Persistent people-pleasing and emotional self-silencing may influence mental wellbeing and chronic pain, highlighting the importance of healthy emotional boundaries.
- People-pleasing and self-silencing were associated with greater fibromyalgia symptom severity
- Women who frequently suppressed their emotions reported higher levels of self-silencing
- Building healthy emotional boundaries may support long-term emotional wellbeing
Growing evidence suggests that people-pleasing is more than simply being kind or helpful. When it becomes a long-term habit of ignoring personal needs, suppressing emotions, and constantly seeking approval, researchers describe it as self-silencing.
A cross-sectional study involving 539 women with fibromyalgia and 184 women without the condition found that
women who reported greater self-silencing also experienced more severe fibromyalgia symptoms, suggesting that chronic emotional suppression may play a role in how some women experience long-term pain and wellbeing.
Importantly, the research shows an association rather than a cause-and-effect relationship. Understanding this distinction can help people recognize unhealthy behavioral patterns while avoiding unnecessary fear or self-blame (1✔ ✔Trusted Source
The association between adverse childhood experiences, self-silencing and symptom severity in women with fibromyalgia
Many people naturally put family, friends, or colleagues first from time to time. However, consistently placing everyone else’s needs above your own can gradually become emotionally exhausting.
Psychologists use the term self-silencing to describe the tendency to hide personal thoughts, emotions, or needs to avoid conflict, maintain relationships, or gain approval. While occasional compromise is a normal part of healthy relationships, chronic self-silencing may contribute to emotional stress that affects overall wellbeing.
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People-Pleasing and Women’s Health: What Does the Research Show?
Researchers from the University of Plymouth investigated whether self-silencing could explain why women who experienced adverse childhood experiences often report more severe fibromyalgia symptoms later in life.
The cross-sectional study included 539 women diagnosed with fibromyalgia and 184 women without the condition, who completed validated questionnaires measuring childhood adversity, emotional suppression, and symptom severity.
Statistical analyses suggested that self-silencing partly mediated the relationship between adverse childhood experiences and fibromyalgia symptom severity, indicating that emotional coping patterns may be one of several factors associated with chronic pain.
The findings do not prove that people-pleasing causes fibromyalgia, but they highlight an important psychological factor that deserves further research.
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How Can Chronic People-Pleasing Affect Mental and Physical Health?
The findings from the University of Plymouth study add to growing evidence that emotional wellbeing and physical health are closely connected. Researchers believe that persistent people-pleasing and self-silencing may keep the body’s stress-response system activated for longer periods, especially when individuals repeatedly suppress their own emotions to avoid conflict or gain approval. Although this response may help people cope with short-term social situations, remaining in a prolonged state of emotional stress may affect overall wellbeing over time.
When the body experiences ongoing stress, it releases hormones such as cortisol, which influence sleep, mood, immune function, and the way the brain processes pain. Scientists believe these biological changes may partly explain why some individuals experiencing long-term emotional stress also report greater pain sensitivity and fatigue.
However, these responses vary widely and are influenced by several factors, including genetics, existing medical conditions, lifestyle, and social support. Current evidence does not suggest that people-pleasing alone causes these health problems (3✔ ✔Trusted Source
Mental disorders
Another study investigating self-silencing found that women who consistently suppressed their own feelings were more likely to experience depressive symptoms, supporting the idea that unhealthy emotional suppression can negatively affect psychological wellbeing. Researchers believe that expressing emotions in healthy ways may play an important role in maintaining both mental and physical health (2✔ ✔Trusted Source
The Silencing the Self Scale: Schemas of intimacy associated with depression in women
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Why Healthy Emotional Boundaries Matter More Than Ever
The message from current research is not that kindness is harmful. Instead, it highlights the difference between healthy compassion and chronic self-neglect. Helping others while also recognizing personal emotional needs allows people to build healthier relationships without sacrificing their own wellbeing.
Mental health professionals encourage individuals to pause before automatically saying “yes,” communicate their needs honestly, and recognize when guilt or fear of disappointing others is driving their decisions. Seeking support from a qualified mental health professional may also help individuals who struggle with persistent people-pleasing behaviors that interfere with daily life or emotional wellbeing.
Rather than asking people to become less caring, the research encourages a healthier balance between caring for others and caring for oneself. Developing healthy emotional boundaries may reduce chronic stress, improve emotional resilience, and contribute to a better quality of life, while continuing to maintain meaningful personal relationships (1✔ ✔Trusted Source
The association between adverse childhood experiences, self-silencing and symptom severity in women with fibromyalgia
Go to source)(2✔ ✔Trusted Source
The Silencing the Self Scale: Schemas of intimacy associated with depression in women
Healthy Habits That Can Help Reduce Unhealthy People-Pleasing
Although people-pleasing is not a medical condition, developing healthier emotional habits may help reduce chronic stress and improve overall wellbeing. Mental health professionals recommend replacing chronic self-silencing with healthy communication and balanced self-care rather than trying to stop caring for others altogether.
| Healthy Habit | Why It Matters |
|---|---|
| Pause before saying “yes” | Taking a few moments to think before agreeing to a request helps prevent automatic people-pleasing behaviors and encourages thoughtful decision-making (2✔ ✔Trusted Source The Silencing the Self Scale: Schemas of intimacy associated with depression in women ). |
| Express your feelings honestly | Sharing emotions respectfully reduces self-silencing and supports healthier relationships (2✔ ✔Trusted Source The Silencing the Self Scale: Schemas of intimacy associated with depression in women ). |
| Set realistic boundaries | Healthy boundaries allow you to care for others without neglecting your own physical and emotional wellbeing (2✔ ✔Trusted Source The Silencing the Self Scale: Schemas of intimacy associated with depression in women ). |
| Make time for self-care | Regular sleep, exercise, relaxation, and enjoyable activities can help reduce the effects of chronic stress on the body (3✔ ✔Trusted Source Mental disorders ). |
What Are the Limitations of the Current Research?
The findings should be interpreted carefully because the evidence has several limitations. The University of Plymouth research was a cross-sectional study, meaning participants were assessed at a single point in time rather than being followed over many years. Because of this design, researchers could identify an association between self-silencing and fibromyalgia symptom severity, but they could not determine whether one caused the other.
The study also focused primarily on women living with fibromyalgia, so the findings may not apply to men or to people without chronic pain conditions. In addition, information about childhood experiences and emotional behaviors was collected through self-reported questionnaires, which may be influenced by memory and personal interpretation. Further long-term studies are needed to determine whether reducing self-silencing can improve health outcomes.
What Does This Mean for Your Health?
The findings should not discourage kindness or caring for others. Instead, they highlight the importance of balancing compassion with self-care. Looking after your own emotional needs is not selfish, it is an important part of maintaining good mental and physical health.
If you frequently feel guilty when saying “no,” constantly prioritize other people’s needs over your own, or feel emotionally exhausted after trying to keep everyone happy, it may be helpful to reflect on these patterns. Speaking with a qualified mental health professional can provide practical strategies for building healthier relationships and reducing chronic emotional stress.
People living with chronic pain conditions such as fibromyalgia should continue following evidence-based medical treatment and should not assume that emotional factors alone explain their symptoms. Chronic pain is a complex condition influenced by biological, psychological, and social factors.
Building Healthy Boundaries Is Good for Everyone
Current evidence does not show that people-pleasing directly causes chronic illness. However, it suggests that persistent self-silencing may be associated with poorer emotional wellbeing and greater symptom severity in some women living with fibromyalgia.
The encouraging message from this research is that emotional wellbeing can be strengthened over time.
Learning to recognize personal needs, communicating honestly, setting healthy boundaries, and seeking support when needed can help people develop more balanced relationships without losing their kindness or compassion.
Caring for yourself and caring for others are not opposite goals, they are both important parts of living a healthier, more resilient life.
References:
- The association between adverse childhood experiences, self-silencing and symptom severity in women with fibromyalgia – (https://pubmed.ncbi.nlm.nih.gov/36544329/)
- The Silencing the Self Scale: Schemas of intimacy associated with depression in women – (https://journals.sagepub.com/doi/10.1111/j.1471-6402.1992.tb00242.x)
- Mental disorders – (https://www.who.int/news-room/fact-sheets/detail/mental-disorders )
Source-Medindia