Performance anxiety and hard decisions at work

He put off every important decision for weeks in order to gather more information. The result was that opportunities slipped away, and then he added his own self-blame on top. That cycle was also breaking his sleep.

First it became clear that the expectation of 'enough information' is an unrealistic standard — the same thing that meant the work never finished.

Then we worked on tolerating consequences: every decision has a cost and the worry about the outcome is itself part of the cost. Short decision exercises under time pressure supported this.

In month two he made his first major decision within two weeks of the deadline and accepted the outcome. By the end of treatment he still worried — but he no longer waited for the worry to go.