Why Creating & Setting Boundaries is Essential for Our Health

At some point, too many of us internalized the belief that being a woman means complete self-sacrifice, not setting healthy boundaries for our well-being, and not taking care of our fundamental needs – even for sleep, quality food, and relaxation. Further, as moms, we often take on the lioness's share of the household. As partners, we plan the dates and stay in touch with old friends. At work, we pick up the slack of others without so much as a peep of protest. But here's the thing – often, others don't even notice that we are doing all of this extra work because we haven't set healthy boundaries – with ourselves or with them. We've been taught to be the “good girl” (definitely listen to last week's podcast episode ALL about this topic if you haven't yet) and with this, we also believe that boundaries are rude or selfish.  So we give and give and give – at the expense of our well-being and sometimes at the expense of our own passions and fulfillment. Time for a reframe! Not only is having boundaries not selfish – but we are better givers when we practice conscious boundaries.

And that's exactly what I'm talking about in this latest On Health episode. Tune in as I dish out my top tips to get you on your way to a boundary-setting queen! And learn all about why it's truly so important, just in time for the new year ahead and beyond.  

 In this episode I share: 

• What boundaries are, including the types we may overlook  
• Why we have trouble setting boundaries 
• How to know whether you need healthy boundaries in your life 
• Exercises to support you in discovering your highest priorities and how to stick to them 
• The boundary-setting practices to get you started and that really work 
• And more – including my weird style tip that relates to healthy boundaries 

 I KNOW that many of you will have at least a few “aha” moments and maybe even have some tears of understanding. Listen and become your own boundaries badass!  

Thank you so much for taking the time to tune in to your body, yourself, and this podcast! Please share the love by sending this to someone in your life who could benefit from this episode.

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Voicemail Recordings

“Hi Dr. Romm, I am currently founding a health tech platform with the prior Chief Technology Officer of (insert a major start-up transportation business of the last decade). We are looking for a holistic lifestyle MD who is not afraid of content or startups, to come on board with us and create something amazing that you dream up. I love your women’s health/ midwife content – I think we could come up with some amazing programming together. I can’t wait to give you my private cell, and schedule a call when you are free. Call me!”

“Hi Dr. Romm, My book drops in six weeks. I’d gladly trade you my book for your time if you’d write a blurb for me. I’d feature it on my Amazon sales page, my website, and my Facebook page.”

“Hi Dr. Romm, I know it’s last minute, but for our one-hour interview in a few hours, can you answer these 12 questions, including the physiology behind these five hormones and these four  conditions, and how they interact with coffee consumption? Sorry we didn’t send these sooner.”

Only 15 minutes into my Inbox and the asks are pouring in, along with the potential decisions I have to make about each one, and the email response that needs to follow. Here’s the thing: I’m grateful for so many asks, and I  would LOVE to be able to say yes to every single one. This exciting opportunity, that wonderful person to meet and collaborate with, potentially financially rewarding opportunities, and people I would love to support.

Like you, who probably has a lot of people asking for a lot of things, I have a full plate of my own responsibilities:  my  family, my personal passions and mission, and my own self-care (which I’ve learned is too easy to postpone). 

It’s taken me years to get really good at setting boundaries that allow me to stay balanced and focused on my priorities; boundaries that keep my energy centered and intact, instead of dispersed and spent. 

The truth is that for many, I said yes to most opportunities that came my way. I remember one year where I traveled to 30+ different conferences and gave a total of over 35 new keynotes and talks. It’s true: I am a woman on a mission. But the underbelly is that any of us can get burned out, including me, which is why I’m talking about boundaries. 

I take care of so many women who are struggling with feelings of overwhelm from taking on too much. They are not listening to the messages their bodies are telling them. They are unhappy, and sometimes unwell,  from too many yeses to others and too few to themselves. 

The yesses to others can compound incrementally until we begin to feel the burn out. I wrote an entire book on the impact of chronic stress on women’s health, called The Adrenal Thyroid Revolution. Stress is so central to hormonal health that I dedicated two chapters in my most recent book, Hormone Intelligence, just to sleep and stress, including how overwhelm can tank us. 

Boundaries not only figure into what’s on our plates: they are an important aspect of self-respect, and of the ability to speak up for ourselves and what we need. This translates into what we accept in terms of how we’re treated medically, professionally, and personally – all of which impact our health and our medical safety. 

When we get better at setting limits, we get better at recognizing and articulating our boundaries. If you were pregnant, for example, think of how nice it would be to tell someone not to touch your belly without asking – and if they did ask, to feel comfortable saying no! There are a thousand examples of how our space is invaded every day.

The holiday season is the time when women report feeling the most stressed and overextended, often entering the new year already needing a vacation from the holidays! We go into the new year with a whole set of resolutions about food, exercise and alcohol (or whatever it is you do to calm the stress response), only to find that we’re struggling to stick to those boundaries. When we’re feeling overwhelmed, it’s harder to find willpower; plus, we’re so busy. Who really has time to meditate, exercise, and prepare healthy meals? 

There is another path you might consider taking, starting now: learn to listen inwardly, to listen to your body (what is called interoception), and use the information you gather to help you set boundaries that allow you to feel more spacious during the holidays. You can extend those boundaries into how you want to feel in your life in general. How you want to live; how you want to be spoken to; how you want to be treated in all of your relationships, including at work and by your kids.

I have found that the act of creating boundaries itself is a powerful opportunity for tuning in to my needs and priorities, something I do during the first few days of the new year, and again in September.  The art of setting those boundaries has opened new pathways of honest communication and empowerment. By giving greater respect to my physical health, mental well-being, and time, I teach others to treat me with that same respect. The things I take on have to be truly in alignment with my personal needs, professional goals, and life mission. 

As we slide out of 2022 and glide into 2023 (hopefully with greater ease than we have seen in the past few years), rather than thinking about resolutions – AKA “more rules to add to your to-do list” – I have a new approach to suggest. It’s resolution-free, and no pain in the gain: simply create better boundaries. 

Creating boundaries is a powerful and transformative life skill: it can open new windows and bring you some major aha moments. It’s also a powerful way to stay tuned into what your body is really telling you, and to redefine your priorities. If things like eating well, exercising, making more time for self-care, or tackling that project you’ve been putting off are on your priorities list, you’ll find that by setting better boundaries, you’ll finally have enough time to make those goals a reality. 

What are Boundaries? 

The APA defines boundaries as “a psychological demarcation that protects the integrity of an individual or group or that helps the person or group set realistic limits on participation in a relationship or activity”. 

Read that one more time so that it really makes sense to you. 

There are many types of boundaries, including:

• Physical Boundaries
• Emotional Boundaries
• Sexual Boundaries
• Intellectual Boundaries
• Financial Boundaries
• And Time Boundaries, to name a few. 

In this episode, I’m going to focus on time boundaries, which overlap with many other boundaries. The act of identifying (or creating) your boundaries is important when it comes to communicating what is and isn’t acceptable to you; what does and doesn’t work for you. We’ll talk about some of these other boundaries, such as setting boundaries in your medical care, in future episodes of On Health; on this podcast, we talk about all the things that make and break our feeling good in our bodies and in our world. 

Time Boundaries: Why We Need Them

Adam Grant is a professor at Wharton Business School, and is the author of the books Think Again and Give and Take. He is an expert researcher on generosity, empathy,  and altruism, and defines generosity as “…caring about others, but not at the expense of caring for yourself”. Most of us are giving to the point of exhaustion – at work, at home, and everywhere else. Grant also says that “By protecting yourself from exhaustion, you may feel less altruistic. Yet you will actually end up giving more”.

Adrenaline and cortisol are tied up in the experiences of chronic stress and overwhelm. If you’re a chronic overgiver and ovderdoer, you may notice the improvement of many symptoms that you “just live with”. These symptoms include, but are not limited to: indigestion, headaches, and sleep troubles. Stress-induced chemicals and hormones also have an impact on blood sugar, immunity, hormones, thyroid function, weight and metabolism, inflammation, and much more. You just might see some big changes in your health when you shift your relationship to your boundaries.  

The obvious benefits of healthy time (which includes emotional, and intellectual boundaries):

• You’ll be happier and have more inner peace and calm.
• Your work quality will be better, and you’ll enjoy more focused time.
• You’ll feel more fulfilled, because you’ll have time and space to actually complete things; you’ll feel more respected in your boundaries. 
• You’ll love the feeling of being honest and in alignment with yourself, and of being more honest with others.
• You’ll multiply by subtracting – By saying no to the things that you’re taking on that are not your priority, you’ll have more time for saying yes to the projects, people, and experiences you want to have. We’ll get back to the subject of priorities shortly. 
• You might find that daily annoyances, as well as bigger health concerns, ebb away as you create more spaciousness and less stress in your life. 

Why Do We Have Trouble Setting Boundaries?

There are many reasons we have trouble setting boundaries, and it’s especially hard for women. We’ve been fed a myth of the happy, capable multitasker – the myth of the woman juggling eight things, and keeping all the balls in the air (our kids, jobs, relationships, etc). Most of us actually manage to keep the balls in the air, but at our own expense – and all the while feeling like we’re shortchanging everyone and everything. I once got a personal email with a major ask in it. The subject line of said email was: “ If you want something done, ask a busy person (AKA a woman)”, which kind of says it all! 

Another reason women have trouble setting boundaries is that many of us have romantic and spiritual ideas about selflessness, especially when it comes to motherhood, intimate relationships, and community contribution. We feel like we’re supposed to give until we have no more.

Women also have trouble setting boundaries (and this intersects with my last podcast, How Being a Good Girl Can Be Hazaradous to Your Health) because of the ”Good Girl Syndrome.” We’re led to believe that we should always be agreeable. Pleasing people is normal for most women because it’s an ingrained shield of cultural invisibility, as well as an expected role:  we bring the coffee. But always being nice breeds resentment; the feeling of being a doormat. 

As we start to tap into this understanding, we often realize that we’re doing many things out of a sense of obligation or guilt. Sometimes askers and takers want us to feel this way: they create guilt for us so that we say yes, and give more. We don’t follow the golden rule with ourselves – by treating ourselves as we wish to treat others!  “Nice” and “kind” are not the same thing, and we always also have to remember to be kind to ourselves. Neglecting your own needs is not being kind to yourself; not having time to bring your genius and beauty to the world because you’re too busy isn’t a true service to anyone. 

With the addition to our lives of email, texts, and social media, we’ve come to believe that we should always be accessible. Your devices act like a doorway for everyone else's agenda to enter into and intrude on your day. Turning off the notifications on our smartphones is one of the many boundaries we can set to mitigate the effects of these constant interruptions. Be conscious of how your electronics cross the boundaries that you set for yourself.

Most women, especially those in helping professions, experience what I call “Helper Syndrome.” This is an extension of some of the beliefs I referenced above, and is sometimes rooted in childhood patterns. We may fill this role because we desire to be needed or to feel important, even at our own expense. Plus, our culture GLORIFIES the woman who puts everyone and everything else first, and it says that those who don’t are selfish. It’s not true; often, that woman helping everyone else is struggling silently with overwhelm, anxiety, depression, and other invisible symptoms. 

FOMO (Fear Of Missing Out) and financial insecurity are also powerful players when it comes to setting boundaries for ourselves. Sometimes saying yes to too many things can cause you to never finish – or even start – what’s right in front of you: you might never get that graduate school application in; you might not apply for that job, or start that book you want to write. You may not have the time to do the things that lead to financial security, or even to think deeply about what those things could be. It can be counterintuitive: it feels like by saying no to opportunities, you’re shutting doors, when actually STRATEGIC yeses are often where real opportunity grows. Additionally, it’s normal to want to fit in and have a sense of belonging. It’s natural to want approval and validation, which shows up in the survival pattern of people-pleasing. 

Interestingly, when we’re already experiencing fatigue, stress, or any form of vulnerability, or if we have high ACE (Adverse Childhood Events) scores, HPA (the adrenal stress response system) dysregulation itself may lead to survival hormones that exacerbate our tendency to say yes, to need to fit in, etc, worsening our overwhelm.

How do you know if YOU NEED BETTER boundaries?

This shows up in any number of mental, physical, or emotional symptoms:

• You’re tired and/or overwhelmed chronically or all the time.
• You can’t rest, even when you do have time off, because you feel like there’s something you should be doing.
• You’re irritable and resentful more often than you’d like to be.
• You feel responsible for other peoples’ happiness.
• You sometimes/often postpone or cancel self-care (dental cleaning, Pap test, manicure, massage, etc) to do something for someone else – or on your personal to-do list.
• You’re unable to say no, but you feel anxious, overwhelmed, resentful,  or angry at yourself when you say yes instead. 
• You say yes to something that’s a few months down the road, and when it finally comes time for it, you’re too overwhelmed to manage it. 
• You think you’re on the edge of burnout.
• You’re having physical or mental health symptoms that mysteriously clear up when you’ve had a long vacation, or even just a long weekend off from work and your to-do list. 
• One of my most telltale signs: if you do a little happy dance when something on your calendar gets canceled – even if it’s something enjoyable, like a party or gathering. 

The motto that I swear by is “if it’s not hell yeah, it’s a no”. 

(How to) Create, Set, and Keep Boundaries

Step 1: Reclaim Wellness (or Put on Your Oxygen Mask First)

The first and most important step in creating, setting, and keeping boundaries is to Reclaim Wellness. You have to value yourself – your emotional, mental, and physical right to not be in constant or chronic overwhelm and stress. You have a right to put your needs first, to value your time, and to ask others to do the same. You have the right to say no to others and say yes to yourself. It’s okay, and even appropriate, to ‘disappoint’ others. This re-alignment with self requires us to move beyond the Good Girl Syndrome and to get honest.

One way to do this is practice being a self-protective giver. Adam Grant defines two types of givers: selfless, and self-protective. 

SELFLESS GIVERS have high concern for others, but low concern for themselves. They set few or no boundaries, which makes them especially vulnerable to takers. By ignoring their own needs, they exhaust themselves and, paradoxically, end up helping others less. 

SELF-PROTECTIVE GIVERS are generous, but know their limits. Instead of saying yes to every request, they look for high impact and  low-cost ways of giving, so that they can sustain their generosity — and enjoy it along the way.

Remember – you can’t pour water from an empty cup; the well eventually runs dry. No matter how committed you are to giving, you have to stop and refill, which means you must have the space to do so on a regular basis. Studies have shown that self-protective givers are more effective givers over time.

How do you know which you are? Go back to the ‘symptoms’ that suggest you need better boundaries; selfless giving is what leads to those symptoms. 

Step 2. Decide how you want to feel – and what’s getting in the way

Knowing how you feel and how you want to feel is some of the most powerful information we have. Recall the term “interoception”; it’s important to take time to drop into your body and listen to what’s going on. How are you really, really feeling? 

Your body is your barometer, the gauge that tells you when the pressure is getting too high. The symptoms you get may be physical: you may get headaches, disrupted sleep, digestive symptoms, aches and pains, or worsening hot flashes, for example. The symptoms could be emotional: you may experience anxiety, depression, irritability, frustration, overwhelm. 

Step 3: Identify Your Priorities – and Use those as a Non-Negotiable Set Point

Now that you’re tuned in to your body and in tune with your well-being, ask yourself what your REAL, TRUE, and MOST IMPORTANT TOP 5 priorities are in life – now, over the next year, and the next 3 years. Figure out what’s currently on your plate that is an absolute must-do, what’s non-essential that you can let go of, what you can get help with, and what you can farm out. 

Now revisit questions 1 and 2; refine your list even more. Put your priorities into a realistic order; what is important to you each week, each quarter, etc. We can’t do all of it all at one time. 

It’s also critical that you figure out what you can realistically get done in any given amount of time. We humans tend to underestimate the amount of time any given task will take by 30%, so don’t cram in too many priorities at once. If you’re not sure how to figure out what you can and can’t get done, do an Audit of your time. Use a Panda, or other planner; you’ll be amazed at how often you unrealistically overschedule yourself, creating a cycle of failure to accomplish rather than a cycle of success. 

Finally, figure out where energy leaks are happening. I once heard that opening your email in the morning is like opening everyone else’s agenda for you before your day even gets started! Are you getting stuck chatting in the parent line at your kids school when you had two hours to work on your novel? To do your yoga practice? To take that bath you really wanted? Plug the leaks so that you’re shoring up those boundaries too. 

How  Do You Learn to Say No?

First, I have some questions for you to ask yourself, either now or after you finish listening. Don’t skip this step if you need to learn to set boundaries. 

When you’re asked to do something you really don’t want to do, you usually _____________.

When you think of saying no, you worry that the other person is going to ________________.

You worry that the following worst case scenario might occur: ________________.

In reality, if you say no, the most likely outcome is that ________________.

Second, always, always, always use your body and your priorities list as the touchstones of saying yes and no. 

You also have to set some rules for yourself. You don't have to prove anything, and you can let go of your guilt and your fear of hurting others. The bottom line: if it’s not on your immediate priority list, it’s a no. Think about Michael Phelps going to the swimming pool when everyone else in his high school was partying. Grand scheme? Olympics. We know the rest of that story! 

Factors such as proving, perfectionism, people pleasing, and other survival modes too often create automatic yesses rather than considered deliberate responses. Touch in with how you feel anytime you're asked to do something or are tempted to add something to your plate. 

Find your NO comfort zone. Learning how to set boundaries can be freakin’ hard. It goes against what most of us have had ingrained in us for most of our lives, as I talk about in my podcast and article How Being a Good Girl Can be Hazardous to Your Health. Use the Wonder Woman power pose that I teach in that article. Learn how to simply say “No thank you,” or “Let me think about it and get back to you.” 

You can explain your boundary honestly and succinctly. You can say “I’ll think about it” and then follow up in writing to make your boundary clear, especially if you’re not good at responding with a no in person. If it makes you feel better, or helps to set the boundary, you can provide an explanation. For example, my email autoresponders do exactly that – they explain that I am in deep focus on work for my own mission, and while I'm grateful to be considered for something (reviewing a book, attending a conference, being on a podcast,  joining an advisory board, answering a health question) – I let people know up front that I do not respond at all to certain types of requests. You don’t owe everyone an explanation – sometimes it's just “no thank you, I’m not able to right now”, or no. No negotiation. End of story. 

You also don’t owe everyone an interaction! That’s especially important on social media and in your email inbox, but also with neighbors, people sitting on the plane next to you, etc. It gets easier – even easy, because it feels so good – with practice. 

Practice in the mirror; practice when someone tries to touch your pregnant belly or your baby in public; practice when you get that next ask that you know you just don’t have the bandwidth to take on. The key is to always remember that your priorities and well-being matter, and that sometimes doing less is actually doing more.

If you’re not good at saying no on the spot, learn to say “I’d like to think about that and I’ll get back to you in a week”, then do a pros and cons list. If you feel tension in your gut about something, say no. Another approach is to say no, with options. For example, “Thank you for offering me this opportunity; it’s not right for me at this time, but I think I know someone who might really love to help you with that.” Ask the person you have in mind and make the connection, or if there's something you’re often asked to do – for example, speaking engagements on days you know you’re not available – have a list of people who you know would jump at the chance and have told you to share their name (always ask before you do, or you’re just turfing your overwhelm to someone else).

Bringing it all home, it’s important – in fact, it’s critical – to remember that you deserve to put on your own oxygen mask first. It just makes basic sense. If service is important to you, as it is to me, remember that we serve others better when we nourish ourselves first. Know that it’s okay to disappoint others, and that those people in your life who are emotionally healthy will actually respect you for having healthy boundaries. Other women may just be inspired, as I know happens when women read my autoresponders and tell me how much they learned from THAT! Ultimately, what others think doesn’t matter – what matters is your health and balance. and everything else flowing from that. 

Happy Holidays, and I’ll see you with incredible new content, phenomenal guests, and a whole lot of love and support in the New  Year. Now get out there and set those boundaries! I wish you the space in your life for the wonderful yes'ses to come!