What are you afraid of?

Somatic symptom disorder, anxiety disorder and illness anxiety disorder all have that one thing in common: fear. But fear of what, exactly?

In order to get over the fears, we need to know what we're afraid of.  Unfortunately this is going to get uncomfortable.

To find out what we're afraid of, we need to start asking the horrible what-if -questions. We need to keep asking until... well, until we're on the verge of, or in, a panic attack. Only then we have found the real issue and can start working on it. 

Example: Bob is afraid of getting sick. He owns an impressive selection of meters, and keeps checking his blood pressure, temperature, blood sugar and blood oxygen. He gets anxious if he reads about sicknesses or hears that someone has passed away.

What is Bob afraid of? Well, plenty of things: that his blood pressure is too high, that he would get sick, that he sees an ambulance, that he sneezes once too many times. Fine, let's start pushing Bob.

Question: What would happen if you got sick, Bob?

Bob: I might need to go to the hospital. Yuck, I'm afraid of hospitals.

Question: What would happen if you were in the hospital? Let's assume that you lie in a hospital bed now, with an IV-needle in your hand and nurses around you.

Bob: I would be very afraid because .. because I don't know what's going on. I don't have any control and I'm away from home.

Question: What will happen at home when you're away?

Bob: The kids.. they would be scared and they don't know what to do! They're alone and scared and no one knows when I'll be back - if I'll ever be back!

 Question: What would then happen to the kids?

Bob: They'll starve to death and die alone in an empty house! They'd be cold and scared and alone! I have failed as a parent, I need to protect them!  What kind of parent leaves their kids like that? 

See what happened here: Bob thought he was afraid of sickness, but he's more afraid of losing control and being a good parent.

Rather than focus on his fear for sickness, Bob could focus on practical concerns (make sure there is someone who can take care of his kids if he's not available for any reason). He could also start to work on his compulsive need for control. Letting go and trusting others around him would give him much more room to breathe even in unpleasant moments.