Grégoire Vitry and Claude de Scorraille
Article published in Hypnosis & short therapies out of series n°16

Without the ability to say no, there is no true yes.

Or when her colleague Jean-Félix leaves the medicine boxes in a mess, she will put all the boxes back in order only to realize that the next day they are mixed up again. And deep down, she said to herself: “ Really, this work is painful, neither done nor to be done. So Samira starts leaving post finally start And there, boom! it's just the opposite that happens , because his colleague ended up complaining about Samira's attitude which he finds unbearable. So I ask him:

- Therapist : " In the end, would you say that you spend your time trying to take good care of the people in your care by accepting everything that is asked of you, or would you rather say that you find it difficult to say no what doesn't suit you?

- Samira : Yes, it's true that I realize that I tend to accept everything I'm asked to do for the best, until the moment I can't take it anymore, and then the risk is that I drop everything. »

Here we have the typical structure of a person who sacrifices himself by saying yes to everything and who ends up turning it against himself. I then tell him:

- Th . “ a bad “yes”, we charge a thousand times over. There
, I see Samira sinking into her chair while staring at me . I feel that she thinks a lot and that she is disturbed by this reframing. I continue :

- Th . “ You are like those people who end up sacrificing themselves and exhausting themselves by saying yes all the time. And you know what, the worst part is that in the end not only are you exhausted, but in addition the others end up resenting you. What I propose to you is that between now and the next

times you can practice saying a tiny “no” every day. It is not a question of putting you in difficulty or in danger, but for example of saying a small "no" which concerns something trivial such as: "I  will take care of the shopping a little later", whereas normally you would have done it immediately; or to be able to say: “I would like to make you happy, unfortunately I don't drink coffee”, when someone offers you a coffee. »

Samira came back a fortnight later, telling me that it had scared her to say a little "no" every day, but that in the end she had the impression of feeling a little more free. At the end of the therapy, Samira tells me that she has taken a liking to daring to say "no" and that she realizes how much she felt trapped in a kind of sacrificial mode which she does not didn't even realize.

Reported testimony (Paul Watzlawick et al., 1974): “ A single woman had very easy affairs. On the one hand she felt devalued, but on the other hand she saw no other way to escape the depressing idea that otherwise no man would want her company. In addition and unfortunately, she felt totally unsatisfied after each sexual intercourse and therefore completely "bad in bed". Usually she was too ashamed of herself to see the same partner again and would start over with another.

What she did not see was that, under these conditions, the attempts at a solution (Vitry et al., 2021a; starting over with another person who was only interested in her sexually) were in fact her problem. . To get her out of this vicious circle, and according to our rule that the therapeutic intervention is about the “solution”, we gave her the following guidelines. She would have to tell her next partner that, for reasons she couldn't reveal, but which were very symbolic in nature, she couldn't have sex unless he first gave her a quarter - but it had to be an old silver coin, not one of those new alloy coins. Once again, we have not made this requirement explicit. The implications she saw there shocked her, but she was otherwise interested enough in therapy to want to pursue it, which left her with no choice but to stop sleeping with anyone. She thus discovered that men did not let her down simply because she did not sleep with them. In this way, a change was achieved, even though the patient did not follow the guidelines. This leads us to another form of intervention. »

Context

They are people who want to avoid conflict. The person acts like a "relational prostitute" and of course does not feel like they act like that at all, because their way of acting with others is guided by high moral principles which become rigid: they have good intentions. Moreover, when asked, she says of herself that she is a nice person and full of empathy. At the same time, she seeks the approval of others, which she often obtains. Moreover , she obtains the approval of others on the basis of what she gives them and what she does (for example, she can give time, availability, attention, affection, she seeks to render service even beyond what is asked of her...).

What she implements means that she is appreciated only for what she does (like the services she renders, or the time she devotes) and not for what she is. The others end up only becoming opportunistic with her. And she does not realize that she has fallen into this trap where she does not dare to frustrate the other. Ultimately, she's scared of rejection. She is so that all her energy is devoted to trying to satisfy others by saying "yes". She gives of herself to “please others”; and she feels a certain pleasure in doing so. But she ends up being disappointed to see how little “real” interest she arouses. To bring this profile of person to allow themselves to say "no", where they say "yes" out of habit, you have to hit hard and give them tools that will gradually help them to assert themselves.

The image of “relational prostitution” is repulsive and frighteningly effective. It is still necessary to introduce it in a strategic way so as not to produce a shock such that it could weaken the relationship with the speaker. Generally people who suffer from a fear of rejection such that they are ready to say all the “yes” possible, recognize themselves very easily in this image of “prostitute”. However, it is very helpful to play with them and make them guess what it is, with the help of paraphrases and suggestive innuendos that lead very quickly to the track... (Wittezaele & Nardone, 2016).

Three ways to learn to say “no” according to Giorgio Nardone (Milanese et al., 2007):

• The “no” as an expression of an inability to say yes. “ I would like to please you, but I cannot do what you ask of me . Expressed this way, no preserves the relationship.
• The “no” that takes priorities into account. “ I could do it, but right now I have other priorities. »
• The “no” which is positioned one degree above and clearly means: “ It does not suit me . »

Encyclopedic file
SAY A LITTLE “NO”
Other technical names used for this prescription
› Relational prostitution (reframing)

In line with Nardone's research, Muriana and her colleagues propose reframing vis-à-vis the original beliefs, sowing doubt as to the validity of the latter. To a person described as caught in a positive utopia, the therapist may suggest: “ You have always sought to please others, with the best intentions and for your peace of life, in a kind of “relational prostitution”, which has made you blind even to the most obvious differences. Or to a person trapped in a projective negative utopia: “ You have always blindly believed that, by being a blameless person, others were the same, exposing you to a condition of great fragility and giving, in short, power to others (Delroeux, 2008).

Various researchers have noted the relevance of a circular reading of conflicts based on the systemic and strategic approach (Bériot, 2014; Scorraille, Brosseau, Vitry, 2017; Milanese et al., 2018; Valitova, Besson, 2020) .

Create an aversion to the rigid scenario of saying yes to everything, in particular by reframing "relational prostitution", and put the patient/client in a position to gradually expose himself by saying small "no", while preserving the quality of the relationship with his interlocutor, until he can position himself and assert himself without fear.

Thanks to the prescription and the progressive evolution of the “sorry, I would like to but I can't”, I make sure that the patient completely reverses her usual mode of interaction, but that she does it very gradually. This is important, because if I asked her to show herself as she really is, she wouldn't be able to, because she probably doesn't even know how to distinguish the person's mask anymore (Nardone & Balbi, 2012) (Wittezaele & Nardone, 2016).

For what types of problems is this prescription used in the case of:

• Disorders related to trauma and stressors : burn-out / chronic fatigue syndrome / exhaustion, fatigue;
• Obsessive-compulsive disorders : obsession / perfectionism / procrastination / pathological doubt;
• Relationship problems : relationship problems with oneself or others with loss of self-confidence / relationship problems at school / relationship problems in the family / relationship problems in the couple / relationship problems in the company / conflicts;
• Personality disorders : borderline / paranoia;
• Addiction - Alcohol ;
• Sexual disorders.

Base: 118* cases where “saying a small no” was implemented
*The prescription listed in the table is part of a therapeutic process for which there may or may not be comorbidity.

For example, for a patient for whom the practitioner has established 3 diagnoses of problems/pathologies, this prescription will be counted for each one.

Overall, all issues combined, the analysis of data from 1,150 patients from the SYPRENE network (Systemic Practice Research Network) suggests, as published in the research journal Journal of Family Therapy (Vitry, 2021b), that
therapy helped patients achieve dramatic improvement.
The results indicate a problem solving improvement rate of 80% as rated by practitioners, and 90% as rated by patients. The evaluation of efficiency shows encouraging results obtained with an average of 5.4 sessions over an average period of 5.3 months.

This article is partly taken from the book:

Vitry G., Garcia-Rivera T., de Scorraille C., Paoli B., Brosseau O. (2019),
Strategies for change: 16 therapeutic prescriptions, Toulouse, Erès.

Thanks to Giorgio Nardone, Claudette Portelli and Olivier Brosseau for their expert advice.

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