How To Say No

Oct 03, 2022

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For a variety of reasons, we say yes more often than we should. This triggers excess stress and stifles honest communication. But what if saying yes is actually the poorer choice? The truth is, we cannot excel at everything. So knowing how and when to say no is not only personally healthy but it can actually be the kindest answer we can give.

Intellectually understanding the value of saying no is much easier than the actual execution of it. Faced with a request, in the moment, it can be hard to not just say yes. That’s why I wanted to share several helpful insights, exercises, and ways to reframe both your answer, and your thinking, around how to say no.

“I feel like being honest in my yeses and nos allows me to be more kind. It might not always be perceived as nice but it’s kind in that it’s honest... I like the question of: What if love, what if acting out of love, might look like a yes and a no?”  – Dr. Sara Dill

What You’ll Learn 

  • Honest communication
  • Reasons we say yes
  • Identifying worries
  • Practicing saying no
  • Gently framing your no

Contact Info and Recommended Resources


A Mind at Home with Itself: How Asking Four Questions Can Free Your Mind, Open Your Heart and Turn Your World Around by Byron Katie

Podcast Episodes:

Connect with Sara Dill, MD, The Doctor’s Coach


Dr. Sara Dill: I’m Dr. Sara Dill, and this is the Stress-Less Physician podcast, Episode Number 34. Welcome to the Stress-Less Physician podcast, I’m your host, Dr. Sara Dill, MD. Using my unique combination of coaching and mindfulness tools, I will teach you practical ways to reduce your stress level, feel happier at work and create a better balance between your medical career and personal life. If you are a busy practicing physician who wants to design a life and medical career that feel good to you, you are in the right place.

Hey, everyone, welcome back to the podcast. Happy Monday or happy whatever day you might be listening to this. I actually just got back from vacation. And this is a re-recording of this episode, I actually recorded it before I left and I did it on the wrong microphone. And so it’s going to be better than ever. That’s what I’ve decided.

But I had an amazing vacation, I went to Turkey and I went to Greece, and I’m home now. It was quite a voyage back lots of unexpected delays with missed connections, rerouting, an emergency diversion to London, stayed overnight there. But I did get the opportunity to do a little unexpected side trip for an hour to Windsor. So that was super interesting. And I’d never been. It was right after the Queen’s funeral and internment there, and so that was sort of silver lining. And now I’m home and all is well. So anyway, it’s fun to be back. And I can’t wait to share this episode with you, take two.

So today I wanted to talk about something that I really do think that if you get better at it, or when you get better at it, it is a skill that does actually significantly reduce a lot of the stress you might be experiencing, especially stress related to trying to get people to stop asking you to do things, and especially stress related to perhaps having an overly busy calendar, or perhaps too many commitments that you don’t want to be fulfilling or saying yes to in the future.

So, I wanted to talk today about how to get better at saying no. And what it looks like to basically be more honest in your communication, not only with others, but also with yourself. Because honest communication really has to start with communicating with yourself honestly, right? So, the first place to even check in with yourself is by asking, are you someone who knows what you want? Are you someone who knows what you want to say yes to and no to? Or do you sometimes find that you just say yes out of habit? Or perhaps because you think that’s what people do? Or you say yes because you’re very uncomfortable saying no? Or perhaps you’re used to taking your cues from other people, or deciding whether you’re going to say yes or no based on whether you care about the other person or love the other person, rather than based on what it is that you truly want to do what you truly want to say yes or no to.

I will say that this is something I have apparently gotten much better at. I had a conversation with a friend—I think this was actually quite some time ago, maybe a year or two ago. And this friend asked, he seems sort of uncomfortable, he asked if he could share something with me that you know, he wasn’t sure if I was going to be upset about but he basically told me that, you know, he liked to ask me to do stuff and he liked to do things with me. But that he found that I was very difficult to plan on doing things with because I only said yes to what I wanted to do. That was his point of contention.

And I 100% agreed with him. I said, “Yes, I do. If I don’t want to do something, I don’t say yes.” I might offer a different way or some other options. But an example and actually I think this was the example is that he was asking me about going kayaking, which I love to do, but I only like to kayak when it’s not windy. And that goes double for stand-up paddling on the ocean. For anyone who’s done stand up paddling when it’s windy in my mind is not fun at all. The water’s choppy, it gets really difficult.

So, I love saying yes to kayaking and stand-up paddling early in the morning, when it’s not windy and the waters glassy. But this friend typically would ask me to go kayaking or stand-up paddling later in the day and it was often windy here, where we live. And so then it was a no—repetitively a no. And I actually really appreciated him sharing that with me. And I agreed 100% with him that I do say yes when it’s a yes. And I often say no when it’s not something I want to do or something that I’m not available for. And I understood that maybe it was hard for him to hear, but I wasn’t going to change my mind on that. And I will say that I think the benefit of this is that when I say yes, someone knows that I really want to do it. And when I say no, they’re very clear that it’s a no, because I’m clear.

So again, this process of getting better at saying no of learning how to say no, really starts with your own communication with yourself. So, I would just have you ask yourself now, are you someone who’s pretty good at saying no? Or could you be better at it? And full disclosure here, this is something I’m still working on as well, of course, there are definitely people who might find it harder to say no to and it’s a practice. So, like with any practice, we are going for improvement, not perfection. I like to start with inquiry and curiosity, like asking myself, why is it so hard for me to be honest with this person and not with this other person? Curiosity is often the doorway through which we can get better at whatever it is we’re hoping to practice or improve upon.

So many of us say yes, for a lot of reasons that have nothing to do with whether we actually want to do what we are agreeing to. If we’re accepting a request or accommodating a request, however, I just want to offer that you can’t say yes to everything and excel at anything. This was a quote I came across somewhere, I don’t remember where I just wrote it down, but I love it. I’m going to repeat it: “You can’t say yes to everything and excel at anything.” We have to have some no’s. We probably have to have a lot of no’s. We have to have some prioritization, if we want to excel at anything, right? It can’t just be a yes for everyone. We simply don’t have enough time.

And that’s not coming from time scarcity, but from the actual fact of 24 hours in a day. And there are always going to be more things and opportunities and activities and options and work than we have time for. We can’t say yes to everything, even if we wanted to. And I think the truth is, most of us don’t want to say yes to everything. I think there are a lot of things that we would like to say no to. And we just don’t know how or we’re afraid to.

So, let’s start looking at where we are—and I mean myself here, too—and where you are saying yes. And perhaps where we would like to feel more comfortable and being able to say no. So, I just made a list of some of the reasons that I find that we tend to say yes, rather than no. These were reasons that I tend to say yes or my clients say yes, or just other people, it’s pretty easy to come up with. You could notice your own reasons, right, notice which of these sorts of resonate with you. Why do you say yes, instead of saying no, when you want to say no? What is your own personal list? So, I’d say one of the top ones probably the top reason we say yes, instead of no is people-pleasing, which basically is when we want people to think of us in a certain way. We want them to like us, or appreciate us or approve of us or think we’re a nice person. So often we say yes, when in fact we might prefer to say no.

We often say yes rather than no, because we have this fear of missing out on opportunities, or experiences, right? So that’s a whole thought pattern. This fear of missing out is actually just a thought that we have. But you might want to notice if this is something that you struggle with, is this fear of missing out, this thought that you have keeping you overly busy, overly committed? Are you actually missing out on things like downtime, or time with loved ones? Or maybe sleep or exercise because of this habit of worrying about missing out on opportunities or experiences? Is this something you need to investigate or notice a little bit more?

We often say yes rather than no because we don’t want to hurt other people’s feelings. I know on this podcast I talk a lot about how our feelings come from our own thoughts, not other people’s behaviors or words. And yet, other people don’t necessarily do this work, and will tell you, like my friend did, that when I say no, it hurts his feelings, and he probably does experience disappointment, right? Sometimes when I ask someone to do something and they say no, I can be disappointed, because of what I’m thinking. And I can be hurt, because of what I’m thinking, and that’s fine. But I can take responsibility for my feelings.

But other people, they might get hurt feelings. And sometimes we say yes, to avoid this. We often say yes, rather than no, because we are more comfortable, or used to putting other people’s objectives and needs above our own. I think this is especially common in physicians, and in healthcare professionals. Really, in anyone in a helping profession, or parents as well, right? We’re used to putting other people, their needs, their wants, their objectives above our own. And so we say yes, rather than no.

We may also say yes, rather than no, because we think saying no is mean or negative or hurtful. Again, thoughts to look at, beliefs to examine. Many of us are taught that being agreeable and saying yes, or being flexible or being pleasing, especially for women in our culture, or at least in my culture, is better or right or the preferred way to be, or the expected way. So, is this a cultural thing for you? Is this the familial thing for you? Maybe it’s both, maybe it’s neither.

And then, a lot of us also have these sort of default yeses or old yeses, right? These are things, something we said yes to before, maybe even a very long time ago, and we haven’t revisited we haven’t maybe reconsidered it. Like, in the podcast episode I did in which I talked about choosing again, or asked you to consider quitting everything, would you say yes, again, to this commitment, or obligation? Or whatever it is, or relationship? Would you choose this? Again, it might just be an outdated yes. Something you said yes to that now you realize you don’t really want to keep doing? You want to take it off your calendar or take it off your agenda, take it off your list of commitments. Just notice those yeses.

A lot of what I hear is often that when we’re not very good, or not very comfortable with saying no, is that what we often want is just to try to have other people not ask us for things. We try to blame other people and maybe even tried to set boundaries of having other people not ask us to do things. But in reality, other people have the right to ask us for what they want. We can’t control other people, both at work and in our personal life.

So, this might look like patients, right? They can ask us to prescribe medications, or maybe to overbook ourselves to accommodate them or family members, or their schedule. Colleagues can ask us to cover for them or to help on a project or teach a course. And then it’s up to us to say yes, or to say no. We get to say yes or no. There may be consequences again, someone could be upset. Maybe it’s an obligation that other people expect you to fulfil. Someone might not want to cover your call if you’re used to trading, and we still get to say yes or no.

And that’s because no one can manipulate us or force us to do anything, unless we allow it. Usually, again, because we’re wanting something from them like their approval, or they’re liking us or their appreciation. So it’s just good to notice that. And again, sometimes we say yes, because we are keeping score, and maybe we won’t pay back eventually for call or coverage. Right Is that sort of a trade-off that you go through in your mind? But notice if what you really want is for people to stop asking you so that you don’t have to say yes or no, that’s usually a sign that you need to get better at saying yes and no. So, people get to ask us things, and then we get to respond.

So, where I would start with this, getting better at saying no, is this: I just want you to start by checking in before you answer people. So you could do this exercise too, that I’m going to describe. You can do it now or you can do it some other time. So this exercise is I just want you to imagine saying no, anytime you’re all on the fence about a request. So if you’re a little bit torn, or you’re like, “maybe. I don’t know what I want to do,” okay, I want you to imagine that your default becomes no.

So if your default was no, what are you worried will happen if you did that? If you just said no, I just want you to imagine some scenarios, with patients, with colleagues, with family with friends, and then write those things down, write down what you’re worried will happen. Are you worried you’re going to feel guilty? Are you worried that someone’s going to get mad or be disappointed in you? Or that you’re going to miss out on things? Are you worried that you’re going to get a negative review or that a patient’s going to be upset? A lot of the reasons I went through above too, might be your reasons.

This list of things that you’re worried will happen if you say no, this list that you’re going to write down, are the thoughts and beliefs for you to start to question, for you to notice and then to question whether they’re true, whether they’re useful, whether they’re serving you, or maybe are they outdated? Because of these are the reasons that you might be saying yes, rather than saying no, when no is more honest for you.

Another way to work with this is to ask yourself, if you knew that either answer, either yes or no, was actually totally okay. Or maybe even better than okay. Which would you say? If you sort of took those worries off the table of the repercussions? If you knew that everything was going to be fine? You were going to have an amazing life and career, your relationship with this person would be fine as it is, what would you say? This is a way to at least start to tap into what you would prefer to say, right? To be honest with yourself.

You can ask yourself as well, if you had only yourself to please, what would you say? You can ask yourself too, what you will have to say no to if you say yes to this request. I like to remind myself that every yes is a no to something else. Every yes I say is a no to some other thing or other requests or other person, or even to myself. So, is this a yes that I’m really excited about? Or is this something that I’d really rather say no to?

And can you just start to notice that maybe there’s a trade-off here? That might give you a little bit more impetus to get better at saying no. This practice of getting more honest with your yeses and your no’s, also requires that you know your own values, who and what do you want to say yes to. Being willing to say no to the unimportant things for you, frees you up to say yes to what you value and care about and to say yes to what is meaningful and important, and maybe fun for you.

So, when your family makes requests of you, that might be a yes all the time or it might not be; it might be hit or miss. But you can just start to notice if you were living out your values, what do you want to say yes to? Do you need to say no to other things that you were available for living out your own values and in your own integrity? If I looked at your calendar, if I looked at your schedule, would I know what you value? Is it apparent? Are you living in congruence there?

And so I want to encourage you hear just to start to play around with practicing saying no. Maybe practicing yes, just practicing pausing, getting familiar with your own sort of habitual, or maybe more instant responses. Because there are so many ways to say no, while still appreciating the invitation. There are ways to say no without disconnecting from the other person.

And this is something I learned actually from someone in Byron Katie, that often if you’re going to say, no, you can use the word’ and’ rather than the word ‘but’ to create or maintain connection, even while saying no, even while declining. And that’s the idea that say no doesn’t have to be negative or mean or hurtful. It might be perceived that way by the other person, we can’t control that. But just notice the difference when you say no using ‘and’, versus ‘but.’

So, an example of this might be if someone asks you for something, you could say “thank you for asking and no,” rather than saying “thanks for asking, but I can’t do it.” “I hear you I understand things and no.” You might say “I don’t know yet and please ask me later.” You can maybe see or hear where if you put the but in there, the word “but” or just make it a hard no, which is always legitimate, of course, right? You can just say no.

I think Oprah was the one that said or popularized the idea that no is a complete sentence. But sometimes that can be a little bit disconnecting. Sometimes that can feel a little bit confrontational or a little too abrupt. So, if that’s true for you, you can examine that too of course, but you may want to try softening your no. Can you appreciate being asked or invited? If so, if that’s genuine, that might be a way to phrase your no. You could say I appreciate how important this is to you and no, I’m not able to do it. I hear what you’re saying and I’m not able to say yes right now.”

So, you can just start to notice, are these some ways that you might feel more comfortable saying no. I would encourage you very strongly not to give reasons, reasons then are just ways that people will then try to convince you to say yes. Can you practice saying no without explanation?” I hear you and no. Thanks for asking and no.” It can feel very uncomfortable. A lot of us are not used to doing that.

And so I will say you have to start practicing this or your default, which is probably yes, will kick in. So, I actually encourage clients a lot of the time to enlist their children, or their significant others or their spouses or friends to practice asking them for stuff, to make requests of you. And then your job is to say no in a variety of ways. You might want to practice saying no, or you might want to practice saying yes, you might be someone that’s already very comfortable at no. Do you need to practice saying yes more to receiving help and assistance, or contribution?

So, start by just practicing being aware, maybe just start by practicing a pause and then start practicing no’s and yeses. I also find it useful to start by asking for more time or information before you make a decision. So, this might look like saying “Thanks for asking, can I get back to you on this? When do you need to know by maybe Monday or Tuesday? Or I need some time to think about it.” Or you might say thanks for asking, “I need to get some more information first, before I can say yes or no, as I’d like to make sure I have time to take on this commitment.”

That’s something I say a lot when I’m being asked about a new project for consulting or some other work project. And then maybe you want to ask follow up questions like what’s the time commitment? When’s the deadline? When do you need this completed by? What are the resources I’ll have? All of that. Just getting the information that you need to make an educated decision, because sometimes you might need more information, and it will slow the process down so you aren’t just in the auto responder of saying yes, by default. And sometimes you might just want to start by deciding to tell yourself the truth, even if you choose not to be entirely honest with someone else. An example of that might be saying yes to cover in a colleague because you want to ask them in the future to cover for you.

So that’s probably a yes, but it may not be a yes that has a beautiful reason. But start by telling yourself “I want to say yes to this, even though part of me maybe doesn’t want to do this, because I’d like to have the possibility of trading in the future.” Or this might sound like telling yourself, “I’m going to say yes right now, because I want to keep the peace with this family member,” rather than be fully honest in decline right now. So, you might not have the bandwidth or the energy or the time to deal with some of the consequences or repercussions in the moment.

And that could be a good place to start if that’s true for you. You could just notice that right now you might be valuing peace over full honesty. And it doesn’t mean you have to be excruciatingly honest, and go into all the details. That’s why I would encourage you just to say “thanks for asking, and no, I understand, I appreciate the invitation and no.” And again, you can just notice how uncomfortable it might be just to say that, and then not go into discussions or reasons or justifications. That’s the energy of trying to convince the other person to understand, versus just understanding yourself. And if they ask for reasons and you feel like sharing with them, you certainly can but initially, I would just encourage you to get comfortable with not offering your reasons. Just practice a clean yes or no.

I want to close with a quote again from Byron Katie. This is from her book, A Mind at Home With Itself. And she’s someone I’ve talked about a lot. She’s someone I really learned a lot from, both from reading her works and from working with her in person several times. So, she says and I love this quote, “Every no I say is a yes to myself. It feels right to me. People don’t have to guess what I want or don’t want and I don’t need to pretend. When you’re honest about your yeses and no’s. It’s easy to live a kind life. People come and go in my life when I tell the truth and they would come and go if I didn’t tell the truth. I have nothing to gain one way and everything to gain the other way. I don’t leave myself guessing or guilty.”

And I found that to be my experience as well. I feel like being honest in my yeses and no’s allows me to be more kind. It might not always be perceived as nice, but it’s kind, in that, it’s honest. It’s where I’m coming from and it lets other people then go and ask other people who might actually really want to do whatever it is they’re being asked. People get to ask for what they want and then we get to say yes or no. And like, the question of what if love, what if acting out of love might look like a yes and a no.

So, you can see, I really love this topic, I ove, love, love it. I would encourage you to practice this. Start now. Successful people say no a lot, a lot. It’s very interesting. If you read any business literature or anything like that, the busier and more successful people are, the more they have to say no, especially to honor the commitments that they do say yes to, and to honor the people and other projects, perhaps in their life. So, you can see this as a skill set, the better you get at it, the more in alignment your life will be. And often, the more you can excel and produce whatever it is you want to produce. If there’s some way that you want to make a contribution, or leave a legacy or whatever it is, you want to create or experience in your life, all of that is going to require that you get better and more honest with your yeses and your no’s.

So please reach out if you have any questions. Or if you want help with this. This is something I work with my clients on all the time. And again, this is something I’m still working on for myself. There’s always a little bit more work to do. And for myself, I just like to notice like, “Oh, did I sort of say that to in some way people-please? Or to be less confrontational or anything like that?” I just like to be curious. So always good to notice, always a little more work to do. That’s what I find fun. So again, email me [email protected] anytime, and otherwise, I will talk to you next week.

If you are a busy practicing physician, ready to start feeling less stressed, enjoy work more and learn how to create a more balanced and sustainable medical practice and life, sign up for a consult call with me at, that’s It would be my privilege and pleasure to work with you.

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