The Power of No

Posted: March 6, 2025 | Author: erikpeper | Published with permission

I felt exhausted and just wanted to withdraw to recharge. Just then, my partner asked me to go to the store to get some olive oil. I paused, took a deep breath, and checked in with myself. I realized that I needed to take care of myself. After a few seconds, I responded, “No, I cannot do it at this time.”It was challenging to say this because, in the past, I would have automatically said “yes” to avoid disappointing my partner. However, by saying “yes” and ignoring my own needs, I would have become even more exhausted, hindering my recovery. I felt proud that I had said “no.” By listening to myself, I took charge and prioritized my own healing.

For many people, saying “no” feels unkind, and we want to be kind while avoiding burdening others. Nevertheless, how you answer this question may have implications for your health! Consider the following question and rate it on a scale from 1 (never) to 5 (always):

How often do you do favors for people when you really don’t want to? Namely, things you really don’t want to do but do anyway because someone asks you to and you don’t want to or can’t say “No.“

In analysis of numerous studies, Prof. George Solomon and Dr. Lydia Temoshok reported that a low score on this question (indicating the ability to say No) was the best predictor of related outcomes across studies, such as survivorship with AIDS as well as more favorable HIV immune measures (Solomon, et al, 1987). This aligns with research suggesting that excessive compliance, self-sacrifice, and conflict avoidance (i.e., people-pleasing) in individuals with cancer and chronic illness may weaken, rather than strengthen, their immune systems (Temoshok, & Dreher, 1992).

Unconsciously avoiding or suppressing distressing thoughts, emotions, or memories instead of dealing with them––a process known as repressive coping–– may even contribute to an increased risk of cancer and cardiovascular disease (Mund & Mitte, 2012). Avoiding emotional cues or dismissing feelings may seem self-protective but can lead to reflexive or automatic behavior such as saying “yes” when individuals would rather say “no.” Although the conflict may not be consciously recognized, it can manifest physiologically (Mund & Mitte, 2012). Paying attention to states of tension, or symptoms such as headache or loss of appetite can serve as a doorway to exploring unacknowledged feelings.

Automatically saying “yes” and sacrificing yourself may contribute to poor boundaries, leading to chronic stress which is linked to numerous health issues, including hypertension and immune dysfunction (Dai et al., 2020; Segerstrom et al., 2004; Deci & Ryan, 2008). Conversely, research indicates that individuals who assertively manage stress—rather than suppress emotions and avoid conflict—demonstrate stronger immune resilience (Ironson et al., 2005; Dantzer et al, 2018) and are better protected against burnout and prolonged emotional distress (Deci & Ryan, 2018).

When faced with illness––or even the possibly death––ask yourself: “Do I really want to do this, or am I doing it just to please my partner, children, parents, doctors, or society? By doing what truly brings me joy and meaning, what do I have to lose?” Altruism is valuable and an important part of maintaining health. At the same time boundaries and assertiveness are essential.

Psychologist Lawrence LeShan (1994) reported that when cancer patients began to seek and start singing their “own song,” their cancer regressed in numerous cases, and some experienced total remission. Living your own song means doing what you truly desire rather than following the expectations of parents, society, or economic pressures. It is important to keep in mind that while psychological factors can influence overall health, the development of cancer is a multifaceted process involving genetic, lifestyle and environmental factors.

The Key Question: When and How to Say “No”?

The answer lies in emotional awareness and acting on it. One woman with cancer confided, “I’ve operated in the realm of expected behavior for so long that I no longer know what I want or feel” (Stockdale, 2009). Teasing out our true feelings—hour by hour, as Bernie Siegel, M.D., recommends—helps us recognize where we stand (Siegel, 1986; Siegel & August, 2004). This practice fosters a sense of agency, a cornerstone of resilience that directly contributes to well-being.

For those accustomed to prioritizing others’ needs over their own, learning to say “No” takes practice. Although one may have feelings of vulnerability and even guilt by disappointing someone, one person shared that only after he stopped exclusively prioritizing others–and instead learned to love himself as well as his neighbor–did he realize how much people genuinely cared for him. Authentic connection is essential for well-being, but trust cannot develop without agency and the freedom to say “no.”

What to Do Before Automatically Saying Yes

When someone asks you for help or a favor, pause. Look up, take a slow, diaphragmatic breath, and ask yourself, “Do I want to do this? What would I recommend to another person to do in this situation?”(In cases where you are asked or ordered to harm another person or do something illegally, ask yourself, “What would a moral person do?”)

If you feel that you would rather not—whether because you are tired or it interferes with your own priorities—say “No.” Saying “No” does not mean you are unwilling to help; it simply means that, at this moment, you are listening to yourself. When we listen to ourselves and act accordingly, we enhance our immune competence and self-healing.

Obviously, if saying “No” would put another person in danger or in crisis, then say “Yes,” if possible. However, true crises are rare. If emergencies happen frequently, they are not true crises or emergencies but rather a result of poor planning.

Saying “No” can be challenging, but if you constantly say “Yes,” you may eventually become resentful and exhausted, increasing your stress and decreasing your ability to heal. You may even notice that when your own well-being is appropriately prioritized you will be in a better position to show up for others in a whole-hearted way, when it is right for them and for you.

Saying “No” Can Be Life-Saving

Beyond personal relationships, saying “No” can be crucial in medical settings. Anthony Kaveh, M.D., a Stanford- and Harvard-trained anesthesiologist and integrative medicine specialist, asserts, “Nice patients come out last” (Kaveh, 2024). Kaveh emphasizes that trusting our instincts is crucial, as the fear of displeasing others can lead to dangerous “fake nice” behavior.See the YouTube video #1 Mistake You Make with Doctors: Medical Secrets (https://www.youtube.com/watch?v=9-E3CHHX05c)

A case example is illustrated by Tracy who was hospitalized with complex fractures of the tibia and fibula. After five surgeries, she felt something was terribly wrong–she knew she was dying. However, the nurses dismissed her concerns. Taking control, she infuriated the staff by calling 911, which prompted a doctor to check on her. It was discovered that excessive negative pressure applied to the drain caused five pints of her blood to flow into her leg causing compartment syndrome.

She was bleeding to death. Tracy’s intuition, resilience, and refusal to comply saved her life. Kaveh argues that those who don’t trust their instincts are more likely to err on the side of “nice” and suffer as a result. Learning to say “No” is empowering as illustrated by one woman who discovered its importance in a cancer educational group she attended. She shared her success in saying “No” with humor, explaining, “I just tell people it’s this group’s fault because I used to be a nice person.”

Learning to listen to yourself before agreeing or disagreeing to do something, may also help you maintain your integrity when faced with pressure to follow an immoral suggestion or order. So often due to social, economic, corporate, or political pressure, people may be asked to do something they later regret (Sah, 2025). The courage to disagree and act according to your moral consciousness is the bases of the Nuremberg Code, established by the American judges in 1947 at the Nuremberg trials for Nazi doctors (Shuster, 1997).

Finally, learning to say “No” and listen to your needs takes practice and time. Explore the following Body Dialogue technique to tap into your intuitive wisdom. You can use it anytime you need clarity about your feelings and responses to life’s challenges.

Body Dialogue (adapted from You Can Beat the Odds: Surprising Factors Behind Chronic Illness & Cancer—the 6-week Program for Optimal Immunity by Brenda Stockdale (2009).

Breathe in deeply and engage all your senses. When you are ready, focus on the sensation of breathing. You don’t have to make anything happen, just feel the air moving in and out. Your lungs, vital to energy production, obtain oxygen from the atmosphere and bring it to millions of specialized cells. All without your conscious awareness, your breath moves in and out, removing toxins and waste from your body and bringing oxygen in.

The beautiful filtering process even protects your heart. That great organ, pumping rhythmically, picks up the oxygen and delivers it to all the vessels of your body, contracting more than two billion times during a normal lifespan. With deep appreciation for this magnificent pump, move your attention down into your abdomen. On the right side is the largest organ in your body, your liver. This amazing organ filters toxins and chemicals, and aids in digestion. This powerhouse of function can even regenerate itself after losing as much as three quarters of its tissue. With a sense of admiration, imagine all that these great and vital organs accomplish. With gratitude, slowly move on to your spleen, your pancreas and all the other organs and systems of your body, taking your time to appreciate and acknowledge all that they do for you.

Consider the multitude of vital functions that take place every minute of every day and thank your body for all that is right with you. All of these complex functions take place without effort or even awareness on your behalf––they just happen. Ask now if there something you can do for your body to help it heal, repair or regenerate more completely. Listen closely to your own intuitive awareness. Is there anything you can do to make your body’s job easier or reduce a burden of some kind? Gently notice if there are any thoughts or behaviors that make some symptoms worse or better. What feels heavy or burdensome? Who or what in your life feels supportive? As you review the past few days or weeks what would you like to adjust? When might saying ‘no’ would bring a sense of relief? Imagine what it would be like to operate in your own best interest. What might that include?

Are there positive feelings you would like to experience more often? If you had to choose just one, what would it be? In what way could you bring more of that quality into your life? In your mind’s eye, see that happening now. Feel the peace or the joy or whatever it is you have chosen radiate throughout your being. And if it seems good to you, carry it with you, back to the present moment and enjoy the fullness of that sensation. When it seems right to you, again focus gently on your body, bringing your attention back to the chair or the place you happen to be. And filled with gratitude, stretch your arms wide with appreciation for all that is right with you.