How to Say No and Mean It

A few years ago, I visited an emergency room for sudden onset chest pain, a deep ache in the center of my chest. I had not experienced this before, and I was worried. Within minutes, a nurse whisked me into an examination room. The doctor was young and confident, with a no-nonsense manner. She listened to my heart and my breathing, then conducted an electrocardiogram, noting nothing out of the ordinary. I was relieved and told her that my pain was subsiding. I expected her to discharge me, but instead, she said that I had to have a CT scan before she could let me leave.

“Why?” I asked.

“Just to be sure you don’t have a pulmonary embolism,” she said.

As a former physician, I knew that a pulmonary embolism—a blood clot in the lungs—causes a sharp, stabbing pain in the chest, one that catches your breath as you inhale and exhale. I was not experiencing that, so I was certain that the scan was unnecessary. A CT scan would also expose me to ionizing radiation—about 70 times more than an X-ray. This is still a small amount, but any exposure can increase the risk of cancer; why take the chance for no real reason?

I also agree with bedrock principles of medical ethics, including nonmaleficence (doing no harm) and autonomy (a patient’s freedom to choose).

I should have said no.

But I was lying on a hospital bed in a chilly room, staring up at fluorescent lights. And the doctor wasn’t asking for my opinion. She was telling me what she was going to do. Before I could object, she had disappeared and someone else wheeled me into the scanning room. Ahead of me was the plastic tunnel of the CT scanner with its raised platform. I sat down on it.

I didn’t want the scan. I didn’t need it. But I also didn’t want the medical team to think I didn’t trust their judgment. I didn’t want to make even a minor scene. So I lay back on the gantry, and as the scanner’s tube whirred and clicked, I was perplexed: I knew the scan was unnecessary. I knew it didn’t align with my values. I knew it could potentially be harmful. And yet I had agreed to it. I went along with what the doctor ordered.

Why? Because she told me to.

I have studied defiance and authority for years. And I have learned that despite everything we believe about ourselves, we often go along with things, even when we know we shouldn’t, in situations both life-threatening and trivial. We are so conditioned to comply that we might not even realize that a moment calls for defiance until it is too late. We believe we’ll do the right thing in those circumstances, but then we freeze, confused and unprepared. We fail to put our values into action.

In experiment after experiment, I’ve learned that for many of us, the distance between who we think we are and what we actually do is enormous and that it is incredibly difficult for most people to defy an order, even an unspoken one. Despite our ideals and best intentions, we most often choose obedience over disobedience, compliance over defiance. In every workplace, home, and classroom, defiance is the exception. Obedience is the rule.

But it doesn’t have to be that way.

Why We Don’t Defy

Before we go any further, I’d like to propose a definition of defiance that honors our individual agency: acting in accordance with your true values when there is pressure to do otherwise.

Our societies are not set up for defiance. We are not always encouraged—or “allowed”— to act in accordance with our values. We are taught from a young age how to obey, that obedience is good and disobedience is bad. We are not given similar instructions for how to defy. So, all too often, we give up our agency without thinking. We say yes when we don’t mean it. We actively resist defiance.

In my research, I have found three key reasons for why this happens:

1. We face enormous pressure to go along with what others want us to do, whether they are authority figures, friends, family, or even strangers.
2. We don’t really understand what compliance and defiance are.
3. Once we decide to defy, to act on our true values, we don’t know how to go about it. We lack the ability to translate inner defiance into outer action.

As a result, our lives are filled with quiet compliance, moments of almost unthinking acceptance of the status quo. I say “almost” because most of us do feel some discomfort in these moments. I felt it in the doctor’s exam room when I accepted that scan. You’ve probably felt it, too: a kind of powerlessness, a reluctant inability to act according to your own values, a yes that doesn’t quite mean yes. It may show up as tension in the back of your neck, a headache, a stomach cramp, sweat, or general uneasiness. It’s natural to want to get rid of that feeling—or to ignore it. And yet that discomfort is the key to our power to defy. It is an internal compass guiding us back to our values.

The forces that lead to compliance are more complex than they might appear, but they are not insurmountable. We may not always know how to defy, but we can learn. And if we can break free from the culture of compliance that surrounds us, we can start to create new possibilities for ourselves and our communities.

Know Your True Yes

To comply is to “go along.” Compliance is reactive and often imposed: by someone else, by a system, by an environment. There doesn’t have to be overt pressure; compliance can be something we passively accept, or allow, or are pressured into.

When I conceded to a CT scan I did not need, I simply did what the doctor wanted me to do. But I certainly did not feel that I was doing something I had chosen. I complied, but I did not consent.

Consent is radically different from compliance. It is a thoroughly considered authorization that is an active expression of our values. Consent is powerful and comes from inside ourselves. It represents our True Yes.

I find the medical definition of “informed consent” to be a useful framework to understand this. Informed consent aims to ensure that the rights and autonomy of patients are not violated. It requires five elements:

• Capacity is the awareness, cognitive ability, or competence to make decisions.
• Knowledge is possessing the facts of the situation. A person who has been lied to lacks knowledge. So does a person from whom vital information—the harmful side effects of an experimental medication or the fact that the home they’re buying lies in a floodplain—has been withheld.
• Understanding is how a person processes the information they’ve been given. Without understanding, the receipt of information is a moot point. Just because a banker gives you hundreds of pages of material about the mortgage you’re taking out doesn’t mean you understand that the loan you just signed up for has an excessive interest rate you cannot afford.
• Freedom means your decision is voluntary, you have not been coerced or unduly pressured, and you have the choice to say no.
• Authorization is an explicit active decision. Valid consent necessitates an affirmative yes, not merely passive acquiescence.

True consent, in any situation, must have all five of these elements. If any one is absent, then consent is invalid. If any are compromised, then even a vocal yes doesn’t signal valid consent—because a person who has been denied capacity, knowledge, understanding, or the freedom to say no cannot give a True Yes.

Our Great Disconnect

Years of psychological research suggest that there is a big difference between what we think we will do in a situation and what we actually do. It turns out that we are very good at predicting whether or not we will consent, but terrible at predicting whether or not we will comply—and we comply much more often than we consent.

Psychologists Julie Woodzicka and Marianne LaFrance presented three questions to a group of undergraduate women, each of whom believed she was interviewing for a job as a research assistant for a professor: Do you have a boyfriend? Do people find you desirable? Do you think it’s important for women to wear a bra to work?

The researchers had already asked a similar group of women what they would do if asked those questions in an interview. Those women predicted that they would feel angry and reject the questions, confront the interviewer, or walk out. But the study found that when women were the actual targets of these harassing questions, not a single one rejected them or walked out. Women in the actual interview situation said they did not feel anger in the moment, as the other women had imagined they would. Instead, they reported feeling afraid and unable to do anything other than smile uncomfortably.

Smiling in a harassing situation might seem counterintuitive, but not all smiles represent true positive feelings. A colleague once referred to the “crocodile smile” I display in situations where I am not comfortable complying but feel I have little choice—such as being expected to perform the role of secretary at meetings, yet again, or politely answer my boss’s questions about my “exotic race,” yet again. It’s an instinctive small upward turn at the corners of my lips: the shape of a strained smile. It’s a response created by years of social conditioning that taught me the importance of appearing conciliatory, helpful, and accommodating. But even as a child, I understood that a yes didn’t mean much if you did not feel you could say no.

The crocodile smile is a survival strategy. It doesn’t necessarily indicate consent, but it often is interpreted that way. It’s a shield that says: I am not a threat. I will play by your rules. I concede. I comply.

The Trouble With Aiming to Please

Often when we fail to defy, we let external and internal pressures cow us into submission. We may doubt our ability to take action; we may displace our responsibility onto others. But just because someone obeys authority does not mean they’ve lost their sense of morality. They have simply redirected it toward an authority figure. Instead of considering whether their actions are moral, an obedient person measures their morality in relation to how well they have obeyed.

Employees, for example, can become so narrowly focused on doing a good job that moral concerns fade. When we aim only to please our boss, our frame of responsibility shrinks. We push any ethical dilemma to the background or remove it from our decision-making altogether—a phenomenon psychologists call “ethical fading.” We jettison connection with our deepest values because we have located our sense of responsibility not to ourselves or others but to the immediate authority.

In several studies that I conducted with my colleague, Kaitlin Woolley, we found that feelings of responsibility actually increase when a person is swayed by another to make a decision that goes against their better judgment and a negative outcome occurs. We call this “the kicking yourself syndrome.” People feel more culpable when they think they should have known better than to follow bad advice: I knew this was wrong. I knew I shouldn’t have done that. Why didn’t I defy them?

We might follow orders because we think the responsibility and blame will lie with another person if something goes wrong. But following someone else’s advice against our better judgment doesn’t save us from feeling culpable; we actually feel worse. We cannot wish away responsibility. Better then to stop running from it and instead use it to align our behavior with our values.

“Who Am I?”

Actions speak louder than words, especially when those actions repeat. So many people I have interviewed about defiance recall thinking, when they found themselves complying with something they didn’t wholly believe in: This isn’t me. This isn’t who I am. Such an inner monologue is a manifestation of tension. It arises from the discomfort of a discrepancy: Who you think you are is in conflict with the values your actions reflect.

When our public behavior differs fundamentally from our private beliefs, who we are changes. We risk becoming a person we don’t recognize, a person we don’t believe we are. When we notice that our actions do not match our core values—that our behavior does not reflect who we want to be—it’s a signal that something is amiss. When we hear the little voice in our head saying, “This isn’t me,” it’s a good idea to listen.

Defiance, then, starts with one question, short but not so simple: Who am I?

So often our values go unvoiced and unexamined, and are therefore unavailable to us when we need them most. We often don’t think to verbalize our values until we are explicitly asked to list them; they are part of who we are, but because we may not have spent the time to deeply consider them, they can feel inchoate, or inaccessible.

For our values to guide our behavior and lead us to a True Yes or True No, we must know them and name them so they can shape our behavior and help us determine how to respond in challenging situations.

Values are not situation dependent, though in practice acting on them may be. Core values do not change if we are at work or at home or dealing with a loved one or a stranger. They are not short-term or tied to specific goals. They come from deep within us, guiding our behavior and framing how we understand the world.

In my exercises with students, common moral values emerge again and again: integrity, equality, compassion, humanity. These widely shared core values transcend cultures, religions, contexts, race, and gender and cannot be boiled down any further. Their apparent simplicity belies their immense power and depth. When we connect with values like these, our actions display our true consent or our true dissent.

Dare to Defy

Each one of us, at some point in our life, will witness something unjust: during a police response on the street, in a conference room at work, or within our own family around the dinner table. Sometimes we are the victims of that injustice, sometimes we are bystanders, but either way, we are often caught between wanting to act and being unsure of exactly how to go about it.

As someone who has come to value and practice defiance, if someone asked me, “What is the one thing you do differently now?” I would answer: “I give myself the power of the pause.” Austrian psychiatrist Viktor Frankl, who wrote Man’s Search for Meaning, describes the moment before we choose to defy: “Between stimulus and response, there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.”

Defiance is a choice. Your choice. So take the space. Take a pause. Ask yourself: What does a person like me do in a situation like this? Compliance has been our default for too long. It is time to put no on an equal footing with yes. To imagine a world in which unjust orders are questioned, unfair structures interrogated, and flawed assumptions overturned. A world in which we only say yes to the things that truly align with our core values. A world in which yes is not taken for granted and no is not discouraged. Choice by choice, decision by decision, we create a world in which all of us can defy.

From DEFY: The Power of No in a World that Demands Yes by Dr. Sunita Sah, to be published by One World, an imprint of Random House, a division of Penguin Random House LLC on January 14, 2025. Copyright © 2025 by Dr. Sunita Sah.

Sunita Sah, MD, MBA, Ph.D., is a physician turned organizational psychologist at the SC Johnson College of Business at Cornell University and the author of Defy: The Power of No in a World That Demands Yes.

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