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Last year, I noticed that I had become more fatigued and it was hard to find enough energy to look for another person to carry out a task that I (on reflection) should have been saying 鈥榥o鈥� to. Instead, I kept on saying 鈥榶es鈥�, albeit in an increasingly defeated tone. I found ways to fit people and projects into ever tighter spaces, and I felt compelled to say 鈥榶es鈥� to whatever it was that I was being asked. Internally, I鈥檇 hear my voice saying, 鈥楤ecause I can help, I should help鈥�. I justified this by telling myself that, 鈥楾he care-seeker probably wouldn鈥檛 find help anywhere else鈥�. I noticed that there were some people who were good at asking me for help or care, and how often I lacked the energy to resist their requests.

And then, having worked like this for a long time, I stopped and came face to face with my exhaustion, my workload and my work/life balance. I had to confront what I might be avoiding by carrying on being frenetically and frantically busy. Experiencing burnout, I discovered that maybe, unconsciously, I was avoiding being me, avoiding living my own life. Instead, I had somehow become my own tyrannical boss.听

A human cost听

Whether you have experienced burnout in your own working life as a practitioner or you鈥檝e heard your workplace clients recount similar experiences, I imagine that what I鈥檝e just described might sound familiar. According to a recent study by Deloitte, poor mental health is costing UK employers 拢51 billion a year, and 63% of respondents are experiencing at least one characteristic of burnout.^1听

In all the organisations I work with, and at the University of Leeds, where I work as a senior staff counsellor with my manager, Dr Sally Rose, we were seeing increasing numbers of clients presenting with burnout, feeling overwhelmed by their wide job remits, and reporting attending meetings but not being able to ever do any of the work generated by those meetings, unless after work or at the weekend. Clients spoke of the increasing demand that they be present and productive at work, while job vacancies remained vacant, leaving additional work for depleted and overstretched teams. Some frontline roles found themselves dealing with yet more crisis and complex needs, and a pressure to keep trying to do more with less. We saw clients straining under the load of their work and life burdens, feeling unable to say 鈥榥o鈥�, or not daring to say 鈥榥o鈥�. We also heard of managers who say, 鈥業t鈥檚 fine to say 鈥渘o鈥濃�� and then when staff did so, they experienced disapproval or even open hostility.听

As an organisational response, we designed a workshop for staff to help those people feeling overwhelmed by their responsibilities and obligations, at work and at home, which left them feeling unable to simply say, 鈥榥o鈥�. However, at the same time that we were rolling out the training to staff, in a parallel world, I too was feeling overwhelmed and struggling to say 鈥榥o鈥� at work.听

This article draws together both the theory and my lived experience which helped inform the workshop and the talk that I gave at the Health and Wellbeing at Work Conference earlier this year at the NEC, Birmingham. I hope it will be helpful to practitioners working with their clients to support them to say 鈥榥o鈥� at work and that it can also be usefully applied in their own lives, personally and professionally.听

Why don鈥檛 we say 鈥榥o鈥�?听

To answer this question, I think we need to go back to the beginning. I鈥檓 co-author of To Be Met as a Person at Work 鈥� a book that explores the effect of early attachment experiences on our work relationships. Those of us who fear saying 鈥榥o鈥�, worry that doing so will lead to us not being professionally needed or 鈥榲alued鈥� anymore. Therefore, our resistance or inability to say 鈥榥o鈥� could be directly linked to our need to seek approval from others.^2听

51bn: According to a recent study by Deloitte, poor mental health is costing UK employers 拢51 billion a year¹

63% of respondents are experiencing at least one characteristic of burnout¹

Of course, this will be different for everyone and depend upon the individual conditions in our early significant attachments. In my case, I understand that when a person seeks my care or support, or when I identify a need in another person, my attachment system is aroused and conscious, and unconscious patterns and processes fire into action. My overactive or defensive caregiving system may inhibit my confidence or competence to say 鈥榥o鈥�, and my fear system may bring to the fore failed social interactions or previous occasions when I said 鈥榥o鈥�, which might not support me to say 鈥榥o鈥� this time. I know this because I鈥檝e spent years researching this and yet, I continued to struggle to say 鈥榥o鈥� as the demands on me stacked up.听

It鈥檚 back to attachment听

As therapists, we might ask our clients how their early attachment experiences may affect the way they seek care or give care to others. We may explore whether, as children, they responded to ambivalent, frightened or absent parents. Were there family rules around compliance, for example, always saying 鈥榶es鈥�, or avoiding conflict by not saying 鈥榥o鈥�? Other clients may come from a culture of 鈥榩ut up鈥� and 鈥榮hut up鈥�. We might ask if the client experienced overburdened parents, and if so, it might be hard for the client to say 鈥榥o鈥� because there hasn鈥檛 been any modelling of how to say 鈥榥o鈥� 鈥� or knowing what it feels like to be overburdened. Neurodivergence may also be a factor to be aware of, and therapists may need to consider whether the client has neurological, cognitive, or biological states that affect how rules or behaviour are learnt and enacted.听

Saying 鈥榥o鈥� in a culture of 鈥榶es鈥櫶�

Beyond the culture of our workplaces, we live in a world of instant responses and this could play a part in why we are so predisposed to say 鈥榶es鈥�. Social media, WhatsApp, Facetime and Instant Messenger lure us with instant gratification, and our patience to wait for anything seems to have been eroded with the ability to access so much 鈥榦n demand鈥�.听

The rise of zero-hours contracts can create pressure on workers to be present and visible to those who are offering the work, whether they want it or not. Is this just another form of people pleasing in order to keep the working coming in? And there are gender implications too, as social narratives refer to women as being 鈥榤ultitaskers鈥� and men as 鈥榩roblem-solvers鈥�. To what extent does being a professional caregiver play out in our workload as we feel the burden of wanting to help others?听

51bn According to a recent study by Deloitte, poor mental health is costing UK employers 拢51 billion a year¹

Arguably, the weight of expectation facing us at work is a new kind of epidemic. Adaptation: enough already is a new play written by the playwright, Samantha Graham of Vegas Nerve Productions, which explores exactly this. According to Graham, women account for around 80% of autoimmune disease sufferers, and her play shines a spotlight on how the business world鈥檚 excessive expectations of women are causing disproportionate, epidemic levels of ill health.^3听

63% of respondents are experiencing at least one characteristic of burnout^1听

So, I鈥檓 aware that whenever I speak on the topic of saying 鈥榥o鈥�, it鈥檚 as relevant to me as it is to the people I鈥檓 speaking to. However much I might wish that knowing the theory means that I鈥檝e become an expert on living a boundaried, uncomplicated life, that鈥檚 simply not the case. I can still recall how my supervisor sagely invited me to look at my own predicament and ask myself the question, 鈥榃hen you are overwhelmed, what can you do less of?鈥� I found this simply insightful. Therefore, I suggest that we need to reframe saying 鈥榥o鈥�, not as a failure, a lack of strength or as a passive act, and instead reframe it as a choice where we are actively saying 鈥榶es鈥� to something else.听

Asking different questions听

In my research, I started to ask myself, 鈥榃hat do I/we get from not saying 'no'?鈥� We know that just taking a moment to consider whether we want to say 鈥榥o鈥� gives us agency, and checking in with our health, our values and our priorities, we might be able to really see what exactly is being asked of us and ask ourselves, 鈥業s it my role?鈥�, 鈥楧o I have capacity to say 鈥測es鈥�?鈥� or, 鈥楥ould this be a learning opportunity for someone else?鈥櫶�

Learning to say 鈥榥o鈥� to something and 鈥榶es鈥� to something else, presents opportunities, such as doing something restorative in the time it would have taken. I needed to unhook my neurological tick and the fear听I have of letting others down but I鈥檓 not the only one. I鈥檝e wondered how our society has managed to sleepwalk into a way of working and living which is so unsustainable.

By this, I mean the slow displacement of corporate or service administration which goes on in our lives 鈥� just think about how much work you have to do to get insurance, open a bank account or purchase your goods from a supermarket. We do the research, add in all the numbers, the statistics and we even scan our own goods. Somehow, we have been saying 鈥榶es鈥� to extra admin for years!听

Helping clients to say 鈥榥o鈥櫶�

To be able to say 鈥榥o鈥� with competence, we need a good understanding of our psychological development and our ability to self-regulate. With clients, I explore how social conditioning is at play and I encourage them to notice what saying 鈥榥o鈥� arouses for them. Our role as counsellors and psychotherapists is to provide a safe enough space where our clients can practise saying 鈥榥o鈥�, feeling the words in their bodies and developing some new muscle memory.听

Working with clients, I frequently use the Workable Ranges Model (WRM),⁴ devised by Dr Sally Rose, to draw out embodied knowing, and help map the client鈥檚 experience and conditions of being regulated or unregulated. The green zone is when we are regulated 鈥� where we feel competent, resourced and sufficiently energised. It is where we are most likely to make an informed 鈥榶es鈥� or 鈥榥o鈥�. In the green zone, our social attachment systems are supporting our wellbeing and our sense of satisfaction in the tasks.听

Outside of this regulated state, we can experience dysregulation up to a hyper-aroused state in the red zone 鈥� where we can feel strained, agitated, frantic and frightened, where our self-defence is unsupportive and inner talk is critical. This is a place where a 鈥榶es鈥� is likely to be rushed or a 鈥榥o鈥� can be compromised.听

The hypo-aroused state is the blue zone, where it is more likely to be typified by retreat or exhaustion, freeze and low mood, and this is also a place where an exhausted 鈥榶es鈥� or a compromised 鈥榥o鈥� can exist.听

I use this model to encourage clients to consider the best state they might need to be in to say 鈥榥o鈥�. It gives them a framework to assess their state and preparedness for saying 鈥榶es鈥� or 鈥榥o鈥�. This model also helps explore what conditions we might need to address in order to move from a dysregulated to a regulated state.听

This is not unusual work with our clients, is it? We know it can be normal to struggle with听self-confidence, boundaries and seeking good care or support. And we know it can be dangerous when we overcommit, leading to burnout, if we are relying on external validating affirmation from others which might not ever come our way. This is so often at the core of what we do as workplace therapists with our organisational clients.

Questions for reflection听

A safe environment can help us to be curious and experimental, and provide the best conditions for learning how to say a healthy 鈥榥o鈥� or an appropriate 鈥榶es鈥�. You may find these questions helpful to explore with clients or for your own personal development:听

• Did you have caregivers, mentors or influencers who were good at saying 鈥榥o鈥� or setting limits?
• What were your early experiences of your caregivers setting boundaries or saying 鈥榥o鈥�?
• Do you find yourself saying 鈥榶es鈥� because you just don鈥檛 have the energy to say 鈥榥o鈥�?
• Could not saying 鈥榥o鈥� be a sign of danger, ill health, despair or care-seeking?
• Could the client use the Workable Ranges Model⁴ to map the times they say 鈥榶es鈥� hastily when they might otherwise say 鈥榥o鈥�? Can they analyse the conditions they are under at these times? And use that knowledge as insight to try it differently another time?
• How can the client tune into these signs and signals, and learn to do something different?
• Can you, as the therapist, provide a place for the client to practise the competence of saying 鈥榥o鈥� to you?
• How might you explore this work in supervision? Might you be aware of any parallel experience or barriers to saying 鈥榥o鈥� in your clinical work?听

If you are looking for further reading, Psychology Today has an excellent blog on the power of saying 鈥榥o鈥� and the key message is that, 鈥楽aying 鈥渘o鈥� can create more mental health stability by helping with self-care, and听build your self-esteem and confidence by setting boundaries.鈥�⁵ Saying 鈥榥o鈥� means you are actively saying 鈥榶es鈥� to something else, and this is a handy mantra to call on when you need it.

Doing things differently听

Of course, as practitioners, we know that change and competence come through practice, research, experimentation, exploration and discovery. Putting in the time to rehearse saying 鈥榥o鈥�, testing it out and getting support, are all incredibly helpful. It鈥檚 a learnt skill, and we need to build up muscle memory and new neurological pathways to develop our competence.听

In our work at the University of Leeds to support staff with their boundaries, we compiled some of our favourite ways of saying 鈥榥o鈥� below. The website is an excellent source.

Ways to say 鈥榥o鈥櫶�

• 鈥楾hank you for asking me to X, Y or Z. Under different circumstances, I would like to be able to help you, however鈥︹��
• 鈥業鈥檓 sorry, I know this will be disappointing鈥︹��
• 鈥極n this occasion, the answer is 鈥渘o鈥濃��
• 鈥楴o, I can鈥檛 do that鈥�
• 鈥楴o, that鈥檚 not possible because鈥︹��
• 鈥業 think this is too important to say 鈥測es鈥� to without thinking this through鈥︹��
• 鈥業 can see you really want to me to say 鈥測es鈥� and I hate disappointing you, it doesn鈥檛 mean I don鈥檛 care about you or this project鈥︹��
• 鈥楳y bandwidth is low, so I won鈥檛 be able to make it work this time鈥�.听

Closing thoughts听

Saying 鈥榥o鈥� is not a negative act. Saying 鈥榥o鈥� changes our world and can, in fact, change the world. If you think about it, all great acts of compassion start with an individual act. In order to take action, we need to get to know what might be stopping us, immobilising us, or even frightening us.听

When we say 鈥榥o鈥�, society changes. We鈥檝e said 鈥榥o鈥� to slavery, to putting children up chimneys, driving without a seat belt, smoking in certain places, and started to say 鈥榥o鈥� to things that cause environmental damage. You will be able to think of many more, but saying 鈥榥o鈥� begins with compassion.听

When I learnt to say 鈥榥o鈥�, it led me to taking a wonderful pottery course. It took me away from the tyranny of tasks and instead to experience being me, feeling free and creative. When you say 鈥榥o鈥�, where might it lead you? When your clients say 鈥榥o鈥�, where might it lead them? Good luck.听