
So a core fear is really the deeper, often more universal fear that drives someone's specific emotions.
obsessions, right? The fear that someone might have with contamination OCD might initially seem that they're afraid of germs.
But when you look deeper, it could be around a core fear of death or dying, right? In some way.
And so a few other examples might be that they're alone or abandoned in some way that they won't be able to handle feeling certain experiences or that they'll just be trapped in this for the rest of their lives.
to find a core fear an erp therapist might ask what would that mean to you repeatedly this is uh something called the vertical arrow where we keep going from here's what you tell me and i say well and if that were to happen what would that mean to you and then they'll say this and if that were to happen what that mean to you and we kind of keep going on that until we hit a spot where there's either nowhere further to go or it might seem like it's starting to circle back up again right So we want to get to that core experience, that thing that people are ultimately afraid of.
So we can make sure that we're designing exposure and response prevention exercises that come at many angles at being able to hit that core fear instead of maybe just the idea of germs.
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