I don’t usually post more than one blog a week, but I’ve been seeing the NOvember meme a lot on social media lately, and it struck a chord with me. It got me thinking about something I cover in my book, specifically in the chapter on "relationship dance"—the idea that many of us struggle to say no, and this can take a significant toll on our health, especially for those of us living with chronic illnesses.
This ties in with the powerful research of Dr. Gabor Maté, who has explored the link between people-pleasing, stress, and the development of autoimmune diseases. Dr. Maté argues that the tendency to put others’ needs ahead of our own, often suppressing our own emotions, can contribute to chronic stress and, over time, lead to inflammation and disease.
People-Pleasing and Autoimmune Disease: What’s the Connection?
Dr. Gabor Maté, in his groundbreaking work, has brought attention to how certain personality traits—particularly the tendency to be a people-pleaser—are often found in those with autoimmune diseases. According to his research, those who habitually prioritize others’ needs, avoid conflict, and suppress their own emotions may be at a higher risk of developing autoimmune conditions.
Autoimmune diseases occur when the immune system mistakenly attacks the body’s own tissues, leading to inflammation and damage. While the causes of autoimmune diseases are complex and multifactorial, chronic stress is known to be a significant contributor to the onset and worsening of these conditions. Dr. Maté’s theory suggests that people-pleasing behaviours, which often involve suppressing one's own needs and desires to avoid conflict, can lead to prolonged emotional stress. Over time, this constant suppression can manifest in the body as chronic inflammation, eventually triggering autoimmune responses.
In essence, the body, in its confusion, begins to attack itself, mirroring the way a person might abandon their own needs for the sake of others.
Why Saying No Matters
So, what does saying “no” have to do with autoimmune health? The answer lies in boundary-setting. Setting boundaries, and learning to say no, is one of the most effective ways to protect ourselves from the emotional and physical toll of people-pleasing. By establishing healthy boundaries, we reduce the pressure to constantly prioritise others at the expense of our own well-being. This, in turn, relieves stress and gives our bodies the space to heal.
When we say no, we’re not just protecting our time or energy; we’re actively reducing the stress signals that are sent throughout our body. We’re lowering the cortisol spikes that come with chronic stress and giving our immune system the break it needs to function properly.
Stress, the Gut, and Your Immune System
As I discuss in my book, stress doesn’t just affect our mental and emotional state—it’s deeply tied to gut health and immune function. Chronic stress can lead to a breakdown of the gut lining, known as leaky gut, which can trigger systemic inflammation and worsen autoimmune symptoms. Stress also disrupts the balance of the gut microbiome, reducing the population of beneficial bacteria and creating an environment that promotes dysbiosis (an imbalance of gut flora).
By learning to say no, you’re not just standing up for yourself emotionally—you’re also giving your gut and immune system the chance to recover and thrive.
Practical Ways to Start Saying No
Pause and Reflect – When you’re asked to do something, take a moment to reflect on whether it’s truly serving you. It’s okay to say no if it’s going to overextend you or if it doesn’t align with your priorities.
Practice Boundaries with Loved Ones – Start by setting small boundaries with the people closest to you. For example, you might let them know when you need quiet time, or simply express when something isn’t working for you.
Recognise Your Own Worth – Remember that your value isn’t tied to how much you do for others. Learning to value yourself, your time, and your needs is key to setting healthy boundaries.
Small Nos Lead to Bigger Nos – Start small. Practice saying no to little things—a meeting you don’t really need to attend, a favour you don’t have time for—and gradually work your way up to bigger commitments.
NOvember: A Month to Start Practicing
This NOvember, I encourage you to join me in practicing the art of saying no. It’s not about being selfish; it’s about self-preservation. It’s about recognising that we can’t pour from an empty cup and that saying no can be one of the most powerful tools for reclaiming your health—especially if you’re managing chronic stress or autoimmune conditions.
Saying no is a form of self-care that allows us to set boundaries, protect our energy, and ultimately give our immune system the space to heal.
Remember, self-care isn’t just about bubble baths and meditation—it’s also about having the courage to prioritise your needs and say no when you need to. Let’s use this NOvember to start setting healthy boundaries, reduce stress, and reclaim our well-being.
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