When Stepping Up Means Saying “No”

Two of my friends this week told me their stories about saying “yes.”

Friend #1 went out to a late night concert with a friend of hers. She really didn’t want to go. It wasn’t a venue or band that she particularly liked and she’s been trying hard to get to bed at a decent time lately. But the friend was insistent and played the “oh but we’re such good friends, surely you’ll like what I like” card. My friend couldn’t resist. She caved. She knew she was caving. She said “yes” when she really in her heart of hearts wanted to say “no.” She was sorry! She didn’t like the band, she did not enjoy herself and she got to bed way past midnight, felt exhausted and out of sorts the next day and missed her 8 am exercise class. But mostly she was mad at herself for not honoring herself. Saying “no” would have been stepping up for herself.

Friend #2  has been saying “yes” to everything lately. When I spoke with her the other day she had just finished a whirlwind week and was heading into a packed weekend. She took two hours out of her day to spend with me for our regular get-together, sandwiched in between clients. She talked about choosing to alter her perception about how she felt about being so committed and busy, thinking about it as “this too shall pass” and “I can do this.” She told me she was trying to “step up” and do the right thing by saying “yes” to requests for her time and expertise, doing work that was in her wheelhouse and very positive. She was entertaining the idea that it was all too much, but she was clearly still feeling catapulted by the notion that it was her obligation to the world to say “yes” as much as possible.

These conversations got me thinking about what it means to “step up,” and what it has meant in my own life as I have worked hard to balance how I invest my time and energy into my self vs. the world.

When my children were very young and I was a new physician building my career, I was asked to give talks on a variety of subjects. Since I practiced an “integrative” style of medicine people were particularly interested in what I had to say about such things as nutrition and women’s health. I felt an obligation to do these talks. I was the “expert” and it was part of my role as a healer to educate. I said “yes” to them all. I worked my tail off, spending many hours carefully crafting each new talk. It was highly stressful juggling this additional work with my home life, raising my boys and running my own practice and keeping up with my own education. It eventually became clear to me that there wasn’t enough of me to go around, I was parceling myself out too extensively and my health and wellbeing were suffering for it.

Physician heal thyself.

I learned that “stepping up” meant saying “no” at times and saying “yes” to myself.

Friend #1 clearly knew from the get go that she was saying “yes” when she didn’t want to. The girl needs to work on boundaries! She said to me as she was recounting her story, “you’re going to scold me for this!” I didn’t. She knew.

Friend #2, while I’m hardly one to know for sure, or to judge, my sensibilities tell me that she is way overextended (at least I would be in her shoes!). Yes, she is doing positive things that are meaningful and even enjoyable. But she has packed in her schedule for the foreseeable future on the foundation of a commitment to “stepping up.” There isn’t much down time or play, save scheduled vacations or dates for coffee squeezed in between work and tasks. This may well be her time to work hard and the play will come, but thinking about her schedule makes my chest feel tight!

I can’t say either of my friends did wrong. I’m hardly one to talk, but I appreciate the chance to reflect on this. Sometimes we don’t know until it’s all over that it was all too much. And sometimes we have to make sacrifices when we are called to something urgent and profoundly important.

I, like my friends, am a work in progress. I find myself in the same quandary at times, wanting to please someone I care about or do the honorable thing. Their stories have inspired me to reflect on what stepping up means for me, in my life. What is important to me?

One thing I’ve learned for sure. We have to step up for ourselves first. We must honor ourselves. It’s an essential part of our commitment to self-care. This includes protecting our sleep, rest and downtime. It means allowing ourselves to have unscheduled time on a regular basis for play, putter, hanging out (in a relaxed fashion!) with the people we care about. To have days on our calendar that are unplanned.

I love how Christiane Northrup, MD says,”No is a complete sentence.”

No excuses are needed. No prelude, no explanations. Just, “I am stepping up for myself. Today the answer is no.”


(Christiane Northrup, MD. Goddesses Never Age, Hay House, 2015.)

Karyn Shanks MD


Karyn Shanks, MD, is a physician who lives and practices in Iowa City. Her work is inspired by the revolutionary science of Functional Medicine, body-mind wisdom, and the transformational journeys of thousands of clients over her twenty-eight year career. She believes that the bones of healing are in what we do for ourselves.

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