
By Carissa Weber, MA, LPC, CSAC
Have you ever noticed how hard it is to say “no?” Why is that? I know many of us (including myself) struggle with the idea that we are able to (and sometimes have to) say no. If you are one of those people who struggle with that famous 2-letter word, this post is just for you!
Although not officially a DBT skill, the art of saying “no” could very easliy be considered one. Why? Well, let me tell you! Saying that formitable word fits right in with interpersonal effectiveness skills (like maintaining healthy and respectful boundaries with people). It also takes a hint from distress tolerance skills (oh you know, like identifying what you don’t need), and helps identify with emotional regulation skills.
Missed the DBT posts? Check them out here:
DBT and Distress Tolerance Skills

The art of saying “no” could also very well be part of the CBT skill set as well. This simple phrase can be seen in Socratic questioning (and understanding why no is a great answer to some questions), identifying unhealthy thought patterns that make it hard to say “no,” or even using facts to calm down that darn amygdala. Regardless of what skillset you want to use, being able to say “no” has to start with PRACTICE!
Where in our brain is it that makes this polite decline so hard to say? Well, like so many other research I have done, there is minimal research out there on the impact of this word on the brain. So, naturally, I explore the alternatives. After a few weeks of researching, I discovered there was more research done on the anticipation of rejection than there was on hearing this two-letter rejection.
Rejection is a powerful emotion. Even just hearing the word invokes a response. According to The University of Michigan, rejection plays a huge role in saying “no” as well as in hearing the word “no.” What role is that? The role of pain.
In 2013, U of M showed that being rejected (for example, when we hear “no”) creates a reaction in the brain identical to physical pain. Say what? You got it! If we hear “no” when we weren’t prepared for it, our darn amygdala processes the emotion the hippocampus sends to it (in this case, rejection) and triggers a new part of our brain. This new part, called the pregenual cingulate cortex, plays a pretty big role in identifying our moods based on events we are experiencing.

Quick note: the pregenual cingulate cortex is located between the frontal lobe of our brain and the hippocampus. It wraps around that darn amygdala and helps it confirm or deny the feelings we are experiencing. When you are struggling with depression, brain activity is significantly stunted in the pregenual cingulate cortex, which is why scientists believe this may be why we struggle with apathy when we are depressed. The pregenual cingulate cortex also helps us apply what we learn to situations.
Okay, back on track. After that darn amygdala recognizes the emotion we are experiencing, the pregenual cingulate cortex says “holy cow Batman! You are experiencing pain! Let me fix that!” How does it fix that? Simple. It triggers the release of the neurotransmitter, endorphin. If you recall from my post, Neurotransmitters: The Language of the Brain, endorphins are responsible for decreasing the sensation of pain. It does this by releasing a chemical in our brain called opioids
Before you go “I didn’t take any drugs!” let’s talk about opioids that naturally occur in the brain. This naturally occurring opioid is known as mu-opioid. When we are in pain, physical pain, our brain releases mu-opioids into our brain to help reduce the pain. For example: runner’s high. When the endorphins release when we run, it is trickling mu-opioid into our brain that says “this isn’t so bad, keep going!”
The same mu-opioid is released when we are experiencing rejection. For some people, their brain releases more mu-opioid than others. How can we tell? When we say “no” to someone and they say “that’s okay.” While the next person goes “why don’t you love me?” we know the first person is getting more mu-opioid based a: on their acceptance of our response, and b: when we stick their head in an MRI the pregenual cingulate cortex is light up like a Christmas tree. The latter response of, “why don’t you love me?” Not so much.

So now that we understand why it is hard to hear “no,” why is it hard to say it? Think about it. When we are denying someone their request, we are ultimately dishing out rejection. Our hypothalamus and hippocampus remember what rejection feels like. For those people pleasers out there, the feeling of rejection can be as painful as a busted arm. Why would we, a good person, reject someone?
Our brain has a way of protecting us. By using a cognitive distortion (oh like the example of overgeneralizing above), our darn amygdala is trying to protect us from any sort of pain and discomfort by justifying what the pregenual cingulate cortex is doing. Sometimes, those cognitive distortions end up costing us something: like our self-esteem, money in lots of cases and perhaps even a busted arm.
Have you ever noticed when your self-esteem really sucks that it is harder to say no? When our self-esteem is shot, so is our pregenual cingulate cortex. It isn’t firing like it should, which helps that darn amygdala do whatever it kinda feels like. To protect ourselves from feeling rejected, we tend to compromise our boundaries, time, and energy to ensure people will not reject us. Boss asks you to stay late? Of course you will! Kids are screaming they want something different than what you cooked for dinner? To get them to shut up and eat, of course I’ll make a second (or third or fourth) meal. Wish someone would tell you that you’re amazing? I will jump tall buildings in a single bound to hear it!
The thing is, all of this external validation we are trying to get makes our brain give us the feel good neurotransmitters we are craving to kick-start our brain into gear. That is why we love receiving praise from people that we are doing a good job. The issue with external validation is we cannot count on it. Let’s use covid for example, shall we? How many of us suddenly started working from home, homeschooling our kids, learning new ways to shop and interact with people, all while working during a pandemic? How did it feel when your boss gave you a certificate to order pizza? I don’t know about you, but that pizza party came about one year too late!
Coping Skills Alert!
This late external validation can also come across as feeling rejection. So how do we handle the most powerful two-letter word in the dictionary? Despite popular belief, avoiding people when we want to say no is not the answer (shock and awe!). This simple two-letter word is in our human dialogue for a reason:
- It helps us provide a natural boundary for when we need time to recharge our energy
- It allows us to participate in activities that are more in tune with our goals, our beliefs, and our safe support network
- Make our needs known (and meet them)
- Taking back the power and control over our mental health, and most importantly, our life!
Simply put, No is a powerful action word. In order to use this word, we first must know what our needs are. Needless to say, self reflection is crucial in order for us to be comfortable saying no. How do we do this? We have to use one of the many skills we have already talked about the practice slowing down one and thinking before we offer an answer. STOPP is one of my favorite skills to use the help identify what our needs are! Another one would be wise mind.
Need to learn more about practicing these skills? Check out my post: What’s With All of This Repetition?
Once we know what we need, we next need to use our interpersonal effectiveness skills to be able to clearly, assertively, and respectfully decline a person’s request. Keeping our communication clear and assertive will ensure we are being as nice as possible about saying no. For all those people who like the phrases “I don’t know” or “maybe” or “I’m not sure,” that isn’t clear. If anything, this releases the stress hormone, cortisol, and the person you’re communicating with, increasing their own symptoms of anxiety.
“No, in itself, is a complete sentence!”
– Carissa Weber
Another thing to keep in mind about clear communication is that you don’t necessarily have to elaborate as to why you are saying no. No, in itself, is a complete sentence! Think about that for a moment. The answer no is a complete sentence. If you feel compelled to explain why you are unable to say yes, keep your explanation to the point. You don’t need to go over how your aunt’s dog is sick. If it doesn’t entail direct information as to why you’re saying no, you don’t have to say it.
If you can’t get over your people pleasing just yet, this would be a great time to offer the person you are saying no to an alternative that is respectful of your time, your boundaries, and your own needs. For example, if I have a friend who wants me to hang out at the same time I already have something else scheduled, I can show gratitude for the offer and extend the alternative that we hang out on a different day. This alternative is respectful of my time and my plans I already had in place, but allowing someone to know I would have availability on a different day.
Saying no will be tricky and uncomfortable at first, especially when you’re use to being a “yes-man.” Remember, it takes 66 days to change a routine. You know what that means? You got it! That means you actually have to practice saying no on a regular basis for it to feel comfortable, safe, and overall, confident.
I want to thank you for allowing me to help you gain confidence in the ability to say no. This is something we all struggle with at some point in time. It is my hope for you that this information will help you gain the understanding as to why no is hard to say all while gaining confidence in being able to say it.
To recap this post:
– Saying “No” triggers the fear of rejection
– That Darn Amygdala and the pregenual cingulate cortex work together to help us feel confident and secure when we have to hear “no”
– Saying “No” becomes easier with practice
References
- Bohns VK. (2016). (Mis)understanding our influence over others: A review of the underestimation-of-compliance effect. Revtrieved from
ecommons.cornell.edu/bitstream/handle/1813/74812/Bohns1_Misunderstanding_our_influence.pdf;jsessionid=34E1889FF25CD08EA193888E012A83B5?sequence=1 - Kross E, Berman MG, Mischel W, Smith EE, Wager TD. Social rejection shares somatosensory representations with physical pain. Proc Natl Acad Sci U S A. 2011 Apr 12;108(15):6270-5. doi: 10.1073/pnas.1102693108. Epub 2011 Mar 28. PMID: 21444827; PMCID: PMC3076808. Retrieved from https://pubmed.ncbi.nlm.nih.gov/21444827/
- Nicola Palomero-Gallagher, Felix Hoffstaedter, Hartmut Mohlberg, Simon B Eickhoff, Katrin Amunts, Karl Zilles, Human Pregenual Anterior Cingulate Cortex: Structural, Functional, and Connectional Heterogeneity, Cerebral Cortex, Volume 29, Issue 6, June 2019, Pages 2552–2574. Retrieved from https://doi.org/10.1093/cercor/bhy124
- Roberts, Nicole (2015). Rejection And Physical Pain Are The Same To Your Brain. Retrieved from https://www.forbes.com/sites/nicolefisher/2015/12/25/rejection-and-physical-pain-are-the-same-to-your-brain/?sh=6a901b514f87
- Tartakovsky, Margarita (2021). How and When to Say No. Retrieved from https://psychcentral.com/lib/learning-to-say-no
Image Sources
- Carissa Weber at www.thatdarnamygdala.com
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