Analysis Paralysis: Values-Based Decisions

I think that it's really important to acknowledge that two people or two couples could look very similar on paper in terms of their numbers and their diagnosis and their previous history , but they might make very , very different choices even in the setting of the same bad news or the same financial constraints or other various factors that guide our decisions .

And so whenever I meet a person or a couple at the very first meeting , I try to understand who is this person in front of me , where are they from , how do they spend their days , how many kids do they want ? Ideally , what are their values ?

And that could be like religious , that can be life-based , it could be sort of you know what's important to them and what guides their decisions . What other decisions have they made based on their values that they're really proud about ?

All those things are really really important because when it comes time to choose among options and sometimes , to be quite frank , it's choosing among many suboptimal options that people never wish they even had to think about . That's when I encourage people to dig deep . That's when I help them to remember their values and their identity , ie their deepest , why .

You know why they're doing this in the first place and that's what then helps them to make values-based decisions that are obviously informed by science and evidence , but also that have a lot of compassion and mindful self-compassion , because it's only in those open spaces that the best decisions can be made , truly without regret and , you know , hopefully aligning with

a person's highest good for them in their lives . So let's talk a little bit about values-based decisions . I think we wouldn't even be talking about this if it were easy , right ? So inherent in talking about this topic is really that notion of stuckness .

I cannot tell you how many times I'm talking with a client or a patient and they just say to me you know , dr Bove , I just feel so stuck . I keep thinking about all these bad options I have in front of me and I don't want any of them . I just want to be a parent . Why do I need to choose among all these bad things ?

And I think that's really important to call out , because I do not enjoy feeling stuck at all . It's a very disempowered space and it's a very like a very small space . Sometimes I even call out you know , I don't intend to feel like a victim , but sometimes I realize like I'm in the victim role , right , because I've given away all my agency .

And then , you know , I just say , ok , well , do I want to feel stuck for myself or does this person want to feel stuck ? The answer is usually no , and then , if the answer is no , it's like OK , well , why is there that feeling of stuckness ?

And how can we , like I said , dig deep , reattune to our values and start to think about , okay , what makes sense in the context of who I am and what I want , and what do I need to do to move on forward ? So I would recommend journaling , as I often do , because I love journaling .

I think it opens us up to ourselves , which sometimes we're close off to ourselves . And I would just ask the question you know , where am I most stuck right now ? What have I done thus far in my fertility journey ? What options have been presented to me ? What are my thought loops Like ? Where do I keep kind of circling over and over and over again .

And also like what wakes me up at 4 am . You know , I think a 4 am test is a really good test of like what am I most afraid of and what is occupying the most of my brain space about this particular topic ? So that question of where am I stuck ? Usually it's a thought or a feeling , you know , oftentimes a thought .

In coaching we learn about something called limiting beliefs , and a belief is really just a thought we've thought over and over and over until it feels like reality , right , like I believe X , y , z to be true . Well , why is that ? Because I've had that thought 20,000 times before .

Right , it may or may not be grounded in truth or what is true for me in my circumstance , but if it feels true to me , it might as well be true because those are my operating assumptions . In coaching we also learn that our thoughts create our feelings and our feelings create our actions and our actions dictate how we show up in the world .

So if we have a very deep-seated thought about something , then it's really important to understand what that thought is and if that thought is serving us , which I help people with all the time .

And then we sort of say , okay , well , how do we want to feel about the circumstance , even if the circumstance doesn't change like , even if the news is the same , even if you know the options are the same , if we can say , well , I want to feel , you know , at peace with my decision , or I want to feel like I don't have regret , you know , in five years ,

no matter how this turns out , like those are things that I frequently help people with . And also , like you know , going back to the why and why am I doing this in the first place ?

And so how can I come back to that original question in that original motivation and I understand things change with time , you know , things evolve but , typically speaking , usually a person's core why , you know it has a certain theme to it and a certain motivation that really wants to remember that Oftentimes we've forgotten , we're like wait , I was just focused on

this most recent IVF cycle . I wasn't even , you know , remembering why I was doing this in the first place . So I think it's just really important to ask that question of where am I stuck ? What are my recurring thoughts and feelings ? You know , what am I telling myself ? What am I making this mean about myself and my options and where do I go from here ?

I think a lot of times we get stuck in comparing ourselves to other people and their journey . You know , I hear a lot of people say well , you know , I started this support group a couple of years ago and everybody else in the support group has gotten to their goal and I'm still the only one who's still struggling .

Or I hear like , oh well , I thought it was great in the beginning that my friend and I shared this fertility process , but she just got a positive pregnancy test and although I want to be happy for her , I really am just so stuck in my own grief and hopelessness and despair that it's very triggering for me to think about her or talk to her right now .

I want to be supportive but I just can't . So I think thou shalt not compare . I think should be the 11th commandment . I say that all the time , but really , if you feel that it is by comparing yourself to other people that you have the most negative thoughts about yourself , if you can , my loves , just try and let that go .

Just even say out loud Dr Bove says thou shall not compare , and just remember that you are on your own path . You are on your own journey . No , two journeys are the same . Right ? We learn so much about ourselves in this process . We learn about who our important people are , who we can depend on .

We learn about , maybe , certain patterns that are our go-to patterns and ways that we've learned to change those over time . I mean , this is all I always say , that this is the access point , is the fertility journey , but it really is much broader than that in terms of how we handle hard things .

You know , for many , many of us , maybe this is the first really hard thing that's happened , or maybe it's just so different than anything else that it feels so crushing .

I will say what you learn along this journey will absolutely help you in your relationships , in your life , in your work , you know , and your friendships and thinking about okay , you know , isn't that interesting ?

That I tend to go to , that I tend to feel resentful , that I tend to feel taken advantage of , that I tend to feel maybe not seen or not heard , and maybe that's very true , right , there are times when we absolutely do not feel seen or heard , and that is 100% valid . I think , though , if we can say , oh , isn't that interesting that that's my default .

For me sometimes it's overwhelmed , I just kind of default to overwhelm and I'm like , isn't that interesting that , like that's my default ? You know , for me sometimes it's overwhelmed , like I just kind of default to overwhelm and I'm like isn't that interesting that that's part of my reflex ? Do I want to feel overwhelmed ?

And if I don't , like , what do I need to do to overcome that ? And that's that stuckness and , like I said , that's that sort of 1% shifts in our thoughts so that we can feel very

differently . Even a 1% shift can change our , um , our , our sense of , our feeling state significantly . And then we get to decide what we want to do about it . We go from the victim stance to being , you know , much more empowered , no longer the victim . We are the author of our lives , right ? We are co-creators , as I like to say .

Um , and we're not , we're not keeping ourselves small anymore . Yeah , so when we ask ourselves this question , you know where am I stuck ? And what are our values ? A lot of us have forgotten our values along the way . Like , hey , I was in training for what 11 years after college ?

I joke that they let me lose in my mid-30s to go and take care of people on my own . I mean , now I'm in my 40s , so it's a little bit different . Every decade is a little different . But I think that as I think about you know , what are my values like for me ?

Actually , at times I go back and I pull out my personal statement of why I went into medical school in the first place . I , you know , read speeches I've given over the years where I really did tune into my values to give those talks and I lean on my own wisdom right to carry me through .

So sometimes , just like having these bullet points of like why you know , why did I start this journey ? Like what am I hoping for ? Who am I ? Maybe , if you're partnered , maybe you sort of diverge from your partner . Maybe they're not as invested in the process as you are .

Maybe they think that you know enough is enough and that you've already , you know , invested enough resources in this and that it's time to focus on a different aspect of life . And maybe you're not ready for that .

Maybe you want to keep going and try a few more things , and so I think that's when it makes sense to get the 30,000 foot view and just look at everything and reflect and say , okay , like , what are my values ? And you know , if you do my program , we have a whole process for identifying these values .

And then you can ask yourself , okay , like , of my top three to five values , how can I use these values as a filter for my decisions ? How can I say , okay , well , if family is one of my top three values , you know , what would family do ? Maybe it's love . What would love do what ? If it's maybe , let's see what would another one be .

Maybe , you know , for me it's joy . Like joy is one of my core values . What would joy do here ? And so we can ask this question in terms of what our values truly are and what would that value do in the circumstance .

So it separates our own ego , our own sense of self , our own sense of success or failure from this process and tunes into something more universal that we very much deeply care about .

And once we can do that , oftentimes we get just the clarity we need , maybe not for the whole journey , but just to take a step in that direction , to choose your next right thing .

And we are all about that at Love Science Every Friday night , at the end of our calls , we always close with what is everyone's next right thing , because I think just having that direction , that purpose , that movement , it really really , really helps with making values .

A word on ambivalence I think it's really really important that we think about this with our detective glasses and our detective hat on , because sometimes , especially when somebody has been doing this for an awfully long time , they'll come to me and just be like I don't even know what I want anymore .

You know , I started this journey kind of bright-eyed and bushy-tailed and I thought I knew , but what I'm learning is that the journey is long and it's exhausting , it's draining my finances , it's affecting my marriage and at this point I've just lost the fight and I just feel like giving up . And so that's really really tough .

Because I think when our reserves are strong in all the senses like emotionally , financially , you know , in terms of our well is full right we can make the highest and the best decisions for ourselves .

When I'm exhausted and say hungry and tired and you know I just don't have much in my well I tend to make very reactive decisions and decisions that are for my own self-preservation and survival , rather than thinking about , well , what is the best case scenario here and how might this work and how might I be able to thrive ?

And so we can take the coaching lens and sort of say , okay , well , you know , on the F line , which is the feeling line and if you work with me you'll learn more about these models are super fascinating and useful , actually very practical . On the F line is ambivalent . And so what thoughts are creating that ?

So the T line is above the F line because our thoughts create our feelings . I never knew that till coaching school , but that is so true . I was actually talking with my therapist this morning about that very concept . So there are lots of people who believe this and there's lots of data to support it .

But our feelings are actually more in our control than we realize . So if I ask myself the question like , what thoughts are creating that , I might say , well , I'm just so exhausted from this process . Or , like I said , I don't even know what I want anymore .

Or , you know , I'm just so tired of bad news at this point that I just don't even want to have to deal with this anymore . Like , I'm just so sick of bad news . It's all I ever get and why do I keep doing this to myself ?

And maybe it's that you know there are two people in the journey like a couple , an intimate couple , and they're at different points in wanting to proceed .

So I see this , like you know , I have one person who is like gung-ho , you know , keeping forward and eye on the prize , like moving on forward , and say their partner is like starting to give up , and they're like you know what , like I , I , I , I , this was . I thought this was a good idea at the beginning .

I had no idea what this would do to me and us , and I'm just ready to move on with my life . I want to go on vacation . When I want to go on vacation , I want to , you know , live my life . I want to , you know , have money to save for retirement . Maybe I don't know , whatever it is , but I all like .

Very frequently I see couples who are at different points of evolution and how much they want to keep doing this , and so you know , what I would say is , when we look at the thoughts that are creating a feeling , I would ask okay , so is that thought true and is that thought serving me ?

And so maybe the thought of like I'm just so exhausted by this process , like that , may be a very true statement . I would then ask that person like yes , exhaustion is part of the human condition like best case scenario , like same circumstance . You know you're still at the same point in your journey , things haven't worked yet .

How do you want to feel about this ? And you know , oftentimes the answer I get is I just want to feel peaceful , I don't want to have regret , I want to feel empowered , I want to feel strong , I want to feel connected to my partner , like sometimes that's it is .

This is just driving such a wedge in the relationship that it's hard to think about anything else . And that's part of the reason for just saying , well , maybe it's time to to change paths . And so when I ask somebody , okay , so how do you want to feel about this situation ?

And they give me an answer Like I just said , like I want to feel , say , maybe connected to my partner , Maybe that's the answer of how they want to feel . I say , well , how ? What would you need to think to feel that way ? Right ?

And so people might say like I , I want to say like we are more than this fertility journey , like there's more to us than this process , even though it feels like that right now .

It might be that , you know , I want us to remember our dream of creating a family and I want us to like zoom out and look at the big view and , you know , maybe define kind of more parameters in terms of , like , how long we'll do this , like we maybe create some boundaries around it .

But I want to zoom out and remember why we did this in the first place . So , you know , we we are on this journey because X , y , z , like that's a thought , and when I think that thought , then I feel hopeful , I feel encouraged . I feel encouraged and I feel aligned with my identity and my vision of myself as a parent having a family with this person .

I married so many years ago when this is what we both wanted at that time . Because I think our wounds get poked in this process . I think our sense of self gets poked , I think we can feel defeated , we can feel tired , we can feel just like worthless and broken , and sometimes it's really hard to communicate that to our partners .

If we have a partner , and so if connected is how you want to feel about it , then we work on those thoughts that will help you have thoughts that are maybe more related to vulnerability in a safe space , and maybe thoughts that are kind of thinking of the big vision and the dream , and maybe it's that , like you know , I can feel seen by my partner .

Maybe it's that I can find my voice when it comes to sharing these things . Everyone's story is a little different , but I do think that if we think about how we want to feel as opposed to how we do feel right now , ambivalence is usually not the primary feeling . There's usually something else driving that , like exhaustion or woundedness or something .

And that's where it makes sense to say , okay , what are the objective chances that this is going to happen ? Does it make sense in your worldview to keep on trying and going ? What other options are available to you beyond the pathway that you're on right now , and what makes the most sense moving forward ?

And so I think about very passionate feelings like love and hate and rage and all those things . I think ambivalence . There's a certain apathy in it , and I don't think that we start this process apathetic , but I think that it can get that way over time , especially with repeated disappointment .

So apathy is like very insidious and it can be very , very hard to navigate , especially when we've lost our passion , when we've lost our why ?

So I would say , whatever it is , to reconnect with those more fiery emotions , those more determined , those more sort of purpose-driven emotions , not that we get lost in them or not , that we just sort of have whatever thought comes to our mind . I think we should be very intentional .

But I think that if we're asking ourselves the question , like I'm doing this because of love and because of the love I have to give and because the love I have with my partner and I really want to bring about a child and share this love as a family , I think that's a very , very different way to think about it than you know .

This has destroyed us , this has destroyed my marriage , this has destroyed our finances and I don't even care anymore . So it's really , you know , it's really about highlighting those thoughts and feelings , thinking about how we want to feel and making the best choices we can . So let's kind of summarize Today's topic is values-based decisions .

I think that's one of the hardest things in the fertility process because if I were to draw an algorithm for each person , there are so many break points , so many decision points , so many numbers of cycles , so many different possibilities . It's like actually so mind boggling .

It would be impossible to do that because there's just so many different possibilities and you know it's almost like endless .

But I think , in terms of coming back to the core , coming back to the person , coming back to the couple , thinking about the values , separating a little bit from the emotion in it and saying what would love do , what would courage do , what would joy do , what would family do , and asking those sorts of questions , because I think you know , when I am making

decisions that are out of alignment with my values , there's this inauthenticity that is so exhausting . But even if it's a very hard choice , even if it's like super , super , super hard to do , it takes a lot of courage , takes overcoming some fear . If that is in alignment with my values and my deepest why .

I truly can do anything , not by myself , to be clear with my village , with my people who love me and support me . Anything not by myself , to be clear with my village , with my people who love me and support me . But I can do very hard things in a very authentic way when I'm coming from my deepest sense of myself .

So that is what I will leave you with . Values-based decisions are very , very tricky in practice . I think they're not quite as challenging as they seem , especially when we have some coaching tools to help us sort these things out , whether it's just our own choices , whether it's whether another person is involved in those decisions .

But , like I said , this is all about empowerment , you know , encouraged by evidence and also using compassion and self-compassion , and with those things we can become closer to each other and we can also take steps in the direction of the future we're trying to create . And with that , I love you dearly . Can't wait to talk to you next time . Bye .