Healthy Boundaries Can Reduce Your Stress Part One:

2.0 CE Hours

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Course Objectives:

1. Learn why clear and healthy boundaries are a vital key to stress managements and to living your vision and creating a fulfilling life.

2. Identify how healthy boundaries empower us.

3. Explore what personal boundaries are.

4. Identify the relationship between responsibility and boundaries.

5. Understand emotional, spiritual and psychic boundaries.

6. Identify the key areas to protect by using boundaries.

7. Discuss boundaries in caregiving relationships.

8. Indicate the necessity of boundaries with other health professionals.

9. Understand about setting boundaries with personal requests.

10. List ways to create boundaries within the family.

 

Do you have a hard time standing up for yourself? Do you keep agreeing to do things that you really do not want to do? Do you tolerate rude comments or pushy people because you cannot handle conflict? Do you take things personally?

Clear and healthy boundaries are a vital key to stress management and to living your vision and creating a fulfilling life. Both in your personal and professional life, a lack of boundaries will pull you away from being your best. This quick guide will help you identify key boundaries that may need your attention.

Healthy boundaries empower us to say, “No thanks, that’s not for me right now,” "No, I'm not able to do that," or “No, that’s not acceptable in my house” with genuine friendliness, neutrality and conviction. But when we are uncertain, or worse yet, when we know what we need but we are afraid of the consequences of voicing it, then we find ourselves straining from our lack of healthy boundaries. Eventually we end up feeling angry, hurt, sick or injured.

If you have trouble finding time for your work priorities, self-care, home maintenance or hobbies because of the time taken up meeting the needs or expectations of others, then setting healthy boundaries can free up time and energy for you. This course will help you identify ways to set the healthy boundaries you need instead of ignoring them.

What Are Boundaries?

Personal boundaries are designed to protect and honor important parts of our lives and to clarify what are acceptable and unacceptable behaviors from others. Just as a fence protects and preserves our real property, so should personal boundaries protect our personal selves. They help us know who we are and who we are not. They help us set appropriate limits and define consequences when these limits are crossed.

In physical terms, a boundary can be easily seen and therefore they can be easily managed. For instance, if you have a house on a piece of land, you may have a fence that clearly defines the boundary of your property. In that case if someone, without the right to, attempted to come onto your land you could make a decision about whether to welcome them or phone the police.

The other side of boundaries is responsibility. With clear boundaries, you know what you are responsible for. For instance, if the roof on your house needs repair, it is your responsibility to have it fixed. You would not go to your neighbor and tell them they needed to come fix your roof. (You could try that, but it probably would not work out so well!)

Emotional and spiritual or psychic boundaries are just as real as physical ones, but they are not as easy to see. The definitions of what one’s responsibilities are versus someone else’s may not be so clear, leaving each of you with different expectations. Boundaries can be especially difficult to see in relationships with strong emotional attachments, such as children and parents or husbands and wives.

Emotional, spiritual and psychic boundaries define us. They define what is part of me and what is not. They help you identify where you end and another person begins. Just as with physical property, it helps us know what we are responsible for and what is the responsibility of others. This gives you the freedom to act within the boundaries that define you. It can also take away any responsibility you might feel for how someone else acts within his or her boundaries. Boundaries are not a contradiction to oneness, love or caring. They help us know our self and another with greater specificity of detail and nuance.

Boundaries are also guidelines for how a person relates to the rest of the world. Personal boundaries help define an individual by outlining likes and dislikes and what feels right for them personally or wrong for them personally. Personal boundaries operate in two directions, affecting both the incoming and outgoing interactions between people.

Defining your boundaries helps you know how you will and will not allow yourself be treated by others. Your boundaries are defined by your feelings. Your feelings will always tell you whether a boundary of yours has been crossed, no matter what kind of boundary it is.

This does not mean that you do not care, or that you will not help someone. What it means is that you recognize where your responsibilities lie and where they do not. It also helps the other person see that when something overwhelming is unexpectedly thrust upon you, you can make the choice to help carry that responsibility... or not.

As healthcare professionals, we have special skills and gifts... unique qualities that not everyone possesses. Where we must be especially careful is being sure we do not start out "repairing the roof" and end up "cleaning the whole house."

In the book Boundaries that he co-authored with Dr. Henry Cloud, Dr. John Townsend tells a story that clearly illustrates inappropriate boundaries and how they affect our lives. Imagine that you have a neighbor who never waters his lawn, and that whenever you turn on your sprinkler system your water only falls on his lawn. Your grass is turning brown and dying. Your neighbor looks out and thinks his lawn is doing fine. If you fix your sprinkler system so the water only falls on your lawn, then your neighbor will have the opportunity to choose if he wants to water his.

Taking care of what is within your boundaries, deciding what to let in and what to let out, can be hard work if you are not used to it. Likewise, letting others take responsibility for what is within their own boundaries can be difficult until you practice consciously and grow that skill.

The benefits of learning to set healthy boundaries is definitely be worth it! Life is better with healthy boundaries. People respect you when you set healthy boundaries and take care of your own needs in healthy ways. Like the instructions we receive on airlines, you must put on your own oxygen mask first, and then help others.

Key Areas to Protect By Using Boundaries

Just as we have property we preserve and protect with physical boundaries, there are several key areas of our lives that should be protected by personal boundaries:

• Your Time – In today’s world, time is an important and valuable asset. We often feel we never have enough time to focus on what is really important in our lives yet time is often what we least protect through effective boundaries. Do you have friends who drop by unexpectedly? Do you have co-workers or employees who demand your time in unreasonable ways? Do you have tasks that could just as easily be completed by someone else? These are examples of violators of our time boundaries.
• Your Emotions – Your emotions are where your love and caring come from. This should be well-protected. Often, people in our lives may say or do hurtful things (often unintentional) that can damage our emotions and our hearts. Has someone in your life made hurtful remarks or comments? Been thoughtless? These are examples of violations of our emotional boundaries.
• Your Energy – Your energy is the wellspring from which you function. This energy can come from many sources; your “alone time”, your inner peace, activities that invigorate you, etc. When others do or say things that rob you of this energy (such as invade your privacy, create turmoil, make unreasonable demands, keep you from prayer, meditation, etc.), you are less likely to function effectively.
• Your Personal Values or Other Areas of Importance to You – Anything in your life that is important to you can be areas that can benefit from effective boundaries. What other areas of your life need boundaries?

The biggest issue usually is not that other people violate our boundaries, it's that we violate our own boundaries. We violate our own boundaries when we let someone violate our boundaries. This is a form of self-betrayal.

Boundaries in Caregiving Relationships

It is particularly important for people caregiving positions to set and maintain solid boundaries that honor your needs and the needs of anyone who is dependent on you. This is especially true in difficult relationships. Difficult people come in all varieties, from self-absorbed and demanding to angry and remote. Caregiving situations vary widely, too.

If your patient is critical, grumpy, intrusive, or just plain mean, you can look at this as a prime opportunity to learn how to stay centered and in your power. Believe it or not, it is possible to make your relationship work more smoothly.

Your experience could be different depending on whether you are providing daily care, supplying occasional care, or relating to the person from a distance.

Boundaries with Other Health Professionals

Because we generally respect health professionals as experts, we often do not think of setting boundaries with them. But health professionals are people too. And despite their professional training and manners, they can have big egos, narrow vision, impersonal approaches, and innumerable other behaviors that potentially can be intrusive or undermining to your safety, health or well-being or to the safety, health or well-being of the patient you are caring for.

It is important to see health professionals as people, and question them and their approaches thoroughly. Make sure they are well-aligned with the patient’s and family’s wishes and if they are not, then set clear, firm boundaries as needed. If you feel unsure how to do this, ask for help. Every hospital has someone who can help you sort out issues like this. You just have to be proactive to do it. The same goes with private physician’s offices, although in some cases you will need to find your advocate outside the office if no one offers to help you.

Know that it is completely legal for people who are seriously ill (or their health proxy) to stop medical treatment that is not curing or controlling an illness. It is also legal to not start a new treatment. People have the right to do this. The law does NOT consider refusing such treatment to be either suicide or euthanasia.

Boundaries with Personal Requests

The following is a fairly typical story. Even though it describes a family caregiving situation, similar dynamics often occur at work, too.

“I don’t check my email very often, so can you just call me with the updates each day?” I was dumbfounded on how to respond. I was spending nearly 2 hours a day calling each person who wanted an update on my mother and I felt obligated to do so since these were people who obviously cared for my mother deeply. They were her friends, siblings and cousins... people who were praying for her and people who had volunteered to help with her caregiving. I owed it to them to at least let her know how she was doing, right? Wrong.

My obligation was to care for my mother, and if I was busy updating all these people two things would occur: 1) I wasn’t going to care for my mother as well as I could and 2) I was going to drive myself into sickness. Neither was a good situation.

So I learned to set firm healthy boundaries. I let people know that I was busy taking care of Mom so we were sending updates via email, and if they didn’t check email then they should find a buddy who did and that buddy could update them. At first I felt guilty being so firm, but people took it well and eventually I learned that it was the best route to take.

There were other boundaries to set too. When friends had overstayed their visit and I knew my Mom needed to sleep, I plainly told them it was time to go — it was naptime. I needed personal space to protect some of our family life.

I also learned to set boundaries with my time. At first I felt guilty when people came from out of state to visit and the second they arrived, I shot out the door to go to work or to just get some time for myself. But that’s why they were there. To help and spend time with my mother… not for me to entertain them or to see me. So I got over my guilt so I could better care for my mother when they were not around.

I truly feel blessed to know people cared, and it made Mom feel better too, but we needed those boundaries.”

Boundaries with Family

Even if we function fairly well in our work and social life, when we are with our family, the family dysfunctions often become overwhelming. All the more reason to set clear, firm boundaries to protect your safety, health, and well-being. This one topic is probably big enough to have a whole course on, by itself!

Here is a story that unfortunately occurs too often, in various versions. You most likely will have one of these reactions to it: 1) you will feel uncomfortable and want to set boundaries with the people involved and/or 2) you will recognize similarities to your own situation and not know how to set those boundaries. This will be discussed that after you have read the story.

“I’m so distraught. I want to run away! My son, his girlfriend and baby live with me in my mother's home. The girl friend is very disrespectful and unemployed. She won’t help me with any housework and she reports the arguments we have to my son while he’s at work. This stresses him out and he calls and abuses me to leave his girlfriend alone. I’m trying to care for mother and I get no help. My son will help out once in a while, but he drinks when he’s under duress. I feel like I have no one to turn to except God, who seems quiet while all this is going on. Usually I have a pretty good grip on life, but this is starting to wear me down. I take antidepressant and anxiety medicine but it doesn’t seem to be helping me much. I suppose I just need to vent. Thank you for listening and God Bless you.”

OK. Not a healthy situation, right? How would you set boundaries in that situation? Here are some suggestions:

1. The person who wrote this story needs to set clear, firm boundaries with her son
2. Since she has probably never done that before, she needs to ask for help from reliable, responsible friends, family, neighbors, members from one’s religious institutions, etc.
3. If those are lacking, she can call the local Area Agency on Aging (AAA) and ask for help: every state has several AAA offices, depending on the area’s population density. They should be able to refer her to a community service provider who has experience with this type of family situation. A hospice or hospital could be called to help with this, too.
4. She needs help to formulate a plan for setting the new healthy boundaries; help to have the conversation with the son and his girlfriend, and help to follow-up with the consequences if they choose to not honor what she and her mother need.
5. For the longer-term, she needs to be part of a supportive circle of people who can fill-in for her when she needs to leave the home for a while, and people who she can talk to for social support.

All of this is hard work for anyone who has not practiced it, but a realistic conclusion is that the situation will not improve on its own.

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References

Blais, K., & Hayes, J. S. (2011). Professional nursing practice: Concepts and perspectives. Boston: Pearson.

Burch, S. (2014) How to Be True to Yourself: Self-Care for the Caregiver. Awakening to Grace, Inc. www.AwakeningtoGrace.org

Cloud, H. and Townsend, J. (2004). Boundaries: When to Say Yes, How to Say No to Take Control of Your Life. Zondervan Press.

Fredrickson, B. (2013) Positive Emotions Broaden and Build, Advances in Experimental Social Psychology, 47, 1-53, University of North Carolina at Chapel Hill

McElligott, D, Capitulo, K, Morris, D, and Click, E, (2010) The Effect of a Holistic Program on Health-Promoting Behaviors in Hospital Registered Nurses, Journal of Holistic Nursing, American Holistic Nurses Association

Pender, N., Murdaugh, C., & Parsons, M. (2006). Health promotion in nursing practice (5th ed.). Upper Saddle River: Pearson Prentice Hall.

Richardson, C. (2011). Begin to Set Personal Boundaries. O, The Oprah Magazine. http://www.oprah.com/spirit/Begin-to-Set-Personal-Boundaries_1