Decision-Making for Sound Mental Health: 3 Useful Principles

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A useful distinction to consider when thinking about decision-making in the mental health space is between principles and rules. A principle is a fundamental proposition that guides a system of belief or behavior. A rule, on the other hand, is a prescribed dictate for action within a particular activity or sphere. Parental authority is a principle; bedtime at 8:00 is a rule.

Principles tend to be broad and more abstract, and they may apply across contexts. Rules tend to be narrow and context-specific. Principles tend to regard general processes, and often represent internal convictions. Rules tend to regard specific content, and are often imposed on us externally. Principles invite contemplation, and need to be applied thoughtfully. Rules demand obedience and can be followed thoughtlessly. “Is it right?” is a question about principles. “Is it legal?” is a question about rules. Principles allow for flexibility and agency, but may generate confusion regarding how they should be applied. Rules are useful in that they clarify proper conduct, but they also limit flexibility and personal agency.

Principles and rules are not unrelated, of course. In fact, a system’s rules are often derived from—and function to uphold—its principles. If “customer service above all” is a company principle, then the company may devise a rule that, “all customers must be greeted within 5 seconds of walking into the store.” Many rules may be subsumed under one principle, and so novel situations usually beget new rules, rather than new principles. For example, upholding the ‘right to privacy’ principle in the new digital environment will require devising new privacy-related rules. This is one reason rules tend to multiply over time. Before long, they may begin to obscure, and even undermine, the principles they ostensibly serve. This is, in essence, the paradox of bureaucracies: designed to advance the worthy principles of organizational efficiency, rationality, and objectivity, their convoluted rules often end up undermining all three.

Our culture prizes both those who follow the rules and those who are principled. But in general, the latter is more highly regarded than the former. If you break a rule in the name of principle, you’ll be often regarded positively. If you obey a rule in betrayal of principles, you’d be perceived negatively. In Lawrence Kohlberg’s famous moral reasoning theory, a rule-based morality is considered ‘conventional,’ and is located lower on the developmental ladder than a principle-based, ‘post conventional’ morality. Yet rules can be helpful in putting principles into practice. A transportation system that includes highways may be considered better developed that one that relies on country roads. But a truly developed system needs both.

Most of the systems that govern human conduct and decision making include both principles and rules, yet systems may differ in which of these they lean more heavily on. For example, American football is a game of rules. Every nuance of the game is closely measured, officiated, prescribed, and addressed in preset ways. Soccer is a game of principles: Move the ball into the opponent’s net without using your hands or breaking other players’ shins. That’s more or less it. American football is heavy on equipment and technology; it involves many more referees than soccer, and many more stops, consultations, and rule-related controversies (Deflategate, etc.). Soccer flows. It is known as ‘the beautiful game.’

The work of psychotherapy concerns itself with principles and rules quite regularly. For therapy clients, I find, focusing on principles is often more productive than focusing on rules. Now granted, therapy is not a one-size-fits-all proposition. What works for one client may not work for another. At the same time, people are people, and commonalities exist. For example, when it comes to parenting, clients often find that they do well to behave in ways that satisfy the principles of generosity, fairness, and responsibility. Giving your kids no treats ever may be fair and responsible, but ungenerous. Giving one child more treats than the other may be generous and responsible, but unfair. Giving each child fifty treats to eat at once may be fair and generous, but not responsible. You get the idea.

Clients often benefit from figuring out general principles of thinking and decision making that work well across content areas in the mental health space. Here are three useful go-to principles of sound mental process:

Flexibility over Rigidity

This principle is based on the fact that cognitive flexibility is a hallmark of cognitive health. Cognitive flexibility refers to our ability to adapt our cognitive processing strategies to novel or unexpected environmental conditions. As such, cognitive flexibility implies a capacity for learning from experience. It also involves the ability to apply and adjust problem-solving strategies by exploring potential solutions inside a given problem space. It therefore is best thought of as a facility with complexity.

Life, as you may have noticed, is, if nothing else, complex. In such an environment, rigid, narrow, and simplistic thinking will not suffice. All-or-nothing perfectionism, for example, is rigid thinking. It is ill fitted to handle real life, which is much more likely to involve more-or-less propositions. Perfectionism distorts our analysis by turning life’s nuanced continua into crude dichotomies. Striving for excellence, on the other hand, affords the requisite flexibility. For the difference to become clear, think about someone in your life whom you love and admire: are they perfect or excellent?

One obstacle to the development of cognitive flexibility is the cache our culture attaches to dogged determination. Many successful people attribute their success to ‘not giving up,’ and to their stubborn insistence on pursuing a dream against the odds. Narratives of success against the odds are heralded and often compelling, but they are also misleading. In principle, it is better to go with the odds rather than against them (see under: Las Vegas). For example, if you want to become financially secure, you can play the lottery doggedly every day, or you can get an education and a good job. Some of those who choose the former strategy may be successful. And they will attribute their success to their stubbornness. But their good fortune doesn’t validate the strategy, because most of those who choose it will fail. Put differently: the fact that Steve Jobs succeeded after dropping out of college and starting a business doesn’t mean that dropping out of college to start a business is a sound strategy for success. The error illustrated by these examples is known in the literature as survivor bias. Those who succeed by beating the odds succeed despite, not because of, their strategy.

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This is why much received wisdom, such as "Follow your dream and never give up," constitutes poor life advice. Better to follow only those dreams for which you have aptitude and good success odds, and give up on the rest. Most successful people have given up on many dreams and goals along the way. Adaptive flexibility predicts success better than rigid stubbornness.

Compassion over Cruelty

This principle appears self-evident: Of course it is better to treat others with kindness rather than cruelty. Yet somehow this self-evident truth becomes less so when applied inward. Somehow, treating yourself with cruelty and lack of kindness doesn’t evoke the same moral outrage as seeing someone else treated this way, or experiencing yourself treated this way by someone else. Yet a fair evaluative system cannot accept an arbitrary double standard. If we accept and respect others who are imperfect, but fail to accept and respect ourselves on account of our imperfections, then we are creating a unique, and uniquely harsh, measurement system just for us, an unjustified double standard.

Self-compassion involves an attitude of encouragement and support regarding our failings, shortcoming, and disappointments. Treating oneself kindly upon the occasion of failure or disappointment is not akin to settling for failure or disappointment. Encouraging and supporting your child when they fail to hit a baseball doesn’t mean that you don’t want them to learn to hit a baseball. It means that you know that failure is a part of life and learning, and that encouragement, support, and compassion will motivate them better than punishment, ridicule, or scorn. Same is true for yourself.

Self-compassion also includes a humble realization of our self-limits. Absent that, we may assume much too great a responsibility for the consequences of our actions, forgetting that no action is taken in isolation from others’ actions, or from history, society, biography, luck, and biology, for that matter—all of which we have little to no control over. To wit: with due respect to your individual effort, smarts, discipline, and skill, the best predictors of whether you are wealthy or not is where, when, and to whom you were born. Our freedom and autonomy are bounded. There are powerful factors at play beyond the self. Thus, in the words of Leonard Cohen: “you cannot command the consequences.” A failure to recognize that is a failure of self-compassion.

Approach over Avoidance

Not all problems that are faced can be solved, but few problems are solved without being faced. Avoidance, we are beginning to understand, is at the root of much psychological and societal suffering. In other words, much eventual pain is caused by initial attempts at pain avoidance (see under: climate change; opioid epidemic). A pattern of avoidance lies at the foundation of many of the problems people seek therapy for. Now granted, some problems have no solution, and need to be carried well as opposed to resolved. John Gottman, the marriage researcher, has famously concluded that successful couples are those who solve their solvable problems, not those who solve all their problems. It is also true that, as they say in the army, not all hills are worth dying on. Some problems are trivial, and not worth the effort it would take to resolve them. However, in order for us to recognize an unsolvable or trivial problem as such, we need to first approach and understand it. To decide which hill is worth dying on, one must understand the battlefield.

Moreover, what we run away from tends to become more, not less scary. The more you avoid public speaking, the more you fear it. William James famously proposed way back in the day that emotions in fact result from behavior: we are afraid because we run away. "My thesis … is that the bodily changes follow directly the perception of the exciting fact and that our feeling of the same changes as they occur is the emotion." He wasn’t entirely correct. But he wasn’t entirely incorrect, either.

A tendency to avoid is not inherently maladaptive, of course. For example, our desire to avoid loneliness may energize our pursuit of intimate connection. Yet an intimate connection established only or mostly in order to avoid loneliness is unlikely to succeed or reward us in the long run. Moreover, we may grant that a knack for avoidance has served our species well as a protection against danger. Some things are indeed best avoided. In a threat-rich environment such as the one in which we have evolved, avoidance would have been plenty useful. However, in our contemporary environs, more often than not what we avoid is merely scary or uncomfortable rather than dangerous. For example, avoiding heights made much sense way back when most heights humans encountered where steep cliffs or treetops. It is much less justified today when most heights we encounter are inside buildings or airplanes.

Avoidance is also problematic because it doesn't teach us anything, other than how to avoid. You can't learn to play by avoiding playing. Approach, on the other hand, fosters learning, and we are a learning animal. Most of what we know, we had to learn. Yet the main problem with avoidance is that, while it tends to be effective in the short term, it often becomes ineffective in the long term. If I use heroin to drown (avoid) my sorrows, I will indeed cease to feel my sorrows for a while. But down the road, my heroin addiction will have become my greatest sorrow. Life, with any luck, is long term. An approach strategy works better for that, in principle.