Indecision, Anxiety, and Terminal Ambivalence: Is Your Past Running The Show?
We live in a world of endless choices. For high performers, the ability to make fast, confident decisions with clarity is essential. Yet many successful professionals that I work with find themselves paralyzed at the crossroads—caught loops and downward spirals that can lead to procrastination and anxiety and undermine self-confidence.
These can be signals that your past may still be running the show.
“I should have chosen differently.”
“Why can’t I make up my mind?”
“I've analyzed every option but none of them feel optimal.
"I feel stuck and unable to make a decision.”
This pattern—known in psychodynamic terms as terminal ambivalence—can silently erode confidence, productivity, and mood. Terminal ambivalence is a chronic internal stalemate and discontent, a sense that of feeling lost, dissatisfied, or directionless. This can lead to inaction, paralysis, and procrastination.
As a psychiatrist and psychodynamic therapist, I see this often in high-performing individuals who are dealing with perfectionism or when their past finally catches up to them. People describe feeling “stuck," at a crossroads in life, professionally or personally, with no clear solution. Beneath their struggle lies a deep, often unresolved tensions, typically from earlier in life.
What Causes Terminal Ambivalence?
When early experiences train you to pay attention to approval, your internal compass may be calibrated to focus on the needs of others over your own wishes and dreams. This can happen if, early on, you voiced your own needs or reached out for help or sought connection but were ignored, rejected, or even punished.
This can lead to:
Overfunctioning while avoiding authentic underlying feelings and wishes
Work to get approval from others, even if it silences your true self
Feel guilty or anxious about choosing what you actually want
Associate taking action with potential emotional danger, regret, or loss
Lack of agency or freedom to choose one's life direction, often specifically regarding personal life decisions
The anxiety of making a decision can become a familiar, if painful, way of moving through life, and lead to delay, conflict and lost opportunities during pivotal life transitions. While you can try to keep both doors open, there can be consequences to not being able to map a path forward.
How It Shows Up in High Performers
You might be outwardly successful but feel inwardly fragmented or alienated from your core self. This can show up as:
Perfectionism: Every decision has to be the “right” one
Creative paralysis: A great idea that never gets finished or shared
Self-negativity and Inner Criticism: Negative rumination and inescapable loops of feeling self-doubt and self-judgment
Feeling of uneasiness or chronic dissatisfaction even if things are going well
Why Logic Alone Is Not Enough
Terminal ambivalence is not about logic—it is about unresolved memories and narratives that are deeply embodied. Intellectually knowing this alone cannot resolve what was not completely processed emotionally.
This is where psychodynamic psychotherapy can help.
Psychodynamic work is not just about symptom relief—it is about understanding and transforming the inner emotional patterns and narratives that keep you stuck. It helps you identify where these ambivalences came from, how they play out now, and what it would feel like to have more freedom in your internal world.
Over time, therapy helps people begin to:
Trust their inner compass rather than seek external approval
Feel less fragmented and more whole and true to themselves
Grieve the costs of having stayed “on the fence” for important life decisions
Experience clarity, metabolizing the underlying emotions
You Do Not Have to Stay "Stuck"
If you recognize yourself in this pattern, you are not alone—and there is possibility for change. Terminal ambivalence is a response to early wounds that can be healed.
With the right support, it is possible to move from feeling frozen with indecision toward a life that feels more integrated, grounded, and true.
If you are a high performer who is tired of spinning in circles, consider psychodynamic therapy. It is not about fixing you—it is about helping you reclaiming your self.
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