Staff Perspective: Just Say “No”: My Current Approach to Self-Care

Staff Perspective: Just Say “No”: My Current Approach to Self-Care

Dr. Carin Lefkowitz

For the past couple of weeks I’ve been hearing about “NOvember” campaigns such as “putting the ‘no’ in ‘November’” and “The NOvember Challenge.” There are a few different versions of the campaign, but essentially it is a call to say “no” to unhealthy/unenjoyable/non-enriching requests and habits. Although this call to action has been around for years, it’s suddenly become relevant to me.

Like many behavioral health providers, I’m not always good at practicing self-care. I’m very good at prescribing it to my clients, but I’m not so good at following my own advice. I feel lucky to get paid to do work that I enjoy and there never seems to be a shortage of it. Clients are looking for treatment, providers are looking for consultation, and students are looking to be taught. I love doing it all and have a habit of saying “yes” to every interesting professional and personal opportunity that arises.

Unfortunately, like many of you, I’ve taken on too much. My private practice is full, I’ve been teaching or consulting on a different topic every week for the last two months, and my weekends are packed with social engagements. As a result, I haven’t cooked a healthy meal in weeks, I haven’t yet unpacked from a work trip two weeks ago, and I haven’t gotten out of my office to enjoy the last of our warm weather. There’s a rumor that it was 75 degrees and sunny out yesterday. I bet that was lovely.

I know I’m headed for burnout if I keep this pace up. So why is it so hard to say “no” when someone asks me to do one more thing? I’m sure everyone has a unique set of answers to that question. For me, I know I succumb to the desire to be helpful. A desire to help is what got me into this field, after all. I also know I have a particular set of skills (very different from Liam Neeson’s) cultivated through years of education and experience and I like to utilize them when I can. That makes it hard to say “no” to professional opportunities and means that I frequently get exposed to trauma recollections. Combine that with the fact that I don’t like to disappoint others or let people down, and it’s a recipe for personal disaster. Whether a friend or a client asks me for help, I’m prone to thinking, “it’s just 10 minutes/two hours/one day of my time. Of course I can help!” But all those minutes, hours, and days add up to burnout.

Having taken the initial step of noticing that I’m headed for burnout, I accepted the “NOvember Challenge” as an attempt at self-care. Despite the personal discomfort, I said “no” and “not right now” much more over the past few weeks, not just to unpleasant requests, but also to extra “good” things.

Things I said “no” to:

  • Attending a yoga class with a friend at an inconvenient time
  • Accepting more clients into my private practice
  • Waking up extra early for an optional meeting

Requests to which I responded “not right now”:

  • Volunteering my time with a charitable organization composed of wonderful people
  • A friend asking me to listen to her vent about her family conflict
  • Mentoring a graduate student
  • Writing this blog

I cringe just remembering all of those “no’s.” I worry that I offended a friend or let a colleague down. I’ll save the rest of my worries for my diary, but trust me when I say it has been uncomfortable for me. But what negative consequences did my “no’s” actually have?


I got an email from an acquaintance making sure I was OK after I skipped the meeting. I scheduled the mentoring meeting for later in the month. My friend sent me a sad face emoji about the yoga class. And I turned in this blog one week late and CDP didn’t collapse. On the flip side, I finished unpacking, I caught up on sleep, I’ve been more present for my clients, and I’m totally getting outside after I finish writing this blog.

This cringe-inducing experiment has been a good one for me. Although I have not gotten any more comfortable saying “no,” I see that the world won’t implode if I do. I’m feeling slightly less stressed than I was 2 weeks ago and think I’ll feel more able to say “yes” after another few days of recharging. In the past, my self-care has been defined by the things I do – exercise, listening to music, and eating chocolate. From now on, I’ll also be thinking about what I don’t do as part of self-care.

The opinions in CDP Staff Perspective blogs are solely those of the author and do not necessarily reflect the opinion of the Uniformed Services University of the Health Science or the Department of Defense.

Carin Lefkowitz, Psy.D.,  is a clinical psychologist and Senior Military Behavioral Health Psychologist at the Center for Deployment Psychology (CDP) at the Uniformed Services University of the Health Sciences in Bethesda, Maryland.