How the Inability to Say “No” Can Lead To Health Issues

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“There is only one way to avoid criticism: do nothing, say nothing, and be nothing.”

– Aristotle

My neck was so stiff I could barely move it. I rushed to the closest Urgent Care as tingles ran up and down my arms and fingertips. Touching my neck and shoulders felt like tapping on concrete. I was stiff as a board and on the verge of complete panic. “What is wrong with me?” I wondered. “Do I have some sort of medical condition?” As I sat in the Urgent Care waiting room, I frantically searched Google for reasons why this was happening to me. I was convinced it was time for me to write my will and say goodbye to life as I knew it. But a few minutes later I was in the exam room, getting a full physical examination and hearing from the doctor that there was no medical reason for my robotically stiff muscles. I was baffled. He prescribed me some muscle relaxers and steroids and sent me on my way. But before I walked out the door, he said something that shocked me: “I don’t know what’s going on in your life, but you need to find a way to relax.”

The doctor’s pointed words left me wondering, “Was that whole terrifying ordeal my fault?” “What was going so wrong in my life that I had to take muscle relaxers and steroids to feel like a mobile human being again?” It started to dawn on me: “Maybe I don’t have it all together like I thought I did.” You see, at that time in my life, I believed I was living the right way. I was an agreeable, courteous, and conflict-free person. I was the one who could always be counted on to smooth things over. I was the perfect Mrs. Fixit, and I thought that was how it should be. However, my body’s painful refusal to be flexible was telling me a different story.

My muscles were inflamed, and nobody could find a medical explanation for it. There were no injuries, car accidents, or diseases to blame. So when I left the doctor’s office, I was more confused than when I arrived. As a doctoral student in a mental and behavioral health program, I’d heard of psychosomatic illness: the tendency to experience psychological distress in the form of physical symptoms. However, learning about it is different than experiencing it. I literally couldn’t move my neck. My X-rays showed muscle spasms, and my sonogram showed evidence of muscle inflammation along with a pinched nerve. How is it that stress can wreak such havoc on the body, especially when the mind believes everything’s okay? Did my body know something I didn’t? If so, what was it telling me? How could I help it heal without medication? And what should I do next?

After doing some research, I found out that I wasn’t alone. Study after study suggests that as many as 20% of patients who present to primary care doctors are experiencing physical symptoms with a purely psychological cause. I found that for many people, emotional trauma often manifests as physical symptoms. I made a decision, right then and there, that if there was an emotional reason for my symptoms, I’d find the cure by taking a closer look at my life. I committed to myself that I wouldn’t rely on medication to mask symptoms in my body that could be resolved with emotional healing.

Less Yes and More You

After going to therapy and diving into many inspirational self-help books, I came to see that my health issues were manifesting from my inability to say no. I’d been a yes-person for as long as I could remember; I never wanted to disappoint anyone. But as I got older and my life circumstances started changing, the more I’d say yes to others, the less I’d show up in my own life. I lacked a sense of my own identity; I went through life as a selfless person who was always accommodating others’ needs and wants. I lost myself in my relationships, allowing other people to dictate my actions. This led me to believe that I must act in certain socially acceptable ways, even if those actions were not aligned with what I truly wanted for my life.

By adjusting myself and my internal functioning to keep what I thought were peaceful relationships, I lost a sense of myself. Without a clear sense of self, I based my wellbeing and functioning on others, leaving no room for me. When aspects of ourselves are distanced, denied, or devalued, they’ll always try to make us listen by surfacing as unwanted physical symptoms. I was ignoring myself, and the weight of feeling responsible for others became a burden on my shoulders that manifested as real pain.

Think about it. When you feel bad or anxious about saying no, you’re basically placing others’ feelings and responsibilities on your shoulders. You don’t want to disappoint people, and you certainly don’t want them to be upset with you. What I learned through my medical crisis is that it’s okay to say no and put your needs first; how the other person interprets that is their responsibility. You alone are responsible for your happiness; other people’s happiness isn’t your responsibility.

In putting less yes and more me in my life, I was able to create a more balanced sense of myself. I began to take care of my health by going to get massages, practicing yoga, working on my relationships, and taking care of my emotional wellbeing. By learning how to say no, I’ve allowed myself more time to do the things I enjoy, and I’ve wound up with more energy as well. The more I get to know myself and bring my true nature to the surface, the more at ease my body feels. I only took one muscle relaxer after learning what was going on with my body. I threw out the rest, because I was committed to feeling—even if it was painful. I now understand that muscle tightness in my neck and shoulders is a signal from my body, letting me know I have to take a closer look at my life. I now know that I never again have to numb my internal alert system—and neither do you.

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Know anyone that has a tough time saying no? Steer them to my latest book, “When It’s Never About You: The People-Pleaser’s Guide to Reclaiming Your Health, Happiness and Personal Freedom.” It is available to order here!

Talk soon,

Dr. Ilene

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