I work with a lot of trauma clients who fawn and this is a common skill we use in therapy for those who over-apologize: replace “sorry” with “thank you.”
It’s not “sorry I’m late,” it’s “thanks for waiting for me!” It’s not “sorry I’m talking so much,” it’s “thanks for letting me unload all that.”
It’s great for exposure with taking up space and an easily defined homework assignment for therapy. Clients love it and the debriefing the next session is always really fruitful.
Changing these words helped me so much. Now when I’m tempted to say sorry I ask myself what can I say thank you for instead. It helped me so much. Took a while to change the habit but it totally worked.
This is how I deal with it too. Always keep it positive is my motto with most things that I do and it's usually served me (and my clients) well. I work a lot with clients suffering from long term grief and one of the things I do is switch things like *I miss him SO much* to *I'm so grateful I had those years with a man that I really loved and who loved me so much*. I deal with over-apologising the same way. I know it can be tiring, but it never annoys me. It's just another opportunity to reinforce a different approach. In the longer term, it does work!
I've had clients who apologize a lot or too much, but never one for whom it has been a specific therapy goal.
I'm curious how you're responding in session when the client apologizes. Are you offering them reassurance and gentle reminders that they don't need to do that? Breaking from the conversation you've been having to give her an opportunity to express her feelings? If you're doing anything like that, you're probably reinforcing the behavior. From a purely behaviorist perspective, you'd probably get more mileage out of simply ignoring her apologies and continuing the session as though she had said nothing at all.
I'm also curious, after all of the exploration your client has done, does she have a sense of what she would like to do when she feels unsure or exposed, instead of apologizing? If not, that would be a useful discussion to have. It allows you to change the valence of the goal from negative ("I want to not apologize") to positive ("I want to do XYZ when I feel unsure"), and to use reinforcement to nurture the chosen behavior... which is a lot more effective than punishing the unwanted behavior, particularly when the natural response to punishment would be to apologize more.
This is a really good idea. And a good point. I do find myself reassuring them when they apologize in session. It's hard because when they say sorry to me they always really do feel, not "remorseful" necessarily, but like they are perceived by me as bad, irritating and a burden. They claim they feel embarrassed all of the time, and often will say they feel extremely embarrassed during sessions for their stagnation and how much of a drag and irritating person they are, or think I (and others) think they are...
We tried EMDR but she seemed unable to access her emotions. She presented as flat while recounting sexual and physical and emotional abuse, more concerned with doing it right than processing. I'm getting trained right now in CPT so may try that in the future after more resourcing etc.
I don’t do EMDR myself, but my understanding is that you’re supposed to be really grounded in the present, like have good emotion regulation, skills, etc., before you begin to do the trauma work. I would wonder if she ever got to that place first.
I have a client I’m working with in couples work who went through extreme extreme exposure to domestic violence, physical abuse, and the worst case of emotional control I’ve ever heard of. And I’ve been a therapist for 33 years.
His wife had an affair, and he cannot get angry at her. Instead, he asks what he did to deserve it. He turns every situation in his life into one of self criticism and blame. Everything. He was absolutely unable to experience any emotion other than fear, and has this deeply etched belief and pattern of blaming himself for everything that goes wrong, inside or out of his sphere of influence. This situation with your client reminds me of him.
I don’t do that work, I referred him to an individual therapist. It’s just the pervasiveness that seems similar. Sounds so tough, I wish you all the best!
Is it possible that this is a compulsion related to OCD? I ask because my sister has a similar problem, with a different but similar phrase. She has done work with her own therapist to stop repeating the phrase, but nothing seems to help (so far). She also has extremely low self-esteem. Her psychiatrist diagnosed OCD, though I think she actually more likely has OCPD. Your description just rang bells reminding me of my sister’s behavior. Might be something to consider/explore, especially if she doesn’t really even know she’s apologizing until after she’s done it.
I apologize that I'm responding without having read through the comments section, so I may be afield of the conversations taking place.
Something I took on about three years ago was a radical re-examination of what is happening during the enactment of apologies. I noticed what I felt was that apologies come in lots of flavors of enactment, and there's often something sticky on both sides. The very day I noticed this, I attacked the relational piece with one of my apologizers. Instead of "That's okay!" or "I'm wondering about this desire to apologize." I just rejected all of it and decided to speak ONLY to my side of the relationship. My response was, "I was not upset."
I've learned over the past three years that those words can be very powerful. You're sorry; you apologize to me. "Thank you. I am not upset." Think about it. That response completely short circuits any enactment or maladaptive transferential/countertransferential exchange. It's a flat statement about my experience. "I am not upset."
It might be followed by, "I just feel bad for X, Y, and Z."
"I hear you. I am not upset."
"But I just don't want you to think A or B about me. I'm really sorry."
"Suzie, I was not upset."
It is honest. And it highlights a shocking moment of individuation. I'm honorting the apology and also removing myself from the relational entanglement.
I've actually adopted this in my life. And it allows me to reflect and accurately say, when I need to, "Yeah, I was upset by that. Here's why. I'm grateful for your apology and I see you and accept it."
There's something powerful about STARTING from a place of "You being sorry is your story; I was never upset."
I'm glad you find space in this.
It's a position that has opened up some wonderful moments with myself and clients. I recall one exchange. I kind of have a magical number: three. When a person (clients, friends, even myself) repeats a behavior or utterance three times, I start looking for neurosis. So, I had a client who apologized for being very late. They apologized. I said, "I was not upset. I'm glad you're here." They apologized two more times, with varying kinds of emphasis. Finally, as I walked them to their next appointment with psychiatry, they apologized again. And we shared a moment where I said, "I don't know what this is about. I have already expressed that I was not upset. So that part is done. It never existed. Yet here we are, you're still apologizing. I don't know what you want from this." There was an awkward moment. It lead to a conversation where I said something like, "If you want me to participate with you in beating yourself up, I won't. If you want me to let you off the hook, I can't. And if you want me to praise you for doing better, I'm not sure that is useful. I was not upset. So what is happening here?" That lead to some remarkable work.
Even in my own personal life, I was friends with a chronic apologizer. And they would get \*mad\* if I said "Hey, Nat. I was not upset." Finally, one day they said, "It doesn't matter if you're upset! It's important to me to apologize!" Old friend told on themselves, and I wasn't sure how many times I could lavish them with "It's okay!" or "Oh, thank you. You're all good!" before it felt like I was patting them on head calling them "Good boy/girl." Constantly inhabiting the space of some well-regulated permissionist became a sticking point for the friendship.
And like I said in my original comment, it allows me to reflect. If somebody apologizes, and if I'm situated firmly in my experience, I can offer back a more clean-burning grace and affection when I \*was\* actually upset or distressed. That applies to clients and friends and my spouse. All of it.
All of this is also hard to do. The enmeshment of apologies, the enactments and entanglements of apologies, are difficult narratives to disassemble. It's kind of in our bones. For a long time I couldn't even keep out a little reassurance: "It's okay! I wasn't upset" or "I wasn't upset. It's all good!" I had to work to even trim those pieces and maintain a loving "I wasn't upset." So, it does feel a little awkward at first. But gosh, has it been worth it.
Thanks for this. Question though: wasn't your friend's response, "it doesn't matter if you're upset, Its important to me to apologize!" similar to what you were doing? Owning that the apologizing is about them, and their feelings and experience, rather than an assumption about what you are feeling or want?
I mean I agree that it is annoying and uncomfortable to be apologized to repeatedly and it is not healthy for the apologizer, but I don't understand why saying "I'm sorry" is always interpreted as a plea to get someone else to respond to them or manage their emotions for them.
Isn't it just an expression of ones personal feeling of anxiety, embarrassment or shame? I don't think the apologizer always wants a response or to burden the other person, but I do suppose everything we say has consequences.and it's not fair to vent and voice publicly our emotions and insecurities too often, because we are forcing others to caretake when we express ourpainful emotions out loud?
Genuinely curious about this. I suppose intense feelings of being sorry or worried should not be expressed verbally because expression itself implicitly demands something of others. I suppose I need to be more aware of my own occasional slips where I without thinking let my own negative self perceptions become evident, not as a bid for attention, just a way to express the intensity and I suppose vent the pressure building up inside. Not to get reassurance or anything, though that is what I am forcing the other to do...
Hey, for sure. I don't take this anything other than a conversation and I appreciate the chance to clarify.
In the case of my friend, I left a lot out in the interest of making a simple point. My friend's chronic apologizing fit into a much larger pattern of interaction that I experienced as cloying, needful, and exceedingly self-depreciating, to the point that it felt like a quiet request for me to participate in or respond to those feelings and behaviors. When they said, "It's important to me to apologize!" they weren't saying it relative to me chastising them or pointing out anything about the chronic apologizing. They were responding to feeling me shift from doing extra work of ameliorating their concerns to simply saying things like "I wasn't upset" or "I didn't feel offended." That was enough to elicit that response, and confirm what I had felt: that they needed something \*else\* from the friendship. It felt to me much more like a protest that I wasn't participating in the ways they expected. And I'm talking years and years of friendship data on this.
I think you sort of said it, in a way: there is often an anxiety wrapped up in an apology. It's just not always the one we think we're expressing.
In my life, I have over-apologized as a way to make myself feel safe. But that's not really the role of an apology, in my feeling. An apology is an expression of contrition, and an invitation for the Other to feel seen. I didn't like my apologies that were a search for a salve for my anxieties.
I'm not judging any of these behaviors. And I am admittedly dynamically oriented. So I'm noting that the apology often comes with luggage. It often comes with contrition, but also as a bid for something else from the person we're apologizing to: affirmation, permission, valuation, safety... things that are less clean-burning. In my own closest relationships, I find myself gravitating to folks who I feel do indulge reflective, clean-burning apology. And I strive for that myself. It's one reason my spouse and I work so well together, and that I'm ever grateful for.
But, again, I do not at all judge. And I don't \*expect\* us to always be efficient in our self-expression. As a therapist, I feel that part of my work is noticing profound and recurrent incongruencies/inefficiencies: in this case, the chronic apology. And as in the case of the client I described, in my early experiments with this positioning, by reflecting on my experience only I was able to more quickly get to, "Wait... what's going on here?"
A messy analogue might be gratuities offered to a therapist. A client offers a cash gratuity. One might say, "Thank you. I don't accept gratuities." And they offer again. We decline again. Maybe they're just that grateful, we think. But by the time they offer a third time or say, "You know what? I'm just gonna make out the check for extra," I think we're compelled to wonder, and probably wonder out loud, "So, I've described my experience and feelings. And you're still wanting to move through that in your way. What is this about?"
It’s similar when I say “Thank you. I wasn’t offended,” and the apologies keep coming.
So, yeah... there are anxieties that come with an apology. But they may often be different from what we suspect. So, focusing on what else may be happening outside of the {offense—>apology} pathway might give us a deeper narrative.
Why did my friend insist on others affirming her obsequious nature? What did that say about how she managed relationships? Why did I apologize repeatedly when I was seeking safety if I didn't really mean it? And from people who weren't actually a danger to me? What unfair position(s) did my unresolved feelings put them in? And why was my client (and yours and a million others) indulging this ritual when I (and probably you and a million others) were never actually offended and we've said so?
Blocking the brighter light that shines from an apology— by communicating "I was not offended or distressed. I notice you're still apologizing. Since you know I wasn't offended, where is the apology going? To whom? Not to me. So whom?" but maybe in fewer words—we can kind of see the more fantastic lights peeking from the edges. (Intentional eclipse reference).
Truly, thanks for the conversation. I wish we were sitting over a cup of coffee. I'm sure we could talk about this a lot. And I'm not bothered by thoughtful, loving disagreement. Truly.
Thanks so much! This was really thoughtful and helpful. I think what some over apologizing clients need is first to figure out what the excessive apologies are really about, and then a game plan for what to do instead, so exactly what you are saying. The balance between talking responsibility for your emotions without imposing your anxieties on others is a hard task, like everything we do in therapy. I think it can be hard for some, who have a lot of unresolved anxiety, to find a balance between, on the one hand, unconsciously forcing others to manage your anxiety and, on the other, isolating or inhibiting oneself too much, in order to avoid placing the burden of ones anxiety on anyone else.
Have you ever had clients feel very ashamed of themselves they come to this realization, that their apologies are often pleas for something from others? I find psychodynamic therapy in general to be so helpful and so painful at the same time. How do you navigate clients shame when they uncover unconscious motives? Maybe I'll make another post about this topic alone...
Hey, thanks for the chat. I've actually been meditating on it today.
I don't know about the word shame, but certainly noticing things about ourselves can be very vulnerable-making. I think a lot of how that plays out in therapy very much depends on the rapport and also a therapist who can think (and feel) on their feet.
In a non-apology example, I one had a client who presented with what I might call subclinical histrionic features and lots of anxiety. They had a running theme, a deep preoccupation with one particular meta-narrative. I pointed that out because I suddenly felt it. They sat down and told a story about deeply unfair and unjust things that happened that day. As they went on I said something like, "We've been seeing each other about six months. I'm noticing something. About 90% of the content you talk about here is something really unfair. Some injustice that's happened to you."
"Well, yeah. You're my therapist. Isn't that what we talk about."
"Maybe. We could talk about all kinds of things. I'm noticing that \*your\* content involves a lot of injustice. See, I'm just some person in a room. This is a blank canvas, and this is a larger theme you frequently go to."
"So?"
"Well, I'm noticing some feelings in our relationship. Like I said, you chose this theme and I'm a person in this room with you. I'm wondering something... Who am I to you that I can adjudicate the injustices you've experienced?"
They went blank and the temperature of the room changes. I let it sit and I said, "Part of why I'm wondering this is because I wonder if other people in your life might be feeling this "
I'll tell you what, our work began in earnest that day. I could go on in detail or in DM, but everything changed. Did it feel risky to say? Yes. Did they hear it, feel it with me, and let it happen? Yes.
And I think that comes to mind as I look at the OP. You said something actually super magical You said, "It does not feel good to be cast in the role of this tyrannical monster and bully."
I can't help but wonder what it would look like to go right there. Some phrases I have used are things like,
"So, I've noted that you didn't commit any offense with me and I've noted that I didn't feel distressed. You're still apologizing. What's happening between us right now?"
If they deflect by calling it a habit, I might say, "Well, a habit is another name for things we do. So what is happening in this habit?"
That kind of moment can feel precarious. I used to offer little lifejackets to my people in the form of, "It's okay. This may feel uncomfortable. But let's stay with it." I don't do that as much any more. I trust my tone and my energy and our relationship to do that work. But it's not bad to do.
They might reach for circumstances. Something like, "Oh, I just get so much sh\*t at work." And I would definitely say, "We're not at work. We're here. This is you and myself." Whatever it takes to support the person going into their body. I often say things like, "The apology is far enough away from my experience that I wonder who you're apologizing to. What is coming up for you?" That usually gets a conversation going and I trust the first one or two things that come out of their mouth. Association has a powerful way of popping out when it's invited.
You might even go more direct like I did with that other client: "Sometimes your apologies feel to me like I must appear frightening or monstrous to you. I don't think I really I am. But I do wonder about that."
"Oh no! You're not that!" would be predictable. So maybe, "Ok, good. I'm not. So then what is happening for you in that moment?"
There are a lot of directions to go. Can it be painful? Absolutely. Shameful? I'm not sure but maybe, depending. I think lots of silence works; having very efficient sentences, and trusting them and yourself to a high degree are key. To borrow from Maria Montessori, if I have prepared the space (AKA the frame) then I can trust them to arrive. So, I think in a very discursive, maybe annoying way, what I'm saying is that the "shame" or whatever it is that comes—the vulnerability—is part of the work and maybe doesn't need to be managed. It just needs room to breathe while we try to focus the lens through it. "I know this can be hard to talk about. It also feels important." Regulating my body helps them regulate theirs.
I call it surfing the relationship. I'm feeling the relational space with them, but instead of being pulled into the ocean, I'm on its edges, noticing it and honoring it. You're absolutely right. It's difficult work. And it takes a lot out of me physically. I find myself meditating \*while\* I'm in session, just to have an accounting of my own responses. My gosh, though... the work! It can be really lovely and deeply meaningful.
One more question. In your own case, of apologizing to feel safe, did you find a better way to feel safe? Did you just realize it and force yourself to stop and that led to feeling safe?
I guess I'm wondering if awareness and practice/exposure was enough or if you found some other way to feel safe in relationships.
As for my experience, I think it was a combination of my own therapeutic experiences combining with an increased sensitivity to others around me (a deep sensitivity, not a reactive sensitivity). As I grew, I noticed and felt that something was off about these interactions, and that I was putting others off or at least making their experience of the apology interaction feel difficult. That took me to, "What else am I doing here?" or "Why don't I feel better when they say it's okay? Why am I hounding these people?" The question "What's really going on?" has become sort of a natural position for me in all of life. Those feelings dropped me in to notice my expectations or at least hopes circling the interactions, and then how that might not be a fair or even honest experience of apologizing. All of this happened sort of quietly in me.; it also happened very quickly and very slowly at the same time. I'm not sure how to explain that. And it was an important part of a growing process. Because by noting this behavior, I landed in the BIGGER experience of "I don't feel safe" which, of course, is much more expansive than pissing off a friend. And that took me to big bigger self-narratives and meta-narratives.
I am a therapist with ADHD, who also used to be a chronic over apologizer due to shame and fear of inconveniencing others. One day my therapist casually said, “stop apologizing for existing, you’re allowed to exist.” it wasn’t until that moment that I realized that it was OK for me to be.. human? And that I was allowed to take up space. I cannot be more serious when I tell you that I had no idea that that was why I was apologizing for nothing. That I felt my mere existence was an inconvenience to others.. obviously progress wasn’t made overnight, but that comment fundamentally changed my life.
I've come across this at the beginnings of therapy. Once I notice this dynamic I stop reassuring in any way and become curious around it, or carry on with the session once the client has regulated and stopped the apologising. At a certain point it reinforces and isn't therapeutic. Very quickly after not coming in to validate this and actually discuss the work we're doing instead, the client stops doing it and either engages or leaves to find a therapist to continue the game with.
I'll often tie this behaviour to childhood trauma and the apology as a way to ward off harm, even when it's unnecessary as the setting is safe. Its a coping mechanism that has outlived its usefulness.
Well, especially because she says for this client, the apologies come from a place of genuine remorse, like they are feeling that they did something wrong every time. That is trauma in my opinion.
But it's not an appropriate response, so if you have been responding in the same way for 2 years and nothing has developed then a change of tact would be needed imo. The occasional sorry is fine - 10 times a session? So every 5 minutes? Where is the genuine remorse there? What has the client done and what are they going to change due to the remorse? This is shame, not remorse. When clients present with shame it's an opportunity to explore in a trauma informed way around it, not to interact with it on a surface level that doesn't acknowledge what is happening in the room, imo.
Sounds like you've been doing a great job and there enothing wrong with that thought.
Is it her goal to not say sorry? Or is it yours? Because we sometimes have different goals than the clients, and that makes it so difficult.
There is always a negative of changing as you've described. There is also a positive, but maybe that motivator is not strong enough..
Would it be worth completing the YBOCS/YBOCS-SR-II just to rule it out?
There have been so many times that a ct says something and I think to myself, “Wow, my OCD spider senses are tingling,” but they deny other issues. Then, when we do the YBOCS it’s like “hah! Bingo!” Some of the OCD symptoms are either shameful and/or unnoticeable to the Ct because they’re so used to it.
It might be to obvious, but exchanging the sorry for a thank you? Expressing gratitude rather than regret?
Sorry(!) if this is something you've already tried
Ok, this might sound weird, but I work with kids, so weird works: Have you tried using a buzzer or something like that? You present it in a playful manner - "every time you say sorry, I'm gonna hit the buzzer/blow the whistle/ring the bell/whatever. Let's see how long you can go without that happening." Maybe whenever you "catch" them saying sorry - you have them rephrase or say something like "I don't need to be sorry for my feelings (or whatever it is)". To spice it up, they can buzz you for something too, like using a common phrase or filler word or any silly little habit (like I fidget with my rind in sessions). Whoever gets buzzed the least wins something for that session (bragging rights, a candy bar, a flower - whatever you want). Make bets on how many times you'll each get buzzed. Obviously you want to deal with the shame and other issues that caused these habits, but sometimes a more lighthearted approach can help with actually making change. It's just a way to create awareness of the habit and motivation to stop that's independent from shame/guilt/feeling annoying.
A lot of good insight on trauma vs/& OCD. I'd like to offer an experiment. Sounds like they have good insight and a desire to change, just can't quite get the space before the compulsion because it feels distressing to NOT say it (but also distressing to do it, too).
I like experiments. I might do a session where they need to break their 'sorry' record by saying it more. Like, after every sentence pause. You can say sorry, too. Notice how it feels for them - is it forced? Does the word lose meaning? Does it feel better/worse? What's it like to make that choice?
A spicier one: You seem like you have years of rapport with this client. I might make a deal with a client that whenever they say sorry, I'm going to do/say the opposite of what they want to hear in an obnoxious way (i.e. "damn right, you SHOULD be sorry!!"). This might, at first, be humorous and give some distance to how inappropriate the sorry is. It could also be a shock to the part that is really anxious about that outcome, even though it's a planned exposure. You could talk about what that was like, even though it was planned. How can they cope without that reassurance? Lastly, it could provide the awareness that it IS choice to say sorry just as much as it is a choice for you to respond. It feels automatic, but we can slow these things down.
You can always start out with, "every time you say sorry, I'm going to quack like a duck". And see how that goes, too. :)
What creative ideas! Love this. I second using exposure. The client has awareness this is a problem and needs to build tolerance for the antecedent emotions that lead to the apology. Many have commented OCD, but rather than focusing on the diagnostic label, simply use ERP principles if it’s functioning the same way. What matters more than labels if treating the function and maintaining factors. Practice during sessions to have them identify and express the feeling (guilt? anxiety? shame?) and sit with it without seeking that reassurance with compulsive apologizing. Strive to extend that time. Doesn’t even matter, and in fact may be better, to not even talk much but rather ride the wave of feeling (like urge surfing) watching that urge to apologize rise and fall naturally. This can build the client’s confidence in their agency to be in control of their actions.
The way you say the client feels like they have to do it and it brings them relief and reassurance seeking sounds like ocd, as many other comments mentioned. I wonder if this client has any other OCD symptoms.
Honestly no. It's strange though because this behavior does seem quite similar to OCD but she has much more the profile of attachment trauma related anxiety and depression or even CPTSD rather than OCD unless I am missing something.
Perhaps saying sorry is a trauma response/coping mechanism. Maybe in the “fawn” territory. Without knowing client’s history, maybe saying sorry, claiming fault where there is none, etc. had served her before in her life when she felt scared, not in control, etc.
True I do not think she has OCD but I do think she has some obsessive compulsive like behaviors that are subthreshhold. But upon reflection I think i may try, under supervision with a therapist well versed in OCD, to use a treatment method that one might use to treat OCD symptoms.
Are you an OCD informed clinician? A lot of people don't understand that OCD can look so different that what people expect. There are many types of themes and they can be tied in with PTSD.
She might have an intrusive thought, feeling, urge, image or sensation before the "sorry" that she feels like she HAS to tend to. And it might be showing up in other ways in her life as well.
You say that but your treatment isn't working. So yeah you might be missing something. I think ocd and so does a lot of the sub. If you aren't sure, have someone assess her or at least get another clinician to do a dx interview for ocd. Get a second opinion.
Ask her to practice saying “thank you” instead. Instead of “sorry I’m late” say “thank you for waiting”. (You might have already tried this, but it’s what I’ve got at the moment).
This has worked for many but not her. We tried. But part is that I don't know if I have full buy in. There is still ambivalence I think, about giving it up. Plus the client is ambivalent generally about confidence and self esteem, for reasons that are somewhat not clear to me. She feels uncomfortable and unenthusiastic about gaining healthy self esteem although she knows it's the healthy and "right" thing to do. Usually clients find their low self esteem and ego dystonic and want to improve it but not with her.
You said it interrupts relationships, but do they have supportive people in their life that could help them work on this goal? Something I’ve seen done in trauma residentials is creating a policy where someone has to say three positive things about themself every time they say an unnecessary sorry. You can’t repeat any positive affirmations in a day. If everyone buys in they will call each other out on it. If your client has people around them that are willing to help then maybe they can make it a “game” that everyone in the house/office/friend group play? Alternately your client could write down 3 affirmations every time they catch themself saying it. It might annoy them into saying “sorry” less and help with self-esteem.
My strategy is to stop and ask the client to identify what is the underneath message of the sorry in the moment. Practice saying that before moving on. Give a lot of space and grace for curiosity—what thought did they have with the sorry? What are they assuming about what you are thinking? Etc You can introduce this in advance to get consent and permission to interrupt/notice in the moment.
I would approach this from a “taking up space” perspective vs self esteem. This sounds a little bit like relationship OCD, adhd, or maybe even high masking autism.
Hi OP. I'm wondering if you have worked with your client on how it feels to be apologised to vs. being thanked. You may have already done this in your work on replacement behaviours because you noted that she's able to see that it is annoying to others, however, I often find that people pleasers or people who worry about upsetting others haven't actually tried to put themselves in the shoes of another person receiving the behaviour. It might be useful to role play apologising continuously yourself in the session to see how this impacts your client. I find this can be helpful when modelling assertive communication.
Good idea. Thanks! I think this could absolutely help. However I also fear it could lead to debilitating shame if she realizes how she comes across, considering how prone she is to feeling annoying and hated by others, and how intensely these thoughts affects her....
Do you ever find that realizing the impact of ones behavior can lead some very self-critical clients to even greater depths of shame and despair? Maybe I'm overthinking it
I totally get that. I think the reason why I think it's helpful is because I've had my therapist do this to me as well and I think the positive effects of engaging in this new behaviour and learning to set boundaries over-road any self-criticism.
I would say that loading up on the tools for self-compassion can be helpful. Reminding them that the reason we engage in these behaviours is because they were useful to us at one stage and we're always doing our best, that we had the best intentions and that we can't change what we have done in the past but we can decide who we are going to be and move towards that.
Trauma response that has morphed into OCD compulsion due to environmental reinforcement and negative reinforcement learning.
Avoid reinforcing the behavior via reassurance or attention.
Read nancy mcwilliams on self-defeating personality organization and see if that gives you any ideas: [https://isotis.wordpress.com/wp-content/uploads/2019/05/mcwilliams.12masoch.personalities.pdf](https://isotis.wordpress.com/wp-content/uploads/2019/05/mcwilliams.12masoch.personalities.pdf)
It sounds like the client probably had a really painful upbringing, AND make no fucking mistake about it - they need to change and find a new way to interact with people. If they can't rely on their family of origin to provide a consistent attachment, they'll need to create their own "family"....the way they currently interact with people is going to be a huge barrier.
You're going to need to address how the apologizing is a barrier to the therapeutic alliance and creates problems in your relationship with the client. If the client can start showing up in a different way with you, then they can start doing it in their life outside session.
(you can't address it head on tho. wait until client is apologizing for not making progress, then see if you can speak to the part of the client that is actually frustrated with you for them not making progress fast enough.)
Why must she be so sorry? What is this shame of making even minor mistakes? What is it that causes her to worry about being bad or imperfect.
Sure the client says sorry, the question is does she feel sorry and where did that come from?
From there invite the client to consider areas where they could invite acceptance of imperfection. Or where imperfections are seen as acceptable in others.
The trauma of perfectionism and needing to be accepted by a parent or important attachment figure is my guess.
If they can access and identify those feelings at the root of feeling sorry, or that precede saying sorry and respond to them differently based of course on an self affirming narrative, then a CBT approach can be used to address the compulsive sorry saying itself.
I suggest identifying why the behavior was useful in the past.
It sounds like autonomy building is needed. That is self efficacy. There may be some dependency developing in the therapeutic relationship.
Thanks for this! Her main caregiver was unpredictably abusive and flew into intense and sometimes violent rages over minor things, and my client is still afraid of them. But also this parent was and still is my clients main source of warmth and closeness, and they had an unhealthily close and enmeshed relationship, and my client was distant with her other parent, who was sexually abusive to her on, though she denies the impact of this.
Anyway, autonomy is a huge issue. My client struggles with seeing the point of anything and, even though she claims she is ashamed of herself for being passive and inactive, feels only intense fear and hopelessness about her future. The idea of "growing up" and getting better seems effortful and my client feels the only reason to do this is because she is "bad" for being the way she is now. As a result it's hard for her to find motivation.
I think my client is somewhat stuck in her longing for love and a safe attachment/authority figure to protect and nurture her and is struggling to let this fantasy go, despite nearing 30. I think she is terrified and upset by the prospect that she will never get what she wants in that way now that she's an adult.
So self parenting and self soothing experiences are important for this client.
Also voice cultivating like let that kid say how they felt and what they would say to the kid self now?
Being able to change the narrative, being that adult that she needed and being there for and providing nuturance for her child self.
Perhaps understanding how wrong and unwell that abusive behavior was, understanding it while not excusing it kinda puts her in the judges seat to decide what her history meant and what she knows better now.
Excellent idea!! I think this is spot on. In the past she has been reluctant to this kind of intervention, but also expressed that she resonated with it, and felt often like a child, but was embarrassed and ashamed to verbalize it in session because it seemed too self-indulgent and would make her seem fragile, "whiney" and entitled, etc. ... So I think pushing through would be useful
Excellent! They have articulated negative self talk. That can be externalized and made into the issue. Are you familiar with IFS?
What theoretical modalities have you been using so far?
What would it give her if she could reduce how much she says it and not annoy others?
Interesting dynamic, here. The “sorry” indicates that she has done something to bother someone, but it sounds like it’s the “sorry” that becomes bothersome.
I’d try to slow her down and instead of trying to extinguish the behavior, explore the physical sensations and feelings that arise. When she apologizes in session, I’d slow down and say something like “How’s your breathing? What do you notice in your body right now?” Explore the terror. “You sound really scared. Is anyone coming to mind?” I imagine there’s a TON of grief around not being allowed to exist and the compulsive apologies ward of not only terror but deep sadness.
Assuming this is caused by trauma, vs a manifestation of OCD, you could use mindfulness and CBT to help the client notice antecedent distress that motivates this behavior. Then they can learn to tolerate, reframe, or act differently in that moment. If the client, for example, says sorry because they perceive someone is mad at them, it could be helpful to identify that internal distress, then have them evaluate the situation. "Is this person actually mad at me? What evidence do I have for that?"
One thing that helped me when I personally had this habit is to train myself to say thank you instead of sorry. "Thank you for waiting" instead of "Sorry im late!" or etc etc. So many unncessary sorry's are replaced easily with Thank you.
Someone I used to work with at a treatment center had a "sorry chair" for a client. Anytime the client wanted to say sorry, they had to get up and sit in the other chair. Ultimately, their laziness won out over their instinct to apologize.
Why Won’t You Apologize? By Harriet Lerner helped change my perspective about over apologizing and motivated me to put the effort into breaking the habit. That book and How To Be Accountable by Harper and Biel. Just wanted to share my experience.
Saying it is soothing and therefore self reinforcing. A lot of tics/OCD/behavior themes work the same way. It's only entrenching a person further into the behavior when they engage in the thing that gives them discomfort when they don't do it.
This one is so specific and identifying (if the client, or someone who knows her, saw this they would certainly know who you're talking about) that I would suggest getting IRL supervision and not posting it here.
Not trying to be an incendiary here, just a possibility with less confidentiality concerns - I get the feeling that this may be a person posting about themselves under the guise of it being a client in order to get therapeutic advice here.
I’ve banned clients and coworkers from apologizing. I literally tell them: You’re not allowed to apologize for having emotions. I don’t accept apologies for natural/rational responses. I’m not accepting that apology bc there was nothing to apologize for.
I often remind them that it’s a safe space; I’m not judging them, etc.
Maybe try Team CBT? There’s a free training for it on Pesi right now, I love it & have used it for 1-2 years. Helps eliminate resistance so quickly.
But, if she doesn’t actually want to stop, then don’t talk about it anymore. “We’ve spent a lot of time talking about that & I want to make sure we’re using our time effectively, let’s revisit it in one month.”
It’s kind of a sneaky way to exert control for some people.
Yeah, about that last part, it may be. She so clearly wants to be a good client and not disappoint me, but unconsciously I think, she doesn't want to stop. She even admitted she wants love and approval more than anything else, more than changing herself, but knows how bad that is and how awful that makes her, or at least unattractive and unsympathetic, in the eyes of others. I think she is really stuck in an infantile longing for someone else to rescue and nurture her. She herself has hinted at this too, but then says she knows it's not how therapy works and she despises herself for it. I don't know how to proceed. I do like working with her and she is not hostile or difficult, and she is making progress, but I feel stuck on the main issues with her....
Currently going through this with a client now and found this post through search. Does the client have a history of negative interactions with other healthcare or therapy providers?
I work with a lot of trauma clients who fawn and this is a common skill we use in therapy for those who over-apologize: replace “sorry” with “thank you.” It’s not “sorry I’m late,” it’s “thanks for waiting for me!” It’s not “sorry I’m talking so much,” it’s “thanks for letting me unload all that.” It’s great for exposure with taking up space and an easily defined homework assignment for therapy. Clients love it and the debriefing the next session is always really fruitful.
Such a good response! Giving our clients replacement behavior is so important if we are trying to help them change their current behavior.
Changing these words helped me so much. Now when I’m tempted to say sorry I ask myself what can I say thank you for instead. It helped me so much. Took a while to change the habit but it totally worked.
This is how I deal with it too. Always keep it positive is my motto with most things that I do and it's usually served me (and my clients) well. I work a lot with clients suffering from long term grief and one of the things I do is switch things like *I miss him SO much* to *I'm so grateful I had those years with a man that I really loved and who loved me so much*. I deal with over-apologising the same way. I know it can be tiring, but it never annoys me. It's just another opportunity to reinforce a different approach. In the longer term, it does work!
I also like “excuse me” as a replacement
I've had clients who apologize a lot or too much, but never one for whom it has been a specific therapy goal. I'm curious how you're responding in session when the client apologizes. Are you offering them reassurance and gentle reminders that they don't need to do that? Breaking from the conversation you've been having to give her an opportunity to express her feelings? If you're doing anything like that, you're probably reinforcing the behavior. From a purely behaviorist perspective, you'd probably get more mileage out of simply ignoring her apologies and continuing the session as though she had said nothing at all. I'm also curious, after all of the exploration your client has done, does she have a sense of what she would like to do when she feels unsure or exposed, instead of apologizing? If not, that would be a useful discussion to have. It allows you to change the valence of the goal from negative ("I want to not apologize") to positive ("I want to do XYZ when I feel unsure"), and to use reinforcement to nurture the chosen behavior... which is a lot more effective than punishing the unwanted behavior, particularly when the natural response to punishment would be to apologize more.
This is a really good idea. And a good point. I do find myself reassuring them when they apologize in session. It's hard because when they say sorry to me they always really do feel, not "remorseful" necessarily, but like they are perceived by me as bad, irritating and a burden. They claim they feel embarrassed all of the time, and often will say they feel extremely embarrassed during sessions for their stagnation and how much of a drag and irritating person they are, or think I (and others) think they are...
It sounds like this has roots in trauma. Has this client done specific trauma work, like exposure or EMDR or anything like that?
We tried EMDR but she seemed unable to access her emotions. She presented as flat while recounting sexual and physical and emotional abuse, more concerned with doing it right than processing. I'm getting trained right now in CPT so may try that in the future after more resourcing etc.
I don’t do EMDR myself, but my understanding is that you’re supposed to be really grounded in the present, like have good emotion regulation, skills, etc., before you begin to do the trauma work. I would wonder if she ever got to that place first. I have a client I’m working with in couples work who went through extreme extreme exposure to domestic violence, physical abuse, and the worst case of emotional control I’ve ever heard of. And I’ve been a therapist for 33 years. His wife had an affair, and he cannot get angry at her. Instead, he asks what he did to deserve it. He turns every situation in his life into one of self criticism and blame. Everything. He was absolutely unable to experience any emotion other than fear, and has this deeply etched belief and pattern of blaming himself for everything that goes wrong, inside or out of his sphere of influence. This situation with your client reminds me of him. I don’t do that work, I referred him to an individual therapist. It’s just the pervasiveness that seems similar. Sounds so tough, I wish you all the best!
Is it possible that this is a compulsion related to OCD? I ask because my sister has a similar problem, with a different but similar phrase. She has done work with her own therapist to stop repeating the phrase, but nothing seems to help (so far). She also has extremely low self-esteem. Her psychiatrist diagnosed OCD, though I think she actually more likely has OCPD. Your description just rang bells reminding me of my sister’s behavior. Might be something to consider/explore, especially if she doesn’t really even know she’s apologizing until after she’s done it.
This was my first thought when reading the client’s symptoms!
sammmeeee.
100%
I apologize that I'm responding without having read through the comments section, so I may be afield of the conversations taking place. Something I took on about three years ago was a radical re-examination of what is happening during the enactment of apologies. I noticed what I felt was that apologies come in lots of flavors of enactment, and there's often something sticky on both sides. The very day I noticed this, I attacked the relational piece with one of my apologizers. Instead of "That's okay!" or "I'm wondering about this desire to apologize." I just rejected all of it and decided to speak ONLY to my side of the relationship. My response was, "I was not upset." I've learned over the past three years that those words can be very powerful. You're sorry; you apologize to me. "Thank you. I am not upset." Think about it. That response completely short circuits any enactment or maladaptive transferential/countertransferential exchange. It's a flat statement about my experience. "I am not upset." It might be followed by, "I just feel bad for X, Y, and Z." "I hear you. I am not upset." "But I just don't want you to think A or B about me. I'm really sorry." "Suzie, I was not upset." It is honest. And it highlights a shocking moment of individuation. I'm honorting the apology and also removing myself from the relational entanglement. I've actually adopted this in my life. And it allows me to reflect and accurately say, when I need to, "Yeah, I was upset by that. Here's why. I'm grateful for your apology and I see you and accept it." There's something powerful about STARTING from a place of "You being sorry is your story; I was never upset."
I really appreciate this perspective.
I'm glad you find space in this. It's a position that has opened up some wonderful moments with myself and clients. I recall one exchange. I kind of have a magical number: three. When a person (clients, friends, even myself) repeats a behavior or utterance three times, I start looking for neurosis. So, I had a client who apologized for being very late. They apologized. I said, "I was not upset. I'm glad you're here." They apologized two more times, with varying kinds of emphasis. Finally, as I walked them to their next appointment with psychiatry, they apologized again. And we shared a moment where I said, "I don't know what this is about. I have already expressed that I was not upset. So that part is done. It never existed. Yet here we are, you're still apologizing. I don't know what you want from this." There was an awkward moment. It lead to a conversation where I said something like, "If you want me to participate with you in beating yourself up, I won't. If you want me to let you off the hook, I can't. And if you want me to praise you for doing better, I'm not sure that is useful. I was not upset. So what is happening here?" That lead to some remarkable work. Even in my own personal life, I was friends with a chronic apologizer. And they would get \*mad\* if I said "Hey, Nat. I was not upset." Finally, one day they said, "It doesn't matter if you're upset! It's important to me to apologize!" Old friend told on themselves, and I wasn't sure how many times I could lavish them with "It's okay!" or "Oh, thank you. You're all good!" before it felt like I was patting them on head calling them "Good boy/girl." Constantly inhabiting the space of some well-regulated permissionist became a sticking point for the friendship. And like I said in my original comment, it allows me to reflect. If somebody apologizes, and if I'm situated firmly in my experience, I can offer back a more clean-burning grace and affection when I \*was\* actually upset or distressed. That applies to clients and friends and my spouse. All of it. All of this is also hard to do. The enmeshment of apologies, the enactments and entanglements of apologies, are difficult narratives to disassemble. It's kind of in our bones. For a long time I couldn't even keep out a little reassurance: "It's okay! I wasn't upset" or "I wasn't upset. It's all good!" I had to work to even trim those pieces and maintain a loving "I wasn't upset." So, it does feel a little awkward at first. But gosh, has it been worth it.
Maybe some of this might be useful to you, u/NoPrior8269. <3
Thanks for this. Question though: wasn't your friend's response, "it doesn't matter if you're upset, Its important to me to apologize!" similar to what you were doing? Owning that the apologizing is about them, and their feelings and experience, rather than an assumption about what you are feeling or want? I mean I agree that it is annoying and uncomfortable to be apologized to repeatedly and it is not healthy for the apologizer, but I don't understand why saying "I'm sorry" is always interpreted as a plea to get someone else to respond to them or manage their emotions for them. Isn't it just an expression of ones personal feeling of anxiety, embarrassment or shame? I don't think the apologizer always wants a response or to burden the other person, but I do suppose everything we say has consequences.and it's not fair to vent and voice publicly our emotions and insecurities too often, because we are forcing others to caretake when we express ourpainful emotions out loud? Genuinely curious about this. I suppose intense feelings of being sorry or worried should not be expressed verbally because expression itself implicitly demands something of others. I suppose I need to be more aware of my own occasional slips where I without thinking let my own negative self perceptions become evident, not as a bid for attention, just a way to express the intensity and I suppose vent the pressure building up inside. Not to get reassurance or anything, though that is what I am forcing the other to do...
Hey, for sure. I don't take this anything other than a conversation and I appreciate the chance to clarify. In the case of my friend, I left a lot out in the interest of making a simple point. My friend's chronic apologizing fit into a much larger pattern of interaction that I experienced as cloying, needful, and exceedingly self-depreciating, to the point that it felt like a quiet request for me to participate in or respond to those feelings and behaviors. When they said, "It's important to me to apologize!" they weren't saying it relative to me chastising them or pointing out anything about the chronic apologizing. They were responding to feeling me shift from doing extra work of ameliorating their concerns to simply saying things like "I wasn't upset" or "I didn't feel offended." That was enough to elicit that response, and confirm what I had felt: that they needed something \*else\* from the friendship. It felt to me much more like a protest that I wasn't participating in the ways they expected. And I'm talking years and years of friendship data on this. I think you sort of said it, in a way: there is often an anxiety wrapped up in an apology. It's just not always the one we think we're expressing. In my life, I have over-apologized as a way to make myself feel safe. But that's not really the role of an apology, in my feeling. An apology is an expression of contrition, and an invitation for the Other to feel seen. I didn't like my apologies that were a search for a salve for my anxieties. I'm not judging any of these behaviors. And I am admittedly dynamically oriented. So I'm noting that the apology often comes with luggage. It often comes with contrition, but also as a bid for something else from the person we're apologizing to: affirmation, permission, valuation, safety... things that are less clean-burning. In my own closest relationships, I find myself gravitating to folks who I feel do indulge reflective, clean-burning apology. And I strive for that myself. It's one reason my spouse and I work so well together, and that I'm ever grateful for. But, again, I do not at all judge. And I don't \*expect\* us to always be efficient in our self-expression. As a therapist, I feel that part of my work is noticing profound and recurrent incongruencies/inefficiencies: in this case, the chronic apology. And as in the case of the client I described, in my early experiments with this positioning, by reflecting on my experience only I was able to more quickly get to, "Wait... what's going on here?" A messy analogue might be gratuities offered to a therapist. A client offers a cash gratuity. One might say, "Thank you. I don't accept gratuities." And they offer again. We decline again. Maybe they're just that grateful, we think. But by the time they offer a third time or say, "You know what? I'm just gonna make out the check for extra," I think we're compelled to wonder, and probably wonder out loud, "So, I've described my experience and feelings. And you're still wanting to move through that in your way. What is this about?" It’s similar when I say “Thank you. I wasn’t offended,” and the apologies keep coming. So, yeah... there are anxieties that come with an apology. But they may often be different from what we suspect. So, focusing on what else may be happening outside of the {offense—>apology} pathway might give us a deeper narrative. Why did my friend insist on others affirming her obsequious nature? What did that say about how she managed relationships? Why did I apologize repeatedly when I was seeking safety if I didn't really mean it? And from people who weren't actually a danger to me? What unfair position(s) did my unresolved feelings put them in? And why was my client (and yours and a million others) indulging this ritual when I (and probably you and a million others) were never actually offended and we've said so? Blocking the brighter light that shines from an apology— by communicating "I was not offended or distressed. I notice you're still apologizing. Since you know I wasn't offended, where is the apology going? To whom? Not to me. So whom?" but maybe in fewer words—we can kind of see the more fantastic lights peeking from the edges. (Intentional eclipse reference). Truly, thanks for the conversation. I wish we were sitting over a cup of coffee. I'm sure we could talk about this a lot. And I'm not bothered by thoughtful, loving disagreement. Truly.
Thanks so much! This was really thoughtful and helpful. I think what some over apologizing clients need is first to figure out what the excessive apologies are really about, and then a game plan for what to do instead, so exactly what you are saying. The balance between talking responsibility for your emotions without imposing your anxieties on others is a hard task, like everything we do in therapy. I think it can be hard for some, who have a lot of unresolved anxiety, to find a balance between, on the one hand, unconsciously forcing others to manage your anxiety and, on the other, isolating or inhibiting oneself too much, in order to avoid placing the burden of ones anxiety on anyone else. Have you ever had clients feel very ashamed of themselves they come to this realization, that their apologies are often pleas for something from others? I find psychodynamic therapy in general to be so helpful and so painful at the same time. How do you navigate clients shame when they uncover unconscious motives? Maybe I'll make another post about this topic alone...
Hey, thanks for the chat. I've actually been meditating on it today. I don't know about the word shame, but certainly noticing things about ourselves can be very vulnerable-making. I think a lot of how that plays out in therapy very much depends on the rapport and also a therapist who can think (and feel) on their feet. In a non-apology example, I one had a client who presented with what I might call subclinical histrionic features and lots of anxiety. They had a running theme, a deep preoccupation with one particular meta-narrative. I pointed that out because I suddenly felt it. They sat down and told a story about deeply unfair and unjust things that happened that day. As they went on I said something like, "We've been seeing each other about six months. I'm noticing something. About 90% of the content you talk about here is something really unfair. Some injustice that's happened to you." "Well, yeah. You're my therapist. Isn't that what we talk about." "Maybe. We could talk about all kinds of things. I'm noticing that \*your\* content involves a lot of injustice. See, I'm just some person in a room. This is a blank canvas, and this is a larger theme you frequently go to." "So?" "Well, I'm noticing some feelings in our relationship. Like I said, you chose this theme and I'm a person in this room with you. I'm wondering something... Who am I to you that I can adjudicate the injustices you've experienced?" They went blank and the temperature of the room changes. I let it sit and I said, "Part of why I'm wondering this is because I wonder if other people in your life might be feeling this"
I'll tell you what, our work began in earnest that day. I could go on in detail or in DM, but everything changed. Did it feel risky to say? Yes. Did they hear it, feel it with me, and let it happen? Yes.
And I think that comes to mind as I look at the OP. You said something actually super magical You said, "It does not feel good to be cast in the role of this tyrannical monster and bully."
I can't help but wonder what it would look like to go right there. Some phrases I have used are things like,
"So, I've noted that you didn't commit any offense with me and I've noted that I didn't feel distressed. You're still apologizing. What's happening between us right now?"
If they deflect by calling it a habit, I might say, "Well, a habit is another name for things we do. So what is happening in this habit?"
That kind of moment can feel precarious. I used to offer little lifejackets to my people in the form of, "It's okay. This may feel uncomfortable. But let's stay with it." I don't do that as much any more. I trust my tone and my energy and our relationship to do that work. But it's not bad to do.
They might reach for circumstances. Something like, "Oh, I just get so much sh\*t at work." And I would definitely say, "We're not at work. We're here. This is you and myself." Whatever it takes to support the person going into their body. I often say things like, "The apology is far enough away from my experience that I wonder who you're apologizing to. What is coming up for you?" That usually gets a conversation going and I trust the first one or two things that come out of their mouth. Association has a powerful way of popping out when it's invited.
You might even go more direct like I did with that other client: "Sometimes your apologies feel to me like I must appear frightening or monstrous to you. I don't think I really I am. But I do wonder about that."
"Oh no! You're not that!" would be predictable. So maybe, "Ok, good. I'm not. So then what is happening for you in that moment?"
There are a lot of directions to go. Can it be painful? Absolutely. Shameful? I'm not sure but maybe, depending. I think lots of silence works; having very efficient sentences, and trusting them and yourself to a high degree are key. To borrow from Maria Montessori, if I have prepared the space (AKA the frame) then I can trust them to arrive. So, I think in a very discursive, maybe annoying way, what I'm saying is that the "shame" or whatever it is that comes—the vulnerability—is part of the work and maybe doesn't need to be managed. It just needs room to breathe while we try to focus the lens through it. "I know this can be hard to talk about. It also feels important." Regulating my body helps them regulate theirs.
I call it surfing the relationship. I'm feeling the relational space with them, but instead of being pulled into the ocean, I'm on its edges, noticing it and honoring it. You're absolutely right. It's difficult work. And it takes a lot out of me physically. I find myself meditating \*while\* I'm in session, just to have an accounting of my own responses. My gosh, though... the work! It can be really lovely and deeply meaningful.
One more question. In your own case, of apologizing to feel safe, did you find a better way to feel safe? Did you just realize it and force yourself to stop and that led to feeling safe? I guess I'm wondering if awareness and practice/exposure was enough or if you found some other way to feel safe in relationships.
As for my experience, I think it was a combination of my own therapeutic experiences combining with an increased sensitivity to others around me (a deep sensitivity, not a reactive sensitivity). As I grew, I noticed and felt that something was off about these interactions, and that I was putting others off or at least making their experience of the apology interaction feel difficult. That took me to, "What else am I doing here?" or "Why don't I feel better when they say it's okay? Why am I hounding these people?" The question "What's really going on?" has become sort of a natural position for me in all of life. Those feelings dropped me in to notice my expectations or at least hopes circling the interactions, and then how that might not be a fair or even honest experience of apologizing. All of this happened sort of quietly in me.; it also happened very quickly and very slowly at the same time. I'm not sure how to explain that. And it was an important part of a growing process. Because by noting this behavior, I landed in the BIGGER experience of "I don't feel safe" which, of course, is much more expansive than pissing off a friend. And that took me to big bigger self-narratives and meta-narratives.
I am a therapist with ADHD, who also used to be a chronic over apologizer due to shame and fear of inconveniencing others. One day my therapist casually said, “stop apologizing for existing, you’re allowed to exist.” it wasn’t until that moment that I realized that it was OK for me to be.. human? And that I was allowed to take up space. I cannot be more serious when I tell you that I had no idea that that was why I was apologizing for nothing. That I felt my mere existence was an inconvenience to others.. obviously progress wasn’t made overnight, but that comment fundamentally changed my life.
Ooo adding this to my list to use. I commented below; but I’ve banned some clients & coworkers from apologizing.
I've come across this at the beginnings of therapy. Once I notice this dynamic I stop reassuring in any way and become curious around it, or carry on with the session once the client has regulated and stopped the apologising. At a certain point it reinforces and isn't therapeutic. Very quickly after not coming in to validate this and actually discuss the work we're doing instead, the client stops doing it and either engages or leaves to find a therapist to continue the game with. I'll often tie this behaviour to childhood trauma and the apology as a way to ward off harm, even when it's unnecessary as the setting is safe. Its a coping mechanism that has outlived its usefulness.
Well, especially because she says for this client, the apologies come from a place of genuine remorse, like they are feeling that they did something wrong every time. That is trauma in my opinion.
But it's not an appropriate response, so if you have been responding in the same way for 2 years and nothing has developed then a change of tact would be needed imo. The occasional sorry is fine - 10 times a session? So every 5 minutes? Where is the genuine remorse there? What has the client done and what are they going to change due to the remorse? This is shame, not remorse. When clients present with shame it's an opportunity to explore in a trauma informed way around it, not to interact with it on a surface level that doesn't acknowledge what is happening in the room, imo.
Yes, you are right, it is shame. what I was trying to say is that it was coming from a deep place, related to trauma.
Sounds like you've been doing a great job and there enothing wrong with that thought. Is it her goal to not say sorry? Or is it yours? Because we sometimes have different goals than the clients, and that makes it so difficult. There is always a negative of changing as you've described. There is also a positive, but maybe that motivator is not strong enough..
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Sounds like an OCD cycle
This is so interesting because parts of it sound like that to me as well but she really doesn't fit the criteria in any other way
Would it be worth completing the YBOCS/YBOCS-SR-II just to rule it out? There have been so many times that a ct says something and I think to myself, “Wow, my OCD spider senses are tingling,” but they deny other issues. Then, when we do the YBOCS it’s like “hah! Bingo!” Some of the OCD symptoms are either shameful and/or unnoticeable to the Ct because they’re so used to it.
It might be to obvious, but exchanging the sorry for a thank you? Expressing gratitude rather than regret? Sorry(!) if this is something you've already tried
Thank you. They have tried this with no luck, but I think this client isn't quite ready to give it up yet.
This makes me think it's a compulsion. I'd look into possible exposure therapy.
Ok, this might sound weird, but I work with kids, so weird works: Have you tried using a buzzer or something like that? You present it in a playful manner - "every time you say sorry, I'm gonna hit the buzzer/blow the whistle/ring the bell/whatever. Let's see how long you can go without that happening." Maybe whenever you "catch" them saying sorry - you have them rephrase or say something like "I don't need to be sorry for my feelings (or whatever it is)". To spice it up, they can buzz you for something too, like using a common phrase or filler word or any silly little habit (like I fidget with my rind in sessions). Whoever gets buzzed the least wins something for that session (bragging rights, a candy bar, a flower - whatever you want). Make bets on how many times you'll each get buzzed. Obviously you want to deal with the shame and other issues that caused these habits, but sometimes a more lighthearted approach can help with actually making change. It's just a way to create awareness of the habit and motivation to stop that's independent from shame/guilt/feeling annoying.
I've done this with adults with success. Didn't think about the competition piece of it though, I'ma add that next time.
A lot of good insight on trauma vs/& OCD. I'd like to offer an experiment. Sounds like they have good insight and a desire to change, just can't quite get the space before the compulsion because it feels distressing to NOT say it (but also distressing to do it, too). I like experiments. I might do a session where they need to break their 'sorry' record by saying it more. Like, after every sentence pause. You can say sorry, too. Notice how it feels for them - is it forced? Does the word lose meaning? Does it feel better/worse? What's it like to make that choice? A spicier one: You seem like you have years of rapport with this client. I might make a deal with a client that whenever they say sorry, I'm going to do/say the opposite of what they want to hear in an obnoxious way (i.e. "damn right, you SHOULD be sorry!!"). This might, at first, be humorous and give some distance to how inappropriate the sorry is. It could also be a shock to the part that is really anxious about that outcome, even though it's a planned exposure. You could talk about what that was like, even though it was planned. How can they cope without that reassurance? Lastly, it could provide the awareness that it IS choice to say sorry just as much as it is a choice for you to respond. It feels automatic, but we can slow these things down. You can always start out with, "every time you say sorry, I'm going to quack like a duck". And see how that goes, too. :)
What creative ideas! Love this. I second using exposure. The client has awareness this is a problem and needs to build tolerance for the antecedent emotions that lead to the apology. Many have commented OCD, but rather than focusing on the diagnostic label, simply use ERP principles if it’s functioning the same way. What matters more than labels if treating the function and maintaining factors. Practice during sessions to have them identify and express the feeling (guilt? anxiety? shame?) and sit with it without seeking that reassurance with compulsive apologizing. Strive to extend that time. Doesn’t even matter, and in fact may be better, to not even talk much but rather ride the wave of feeling (like urge surfing) watching that urge to apologize rise and fall naturally. This can build the client’s confidence in their agency to be in control of their actions.
The way you say the client feels like they have to do it and it brings them relief and reassurance seeking sounds like ocd, as many other comments mentioned. I wonder if this client has any other OCD symptoms.
Does she meet criteria for OCD?
Honestly no. It's strange though because this behavior does seem quite similar to OCD but she has much more the profile of attachment trauma related anxiety and depression or even CPTSD rather than OCD unless I am missing something.
Perhaps saying sorry is a trauma response/coping mechanism. Maybe in the “fawn” territory. Without knowing client’s history, maybe saying sorry, claiming fault where there is none, etc. had served her before in her life when she felt scared, not in control, etc.
Yes this is true. I do think this is it. I think it's as simple as defusing conflict but it has become compulsive over time
She probably doesn’t realize she’s doing it at this point.
But you say she doesn't have ocd?!
True I do not think she has OCD but I do think she has some obsessive compulsive like behaviors that are subthreshhold. But upon reflection I think i may try, under supervision with a therapist well versed in OCD, to use a treatment method that one might use to treat OCD symptoms.
Are you an OCD informed clinician? A lot of people don't understand that OCD can look so different that what people expect. There are many types of themes and they can be tied in with PTSD. She might have an intrusive thought, feeling, urge, image or sensation before the "sorry" that she feels like she HAS to tend to. And it might be showing up in other ways in her life as well.
What makes you think they don't meet criteria for OCD? Just curious because someone can have attachment trauma, CPTSD and OCD.
You say that but your treatment isn't working. So yeah you might be missing something. I think ocd and so does a lot of the sub. If you aren't sure, have someone assess her or at least get another clinician to do a dx interview for ocd. Get a second opinion.
Ask her to practice saying “thank you” instead. Instead of “sorry I’m late” say “thank you for waiting”. (You might have already tried this, but it’s what I’ve got at the moment).
Yes, this literally solved it for me when I had this issue 12-15+ years ago and now it's ingrained.
This has worked for many but not her. We tried. But part is that I don't know if I have full buy in. There is still ambivalence I think, about giving it up. Plus the client is ambivalent generally about confidence and self esteem, for reasons that are somewhat not clear to me. She feels uncomfortable and unenthusiastic about gaining healthy self esteem although she knows it's the healthy and "right" thing to do. Usually clients find their low self esteem and ego dystonic and want to improve it but not with her.
You said it interrupts relationships, but do they have supportive people in their life that could help them work on this goal? Something I’ve seen done in trauma residentials is creating a policy where someone has to say three positive things about themself every time they say an unnecessary sorry. You can’t repeat any positive affirmations in a day. If everyone buys in they will call each other out on it. If your client has people around them that are willing to help then maybe they can make it a “game” that everyone in the house/office/friend group play? Alternately your client could write down 3 affirmations every time they catch themself saying it. It might annoy them into saying “sorry” less and help with self-esteem.
My strategy is to stop and ask the client to identify what is the underneath message of the sorry in the moment. Practice saying that before moving on. Give a lot of space and grace for curiosity—what thought did they have with the sorry? What are they assuming about what you are thinking? Etc You can introduce this in advance to get consent and permission to interrupt/notice in the moment. I would approach this from a “taking up space” perspective vs self esteem. This sounds a little bit like relationship OCD, adhd, or maybe even high masking autism.
Hi OP. I'm wondering if you have worked with your client on how it feels to be apologised to vs. being thanked. You may have already done this in your work on replacement behaviours because you noted that she's able to see that it is annoying to others, however, I often find that people pleasers or people who worry about upsetting others haven't actually tried to put themselves in the shoes of another person receiving the behaviour. It might be useful to role play apologising continuously yourself in the session to see how this impacts your client. I find this can be helpful when modelling assertive communication.
Good idea. Thanks! I think this could absolutely help. However I also fear it could lead to debilitating shame if she realizes how she comes across, considering how prone she is to feeling annoying and hated by others, and how intensely these thoughts affects her.... Do you ever find that realizing the impact of ones behavior can lead some very self-critical clients to even greater depths of shame and despair? Maybe I'm overthinking it
I totally get that. I think the reason why I think it's helpful is because I've had my therapist do this to me as well and I think the positive effects of engaging in this new behaviour and learning to set boundaries over-road any self-criticism. I would say that loading up on the tools for self-compassion can be helpful. Reminding them that the reason we engage in these behaviours is because they were useful to us at one stage and we're always doing our best, that we had the best intentions and that we can't change what we have done in the past but we can decide who we are going to be and move towards that.
Trauma response that has morphed into OCD compulsion due to environmental reinforcement and negative reinforcement learning. Avoid reinforcing the behavior via reassurance or attention. Read nancy mcwilliams on self-defeating personality organization and see if that gives you any ideas: [https://isotis.wordpress.com/wp-content/uploads/2019/05/mcwilliams.12masoch.personalities.pdf](https://isotis.wordpress.com/wp-content/uploads/2019/05/mcwilliams.12masoch.personalities.pdf) It sounds like the client probably had a really painful upbringing, AND make no fucking mistake about it - they need to change and find a new way to interact with people. If they can't rely on their family of origin to provide a consistent attachment, they'll need to create their own "family"....the way they currently interact with people is going to be a huge barrier. You're going to need to address how the apologizing is a barrier to the therapeutic alliance and creates problems in your relationship with the client. If the client can start showing up in a different way with you, then they can start doing it in their life outside session. (you can't address it head on tho. wait until client is apologizing for not making progress, then see if you can speak to the part of the client that is actually frustrated with you for them not making progress fast enough.)
Why must she be so sorry? What is this shame of making even minor mistakes? What is it that causes her to worry about being bad or imperfect. Sure the client says sorry, the question is does she feel sorry and where did that come from? From there invite the client to consider areas where they could invite acceptance of imperfection. Or where imperfections are seen as acceptable in others. The trauma of perfectionism and needing to be accepted by a parent or important attachment figure is my guess. If they can access and identify those feelings at the root of feeling sorry, or that precede saying sorry and respond to them differently based of course on an self affirming narrative, then a CBT approach can be used to address the compulsive sorry saying itself. I suggest identifying why the behavior was useful in the past. It sounds like autonomy building is needed. That is self efficacy. There may be some dependency developing in the therapeutic relationship.
Thanks for this! Her main caregiver was unpredictably abusive and flew into intense and sometimes violent rages over minor things, and my client is still afraid of them. But also this parent was and still is my clients main source of warmth and closeness, and they had an unhealthily close and enmeshed relationship, and my client was distant with her other parent, who was sexually abusive to her on, though she denies the impact of this. Anyway, autonomy is a huge issue. My client struggles with seeing the point of anything and, even though she claims she is ashamed of herself for being passive and inactive, feels only intense fear and hopelessness about her future. The idea of "growing up" and getting better seems effortful and my client feels the only reason to do this is because she is "bad" for being the way she is now. As a result it's hard for her to find motivation. I think my client is somewhat stuck in her longing for love and a safe attachment/authority figure to protect and nurture her and is struggling to let this fantasy go, despite nearing 30. I think she is terrified and upset by the prospect that she will never get what she wants in that way now that she's an adult.
So self parenting and self soothing experiences are important for this client. Also voice cultivating like let that kid say how they felt and what they would say to the kid self now? Being able to change the narrative, being that adult that she needed and being there for and providing nuturance for her child self. Perhaps understanding how wrong and unwell that abusive behavior was, understanding it while not excusing it kinda puts her in the judges seat to decide what her history meant and what she knows better now.
Excellent idea!! I think this is spot on. In the past she has been reluctant to this kind of intervention, but also expressed that she resonated with it, and felt often like a child, but was embarrassed and ashamed to verbalize it in session because it seemed too self-indulgent and would make her seem fragile, "whiney" and entitled, etc. ... So I think pushing through would be useful
Excellent! They have articulated negative self talk. That can be externalized and made into the issue. Are you familiar with IFS? What theoretical modalities have you been using so far?
What would it give her if she could reduce how much she says it and not annoy others? Interesting dynamic, here. The “sorry” indicates that she has done something to bother someone, but it sounds like it’s the “sorry” that becomes bothersome.
Explore if intrusive thoughts or physical anxiety leads up to the apologizing. It may be a compulsion, which then ERP would be helpful.
I’d try to slow her down and instead of trying to extinguish the behavior, explore the physical sensations and feelings that arise. When she apologizes in session, I’d slow down and say something like “How’s your breathing? What do you notice in your body right now?” Explore the terror. “You sound really scared. Is anyone coming to mind?” I imagine there’s a TON of grief around not being allowed to exist and the compulsive apologies ward of not only terror but deep sadness.
Assuming this is caused by trauma, vs a manifestation of OCD, you could use mindfulness and CBT to help the client notice antecedent distress that motivates this behavior. Then they can learn to tolerate, reframe, or act differently in that moment. If the client, for example, says sorry because they perceive someone is mad at them, it could be helpful to identify that internal distress, then have them evaluate the situation. "Is this person actually mad at me? What evidence do I have for that?"
One thing that helped me when I personally had this habit is to train myself to say thank you instead of sorry. "Thank you for waiting" instead of "Sorry im late!" or etc etc. So many unncessary sorry's are replaced easily with Thank you.
Someone I used to work with at a treatment center had a "sorry chair" for a client. Anytime the client wanted to say sorry, they had to get up and sit in the other chair. Ultimately, their laziness won out over their instinct to apologize.
Why Won’t You Apologize? By Harriet Lerner helped change my perspective about over apologizing and motivated me to put the effort into breaking the habit. That book and How To Be Accountable by Harper and Biel. Just wanted to share my experience.
Saying it is soothing and therefore self reinforcing. A lot of tics/OCD/behavior themes work the same way. It's only entrenching a person further into the behavior when they engage in the thing that gives them discomfort when they don't do it.
This one is so specific and identifying (if the client, or someone who knows her, saw this they would certainly know who you're talking about) that I would suggest getting IRL supervision and not posting it here.
Not trying to be an incendiary here, just a possibility with less confidentiality concerns - I get the feeling that this may be a person posting about themselves under the guise of it being a client in order to get therapeutic advice here.
Interesting! Certainly could be ...
I’ve banned clients and coworkers from apologizing. I literally tell them: You’re not allowed to apologize for having emotions. I don’t accept apologies for natural/rational responses. I’m not accepting that apology bc there was nothing to apologize for. I often remind them that it’s a safe space; I’m not judging them, etc.
Maybe try Team CBT? There’s a free training for it on Pesi right now, I love it & have used it for 1-2 years. Helps eliminate resistance so quickly. But, if she doesn’t actually want to stop, then don’t talk about it anymore. “We’ve spent a lot of time talking about that & I want to make sure we’re using our time effectively, let’s revisit it in one month.” It’s kind of a sneaky way to exert control for some people.
Yeah, about that last part, it may be. She so clearly wants to be a good client and not disappoint me, but unconsciously I think, she doesn't want to stop. She even admitted she wants love and approval more than anything else, more than changing herself, but knows how bad that is and how awful that makes her, or at least unattractive and unsympathetic, in the eyes of others. I think she is really stuck in an infantile longing for someone else to rescue and nurture her. She herself has hinted at this too, but then says she knows it's not how therapy works and she despises herself for it. I don't know how to proceed. I do like working with her and she is not hostile or difficult, and she is making progress, but I feel stuck on the main issues with her....
Currently going through this with a client now and found this post through search. Does the client have a history of negative interactions with other healthcare or therapy providers?