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People pleasing can affect a person’s mental health. Sometimes the negative impact can be significant. It can also be a sign of an underlying condition that may benefit from treatment. For help decoding this common behavior, including what can cause it, who may be more prone to it, and its adverse effects, we reached out to Dr. Beau A. Nelson, DBH, LCSW, who is Chief Clinical Officer at FHE Health.
Dr. Nelson has decades of clinical experience helping people address people-pleasing behaviors that are negatively impacting their mental health and quality of life. In the below interview, he offered some eye-opening insights that may be valuable for anyone who has ever struggled to set healthy boundaries.
What Mental Illnesses Co-Occur with Being a People Pleaser?
“While people pleasing is not an actual mental health diagnosis,” Dr. Nelson said, “there are some conditions that tend to be associated with this kind of behavior,” including:
- avoidant personality disorder, characterized by anxiety, feelings of inadequacy, and hypersensitivity to rejection in social situations
- dependent personality disorder, involving feelings of helplessness or inadequacy about taking care of oneself
- anxiety
How People Pleasing Can Be a Response to Trauma
People pleasing can also be a trauma response that is sometimes called “fawning,” according to Dr. Nelson. Fawning is “a way to avoid a potentially distressing situation recalled from the past,” so as “to feel safe and mitigate any situation by people pleasing rather than being more assertive and or confrontational.”
How People Pleasing Can Cause Mental Health Issues
“Being a people pleaser can also lead to certain kinds of behaviors and feelings over time,” Dr. Nelson observed. He said that when people “stop taking care of themselves because they are more fearful of what will happen around others rather than concerned about what they themselves want,” that can take a toll on their mental health. How? “Most of the time you will see that people pleasers overextend themselves, are not able to pick up on cues for self-care, and are so focused on avoiding conflict with others that they may make choices that are not necessarily in their best interest.”
What Causes People Pleasing?
There can be many reasons for people pleasing. Dr. Nelson named some of the more common ones. Fear of conflict was at the top of this list: “Generally speaking, people pleasers do try to avoid conflict and would rather put their own needs after others’ needs, in order to maintain what they believe is a harmonious or conflict-free environment,” Dr. Nelson said.
Another common reason is “the desire to make others happy in order to receive validation or safety or avoid disruptions, difficulties, or uncomfortable situations.”
People-pleasing tendencies can also have their roots in childhood and a person’s family of origin. Those who struggle with saying “no” or setting boundaries may have had “difficulties in childhood with anger or needing to be approved of or may have learned that they can exist more easily with others by putting themselves second to other people’s wishes and desires.”
Of course, “being aware of others and of others’ needs is not necessarily a bad thing,” Dr. Nelson was quick to note. He went on to explain what makes people pleasing more insidious than that: “People pleasers often neglect themselves and do not recognize their own feelings and desires; in doing so, they put themselves at risk.”
Can People Pleasing Be a Toxic Behavior?
Not surprisingly, then, “over time, being a people pleaser could become a toxic behavior and could actually become a difficulty in relationships and relating to others.” Dr. Nelson elaborated further on the potentially toxic effects:
People pleasing can affect the self-care of the person who is pleasing others rather than focusing on their own needs. Eventually only taking care of others means that we are at risk of being in situations where we make decisions based on external variables and ignore our own self-care and self-determination. Because we have not learned to say “no” to others, over-extended ourselves on others’ behalf, or have neglected ourselves in the process, we may end up dealing with feelings of depression, anxiety, or other mental health symptoms that, for a chronic people pleaser, can seem unsolvable.
Don’t Be a People Pleaser – How to Stop People Pleasing
One common concern among those who want to reduce their people-pleasing behaviors is what will happen when they stop. For some people, this concern is enough of an obstacle to prevent healthy behavioral change in the direction of less people-pleasing, but it does not have to. Yes, there will be a “change in relationship dynamics” once someone who has engaged in people pleasing decides to stop, Dr. Nelson observed:
This means that if you’ve always been giving in to other people and you eventually set a boundary where you choose yourself first, others may not actually like that and may push back against it. The fact is healthy, appropriate boundaries are something that we need to be mindful of.
There remains the more practical question of how to stop people pleasing. Here Dr. Nelson suggested one important first step— namely, a change in perspective. It can begin with the recognition “that while others may not always approve or like what we make decisions about, very few of them are actually life or death situations.”
