Black. That is all I see. Pain rushes from my head, filling my body with fire. I try to move forward, but I am stuck. I look down, trying to find what is keeping me from moving. There is nothing. I am paralyzed by the deafness in the dark. Am I moving? Is this all a dream? I feel like I am running away, but from what?
All of a sudden, I am tied up, sitting as the flush of tension fills my entire being. Trying to breathe, and the air is cold and sore. Trying to escape the chair I am tied to I fall. I am left there tied up and unable move. A sudden burst of pure agonizing agony. A shadow fills the room. Gretchen has awoken and is kicking and beating me. I scream. Nobody can hear me. Just as soon as I see her disappear, she slowly walks back to me. Unknowing what is going to come next, I tense my body in fear. She pulls my chair up, loosening the rope. She is sweet. Comforts me as I recover from her beatings. She glazes her cold dead hands on my cheek where she kicked me.
This piece is poetic prose or experimental creative writing; specifically, it’s a visceral, metaphorical exploration of internal psychological experience.
The Core Issue: Intolerance of Uncertainty
What “The Rush” Depicts:
In the piece, the central experience is not knowing:
- “Am I moving? Is this all a dream?”
- “Unknowing what is going to come next, I tense my body in fear”
- The paralysis comes from not knowing what’s happening, what’s real, or what comes next
This is the heart of OCD.
How Uncertainty Drives OCD
From Maxwell’s “Living with Gretchen” guide:
“Underlying many obsessions is an intolerance of uncertainty and an inflated sense of responsibility. The mind whispers, ‘What if…?’ and insists on absolute certainty before allowing you to move on. This demand for certainty is a trap: compulsions never satisfy it for long, and the cycle tightens its grip.”
The OCD Loop:
- Uncertainty trigger → “Did I wash my hands enough?”
- Anxiety spike → Body floods with fire (as in “The Rush”)
- Demand for certainty → Need absolute proof
- Compulsion/ritual → Wash again, seeking certainty
- Temporary relief → Brief safety
- Uncertainty returns → “But what if I missed a spot?”
- Loop tightens → Rituals increase
The problem: Certainty is impossible. You can never be 100% certain you washed enough, that you’re contaminated, or that nothing bad will happen. OCD demands the impossible.
ERP’s Direct Answer to Uncertainty
ERP = Learning to Live with “Not Knowing”
What ERP does:
- Exposes you deliberately to uncertainty (don’t wash, sit with the doubt)
- Prevents response (resist the ritual that seeks certainty)
- Teaches habituation (anxiety naturally decreases without the ritual)
- Rewires the brain (uncertainty becomes tolerable, not dangerous)
The Key Shift (instead of):
- “I must wash until I feel certain”
- “I must check until I’m 100% sure”
- “I must avoid until I’m safe”
You learn:
- “I can tolerate uncertainty”
- “Anxiety exists, and I can survive it”
- “The ritual doesn’t actually provide certainty anyway”
From the International OCD Foundation and the style guide.
Why “The Rush” Shows This So Clearly
The piece captures the experiential reality that clinical language misses:
In “The Rush,” Gretchen represents the demand for certainty amid uncertainty.
Maxwell is…
- Paralyzed by not knowing what’s happening
- Tensing in fear of the unknown
- Experiencing the full-body terror of uncertainty
- Trapped in a cycle he can’t predict or control
This is exactly what ERP asks someone to do: Stay in that uncertainty. Don’t try to resolve it. Let the anxiety be there. Learn that you can tolerate not knowing.
Helpful Resources & Links
What is OCD (includes uncertainty concept): iocdf.org/expert-opinions/expert-opinion-what-is-ocd
ERP Explained: iocdf.org/expert-opinions/expert-opinion-exposure-and-response-prevention
What is ERP: treatmyocd.com/about/ocd-treatment/erp
How ERP Works (includes uncertainty tolerance): treatmyocd.com/blog/how-does-exposure-and-response-prevention-work
OCD Overview: mayoclinic.org/diseases-conditions/obsessive-compulsive-disorder/symptoms-causes/syc-20354432
OCD Treatment (includes ERP): mayoclinic.org/diseases-conditions/obsessive-compulsive-disorder/diagnosis-treatment/drc-20354432
Why these work: Explains obsessions and compulsions clearly; good for understanding the uncertainty-seeking cycle.
OCD Overview: my.clevelandclinic.org/health/diseases/4667-obsessive-compulsive-disorder-ocd
ERP Therapy Explained: my.clevelandclinic.org/health/treatments/22158-exposure-and-response-prevention-erp
NIMH (National Institute of Mental Health) — Federal Research Resource
OCD Information: nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd
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