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Behavior:
Client logged into the virtual session appearing frustrated and reported feeling resentment toward people she cares about. Client stated, "I just say yes to everything, and then I'm angry about it later." Client discussed a pattern of people-pleasing in her close relationships, describing how she agrees to things she does not want to do, prioritizes others' needs over her own, and ends up feeling used and exhausted. Client noted this pattern has been negatively impacting her friendships and relationship with her partner, as the built-up resentment leads to snapping over minor issues.
Intervention:
The session lasted 60 minutes and was conducted virtually. Therapist introduced DEAR MAN, a DBT interpersonal effectiveness skill, and broke it down into its components. Therapist and client practiced applying the skill to a real-life situation where the client’s friend frequently asks her to babysit last minute, causing stress. Role-playing was utilized to help the client practice naming the pattern, asserting her needs, and maintaining confident tone and body language. Therapist also guided the client in preparing for potential pushback from her friend and strategies to stay mindful and avoid caving to discomfort.
Response:
Client engaged actively in the session and acknowledged the connection between her people-pleasing behaviors and her feelings of resentment. Client initially found the role-play awkward but showed improvement in her tone and body language with practice. Client expressed willingness to apply the DEAR MAN skill in a real-life context and appeared motivated to work on setting boundaries.
Plan:
Client was assigned homework to have a conversation with her friend using the DEAR MAN skill, write down how it goes, and reflect on how she felt during and after the interaction. The next session will include debriefing this experience and continuing to build boundary-setting skills. Treatment will focus on further developing interpersonal effectiveness and addressing the underlying fear of conflict or rejection.
We had a 60-minute virtual session today. Maya logged in looking frustrated and said she's been feeling a lot of resentment toward people she cares about. She said quote 'I just say yes to everything, and then I'm angry about it later' unquote. She talked about how she has this pattern of people-pleasing in her close relationships, she'll agree to things she doesn't want to do, she'll put other people's needs first, and then she ends up feeling used and exhausted. She said it's been affecting her friendships and even her relationship with her partner, because the resentment builds up and then she snaps over small things.
We talked about how people-pleasing often comes from a fear of conflict or rejection, but it ends up creating more problems because the resentment doesn't just go away. I introduced DEAR MAN, the DBT interpersonal effectiveness skill. We broke it down, Describe the situation, Express your feelings, Assert what you need, Reinforce the positive outcome, stay Mindful, Appear confident, and Negotiate if needed. We practiced it together with a real situation she's been avoiding, her friend keeps asking her to babysit last minute, and she's been saying yes even though it stresses her out.
We role-played the conversation. She practiced naming the pattern and asking for more notice, explaining that way she could help without feeling overwhelmed. It felt awkward for her at first, but we worked on her tone and body language so she could appear confident even if she didn't feel it inside. We also talked through what might happen if her friend pushes back, and how she could stay mindful and not cave just to avoid discomfort. Her homework is to have that conversation this week using DEAR MAN, and to write down how it goes and how she felt. We'll debrief next session and keep building those boundary-setting skills.
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