Anxiety and OCD: The Strategy Mismatch Issue (Podcast Episode 351)

Anxiety disorders and OCD tend to be built on strategy mismatch. A perfectly functioning brain that is really good at solving problems tries to use its usual problem-solving mechanisms, but to solve the wrong problems. And then you end up stuck in a never-ending cycle of being triggered, fixing that, and repeating ad nauseam. So, let's talk about that this week on The Anxious Truth. Hello, everybody. Welcome back [music] to The Anxious Truth. This is a no video episode of the podcast, episode 351, recorded in August of 2026, in case you are listening from the future. Sorry, YouTube, no video this week, but you can listen along as well. I am Drew Linsalata, creator and host of The Anxious Truth. I'm a therapist that practices in New York specializing in the treatment of anxiety and anxiety disorders. I am a former sufferer of the things we talk about on The Anxious Truth, uh fully recovered now, four-time author on this topic, podcast host, not only here, but uh podcast called Disordered that I do every Friday with my buddy Josh Fletcher, an anxiety therapist in the UK, psychoeducator, advocate, guy with too many microphones and cameras, and yeah, we're going to talk today about strategy mismatches in anxiety disorders and OCD, because it's an often overlooked topic. Before we do that, just a very quick reminder that The Anxious Truth is more than just this podcast episode. Head on over to my website at the anxioustruth.com. There are all kinds of goodies there. If you want to find ways to support my work or get more useful resources, check out the website and avail yourself of everything, most of which is free, and even the stuff that does carry a cost is pretty low cost. Uh of course, the best way to really interact with me, if you really want to do that and ask questions about these episodes, is to check out Disordered, which is the podcast I do with Josh every Friday. Go to disordered.fm/community, and you can check out the Disordered community space. That's where we tend to be hanging out. Uh and that is where you're much more likely to be able to interact with me in some way, ask questions about these podcast episodes, interact with other people that share your experience and know what it feels like. Uh it's not gatekeeping. There's no magic fixes there. We're not promising anybody, you know, full recovery as of sort of magic hack that's going to fix everything. It's not a cult. Uh and it is completely optional. But if you're interested, go check out disorder.fm/community. So, let's get to today's topic, which is strategy mismatches in anxiety disorders and OCD. So, let's start by looking at the common, and I'm using air quotes, problems that you find with people who are struggling with different forms of anxiety disorders or OCD. We might find problems that are focused on thoughts that are uncomfortable, disconcerting, or disturbing. Thoughts about harm or self-harm. Thoughts about moral failure or being a bad person. Thoughts about existence and death and existentialism. Uh thoughts about relationships, especially romantic and intimate relationships. Thoughts about events that may or may not have happened in the past or may or may not happen in the future. Uh we can get stuck in anxiety and OCD on concerns about actual real-life, real things, but things that we can't control, like overall safety and security, or our health or the health of our loved ones, or the actions of others in the world, or the opinions of others in the world, or the general unpredictability and not knowing that comes along with a human life, or the inability to to gain any sort of real certainty or guarantee about the future and what awaits us. Uh we also will find fixations on physical sensations. Things like racing heart, or feeling off balance, like you're sort of on a boat, or tummy issues, feeling upset or nauseous, dissociative issues, like DPDR, or muscle tension, or chest or throat tightness, which may be associated with something called air hunger. I mean, I could go on and on for 2 hours on the the common, air quotes, problems or fixations that we see in anxiety disorders and OCD, but this is sort of a general list. It's either triggering thoughts, uh issues in real life that we find intolerable or uncontrollable, or physical sensations. So, those are the problems that your anxiety or your OCD is latching onto, but are those the actual problems? Now, remember that when we're talking about anxiety disorders and OCD, we're specifically focused on repeated attempts to soothe anxiety and fear and discomfort and feelings of vulnerability. We're not actually trying to solve real-life problems like heartbeat or relationships or moral character or anything like that. So, really, if you're struggling with an anxiety disorder or OCD, the problem you're actually attempting to solve is that you are anxious or afraid or uncomfortable, feeling a sense of distress or uncertainty, or feeling like you are doomed. Feeling like you are doomed, threatened, or maybe unable to handle the experience that you're having right now, but the inside experience, the inside inside the experience inside of you, right? So, when your brain isn't confronted with this, all the responses and actions that it wants to suggest appear to be targeting like real problems like your heartbeat or air hunger or dizziness or what if you accidentally cheated on your partner and don't know that, or what if you're going to harm yourself, or what if something happens to your health or the health of your loved ones. Like, your brain is going to suggest responses and strategies that appear focused on like what appear to be real problems to you, but they're not. Now, how do you know this? When you do your escaping or avoiding or getting saved or you do your rituals or your compulsions and you can find a way to feel a little better about what you think this problem or threat is, has the actual problem that triggered you or the thought or the concept or the possible disaster that triggered you, has it actually been solved or has it only been sort of temporarily glossed over because you feel a little better, but then you have to do it again? So, when you think about it, that is the hallmark. That's how we know we're not really working on real-life problems when we have to keep trying to solve the problems. So, you know, you may have a concern about a physical sensation and you go and get reassurance for the 10,000th time from ChatGPT or Reddit or your support group or your doctor or your family or your friends and you feel a little better about it, but then you wonder, I don't understand. I felt better yesterday, but now I'm back to figuring that everybody is wrong and I have to check that out again. So, an anxious mind caught in that sort of loop right, anxiety disorders and OCD is going to create and drive strategies to solve problems that are not actual problems. They just look like problems. The actual problem is how you feel, the anxiety, the fear, and the discomfort. So, when your anxious mind suggests responses like avoidance or rumination or actively worrying or trying to gain excessive control or escape or seeking of reassurance or compulsive research and resource gathering and asking over and over or relying on saving people or devices. too far from a hospital. Don't go too far from your safe people. It's giving you a strategy that doesn't match the actual problem in front of you, right? These are all strategies it is going to suggest for you to get away from what it tells you is a problem, your health, your relationship, or your safety, or whatever it is. Your mind thinks you need to solve your heartbeat or uncertainty about health or your moral status as a few examples. But you can never actually solve those things because they're not the real things that you're threatened by. So, you're calming yourself down over and over and over and it never ends because you have been tricked into, wait for it, title of today's podcast episode, a strategy mismatch problem. Now, at this point you might say, wait a minute. What do you mean my heartbeat, for example, isn't a problem or being a terrible person isn't a problem? Of course they are, right? You may want to argue that and I get it. Especially if you're new around here, new to this podcast, new to this topic, maybe this is a new experience for you and you're trying to figure out what's going on with you. I get it. Everybody starts there. You might be shaking your head right now because you will say, or at least your anxious mind will say, clearly my heartbeat is the most important thing. Clearly insanity is the most important thing. Clearly my health is the most important thing. Clearly caring for my kids is the most important thing, right? All of these things, clearly being a good person, or or or, you know, a true to my faith is important. How could you say that these are not problems? Well, I'm saying they're not problems. I'm not saying they're not important, right? You may argue, or your anxious brain will argue, because those are important then and and are real actual things, then they must be the problem. But they're not. So, I'm not saying that they're not important, or things that you might be concerned with, or any person might be concerned with from time to time. These are things that we all think about. We may have concerns about them. There's no argument about that. But when a non-anxious person has a fleeting thought that bothers them, or encounters a scenario they find intolerable, or, you know, maybe has a sensation they didn't expect in their body, they might kind of bristle for a moment, or maybe, you know, wonder what that was. But then they tend to move on, right? The key part is a non-anxious person can have that experience and then sort of move on. Do you move on? Is the question you have to ask. Or does the discomfort that you're feeling, the anxiety, the fear, seem to confirm to you that you really need to do something immediately to prove that you didn't accidentally cheat on your partner, or that your heart isn't going to stop beating, or that you're not having a stroke, or that you have to do something to prevent some impending doom or disaster from like getting you right now, right? Does that discomfort seem to confirm, cuz it it feels so real, that something must really be wrong. And that's the difference between the anxious person and the non-anxious person. How long have you been trying to solve these problems, air quotes, and move on, but can't? You have to keep trying to solve the problems, right? So, the point here is not that health or moral fiber, for example, are irrelevant on a universal level. We would all agree that they are relevant and and important. The point is that discomfort triggered by those ideas and concepts does not in any way confirm that they are current actionable threatening problems in your life. Discomfort, fear, and anxiety do not confirm that you have the problem you think you have. They only confirm that you're afraid to have that problem. They only confirm what you care about and fear. That's it. So, if you want to try to argue or your anxious mind wants to argue that this guy is is clearly doesn't know what he's talking about because my heartbeat must be important, ask yourself how long you've been trying to solve your heartbeat and keep yourself safe and it never seems to work, right? So, you are afraid of health problems, which all human beings are, and then you get stuck on that loop. So, keep that in mind. Um that's why I say that the problem you think you're solving is not actually a problem you have to solve. So, if we call this a strategy mismatch, then what should the strategy be? And I think that's a really good question. Clearly, it's a question you have to ask, right? So, it given that what we're dealing with here, the actual issue is that you're trying to fix discomfort, anxiety, and fear. You're not trying to fix actual real-world problems like your health or relationships or safety or that sort of stuff, then the strategy that gives us the best chance of a positive outcome when we work as as therapists like I am with anxiety and OCD, which I specialize in, with the strategy we use that has the best positive outcome here is to stop trying to solve all those problems because they're not problems at all. That's that's a big ask, of course, but the first thing we have to do is recognize like I have to stop trying to solve the problem with my heart or my breath or my dizziness or my stomach or my relationships or my moral fiber or or harm. I have to stop trying to solve those problems cuz those aren't the actual problems. Uh now, that seems weird. I know we're going to get to that, but the shift in anxiety disorder treatment is that we stop attempting to gain absolute certainty. We stop trying to eliminate all doubt. We stop trying to fix your symptoms. We stop trying to prove that your thoughts and fears are not true. We we stop trying to fix the things that appear to need fixing. Instead, we work on getting better at handling the discomfort that those worries, fears, and concerns produce in you because that's the actual problem, right? So, if you remember the part where the discomfort can turn confirms the danger, that's kind of the bad joke that anxiety and OCD will play on you. And it played on me when I was suffering, right? It's going to create a fear that comes before an actual threat. I talk about this all the time. The reason I like the word disorder in our context is it's it's legitimately like literal. Out of order. The fear comes before an actual threat. So, anxiety and OCD will create a problem, discomfort, but then instead of saying, "Well, the problem is I'm uncomfortable." it will tell a catastrophic story to explain why you feel that. Because there's no actual threat to trigger it. So, it needs to it needs to come up with a story for why you're having that that really difficult internal experience. And it's going to come up with all kinds of crazy horrific stories like you're a terrible parent or you're about to lose your mind or you're having a stroke or a heart attack or you did something wrong and you just don't remember. It's going to tell a story to try to explain why there's discomfort without a threat. Then, like a true cult leader, I've talked about anxiety and OCD as almost akin to a cult leader, it's going to suggest a fix for the problem it just created with a story. Except that that fix never actually works and has to be repeated endlessly. And this is why the real strategy when we're addressing anxiety and OCD is to work on recognizing that process as the problem. We're trying to explore ways to experiment with anxiety, fear, and discomfort rather than trying to eliminate by solving problems that are not problems at all. So, this is where we talk about content versus process. So, you know, I talk about that on this podcast. We've talked about it on Disordered, like content versus process is really important. If you try to solve the content of your fear, your heartbeat, cheating, moral fiber, self-harm, whatever it is that you're worried about, air hunger, you'll get stuck. And then you also know that it's anxiety and OCD when the the problem keeps morphing. Once you're seemingly not afraid of air hunger anymore, some other physical symptom will pop up. When you're not worried about your relationship anymore, some fear about it an imaginary past event, like real event OCD, will pop in. Or uh you know, scrupulosity will pop in, or some sort of harm or magical thinking thing will pop in. When a GAD person is stops, you know, was able to get away from maybe like excessive planning and you know, a predicting what's going on in the family schedule, well, some other, you know, worry or failure, imagine failure, will pop up that they then get stuck with ruminating and worrying about. So, that's how you know that you're dealing with anxiety disorders and OCD, right? Uh it fixes that never end and problems that constantly morph. So, you have to look at the process. The more effective strategy that we tend to use when we treat these things is that we have to disregard all of the safety instructions and fixing instructions that your anxious brain is barking at you, which is really difficult and definitely counterintuitive, right? We talk about this stuff all the time here. The strategy at first for somebody who's new, if this is the first time you've ever listened to the anxious truth or you've just started experiencing these things and you're scouring the internet try to figure out what it is, when you hear people like me say like, "No, you have to stop solving the fear that that you think is a problem," there's often disbelief. And even when an anxious person begins to come to grips with this plan, like, "Okay, this is starting to make sense," they will often feel that it's impossible to execute this prob- this plan because the problems, air quote, which are not problems, feel so real in the heat of the moment, right? I mean, how many times have you said to in my comment section or to your therapist or your friends or your support people, "But it feels so real." Or I hear all the time in my comment section or emails and whatnot that I get like, "You know, I love the podcast." or you know, you read my books or whatever it is, you listen to Disordered, and you get it, but the minute you get triggered, everything goes out the window because it feels so real. The process will tell will create such a powerful feeling in you that the content of the fear suddenly feels real. No, no, this time it really is a health problem. No, this time it really is a stroke. No, no, this time I really do need to be sane. No, no, this time I really am going to go insane. Right? So, anybody who has struggled with this for any length of time, whether it's an anxiety disorder or OCD, which by the way are not not officially the same things, but so closely related that they kind of melt together. Uh yeah, I get it. Like it it feels like either this can't be the right strategy or even if it is, it's impossible to implement. So, something else has to be done, right? The question that we always get asked, and you hear if you listen to Disordered, Josh and I talk about it all the time, anybody who sounds like me will talk about that. We will always hear the question, "Okay, great. Cool. Thanks for the explanation, but how do I do that? How do I make this strategy shift?" Excellent question. Clearly question you have to ask. Here's where things get dicey for a podcaster or somebody making YouTube videos or a social media person. If you're listening to this podcast episode, which mean it means by default I cannot give you specific instructions on exactly what steps 1 2 3 4 5 to take in your specific situation because I don't know you. Right? Nobody with a microphone or a camera on the internet, content creators, wellness gurus, influencers, nobody can do that. And it doesn't matter who's trying to sell you peace, calm, happiness, and regulation, they don't know you. I don't know you. Josh doesn't know you. Kim doesn't know you. All the people you see me collaborate with, Joanna, Lauren, we don't know you. So, the best people like us can do, if we're being honest with you and being ethical and and helping to not harm you with this content that we create, is to give you sort of a 50,000-ft view of the concepts. Like, that's what psychoeducation is all about in a podcast or a YouTube channel. From there, you have to apply it in your unique situation. And as people do do it on their own, it is certainly possible. It's it's a little bit more difficult that way, but it's done. Uh and if you can access it, which I know it's very difficult to access this stuff, this is where sort of qualified, trained, personal, in-person help, uh like an anxiety or an OCD therapist, can come into play. Right? So, keep this in mind. How do I do this? So, how do I shift from like, okay, that my heart really isn't a problem, it's actually, you know, facing the fear of my heart, that's the problem. But, how do you do that? I can only give you a very broad brush of the the the concepts here. So, first, you kind of have to notice that the only thing that confirms your problem, your heart, your relationship, self-harm, whatever, is the feeling that gets triggered inside of you. If that feeling went away, you wouldn't see a problem anymore. That's how you know that it's you're dealing with a, you know, OCD or an anxiety disorder. The only thing that confirms the the fear is the feeling. If the feeling went away, there'd be no evidence of a heart attack anymore. If the feeling went away, there'd be no evidence of a plane crash caused by not compulsing or something like that. Right? So, the second thing you have to notice is that all of the things that you do, that your brain decides, the strategy your brain gives you, the mismatch strategy your brain gives you when you get triggered, all of the things you do is trying to fix the problem, right? So, you have to start to look at like, well, what are the things that my brain tells me I'm supposed to do? I have to call my safe person. I have to do my rituals. I have to compuls. I have to ruminate. I have to worry. I have to call a safe, you know, I have to get my ice packs. I have to go back home. I have to go to the ER. I have to ask ChatGPT. I have to ask my support group online. Like, what are all the things that your brain has decided are the right things to do when triggered to solve the perceived problem. So, the third thing is you got to ask yourself if when you do those things, have you actually ever fixed a real problem or are you just sort of talking yourself off the anxiety and fear ledge when you do that? Right? And how do you know? The fourth thing you need to notice is how often you repeat the cycle over and over and over. So, if the problem only gets solved temporarily for 5 minutes, 5 hours, or 5 days, and you got to just do it all over again, you don't know why, well, notice how that cycle just keeps repeating. So, you're you know, your brain is going to tell you, "Here's how to solve the heart problem or breathing problem or a self-harm problem." Okay, cool. I feel better if I do those things that my brain tells me to do, whether they're rituals, compulsions, or safety behaviors. And then you figure, "Okay, cool. I figured out the problem was solved. Okay, I'm not going to go crazy. I get it now. Definitely, I'm not going to go crazy." But then the next day you have a a thought, "What if I'm going crazy?" And then the whole thing starts again, right? And the last thing that you have to think about, let's sort of the fifth concept here from the 50,000-ft view, is think about what might happen if you were to start eliminating all the fixing, saving, escaping, compulsing, ritualizing, and avoiding things. What if you allowed your discomfort to rise and fall on its own, which spoiler alert, it was always going to do? Like, you know, on Disordered, we talk all the time about what gets the credit. You think the compulsions get the credit for keeping you safe. You think your escape get keep, you know, gives the credit for keeping you from having a heart attack. You think that reciting your kids' birthdays keep you from losing your memory. Like, no, the the difficult feeling, the fear, the terror even that you feel, the discomfort, it was always going to end on its own because all internal experiences do. So, that's sort of the plan in a nutshell, right? I can give you those sort of five principles. Now, you're going to have to learn how to apply them in your unique circumstance cuz the actual implementation is going to vary depending on your lived experience and your culture and your beliefs and what you've tried before and your specific situation, right? Um you can listen to all the other podcast episodes I've done. There are This is 351, so there are 350 other podcast episodes. You could follow along with me on social media. You can listen to Disordered that I do with Josh every Friday. You could check out my books. You could read the videos. You could join the Disordered community space. You could do all those things, but none of those things, and that's why I'm really careful when I do things like workshops or we have the Disordered community, like we're very careful to make sure like listen, we still aren't going to be able to give you specific instructions on how not to be afraid or exactly how to be brave. Uh so keep that in mind. I always like to be fair with you guys and and and you know, kind of address the limitations of a platform like this one. So in the end, the most effective strategy here doesn't mean uh it does mean like accepting anxiety and fear. It does mean that you're going to have to be brave, right? So the effective strategy here is not trying to solve every symptom or the content of every thought and fear. The the uh most effective strategy is just recognizing I'm really uncomfortable. I'm afraid. I feel like something bad is going to happen, but I I can't do anything about that, which is really difficult to do cuz it's counterintuitive and it means you have to be brave. So even if this has all made perfect sense to you and you're like, "Yeah, cool strategy, Miss Match. I never thought about it that way. Thanks, Drew." But then you instantly get stuck on like, "Oh, but how do I accept something that feels so bad and how do I be brave?" Well, then that's where you have to start. You know, it's kind of okay. Everyone gets stuck on I don't want to accept something I hate and fear, and everyone gets stuck on like, "I don't know if I'm brave enough to do that." Right? So it's okay. Like everybody has to find find their way to the point where they are willing to accept that this is my reality, fear without threat, and that I have to be brave to to learn the lessons I need to learn to to kind of fix that problem cuz that's the actual problem in an anxiety disorder and in OCD. Feels risky, but I have to do that to get better. You will get there. Acceptance and sort of brave, committed, you know, consistent action for your own reasons. Like you'll get there in your own time and for your own reasons. So, keep that in mind and if you're listening and you're doing that whole like, "Yeah, I get it, but it goes out the window. Why can't I breathe? I just can't accept it." You get there when you get there. I don't know when that's going to be, but you're going to have to be patient with yourself and be nice to you yourself while you try to implement the strategy shift. So, overall, like it's kind of wrap it up in general, while again, I'm always giving you like I'm going to leave you with you got to do really difficult counterintuitive brave things. In a way, this is really good news though, because there's power in that you could do that. You could learn that lesson. You can solve the problem of, you know, recognizing that fear and danger don't always aren't always connected. Fear doesn't always equal danger. You can do that. Like you have agency there. Yeah, it's hard, counterintuitive, you got to be brave, but you could do that. You cannot solve problems like heartbeat, passing out, suffocating, accidentally cheating, harm that never happens, outcomes that never happen. You can't solve problems that aren't actual problems. So, you have no agency there. If you keep listening to the the mismatch strategy that your anxious brain keeps throwing at you, you're kind of doomed cuz you can never solve a problem that doesn't actually exist. So, in a way, it's a good thing that if I I can learn, you we can learn to be better at being anxious or afraid or uncertain or doubtful or unknowing because that kind of puts us in alignment with the general nature of existence in the universe. And it can be really ex you know, exhausting to try to solve problems like death endlessly cuz they're unsolvable. So, if you've been trying to do that, you're trying to solve the content of your fears, your symptoms, your thoughts, the scary scenarios in your head, you can stop doing that because it was never going to work. It's totally exhausting and it feels really good when you stop beating your head against the wall, right? And you know, it might seem hard to accept that being afraid without fixing that is a thing, but it really is a thing, right? So, we know this from decades and decades of good clinical outcomes. And by the way, when I say the strategy that gives us the best chance of a positive outcome, I said at the beginning of podcast, let me just explain that very quickly as I wrap up here. We're not That's the strategy that's most likely to help you get better. How would somebody like me, how does a working therapist define get better? Your life gets bigger and more flexible, and you don't have to ask anxiety or thoughts or fears or physical sensations for permission to live the life that you want to live. Your life starts to look more like the way you want it to, and your life starts to look less like the way you think you have to live it to stay safe. That is the the positive outcome we're generally looking for, uh and when we are working with anxiety disorders and OCD. So, it seems like a ridiculous answer. Like, if if being brave and accepting this awful feeling is the answer to the question, "How do I get better?" I hear you on that if you're still not sure on it, but being brave and allowing discomfort is difficult for now. Like, making the strategy shift, eliminating the you know, getting rid of the mismatch strategy, or at least detaching from it and trying a different strategy that requires accepting the situation and being brave as a feeling comes and goes, that is difficult for now, especially when you first get started. But in the long run, this way tends to take less effort and energy than trying to fight every thought, every emotion, every imagined scenario, every bodily sensation, always trying to prove that you're safe even though you can't seem to really prove that. That is exhausting, takes a lot of energy, never ends. In the end, if you can implement a a process versus focus strategy rather than a content focus strategy and eliminate that mismatch, you do have a better chance in moving forward toward what we would call recovery or desensitization or the life that you're missing and want to get back to. So, hopefully this helped. That's episode 351 in the books, 26 minutes if I look at my timer. That's not too bad. I'm kind of winging it. This is old school Anxious Truth. Again, just a quick reminder, if you appreciate the work that I'm doing here, if you're watching as a YouTube video, hit the like and subscribe button. Most people on YouTube are not subscribed to the channel. They watch the videos without subscribing. It's one little click for you, means a lot for me because YouTube likes to bury this sort of content in favor of We'll just say other content. And of course, if you're listening to the podcast on Apple Podcast or or Spotify or some platform that lets you rate and review. If you like this episode or like The Anxious Truth in general, maybe leave a five-star rating if you think I deserve it. And if you really dig it, maybe take to write a quick review of The Anxious Truth cuz it helps other people find the podcast and more people get help and makes me feel good when I'm talking to microphones that I can help people, right? And of course, if you want more resources, go check out my website at the anxious truth.com, most of which is free, some of which is very low cost. Check out the Disordered podcast at disordered.fm. We do that every Friday. You join the little disordered community space if you want to interact with me and your peers. Of course, optional. I always say that optional. You don't need it to get better. And yeah, if think about this today. Like if you could take anything out of this episode, maybe can you at least consider the possibility that the strategy that your anxious mind is is handing you, thinking it's doing a good job, is mismatched. It's really good at solving problems, but it's trying to solve the wrong problem. So, if you can see the strategy mismatch and slowly start to shift over from a content focus to a process focus strategy, even though that's really hard and you will trip up and you will fail sometimes and be bad at this, you are winning. As always, be patient, be kind to yourself while you do this. Cheer for yourself. Get your friends and family to cheer for you while you do difficult things. It can really make a big difference. Thanks for hanging out. I'll be back again in 2 weeks with some topic of undetermined nature at this moment. I appreciate you guys hanging out there and supporting my work. And yeah, see you in 2 weeks. [music] We're out. >> I'm a good boy.