Sunday, December 15, 2019

How to make a good decision...


This week’s focus is on mental health.

This year I’m working as an outpatient psychiatrist. It seems like a lot of my work with patients involves their decisions—past, present, and even future. The consequences of past decisions that in retrospect were not in thier long-term best interest cause a great deal of mental angst. Examples include forming unhealthy relationships, using/relapsing, going off psych meds without consultation, making impulsive choices, taking the easiest path, sticking to a decision that in retrospect was wrong, etc. Making  today's decisions can also be very difficult or seemingly impossible for some people (but to quote a line from the band Rush—"you can choose not to decide—you still have made a choice.”) And others seem to get caught in a spagetti bowel of future decisions and  hypothetical “what ifs” which is a sure recipe for anxiety. And the problem isn’t just with bad decisions, sometimes choosing between two good options can be absolutely debilitating.

Making good, well thought out decisions is critical to our overall happiness and mental health. Towards that end, this week I’m sharing a decision-making tool that a trusted mentor taught me years ago when I was trying to decide if I should accept a permanent church position in New Zealand or return back to the United States. It’s a method that helps to clarify our core values and keep them in mind when we make decisions. Here’s how to do it:
  1. Make an empty chart (you can fill in rows and columns as you go).
  2. On the left side of a chart, write out each of the factors in your life that are important to you that are related to this decision. Take time doing this part. Really think about your core values and what is important to you long-term. You might need to go back and add to this list over time.
  3. Across the top of the chart write the different options you are considering. Try and be creative.  Even if it doesn’t seem realistic try and include as many options as possible. Someone once told me it takes an average of 13 different options to reach the final best option. I wonder how often we falsely limit our possibilities. 
  4. On a scale of 1-10, with 10 being highest, assign a numerical score in each box for how well that option fulfills the value/important factor that you’ve listed on the left.
  5. Once completed, on the bottom of the chart add up the numerical value for each of the options in the columns.
  6. The option with the highest overall numerical total signifies the choice that best fulfills your values. 
Here’s an example. It’s only part of that original chart from when I was trying to decide whether to accept the church position in New Zealand, or return home to the US:

Remain in New Zealand
Return to US
Meaningful vocation—serving God, answering God’s call
Proximity to my parents
Opportunities for my children
Familiar culture
Ability to support family financially

At the time this process was very helpful for me. I really hadn’t realized how important my own culture was to me, and how much I was missing my parents and that I wanted to be near them in the years to come. What felt like a very hard decision because the options seemed evenly matched prior to this exercise became clear when I saw the numerical difference. I realized that I could fulfill my vocational call in either place but that family and cultural considerations were best served by returning to the US. As hard as it was, I declined the offer to serve permanently in New Zealand and returned home.

This is just one tool to assist in making good decisions. I hope it’s helpful…


  1. This is extremely helpful. Thanks so much for sharing, Rev Doc.

  2. Thank you for your blog, you are an inspiration! I am a widowed mom in her 50s who is finishing a PhD with a career in social work and law. At times, I feel discarded by our culture which seems to value younger individuals. Seeing your perseverance and strength in your career changes has been incredibly helpful for me. Thank you for your blog and all you've shared!

  3. Thank you for this! I wish I had seen it years ago. I will use it to make future decisions.


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