Why Boundaries are Better Than Prozac

Learn why this top psychiatrist prescribes boundaries more than medications, and discover a 3-step approach to implementing healthy boundaries

As a psychiatrist, I get the distinct privilege of observing and being curious about how people treat and interact with themselves, with others, and with the world. Depending on a variety of things (diagnosis, past treatment, family history, current medications, other medical conditions) I may recommend and prescribe medication. Sometimes the medication I recommend and prescribe helps. Sometimes the medication I prescribe has no side effects.

I always recommend boundaries. Always. When used correctly, they work. When used correctly, there are few intolerable side effects.

A typical conversation I have with my clients goes as follows:

Me (psychiatrist): “How are you with boundaries?”

Client: “What are boundaries?”

or

Client: “Ummmmm……… (while checking their email during a psychiatric assessment) … …I’m great at boundaries!”

A misperception that I frequently encounter is that setting boundaries means being selfish. It does not. Full stop. For example, if doctors didn’t set boundaries, we would be seeing patients 24 hours a day 7 days per week. Is it selfish of me and my colleagues to sleep, eat, exercise, self-care and have a life? No. So why is it selfish of you?

I tell my clients that boundaries like skin. They are to our emotional health what skin is to our physical health. Without skin, we are prone to infection, sepsis and death. Without healthy boundaries (consistent, clear, purposeful and practiced), we are prone to burnout, depression, anxiety, illness and death.

3-Step Guide to Setting Healthy Boundaries:

Step 1: Identifying a need

If you are overburdened, stressed, tired, dissatisfied with your work, overworked, uncertain or unclear in relationships, you may want to take a close look at your boundaries. If you think boundaries are a problem; they are. If you have great boundaries in one area of your life and fluctuating and unclear boundaries in another area, ask yourself why you treat yourself better in one area of your life and why you choose to treat yourself differently in other areas. PEOPLE WILL TREAT YOU THE WAY YOU TREAT YOURSELF.

Step 2: Determination of boundaries

Our bodies know when our boundaries (emotional, mental, physical) are being violated. Listen to your body. You know that nagging ‘gut feeling’? I call it the ICK feeling; that ‘ICK’ feeling is the feeling we get when something isn’t right but we aren’t really doing anything about it. That ‘ICK’ feeling is your body telling you that something is wrong. Your brain has likely had a lot of practice trying to convince that things are ok, so pay attention to the ICK feeling because that ‘ICK’ feeling is innate. If you’re completely out of tune with your body, get familiar with somatosensory feedback through mindfulness, meditation and exercise.

Step 3: Practice

Recalibrating boundaries is not a simple task. If you’ve spent 95% of your life (43 years for a 45 year old) practicing inconsistent, unhealthy or fluctuating boundaries, YOU WILL NOT GET IT RIGHT THE FIRST TIME. Setting consistent, clear, purposeful and practiced boundaries takes practice. Start by identifying one boundary that you want to work on. Write it down. Write it down on your phone, write it in your calendar, write it in your agenda, and write it on your forehead. Remind yourself over and over again WHY you are choosing to set this boundary. How will this new boundary serve you? How will it help you live the life you want?

How will setting consistent, clear, purposeful and practice boundaries add value to your life? How will it help you live the life that you want?