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Today’s post is the third and final one in this series on people pleasing.
This post will offer a framework for how to work on breaking free of your people pleasing tendencies.
Learn about where people pleasing comes from in the first post here.
Read about 12 signs that people pleasers exhibit in the second post here.
You Do Not Belong on the Back Burner
In the prior posts on people pleasing (found here and here), I demonstrated that the foundation of people pleasing is a lack of a genuine sense of worthiness inherent to one’s self.
This thought error is central to many of the problematic belief patterns that we’ve looked at including perfectionism and imposterism.
These often go hand-in-hand or feed into each other because of a lack of understanding or belief in the fact that we are innately and inherently worthy and whole.
People pleasers derive their worth from the praise of others. They rely on external evidence to prove it to themselves.
Unfortunately, this means they have to keep proving it to themselves over and over because external validation is not a self-sustaining way to love oneself—it’s a leaky cup that constantly needs to be refilled.
If you’re a people pleaser, then know that you can be kind towards others AND not subordinate your needs to those of others. These are not mutually exclusive.
Self Interest is NOT Selfish
You’ve heard the “oxygen mask” analogy, right? You know, the one in which flight attendants instruct passengers to put on their own oxygen masks first before assisting others? Turns out if you’ve lost consciousness you’re far less useful to others! Who’d have thought!?
Too often in medicine we try to put the oxygen mask on just about everyone else before ourselves.
Unfortunately, in the short-term, not only do we suffer because of this, but also our loved ones.
And in the long-term, if we remain practicing while burned out (maybe just going through the motions) or end up leaving medicine prematurely, then not only do our current and future patients suffer, but so does society at large.
But if we put on our oxygen masks first and take care of ourselves, then we can fulfill our mission of serving others with more integrity from a place of wholeness and abundance.
Unless this is the oxygen mask you’re wearing. Then it’s probably from a place of anger and/or world domination.
This is all a prelude to the bulk of this post which will show you one method to work on breaking free from your reliance on external validation.
A People Pleasing Busting Framework
If you’re a people pleaser, you’ve likely been honing your “skills” since childhood. Know that you’ve had years, even decades, to develop and perfect this deleterious behaviors.
Working to stop this tendency is going to be HARD. It will take time and sustained effort. There will be setbacks, ups and downs.
You will have to try things repeatedly before you get the hang of it and build up your new muscle memory.
Do not let this discourage you. Do not use the fact that success may not come immediately as evidence that you’re not worthy.
(Because you are. Even if you remain exactly where you are).
Let’s get to it!
Step 1. Review Recent Yesses
The plural of “yes” always looks awkward to me, but it can be either “yeses” or “yesses.” I go back and forth on which one looks more awkward, but for today “yesses” wins out.
Anyway, I want you to review the last 3-5 times you said “yes” to requests or petitions for your attention and time. They can be big or small.
For the purposes of this post, I’m going to use medicine-related examples.
Examples include:
- Adding on a patient show asked to be seen same-day
- Addressing a last-second “oh by the way” problem brought up at the end of a visit
- Prescribing an antibiotic over via a medical message exchange (even if you don’t think it’s good medicine to do so)
- Taking on yet another “interesting” committee assignment (I’m looking at you, academic physicians!)
This is one way to leave a patient room that may help avoid those “oh by the ways….”
Step 2. Examine Why You Chose to Help
Looking at your list of 3-5 recent yesses, what was your intention behind saying “yes?”
Did it align with your values and/or bring you incandescent joy? Or was it out of guilt or yearning or desperation?
Did you feel good about it, or did you feel resentment or disdain?
Even if the latter, you benefitted in some way from making the decision, and it’s important to recognize that fact and uncover why.
For example, relieving yourself of an in the moment discomfort including guilt is a benefit to you and a motivator driving you to say “yes.”
At work, maybe your clinic schedule is booked out for three months and you feel guilty that you don’t have availability and so you just keep adding on patients who request to be seen sooner.
Doing so alleviates your guilt, but then sets you back time- and work-wise.
In this scenario, maybe your employer will not let you block slots for same-day or acute visits and so you feel stuck. Know that it’s not your personal responsibility to bear the burden of the ramifications for decisions your employer makes.
I would encourage you to make it known (repeatedly, if need be) to those in control of your schedule that this is an issue and seek to work together to remedy so you can get your patients seen and cared for.
It’s in everyone’s interest to do so.
Step 3. What Are the Negative Impacts of Doing So?
List out the consequences to you or others around you for acquiescing to requests for your time and attention.
In the example above of working in extra patients, some clear cut repercussions will be running late for your routinely scheduled patients (and inconveniencing them) or adding to your charting burden (and staying later at work or bringing work home, which impacts you and/or your family).
Taken further, maybe it’s showing your employers that you’ll bear the burden of their arbitrary decisions (I know, I know, that’s sort of the definition of an employee), which invites more such decisions.
But that may lead to burnout and you cutting back hours or leaving medicine entirely. Then everyone loses: your patients, your employer, society, and you.
See this post on the business case for addressing burnout as all employers need to know this (unfortunately, money talks the loudest to some).
Step 4. Write Down Your Values and Priorities
Core values are the things that matter most to you and are generally “set in stone.” These are things like family or health.
Priorities are the things you focus your time and attention on and can be short-term and can shift even day to day. So priorities include things like training for a marathon or wanting to cook meals at home every evening as well as being focused at work in order to get your work done at work so you can come home unencumbered.
So list yours out.
I find it’s best to put pen to paper. Or stylus to tablet. Seriously, writing it out gets it out of your brain and into existence.
Step 5. How Do You Measure Up?
Now that you’ve listed out your values and priorities you can compare where you are now and where you want to be in terms of alignment with them.
So, are you living out your values and priorities?
If so, congrats! You’re being true to yourself and your needs.
Chances are, however, that you’re not—or at least not as much as you’d like to be. This disconnect can cause unfulfillment.
By identifying the delta between where we are and where we want to be, we can take steps to narrow or eliminate that delta.
Start pondering how you can move closer to your ideal life that is in line with your values and priorities.
Does it involve making sure everyone else’s needs are met instead of your own? I’m guessing this is not a stated objective of yours.
If you list family as a core value and spending time with them as your number one priority but spend ALL of your time working and barely see them, then you have to pause and reassess.
Are your stated values and priorities actually your values and priorities? If so, how do you feel about the disconnect?
Start brainstorming ways that you can move closer to your stated ideals.
Step 6. Set a New Default
Unless your initial thought is “hell yes,” it’s something on your bucket list, or it makes you incandescently happy, your default response to a request for your time or attention should be “no.” See this post if you need more reasons why.
Sometimes in the moment it’s hard to say no. If you do, you may want to give them a legitimate excuse and over explain yourself into awkwardness.
Remember, you don’t owe them an explanation because they are making a request of YOUR TIME.
You’re setting a broad-based boundary for others and, let’s be real, also yourself.
A boundary is a request (whether spoken or unspoken) which if crossed will lead to a specific consequence.
It may look something like this: “If my time is requested, I will pause and ______ .” <insert whatever you plan to do/say>
Boundaries are necessary because others taking advantage of your people pleasing is not on them. It’s on you.
Really.
You have to set your own boundaries. It’s not up to others to set boundaries for you (unless you’re a child or have a guardian, etc.)
So, if at work you’re asked to take on yet another task or work in another patient, run it through your algorithm and make an intentional decision that reflects your wishes.
Step 7. Get All the “What Ifs” Out of Your System
Okay, so you just created a boundary and the thought of it horrifies you. Your brain will start catastrophizing about how your relationships will fall apart and your life will crumble.
It’s just distracting, primitive brain chatter to keep you in your status quo—keep you stuck in your people pleasing.
Now I want you to imagine what upholding this boundary looks like. What would happen if you said “no?”
What are the worst outcomes?
Oh stop!
How do they compare to not living true to your values and priorities?
Maybe you’re worried that a patient you don’t work in will be upset or will go see someone else. And…?
That’s okay. You’re not responsible for how they feel. It doesn’t mean they don’t like you or are seeking a new physician altogether.
Also consider the fact if you burnout and leave that practice sooner than you otherwise would have, then you’re forcing them to see someone else.
Step 8. Learn to Actually Say “No”
I’ve said before that “no” is a complete sentence because it is.
Don’t worry, the heavens won’t part and you will not be smited by a slighted deity. (But don’t blame me if you are!)
It will feel uncomfortable.
If you really struggle with this, then I highly suggest you literally practice saying it.
One way to do this would be to listen to the song from the Disney movie Encanto called “We Don’t Talk about Bruno” since the chorus ends with “Bruno, no, no, no!”
Go give it a listen. It’s super catchy.
Saying no doesn’t hurt your reputation or make you a bad person. It signals that you know your limitations and how to honor your own needs.
Saying no also doesn’t mean you’re not approachable. You don’t have to be curt about it. You can still help even if not in the way that someone else wants.
For example, for an end-of-the-visit “oh by the way” issue, you can direct the patient to schedule another appointment where you can give their concern the time and due diligence it deserves because you want to provide the best care possible for them and it’s a priority for you to preserve your own self-integrity (in providing the best care possible). You also want to minimize disruptions to subsequent patients where possible.
It’s not your fault if they have a high-deductible health insurance plan or high copays. Your time and expertise are extremely valuable, and, again, it’s not your responsibility to bear (more) repercussions of a faulty medical system. That being said, I do highly encourage you to resist and push back against it!
I find agenda setting at the onset of a visit extremely helpful for trying to capture “oh by the ways” at the beginning or as a reference to how you both decided to allocate the visit time, thus the need for a future appointment if something new comes up.
Miscellanea
Here are a few other tips and comments that may help:
- Practicing your “pause for the cause.” Develop a go-to phrase that gives you the space and time to make a decision that is in alignment with your values.
- Find low stakes situations for putting forward your opinion on a matter. Maybe this is with a family member or friend who is your ride or die and who doesn’t care if you’ve been pretending to like Star Trek this whole time (ewww!) when you’re true love is Star Wars (what in coaching is called “a correct decision”
). - Similar to #2, find low stakes situations to disagree with someone or say no.
- Stop over-apologizing. If every other sentence out of your mouth is an apology, then you’re an over-apologizer. Furthermore, if you apologize for apologizing, then you’re an over-apologizer.
- Cutting back on people pleasing tendencies to any degree is a win and can bolster your confidence to keep progressing!
- It takes courage to face your fears, including those of being disliked. As always, approach this with curiosity and compassion.
).As rapper Nelly said in 2001, “What does it take to be number one? Two is not a winner, and three nobody remembers.”
What does it take to be number one…in your own books?
That’s where you’ll find your source of internal validation and stop relying on others’.
What do you think of this people pleasing busting framework? Let me know in the comments below.
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