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Subjective:
Client attended a 60-minute virtual session and appeared frustrated. Client reported feeling resentment toward people she cares about, stating, "I just say yes to everything, and then I'm angry about it later." Client discussed a pattern of people-pleasing in her relationships, describing how she prioritizes others' needs over her own, which leads to feelings of being used and exhausted. She noted this has been impacting her friendships and relationship with her partner, as resentment builds and causes her to snap over minor issues.
Objective:
The session lasted 60 minutes and was conducted virtually. Client presented as frustrated and engaged in the session. Therapist introduced DEAR MAN, a DBT interpersonal effectiveness skill, and guided the client in breaking down its components. Role-playing was used to practice applying the skill to a real-life situation involving a friend who frequently asks her to babysit last minute. Therapist provided feedback on tone and body language to help the client appear confident.
Assessment:
Client is gaining insight into the impact of her people-pleasing behaviors on her relationships and emotional well-being. She engaged actively in practicing DEAR MAN and demonstrated progress in identifying and addressing her pattern of avoiding conflict. Client initially found the role-play awkward but showed improvement in tone and confidence with practice. Continued work on boundary-setting skills aligns with her treatment goals.
Plan:
Client is assigned homework to have a conversation with her friend using DEAR MAN and to document how it goes and how she feels. Therapist and client will debrief on this exercise in the next session and continue building boundary-setting skills. The next session will focus on refining interpersonal effectiveness strategies and addressing any challenges that 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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