diabolically chilling in a comfy sweater

A Nervous Old Man (right) and his Emotional Support Violence Machine (Left)

a lot of my ritual behaviors are "checking"

self-guided ocd exposure therapy can be as simple as resisting the urge to check if your door is locked more than once and sitting with the discomfort until it passes without engaging in any reassurance rituals.

it can look like sending an email and resisting the urge to re-read it over and over again obsessing over your wording, sitting with the discomfort until it passes without engaging in any reassurance rituals.

some of my rituals are also "avoidance"

in which case it can look like checking your email inbox you've been obsessively avoiding because you're anxious about receiving a specific email you don't want to see.

and YEP! ☝️

!!!

it might be hard to believe, but learning distress tolerance for things like "checking" with emails and door locks actually prepared me for the Big Ones like harm and sexual OCD themes.

I think this article from 2007 is a good introduction to the basic concepts of exposures:

that SAID, a lot has changed since 2007! the idea that exposure therapy can (or even should) prevent fears from every happening has come into question!

now the conversation about OCD exposure has turned to training distress tolerance:

...rather than aiming for the decline of anxiety (habituation) during exposure, the inhibitory learning approach to ERP teaches people how to be open-minded toward experiencing anxiety and fear when these experiences inevitably show up. Indeed, fear and anxiety (and other emotions in OCD such as disgust or guilt) are universal and even adaptive experiences, not something that need to be “fixed” or gotten rid of. Most importantly, even if they can be unwanted, intense, and distressing, these emotions and thoughts are safe. From an inhibitory learning perspective, fear extinction (and long-term improvement in OCD) depends not only on learning that feared stimuli are safe, but that it is also safe to experience the emotional response that is triggered by these stimuli.

And remember at the end of the day I AM NOT a specialist. I am discussing my own OCD journey and referencing the available material on OCD exposures.

I'm not always right, and I can't know what's best for you.

Which is why I haven't recommended any of the old workbooks I've completed, because some of them are old enough that there are better ones to follow that I haven't gotten to trying yet!

I recommend doing your own reading from OCD-aware organizations:

"am i normal" is not as helpful question to ask as "are intrusive thoughts causing me frequent distress?" and "would my life be better if i could find a way to feel less distress/learn to tolerate the distress?"

There are a ton of quick and cheap electrolyte drink recipes that you can find online. Tea, coffee, cocount water, milk, milk substitutes, juice, etc are all hydrating despite extremely persistent myths. Many fruits and veggies like cucumbers, watermelon, strawberries, bell peppers, etc have high water content and are a great way to hydrate while also getting vital nutrients. Popsicles are also a good way to stay cool and hydrated and you can buy them or make your own with whatever ingredients you want; there are recipes online, including ones for electrolyte popsicles, but you can also just do basic ones with your choice of fruit juice and whatever you want to add, like chunks of fresh or frozen fruit.

"You know you don't have to wear that."

"My mother is undergoing treatment for stage four cancer, and I refuse to be the one who brings an illness home that kills her."

Do you have medications which will be destroyed if exposed to excessive heat, like insulin? How are you gonna carry them and keep them cool? Do you have to carry your entire day's worth of belongings with you at all times, or do you have a friend's house or something where you can stash them? How much extra time are you gonna have to waste traveling back and forth? An extra hour this way, an extra hour that way. Gotta factor in the time. What if it's chilly overnight? Do you have to carry your jacket with you? What's for lunch? Can you bring food, or will the heat ruin it?

All sticky and sweaty from the sun, just wanna peel your clothes off and cool down in the shower? Designated times when showers are available at many shelters are periods of maybe sixty minutes, maybe twice a day if you're lucky, 5:30-6:30 AM and 9:00-10:00 PM or whatever. No other accessible times. Can't make it because you're at work? Too bad. Get off work later than that, and just wanna quickly bathe? Too bad.

Do you work full-time, clock out exhausted, and wanna take a nap in the afternoon? Find a park with shade, I guess, because you're only allowed inside the shelter between 10:00 PM and 5:30 AM. Did you get off work a little late? Too bad, you missed the strict curfew of 10:00 PM and now you're not allowed in the shelter. Can't hang out on the bus, can't linger too long at the coffee shop, can't doze off at the library. Many cities went out of their way to explicitly criminalize falling asleep--or merely sitting in one place for too long--in a park, too. Are you sick? Can't take a nap. Are you disabled? Can't take a nap. You're forced to be awake, all day. You're forced to be upright, or moving. No loitering. No sleeping. No taking your shoes off. All day. Every day.

Do you need even a quick momentary escape from the heat? Well, you'd better have money. Even if you do, you'll have to doctor your appearance, go stealth-mode, don't attract the attention of petty middle managers. The coffee shop now locks their bathroom. It's for paying customers. Maybe you bought some tea. Well, don't overstay your welcome (the boss saw your backpack and perceived that you're homeless, which means you're essentially an intruder now, so you better get out and move on soon). The university campus added card-swipe readers to all the doors, so now you can't visit the library or cafeterias. Oh shit, you spent money on the tea, so now you can't afford lunch.

You don't have a pantry, you don't have a refrigerator. No pasta, no rice, no meal-prep, no stovetop, no oven, no leftovers. So you pretty much have to eat out all the time. You'll bleed more money.

And during a heatwave, during summer in general in some climates, each day brings the same challenges and anxieties again.

Where are you sleeping? Outside? What are the cops gonna do to you? What about the sneering homeowners, skeptical of your presence in their neighborhood? Staying at a shelter? Every morning, you enter a lottery, hoping your name will be randomly selected, giving you one of the available spaces to sleep indoors at the shelter. Maybe 300 people competing for 75 available spaces. And these aren't even necessarily 75 beds, might simply mean 75 available spaces to sleep on the concrete floor. So all day long, you commute, you hide from the sunlight, you go to work. And you wonder. You worry. You don't know if you'll even get to sleep on the floor later tonight, if they don't draw your name. Should you make alternative back-up plans, identify an outdoor space to sleep in? You line up single-file at the shelter door. Required. Can't be late. Is it still hot outside? Do you need to pee? Better hold steady. (In seasons other than summer: Is it raining? Is it snowing? Is there frigid wind? You've gotta stand in line for thirty minutes.) You find your designated inch-thick cheap plastic mat on the floor. No phone charger, no power outlet. Better not lose track of your phone, your bag, your cards/cash. Leave it unattended for a minute, and not only might it get snatched, but the shelter staff themselves will toss unattended items in the trash. Stepped to the bathroom for a couple minutes? You left your water bottle next to your floor-mat, now it's gone. In the same room with you, maybe 50 people, maybe more. Some crying, some conversing, some feuding, some coughing. All night. Next morning, 5:30, the lights are on, you've got ten minutes to get up and get back outside. Oh shit, did you take off your glasses? Anything you accidentally leave behind, you'll never see it again.

Unhoused people account for a massive percentage of heat-related deaths. In 2024 in Maricopa county (which covers most of Phoenix), 608 people died of heat-related causes. Of those, roughly half (49%) were without a place to live. Unhoused people are 0.2% of the population here.

Think about that. 0.2% of the population, yet they’re 49% of heat-related deaths.