Deepening your understanding of your current boundary needs and setting a plan to honor them is radical self-love.

If you have a hard time setting boundaries, you might struggle to feel productive or that you’re truly tending to your own needs. Life often feels scary and overwhelming without them. You set boundaries to protect yourself and so you can be at your best. Thinking carefully about your boundaries with self and others helps you to be more intentional.

Can you think of a recent experience where you could have benefited from setting a better boundary?

When I first started my private practice back in 2014, some of the advice I received was “you want to be available anytime so you can accommodate appointments.” It can be easy to overextend yourself in the service of others–especially as a therapist. While this may sound like a great idea in theory, what I’ve learned in my decade of being a practicing therapist is that offering the special service of therapy is a very energy-sensitive kind of offering–one that requires great care to deliver well. If I am not rested, nourished, or if I’m struggling in some way to meet my own needs, it’s not possible for me to provide the best possible service to my clients. In being thoughtful about my boundaries when it comes to type of offering/ when I offer my services and for how long, I am able to map out my time in such a way that allows me to be at my best.

When you have good and clear boundaries with self and others, everyone wins. Because I have thought through my own needs, I’m able to be flexible in certain areas and I also know where I’m not able to be flexible.

What do boundary problems look like?

Boundary problems often present themselves in two ways: diffuse or rigid. When boundaries are too diffuse, we may struggle with enmeshed relationships. Essentially, there is too much closeness. When boundaries are too rigid, we might struggle to let someone in or build healthy connection with others. Essentially, we are too distant and have a hard time trusting others.

Boundary issues are important to correct and work on because they impact how we function in various relationships — with partners, colleagues, family members, friendships, and even on a first date.

Boundary issues can cause serious problems if unaddressed because they can lead us to being taken advantage of, exploited, or unable to feel entitled to stand our ground on an issue. They can also lead to shutting people out, isolating ourselves, and not asking for help when we need it.

In real life this might look like:

• Struggling to say no when you want to
• Not listening to yourself/ going against your judgment
• Indecision for fear of letting others down
• Giving in too easily
• Not being clear with others
• Subordinating your needs to others
• Withholding from others
• Closing self off from connection
• Struggling to reach out
• Struggling to make meaningful connections

What are intrapersonal boundaries?

A critical but often overlooked aspect of this work is intrapersonal boundaries or boundaries within self. We often think of boundaries in the context of being between people, but boundaries within self are just as important.

For example, how you might talk to yourself about engaging in a potentially harmful situation or leaving work at a normal time rather than overworking. Intrapersonal boundary work is especially important since we can’t change others, we can only change ourselves. You can begin to work on boundary issues by practicing out loud what it sounds like/ feels like to say “yes” and “no” in specific situations of your life.

I’ll share more about this in an upcoming post ; )

If you are struggling with this area, here are a few questions that might be helpful to consider:

• My ideal situation would be_____.
• I wish _____ was different about _______.
• What makes it tough to set a boundary when it comes to _______?
• How would it feel to have a more clear boundary in place as it relates to _______?
• What are my top priorities right now?
• What are three areas of struggle for me right now and how long has it felt this way?

The post Learning how to set healthy boundaries… appeared first on Modern MFT.

Frequency and Presentation:

It is estimated that depression affects approximately 16% of the US population.

Depression can feel like seeing life through dark sunglasses, making it hard to find any joy in daily life. You might feel withdrawn and desire to isolate more and more. Depression can look like prolonged sadness, loneliness, irritability, lack of motivation, sleep issues, frustration, anger, resentment, and can lead a person to isolate and pull away from connecting with others; inadvertently worsening the feelings of depression. Life then, can become a self fulfilling prophesy–you feel depressed and then you don’t take any action and because you don’t take action, you continue to feel depressed.

Sometimes it can feel so apparent that something needs to change, but actually taking that first step of asking for help feels like the hardest part. 

Context

In my experience, depression, and more generally speaking mood related issues, also manifest differently based on an individual’s identity, background, socialization, and environmental factors that are experienced as being “out of one’s control,” making it difficult to identify mood concerns as depression. One example of this was found in a recent study published by the Journal of the American Medical Association which found that when men are depressed they may experience symptoms that are different than what is included in the current diagnostic criteria. Although men were likely to experience many traditional depression symptoms, men were much more likely to report symptoms of anger attacks/aggression, irritability, substance abuse, and risk-taking behaviors over symptoms such as withdrawal from friends, sleep problems, and feelings of complaintiveness. (JAMA Psychiatry)

Depression may manifest as a major impairment or in a more mild form which prevents you from actively working toward your goals and living with more intention. If left untreated, depression can be quite damaging to your sense of self, perceived competence, and your ability to maintain satisfying relationships.

Finding Relief…

Therapy for depression includes constructing a plan to relieve symptoms which also involves developing a deeper understanding of how to feel empowered within the contextual factors that contribute to what you’re experiencing. A holistic, 6-part approach has been known to be effective when treating depression: 

• Brain Food– evaluating your diet and making changes to help support your mood and overall functioning can help to improve moods. I often collaborate with other providers such as your primary care physician and nutritionist in order to help you make improvements in a healthy and responsible way.
• Action-putting into place a plan that is doable. Setting achievable goals and following through with them is part of managing depression. Through therapy, we will also help you to put outside supports in place and create a sense of community for yourself.
• Exercise– studies have shown that just 35 minutes of working out even in the form of a simple brisk walk, can be just as impactful as medications for depression so it’s worth giving it a try. In therapy, you will be able to make a plan that works for your lifestyle so you can make realistic progress.
• Exposure to light-bright light stimulates the brain’s production of serotonin, which is crucial to our well-being. Serotonin is a neurotransmitter with widespread effects on mood and behavior. (The Depression Cure)
• Sleep-is critical to our overall well-being and worth working on to improve. Here are a few tips to help you make some adjustments (list adapted from the book The Depression Cure, by Dr. Stephen Ilardi):
  • Set the scene for sleep. What does your bedroom look and feel like? Is it peaceful and conducive to rest? If not, what small improvements can you make to help set the scene? Studies show that cooler temperatures and a dark room facilitates higher quality sleep.
  • Anytime you’ve been lying awake for fifteen minutes, get up, leave the bedroom, and do something relaxing until you feel drowsy enough to return to bed.
  • Avoid getting into bed anytime you aren’t drowsy.
  • Anything you do to increase your drowsiness should be done somewhere other than the bedroom.
  • You can make an exception in the case of sex.
  • Avoid sleeping anywhere other than your own bed (i.e.- sofa, guest room, recliner).
    • Also helpful: get up at the same time every day, avoid napping, avoid bright light at night, avoid caffeine and other stimulants, avoid alcohol at night, if possible, keep the same bedtime every night, avoid taking your problems to bed with you (try a brain dump in a journal before getting to bed for example), don’t try to fall asleep.
• Cultivate healthy, reciprocal connections/ let go of toxicity-connection heals and combats loneliness. All of us are born to connect. When we don’t feel meaningfully connected to others, we inevitably suffer. The late researcher, Dr. John Cacioppo developed the following acronym to help people with the process of cultivating connection. He believed it was important to EASE your way back into social connections…
  • The first E stands for “extend yourself,” but extend yourself safely. Do a little bit at a time.
  • The A is “have an action plan.” Recognize that it’s hard for you. Most people don’t need to like you, and most people won’t. So deal with that, it’s not a judgment of you, there’s lots of things going on. Ask [other people] about themselves, get them talking about their interests.
  • The S is “seek collectives.” People like similar others, people who have similar interests, activities, values. That makes it easier to find a synergy.
  • And finally when you do those things, “Expect” the best. The reason for that is to try to counteract this hyper-vigilance for social threat.  

Hope

Therapy can be instrumental in making important shifts when it comes to managing depression. In my practice, I work with folks to help them honor what their depression may be trying to communicate and set a realistic plan to create a healthy routine and connection. Together we’ll work to help you gain a sense of stability while creating a more sustainable path forward. Treatment will take into consideration your history, past coping mechanisms, overall health and wellness, and your current support system and aim to strengthen these areas. Therapy is a unique type of service in that it requires you to be active both inside and outside of the therapy office. With that said, therapy requires a commitment to the process and a willingness to try something new and different.

Lisa A. Martin, PhD¹; Harold W. Neighbors, PhD²; Derek M. Griffith, PhD^3,4

JAMA Psychiatry. 2013;70(10):1100-1106. doi:10.1001/jamapsychiatry.2013.1985

The Depression Cure by Stephen Ilardi

**This post is meant to provide general educational information regarding the management of depression; it does not take the place of therapy or medical advice from your doctor.

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