Patient Blogs | Multiple Sclerosis
Pleasing People Doesn’t Help My MS
photo of feet in front of no sign on the street

Stress is a major contributor to autoimmune diseases like multiple sclerosis (MS).  At least it has been in my case. My biggest stressor has been a behavior called “people-pleasing,” and I think a lot of people with MS can relate.

What is people-pleasing? Life coach Kaliopi Nikitas gives this definition: People-pleasing is the habitual act of putting others’ needs above one's own, and is typically a reflexive coping mechanism, learned in early life. It is marked by suppression of emotions, inhibition of self-expression and assertiveness, along with a genuine difficulty saying 'no.'” 

I have had that difficulty as far back as I can remember, but I didn’t know how much of a problem it was until I read psychiatrist Gabor Máte’s book, When the Body Says No.  Máte explains how inability to say “no” creates chronic stress. Increased levels of stress hormones, such as cortisol, weaken our immune systems and set us up for chronic disease. 

“If you can’t say no,” he writes, “your body will say no for you by getting sick or even dying.” I believe it. When we’re too stressed, our bodies may get the idea, “Illness is my one and only ticket out of here.”

I read that book 30 years ago, shortly after I was diagnosed. It really spoke to me, but I still struggle with people-pleasing habits every day. 

It’s weird. I have written about the value of saying no in books and articles and spoken about it in lectures and workshops. I have written often about how people with chronic illness can’t afford to be “nice,” another word for people-pleasing. We can’t keep putting other people’s wants ahead of our own needs. I had buttons made up that said “No more nice girl,” and “No more nice guy,” and sold them at my talks. They sold like hotcakes. But I still have trouble saying no in my personal life.

Dr. Máte says I shouldn’t feel guilty about people-pleasing. Lots of people do it; we learn this behavior very early because of our need to be loved by our caregivers. I think that’s what happened to me. My mother was very stressed, and I think I felt a need to soothe her. I can’t blame her; she probably grew up stressed in her own family, and I probably was a stressful baby. But her anxiety definitely left a mark on me.

I get very anxious when I think I’m being attacked, and I am uncomfortable around other people’s anxiety or conflict, even if I’m not involved.  I need everyone to get along, and I try to calm people down when they are angry and cheer them up when they’re sad.

Beyond giving others emotional support, I try to please in other ways. I hate to inconvenience other people, and I hate to disappoint them, and these fears cause constant low-level stress.  There is always going to be conflict. We are going to have to inconvenience or disappoint others at times. If we feel we can’t inconvenience others, we will be stressed whatever we do, whether by doing things we really didn’t want to do, or by feeling guilty for not doing them. 

We might have attitudes like this and not be aware of them. We may have lost touch with our underlying fear that people won’t love us if we’re not giving enough. We may not realize how much stress we’re under. But our bodies know. 

Examples of People-Pleasing

How do you know you’re people pleasing?  Coach Nikitas gives some everyday examples:

“You didn't want to disappoint your boss, so you said yes to the last-minute report.”

“You were worried your spouse would feel neglected, so you stayed up late watching TV together.”

“You felt guilty not answering your mother's phone call 2 days in a row, so you talked with her for an hour instead of going to yoga class.”

Note that all these "nice" behaviors have good reasons.  We do need to talk with our parents and spend time with our loved ones, and we want to stay on good terms at work. But it’s easy to take niceness too far. 

I still find this balance difficult.  A couple of years ago, when my wife and I were still sleeping in the same bed, I would be very reluctant to get up to pee in the early morning. Getting out of bed was a big project by then, and I needed to turn on a light so as not to fall, but I didn’t want to wake her up.  I would just try to get back to sleep until she woke or the sun came up. But I was never comfortable until we got separate beds and I got mobility support so I didn’t need the light.

Another way I people please is by listening to others way past where I’ve lost interest and want to be somewhere else.  A friend goes on about a show she saw or a trip he took, or a political rant, and I just listen.  My listening is something people like about me, and it’s not always bad. If people have problems or emotional needs, I’m happy to share and try to help. But longwinded small talk wears me out.

Being there for others is good, but we have to take time for our own needs, too. Jennifer Powell, host of the MS Podcast, says, "Taking care of ourselves is not mutually exclusive from being a light in this world. We illuminate brightest when our flame is strong.” 

Unlearning People-Pleasing Habits

Since people-pleasing is a lifelong habit, it’s not easy to change, as I have discovered. I have learned some better ways to cope, though. Just saying “no” is not enough, if your body/mind is screaming “Yes. We have to do this.”  We need to reframe how we think about ourselves and our relationships with others. Some psychotherapy or counseling might help with this, and there are books and web pages to learn from. 

Mostly, it takes practice and gets easier with time. Support from family or friends also helps.  While some people benefit from our people-pleasing and don’t want us to change, others worry about us and want us to do better. 

One student in a workshop for people with chronic illness told me, “I was afraid to tell my family no, but they were really OK with it, after the shock wore off. When I told them clearly why I was changing, my son even congratulated me on taking better care of myself.”

It is chronic stress, not people-pleasing per se, that undermines health. We can reduce the stress by being honest with ourselves and with others. If I’m getting stressed listening to someone rant or tell pointless stories, I shouldn’t pretend to be enjoying it.  MS gives me a great excuse for getting out of situations like that. I can just say, ‘I’m tired. I have to rest now.” They won’t stop being my friends.

Last point about saying no: It’s not just for other people’s demands, but also to some nice-sounding invitations.  If we’re tired or the activity feels like too much, we need to learn ways to say no that don’t dissuade them from asking again. 

Like “I’m sorry; I’d really like to, but I have a busy day and will need to rest. Please ask me again; I’d really like to hang out with you.” (Or suggest an alternative get-together.)

People-pleasing doesn’t cause MS. But the stress of it makes illness more likely and makes coping with MS harder. That’s why I call “No” the magic word.  It prevents so many problems.  Good luck using it.


To connect with other people living with multiple sclerosis join our MS Facebook Support Group.




Photo Credit: Christina Reichl Photography / Moment via Getty Images

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David Spero, RN

David Spero, RN

Diagnosed since 1989

David Spero, RN, became a writer and health coach after being diagnosed with multiple sclerosis in 1989. He writes books and blogs about living with chronic illness and the social causes of illness. A married father of two and grandfather of one, Spero is active in causes including health care, peace, and the environment. See his books; follow him on Medium or Twitter.

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