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Decision making in times of crisis

Decision making in times of crisis

27 February 2020
Once you receive a cancer diagnosis, everything happens very quickly. You are seen by oncologists, multiple specialists, sometimes surgeons and nurses, and you are confronted with big scary words and and statistics. A treatment approach is basically decided for you and you are thrown right into the deep end of "the world of cancer".

You may not even have the time to realise that you are in crisis.

Crisis
From the Greek word Krisis (decision) or Krinein (decide).

The focus is on putting one foot in front of another; taking it one day at a time.

Despite this, it may be inevitable that you have to make some very significant life decisions. About your treatment options, about care arrangements for children or dependents during treatment, about expenses, about work arrangements, potentially even about situations that may arise in case your health declines...

Decision Making in times of crisis

With illness we come to a fork in the road and decision-making can be very difficult. We may feel baffled, uncertain, lost, confused, puzzled, unsure, frozen, bewildered. We worry about making the wrong decision or fear about upsetting others. We may not be able to talk it through with our significant others or friends, as sometimes they "just don't get it".

What you are experiencing is completely normal.

During decision making we often find ourselves with an inner conflict between our head and our heart. You may benefit significantly from talking it out with someone further removed from the situation than a partner, family member or close friend. Psychologists that specialise in Oncology can help you process what has happened, help you understand what you are experiencing, and apply practical tools to help with decision making.

Head Challenges

Head challenges require the application of logical, rational thinking, research and investigation. Dr Arthur Nezu developed Problem Solving Therapy as a way to define the problem and then work through exploring solutions, selecting one and developing a plan.  This can be helpful for instance when digesting treatment options.

Heart Challenges

These confront us from the neck down- emotions, belief systems and assumptions. We often question the meaning of life and our values, look at relationships in a different way, or may feel that we cannot return to life as it was before. A more existential approach is used to help people explore the meaning of their life and their values.    

Atul Gawande in his book 'On Mortality' asks us to consider:

  • What do we know of where we are in life and any illness process happening?
  • What really matters to you?
  • What are your fears and worries?
  • What is unacceptable and what are you willing to sacrifice?
  • What would a good day look like?


'I wonder' is a helpful mindset to cultivate, exploring problems without the need to feel committed or boxed in.  Decision-making is complex because there are so many parts to consider and new things to learn. Effectively coping with crises can build our resilience and self-confidence and minimize trauma.

The team at MIOG will help create the space for you to reflect and explore when you reach a fork in the road.

About the Author: Belinda Astl

Belinda is a Psychologist with over 25 years experience in health and organisational settings. Adjustment to cancer has been a career long interest for her, and she blends approaches from cognitive behavioural therapy, family systems therapy, Buddhist philosophy and self-compassion to help people cope and return to wellness after cancer.

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