Patients often contact me for therapy in the throes of a difficult decision. They want to know if they should get a new job or change their child's school, move to another city or leave their spouse.

When they can’t make a decision, it is usually not for lack of relevant information and advice but because of all of the unknowns. The future is certainly unknown. Making a decision can be risky; we might make a mistake.

Patients often lay out exhaustive lists of pros and cons at this point, weighing the potential risks against odds of success, hoping their therapist can tip the scales in one direction. If, after this exercise, they still can’t decide what to do, it is usually because of an inner conflict; something that a person may not wish to know about themselves.

Unfortunately, when we don’t want to know things about ourselves, there is a good reason for it. Either it would be too painful or too emotionally disorganizing to know it. All we have, at these times, is a lot of confusion and anxiety.

In fact, confusion and anxiety are excellent indicators that an inner conflict may be brewing; inner conflict is qualitatively different from fear of the future or of the unknown -- precisely because it is much more intense and emotionally gripping. If you find yourself perseverating about your problem, dreaming about it, feeling close to reaching a decision only to find yourself reeling back to indecision and confusion, and otherwise feeling like you are involved in some kind of emotional struggle, then you know you probably have an inner conflict about whatever decision you are trying to make – something you may not yet want to know about.

Trying to make a decision when inner conflict is at play is wildly difficult. It is almost like asking a mother to decide between two of her children. She can’t do it, even if one of them is obviously smarter or better than the other. Friends or family members can get very aggravated and annoyed and impatient when a rational decision can’t be made at these times. Inner conflict is difficult to comprehend and to resolve.

At these times, I wish that people could just have an “aha” moment and say to themselves “Oh, my – this is intense! I must have an inner conflict!” Then, they could temporarily shelve their detailed mental lists and get on with the business of evolving.

Evolving happens naturally. A mother, for example, usually doesn’t have to decide between her children; sooner or later, they usually grow up and leave the house. This is exactly how it should work with inner conflict: whenever possible, people should not be forced to know things about themselves they do not wish to know. The ability to explore your own mind has to come from the heart, naturally, when the time is right, and not be forced wrenchingly, from the head. It may happen through periods of dedicated exploration or without dedicated thought, simply via a process of psychological gestation.

Here is an example. A patient who had seen me for some time was offered a very high-powered executive position. It seemed like a great job but she was very conflicted about taking it. She talked extensively about everything she was afraid of, ultimately drawing an extensive list of pros and cons about taking the job.

After several weeks, she came to her session, and commented on the weather. After some silence, this led to tears. She remembered, as a teen, switching to more revealing clothes when the weather became nicer. At every possible opportunity, she had tried to reveal as much of herself as she could, often skinny-dipping and streaking with friends through public places.

Despite the intense enjoyment this woman derived from exposing herself, she had come, in later years, to feel very ashamed and disgusted with herself about it. In fact, she had become somewhat of a prude to counteract against this reviled tendency towards exhibitionism.

After this session, she came back to therapy with a happy pronouncement: she had decided to take the job. Her decision was not based, particularly, on any pro outweighing a con. Instead, knowing that she would really like to become an exhibitionist again helped her to decide how she might better deal with the tendencies, without suffering so much intense disgust and shame. Accepting that she liked to expose herself, freed her to enjoy it in a way that could be acceptable, making it possible for her to accept a high-profile, high-visibility position without so much anxiety.

There is no formula for how long it takes to resolve an inner conflict so that we are free to make decisions and stop feeling gripped by a clenching anxiety. The world of emotions is not cut and dry like the world of logic; it’s murky. It requires patience. It can be frustrating and disappointing for all.

If you are ever faced with a not being able to make a decision, try to remember that you may have an inner conflict brewing. Then, put your list of logical pros and cons aside for awhile. Take out a blank sheet of paper or schedule a session where you can talk freely. Write, or talk, without thinking; free-associate. It may even work not to think at all about your problem at all for awhile; answers sometimes come to us like forgotten words, unexpectedly. If you can, try to wait for the right decision to make itself known to you. Eventually, it will.

Author's Bio: 

Claudia Luiz is a psychotherapist in Westwood, MA. She is the author of Claudia Confidentially, a column about inner life. She is the winner of the 2006 Phyllis W. Meadow Award for Excellence in Psychoanalytic Writing and of the 2008 Writer's Digest Award for Best Writer's Website.