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Counselor's corner: Saying no without guilt

Oct. 15, 2019
For many of us, saying no is not easy. As a result, our lives become cluttered with with things that make us unhappy. In this month's Counselor's Corner, Kandice Swarthout, RDH, LPC, explains our fear of saying no and how to overcome it.

A recent conversation with a friend sent me on an introspective questioning of my personal responsibility for saying yes to activities that do not fit into my long-term goals. This well-intentioned friend reminded me that a colleague had taken on a very daunting project during a difficult personal time in her life. She followed it up with, “Since she took this on, there is really no excuse to say no and not be involved.”

I sat in guilt about this for an hour. Guilt that I was not doing enough and leaving people in need for a leader. Guilt that the world of dental hygiene might implode if I did not step up in that moment. I felt guilty that this acquaintance had toed the line even with something so heavy on her back. I felt compassion for my colleague and realized how hard the last year must have been for her. On my drive home it hit me: is it really my responsibility to take things on because someone else made a choice for themselves? Why was I feeling such guilt for my saying no?

As I further pondered this dilemma, my counselor brain reminded me that perhaps the guilt I was feeling stemmed from something deeper. I was reminded of my perfectionist roots and that my so-called "recovery from perfectionism" may be challenged in moments such as these.

Perfectionism is often confused with striving for excellence. In reality, one common symptom of perfectionism is the feeling that we are not enough. It is based in a lie that we can do more. We think, "Doing more would make me a better person."

Guilt versus shame

The American Psychological Association defines guilt as "self-conscious emotion characterized by a painful appraisal of having done (or thought) something that is wrong."1 It is related to but distinct from the concept of shame. Shame is that unpleasant feeling of self-consciousness that leads one to believe that they are flawed. These definitions point out an important difference. The definition of guilt emphasizes doing  wrong, whereas shame highlights that there is a sense of being wrong. These two thoughts are often confused, and perfectionists may make the mistake of confusing shame for guilt.

So, if the definition of guilt says that I have to do something wrong to be guilty, what was the tug in my gut that I felt at that moment? Understanding I had done nothing wrong, I realized that I was actually being plagued by shame.

Saying yes to please others

When you say yes to please people when you really mean no, ask yourself if this stems from an urge for acceptance and belonging. Are you feeling a pull that your yes is connected to who you are as a person? Do you feel that if you were to say no it would define your character and integrity? If the answer to either of these is yes, you may be suffering from the perils of shame from perfectionism.

Melissa Ann Roush, a licensed professional counselor in Frisco, Texas, asks, “When and where in your life did you learn that you needed to produce and overproduce to be enough? When will you learn that you are enough?”2 She goes on to say that many family systems treat no as a four-letter word. Therefore, as children, individuals are conditioned to believe that saying no is disrespectful and synonymous with being a bad kid.

Roush says that over-functioning, people-pleasing, workaholism, and perfectionism all stem from past defense coping mechanisms. These strategies developed in an attempt to either control chaos, avoid negative feelings, or gain love and acceptance. But what we learned to do as children we need to unlearn to thrive as adults. Roush says, “You would be surprised at how many people struggle to understand that 'no' is a complete sentence. If it was never an option in their formative years, it is very difficult to separate saying no from feelings of guilt and shame.”2

Unlearning what you've learned

Defining yourself by what you do versus who you are might be a deep-seated pattern that began in childhood. If this issue is not worked out as an adult, taking on extra work (when it is not the desire of your heart) may be a first-class ticket to exhaustion and bitterness. As busy dental professionals with demanding work schedules and personal lives piled high with things like kids, spouses, homes, and trying to stay healthy, we have to learn ways to balance this guilt monster when the next committee invitation shows up in the inbox.

Next time you feel guilty about saying no, consider the following:

  • Take a moment to discern between guilt and shame. Ask yourself, “Did I do something wrong that I need to apologize for?” If the answer is no, give yourself grace and recognize from where these feelings stem.
  • Remember that “No” is a complete sentence. It does not require a follow-up explanation or excuse.
  • Take time for deep introspection. Make room in your life to understand how childhood bruises carry into adult life. Think of this as reparenting your inner child that feels guilty for saying no.

Managing your work and personal life is already daunting enough without carrying around unnecessary shame. When requests come your way that do not make you light up with excitement, say no with confidence. Let your no stand without apology. 


  1. Guilt. American Psychological Association website. https://dictionary.apa.org/guilt. Accessed October 15, 2019.
  2. Roush, Melissa Ann. Personal interview. 2019. 
Kandice Swarthout, RDH, LPC, is a full-time dental hygiene educator in Texas. Swarthout is the owner of Inspired Education & Wellness, where she combines her clinical dental and mental health experience to help other health-care professionals have a fulfilling work-life experience.

Additional articles 

Is multitasking a burnout maker?

Editor's note: Read Swarthout's monthly column, Counselor's Corner, in the RDH eVillage e-newsletter. (Subscribe here.)