Some of the reasons why clients say they can't say no

One of the most common situations which results in clients coming into therapy is where they have taken on too many responsibilities, many of which, more often than not, were not their's in the first place and which eventually left them feeling overwhelmed and exhausted, unable to sleep and very often reliant on anti-depressants. They find it hard to say no, they have difficulty letting others take responsibility or making choice for themselves; they think they have to take control of situations as others cannot be trusted.

Jo felt she would be letting her work colleagues down if she didn’t agree when her manager asked her to cover extra shifts at the restaurant she worked at. Her manager knew that she would feel bad if she said no and so frequently took advantage of that knowledge to ensure sufficient cover, a situation which resulted in the establishment constantly running on crisis management and which led to Jo feeling overwhelmed and on anti-depressants.

Lizzie was a supervisor in an insurance claims company’s pension department. She came to therapy at the suggestion of the company’s HR department as she had lost control in a meeting, shouted at her boss and had stormed out. She was in tears as she said she had felt she was always being taken advantage of, that she was drowning in work and feeling out of control. It transpired she had always taken on work that was the responsibility of others to complete because she didn’t trust them to get it done right or on time. She had made a rod for her own back and was now feeling completely overwhelmed.

Sarah’s mother had had mental health problems for many years. Sarah would always be the one taking responsibility for organising hospital and doctor’s visits or hair appointments, despite the fact her mother had a capable husband and there were two brothers who lived close by.

Rachel’s husband had type 1 diabetes and totally relied on Rachel to keep him well and to pick up the pieces every time he had a hypoglycaemic episode or fell into a diabetic coma. She was complicit in this situation for years. He completely abrogated all responsibility for himself to her, and now years later she was finding it all too much and didn’t know what to do.

It had never occurred to these women to say no.

Men, of course, are not immune. David felt that he had to shoulder responsibility for all of the problems relating to his parents on his own. He was so overwhelmed his home and work life had spiralled out of control. He felt he could not burden his brother with his parent’s problems as his brother had financial problems of his own and so already had enough on his plate. He had to be the strong one. This, even though he had attempted suicide due to the stress of trying to cope with everything.

There are many reasons why some individuals feel they cannot say “no” or “this is not only my responsibility”. Very often they have experienced situations growing up where they have taken the role of carer for a parent or peacekeeper in the home. Maybe the parents were always fighting and the child agreed to do anything they felt was needed to keep the peace rather than live in fear of the arguments and the frightening outcomes they had witnessed previously. Maybe a parent had left the family home and then later returned. The child would likely do anything to try and stop the parent from leaving again. They would become the good boy or girl and as they got older, very often would become what therapists refer to as "rescuers", i.e. individuals that try to take control of people and situations in the oft mistaken belief that by taking away the agency of others they can prevent calamity and keep everything, and everyone, safe. The role of rescuer becomes a habit, and agreeing to do things to please others or manipulating situations so that they are in control becomes their normal way of relating.

If this sounds familiar and you too are feeling overwhelmed by these types of responsibilities, a few sessions of therapy may be all that is needed to help you change the behaviour to a healthier way of relating to others and so avoid these problems in the future.