Why “Just Take a Holiday” Doesn’t Work: The Decision Paralysis Loop

You know you can’t keep going as you are, and you can’t see how to change it.

A holiday rests you without breaking the loop. Here are the three fears that hold it together, and how to take them one at a time.

For months in 2012 and 2013, I avoided one decision. Stay in my practice, or move five hours away and start again in a small village practice.

I booked weekends away instead. Each one was supposed to give me the distance to decide. I came back rested, and the question was exactly where I had left it.

If you’re a dentist who knows you can’t keep going as you are, and can’t see how to change it either, this is for you. By the end you’ll know the three fears that keep the loop running, and which one to look at first.

What is the decision paralysis loop?

It’s a kind of stuck that doesn’t look like stuck from the outside. You still go to work. You still hit your numbers, mostly. By any measure the practice uses, you’re functioning.

Underneath, one thought has been running for months, sometimes years: I can’t keep doing this. I also can’t change it. So I’ll do neither, again, tomorrow.

The decision inside the loop isn’t always “leave dentistry.” For me it was whether to move practices. For others it’s going part-time, selling a share, stepping away from an owner role, or leaving clinical work. The shape of the loop is the same.

Why doesn’t a holiday break the loop?

The advice dentists hear is kind and well meant. Take a holiday. Cut back a day. Think about a sabbatical. All of it assumes the loop runs on tiredness, and that with enough distance the answer will appear.

A holiday reaches the tiredness. It doesn’t reach the loop. You come home, and by the drive to work on Monday the same thought is back, word for word. I wrote about rest and burnout in Your Burnout Is a Symptom. Examine It Like One. This loop is a narrower problem: a decision that won’t get made.

“Rest reaches the tiredness on top of the loop. It never reaches the loop.”

Why can’t dentists think their way out of it?

Dentists are good at structured problems. We diagnose, plan in phases, weigh risk and benefit, and act. So it’s confusing when that same mind circles one decision for two years.

The reason is where the decision sits. It touches who you are, and a list of pros and cons was never built for that. Each time you try to decide, three fears answer at once, and together they feel like one wall of dread.

What are the three fears inside the loop?

In my own loop, and in nearly every dentist I’ve coached through one since 2019, the same three fears show up in different proportions:

• The money fear. Income, the loan, the mortgage, the cost of years of training. This one is well founded, and it deserves respect.
• The identity fear. “Dentist” has become so fused with who you are that changing the work feels like losing yourself.
• The judgement fear. If you change course and it doesn’t work, you’ll have proven something about yourself. That you couldn’t cope. That you gave up. That the training was wasted on you. This is the one dentists rarely say out loud.

You can’t rest your way out of any of the three.

How do you take the fears one at a time?

Start with money, because it’s the most concrete. Turn it into figures with your accountant or financial adviser: what you need, what you have, what each option would cost. The version at 3am is almost always bigger than the version on paper. Sometimes the number is hard. Even then, a hard number is something you can plan around. A vague dread isn’t.

The identity fear is slower. Ask who you are without the title, and let yourself sit without a tidy answer for a while. It’s uncomfortable and survivable. It also helps to notice that most of the options in front of you don’t require giving the title up. Changing how you work in dentistry is still a change.

The judgement fear needs the most direct look, because it held me longest. In 2013 I started building my own practice. I rented the premises, hired a builder and ordered the chair. Months before it was finished, my intuition was telling me it was the wrong decision. The money scared me. What scared me more was picturing the people around me when I told them. Incompetent. Couldn’t finish what he started.

So I kept building until I was completely exhausted. When I finally cancelled, I lost a big investment, and it was the most painful thing I have been through mentally. Underneath the pain, I felt a lightness and freedom I couldn’t explain to anyone. The judgement I feared had kept me building for months after I already knew.

What broke my own loop?

The stay-or-move question didn’t resolve on a holiday or a course. It moved when I named it plainly, was honest with myself about what I wanted, and decided to change. The recurring headaches I’d been treating for a year eased. In September 2013 I moved to a private practice in Somerset, as an experiment I didn’t know would work.

It wasn’t my last change. Across twenty-two years of clinical work I’ve changed direction several times, and today I work as a locum a few months a year and spend the rest coaching dentists. I expect to change again. A decision doesn’t have to be permanent to be the right one now.

Which fear is running your loop?

“How do I finally decide?” is too big a question. It keeps you circling. Try these instead, the same ones I still use with myself:

• Where I am now, do I feel lightness or heaviness?
• What decision would I have to make to change that?
• Am I willing to make it?
• If I don’t change, what am I learning from staying?

Then notice which of the three fears answered first. Money, identity, or judgement. That’s the one holding the loop together today, and it’s the only one you need to look at this week.

One clinical note. If the loop comes with persistent low mood, hopelessness or thoughts of harming yourself, see your doctor first. That needs a clinician, and there’s no weakness in going.

From inside, the loop feels permanent. It rarely is. It’s three fears that have never been looked at one at a time.

If you want to go further, the stages that take a decision like this from Acceptance to Integration are in my book The Shift. It’s free for any dentist who wants it. You can get your copy here.

If you’d rather talk it through, book a free 30-minute conversation with me. Dentist to dentist, no pressure, and no script.

Dr Georgios (Amrishan) Kallivretakis
Dentist with 22 years of clinical experience and ICF-accredited coach (ACC). Coaching burned-out dentists in the UK and US since 2019.