Decisions & Transitions Therapy
with Erik Giles, LCSW (he/him)
Direct therapy for big decisions and life transitions—career changes, relationship choices, moves, family decisions, and the paralysis that comes with high-stakes change.
A lot of people seek therapy because they are stuck in a decision they cannot seem to move through. Should I leave the relationship? Should I take the job? Should I move? Should I stay where I am? Should we start a family? Should I take the promotion? Even when the options are clear on paper, the emotional weight can make the whole thing feel paralyzing.
Life transitions can create the same kind of stuckness. Sometimes you are not deciding between two options so much as trying to adjust to a new reality you did not exactly choose. Either way, the problem often feels high stakes. It can be hard to tell whether you truly do not know what you want or whether you already know and are struggling to accept what comes with the choice.
That is where this work becomes useful. Therapy gives us a place to slow the decision down, get underneath the panic or overthinking, and figure out what is making the transition or choice feel so hard. My style is direct and interactive, which means I am not afraid to say what I see once the pattern becomes clearer.
Why Big Decisions Feel So Hard
The hardest decisions are rarely hard because the options are equal. They are usually hard because the meaning attached to them is heavy. A move may feel like a referendum on your identity. Leaving a job may feel like wasting years of effort. Ending a relationship may feel like failure, guilt, grief, or fear of hurting other people. Starting a family may bring up all kinds of questions about who you are and whether you are ready.
Sometimes the issue is simply too many options. But just as often, the issue is that the decision feels like it is about your whole self. That is why logic alone is often not enough.
Sometimes the Hard Part Is Accepting the Decision You Already Made
One of the most useful distinctions in this work is whether you are actually making a decision or trying to live with one you already know is right. A lot of people tell themselves they are undecided when, underneath, they already know what they want. What they do not yet know is how to tolerate the fallout, disappointment, grief, or uncertainty that comes with acting on it.
That is a very different problem, and once we name it, the work gets clearer. We stop trying to create certainty where certainty may never come, and we start building a way to live with the decision in a way future-you can respect.
I Am Not Here to Decide for You, But I Will Tell You What I See
I am not interested in becoming the authority who tells you what to do with your life. But I also do not think good therapy requires me to pretend I have no perspective. When we spend enough time with the problem, I often have a sense of what is aligned with your values, what is fear-driven, and what you already know but are struggling to admit.
If I see that clearly, I will say it. You still make the decision. But part of why people come to me is that they want someone who is willing to be thoughtful, honest, and direct enough to say what seems to be true.
Decisions, Values, and the Person You Have to Live With
When I work with people on a big decision, I am usually less interested in whether I like the choice than in whether future-you can live with it. That is the real standard. A year from now, five years from now, ten years from now, will this choice still make sense to the person you are becoming? Even if it turns out not to be perfect, will you be able to say you made the best decision you could with the information you had?
That kind of clarity matters. It lowers the emotional noise and helps people move forward more decisively, both in the decision they are facing now and in the next one that will inevitably come.
What I Help Clients Work On
- Relationship decisions, including whether to stay, leave, commit, or move forward
- Career choices, job changes, promotions, and major professional pivots
- Moves, relocations, and transitions that affect identity and stability
- Family decisions around marriage, parenting, and next steps
- Making peace with a decision you already know is right but do not want to face
- Sorting out values from fear, guilt, pressure, and expectation
- Reducing paralysis, overthinking, and the need for impossible certainty
- Building a decision-making process you can trust in the future
How This Work Connects
You may also be interested in:
✔ Career & Work Support
✔ Couples & Relationship Therapy
✔ Financial Challenge Issues
Looking for another therapist who works with life transitions? You may also be a good fit with Jacob Nathan, LSW or Chris Sampsell, LPC.
Frequently Asked Questions About Decisions & Transitions Therapy
Can therapy really help me make a decision?
Yes, though not by magically removing all uncertainty. Therapy helps by clarifying what is actually making the decision hard, separating values from fear, and helping you move toward a choice you can live with rather than staying trapped in endless circling.
What if I already know what I want but cannot make myself do it?
That is very common. Often the problem is not the decision itself but accepting the consequence of the decision. Once we identify that, the work becomes much more direct and much more useful.
Will you tell me what to do?
I am not here to make your decision for you, but I am willing to tell you what I see. If something becomes clear in the work, I will say it. You still make the final call.
What kinds of decisions do people usually bring in?
Everything from jobs, promotions, moves, and career changes to marriage, children, breakups, family transitions, and the feeling that life no longer fits the path they are on.