The Disease to Please: Hypervigilance Around Others’ Needs

People-pleasing, known as sociotropy in the field of psychology, is defined by the APA as, “the tendency to place an inordinate value on relationships over personal independence (…) in response to the loss of relationships or conflict.”[1]

People-pleasers, or those with sociotropic tendencies, wish to make other people happy, often at the sake of their own needs or values. While being warm, kind, and helpful are positive traits, they can result in strong feelings of resentment, anxiety, stress, and emotional depletion when they come at your expense.

This article explores the characteristics of sociotrophy, its possible behavioral causes, and the detrimental impact it can have.

What Is People-Pleasing, or Sociotrophy?

People-pleasing falls at the opposite end of the scale from autonomy. Autonomy places emphasis on independence whereas people-pleasers prioritize  interpersonal relationships above all else.

People-pleasers are often extremely empathic and attuned to others’ needs. A people-pleaser therefore tends to pursue intimate, affectionate, and confiding relationships. These people have a strong desire for external validation and avoid, or are sensitive to, situations where conflict may arise.[2] They will go above and beyond to avoid displeasing others out of fear of diminished social acceptance.

This behavior can have detrimental effects on a person’s self-worth and self-esteem.  A never-ending pursuit of approval, a desire for acceptance, and a sense of validation that arise from others happiness often result in a negative self-image. The person is likely to feel unworthy, powerless, or resentful, which may result in a lack of self-care.[3]

Sociotropic tendencies are often associated with mental health disorders such as:[4]

  • Anxiety or depression
  • Avoidant personality disorder
  • Borderline personality disorder (BPD)
  • Co-dependency or dependent personality disorder

Signs of People-Pleasing

The positive qualities of a people-pleaser include being thoughtful, caring, and empathic. However, the negative traits that accompany these include the tendency to over-achieve, the need to take control, low self-esteem, anxiety, and fear of conflict. 

The following characteristics can indicate people-pleasing tendencies:

  • Finding it hard to say “no” and feeling guilty, selfish, or unkind if you do
  • Being overly concerned with others’ perceptions of you
  • Agreeing with opinions you do not share or doing things you do not want to do to earn approval or to be liked
  • Low-self-esteem and poor self-image
  • External rather than internal sense of self-worth
  • Apologizing even when you do not need to
  • Taking the blame when it’s not your fault
  • Helping people at the expense of your own needs or time

Impacts of Being a People-Pleaser

Creating and maintaining healthy relationships require warmth, understanding, empathy, care, and awareness. People-pleasers have these qualities in abundance. However, people-pleasers tend to struggle with poor self-worth, and their need for external validation can be debilitating. Not only does it affect their emotional well-being and health, it can also break down the very relationships they seek to secure.

If a person is overly focused on others’ happiness above their own needs, they may experience the following:

  • Stress – People-pleasers often do not leave enough time for themselves, so their energy reserves run low. Overfocusing on others’ needs leaves little time for one’s own. When physical and mental resources are thin, chronic stress and emotional health difficulties can arise.
  • Anxiety / Depression – If you are not being true to, or taking care of, yourself, it is common to feel powerless, helpless, or hopeless.
  • Anger / Frustration – Acting out of obligation rather than choice can lead to feelings of intense frustration, resentment, and bitterness. It is not uncommon for involuntary outbursts of anger to occur, which the people-pleaser will do their utmost to undo for fear of disapproval.
  • Disordered eating – People-pleasers’ focus on social harmony may lead to their eating foods they do not like or want to eat, eating even when not hungry, and a preoccupation with matching the group’s eating habits. Research has demonstrated that people pleasers tend to overeat in social environments so the people around them are more comfortable, which can lead to disordered eating habits or eating disorders.[5]
  • Depleted willpower / confidence – The focus on others’ goals and needs leads to a lack of motivation and confidence in one’s own ambitions or passions.
  • Lack of authenticity – People- pleasers often hide their real feelings in order to accommodate others. This can lead to a perceived lack of authenticity or control, which can lower self-esteem. People-pleasers may also feel disconnected from their own thoughts, opinions, and feelings.
  • Relationship difficulties – Self-disclosure is important in relationships, and people-pleasers often do not disclose their true selves. This can prevent them from experiencing real connection and intimacy. Additionally, people-pleasers can often feel taken for granted in relationships and become resentful. Their unwillingness to say “no” means that partners, family, or friends cannot see how overstretched they are. 

Causes of People-Pleasing

A person with people-pleasing traits may have a strong sense of altruism and genuinely want to treat people with compassion and kindness. However, when individuals are acting from a position of wanting to be liked and accepted, useful, and valued, their actions are arising as a result of complex emotional needs.

The following factors might play a role in the development of people-pleasing traits:

  • Childhood Trauma: Difficult or traumatic past experiences, such as abuse, can lead people to become more agreeable in order to feel safe and secure. They may believe that pleasing others will stop any abusive behaviors from being triggered.
  • Family Dynamics: People-pleasing is frequently a learned behavior. Children of people-pleasers may have witnessed their parents’ validation from certain behaviors and learned to act accordingly.
  • Poor self-esteem: Due to a lack of self-confidence, people-pleasers struggle with validating their own desires and needs. They therefore seek external validation to gain approval and acceptance.
  • Perfectionism: People-pleasers can often exhibit perfectionist traits which lead to a need for control over how other people think and feel. 


If your (or a loved one’s) people-pleasing tendencies are affecting your health, mental health and overall well-being, it is important that you speak to a professional. A trained therapist will help set boundaries, re-establish self-care, manage behaviors, prioritize needs, and uncover the root causes.

If you are concerned about any issues discussed in this blog, please contact Heather R. Hayes & Associates – call 800-335-0316 or email today.


[1] “APA Dictionary ff Psychology”. Dictionary.Apa.Org, 2021,

[2] Otani, Koichi et al. “Distinctive Correlations Of Sociotropy and Autonomy with Working Models of the Self and Other“. Comprehensive Psychiatry, vol 55, no. 7, 2014, pp. 1643-1646. Elsevier BV, doi:10.1016/j.comppsych.2014.05.013.

[3] Bowlby, J. (1977). The making and breaking of affectional bonds: I. Aetiology and psychopathology in the light of attachment theory. The British journal of psychiatry, 130(3), 201-210.

[4] Trull TJ, Widiger TA. Dimensional models of personality: The five-factor model and the DSM-5. Dialogues Clin Neurosci. 2013;15(2):135-146. doi:10.31887/DCNS.2013.15.2/ttrull

[5] Exline, Julie J. et al. “People-Pleasing Through Eating: Sociotropy Predicts Greater Eating in Response to Perceived Social Pressure”. Journal of Social and Clinical Psychology, vol 31, no. 2, 2012, pp. 169-193. Guilford Publications, doi:10.1521/jscp.2012.31.2.169. Accessed 8 Sept 2021.

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