How to align your decisions with your values when all choices seem wrong

How to align your decisions with your values when all choices seem wrong

Reading Time: 4 minutes

In the middle of July, I received a voice message on WhatsApp from my cousin in São Paulo.

“Can I talk to you?” he asked with a trembling voice.

I pressed the green phone icon next to his name, Cali, on my silver cell phone.

  • “Tio Juani, meu pai [my father] is in intensive care in the hospital; they did an MRI,” he said slowly while struggling to catch his breath.
  • “Do you have the medical report?”
  • “I just sent it to you.”
  • “Give me a second, I want to go over it.”

As I read the two-page report on the small screen of my phone, my eyes began to fill with tears. There wasn’t any medical procedure that could be done to protect my Tio Juani. His time was slipping away.

  • “How much time do I have to see him?”
  • “Would I make it to São Paulo on time?”

At the beginning of August, my kitty, Melli Milagrocito, became incontinent for five days. He had been diagnosed with cancer two months ago, and despite his sweetness, tenderness, and regular appetite, he had other medical conditions that made things very complicated for him: positive feline IV, kidney problems, heart murmur, and anemia.

  • “Is today the day to give him peace?”
  • “What if this incontinence is just a fleeting shadow?”
  • “He has bounced back so many times; is this the final time to let him go?”

At various points in our lives, we’re confronted with the need to make a decision with no good options ahead of us.

I honestly didn’t know whether I should jump on a plane to São Paulo to say goodbye to my uncle or continue with all the scheduled demands I had already (e.g., sessions with clients, workshops, writing commitments, meetings, deadlines).

I didn’t know whether to give Melli Milagrocito a death with dignity that day or wait a few more days for the incontinence to pass, hoping it would fade.

  • Staying in the Bay Area felt wrong because I was far away from the family.
  • Traveling to São Paulo at the last minute didn’t feel right either because there wasn’t a guarantee I’d make it on time.
  • Calling a vet for in-home euthanasia felt wrong because I wasn’t sure I was exploring all possibilities of medical care for Melli Milagrocito.
  • Waiting for the incontinence to pass felt wrong too because little Melli Milagrocito was sleeping most of the time, dragging his leg when going to drink water, and just existing in a world of shadows.

I searched tirelessly for the right answer, the right choice, the right decision in both situations. I looked up plain tickets, played different scenarios in my head, reached out to close friends, and talked with some relatives.

I was hoping for the right decision that would lift the weight of doubt, guilt, and uncertainty from my shoulders.

I yearned to do the right thing as a niece, cousin, daughter, friend, and animal lover.

I didn’t find any.

Regardless of all the logistics and how thoughtful I was trying to be, all the options in front of me felt like stepping into the unknown.

I turned to Acceptance and Commitment Therapy (ACT).

ACT (pronounced as one word) is an evidence-based treatment that integrates cutting-edge behavioral science and eastern principles. There are six core psychological processes at the core of the ACT model, clarifying your values one of those processes.

Your values are the life principles you want to stand for; they give you purpose and direction in every step you take. They are not goals or destinations but rather a compass that you can rely on at all times. Your values are the whispers of your heart, guiding you to be who you aspire to be.

Living your values has nothing to do with your emotions – which come and go, – or with what feels logical in the moment.

A values-based life is not about doing things perfectly all the time or measuring the size of your actions; it’s about choosing to put what’s truly important to you in the driver’s seat, aligning your being with your doing, even when the road is rough and the path uncertain.

Living your values is like finding a lighthouse in the storm.

As I was going through this emotional rollercoaster, I turned to the questions I often ask my clients:

  • “What do you want to stand for as you go through these painful moments?”
  • “What matters the most to you in each one of these hurtful circumstances?”
  • “What would my Tio Juani advise me to do in both situations?”
  • “What do I need to do to manage the anxiety of making a good-enough choice, not the right one?”

My Tio Juani passed away seven days after the phone call with my cousin. I had many imperfect video calls with him every day. He felt my love and care as he was going in and out of pain meds in his last days.

I held Melli Milagrocito as he took his last breaths in my arms at 4:33 p.m. on a cloudy Monday in the Bay Area.

There are times in which there are simply no good options in front of us.

When my wonderful mind – my glitchy helper – tries to replay and question both decisions, I remind myself that I acted on what truly mattered, as best as I could, in both those difficult moments.

Resources on decision-making and chronic indecisiveness

4-min article to read: 8 Principles to make values-based decisions

3-min a/rticle to read: Don’t trust your gut feelings when making important decisions

1-minute video to watch: What to do about decision-paralysis

1-minute video to watch: One tip to make effective decisions

Podcast to listen to: How to overcome chronic indecision

Podcast to listen to: Dr. Z. on Choices

1-hour online class: ACT for indecisiveness

5 Ways to Harnessing the power of values-based exposures

5 Ways to Harnessing the power of values-based exposures

Today’s episode takes off with discussing fears of driving. This is the starting point to examine a key process within acceptance commitment therapy: values-based exposures.

In this episode, you will learn the principles to approach your fears, worries, and anxieties flexibly and in the service of your values.

Brian Thompson, Ph.D. and I covered different ACT skills such as defusion, values, willingness and what you can do if you’re getting stuck in conquering your fears or you’re afraid of starting the process of facing your anxieties.

Key Takeaways

  • What is willingness
  • How to deal with uncertainty
  • What to do when you’re powering through a fearful situation
  • What is exposure
  • Understanding fear-based reactions and safe behaviors
  • Exploring the concept of exposure in overcoming fear
  • Dealing with physical sensations during fearful situations
  • The role of acceptance and commitment therapy in overcoming fear
  • Understanding the concept of willingness in therapy
  • Addressing fear of uncertainty and unpredictability
  • Introduction to the upcoming book on act-informed exposure for anxiety
  • Understanding act and exposure
  • Dealing with chronic worry
  • Effective problem solving vs. worry

About Brian Thompson, Ph.D.

As a licensed psychologist and Director of the Portland Psychotherapy Anxiety Clinic, Brian specializes in evidence-based treatment for problems related to anxiety, stress, and worry. His specialty areas include obsessive-compulsive disorder (OCD—including Pure “O” and relationship OCD), repetitive hair pulling (trichotillomania) and skin picking (excoriation), and trauma/PTSD. Additionally, Brian works with panic and health anxiety (aka, hypochondriasis).

In Brian’s therapeutic approach, he mainly draws from a newer cognitive behavioral treatment, Acceptance and Commitment Therapy (ACT, said as one word, “act”), which he values for its broad flexibility and commitment to scientific rigor. Additionally, Brian often flexibly incorporates exposure therapy in treatment.

The clients with whom he tends to work best are those interested in an active approach to learning skills to more effectively deal with barriers to living meaningful lives. Much of what he does in the beginning of treatment is to help people learn tangible skills to more effectively relate to their difficulties, clarify meaningful goals and directions, and identify concrete steps that may help you move towards what’s most important to you.

exposures values acceptance uncertainty anxiety worry fear

Resources

Resources from Dr. Z.’s desk

Show notes with time stamps

00:31 Understanding Fear-Based Reactions and Safe Behaviors
01:00 Exploring Exposure Therapy and Anxiety
01:09 Dealing with Physical Sensations During Panic Attacks
02:44 Strategies to Manage Anxiety and Fear
03:39 Addressing Intrusive Thoughts and Fears
04:16 Understanding Acceptance and Commitment Therapy
07:33 Exploring Willingness in Therapy
14:28 Addressing Fear of Uncertainty
17:28 Introduction to ACT-Informed Exposure for Anxiety
19:19 Discussing the Book and Its Approach
19:44 Recommendations for Approaching the Book
19:45 Understanding the Process of Exposure
20:38 The Role of Repetition in Exposure
21:37 Handling Chronic Worries and Ruminations
22:12 Using ACT for Chronic Worry
23:11 Writing Imaginal Scripts for Worries
26:13 Effective Problem Solving vs. Worry
26:50 Distinguishing Between Productive and Unproductive Worry

Listen Here

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Breaking free from worry loops

Breaking free from worry loops

Picture this scenario: you encounter an ambiguous and uncertain situation, and then, of course, you quickly try to solve it. You anticipate all types of scenarios and try to prepare for each one of them, without realizing you are worrying and consumed with anxiety.

Worry is primarily a thought-based process, and that’s what makes it tricky. 

We’ll worry from time to time; that’s unavoidable. But playing-it-safe by worrying all the time takes a hefty toll on your well-being, happiness, and relationships.

In this episode, I interview Dr. Chad Lejeune, Ph.D.

We discussed the subtleties of worrying, what keeps worry cycles, and the importance of developing a new relationship with your mind. In the second part of the interview, I shared with Chad an unexpected situation I encountered when traveling, and we used that event as an opportunity to discuss micro-skills to manage uncertainty, what-if thoughts, and reassurance-seeking and information-seeking behaviors.

Key Takeaways

  • How to develop a new relationship with thinking
  • How to distinguish effective problem-solving from ineffective one
  • Understanding fear and anxiety
  • Defining worry and its impact
  • The role of worry thoughts
  • Distinguishing between productive and nonproductive worry
  • The consequences of worry
  • Addressing beliefs about worry
  • Changing our relationship with our thoughts
  • Dealing with unexpected situations
  • Embracing uncertainty and ambiguity
  • The anxious brain and uncertainty
  • Productive thoughts and problem-solving
  • The power of narratives and storytelling
  • The distinction between problem solving and creating narratives
  • The danger of excessive information seeking
  • The power of accepting uncertainty
  • The importance of learning from the past

About Chad Lejeune, Ph.D.

Dr. Chad LeJeune is a professor of psychology at the University of San Francisco. He has more than 30 years experience treating people with anxiety problems. He is a founding fellow of the Academy of Cognitive Therapy, and was among the first clinicians to receive training in acceptance and commitment therapy. He lives and works in San Francisco.

Dr. LeJeune offers compassionate, focused, research-supported treatment for individuals and couples using both Cognitive-Behavioral Therapy and Acceptance and Commitment Therapy. He specializes in the treatment of anxiety-related problems.

worry<br />
playing-it-safe, shame, feeling lost, understand your actions, play-it-safe, negative thoughts, loneliness, perfectionistic actions

Resources

Resources from Dr. Z.’s desk

Show notes with time stamps

00:27 Understanding Fear and Anxiety
01:26 Defining Worry and Its Impact
02:27 Distinguishing Between Worry and Problem Solving
05:50 The Consequences of Worry
06:43 Addressing Beliefs About Worry
11:27 Changing Our Relationship with Our Thoughts
17:41 Practical Example: Dealing with Unexpected Situations
22:59 The Power of Productive Thoughts
23:56 The Mind’s Narratives and Their Impact
25:46 The Distinction Between Problem Solving and Worrying
28:15 The Power of Acceptance and Living in the Present
28:20 The Pitfalls of Excessive Information Seeking
29:12 The Role of Google in Reassurance Seeking
32:29 The Importance of Embracing Uncertainty
34:53 Reflections on the Past and the Future

Listen Here

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The benefits of mindfulness when dealing with anxiety

The benefits of mindfulness when dealing with anxiety

Our minds are amazing at many, many things. Our minds are capable of remembering the birthday of the ones we love, calculate a budget for our next trip, think about our next writing project, and come up with questions for a podcast.

Our minds are also capable of ruminating, dwelling, coming up with strange thoughts, announcing all types of bad scenarios, and many more challenging scenarios

  • Why are our minds both so awesome and so challenging to deal with at times?
  • How can we skillfully and effectively deal with our busy minds?

In today’s episode, I interview Josh Malina, host of the podcast “Anxiety Book Club.” We discuss the different ways in which our minds influence our physical and mental health and the different approaches to deal with them.

Josh and I discuss how mindfulness and meditation can help us deal with our busy minds; he points out different times in which anxiety, intrusive thoughts, and worry thoughts took him away from being present and pushed him to play-it-safe.

You will hear from Josh about his regular mindfulness practice and how it has helped him transform his relationship with his thoughts, become an observer of his thoughts, and to be non-judgmental of his worries, fears, and anxieties.

We discuss in particular three practices: exposure exercises, acceptance and commitment skills, and internal family systems.

I leave you with this quote:

“You can spend minutes, hours, days, weeks, or even months over-analyzing a situation; trying to put the pieces together, justifying what could’ve or would’ve happened… Or you can just leave the pieces on the floor and move the fuck on.”
 
– Tupac Shakur

Key Takeaways

  • What is OCD
  • What is Generalized Anxiety Disorder
  • What is Internal Family Systems
  • What is perspective taking
  • Values
  • Exposure therapy
  • Talk therapy
  • Transcendental meditation
  • Choiceless meditation
  • Mindfulness-Based Stress Reduction (MBSR)

About Joshua Malina

Joshua Malina is a podcaster and a mental health advocate. He does monthly interviews with authors on anxiety, OCD and more. He is the host of the Anxiety Book Club Podcast, which helps its audience learn about mental health and anxiety through books and laughs!

mindfulness

Resources

Resources from Dr. Z.’s desk

Show notes with time-stamps

01:00 Exploring the Power and Challenges of Our Minds
01:48 Josh Malina: A Journey Through Anxiety and Mindfulness
03:01 Announcing the Act Beyond Perfectionism Online Class
26:22 Practical Applications of IFS and Other Therapies
 

Listen Here

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The upsides and downsides of perfectionism (part 2)

The upsides and downsides of perfectionism (part 2)

In this second part of my conversation with Andrew Nalband, we discussed in detail skills to manage all the noise that shows up in our heads, what has worked, and what hasn’t worked for him when dealing with a tendency to do things right and perfectly.

Perfectionistic and high-achieving behaviors are very common in different areas of our life, and yet, they can also be a hidden problem for many.

Perfectionistic actions don’t develop from one day to another but over a long period of time. So, likewise, it takes time and practice to change them, learn to behave differently, and take action.

Key Takeaways

  • Why meditation/mindfulness practices matter
  • The influence of cell phones on our thinking
  • The difference between cognitive restructuring and acceptance
  • A key question to ask yourself when your mind comes up with a lot of thoughts
  • The impact of “positive thinking” in our wellbeing
  • How to practice mindfulness on-the-go

About Andrew Nalband

He is a veteran of three classes of Techstars and the former Director of User Experience at Ubersense Inc. (acquired by Hudl in August 2014). Nalband has helped more than 25 companies improve their products, and has driven iPhone apps to the top of the App Store and millions of installs.

perfectionism

Resources

Resources from Dr. Z’s desk

Show notes with time-stamps

01:11 Andrew Nalband: A Tech Veteran’s Journey
02:13 Exploring Mindfulness and Overcoming Perfectionism
06:53 Mindfulness in Daily Life: Practical Tips and Insights
12:58 The Impact of Technology on Mindfulness and Presence
30:28 A Hypothetical Coffee Chat with Steve Jobs
 

Listen Here

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Two crucial tips to distinguish effective safety behaviors – playing-it-safe moves – from ineffective ones

Two crucial tips to distinguish effective safety behaviors – playing-it-safe moves – from ineffective ones

This is a super special interview with one of my favorite colleagues and author, Jonathan Kaplan, Ph.D., author of “Urban Mindfulness.”

Key Takeaways

In this conversation we discussed:

  • One of Jonathan’s favorite mindfulness exercises: sending warm wishes to people around you
  • Why playing-it-safe behaviors are natural
  • What is a playing-it-safe move
  • Two skills to distinguish effective playing-it-safe moves from ineffective ones
  • How to handle uncertainty
  • How to handle ruling-thoughts about thinking (metacognitions)

In the middle of the conversation, you will hear me practicing “how to say” one of my favorite words in English and one of Jonathan’s favorite jokes related to anxiety and playing-it-safe.

About Jonathan Kaplan, Ph.D.

In 1991, Jonathan earned a B.A. in Asian Studies (Japanese) from Tufts University.  After spending a few years working in law, he later earned both his M.A. and Ph.D. in clinical psychology from UCLA. He has also been active as a professor, writer, and clinical supervisor.

As a clinical psychologist, he specializes in: issues unique to New York City professionals, couples therapy, young adult informed therapy, cognitive behavioral therapy, acceptance and commitment therapy, interpersonal psychotherapy, mindfulness and meditation, evidence-based treatments, and achieved Diplomate status in cognitive therapy.

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