Bonni Stachowiak [00:00:00]:

Today on episode number 563 of the Teaching in Higher Ed podcast, Defy- The Power of Saying No in a World That Demands Yes with Dr. Sunita Sah. Production Credit: Produced by Innovate Learning, maximizing human potential. Welcome to this episode of Teaching in Higher Ed. I’m Bonni Stachowiak, and this is the space where we explore the art and science of being more effective at facilitating learning. We also share ways to improve our productivity approaches so we can have more peace in our lives and be even more present for our students. It’s with joy and excitement that I welcome to the show Dr. Sunita Sah. She’s a award winning professor at Cornell University and an expert in organizational psychology.

Bonni Stachowiak [00:01:04]:

Dr. Sunita Sah leads groundbreaking research on influence, authority, compliance, and defiance. A trained physician, she practiced medicine in The United Kingdom and worked as a management consultant for the pharmaceutical industry. She currently teaches executives, leaders, and students in health care and business. Dr. Sah is a sought after international speaker and consultant, adviser to government agencies, and former commissioner of the National Commission on Forensic Science. Her multidisciplinary research and analyses have been widely published in leading academic journals and media entities, including The New York Times, Los Angeles Times, Harvard Business Review, and Scientific American. Dr. Sunita Sah, welcome to Teaching in Higher Ed.

Dr. Sunita Sah [00:01:57]:

Thank you so much. I’m so happy to be here.

Bonni Stachowiak [00:02:00]:

I have been having a conversation with you in my mind ever since I first became familiar with your work, and I just wanna start out today’s conversation saying thank you. Thank you. I thank you from me in the present, but also from all the people that are gonna discover your work and how vital it is for us in our lives. I’d like to start with a question, which is we’re speaking mostly to people who are in higher education. Why is it so hard for us to say no? And how much of that is unique to potentially our context? What what maybe unique characteristics? But, of course, I know some of this is just universally being human. Why is it so hard to say no?

Dr. Sunita Sah [00:02:41]:

I think you’re right. It is part of being universally human for many people because of the way that we were brought up. Right? We were socialized to be compliant from a very young age. At least I was. Right? I I was a child. I was I was known for being an obedient daughter and a student. But I’ve also worked in two areas, medicine. Medicine was my first career, mainly due to expectations and following those expectations.

Dr. Sunita Sah [00:03:07]:

Then I worked as a physician in The UK, and then I transitioned later on to academia. And both of those professions, medicine and academia, I would say, are very hierarchical and very much require huge amounts of compliance, or that’s the expectation, especially from some rather than others. So I think the context is definitely important, but there’s also an aspect a very important aspect of the way that we were socialized growing up.

Bonni Stachowiak [00:03:41]:

As you were sharing that story, I was thinking about my own path to pursuing tenure at my institution. And my first couple of years, I distinctively remember. You will be in the faculty meeting, and you will say nothing. You will walk in, and you will put your head down. And if controversial things start you you say nothing that you don’t get to say anything until you have tenure. And that was really ingrained in me. And then when I’ve shared I work at a very small university. So when I when I talk to other people at research institutions, they they very lovingly tease me and say, oh, you don’t even understand the politics behind.

Bonni Stachowiak [00:04:18]:

And I would be so confused where they would say, essentially, they’d have to say that they were leaving in advance and secure a job somewhere else before they could ever get I mean, it was just the weirdest set of sort of setting yourself up to comply, although not in a hundred percent of those cases because part of that might be an act of defiance to go find another job somewhere else so you can keep the one that you have. But, yeah, I I just think about all the ways in which our culture can affect us in the present, but you started to talk about yourself as a little girl. Tell us a little bit more about even your very name and what it said to you about what it means to be a little girl and what it means to be good.

Dr. Sunita Sah [00:05:00]:

Yeah. So as I said that, I remember asking my dad at one point when I was quite young, what does my name, Sunita, mean? And he told me, in Sanskrit, Sunita means good. And that’s what I mostly lived up to. I did what I was told. I went to school on time. I did all my homework as expected, and I even had my haircut the way my parents insisted. And I remember that so much because I wanted a different hairstyle, but they insisted on particular things, and I followed that. And these were the messages that I received, not just from my parents, but from the teachers and from community was, like, to be good was to fit in, to obey, to be polite, not make a scene, not question authority.

Dr. Sunita Sah [00:05:46]:

And we often teach children these messages. We’re often expected to comply. And that’s what I thought. I believed or became to believe that being compliant meant being good, and being defiant equated to being bad. And that was the moral equation that I received growing up for many, many years.

Bonni Stachowiak [00:06:09]:

You and I both shared in that our mothers were somewhat we we were accustomed to seeing them mostly being compliant in as we were growing up. Although you have a pivotal memory I’m gonna have you share in just a moment about seeing your mother in a different light. I just wanted to quickly share about mine. And as I was reading your story, I started thinking about the the musical and getting actually to go see it in on stage, the Sound of Music. And there’s a piece of music where Julie Andrews in the movie sings, I must have done something good. And it’s all about, like, how she got into this relationship, and the only reason why she must have gotten in there was because she did something good. And I remember my mom being uncharacteristically angry about that and wanting to break down that model. No.

Bonni Stachowiak [00:07:00]:

You’re not in a relationship because you’re lucky and you did something good. Like like, somehow you’re subservient or beneath this person. And I’ve thought about that so much because the musical has meant so much to me. But every time that song comes on, I always think, thank you, mom, for helping me read more carefully the lyrics that are being said and the and sung and what that could potentially shape in terms of our potential romantic relationships. And you’ve got such a wonderful story about your mom, and you’ve seen her in such an uncharacteristic light, and you’ve been able to carry that forward. Talk about the the trip back home.

Dr. Sunita Sah [00:07:36]:

Yeah. Absolutely. Well, first of all, I have to say that’s a fascinating story about your mother that you you relay there because, you know, it’s these kind of statements and all these kind of actions that you see from your parents that they might not even register, they might not even remember, and yet it’s really stays with you as a child, and they remember your words. I often find that with my students as well. I say something that and then they come back to to me with what I’ve said. So a few years later, that’s really stayed with them. And I think, oh, wow. That was quite profound.

Dr. Sunita Sah [00:08:07]:

Did I really say that? You know, I wish I could remember it for myself at times. But, yes, the the way I viewed my mother growing up, and even now to a certain extent, like, at one point, I believe that compliance and defiance were two binary things, two opposite binary things. Now I’ve come to understand a lot more about compliance and defiance, and I talk about it in a series of stages. But at that time, believing it was binary, I’d very much put my mother into the bat into the compliant box. She did all the cooking, the cleaning, the grocery shopping. She looked after the whole family, all of our needs. I saw her as very subservient, very kind, very generous person, willing to help anyone, and never saw her raise her voice or be defiant in any way or what we imagine what defiance might look like. And then one day, I was walking back.

Dr. Sunita Sah [00:09:04]:

I was about seven or eight, and I was walking back from the grocery store with her, and she had her she was wheeling along our rickety shopping cart, which is just like a small it looks like wheeled luggage that you take to the airport, two small wheels, and we were wheeling at home. And it’s actually a long walk back home from from the grocery store. And so we had a discussion as to whether to take a shortcut through what they call in Yorkshire a snicket, which is just a narrow alleyway. So I always got told when I was young not to go through the snicket because it might be dangerous and, you know, it’s a narrow alleyway. But, I was with my mom, so we decided to go through the snicket. And in that snicket, we were stopped by a group of teenage boys. And they blocked our path and started shouting out some obnoxious things to us and telling us to go back home. Now my mom was there.

Dr. Sunita Sah [00:09:57]:

She was wearing her blue sari. She’s petite, about four foot ten at the most. And she had her hair sort of plaited back one single braid. And my reaction to those boys was instant. So I grabbed her arm, and I looked away from the boys. I averted my gaze, and I just wanted to maneuver as fast as possible through them so we could get home. And I kinda clung on to my mom. And she, though, stopped.

Dr. Sunita Sah [00:10:29]:

And she looked at the boys, and she just said, what do you mean? She wasn’t particularly allowed or anything. And the boys didn’t say anything. They just kinda looked back, started looking at each other. I was panicking. My heart rate was going up. And so I grabbed her arm even tighter, and I whispered to her, come on, ma. And then she said no to me. And she shook off my hand, which really surprised me.

Dr. Sunita Sah [00:10:54]:

I was like, mom. And then she put the shopping cart up vertical, and she put one hand on her hip. And she looked back at the boys directly in their eyes, and she was saying, no. What do you mean? And they still didn’t say anything. So there was a silence, and then she said, oh, you think you’re big, strong, tough boys. Right? Really clever. Really clever. And the boys just were looking at each other, and then one of them said, let’s go.

Dr. Sunita Sah [00:11:22]:

And they just dispersed. And my mom grabbed the shopping cart, and then she walked really fast through the rest of the alleyway to get home. And I was, like, stood there frozen for a while and then ran to catch up with her. And I thought, what just happened there? It was so beyond what I had imagined her to be that it just really struck me. And what this really taught me was that a couple of things. First of all, defiance isn’t a personality. It’s not about being loud and brash and being a certain way and either you are defiant or you’re not defiant. It’s a skill set.

Dr. Sunita Sah [00:12:00]:

So we can choose to utilize it or not. And my mom must have encountered those boys or people like those boys before, and she must have thought about what she would do, especially in front of her daughter. And so even if compliance has been your default, like it has been for me, and very much so, I believe, for my mom growing up, then and even in our adult life, it’s not our destiny. So defiance is a practice, not a personality. So it’s something that we really need to take home, and that’s really powerful for us. If we see ourselves or have a self-concept that we’re compliant, which I did for many, many years, and maybe to a certain extent still do, We can view defiance as a skill, one that’s available and necessary for but all of us to use. And and that’s the aim with my book is to make defiance accessible to everyone.

Bonni Stachowiak [00:12:51]:

As you share about that story with your mother, the other thing that it when I think back to reading your book and also hearing you share the story today is, yes, it’s a practice. It’s a set of skills, but it also can look different depending on who we are. And it sounds like she was able to use her unique strengths and her unique positionality in that particular situation to draw back, you know, and away from the boys who were attempting to subjugate the two of you in some way to to bring back some of that in her own unique way. The there was, something that was so fascinating to me as I read, and I I I feel like I maybe need because it’s something that I struggle with and I’m yearning to grow in. You talk about it as a practice, And that’s something that, by the way, Peter Felton when he was on the show, he talked about this also with curiosity. We tend to think of curiosity as you either have it or you don’t, and that curiosity is a practice. So we we think about sometimes we’ll get a little sassy with our students and say, oh, students today, you know, they’re not curious about things. Well, you know, what if we were part of planting some seeds for curiosity? So I was thinking about that same idea as you wrote about that we could practice our ability to defy, and yet you also talk about we’re pretty bad as human beings at knowing how we would be in a certain situation.

Bonni Stachowiak [00:14:14]:

And both of the I thought in myself, both of those things can be true, and both of those things are true. I believe in both of those things, but maybe you could help me bring together some some ways in my mind to help them become more true. So so it’s yes. It’s a practice, and, yes, I’m also, as a human being, gonna be pretty bad at knowing if I was in this terrible crisis of a situation how I would do, and it’s so easy to judge other people and how they chose to respond. So I don’t know if that’s a probably I hope the worst question I’m gonna ask you because I’m I’m really

Dr. Sunita Sah [00:14:47]:

but that’s just It’s a fantastic question. It’s a really wonderful question because that’s what we all that’s what we grapple with. Right? So many of us grapple with how to be defiant and being caught in that moment of crisis. Yes. And I do talk about we find it very difficult to predict how we will react in a particular situation. And that’s because I’ve learned that so for many of us, the distance between who we think we are and what we actually do is enormous. Like, we think that we will enact our values, and there’s a lot of research along these lines. So one one study by Woodzicka &  LaFrance asked a group of of women students, if you were applying for a job as a research assistant and you got asked a series of of questions such as, do you have a boyfriend? Do people find you desirable? Do you think it’s important for women to wear bras at work? These are offensive questions.

Dr. Sunita Sah [00:15:41]:

What the women said would that was that they would be angry at these questions, and they would walk out. But when they actually conducted this experiment with a different set of women but from the same population, similar demographics, they didn’t walk out at all. And the emotion that they reported was feeling fear, not anger, but fear. And they some of them even smiled uncomfortably. And I I talk about my crocodile smile, which is a sort of instinctive thing that I do in situations when I feel very uncomfortable is, like, I start to smile because you want to try and appease the other person, and it’s actually when I feel uncomfortable. And so I had a colleague that once called it a crocodile smile. And I was like, yeah, you’re right. That’s exactly what it is.

Dr. Sunita Sah [00:16:29]:

Right? This instinctive small smile when we’re put into difficult situations. So then the question becomes, how do we learn to practice defiance so we can actually react appropriately the way that we want, the way that we aspire to, the way that we might predict if we think about our aspirational selves once we’re in the moment. And that practice requires doing so long before the moment of crisis. So we’re practicing in advance. And some of the things we can actually predict well. So some of the things that we need to defy are probably things that we’ve experienced before. So perhaps my mom had experienced those teenage boys in the alleyway before and not said anything at all. And this is the thing that we forget.

Dr. Sunita Sah [00:17:14]:

We remember those great moments in history where somebody defied, and then we think it’s a personality and that we couldn’t do that. So we remember being taught about Rosa Parks and her famous no on the bus. But how many times had she complied before the famous no with segregation laws? This is what we have to remember that a lot of us are compliant. And I think I think Rosa Parks also had said when I read that autobiography that she even agreed to be secretary once in this association because she was too timid to say no. Right? So we don’t visualize Rosa Parks as being timid. But that day, she had practice to say no on the bus. It wasn’t spontaneous like some people think. For example, in the workplace that we might know that we have to be defiant in a particular situation, that there’s going to be somebody in a faculty meeting that’s going to say something inappropriate, or they’re going to evaluate somebody’s a job applicant in a way that’s not to what the criteria are.

Dr. Sunita Sah [00:18:14]:

Like, what do we do? We can often predict that because we’ve seen that person do it many times before, or we just know this is what happens. And and previously, we might not have spoken up. Maybe pre tenure, we did not speak up, but I got the same advice as you got. Like, keep keep your head down. So it’s difficult. But once you are can anticipate the most common situations that arise and think about them, then you can start to visualize it, and then you can start scripting. What is it I wish I had said? What how could I have done that better? How could I have handled that situation? And then we can start role playing because it’s that practice of sort of saying the words out loud that change the neural pathways in our brain. So if we are wired to comply, which is the term that I use, if we are socialized to be compliant and we’ve been using that, oh, sorry, and going along, not saying anything, Those neural pathways are really strong.

Dr. Sunita Sah [00:19:14]:

The only way to change it is to start practicing sort of that defiance and practicing it over and over. And it doesn’t have to be anything sort of loud or aggressive or which often comes out if we’ve been restraining ourselves for a long time. We want to sort of think about maybe we can just say in that faculty meeting, what do you mean by that the way my mom did? You know, what do you mean by that? Can you clarify that for me? Oh, shouldn’t we go along with this criteria? Have you considered this? You know, there’s there’s ways of clarifying, and we could use the word challenging, but it’s not confrontation. I would say curiosity rather than confrontation.

Bonni Stachowiak [00:19:58]:

I at the risk of I don’t I don’t wanna certainly make this part about me, but I resonated so much when you started talking about in a medical context. And to be clear for listeners, you worked as a physician in The United Kingdom. I never have worked as a physician, but I I have some level of what I could best describe as trauma. And so it was really remarkable to me when I have what they call white coat syndrome is the casual way of phrasing it. But for listeners, that would be that my blood pressure, if I’m being measured in the office, it’s just gonna be off the charts, and that’s always been the case. And when I’ve tested it at home, it’s it’s not been an issue previously. And someone once told me, like, you could just tell them that you don’t wanna take your and it it was literally revelatory, like, wait. You’re allowed to do that? You could actually tell them, no.

Bonni Stachowiak [00:20:47]:

You could say no. And the the other thing for me is weighing. I don’t I don’t like to be weighed. And to date, this is in early twenty twenty five when we’re having this conversation. I haven’t done this yet, but I desire to go, no. I weigh myself at home. And if you’d like me to let you know what that amount is, but, like, why do we need to comply with the actual act of being weighed in the office? What difference would it make? But this all feels I mean, literally, like, sweating just talking to you about it. But you have a story of your own, and yours is so different than mine because you had the knowledge that you know, of of some medical background.

Bonni Stachowiak [00:21:21]:

So tell us about your little med medical visit so I can stop getting all nervous over here.

Dr. Sunita Sah [00:21:26]:

No. So so many people tell me about their medical experiences because it is an environment. There’s so many things going on. Like, so first of all, you’re often there and you’re worried about your health. Right? Or you’re having an annual checkup. Maybe you think everything’s fine, but you’re always maybe a little bit worried that some some things are going to go wrong. And you want like, doctors are supposed to be so trustworthy. But some medical environments, it’s you’re expected to be the compliant patient.

Dr. Sunita Sah [00:21:54]:

Even though now there’s been a big movement for many years to have for the patient to make informed decision making, shared decision making with the physician. And for patients, there was a whole initiative to choose wisely. How can we choose wisely when the dynamic is set up in such a way that you have to come in before you even see the doctor? There’s a series of things that happen that are different by country, but still, it it takes away your agency in a lot of these things. And sometimes, you know, you’re in your bed clothes or you’re wearing a gown. And and this, again, I remember from when I was working as a physician, some of the comments people make, oh, we see these people in their bed clothes, and we don’t realize, like, they have important jobs outside. And I might remember thinking, well, why not? Why didn’t you realize that? You know, they’re humans at the end of the day. But we I having had that full knowledge when I moved from The UK to The US, One of my first experiences was when I had some really sort of central chest pain. And it was kind of crushing, which is of the pain that people describe when they’re having a heart attack.

Dr. Sunita Sah [00:23:02]:

So I was immediately worried, and I went to the emergency room. And immediately, I was through triage. They was doing so many tests and also an electrocardiogram, and they ruled out that there was anything wrong with the heart. So I was relieved, and the pain was actually going away. So I was like, okay. That’s great. And I thought I was going to be discharged. But then before I went, the doctor just said to me, oh, I want you to have a CT scan before we discharge you.

Dr. Sunita Sah [00:23:31]:

And I I was like, why? And she said, oh, we want to make sure you don’t have a pulmonary embolism. And a pulmonary embolism or what you call a PE is just a blood clot in the lungs, and it can be quite dangerous. But it creates a specific type of pain, which catches your breath when you breathe in and you breathe out. It’s kind of a very sharp pain. And I wasn’t experiencing that kind of pain. So I did not think I had a pulmonary embolism at all, and my pain was going away. And I know that a CT scan exposes you to ionizing radiation about 70 times more than an X-ray, which still to some people isn’t a large amount, but it can cause cancer later on in life. So why why take the risk for something I knew I didn’t have? And so I should have said no to that scan.

Dr. Sunita Sah [00:24:26]:

And yet, I was being too polite to tell the doctor I didn’t want it. And so I ended up going along with something that I really regretted. And as I sort of sat there in the the scanner with all the machinery going around me, I was like, why couldn’t I have done more? Why couldn’t I have said no? I had the knowledge. I had the understanding. I had all the elements required for informed consent, which is needed in medicine, and yet I went along with something that I really didn’t want to. And if I found that so difficult to do, what must it be like for other people that don’t have the knowledge and understanding in that situation because we put so much trust in our medical practitioners. And even when we feel that tension, oh, that doesn’t sound quite right for me, we often just go along with it.

Bonni Stachowiak [00:25:12]:

One thing that your work brings up in me is while we can sometimes be more self deprecating, where I can draw strength is when we are doing these acts on behalf of others. What does it look like in terms of our ability to defy when we think of it not in terms of our own needs, but of others?

Dr. Sunita Sah [00:25:33]:

Yeah. I call this the superpower of responsibility in that one of the things that really enables our defiance is when we take responsibility for those actions. And it could be values, or it could be for a loved one. I I find it so much easier to defy for my child than I do for myself. If I think something is going wrong in a medical situation with him, I find it so much easier to say, no. I want a second opinion. I want to understand this and to really enact, like, what I would hope for myself and for other people could do when it’s about somebody else. So we should use that.

Dr. Sunita Sah [00:26:10]:

We should use that connection that we have with our values that we taking when we take responsibility for ourselves and for others and our community, then we know what the right thing is to do. Like, when I’m in that faculty meeting, I think about what’s the harm being done to the people that are being discussed, you know, then we can take responsibility that if I don’t do anything here, this will perpetuate.

Bonni Stachowiak [00:26:34]:

Would you walk us through what it looks like to plan in advance to defy what are some of the things we might ask ourselves and some of the literal behaviors we might take on to to do that planning in advance?

Dr. Sunita Sah [00:26:46]:

Sure. So after that X-ray, actually, I very much regretted what happened. And I was thinking, why did I go along with that when I believe in the principles of medical ethics, which is patient autonomy, the patient’s right to choose, and do no harm. Right? So I started thinking about that, and I started thinking about what I could have said. I could have just said, is this really necessary? I’m not comfortable with that. I I prefer not to have that. Right? There’s so many things that you could say that are in alignment with my character. Right? That’s not going out of alignment with who I am.

Dr. Sunita Sah [00:27:20]:

I don’t you don’t need to be aggressive or violent. But just asking those questions. And why didn’t why couldn’t I do it? And I think I was also surprised a little bit because when I was in The UK, I used to ask questions if I was not happy with something. So I think I would ask, oh, there’s not that much radiation, is that? Even though I know the answer. And I would hope that somebody else would pick upon it and then ask me whether I really want to do it or not. But in some context, nobody’s going to do that. You have to do it for yourself. Right? So nobody is gonna ask you, are you really comfortable with that, which you kind of hope for.

Dr. Sunita Sah [00:27:56]:

So you you have to just bring it home, really. You have to work through what I call the five stages of of defiance to be able to say no. And so what I did after that CT scan was really start thinking about what what would happen the next time I’m in that situation, and what is it that I would have preferred to have said. So I started visualizing it. I started practicing it. And then about a year later, I was in a similar situation where I had some shoulder pain, and I knew it was gonna be some kind of inflammation, and I wanted physical therapy. And then when I had a look at what I needed to go and get physical therapy, I needed to get a referral from a doctor. So I went to the doctor attached to my university’s medical center.

Dr. Sunita Sah [00:28:41]:

And as I walked in, I was put on a big sort of conveyor belt of, you know, seeing lots of people, getting your blood pressure taken, getting weighed, all those things. Right? It’s like before before you see the doctor, this is what’s happening. Do this. Do that. And then I was back in the waiting room after all of that. They called my name again, and I was with, like, a a technician or an assistant. And we were walking along, and I saw at the end of the corridor a big sign saying X ray, and I kind of just laughed. Oh, it’d be so funny in my head.

Dr. Sunita Sah [00:29:11]:

I was thinking it’d be so funny if they took me for an X-ray before I started seeing the doctor. And then we started getting closer and closer to that. And then I said, where are we going? And she said to get your X-ray. And I was like, but I haven’t seen the doctor yet. Like, you know, so the way that we are taught to practice medicine at medical school, is that you see the patient, you take a history to understand what’s going on, then you examine them to sort of look at the relevant like, what do you find from examination? Only then, once you have your list of differential diagnosis, your list of different things that it could be, do you conduct investigations as to basically eliminate? Right? And you only do that if it’s gonna change the clinical treatment of the patient. So you don’t end up doing an excess of investigations or procedures or that is how we were taught medicine. And so I was so surprised. So I just but I haven’t seen the doctor yet.

Dr. Sunita Sah [00:30:11]:

How could you possibly know I need an X-ray? And she said to me, all new patients have an X-ray before they see the doctor. And I was like, repeat it again, but I haven’t seen the doctor yet because I was so stunned by this. And then she looked uncomfortable. And she said to me, are you refusing an X-ray? And I kinda stood there, and I thought about the CT scan. And I just said, yes, until I see the doctor. And then she didn’t know what to do, and she looked more uncomfortable than me. And she said, took me back to the waiting room, and she just said, sit there. And I sat there for a long time, and I did feel like some kind of, oh my goodness.

Dr. Sunita Sah [00:30:51]:

I’m being the difficult patient. I’m not being compliant. I did have all those feelings, but I was knew that this was not the right thing to do. And then I got called in to see some other assistants and technicians. They would open my file, and each one would be no X-ray. It was really like a comedy at the end. And each time, I was saying, no. No X-ray.

Dr. Sunita Sah [00:31:11]:

And, eventually, I got to see the doctor who also questioned no X-ray. And and I said, yeah. But you haven’t even examined me yet, you know, at this point. And he gave me the quickest examination. It was almost like he didn’t want to touch me. So and then after that, he said, you need to have an X-ray. And I said, why? What’s your differential diagnosis? And he was like, oh, I don’t know. I wanna see if something bony is going on.

Dr. Sunita Sah [00:31:35]:

And I said, what? And he was like like, bone cancer? And I said, bone cancer. You think I have bone cancer? And he was like, oh, no. No. No. No. And then he didn’t know what to say. And then he’s like, this is how we practice medicine here. And how it was more efficient, and that’s how the clinic works.

Dr. Sunita Sah [00:31:52]:

And he was basically telling me off. I ended up leaving with my physical therapy referral and no X-ray, and everything was fine. And I did end up writing about that experience in like, I was telling people, and they were like, oh, you should write about it. So I did write about it and and actually ended up publishing it in JAMA Internal Medicine, and it got a really good response. So so many physicians wrote to me, some to say, yes. We need to do it this way. And others like, yeah. This is a really bad aspect of for profit medicine is that I’ve even been asked by my medical center to conduct more tests, more scanning so we can make more profits.

Dr. Sunita Sah [00:32:28]:

And so it was really eye opening. And so some small active defiance that I did hopefully had, like, a ripple effect. Maybe it didn’t change the physician’s mind, my questioning. But if you do have the knowledge and the understanding, maybe if one other person asked, you might think a little bit more. And so that’s what we hope for.

Bonni Stachowiak [00:32:47]:

One of the tensions that your story uncovers for us, of course, is we some of this is me projecting, but it’s also in your work. But the thought the idea that we wonder what they’ll think about us. You know, are you the bad patient? That part is evident to many of us. The really surprising thing for me that I just hadn’t contemplated as much until reading your book is there’s a lot of research around that we’re worried what they will think, we think about them. So tell us about that. This this was a whole dynamic that just blew my mind of how if someone’s negotiating with us. I’m trying to remember the research study, and you’ll you’ll know it because

Dr. Sunita Sah [00:33:24]:

you’re about Yes. I know what you mean.

Bonni Stachowiak [00:33:27]:

That’s just such a powerful example. Tell us about this whole I another idea. We’re not only worried about what they think about us, but also what they think we think about them.

Dr. Sunita Sah [00:33:35]:

About them. Yeah. So this is a psychological process that I call insinuation anxiety, And I’ll come back to that term shortly. But let me describe an experience in another context that that you might recognize. And when I I describe these experiences, so many people can relate to it. So much. But this one’s I was this is actually my first job as a medical doctor in The UK, in Scotland, at the Western General Hospital. I was working very long hours from 08:00 in the I was doing what you call a one in two.

Dr. Sunita Sah [00:34:05]:

So you would start work at 08:00. You would work the whole day, the whole evening, the whole night. I would be on call, and then I’d finish the next day at five. I would have that evening off and night to sleep, and then I would do the whole thing again. So that was a one and two. It was like the kind of worst rotation. And so you’re not doing anything in your life at that point apart from working and then trying to get sleep if you can. And so when I received this email to meet with a financial advisor for free at work, I was like, Oh, well, that’s something different.

Dr. Sunita Sah [00:34:37]:

So I think I’ll I’ll take up on that. You know, I’ll go and see this financial adviser since they’re making the effort to come to my workplace. And I remember that meeting really well because it was in the posh meeting room at work, I think, as posh as you can get on The UK’s National Health Service. And it had a carpet rather than cold stone tile walls, and it had a nice sort of sofa. And I so sank down into that. I was like, oh, this is so nice while I’m so tired. And then Dan, the financial adviser, when he came, he was really big, tall, handsome, big so really nice smart suit, and he greeted me with this big warm smile. And he asked me many questions, mostly about my finances, which was surprising because I had a extremely limited disposable income at the time.

Dr. Sunita Sah [00:35:26]:

And we spoke for about an hour, and he built up this amazing rapport with me. And at the end of an hour, he recommended that I invest in a couple of funds and that he was gonna write a report for me, and it would all get back to me in a few days. And all of this was for free. So I was really impressed. And I had to ask him, what’s in it for you? And he said, well, there’s no such thing as a free lunch and that he would get paid commission if I invested in the funds that he was recommending. And so he disclosed his conflict of interest, and that immediately did hit home. I understood what he was saying, and I felt uncomfortable. I actually felt less trust in his advice, which is arguably the intended purpose of that kind of disclosure.

Dr. Sunita Sah [00:36:11]:

Like, we’re supposed to feel some uncertainty as quality advice and take it into consideration. But what happened is that I didn’t want to signal that distress to Dan. I didn’t want him to know that I no longer trusted him because of what he had just revealed to me. I didn’t want him to know that I thought he could be biased or incompetent or just that his advice was not right for me. It was very difficult. This is what I call insinuation anxiety, where you don’t want to insinuate that the other person is untrustworthy, biased, corrupt, incompetent, unethical, or just not whom they should not whom they appear to be or should be. It’s a distinct type of anxiety that comes up when we start worrying that our noncompliance with another person’s wishes or expectations is going to be interpreted as a signal of distrust. And then you risk offending them.

Dr. Sunita Sah [00:37:10]:

Like, of course, I wouldn’t do that. Right? And so it what I found, it really is an aversive emotional state where you become so concerned with offending the other person, and these relationship concerns overtake what’s right for you. And you can feel it in small situations where you’re soft sat on the hairdresser’s chair, and they’re cutting and cutting, and you’re like, I did ask for that, but not that. Why why is she doing that? Why can I tell her to stop doing that? And she’s saying, oh, this is gonna look so good. This is gonna look so good. You know, trust me. And she’s going along with it. And I was like and you’re thinking, no.

Dr. Sunita Sah [00:37:44]:

No. No. Please stop. And it’s so hard to tell them. And in my experiments that I’ve run-in all different contexts, I’ve done some medical scenarios, but also looking at real behavior and offering people bad advice where it’s very clear it’s bad advice. Even in one off situations, even with strangers, I see this insinuation anxiety that we don’t want to insinuate that a stranger or our advisers, coworkers, or friends are not trustworthy. So we need to think about that. It can happen in small stakes situations, the hairdresser, large stakes situations, medical scenarios, other ones such as why copilots might not speak up to their pilots when they see an error.

Dr. Sunita Sah [00:38:24]:

So one survey of over 1,700 crew members on commercial airlines found that fifty percent of them found it difficult to say something when they noticed a mistake. That’s not what we want. So this insinuation anxiety can be very powerful.

Bonni Stachowiak [00:38:40]:

This is the time and the show where we each get to share our recommendations, and I feel like our conversation just gets to continue because I wanna recommend Defy the Power of Saying No in a World that Demands Yes. It was such a gift to me personally, and I feel so much everyone that I have talked to about this book and in preparing to talk with you today and listening to some other interviews that you’ve done as well. Every time someone hears the name of that book, they go, I I need to have that book, and they wanna write it down. And I just see it as such a gift to us in the world and specifically to those of us that work in higher education. So much of that work comes so often from our values deeply rooted, and you’ve given us so many tools and constructs to help us be able to defy using our own unique strengths and in our own unique constructs. And what I especially appreciate about it is because you’re so vulnerable in sharing stories from your life where maybe you didn’t defy the way that you would have today that you might wish to, you give us permission to go, that’s that’s alright. That happened. And it you you released me from some of, I guess, my own feelings of shame and guilt around those times and were equipping me throughout the read.

Bonni Stachowiak [00:39:50]:

I also wanna recommend two other related things. So many people who’ve listened to the show for any time know that my husband, Dave, also has his own podcast. That’s where I first heard about Sunita’s work, and so I wanna recommend coaching for leaders episode seven fifteen, how to stand up for yourself. What I already anticipated today’s conversation would look so different from that one because Dave and I have such different styles and approaches, and it it’s certainly I every time I’ve heard you, I just get a different slice of it being able to read your words and then also hear these conversations. So the last thing I wanted to recommend is a wonderful episode of the podcast Armchair Expert, and the episode is with your name, Sunita Sa, and then the subtitle is on defiance. And these stories that you tell and the tools that you give us are so relatable, and this feeling like any of us could do this. We can do this. It’s important work.

Bonni Stachowiak [00:40:47]:

And, yeah, that’s why I wanted to recommend those things, those three things. And I will pass it over to you, Sunita, for whatever you would like to recommend.

Dr. Sunita Sah [00:40:54]:

Yeah. Well, absolutely. Thank you so much for that. And, yes, I have to say both both Dave on his podcast and Dax and Monica on their podcast, they were excellent hosts. So they always make me feel very comfortable, and it’s always a fantastic conversation as it has been with you too. And I do want to leave your listeners to sort of think about that sort of moral equation of defiance and compliance that we started with and really start to think about in these situations where we’re not speaking up and it’s actually harming ourselves or harming other people, we have to start wondering whether it’s sometimes bad to be so good. That’s the question we need to ask ourselves. What do we sacrifice by being so compliant? And I’ve spent decades now studying some influence advice and authority.

Dr. Sunita Sah [00:41:42]:

And what I found that was really significant and really helped me and changed how I think is that we’ve misunderstood what it means to defy. And so I did came to a come to a revelation that we need this new definition of of defiance. And so my the old definition is that to defy is to challenge the power of someone else boldly and openly. But my definition of defiance is that to defy is simply to act in accordance with your true values when there’s pressure to do otherwise. And that makes defiance such a proactive positive force in society. Because everything we do, every day, our decisions, our individual actions of consent and dissent, they create the society that we live in. And what I really wish for with my work and making Defiance accessible to everyone is that the way that we raise our children is that we think more about less about training them for compliance and more about training them for defiance when needed. Because what I would really like is so one day, if you are stuck in an alleyway with your mother as a child, that one of the teenage boys would speak up and tell his peers to stop doing what they’re doing because it’s not right so that my immigrant mother wouldn’t have to do that.

Dr. Sunita Sah [00:43:03]:

That’s the type of society that I aspire for, and I think lots of people aspire for. And that’s the hope with my work is to make defiance accessible to everyone.

Bonni Stachowiak [00:43:12]:

Dr. Sunita Sah, thank you so much for this generous conversation and for this incredible book.

Dr. Sunita Sah [00:43:19]:

Thank you so much. It’s wonderful to be here.

Bonni Stachowiak [00:43:24]:

Dr. Sunita Sah, thank you for being the guest on today’s episode of Teaching in Higher Ed and for your incredible book, Defy- The Power of Saying No in a World That Demands Yes. Thanks also to each one of you for listening to today’s episode of Teaching in Higher Ed. Today’s episode was produced by me, Bonni Stachowiak. It was edited by the ever talented Andrew Kroeger. Podcast production support was provided by the amazing Sierra Priest. And if you’ve been listening for a while and haven’t signed up for our weekly email, head over to teachinginhighered.com/subscribe. You’ll receive an email in your inbox once a week with the most recent episodes, show notes, as well as some other resources that are unique to the update. Thanks so much for listening, and I’ll see you next time on teaching in higher ed.

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