From a young age, I learned to prioritize others’ needs above my own, to achieve perfection in everything I attempted, and to silence my own discomfort. This pattern continued well into adulthood until at age 36, my body finally staged a rebellion. I developed chronic pain and fatigue that changed my life.
After seven years of unanswered questions about the source of my pain, I was finally diagnosed with hypermobile Ehlers-Danlos Syndrome (hEDS) and attended an amazing pain neuroscience program. But there I was forced to confront an uncomfortable truth: my “good girl” behaviors weren’t virtues—they were slowly destroying me. If I wanted to turn things around, I was going to have to go from lifelong people-pleaser to fierce self-advocate. And I did.
The silent epidemic: understanding Good Girl Syndrome.
“Good Girl Syndrome”, though not a clinical diagnosis of course, manifests as an internal drive to meet expectations, avoid disappointing others, and maintain harmony at significant personal cost. Women and girls with this pattern prioritize external validation over internal needs, creating a dangerous disconnect between their authentic selves and the personas they present to the world.
Psychologist, Dr. Susan Albers, says that women with Good Girl Syndrome experience guilt and fear of being judged if they deviate from typical “good girl” behavior, and as such, they avoid it, often at the expense of their own well-being. Those affected constantly seek approval and struggle with saying no, fearing rejection or abandonment if they assert their own boundaries.
The behavioral patterns extend beyond simple people-pleasing. Perfectionism becomes a defining characteristic, with impossibly high standards applied to every task. Achievement becomes tied to worth, creating a conditional relationship with self-acceptance that demands constant performance.
Many who experience Good Girl Syndrome develop a heightened sensitivity to others’ emotions while simultaneously disconnecting from their own needs. This emotional caretaking creates an imbalanced dynamic in relationships where giving becomes compulsive and receiving feels uncomfortable or undeserved.
The early seeds: how Good Girl Syndrome takes root.
According to Dr. Albers, this behavior is “rooted in societies’ stereotyped expectations of how women should be and the role they should play.”
Children absorb expectations before they can even articulate them. Research shows that as early as preschool age, girls receive different behavioral feedback than boys, with compliance and helpfulness praised in girls, while boys are given more tolerance for rule breaking and more encouragement for active participation.
Family dynamics often reinforce these patterns. Girls frequently observe their mothers and other female relatives prioritizing other people’s comfort above their own, creating a blueprint for their future behavior. The messages aren’t always explicit; sometimes the most powerful lessons come from watching how the women around them navigate their own relationships and responsibilities.
Media representations further cement these expectations. From princess stories that reward patience and passivity to teen narratives where “good girls” find love and acceptance, cultural messaging consistently reinforces the notion that feminine value is tied to selflessness and agreeability.
Generational patterns: the inheritance of perfectionism.
My grandmother passed it to my mother who passed it to me—the unspoken legacy of self-sacrifice. This inheritance doesn’t happen through explicit instruction but through modeling and subtle reinforcement across generations.
Women born in previous eras faced even stricter gender expectations, with fewer opportunities for independence and self-definition. Their survival often depended on being agreeable and accommodating within highly restrictive social frameworks. These adaptations became deeply ingrained behaviors passed down as “wisdom” about how to navigate the world successfully as a woman.
Family systems theorists note how behavioral patterns can persist across multiple generations even when the original conditions that created those adaptations have changed. The mother who learned to silence her needs to avoid her own mother’s disapproval unconsciously teaches her daughter the same strategy—not maliciously, but as a perceived survival skill.
Intergenerational trauma research supports our understanding of how unhelpful coping mechanisms are passed down. When women experience stressors related to gender expectations, they develop coping mechanisms that, while potentially protective in the short term, create long-term health consequences. These patterns become normalized within family systems until someone interrupts the cycle through awareness and intentional change.
Economic and social pressures throughout history have reinforced these tendencies. When women’s financial survival depended entirely on maintaining relationships with men who held the economic power, people-pleasing wasn’t merely a personality trait—it was a necessary survival strategy. These deeply embedded patterns don’t disappear simply because external circumstances evolve.
The health toll: when being good hurts.
Constant performative niceness destroyed my body from within. My diagnosis of hypermobile Ehlers-Danlos Syndrome (hEDS)—a connective tissue disorder that already predisposed me to pain—became significantly worse as I pushed through discomfort to meet others’ expectations and maintain my “good girl” image.
Medical research increasingly recognizes the relationship between chronic stress and autoimmune conditions. The physiological impact of perpetual people-pleasing includes elevated cortisol levels, inflammation, and immune system dysregulation. These biological responses don’t distinguish between physical and emotional threats—both trigger the same stress cascade within the body.
Ignoring bodily signals creates a particularly dangerous situation for those with underlying health conditions. My refusal to acknowledge pain until it became unbearable meant I consistently exceeded my body’s limits, exacerbating hEDS symptoms and creating a cycle of inflammation and tissue damage that became increasingly difficult to interrupt.
Sleep quality suffers dramatically under the weight of perfectionism and people-pleasing. The racing thoughts about others’ expectations, rumination over perceived failures, and anxiety about future performance create a hypervigilant state incompatible with restorative rest. This sleep disruption further compromises immune function and pain regulation.
Mental health conditions including anxiety and depression correlate strongly with Good Girl Syndrome behaviors, according to Chartered Counselling Psychologist, Dr Ashling Doherty. The constant gap between authentic needs and expressed ones, creates a form of cognitive dissonance that strains psychological resources. The emotional exhaustion of maintaining a carefully crafted external image depletes the energy needed for genuine self-care.
Masking and neurodivergence: the hidden connection.
Throughout my life, I sensed I processed the world differently than the “norm”. The connection between my neurodivergent traits and Good Girl Syndrome became clear only in adulthood. For neurodivergent women, such as those who are autistic, ADHD, or both (AuDHD), the pressure to conform creates an additional layer of masking—hiding not only authentic emotions but also natural, but different, cognitive and sensory processing styles.
Research from Dr. Sarah Bargiela and colleagues at University College London has shown that autistic women are particularly vulnerable to developing compensatory strategies that hide their natural social presentation. This “camouflaging” or masking often results in exhaustion, identity confusion, and delayed diagnosis, as their autistic traits remain hidden behind carefully constructed social performances.
The energy cost of this double masking—hiding both authentic emotions and neurodivergent traits—creates profound fatigue. For those of us with conditions like hEDS that already impact energy levels, this additional drain can tip the balance from manageable symptoms to debilitating exhaustion.
Furthermore, neurodivergent individuals often exhibit heightened pattern recognition and rule-following tendencies. These traits can intensify Good Girl Syndrome when applied to social expectations, creating rigid adherence to perceived rules about acceptable behavior and extreme anxiety about potential social missteps.
Breaking the pattern: my pain management journey.
Entering a pain management program based on neuroscience principles became my unexpected pathway to liberation. Initially seeking only physical relief, I discovered the profound connection between my thought patterns and physical symptoms.
Learning about pain neuroscience educated me about how emotional stress amplifies physical pain through central sensitization. My perfectionism and people-pleasing weren’t just psychological issues—they were directly intensifying my physical symptoms by keeping my nervous system in a heightened state of threat response.
The program introduced me to cognitive behavioral techniques that revealed my black-and-white thinking patterns. Beliefs like “I must always be useful” or “If I say no, I’m letting people down” emerged as unconscious cognitive distortions rather than objective truths. Gently challenging these thoughts created space for more nuanced understanding of my needs and responsibilities.
Dismantling decades of conditioning required persistent effort, which began with simple awareness—noticing when I automatically said yes when I meant no, or apologized for needs that deserved no apology. The first time I declined a request without offering an explanation beyond “I can’t do that right now,” I experienced intense anxiety.
Gradually, these practices became easier as I witnessed that relationships based on authentic connection survived—and often improved—when I expressed my genuine capacity. Relationships that had been built entirely on my accommodating nature sometimes fell away, but deeper connections emerged with people who appreciated my genuine presence rather than just my usefulness.
Physical practices proved as important as the psychological ones. Learning to recognize bodily sensations associated with stress and people-pleasing—the tightened chest, suppressed breath, and tensed shoulders that accompanied silencing my needs—gave me early warning signals when I was slipping into old patterns.
Self-compassion was perhaps the greatest challenge of all. Directing toward myself the kindness I automatically offered others felt unnatural and uncomfortable. The program taught me to recognize self-criticism as a bad habit rather than a virtue, and to practice speaking to myself with the gentleness I would offer a friend experiencing similar challenges.
Breaking the cycle: creating change for future generations.
Future generations deserve freedom from these restrictive patterns. Breaking the cycle requires both individual and collective change in how we socialize children of all genders.
Educational settings must recognize and address gender differences in how they respond to children’s behaviors. Teachers can consciously work to praise girls for assertiveness and boys for empathy, creating more balanced development of social-emotional skills across genders.
Parents play a crucial role by modeling healthy boundaries and authentic self-expression. When children observe adults—particularly female caregivers—prioritizing their own needs alongside others’, they internalize permission to do the same.
Media literacy offers another intervention point. Teaching children to critically examine gender messages in books, movies, and advertising helps them recognize and question limiting stereotypes rather than unconsciously absorbing them.
Healthcare providers need education about “Good Girl Syndrome” and its health impacts. When medical professionals recognize how people-pleasing behaviors can mask neurodivergent traits and prevent accurate diagnosis, they can ask better questions and create safer spaces for honest communication.
Final thoughts on finding balance.
The journey from Good Girl Syndrome to authentic living isn’t about rejecting kindness or consideration for others. Rather, it’s about bringing these qualities into balance with genuine self-care and honest self-expression. True generosity flows from a place of choice rather than compulsion.
My health journey continues, as hEDS doesn’t disappear with psychological growth. However, the relationship with my condition has transformed as I’ve learned to respect my body’s signals rather than overriding them to meet external expectations. This shift has created space for genuine management of my symptoms rather than constant crisis response.
Breaking free from Good Girl Syndrome doesn’t happen overnight, but even small steps toward authenticity create ripples of positive change. Each time we choose self-respect alongside consideration for others, we help redefine what it means to be truly “good”—not just for ourselves, but for all who come after us.
