Do you have trouble saying "no"? Lots of people do—and it can sometimes get you into trouble.

In spite of many best-selling books on assertiveness, like Manuel J. Smith’s classic book, “When I Say No I Feel Guilty,” many people still have trouble saying no. For example, you may have led someone on in a romantic relationship because you were afraid of saying no and breaking the other person’s heart. Or, you feel burned out, because you're always giving, giving, giving because you can’t—or won’t—say no. Or, you may end up hopelessly over committed at work, putting in long hours and feeling secretly used and resentful, because you don't know how to say no.

Sound familiar?

In this Podcast, Fabrice and David interview Dr. Jill Levitt, the Director of Clinical Training at the Feeling Good Institute in Mt. View, California. Jill confesses that she sometimes has trouble saying no—to new referrals when her practice is full, to her family, who she loves tremendously, as well as colleagues who request this or that. David admits he sometimes has similar problems.

There are lots of reasons why you may have trouble saying no. Some are negative, but some are actually positive, including:

1. Conflict phobia. You are afraid that if you say no, the other person will get angry and annoyed with you.
2. Fear of disapproval or rejection. You are afraid that if you say no, the other person will judge you, disapprove of you, or reject you.
3. Perceived narcissism. You believe that other people will lash out if you don’t give in to their demands.
4. Submissiveness. You believe that your role in relationships is to make others happy, even at the expense of your own needs and feelings.
5. Joy / Love. Jill confesses that she often says yes to this or that request because she feels it will be fun, or because she doesn’t want to let the other person down. One example would be baking brownies for her sons when she’s exhausted. One consequences would be giving in, but resenting the person she’s saying yes to.
6. Guilt. You may feel that if you say no, it means that you are somehow “bad,” and that it’s your duty to please other people.
7. Achievement addiction. You say yes to almost everything because you think this or that activity will make you more productive and successful.

Fabrice, Jill and David discuss many strategies for overcoming this problem, including:

1. Empathy--as a therapist, you always want to start with empathy, without trying to "help."
2. Motivational strategies such as the Paradoxical Cost-Benefit Analysis, Positive Reframing, or even the Straightforward Cost-Benefit Analysis. This is crucial to find out if patients really want to change before using methods to help them become more assertive.
3. Punting. This is a delay strategy that David uses to get himself off the hook when feeling ambivalent about a request. For example, you can say, “I’m really pleased and honored that you’ve invited me to do X. I’m going to check with my schedule and see what might be possible, and I’ll get back to you.” Then, he has a day or two to work up the courage to say “no” in a kindly way.
4. Write down your Negative Thoughts. when you're feeling compelled to say yes because you're feeling anxious or guilty, Ask yourself, "What am I telling myself?" Those thoughts will nearly always be distorted. Then ask yourself how you could challenge and talk back to those thoughts.
5. Fabrice, Jill and David also discuss how to say no effectively and demonstrate this skill in a role-play with Jill that is surprisingly challenging!

They also demonstrate the Feared Fantasy, a powerful technique to help patients say no, using Jill’s example. Her worst fear is that if she says no to colleagues, they will:

1. Feel disappointed.
2. Become angry and demanding.
3. Will say they won’t work with her in the future if she says no.
4. Will say they’ll get someone else to do whatever it is, and that Jill will miss out on all the fun.

David and Fabrice play the role of colleagues from hell who put demands on Jill to do another podcast and then get upset when she tries to say no. The dialogue is quite entertaining and dynamic, and Jill finds it helpful, though anxiety-provoking.

They also describe the importance of giving patients homework to actually say no between sessions to requests that are excessive or inappropriate.