Boundary Setting as a Physician

Picture this: You have been assigned the task of emptying a large tub of water. In one hand, you hold an empty pitcher. In the other hand, you hold a garden hose that is spraying directly into the tub.

If you don’t move the hose, you’ll never empty the tub.

You can scoop as fast as you can for as long as you can. You can seek out expert guidance on how to improve your scooping efficiency. But you will not move water out faster than the hose can put water in.

The same can be true of demands on our time. This reality is one of the reasons why setting boundaries is an essential component of self-kindness and self-compassion.

Setting boundaries is an intensely personal and value-driven endeavor. In order to set boundaries that are right for you, you first need to know what’s right for you.

This means that you don’t work more than you’re comfortable with because your workplace system says so and you don’t work less than you’re comfortable with because TikTok says so. There is no one right answer.  It is not necessarily right or wrong to sit in your car and have a snack up until the moment that you are supposed to begin work, as one TikTokker posted recently. It is neither right nor wrong to come in a bit early so you are prepared for the day. It is only right or wrong for you, your values, and your life outside of your job.

Healthy boundaries are flexible boundaries. They are not so infinitely malleable that they end up meaningless, but they are also not so rigid that they don’t allow for situational variation.

One of the most common obstacles to healthy boundary-setting is guilt. We might feel bad about saying no, declining a request, refusing to do what is being asked of us. 

There are a number of different ways to manage guilt around boundary-setting. One management strategy might more accurately be called an “unmanagement” strategy. You can feel the guilt, acknowledge the guilt, and accept the guilt. Sit with it. It’s uncomfortable but ultimately tolerable. You can also ask yourself whether this discomfort is greater than the discomfort you feel scrambling around trying to fulfill all the obligations that come with constantly saying “yes.”

Along those lines, you can manage guilt by considering what you are giving up by not setting healthy boundaries. If you are indiscriminate with your time and energy, you are not giving your best to the things and people that matter most to you. You are depleting your resources. What part of dedicating yourself to your priorities warrants guilt?

In a recent piece focused on self-compassion exercises, I talked about treating yourself as you would treat a good friend and offering yourself the same compassion and empathy. In order to manage guilt while setting boundaries, you can try thinking about the situation from the perspective of a friend. What might your friend say to you if they saw the way you were being treated? Would they support you setting a boundary? Encourage you to set the boundary if you were reluctant or ambivalent?

Managing guilt is only one aspect of successful boundary-setting. It is also important to set your boundaries when you are calm and emotionally regulated. If you take on more and more (and more!) demands, you will eventually reach your breaking point. If you are setting a boundary once you are at that breaking point, you are more likely to communicate it in ways that are harsh or even aggressive. Setting boundaries is not a hostile thing to do. But it can feel hostile if you wait too long to do it.

And if you have generally had weak boundaries and you begin to have more adaptive ones, expect the people around you to have a period of adjustment.

Consider this scenario:

Let’s say every single time my daughter asks for a cupcake, I give it to her. Every single time. How will she react the first time she asks for a cupcake and I say no?

The people in your life who have become accustomed to you picking up the slack and taking on extra tasks will be similarly disappointed when you first set a firm boundary. That’s okay. Their disappointment is not the point of the boundary, but it is an acceptable price. Still, you can make the adjustment easier for both you and them by expecting and accepting some degree of strain. 

Lastly, I want to emphasize that we can only set boundaries for ourselves, what we will do, what we will and won’t accept. We can’t set a boundary that our partner should make dinner three times a week, but we can set a boundary that we won’t make dinner more than four times. We can’t set a boundary that we won’t be asked to do more, but we can set boundaries around how we will respond to those asks. And setting boundaries that are right for us is a vital part of preserving our wellbeing.

Takeaways:

  • Setting boundaries is an intensely personal and value-driven endeavor.
  • Healthy boundaries are flexible boundaries. 
  • One of the most common obstacles to healthy boundary-setting is guilt. 
  • You can “unmanage” guilt by feeling, acknowledging, and accepting it. 
  • You can manage guilt by considering what you are giving up by not setting healthy boundaries. 
  • You can try thinking about the situation from the perspective of a friend. 
  • It is important to set your boundaries when you are calm and emotionally regulated.
  • If you have generally had weak boundaries and you begin to have more adaptive ones, expect the people around you to have a period of adjustment.
  • We can only set boundaries for ourselves.

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