If you are a therapist, you talk about boundaries. I’m not a fan of absolute statements, though I feel pretty confident using that one. I don’t believe I have ever had a session where I didn’t discuss the B word at least once. Discussing the importance of boundaries is not what I will be focusing on here– I’m fairly certain we are all believers at this point. My question is whether we are setting healthy boundaries in our day to day practice. Are you modeling healthy boundaries in your more basic interactions with therapists?
There are MANY things to read out there about setting boundaries and limits when it comes to ethics. Legal concerns, egregious challenges to professional boundaries etc. This is not what I am going to focus on here. I want to take a look at the boundaries that are necessary in our practice that we may forget about, the ones we may feel compelled to be more flexible with than we would like for the sake of being a “good helper”. These boundaries are often forgotten about, though they are remarkably important.
“Do as I say, not as I do” can work in a lot of situations. Therapy isn’t really one of them. As therapists, our words are powerful though our actions may have just as much weight. Setting legal and ethical boundaries are important, but I think we forget how important it is to also model boundaries when it comes to time, availability and self-care.
To throw another cliche statement out there, it can be “easier said than done” to not only talk the talk but to walk the walk. Teaching skills surrounding boundary setting can be easier than having more basic discussion with a client about things like the importance of being on time for sessions or frequently missed appointments.
It Is Hard to Set Boundaries
With all the skills we have learned and shared you would think setting boundaries would get easier for us therapists. The reality is that boundaries are difficult no matter who you are.
Setting boundaries when it comes to ethics or legality can be far easier than the more mundane day to day practices. This may be because these types of boundary violations and concerns are far more evident, they happen less often and bring with them more of a sense of urgency. These types of boundaries are NOT what I am talking about today.
There are a lot of things that get in the way of setting boundaries, especially in a professional capacity. You may worry your clients will feel rejected, you may be averse to confrontation or conflict, or fear causing harm. What if you plain don’t know what to say? All of these concerns are valid.
As I mentioned, ethical boundaries, like not having a dual relationship with your client, can be more obvious. I am fairly certain no one has encouraged you to be flexible with this type of boundary setting, but when it comes to setting limits on your time you may have received mixed messages.
Most therapists become therapists to help people. If you want to help others you may also be inclined to put others needs before your own. This doesn’t mean you always do it, I’m simply saying this may be your initial response in situations. This can play out by scheduling more people than is healthy for you in a week, being more flexible about when you take calls than you would like, allowing for more missed appointments than you are comfortable with before discussing consequences… the list goes on.
An added layer of difficulty may come from expectations or judgements you are placing on yourself. You may believe that you SHOULD be more flexible with these kinds of boundaries, it SHOULD be easy for you to say no, you SHOULD know what to say. You are essentially “shoulding” all over yourself. Piling on this kind of pressure is unfair and not helpful. Boundaries are difficult enough without negative self-talk added on top!
Take a Hard Look
We know boundaries are hard to set, so perhaps ask yourself what your boundaries are like right now. Do you feel emotionally exhausted? Are you saying yes in situations where perhaps you need to say no? Are you helping so much that it’s hurting you? If you answered yes to any of these questions you may need to make some changes when it comes to your more routine boundaries.
Being a therapist doesn’t make us magical unicorns. We experience the same challenges as everyone else. We all put our pants on one leg at a time or maybe you go both legs at a time, you rebel! Either way, we are all human. It’s okay to have trouble setting boundaries. If anything, it will help you to have more empathy for clients when helping them to set boundaries in their own lives.
Where the real change can happen is recognizing that you need to set different boundaries and then actually starting to put it into practice. Notice I said “starting,” as it’s a journey. No one has perfect boundaries, no one has boundaries that are never tested or in need of fine tuning. Take a look and start adjusting.
Common Boundary Obstacles
Be mindful of ethical and legal boundaries that need to be set. It goes without saying that these boundaries must be set and maintained, though I wouldn’t be me if I didn’t say this, again. Follow ethical and legal guidelines of your State licensing board and your profession. I can’t stress how important this is. But it is also very important to address other types of boundaries. Let’s take a look at what can get in the way of those limits:
Fear of Rejection
Rejection gets in the way of setting boundaries for most people. No one wants to feel rejected, and they don’t want to leave anyone else feeling that way either. This fear can get in the way of you saying no to clients, and it’s two fold: you don’t want them to feel rejected and you don’t want them to reject you as their therapist.
You may worry if you say no and/or set boundaries that your client will be hurt, and in turn stop coming to see you. This is a natural concern to have. While it isn’t enough of a concern that you should consider NOT having boundaries, it is a concern that is natural and can even be helpful in the therapeutic process. Don’t forget you are a safe person for your clients to process this with.
If your client is left feeling rejected when you say no or set limits, they can process that with you! You may be one of the few people in their lives with healthy boundaries. You may even be the only person. You can worry about rejection and still set those boundaries.
What if they get angry?
I don’t know about you, but I don’t like being told no. Most folks don’t. It’s likely your client won’t love it either, and guess what? That’s okay. Much like fear of rejection, this could be helpful to the therapeutic process. If your client becomes angry with you for setting boundaries it’s likely they get angry with others when they set boundaries.
I am not saying this concern isn’t valid. It certainly is. It simply isn’t enough of a concern to keep you from setting healthy boundaries. It can be a lovely place to practice radical acceptance. Anger can happen, so plan what you can both do with it.
Not Knowing What to Say
It can be difficult to know what to say when it comes to setting boundaries. Having clear expectations and limitations for therapy can be extremely helpful to discuss with your clients from the beginning of treatment. For example, discuss when you are available and what clients can do if they need something during a time you are not available. Discuss your missed session policy and expectations surrounding this in the first session. This type of open communication surrounding limits and expectations can create a feeling of safety for both of you. It can also make it easier to discuss possible boundary concerns later on if they arise. If they try to push or violate a boundary you have set and already discussed, it can be easier to broach the subject.
Something as simple as having clear expectations for when sessions will start and begin can do a world of good. We are all humans, but starting and ending on time most of the time is important. Discuss what it means to miss a session, if you require a certain number of hours notice of cancellation, let your clients know, and stick to it. Having a policy and prepared statements can be helpful in these situations.
If you don’t know what to say, that’s okay! No one knows what to say in every situation. Seek supervision or additional education in areas you feel unsure of. Just because you don’t know how to handle a given situation doesn’t mean you never will.
Set Healthy Boundaries with Yourself
If you’re going to talk the talk you better walk the walk. We have discussed this a lot in relation to our work with clients, but don’t forget about boundaries you set with yourself. You aren’t just going to have to say no to others, you will also need to say no to yourself.
Take a look at how you structure your day, do you leave time for yourself? Are you eating during the day, taking vacations when you need to? You may be engaging in unhealthy habits that you need to say no to.
Be sure to structure your work life and personal life in a way that you can take care of yourself. Set those boundaries. Create a work-life balance, because no one is going to do it for you.
To Sum It Up
Boundaries are wonderful and they can be really scary to set. They create safety and a little bit of distress sometimes too. When you set boundaries you give both parties the benefit of knowing what to expect.
Setting limits can be easier when it comes to clear cut ethical or legal circumstances. I hope that you always set and maintain those limits. I also hope that it becomes easier and easier to set other limits as well, the ones you may feel you “should” be more flexible with.
With all new things, it is often helpful to start small. Look at your day to day policies and see if you are utilizing them in a way you feel good about. Pick one small limit you’d like to be more consistent with and start being more consistent.
It is important for you, and for your clients, to know that you will follow through on what you say. This can instill confidence and allow for trust to develop. You don’t have much in a relationship without that!
If you feel that something is off and that your boundaries need to be adjusted, you’re probably right. A lot of things can get in the way of setting boundaries, but you don’t have to let them. Practice what you preach, my therapist friend. See you next time.
