I Just Can’t Decide. What Should I Do?

It’s pretty common in my practice to have clients come in with what feels to them like life-or-death decisions.

A medical student is trying to decide whether to do residency in pediatric neurosurgery or psychiatry. He doesn’t want to close the door on working with kids, but he also knows he may have a more flexible schedule as an psychiatrist—and that matters to him if he wants to have his own kids someday.

A musician in her late twenties falls in love with a man ten years older. He wants to get married. She isn’t ready. She can’t decide: should she stay with the man she loves, knowing it may mean giving up some of the freedom she associates with her music?

An older man is texting with a romantic interest. There’s no response after he writes “I’m back from my trip.” Should he reach out again? Will she think he’s desperate if he does? Will she disappear if he doesn’t?

A part of us wants this. A part of us wants that. And we don’t want to miss out on either. Or maybe, more truthfully, we don’t want to feel the pain of losing either.

In motivational interviewing, ambivalence is seen as a normal part of change. It’s not resistance, but rather a sign that something matters. There are specific strategies therapists use to work with ambivalence, including what are called OARS questions:

O — Open-ended questions: What matters most to you here?
A — Affirmations: It makes sense that this feels hard. You care about both paths.
R — Reflections: A part of you wants freedom, and a part of you wants intimacy.
S — Summaries: So you’re feeling pulled between security, connection, and not wanting to regret your choice.

Questions like these can open up the crack a little. But even after all that questioning, you still may not be able to decide. That’s because ambivalence is not just about being rational, it’s about motivation. In general, humans have three major motivational drives:

We want to get resources.
We want to avoid threats.
We want to build relationships and belong.

When we are ambivalent, it’s often because one of those drives feels threatened.

A few questions to ask yourself:

What am I afraid I will lose?
What am I trying to protect?
What do I want more of?
Where am I afraid I won’t belong?
What pain am I trying not to feel?

When we feel pulled in multiple directions, it is often because we are torn between these drives.

The medical student wants to avoid the threat of long hours, but he also wants meaningful connection with patients. The musician wants to keep pursuing her freedom and creative life, but she also wants love and intimacy. The man who is texting wants to have fun tonight, but he is afraid of being left unread.

When my clients are stuck in the middle and don’t know what to do, I see it as the perfect opportunity for psychological flexibility. Because the truth is: there is no one right path for any of us.

But if we are driven only by avoiding threat, seeking resources, or clinging to belonging, we will always feel like maybe we should have taken the other path.

No matter what you decide, there will likely be discomfort, loss, or disappointment. Decisions mean you have to let go of something and avoidance of that pain is what keeps us in limbo. Plus, the limbo of procrastination is painful in itself. You churn the decision over and over again and live out the pros-and-cons scenarios in your head. And after all that thinking, you often feel worse.

Here’s what I what I ask my clients when they are stuck in indecision.

What are the two competing stories your mind is telling you?

Write them down as “if/then” statements.

For example, for the texting father, it might sound like this:

If I text her again, she will think I’m desperate.
If I don’t text her, she won’t know I want to see her, and I’ll be alone tonight.

Now rewrite the sentences around what you don’t want to feel:

If I text her or don’t text her, I don’t want to feel desperate.
If I text her or don’t text her, I don’t want to feel lonely.

Notice how your mind is trying to get you not to feel something by solving the decision? The problem is, you can’t really solve loneliness or desperation by making the perfect choice. Feelings are not math problems. You don’t get rid of them by choosing correctly.

Which is why we move to the next step.

Take the sentence you wrote above.

I don’t want to feel desperate.
I don’t want to feel lonely.

Now ask: What does desperate feel like in my body? What does lonely feel like in my body?

And what if that feeling is a prerequisite for both sides of the decision? You may feel it either way. That is why you are caught in the middle. So the question becomes: Are you willing to make room for this feeling?

What would it be like to swim in the waters of loneliness for a little while? To get to know it? Or the waters of desperation? To dive into the deep end and discover that these feelings are not enemies. They are old friends. As Simon and Garfunkel sang, “Hello darkness, my old friend.”

Once you swim around a little and see that either way you may feel the thing you don’t want to feel, you are ready for the next big move.

Self-as-context is the recognition that you are bigger than your feelings. You are bigger than this decision. And you certainly are not the outcome.

Who are you?

This is a question I asked a client over and over again today—the father who was stuck about whether to text.

Who are you?

He started with lots of obvious roles: father, entrepreneur, widow.

Then after a while, when I asked him to answer from his heart, he said:

“I see myself as an eight-year-old riding my bike. I am me. Free.”

I smiled, “Yes, that’s you!”

There is a you that is bigger than this decision. There is a you that is more spacious, more whole, more transcendent than the part of you trying to figure everything out. And when you contact that version of you, it frees you up for the next step.

Ask yourself: What matters most to me here?

The medical student cares about his self-care, and his downtime. He also cares about kids and connecting with patients.

He feels torn because he thinks his values are context-bound. He thinks He can only live them in one setting or the other. But the reality is: you can act on your values anywhere, anytime.

He can care about his time right in the session with me by letting himself off the hook. He can practice self-care by not beating himself up for needing to make the “right” decision. He can care about connecting with patients right now as a medical student—and in whatever step he takes next.

Values are how you show up, no matter what. They are not how you show up only after you figure everything out. Please, don’t wait to make the decision to start living them.

Which brings us to the next step.

Often when we are stuck in indecision, we are time traveling to a pretend future. Playing out all the stories trying to figure out which is the perfect ending.

I was talking with a client recently who said she worried about money for most of her marriage. Then her husband died, and one year later, she came into a large sum of money. She told me she wished she hadn’t spent so much time worrying about money and had spent more time enjoying her husband.

Please don’t give up the present for a future you don’t yet know, or may never know. The only time we actually have is now. Especially when you are in indecision, it helps to be in the now.

Right now, what is good?
Right now, what is hard?
Right now, where do you want to place your attention, even with this decision hovering?

Which leads us to the final step.

Steven Hayes, the orginator of ACT, once jumped off a phone book in a workshop I attended.

He said, “See? That is what it looks like to commit. You have to jump.”

He went on to say that he could have stepped off the phone book, but he jumped because while you can take a tiny step off a piece of paper, and you can take a tiny step off a book, the only way to get out of a plane is to jump. So you better start practicing jumping.

At some point, you just decide. And then you live from the decision—using all the processes you just ewnt through:

You don’t let your mind keep punishing you. You accept the pain that comes with choosing. You remember that you are bigger than the decision. You live your values. You come back to the here and now.

And I promise: you will be just fine.

Want to know what my clients did?

The medical student is going to become a psychiatrist.

The musician left the relationship.

And after showing the father how to send a voice memo, he voice memo-ed a text that said:

“I’m on my way to kayak. I’d love to see you tonight.”

That’s wise effort. Love it.