There is an irony at the heart of analytic, therapeutic, and coaching practice that the field rarely examines, which is that people whose work is devoted to the relationship between mind and body spend their days in the one posture that medical research now describes as quietly harmful, sitting almost perfectly still for hours on end. The irony does not stop with the practitioner, because the client sits too, and although the client sits for an hour where the practitioner sits for a working day, the seated and face-to-face format imposes a cost on the client as well, a cost that is harder to measure than mortality because it is paid in the reach and quality of the work itself.

She arrived with a long list, the kind of list that feels heavy even before it is spoken aloud, a list of things not working in her life, at work, in her relationships, in her finances, in the quiet corners of her days, and each item on that list could have justified an entire coaching process on its own, each one large, complex, demanding attention, demanding time, demanding care, and yet as we began to look more closely, to slow down enough to see rather than react, a pattern started to emerge with a clarity that was almost unsettling in its simplicity: all these difficulties, despite their different shapes and contexts, were organized around a single fault line, a single difficulty that ran through everything, the near impossibility for her to say no.

Executives make decisions constantly. Every day involves choices about strategy, priorities, hiring, partnerships, budgets, and direction. Many of these decisions must be taken with incomplete information and under time pressure. Over the course of a career, leaders develop a strong capacity to analyze situations and weigh consequences. This ability often becomes one of the reasons they rise to positions of responsibility.

Yet even highly experienced leaders reach moments when decision making becomes unexpectedly difficult.