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  • Writer's pictureErin & Jaci

Self-care vs Setting Boundaries: Are they the same?

Updated: Nov 9, 2018

This week’s blog post will be little different than others. Personal and professional changes in my life have finally allowed me to shed the worry of what others think and share my own candid thoughts in regards to self-care in women and why we need to redefine what it really means.

A couple of weeks ago Erin sent me an article titled “We don’t need self care; we need boundaries” (1), written by psychiatrist Dr Pooja Lakshmin (2). After reading it (3 or 4 times!) it became evident to me that we as women, especially in healthcare, have the term “self-care” all wrong. And it made me reflect on what self-care means to me- or at least what I thought it meant to me.

Since reading Dr Lakshmin’s article, I have noticed a huge influx of “self-care” articles on various health and wellness websites and blogs, on magazine covers or even talking more with like-minded practitioners on what the term “self-care” means to them. This might be due to the holidays coming up, the new year approaching rapidly, or like when you are looking at a particular type and color of a car and all you end up seeing on the roads is that exact same car. Regardless of what the real reason is, it has definitely prompted me to ask the question

“What does self-care mean to me?”

Self-care is something that is most definitely lacking in medicine as training requires you to put the needs of others above your own. Many clinical articles show the evidence that provider burnout is real and is becoming more prevalent (3) (4) as we don’t perform our own daily self-care. We tend to take this into our personal lives as well. I’m not saying that this is just in relation to professionals in healthcare, as I also see it in teachers, therapists, stay-at-home moms, caregivers, and many other professional. We as women tend to put the needs of others above our own.

As I mentioned above, the article made me take a step back and question what self-care means to me. For a long time (the past few years specifically), I have been prioritizing the needs and wants of others above my own which has caused a lot of anxiety, emotional distress, and anguish at times. I was not setting the boundaries that Dr Lakshmin mentions in her article. I felt that self-care, at that time, was getting my workouts in, making time for a pedicure or hair appointment, and going to the beach on the weekends with my family in order to feel the sand on my feet and listen to the waves on the ocean. That was my self-care. But, over the past 6 months I consciously made the choice to start setting boundaries in regards to what I was capable of taking on and with people in my life. I did not realize at that time, when I decided to set those boundaries, that I was performing my own self-care. Dr Lakshmin validated, for me, that what I was doing was not being selfish or mean, but rather was a necessary daily self-care ritual.

Dr Lakshmin opens up her article with this:

“If you’re a woman in medicine who is feeling burnt out and exhausted, it’s likely you’re getting advice to do more self-care — take yourself out for lunch, get a manicure, do some yoga. Sure those things are great, but, let’s be clear, this is not self-care. I often find that when I’m feeling exhausted and down to the wire, self-care ends up as another item on my to-do list. And, counter-intuitively, I end up feeling guilty if I don’t get to it (I should be doing self-care better!) or if I do indulge, I feel bad that I’m not tackling something else on my to-do list.” (1)

Can I get an AMEN?!? My first thought after reading her article was: “Finally, someone is saying what I am feeling!” Those things all sound great but they do end up being another item on my list of “tasks to accomplish” in my agenda. And when I don’t get around to them I end up either scratching them off or moving them to another date and feel a bit disappointed that I didn’t get them done.

So, while YES, it would be nice to grab a pedicure/manicure every 2 weeks or attend a hot yoga class, it sometimes doesn’t end up happening and I have a tendency to feel like I have “failed” at something. This isn’t me being a martyr, rather just stating the truth that sometimes in my life these “things” end up on the back burner because I only have 24 hours in a day. And “mommy guilt” is a real thing!—regardless if you have children, fur babies, or, in my case, both. Dr Lakshmin states that “for women in medicine, martyrdom is almost an epidemic. What martyrdom gets you is exhausted, burnt out, and still running at full speed pretending that you love to help everyone else, but actually just oozing resentment. It’s a formula that’s set up to fail.” I see this every day in both colleagues and patients, but 6 months ago I was starting to see that in myself and I knew I couldn’t do it any longer.

Dr Lakshmin uses a 1-2-3 method when it comes to making decisions and when to know to say “No”. She explains in her article that the only person responsible for saying no is you. Making a decision requires either a yes (1), no (2), or can I negotiate (3). She explains that, in medicine, women tend to not know that decision 2 or 3 exist as we have been wearing a superwoman cape of some sort throughout training and our career. I can definitely attest to that one! But as I mentioned above, this resonates with many other women as well. I feel that every woman reading this blog post right now is shaking their heads and responding “Yes, I know how this feels.”

Her article goes on deeming “faux self-care” as being an enemy that we have all created. I know I did! We are conditioned to think that making time for that lunch by ourselves by the water or laying out on the beach to grab a tan will make us feel better in our everyday routine. Unfortunately, it won’t. “Self-care is the internal hard work of making tough decisions for yourself and by yourself. It starts with recognizing that you have limits, and you really do have to choose what you prioritize because just like everyone else, you are human. It’s actually not that pleasant of a process, because it means you have to set boundaries.” (1)

Let me tell you first hand this is an on-going process and it really is hard-work. As a healthcare provider, you always want to please people and it’s difficult when people don’t like you or become upset with you. For years, I wanted to make everyone happy- even if that meant sacrificing my own happiness. That’s just what I thought I needed to do in order obtain “inner peace.” What I didn’t know was that I was self-sabotaging and letting down the most important people in my life—my family. My inner “balance” was not there and something needed to change. That’s when I made the decision to start to setting boundaries. And trust me, it was difficult for many people in my life. Setting boundaries taught me that people, for the most part, do not like change and are unable to adapt; which can be very sad in certain situations.

“Self-care is valuing your own feelings and thoughts, despite knowing that you may let other people down. It means being able to tolerate other people’s disappointment and trust that it is not a moral failing on your part.” (1) This line literally almost brought me to tears as I felt that people responding to me setting boundaries negatively was quite defeating. But I do have to say, for the most part the people in my life who I know truly care about me, my well-being, and my family didn’t blink twice when I lightly began setting those boundaries. They all knew of my situation and knew I needed a reprieve from commitments and social engagements. They knew I needed that alone time with my husband and myself. Those people, the ones who understand, are the keepers in your life. And they are likely setting their own boundaries and performing their own self-care as well. It becomes a mutual respect.

While setting daily boundaries, I found ways to lessen these negative feelings and distinguish between what makes me truly happy and what I am just tolerating.

Some ways that I am setting boundaries in my own life:

>Only attending functions or meetings that I feel will benefit me: mind, body, and soul

>Not engaging in negative self-talk about myself or about others

>Not allowing narcissistic people to project their own inner feelings onto me

>Standing up for what is right, even when its not the “majority feeling”

>Saying “No” to events/invites that cause me anything but happiness, joy, and excitement

>Taking time to read, whether in the car via Audible app or 10 minutes prior to bed

>Listening to Podcasts that only meet MY needs and no one else’s

>Sundays are only for family/friends and FYGMDNP

>Friday is an “off-day,” whether it’s accomplishing work for FYG, having lunch with my daughters at their school, having a day-date with my husband, or literally sitting by the pool with friends engaging in “mommy conversations”

>And the list is continuing to grow

These are only a few that I can think of off the top of my head, but as you can see the main objective is to be present in situations that allow me to preserve my well-being and allow me to be fully present for those who need me.

“You end up learning to value your time, your feelings, and your goals. And, perhaps counter-intuitively, when I am setting boundaries, I find myself feeling generous, full and willing to give more to others without feeling resentful. I also find myself able to indulge in “faux self-care” without feelings of guilt or pressure to perform.” (1). Dr Lakshmin does allude to the fact that resentment comes back from time to time, but it’s a matter of recognizing and re-evaluating why. She states it’s not a “one and done” kind of task and setting boundaries needs to be performed daily.

As of recent, I have became unemployed. Yes—no job. Scary, right? Actually, it has become quite liberating as I am a beginning a new chapter in my life. For the past 6.5 years, I have had the privilege of caring for and maintaining the health and wellness of others—no matter what the price was for me. The inner turmoil that can go on behind the scenes can be tasking on someone physically, mentally, and emotionally. And over the past 6 months it was at an all-time high. I tried my best to maintain my highest level of confidence along with not backing down on the boundaries I had set, but in the end it came down to the fact that some people in your life are not able to understand these boundaries and only see what they want to see. Is it unfortunate? Yes—to an extent. But if this was not forced upon me, I most likely would never have removed myself out of the situation due to my loyalty to my patients and colleagues. But I truly believe a higher power knows that something greater is out there that won’t make me sacrifice my boundaries and will allow me to flourish.

Reading Dr Lakshmin’s article opened up an unspoken dialogue—we as women MUST set those boundaries to care for ourselves. If not, we are setting ourselves up for failure. It’s not about if we take that 7-day vacation that’s 6 months away or a spa day we “chiseled” time out of our schedule for. It’s about making daily, small changes to our routine in order to care for ourselves EVERYDAY- not just when we get the time. We must have self-preservation because, if not, we won’t be able to care for others the way that they deserve. We won’t be able to give our all as a mother, wife, sister, best friend, and more, and the ones you love will be affected.

What does this next chapter mean for me? It means finding a place that truly values what I bring to the table as a practitioner without having to sacrifice myself—mentally or emotionally. It means being able to exercise my self-care rituals daily and, in turn, be able to give the best care possible to my patients along with being be more present for my family. This next chapter will be the beginning of something great. I’m not sure exactly what that is, but I have the utmost faith that hard work, dedication, and remembering what I have to offer will carry me into the best situation for me and my family.

Continue to Follow Your Gut,


#selfcare #settingboundaries #followyourgut

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