This statement resonates for many of us throughout our daily lives as we manage busy schedules, looming obligations, and never-ending deadlines. But when you are confronted with a life-threatening health challenge such as a cancer diagnosis, Gilda’s words truly hit home: there is always something. In fact, as time passes after a diagnosis, you may wake up one day and ask yourself, “What has happened to my life?”
Recognizing that there is an imbalance of control in your life is a healthy first step toward regaining your equilibrium. Equally important is examining what initiated the process of feeling out of control in the first place.
The obvious culprit, of course, is the existence of the disease itself—an invader that you cannot reach inside and remove, as much as you may want to do just that. When you add to that fact your foray into the foreign language, complex procedures, and intricate protocols of the healthcare system, it’s no wonder that you might feel helpless, incompetent, and out of control.
So how do you go about regaining some control and empowering yourself? By taking charge of the decision-making process.
Regardless of disease, we all make hundreds of decisions, conscious and unconscious, trivial and pivotal, in our everyday lives. Even when you choose to not make a decision, that in itself is a decision. But when decisions are made for you by others, or when they are presented as foregone conclusions without the opportunity for discussion or analysis, you can lose your sense of mastery over your life and can wind up on the slippery slope toward feeling powerless.
Decision-making is like many other acquired skills: the more you practice and see results, the more you enjoy the process and the more masterful you become. The following are a few concepts to keep in mind as you hone your decision-making skills and navigate your way toward self-empowerment.
Dissect the big picture down into smaller parts. Experts say that breaking down complex tasks and tackling them piecemeal leads to better solutions. Decipher what the single next step should be, then determine whether you really must make a decision right now. Many decisions can be put off until you have more information or until you’ve had more time to process your feelings. Postponing a nonurgent decision can be a very wise decision in and of itself.
Evaluate the information that is available to you. Is it current, reliable, and applicable to your individual situation? Explore more information if you feel the need. If you don’t know where to find it, ask someone who does. Equally important is eliminating extraneous information that will cloud your current decision. Concentrate on the realistic situation at hand. There’s no need to entertain “what ifs.”
Choose which regrets you are willing to live with. All choices in life require a tradeoff—we give up one thing to gain another. Consider which consequences you can tolerate more easily and which regrets you can more readily accept. Minimizing your “should haves” in advance will allow you to live life more fully moving forward.
Identify the person most affected by this decision. Is it you? Whose needs are you trying to meet with this decision? It’s easy to get pulled into listening to others’ opinions, but your loved ones can be so emotionally invested that they are unable to contribute unbiased input. Deep feelings can interfere with logic and overshadow reasoning, and your needs can easily get lost in the emotional shuffle. Ultimately, it is your life, your health, and your journey. You can always seek out a professional who knows you (a nurse, social worker, or spiritual adviser) to ask for an impartial perspective focused on your best interests.
Speak about your process openly and without restraint. Let your opinions, objections, feelings, and concerns be heard. Voice any ideas that you have, especially those that may be unconventional or “outside the box.” Give voice to your hopes and your fears, then step away from the process for a while and take the pressure off yourself to decide. You’ll know when you’ve talked it all out and when it’s time to go within and be silent; and in that silence, you can access more decision-making skills.
Acknowledge instinct and intuition as useful tools. To intuit, according to Webster’s, means to “understand or work out by instinct.” Once you’ve exhausted the external processes of discussing and debating, pay close attention to your internal responses. This is not to suggest that you forsake logic or rationality, but neither do you want to ignore your instinct. Your intuition is always with you. Listen to its voice and trust its significance.
Avoid the seductive trap of overthinking. There is no 100 percent “right” decision, and in truth there really is no way to ever know which decision is “best.” Choices and decisions are as unique as the individuals who make them. Every decision will have varied consequences, benefits, tradeoffs, and outcomes. Getting stuck in the concept that there is a perfect decision only postpones action and prolongs the stress of indecision. Set a time frame for each decision, put off the ones you don’t have to make immediately, and each time you make one, exhale and let it go.
Resist the temptation to second-guess. Once you come to a decision, go with it; stand behind it and own it. Do not waste more time or energy revisiting doubts or second-guessing yourself. Don’t allow others to impose their doubts. Once you have made up your mind, stick with it. Go confidently forward and don’t look back.
Stay tuned in. After you’ve committed to a decision, it’s still important that you regularly evaluate and assess how things are going. How are you feeling? Are you getting the results that you expected? Are you heading in the direction you intended? If not, it’s time to speak out again. Unfortunately, whether inhibited by guilt or a sense of obligation, many people still have a hard time saying, “Sorry, but this is not working for me. I’ve changed my mind.” Trust that you are the best judge of whether the decision you made still feels right to you. Give yourself permission to change your mind—at any time, with anyone. The more you observe and assess your situation and pay attention to your intuition, the more skilled, confident, and at ease you will become at making sound decisions, and this will take you farther on the path of self-empowerment.
Human beings are complex, dynamic creatures. Life itself is complicated and unpredictable, and the future is an unknown quantity. But each of us does know what we need or want at any given moment, one moment at a time, one hour, one day. We have the fundamental freedom to express that tuned-in self-awareness and, in most cases, to act on it and do it our way.
The more often you make conscious decisions to do it your way, instead of doing what you think is expected of you—or that which is “acceptable”—the more you will feel confident about managing your life, recapturing control, and navigating a life course that is uniquely yours. ?
Kathryn (Seng) Gurland, LCSW, is a Licensed Clinical Social Worker and Cancer Navigation Consultant in New York City. Having lost sisters Judi and Peggy to cancer, Kathy is acutely aware of the need for personalized services for those affected by cancer. Her many years as a medical social worker and private psychotherapist, specializing in psycho-oncology, pain and palliative care, and end-of-life-care, exposed her to the intricacies of cancer and its effect on everyone involved. Assuming the roles of advocate, healthcare surrogate, and caregiver for her sisters motivated her even further to develop PEG’s Group, a private consulting group of Cancer Navigators. The company name, PEG’S Group, originated out of her sister Peg’s name and stands for Personal, Education, Guidance, and Support. PEG’S Group has been both a personal and professional endeavor conceived and developed by Kathy to meet the vital needs within the cancer community that our healthcare system is unable to provide at this time. For more information, visit www.pegsgroup.com. Kathy holds affiliations with NASW, AOSW and is on the Advisory Board of SocialWorkersSpeak.org.
If you have questions that you would like to see addressed from a social work perspective, please send them to firstname.lastname@example.org.
Chart Your Own Course
Through Proactive Decision-Making
There is another process that can be very useful in preventing loss of control as you navigate life’s challenges: proactive decision-making. Believe it or not, honing this simple skill can incrementally and cumulatively result in a rebalance of control in your day-to-day existence.
The essence of this skill is to recognize situations where you think you have no choices and then identify and anticipate every opportunity where you actually can exercise a choice. Here are just a few examples:
- If you want to have a discussion with your doctor with your clothes on, say so.
- If during the actual examination, you want to keep your socks on, do it.
- If you have to take a pill while at an appointment, ask if there is a choice of beverages.
- If you function better at the end of the day, ask for an afternoon appointment.
- If you need more time to think about things, let everyone know this is what you are choosing to do.
- If you need to be in a clinic or hospital for any length of time, bring along as many personal comfort objects as you want.
- Choose if and when you want people to visit you and how long you want to socialize—if at all.
- On a daily basis, choose what music you want to listen to, what food you want to eat, and what movies or shows you want to watch.
- Choose whom you feel like calling back or e-mailing and whose messages you don’t need to return.
- Most important, choose to change your mind whenever you want.