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You hit send. Then you reread the message. Then you reread it again, this time in their voice instead of yours, trying to work out whether the full stop felt cold or just final.

You replay the meeting. Did that pause mean something. Did your laugh land oddly. Was the silence at the end disapproval, or was she just thinking.

You know none of this is fair on you. You know it isn’t fair on them either. And hours later you’re still flicking back through the same thirty seconds, looking for evidence of something that probably isn’t there.

This is the worrying-what-people-think loop. It’s exhausting. It’s incredibly common. And it’s one of those patterns that gets louder the harder you try to argue with it.

A YouGov survey found that 73% of 25 to 34-year-olds in the UK say they overthink regularly [1]. National Institute of Mental Health data put the lifetime prevalence of social anxiety disorder in the United States at 12.1% [2]. NHS England’s most recent figures show that 25.8% of 16 to 24-year-olds in England now meet the threshold for a common mental health condition [3]. Approval-seeking and people-pleasing aren’t standalone diagnoses, but they sit right at the heart of the conditions that are: social anxiety, generalised anxiety, perfectionism, low mood.

This article isn’t going to tell you to stop caring what people think. Most people who give that advice are quietly underestimating how deep the wiring goes. It’s about understanding why the pattern is there, what one of the most influential thinkers on the subject says about its origins and what the evidence says actually helps.

Why caring what people think runs so deep

Caring what other people think of you isn’t a flaw. It’s a feature of being human. Our nervous systems evolved in small groups where social inclusion was a matter of survival, and the brain still treats the threat of disapproval as something close to physical danger.

Neuroimaging makes this visible. A landmark fMRI study by Stein and colleagues found that people prone to social anxiety showed significantly heightened amygdala activation when viewing harsh or critical facial expressions, compared to controls [4]. The amygdala, the brain’s threat-detection system, fires for a glance from across a room the way most brains fire for a real-world risk. Etkin and Wager’s meta-analysis of neuroimaging studies confirmed the same broader pattern: hyperactive threat circuitry alongside an anterior cingulate cortex that runs in overdrive, monitoring every word and gesture for signs of failure [5]. Research published in Biological Psychiatry showed that the connection between the amygdala and the prefrontal cortex, the part of the brain that calmly applies context, is often weaker in people who get caught in this loop [6]. The alarm rings, and the part of you that would normally say “this is fine” arrives too late or not at all.

So if you replay conversations in your head for hours, that isn’t weakness. That’s a normal nervous system doing what nervous systems do, in a body that has learned to scan the social world for threat. (We unpack this in more detail in our piece on why social anxiety is more than just shyness.)

The question is why your nervous system learns that, and why it sticks.

What Dr Gabor Maté says about approval-seeking

In a recent live episode of Jay Shetty’s On Purpose podcast, recorded at the Orpheum Theatre in Vancouver, the Canadian physician and trauma specialist Dr Gabor Maté works through this question in detail [7]. The episode is called “Dr. Gabor Maté: Constantly Worrying What People Think of You? (THIS Simple Shift Will Help You Trust Yourself and Stop Seeking Approval)”.

Maté’s argument, paraphrased from the conversation, is that the pattern almost always starts in childhood. The basic need every child has, to be seen and accepted as they actually are, isn’t always fully met. When it isn’t, children adapt. They quietly learn which parts of themselves bring warmth and which parts bring distance, and they start to perform the version that keeps the connection intact. Over time, that performance stops feeling like a strategy and starts feeling like who they are.

This idea draws on a wider framework Maté sets out in his book The Myth of Normal, written with his son Daniel Maté [8]. He argues that we’re born with two essential needs. One is attachment, the bond with caregivers without which a child cannot survive. The other is authenticity, contact with our own feelings, instincts and sense of self. When the two are in tension, when being authentic seems to put attachment at risk, the child has no real choice. Attachment wins. Authenticity gets quietly filed away.

That trade-off doesn’t switch off when the child grows up. The adult version sounds like rereading the message six times. Apologising before you’ve said anything. Saying yes when your body is already saying no. Smoothing your edges in meetings. Performing a version you think the room wants. The loop you’re in at thirty isn’t new behaviour. It’s an old strategy still doing the job it was hired to do.

Maté’s point isn’t that this makes you broken. It makes you adapted. The strategy worked once. The cost is just that it’s still running long after the original conditions have changed.

The simple shift Maté describes

Listening through the episode, the “simple shift” Maté keeps returning to isn’t a technique. It’s a stance. Paraphrased: pause for long enough to notice what is actually true for you, ask yourself an honest question about it and then give yourself permission to act on the answer, even in small ways.

That sounds modest because it is. But it’s doing something specific. It’s rebuilding a signal you learned to ignore. Each small moment of “what do I actually feel about this” or “is this a yes from me, or a yes for them” gradually reconnects you to the part of yourself that got filed away. You aren’t trying to stop caring what other people think. You’re trying to make sure your own voice is in the room too.

This is also why the work has to be small to be sustainable. Trying to overhaul approval-seeking in a weekend, by force, tends to produce more performance, just dressed up as growth. Slow, quiet attention is what the nervous system can actually metabolise.

What doesn’t work

Telling yourself to stop caring. Obviously. But it’s worth saying, because most people’s first instinct when they catch themselves in the loop is to try to think their way out of it.

The problem is that suppression backfires. Daniel Wegner’s well-known white bear experiments showed that when you actively try not to think about something, the part of your brain that has to keep checking whether you’ve stopped thinking about it keeps the thought alive [9]. Trying to push the worry away tends to give it more airtime, not less. (We covered this loop in detail in our piece on overthinking.)

Reassurance-seeking tends to backfire too. Running the same worry past three friends, screenshotting the message, asking whether you sounded weird in the meeting. In the moment, it takes the edge off. Over time the loop learns that it can only quiet down once another person has signed off on it. The internal signal you actually need to rebuild gets weaker, not stronger.

And then there’s the most expensive strategy, the one Maté describes most directly. Working harder at being who you think people want. Tightening the performance. That tends to produce the opposite of what it promises. The more you contour yourself, the less safe you feel being seen, because the version of you being seen is one you don’t quite believe in.

What the evidence says actually helps

None of what follows is a fix. Approval-seeking is a pattern with deep roots. It loosens slowly, through small and repeatable shifts, not heroic ones.

Name what you’re feeling

UCLA’s affect labelling research found that putting feelings into words directly reduced amygdala activity [10]. When participants named their emotional state, the brain’s threat-detection system quietened. Naming the feeling is one of the cheapest things you can do for a nervous system mid-spiral.

For approval worry, this often means moving from “I feel weird about that text” to “I’m worried she thought I was being too much, and that’s making me feel ashamed”. Specificity is what makes the difference. Vagueness keeps the loop fed. Edges give the feeling a shape you can actually look at.

Slow your breathing down

When the worry is running, your breathing usually goes shallow and fast without you noticing. That nudges the sympathetic nervous system, which feeds the worry, which feeds the loop. A systematic review in Frontiers in Human Neuroscience found that slow breathing at around six breaths per minute activates the parasympathetic nervous system and measurably reduces anxiety within minutes [11].

Two minutes is enough to shift the dial. In for four, hold for four, out for four, hold for four. You aren’t trying to feel calm. You’re giving the body a different signal to work with.

Reframe the prediction

Approval worry runs on predictions. “She thinks I’m annoying.” “He noticed I went red.” “They’ll all decide I’m not worth keeping around.” These feel like facts. They’re guesses your brain is making with very limited evidence.

Cognitive behavioural therapy treats this kind of thinking not by replacing it with positivity but by checking it against what is actually known. A meta-analysis of 41 randomised placebo-controlled trials found CBT effective across anxiety-related disorders, and follow-up research in JAMA Psychiatry has shown that the gains stick around well after treatment ends [12]. (We’ve written more on this in our guide to how CBT works for anxiety.)

You don’t need a therapist in the room to try this. Catch the thought. Write it down. Ask yourself: is this a fact, or a prediction. What would I say to a friend who was thinking this. Is there a version of this that’s more accurate than the worst-case reading. The point isn’t to be positive. It’s to be accurate. “She hasn’t replied because she hated my message” is almost always less accurate than “I don’t actually know why she hasn’t replied yet”.

Drop the safety behaviours

This one is uncomfortable, and it’s also where the real movement tends to happen.

Safety behaviours are the small ways you stay protected while looking like you’re showing up. Rehearsing a sentence three times before you say it. Making yourself smaller in a meeting so you can’t be wrong. Saying yes to keep the peace. Apologising preemptively. Drafting and redrafting a message until any trace of you has been edited out.

A study by Wells and colleagues, building on Clark and Wells’s influential cognitive model of social anxiety, found that people who used safety behaviours during social interactions experienced just as much anxiety afterwards as those who avoided the situation entirely [13]. The brain doesn’t register the experience as evidence that things were fine. It registers it as “I survived because I kept my guard up”. The threat appraisal stays intact.

The work is to do the small thing without the safety net. Send the message without rewriting it for the fifth time. Say the unpolished sentence in the meeting. Let the silence sit for one extra second. Each time, the brain gets a clean piece of new information: “I did the thing, and I was fine”.

Notice one thing that’s true for you, not for the audience

Most of the loop is built around what you imagine is going on inside other people’s heads. A useful counterweight is to spend a small amount of attention each day on what is actually going on inside yours. Not the curated version. The honest one.

Pennebaker’s expressive writing studies showed that putting thoughts on paper, in private, reduced intrusive thinking and improved psychological wellbeing [14]. It doesn’t need to be eloquent. It doesn’t even need to make sense. The act of moving what’s in your head onto something outside your head changes the relationship you have with it.

This is the muscle Maté is pointing at. The small, regular practice of asking what you actually feel, and giving that answer the dignity of being noticed.

Small shifts, repeated

Approval-seeking isn’t something you fix once. It’s a pattern you gradually interrupt, one small response at a time.

The breath you slow before sending the message. The feeling you name instead of trying to outrun. The thought you write down so it stops bouncing off the walls of your skull. The yes you don’t give. The sentence you let stand without editing yourself out of it.

None of this is dramatic. Most of it takes less than two minutes. And over time, those interruptions rewire the habit. Not perfectly. Not permanently. But meaningfully.

A quieter way to start

We built MoodFire for moments like these. Not as a fix for caring what people think, but as something concrete to reach for when the loop kicks in.

Morning and evening mood check-ins drawn from affect labelling research, so the feeling has somewhere to land. Reframe, our CBT-based thought-reframing tool, walks you through catching the prediction and testing it against what you actually know. Breathe guides you through slow breathing shaped around parasympathetic activation. Ground brings you back into the room when the loop is three laps deep. Spark offers a small daily counterweight to a brain that’s wired to scan for disapproval.

None of it claims to fix the pattern. It’s just somewhere to put your attention when “what did they think of me” shows up at 11pm and you don’t know what to do with it.

You aren’t trying to stop caring what other people think. You’re slowly making sure your own voice is in the room too. One named feeling. One slow breath. One unedited sentence at a time.

MoodFire is not affiliated with, endorsed by or sponsored by Dr Gabor Maté or Jay Shetty. References to their work, the On Purpose podcast and The Myth of Normal are editorial and intended for educational purposes only.