The Surprising Link Between People Pleasing & Your Health: MD’s Recommendation on How to Say “No”

KEYPOINTS

• 01

  A 'yes person' has lost their inner anchor

  Internal medicine physician Dr. Neha Sangwan describes people-pleasing as becoming driftwood in the ocean: you go wherever the wind pushes you and lose track of how you make decisions. The goal is not an anchor that stops you from moving. It's a sailboat with a rudder, which feels the wind but charts its own course. When it's time to decide, she says, let your own heart be slightly louder than other people's voices.

• 02

  Her definition: giving up what matters to you so you can belong

  People-pleasing, in Sangwan's words, is the moment you give up what matters to you to appease someone, avoid conflict or keep a relationship intact. She frames it as a spectrum, not a label. She wants to keep caring what her partner and the people around her want, but she had to learn to sit in someone else's discomfort in order to stay true to herself.

• 03

  People-pleasing is a coping strategy for feeling safe

  Sangwan calls it a behavior we use to feel safe and belong, often formed in childhood by scanning the room and adjusting to get love or keep the peace. She mentions Gabor Maté's idea that we sometimes choose attachment over authenticity. A coach once challenged her for blaming her parents for her engineering and medical careers: she was the one who applied and did the 36-hour shifts. That made her see she was chasing being seen, valued and never sent away again.

• 04

  The real root is not being able to tolerate discomfort

  Most of us were never taught how to handle disappointment or unease in the body. When that feeling rises, we do anything to make it stop, including saying yes when we mean no. Mel's takeaway is that before boundaries can work, you have to build the ability to ride out that wave. Being aware of the discomfort is what gives you a choice.

• 05

  Avoiding conflict feels easier now and costs more later

  Shoes in the house, dirty dishes in the sink, hosting the holidays again, 'I'll take the pager': skipping the conversation gives you what Sangwan calls 'the short-term high' and leaves you with 'the long-term yuck.' An ignored conflict doesn't go away. It grows and moves somewhere else, until you're asking whether everyone thinks you're a magic fairy who does everything.

• 06

  Resentment means your boundaries have been crossed

  Sangwan treats resentment as a sign that boundaries were trampled, often ones you never actually stated. She cites the saying that resentment is like drinking poison and hoping the other person dies. Notice where it shows up in your body, like a sinking stomach or weak knees. Mel finds it helpful to treat resentment as a sign of a broken system or outdated communication pattern instead of a personal attack. Sangwan's follow-up question: have you said this out loud to anyone, or only vented at home?

• 07

  Me-we-world: look at all three parts of a conflict

  Trained as an engineer, Sangwan looks for root causes. In any conflict, ask what your part is, what the other person's part is, and what role the environment plays. With aging parents, if you always rush over right now while a sibling says 'in an hour,' look at your own urgency and the role you've long played in the family, and not just at their lack of help.

• 08

  Stress causes or worsens most illness, in her view

  From her patients, Sangwan concluded that stress causes or exacerbates more than 80% of all illness. She believes not communicating with yourself and others makes people physically sick. When she urged colleagues to ask patients about the roots of their stress, they told her not to ask a question she didn't know what to do with. She says medications for anxiety, depression or sleep help when someone is near the edge, but used alone they send people 'back in the ring for round two' without new insight.

• 09

  Survey results from Mel's audience

  When Mel's team surveyed listeners, 70% said they often say yes when they mean no, mostly at work and with friends. 82% said they feel constantly stressed, irritated, tired and impatient, and linked it to conflict they were avoiding. The most common reason given was 'I hate confrontation.'