Holistic Decision-Making – It’s Not Just for Doctors

Center for Courage & Renewal

October 14, 2014


“Decision-making is something that you can do with either your limited mind and ego, or by letting the choices percolate through your body, emotions, mind, heart, creative self-expression, intuition, spirituality, as well as through the dimensions of context and time – until a decision becomes clear with input from your total Self. Decisions made this way may ‘freak out’ your ego, but they can be truly transformative.”

That advice comes from a new book by Dr. David Kopacz, Re-humanizing Medicine: A Holistic Framework for Transforming Your Self, Your Practice, and the Culture of Medicine. This is a book for people who are willing to change at a personal level in order to be better doctors and clinicians. Download this PDF to read the Table of Contents, Foreword and Introduction.

While Kopacz wrote this book mainly for medical professionals, we found it to be full of great insight and practices for anyone wishing to stay true to themselves in challenging times – in life and work. In that spirit, here is an excerpt – an exercise in “whole-self decision making."


Making Decisions with Your Whole Self Exercise

We often think of decisions as something that we make with our logical, rational mind. Those of us who have gone through medical education have become decision-making machines, and have memorized and internalized algorithms and flow charts.

However, most important decisions are made with more than just the mind.

We can tap into nine different avenues of experience for greater self-awareness: body, emotions, mind, heart, creativity, intuition, spirit, context and time. Each dimension provides unique information that can be integrated for holistic decision-making.

This exercise presents an integrated way to make decisions. You don’t have to be a medical professional to try out this approach:

  1. Focus on a question you have about a particular decision in your life. Write the question on a piece of paper, or simply hold the question in your awareness. You can now work through each dimension to explore it from different perspectives.

  1. Start with the spiritual dimension. Allow yourself to feel into the ‘big picture’ level of meaning and purpose regarding the decision. How do different aspects of the decision lead to different possibilities for who you are as a person in the world? How might the decision affect your personal mission, goal and values in life?

  1. Next, move to the level of intuition. Do not work or push your brain to think. Let different aspects of the decision come together and separate. Decision-making at this level is almost like watching a kaleidoscope make different patterns before your eyes, as you daydream about what the patterns look like.

  1. Now move to the level of creative self-expression. Do not worry about practicalities or limitations at this point; just focus on what you are drawn to create in your life and with your life. What are the projects you have always dreamed of? Does this decision move you closer to your dreams? At this level, you are more actively engaged, as if you are influencing the way that the kaleidoscope pieces are coming together.

  1. The next level is your heart. Take a deep breath and feel into the center of your chest. Notice the changes in your heart as you examine different aspects of the decision. It may be a great decision, but if your heart is not fully in it, it will be a chore rather than a joy. See if you can notice a feeling of your heart opening or closing when you work with the decision.

  1. Now you can move to your mind and intellect. Your intellect is great at focusing the information from the other dimensions into a concrete plan. Maybe you are dreaming about being an astronaut. That may be very unlikely to happen, but you can ask yourself if there are any alternatives that capture the essence of being an astronaut. Maybe you could learn scuba diving – a more realistic way to explore another realm. Once you have this attainable dream, you can use your mind to think, develop a plan, organize and reality-test your dreams.

  1. After your intellect has shaped the input from the other dimensions, how do you feel, emotionally, about all of your options? Are you excited about the intellect’s proposal, or has it taken all the fun and adventure out of it? Feel back and forth through different aspects of the decision.

  1. Finally, you arrive at the dimension of physical reality. There are a few more steps before implementing your decision. You can use body awareness as another tool in making decisions. As you explore different aspects of the decision, what do you notice in your body? Are there butterflies in your stomach from excitement or anxiety? Do you have a headache, or feel dizzy or tired? Are you having a feeling of panic? Do you feel more alive? Does your body feel more solid and connected? Take notice of how your body responds to your decisions. Using body sensations can be challenging. Your body might be panicking over a decision about which the rest of your Self is very excited, but which calls for a lot of change at the physical level. Not all anxiety is bad or to be avoided. Sometimes the best decision for you is the one you are most anxious about. If you are patient with your bodily feelings, you will notice that you will pass through different waves of sensation and it may take a while to get to how you really feel deep within your Self.

  1. From the physical dimension, expand your awareness to consider your context. How does the context of your physical environment and your social situation provide new information about your decision? If you are moving forward with a change, how can you mobilize resources and support?

  1. Now, consider the temporal dimension. Can you implement the decision right now? Will it take years of planning because it is a long-term goal, like becoming a doctor? Are there many steps that you will have to negotiate and organize over a period of time? How does the decision fit into the timeline of your life?

  1. Now that you have gathered information from these nine different dimensions, the work of integrating them begins. You could do this in different ways, maybe just by an overall gestalt feeling, or by a vote from each dimension. At one level, you may feel incredibly excited. In another dimension, you may be terrified. How do you work with both of these contradictory feelings? That is the work of integration.

The process of integrating information from different dimensions into a holistic decision is a skill you develop over time. It is the same process that goes on at all levels, whether you are engaged in personal growth and the pursuit of self-knowledge, working with an individual client, developing your practice, or working for social change to transform the culture of medicine. This holistic work of examining, valuing and balancing different kinds of information is the work of transformation.

Excerpted with permission. Re-humanizing Medicine: A Holistic Framework for Transforming Your Self, Your Practice, and the Culture of Medicine, by David R. Kopacz, MD. Chapter 10, Holistic Decision-Making (Ayni Books, Winchester, UK, 2014). This book launches November 28.

This book launches on November 28. You can pre-order at Amazon: http://amzn.to/1CeRsFS

David Kopacz