The Challenge of Helping the People Pleaser

Boundaries bind. They limit, stop, and inhibit. But they also free people up to be themselves. It’s hard to live with them, interpersonally speaking, and even harder to relate well to others without them. They’re at the crux of so many clients’ struggles. With couples, whether the presenting issue is affair recovery or split loyalties in a blended family, it’s the joint boundary-setting skills of two often vastly different individuals that can either expand or deplete their relational resources. Add a people-pleasing partner to the mix and things can get even more complicated.

Over the years, I’ve come to think of myself as a bit of a boundary specialist. My father was an Andalusian miner’s son who didn’t care what people thought of him. He believed children learned morality lessons best at the end of a leather belt. For my mother—a college-educated prom queen—being liked was a guiding principle. As an apple that fell from these trees, I’ve grown up sensitive to the ways boundary setting and people pleasing can collide. And yet, as a clinician, I’ve learned there’s no way to know for sure how relationship dynamics will alter when clients try to do less people pleasing and experiment with assertive boundary setting. Like changing lanes on a highway, no matter how many times you’ve checked your mirrors, setting new boundaries in a relationship involves a degree of risk. In my work with Sophia, helping her assert her boundaries led to an unforeseen therapeutic skid.

Boundary-Setting Differences in a Couple

“My partner, Amy, is angry about my mom,” Sophia told me when she called to set up an appointment. “Since we adopted our daughter, Coco, six months ago, my mother comes over almost every day. We argue about it all the time. Amy has a therapist, and she’s been bugging me to see someone since we met. I probably should’ve done this years ago.” Although the treatment would be with Sophia, we set up a couples session first.

During this initial session, I invited Sophia and Amy to imagine a brief video clip of how they saw themselves in three, six, or nine months’ time. What would change between them when their relationship was more aligned with their desires? What would they be saying or doing?Sophia shared her clip first, stealing quick, nervous glances at Amy, who projected an attitude of controlled indifference. “We’re on vacation. Coco’s building a sand castle. You and my mom are laughing and talking.

“So where are you in this clip, Sophia?” I asked.

Sophia chuckled weakly. “I’m there,” she said. “I guess I’m just happy when everyone else is happy.”

People-pleasing clients with boundary-setting challenges often interpret others’ unhappiness as unhappiness with them. If her mom, Ruth, and Amy are happy with her, Sophia is happy with herself. If they’re displeased, she feels anxious and adrift. A moderate amount of sensitivity to others is normal and adaptive, but with boundary-challenged clients, relying on others for a sense of self can be crippling. It’s not easy to launch a life from a helipad floating on the random currents of other people’s emotional reactions. For Sophia to set boundaries with her mother, her partner, her daughter, or me in our therapy sessions, she first needed to feel safer having a separate self.

“What about your clip, Amy?” I asked, turning my attention to Sophia’s partner, who’d been sitting stoically in her chair, staring out the window.

“Same thing,” Amy stated matter-of-factly. “We’re on vacation. Coco’s playing. All that’s different is your mom. She’s gone. Not dead, or anything, don’t get me wrong,” she added quickly. “She’s just not there. You and I are the ones hanging out and laughing.”

Sophia slumped in her chair ever so slightly. It was an awkward moment. I could feel my own old people-pleasing tendencies activated, like the aches and twitches of a phantom limb. I had the urge to make a joke, change the subject, guarantee their success. I took a deep breath, rebooting myself, and exhaled.

“Sophia, can you mirror Amy’s vision?” I asked, hoping to empower her to do something small but still achievable in this moment.

“You want me to put us first,” Sophia said sheepishly. “You want me not to let my mother intrude.”

“Correct,” Amy said. For a moment, it looked like she’d reconnected with some deeply buried grief. Then she tossed her head and set her jaw resolutely and continued, “I’m sick and tired of begging you to get the house keys back from her. It feels like a violation every time she comes over without checking in first. You married me, not her.”

Eyes Closed: A Boundary to Foster Self-Attunement

As I began seeing Sophia twice weekly for individual therapy, her interactions with me offered a microcosm of what would most likely happen when she interacted with people out in the world. She alternated between avoiding eye-contact and scanning my face intently. She was deferential and polite, but also skittish and wary. She apologized when she wasn’t able to respond to something I’d asked, or when she had an unexpected emotional reaction. She was trying hard to be a good client.

I took a risk during our third session. “I wonder if you’re aware of the way you look at me,” I asked.

“Not really,” she said.

“You look at me intently and your eyes move as if you’re scanning my face. Then you look away.” I paused, keeping my facial expression as gentle as I could. “Have you noticed that?”

Amy froze. Red blotches appeared on her neck.

“It looks like that brought up some feelings,” I said gently.

“No,” she muttered. “It’s not that. Or maybe it is. It’s uncomfortable holding your gaze.”

“Where’s the ‘uncomfortable’ in your body?” I asked.

“Here,” she said, placing her hand flat on her chest. “It’s tight.”

“See if you can stay with the tightness,” I suggested, “Maybe close your eyes?” Encouraging clients to stay with sensations can allow for what in Accelerated Experiential Dynamic Psychotherapy is called dropping down.

Sophia’s eyelids fluttered closed.

When clients drop down, they can connect more deeply with embodied experiences in the moment, rather than just thinking about them. Often when this happens, you can sense a marked shift in the quality of their presence. With Sophia, it was as though an activating agent had been added to the air particles in the room, converting them into something weightier.

“There’s a pressure in my chest,” she said, “like a balloon filling with water. The more I look at you, the more it feels like the balloon’s going to burst.”

“What’s it like when you keep your eyes closed?” I asked, “Just sensing me here with you?”

Sophia paused. “Relaxing.” A look of pleasure spread over her face. “My chest feels lighter. It’s like the balloon has started to rise up and float away. It feels like I can just let go and be myself.”

Reducing the amount of bandwidth I took up in Sophia’s mind — at least visually — allowed her to sense and hear me in the room while staying present to her own experience. By placing more of her attention on her inner reality than on my reactions to her, she began setting an important boundary that helped her trust herself more, feel safer, and go deeper in our sessions.

Thou Shalt Not Share Thy Parent’s Boundary Violations

Sophia felt guilty sharing anything even remotely negative about either of her parents, especially her mother. To undo hardwired people-pleasing survival strategies and the rigid or collapsed boundaries that accompany them, it’s often important to have clients focus on historically overwhelming emotional experiences in the here and now. I wanted to help Sophia see how as a child, maintaining her attachment to her parents had been her greatest life insurance policy; now, however, it was inhibiting conscious access to some of her deepest emotional truths.

My goal was to help her draw on the wider array of resources available to her as an adult, while taking in my care so she could better manage her fear and self-judgement. For the adult Sophia to feel more entitled to set boundaries, it was critical to reconnect with the emotional reality of the overachieving, self-sacrificing child she’d once been and integrate those experiences into her self-concept with awareness, support, and understanding.

Sophia’s father had grown up with a single mom in Queens and had been bullied relentlessly by his older brother. Her mother had been the daughter of high-society parents who’d given her everything she wanted except attention. As parents, they’d groomed Sophia and her younger brother to achieve excellence, inadvertently teaching them that who they were mattered less than how others perceived them—which created an extra burden for Sophia, who knew she was gay from a young age and struggled with her parents’ disapproval.

Nonetheless, when Sophia shared a painful event in therapy—like when her father had locked her in a closet for giving her dolls mustaches and cutting their hair—she’d experience a backlash of shame. “People gave me those dolls, and that’s no way to treat gifts,” she’d argued in response to my words of empathy for that young child in the closet. Gradually, though, even as Sophia excused her mom and dad’s parenting missteps, we made inroads to the raw truth of her childhood.

Repairing the Past in the Present

During one of our sessions, Sophia began talking about her fear of asking her mom to return her house keys. Amy had been getting increasingly frustrated with Sophia’s avoidance of this seemingly simple goal and had recently threatened to change the locks.

Over the course of her closed-eyed explorations with me, Sophia had learned to remain present with her sensations and feelings. As she stayed with the physical experience of fear in her body, she was able to locate an uncomfortable vibration, like an electrical current, in her arms and legs. She stayed with that feeling as it spread through her body into something bigger and stronger. She described it as “death by paralysis.” Her legs and arms shook slightly. Suddenly, she winced.

“I remember feeling this,” she said, her voice sounding small and weak. “Driving to church. I refused to cross my legs and sit properly. I was always fighting with my mom about being proper and ladylike. My mom stopped the car and screamed at me to get out.”

“What are you seeing?” I asked.

“I’m five, maybe six years old, in a pink dress. Cars are passing.” Sophia’s eyelids reddened and tears trickled alongside her nose. “I couldn’t move. I felt paralyzed.”

“Let the emotions surface,” I encouraged. “You’ve held this in for a long time.”

Sophia started sobbing.

“What does that little girl need, Sophia?” I asked. “Can you check in with her? Is there a way we can reach back through time and give her some of what she needs?”

“She needs a loving mother,” Sophia said. “A mom who sees her and gets her.”

“And if you were that mother in this moment?” I asked. “Would she let you comfort her?”

Sophia lifted her hand up and began stroking her own hair. “I see you,” she murmured. Then her face contorted in a fresh wave of emotion. She seemed to be toggling back and forth between two different people, the scared little girl and a loving mother figure. “I’m keeping you safe.”

“Check and see if she can hear you,” I suggested quietly.

After a minute or two, Sophia’s face softened.

“She’s relaxing. She wants me to hold her hand.” Sophia slipped one of her hands into the open palm of the hand resting on her lap, squeezing it tightly.

Zones of Uncertainty and Skids

At our next session, Sophia pranced into my office dangling a set of keys from her index finger and thumb. “I got the keys!” she proclaimed.

“How does it feel?” I asked. I wanted to help her stay in the moment long enough to notice and experience her pride in herself and her sense of accomplishment.

“Scary and good,” Sophia said with a wry smile. “Scary-good. Is that an emotion? I still think something’s going to go wrong, like my mother disappearing from my life. But I also feel strong.” She was beaming.

“Wow!” I leaned forward in my chair, spontaneously clapping my hands. “This is amazing!”

“That’s not all,” she told me, brimming with excitement. “I’m feeling better about drawing the line with Amy, too. Last Sunday, just as we were putting Coco in the car, I told her I wasn’t going to church with her. I didn’t feel like it, so I said I was going for a run instead. I could tell Amy was shocked. I could feel her disappointment, but I stuck to my guns and did what I wanted.”

I smiled broadly and nodded as I listened, swept up by Sophia’s success. We spent the rest of that session thinking of ways to build on this momentum at work and with friends.

Expecting more boundary-setting triumphs, Sophia took me aback the next week with a different announcement. She slumped down into the chair across from me, avoiding my gaze. “I feel awful telling you this,” she blurted out. “But I think this might be our last session. My brother and Amy want me to stop coming to see you. They say I’m changing for the worse.”

“What’s your view on it?” I asked, my stomach tightening.

“My mom has a weak heart,” Sophia continued without registering my question. “My brother says her health has been getting worse because I’ve stopped talking to her. He says what I’ve done to mom is selfish. Then last night, Amy and I got into a fight. I used to just go numb, but I feel so angry these days. I yelled and slammed doors. It scared Coco, who cried for an hour.”

Sophia and I sat motionless in the silence. Had I overdone it with helping her set boundaries and prioritize her own feelings, needs, and preferences? What if her brother was right? Was Coco missing out on precious time with her grandmother that would never be recaptured? And what about Sophia’s relationship with Amy? Maybe we weren’t focusing enough time on processing the anger that was surfacing in our work, anger that was now impacting her marriage. Had Sophia’s people pleasing morphed into destructive selfishness? These and other questions washed through me.

We were in the skid.

Changing boundary-setting lanes involves a unique, imprecise calculus of intuition, experience, probability calculations, and a willingness to juggle uncertain gains and losses. There are always risks. More boundary setting may not allow all relationships to flourish, whether in the short or the long run. In fact, some key relationships may end as a result of a person feeling more entitled to be themselves. The best I could do was let Sophia know her fears made sense.

“The fact that you’re telling me this is huge,” I told her.

“Really?” she said. “I was afraid you’d get mad or offended.”

“And yet you still spoke up,” I said. “That takes courage.”

“I never thought of it like that,” Sophia said, looking relieved.

A New, Slightly Wobbly Homeostasis

Many clients, particularly under pressure from partners and relatives, might have ended our therapy at this juncture. After Sophia and I explored her ambivalence about the changes she was experiencing and the ways people in her world were experiencing her, she chose to continue treatment. And I took the opportunity to recalibrate my approach, focusing on how Sophia was setting boundaries and whether there might be more collaborative ways of moving forward with Amy and her mom, keeping her long-term interpersonal objectives in view.

For instance, the day Amy announced her desire to arrange a family camping trip, Sophia was prepared. It was hard for her to speak up in the moment, especially when she felt like a little girl who might get kicked out of a car, but she’d gotten better at soothing her panic in these situations, and she managed to stay present rather than shut down. She’d closed her eyes, grounded herself, and gotten clear on what she wanted to say. “I know you love camping,” she’d told Amy. “But it scares me to be out in the woods, and I’d really rather not do it.”

To Sophia’s surprise, Amy had thanked her for speaking her mind, explaining that she preferred hearing Sophia’s concerns early on in the decision-making process to being blindsided by a last-minute refusal.

Sophia also worked up the courage to speak to her mother directly about what would feel comfortable for her in terms of the amount of contact they had on a daily, weekly, and monthly basis, whether by phone, text, email, or in person. Although her mother sniffled quite a bit as they spoke and complained about adult children abandoning their mothers, Sophia reported that after a few weeks passed, her mom was more or less complying with her requests and giving her more breathing room. Their relationship was achieving a new, albeit slightly wobbly, homeostasis.

I was pleasantly surprised when Sophia scheduled a couples session with Amy toward the end of our treatment. We explored some of the shifts in their roles and expectations since they’d adopted Coco and Sophia started therapy. Sophia mentioned her desire to go on a family vacation to Cape Cod in the summer. To our surprise, Amy had immediately suggested that Sophia’s mother join them for the last three days.

“I can’t believe you’re open to that,” Sophia said.

“Well, things have changed,” Amy said. “Besides, Coco loves her grandmother.”

When I reminded Sophia and Amy of the video-clip visions they’d shared during our first session, and noted that each of their visions seemed to be coming true, they smiled happily.

“You’re right,” Amy said, taking Sophia’s hand. “I forgot about that. It’s a win-win.”

Since working with this couple, I’ve become much more mindful of my tendency to cheerlead prematurely when my clients draw hard-and-fast boundary lines in their lives. Sophia taught me there’s a delicate art to creating boundaries. Although by definition, boundaries should be clear and defined, like lane lines on a highway, we can use them as guides rather than barriers. As much as I like to see my clients prioritize what they need in their relationships, I’ve learned to bring a more nuanced perspective to understanding the challenges people pleasers face in learning the delicate art of boundary setting within a web of interlocking relationships.

Case Commentary

By Courtney Armstrong

Alicia Muñoz poignantly illustrates the potential risks therapists need to examine before encouraging clients to assert themselves more actively, particularly within family systems. Encouraging her client Sophia to get in touch with her emotions, whatever other people’s reactions, was a great first step to helping her become comfortable expressing herself. But as we know, the people in our clients’ lives are not likely to be as accepting of new behaviors. Moreover, clients often feel that maintaining certain family roles are downright necessary to their survival. As psychologist Harrier Lerner warns in The Dance of Anger, when one member attempts to change the dance steps in a relationship, it can create tremendous anxiety. Uncertain of the consequences of this new dance, family members will inevitably pressure clients to change back to their old moves.

Our clue that this was the case for Sophia was when she said she experienced a sense of “death by paralysis” at the thought of standing up for herself. For her, asserting herself was akin to being put out on the street. Guiding Sophia to be compassionate toward her younger self so she could learn to manage her fears was an important therapeutic intervention. But given that family members may be incapable of showing the same empathic response, it behooves the therapist to help the client prepare for potential family protests and explore ways to handle them. Clients have to carefully time and choreograph their new moves so that they don’t send their family careening into a nasty fall, from which it may be difficult to recover.

This case also demonstrates that we need to be clear as to whether a client’s therapeutic objectives are really her goals, our goals, or somebody else’s goals. Clearly, Sophia and her mother had an enmeshed relationship, which was negatively affecting Sophia’s marriage. It makes sense that Muñoz would identify setting boundaries with her mother as a primary therapeutic goal. Yet taking back the house keys from Sophia’s mother seemed like Amy’s goal for Sophia’s therapy. I’d have wanted to understand why Sophia had handed the keys to her mother in the first place, and how involved she wanted her mother to be in Coco’s life. Only then could I determine what Sophia’s goals truly were and how to help her negotiate these changes with her mother, and Amy, without shutting down the whole family system.

The fact that Sophia has been able to come out to her family suggests she does have courage and a strong sense of self. Even if she hadn’t had the experience of being put out on the street when she’d asserted herself at a young age, she was taking a huge risk of breaking family ties when she came out to her family. I would’ve explored how she navigated the challenges of this process as a blueprint for how to move forward with the next set of boundaries.

Muñoz is obviously a skilled therapist (and lovely writer), who manages to distill the highlights of a complex case into a few short pages. She may well have addressed the points I mention, but couldn’t include them here because of space issues. In the end, the key issue this case stresses is the importance of exploring the risks of making change before we blindly cheer our clients on. Even the unhealthiest behaviors are likely creative ways our clients adapted to a family system that still influences their lives. As we embolden them to make changes, we must also help them prepare for their family’s countermoves and choreograph their new dance steps without tripping themselves up.

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© Illustration by Sally Wern Comport