Assertiveness and Mental 
Health

Liz Sherry

Recently I came across the following UK statistics:

• 
Even the most conservative medical opinion agrees that up to
 80% of all disease has psychosomatic origins.
• 
Valium is the most prescribed drug in the world.
• One in 10 people in the UK will spend some time in a mental 
hospital at least once in their lifetime.
• Mental health problems are among the fastest growing sources 
of days lost from work – over a 15 year period an increase of 150% 
for male and 300% for females.

Over the last 10 to 15 years there has been a growing interest in personal development, assertiveness training, stress management, counselling etc. As Irish people we are 
becoming more aware of self-help and conscious of how stress actually affects our health 
both physical and mental. I feel this is a very positive move and I see more and more 
people taking charge of their lives in a very positive way. I am also aware of the number 
of people who suffer in silence and won’t seek help because they feel it is too alien for
 them – a taboo. Fortunately a good deal of my work involves in-company training and 
I come across a wide range of people who wouldn’t dream of going for counselling but
 who think again after they experience some group work.

Assertiveness training has become more “respectable” in recent years as more people
 realise that it is not about ruthlessly getting what you want which tended to be the media’s
 presentation of it. In my work as a development consultant I have observed that significant percentage of career and personal problems are directly related to a person’s
 self-esteem. Consequently the focus of my work has been developed to assist others to 
better understand who they are and to provide them with the skills to deal more effec
tively with their lives and the people around them.

The aim of assertiveness is to demonstrate that change is possible. It is rooted in 
learning theory which claims that all behaviour is learned and therefore we can unlearn
 behaviour which is no longer useful for us and relearn more effective behaviour.
 Assertiveness is used widely with individuals and groups in the clinical context. It is extremely useful as a preventative measure before people get into serious difficulty.

The Redwood model was pioneered by Anne Dickson, an English psychologist and 
has been evaluated by Irish Clinical psychologist Nuala Doherty. Her findings demon
strated consistent effective levels of competency amongst Redwood trainers aligned with a well balanced training model. Participants showed significant improvements in their 
assertiveness levels and self-esteem.

Assertive communication is the art of clear, honest and direct expression of positive
 and negative feelings. It involves learning how to avoid being taken advantage of by 
others and to avoid punishing others as well. Some common areas of difficulty for people 
are:

At Work

• 
Being criticised by a supervisor
• Confronting someone for continual lateness, sloppy work, B.O. etc.
• 
Noticing that someone has worked particularly well.

In Public

• 
Someone lights up a cigarette just as you start eating.
• Someone barges in front of you in a queue.
• 
Your washing machine breaks down for the fourth time.

Among Friends

• 
A friend persistently uses you as a shoulder to cry on.
• You are upset by a racist or sexist comment.
• You want to ask for repayment of a loan of some money.

At Home


• You want some privacy.
• You are infuriated by a persistent habit in someone you love.
• 
You want to say “NO” to a child’s request or to a proposed visit of a relative.

All of these difficulties have to do with self-esteem or feeling worthwhile as a person.
 This is a core element of assertive behaviour. People with good self-esteem handle situations with confidence and authority. People with low self-esteem will either say 
nothing and feel bad or become aggressive and also end up feeling bad.
 When our self-esteem is low we often do things to please people to win their ap
proval. We forget that we have rights. Some of the rights we explore are:

1. I have the right to have and express opinions, views and ideas which may or may 
not be different from other people’s.

2. I have the right to refuse a request (say no) without feeling guilty or selfish.

3. I have the right to be treated with respect as an intelligent, capable and equal human 
being.

If we don’t believe we have rights we often behave badly. If we feel we have the right 
to say “NO” it stops us from saying “YES” and then end up letting people down because
 we never intended doing what they asked in the first place. When we realise that we have 
rights it can often be the first and a very positive step towards building good self-esteem.

Aggressive behaviour is competitive and the implicit or explicit goal is to emerge as 
winner. With very little real self-esteem, the aggressive person cannot afford to consider another person’s point of view and faced with confrontation or conflict they respond 
with outright attack.

Passive behaviour is characterised by being the doormat and makes ideal fodder for
 the aggressive character. The passive outlook is negative and frustrated by a lack of 
willpower and an attitude of profound resignation.

Indirect/aggressive behaviour is more subtle and hidden. The need to manipulate
 stems from fear of exposure – it becomes safer to control and manipulate then face con
frontation and risk being rejected.

Assertive behaviour involves a genuine respect for self and others. Self-esteem is anchored deeply within and is not dependent on the approval of other people. There is no 
need to put others down (aggressive) because the need to win is not important. There 
is also no need to put others on a pedestal (passive) because an assertive person sees them
selves as equal – not superior, not inferior, but equal.

You may recognise all four behaviours in yourself. It is easy to be judgemental – to 
be critical of yourself and the people around you. However, if you take a more compassionate and realistic view of the aggressive, passive and indirect behaviours you realise 
they stem from low self-esteem. This usually reflects our experience as children. To
 quote from “The Post-Colonial Personality” by psychotherapist Vincent Kenny, “Our
 (the Irish) child-rearing patterns leave a lot to be desired, especially where we see authoritarian parents treating their children as if they had no rights at all, as if they had no 
feelings to be taken seriously, as if all their experiences were trivial and altogether as if
 they were objects as opposed to people. Many parental techniques or relationship patterns with children focus on BELITTLING the children. This is a very good word to 
describe what they are doing, that is making small (as a child) or making of no consequence. Children are often teased and jeered also as a technique of ‘cutting them down
 to size’. In this we see a repetition and a parallel process to the national experience where 
our autonomy, independence and confidence was systematically crushed by our treat
ment at the hands of authority figures (British). So we may interpret that certain parents,
 as authority figures, are imposing the same type of constricting oppressions on their children that foreign oppressors imposed on the nation.”

On an assertiveness programme I encourage people to drop the self-critical/judge
mental voices and concentrate on building up their self-esteem enabling them to handle
 their lives more effectively. Through role play and case studies they learn the skill of as
sertiveness which many people put into practice straight away with great success. Other
 areas covered on a programme are: body language, breathing and relaxation, saying NO,
 giving and receiving criticism, dealing with feelings, especially anger, personal power,
 goal setting, developing a plan of action. An important ingredient in the learning process is witnessing both shared difficulties and changes in others’ behaviour. This relieves 
feelings of isolation and loneliness and also begins to shift the emphasis from helpless
ness to the power to change.

The trainer is there to instruct and model assertive behaviour (which doesn’t imply
 perfection!). She is there to establish a climate of trust and support and to make it pos
sible for participants to acknowledge similarities and differences in each other, to avoid
 competitive behaviour and the tendency to blame others or put oneself down. As the 
programme progresses more responsibility can be taken by participants so that feedback 
and encouragement can be shared. “Each member is the therapeutic agent of their own
 change”.

If we continue to distrust our emotions, be over-dependent on approval from others, 
hide or belittle our abilities, suppress feelings of anger in favour of compassion, identify too readily with statements like: “I can’t”, “I’m helpless” or “I’m not geed enough”
 our mental health will suffer. When we pay attention to ourselves; recognise our unique
ness; congratulate and reward ourselves; challenge ourselves; and act as if we really count 
we can take responsibility for our actions and behaviours we become mentally and physically healthy.
”

And now for something completely assertive “
LIGHTEN UP!!

Liz Sherry is a qualified counsellor and has spent the past six years as a
 consultant to large and small Irish Companies in the management of change.


Her experience includes Assertiveness Training, Team Building, Stress Management 
and Outdoor Management Development. She is an advisor to the Council for the Status
 of Women and a member of the European Network of Women, a founder Member of
 Redwood Ireland Training Association and has been a member of the Board of
 Management of the City of Dublin VEC. She has published many articles on assertive
ness and is a regular contributor to TV and Radio Programmes.

SOME USEFUL BOOKS


Palladino, Connie D.: Developing Self-Esteem. Kogan Page

Donavan, Mary Ellen & Sandford, Linda: Women and Self Esteem

Alberti, Robert E & Emmons, Michael: Your Perfect Right. Impact 1974

Back, Ken & Kate: Assertiveness at Work. McCraw Hill 1982

Dickson, Anne: A Woman in Your Own Right. Quartet 1982

Kelley, Colleen: Assertion Training – A Facilitator’s Guide. University Associates

Smith, Manual: When I Say No I Feel Guilty. Dial 1975

Norwood, Robin: Women Who Love Too Much. Arrow Books 1985

Jeffers, Susan: Feel The Fear And Do It Anyway. Century

Gawain, Shakti: Creative Visualisation. Bantam New Age

Hanson, Dr. Peter: The joy of Stress. Kogan Page