Boundaries 101: What I teach my patients
Everything you need to know about setting healthy boundaries.
Hi folks,
If you had to pick one psychological skill to learn and master over the course of your life, hands down — learning how to set and maintain boundaries is it.
In my book, Real Self-Care, I write about four real self-care principles:
Boundaries
Compassion
Values
Power
For today’s letter, I’m giving you a Boundaries 101 lesson — because without boundaries, there is no real self-care.
(This post, and all RSC principle posts, will always remain free for all readers.)
Let’s dive in.
The Boundaries Bulletin
What you need to know when it comes to setting boundaries.
Your boundary is in your pause. You can say yes, you can say no, or you can negotiate. (More on this below).
When communicating boundaries, be clear, be concise, and don't apologize.
The point of setting a boundary is to communicate what you need in a relationship — not to control the other person's response.
Just because you feel guilt does not mean you are making the wrong choice. Guilt does not need to be your moral compass. (We will talk more about how to deal with guilt when we explore the next self-care principle, compassion.)
Don't go to the hardware store for milk; i.e., be careful about trying to get approval for setting a boundary from someone who is not capable of giving it to you. “Don’t go to the hardware store for milk” is a common therapy saying. It’s a great shorthand reminder that your sister-in-law who is terrible at boundaries is not the person to go to when you need help setting limits with your micromanaging boss. Be careful to seek support from those who have clear evidence of setting boundaries in their own lives.
You are allowed to change your mind. Honestly, this needs to go on merch. You are allowed to change your mind. You are. I promise. And changing our minds is a natural part of our changing lives and worldviews.
If you've never set boundaries in the past, it's normal for it to feel uncomfortable. Enforcing boundaries is like building a muscle. You will have growing pains. That’s to be expected. Start small, and build boundaries over time. Setting boundaries with family is always the most difficult, so do not start there! That’s advanced-level boundaries. Start somewhere easy, like in line at the grocery store.
Let’s talk more about why “the boundary is the pause”
My “aha moment” came to me in 2016. I had just graduated my psychiatry residency at George Washington University. I had been offered my dream job on the faculty in the psychiatry department, helping to run the women's mental health clinic.
My mentor took me out for lunch on my first day on the job and said, “Pooja, I have a piece of advice for you. You don't need to answer your phone. You can let it go to voicemail, listen to what they want, decide, and then respond.”
I had just come from medical school and residency where we had pagers that would go off at all hours; we had to respond right away, and it developed into something akin to a PTSD response for me. My mentor’s advice was the first time I understood that I could actually pause and take a beat.
At the time, I was working in full-time academics and seeing patients all day. Sometimes, the front desk would have some insurance paperwork for me to take a look at and sign. That was a situation I could pause and let them know I’d come back around at the end of the day, because it wasn’t urgent.
But other times, I’d have a patient who needed her ADHD medication ASAP, because if she missed a dose she could literally get into a car accident, so I'm going to make sure to put that refill in right away.
The boundary is the pause. And after you pause and think, you always have three options: yes, no, or negotiate. The reality is that “no” always comes with a cost, and no is not accessible for everybody.
If your company is in the middle of a restructuring and your boss says to you, “Hey, we're going to need you to pick up an extra shift on a Saturday,” and you say no, you could literally lose your job. And let's say your job is what provides health insurance for your whole family, so saying no isn't really an option.
So what do you do when can't say no? Make a mental note for yourself and say, “Okay, six months from now, I want to be closer to being able to say no. I want no to feel more accessible. So what do I need to do to make that a reality?” Take that question to your journal, therapist, advisor, coach, or book club — whoever you have in your life to talk about these things with — and find your way to a solution.
A lot of times people think that a boundary should be a brick wall. There’s a lot of conversation online right now about cutting friends and family off. I'm not saying that that's never appropriate. I have patients who, after months and sometimes even years of therapy, come to the conclusion that a certain relationship is just not something that they can be a part of. But I think that that is the exception, not the rule.
A healthy boundary should be flexible, like the net on a trampoline. There’s room to move around and experiment, but the net keeps things in (or out).
Another issue I see people run into with boundaries is trying to control other people's feelings and behaviors — you can only ever control your own. So, when you set a boundary, you have to recognize that there are two different processes happening at the same time. The first is the actual communication. How are you going to communicate this boundary? What are you going to say? How are you going to be clear? Is an email, phone call, or in-person conversation better?
Then the other piece of the boundary is the feelings. You cannot expect the person that you're setting the boundary with to react well, or to take care of your feelings. Instead, take your feelings to a third party (again, that trusted person in your life) that you can express your worries and fears and full feelings to, without any worries it will further damage the relationship in question. It’s ultimately not their job to manage your feelings, just as it’s not your job to manage theirs.
Their job is to hear and receive the boundary, then decide what they're going to do, and whether they're going to respect it or not. If they don't respect it, then that's when you have to take further action.
xo,
Pooja
You are reading Real Self-Care, the weekly email newsletter written by psychiatrist and bestselling author Dr. Pooja Lakshmin MD.
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This post put words to something I’ve struggled with for so long. The idea that the pause is the boundary—that we don’t have to respond, fix, or explain immediately—feels both obvious and impossible at the same time. My nervous system wants urgency, wants to make things right now, but every time I force myself to wait, I realize how much power is in that space.
And the trampoline metaphor? That’s everything. I’ve spent years either having no boundaries at all or locking things down like a fortress, convinced that if I didn’t build walls, I’d get swallowed whole. But real boundaries move. They flex. They give me a chance to check in with myself before reacting to someone else’s expectations.
Also, the part about “no” not always being immediately available? That hit hard. Boundaries aren’t just about saying no—they’re about building a life where saying no feels possible. Sometimes that takes time. Thank you for this—it’s a perspective shift I needed today.
I gave the same talk at two high schools today. i was asked to speak about "Personal Wellness." I included the topic of boundaries - limits set for yourself and others to promote your personal wellness. Both the kids and the adult mentors in both groups were very interested in talking about boundaries and had a lot of questions about how to apply them in relationships. We all need more training in this area. Glad to have found your work.