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Data:
The session lasted 60 minutes and was conducted virtually. Client appeared frustrated and expressed feeling resentment toward people she cares about. Client stated, "I just say yes to everything, and then I'm angry about it later." Client described a pattern of people-pleasing in her close relationships, agreeing to things she does not want to do, prioritizing others' needs, and subsequently feeling used and exhausted. This pattern has been impacting her friendships and relationship with her partner, as resentment builds and leads to snapping over minor issues. The therapist introduced DEAR MAN, a DBT interpersonal effectiveness skill, and broke it down step by step. The client practiced applying DEAR MAN to a real-life situation involving a friend who frequently asks her to babysit last minute. Role-playing was used to rehearse naming the pattern, asking for more notice, and maintaining confidence in tone and body language. Potential responses to pushback were also discussed.
Assessment:
Client is gaining awareness of the negative impact of people-pleasing on her relationships and emotional well-being. She engaged actively in learning and practicing DEAR MAN, demonstrating initial discomfort but improving with guidance. Progress aligns with treatment goals of developing boundary-setting skills and reducing resentment in interpersonal relationships.
Plan:
Client is assigned homework to have the conversation with her friend using DEAR MAN, write down how it goes, and reflect on her feelings. The next session will include debriefing this experience and continuing to build boundary-setting skills. The treatment plan will focus on reinforcing interpersonal effectiveness and addressing challenges as they arise.
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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