Just say YES – the Ir­ish in ques­tion:

The Irish Times - Tuesday - Health - - Front Page - Jackie Jones

Irarely dis­agree with the opin­ions ex­pressed by Ir­ish Times columnist Lucy Kell­away. In a re­cent col­umn – “The sheer bliss of just say­ing no” – she wrote: “Yes can be said by any old fool, while no re­quires char­ac­ter, com­mit­ment and courage.” She re­ferred to a num­ber of new self-help books on as­sertive­ness skills, in­clud­ing one by Laura Tong, The Life-Chang­ing Power of No.

The truth is that most adults have dif­fi­culty say­ing yes as well as no. Say­ing yes as­sertively – which means say­ing it en­thu­si­as­ti­cally and with­out mak­ing the asker wait – is a skill that must be learned. In fact, Ir­ish peo­ple gen­er­ally find it hard to be as­sertive with fam­ily mem­bers, col­leagues in the work­place, friends, neigh­bours and even strangers. Most adults find it daunt­ing to com­plain in restau­rants if the food or ser­vice is not up to scratch, and to stand up to health pro­fes­sion­als.

Peo­ple of all so­cial classes and oc­cu­pa­tions have dif­fi­culty be­ing as­sertive. When work­ing as a health pro­mo­tion of­fi­cer, I ran hun­dreds of as­sertive­ness cour­ses for women, men, teach­ers, priests, school in­spec­tors, nurses, doc­tors, com­mu­nity groups – and Gay Byrne’s ra­dio show. Re­gard­less of age or oc­cu­pa­tion, par­tic­i­pants in these cour­ses all had dif­fi­culty say­ing yes and no. Most at­ten­dees were also un­able to ex­press their feel­ings as­sertively, han­dle crit­i­cism or deal with con­flict. Par­tic­i­pants agreed that in most sit­u­a­tions they be­haved ei­ther ag­gres­sively (dom­i­nat­ing oth­ers), or pas­sively (be­ing a door­mat) in­stead of as­sertively, which means stand­ing up for our own rights in a way that re­spects the rights and needs of oth­ers. Ask­ing for what they wanted while ac­knowl­edg­ing that the other per­son has the right to refuse was dif­fi­cult for vir­tu­ally ev­ery­body on the cour­ses.

Adults have prob­lems be­hav­ing as­sertively be­cause they were not taught to be as­sertive when they were chil­dren. From the time they could talk they were told not to say no to their par­ents and other author­ity fig­ures. Say­ing yes too en­thu­si­as­ti­cally was also frowned upon.

Learn­ing to be unassertive con­tin­ues in schools. The­o­ret­i­cally, chil­dren now learn as­sertive­ness as part of the so­cial, per­sonal and health ed­u­ca­tion (SPHE) pro­gramme, but this is of­ten con­fined to teach­ing them to say no to al­co­hol, drugs and sex and to say yes to a healthy life­style. Teach­ers are not good at teach­ing as­sertive­ness be­cause they are not as­sertive them­selves. Many chil­dren learn to use ma­nip­u­la­tion (sulk­ing) to get their own way, and this game-play­ing con­tin­ues into adult re­la­tion­ships.

There is con­vinc­ing ev­i­dence that as­sertive­ness skills pro­mote health, and lack of as­sertive­ness leads to stress, anx­i­ety, and men­tal health prob­lems, or what Laura Tong calls “the dis­ease to please” in The Life-Chang­ing Power of No. Men­tal-health pro­fes­sion­als of­ten pro­vide as­sertive­ness train­ing for their pa­tients. Un­for­tu­nately, there are not enough of these des­per­ately needed cour­ses.

As­sertive­ness books have been around for about 40 years and have not made peo­ple more as­sertive, be­cause as­sertive­ness skills can­not be learned from a self-help book. They must be taught by trained fa­cil­i­ta­tors us­ing role play, where par­tic­i­pants get a chance to prac­tise the skills and re­ceive feed­back. With the skill of say­ing no, for ex­am­ple, par­tic­i­pants on these cour­ses are of­ten amazed to find that they do not ac­tu­ally use the word “no”. They think they have said no when they have ac­tu­ally ob­fus­cated or made ex­cuses.

In ad­di­tion, say­ing no must be taught in the con­text of rights and needs. These rights in­clude “I have the right to say yes and no for my­self” and “I have the right to ask for what I want”. Re­fusal skills mean us­ing the word no, say­ing it as soon as pos­si­ble and then thank­ing the per­son for ask­ing. Ex­press­ing feel­ings as­sertively in­volves iden­ti­fy­ing the feel­ing ac­cu­rately and mak­ing an “I” state­ment such as “I feel afraid when you shout”. Do not use “you” state­ments such as “you make me feel afraid when you shout”.

Sim­ple, maybe, but these skills need prac­tice. Most as­sertive­ness cour­ses last about 20 hours, and par­tic­i­pants’ health, es­pe­cially men­tal health, will im­prove if they prac­tise the skills in their every­day lives.

As­sertive­ness skills such as han­dling crit­i­cism, deal­ing with put-downs and con­flict res­o­lu­tion are cov­ered in Well­be­ing through Group­work: A Man­ual for Fa­cil­i­ta­tors Who Are Pro­mot­ing Health

(HSE, 2004). My Bill of Rights from Anne Dick­son’s A Woman in Your Own Right: As­sertive­ness and You (1982) is in­cluded. A free PDF ver­sion of the man­ual and hard copies are avail­able from health­pro­mo­tion@hse.ie.

Adults have prob­lems be­hav­ing as­sertively be­cause they were not taught to be as­sertive as chil­dren . . . they were told not to say no


Could you re­peat the ques­tion?: Adults have prob­lems be­hav­ing as­sertively be­cause they were not taught to be as­sertive when they were chil­dren.

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