A Boundary Building Crib Sheet

YES and NO are two very powerful words. They are the gatekeepers that maintain the boundary of self and other. We need boundaries to protect ourselves from things that don’t serve our well-being; however, they also need to be flexible enough to filter in the good stuff like life experiences and connections. Many of us have great difficulty building and maintaining healthy boundaries especially in situations and with people we are emotionally invested in. This is because our emotions sometimes mess with the circuitry of our rational higher brain when they interface with each other in our decision making. Finding that middle ground between masochism (YES-ing to death) and isolation (building a wall of NO) is possible, but it takes practice. I’ve created this crib sheet to help guide the process and deal with some of the challenges that come up along the way.

(1) EMOTIONAL ASSESSMENT

It’s important to really examine the emotions that come up for us when setting limits and boundaries. I often ask clients (and myself) to reflect on how they feel when they say either YES or NO. After getting a general sense of what that brings up for them emotionally, we start to examine the feelings triggered in different situations and settings where YES and NO have been exercised. This self-reflection is key in helping us to understand and eventually reframe the responses of others.

Perhaps your friend’s inability to handle your NO is about their own fear of rejection, but their passive aggressive response to you may trigger a stream of intrusive negative thinking that has you fearing you will lose this relationship if you don’t say YES. This cycle only maintains and perpetuates some pretty shitty self-esteem and relationship dynamics.

(2) IMAGINING THE OPPOSITE

What would life be like if you didn’t always say YES? How would it feel if you could just say NO without an explanation? What would change for you? These are just some of the prompts to get you thinking about the real costs and benefits of boundary building. Imagining the opposite is kind of mind blowing. One of my clients sat with the word that came up for her (i.e. freedom) when imagining what life would be like is she didn’t say YES all the time. That imagined life prioritized her own needs and took the burdens of others off her chest. It sparked a series of small changes in behavior that prepared her to let go of a very toxic relationship.

(3) COMMUNICATING OUR BOUNDARIES

This should not be confused with explaining our boundaries. People respond best to open and direct communication that is compassionate. Congruent communication is a skill that helps people in relationships understand and express each other’s needs without defensiveness. Adapting this style of communication to express our need for boundaries will help reduce the blow-back from people in our lives not used to us having them.

Some great examples are the following:

“I know I haven’t always been good at letting you know how I feel and as awesome as you are, I know you’re not psychic. This is why I want to talk to you about a few things.”

“You are very important to me and it means a lot that I can be this honest with you about my needs.”

My personal favorite and one that I find is absolutely necessary when you work in a care-taking and/or helping profession is the following:

“I want to be there for you, but there are times when I am too overwhelmed with my own stuff and life. The only way I can be present for the people I care about is if I am taking care of myself first. This is when I have to say no to certain things.”

(Insert the flock of doves emanating from the heavens)

People may still react to your compassionate dialogue; however, rest assured that their reaction tells you more about whether they are meant to remain in your life or not. A healthy relationship is one that is reciprocal and interdependent. If they truly care about you, they will support your needs even if it takes them a little time to process and understand them. For those that don’t get it, keep reading to (5) TAKE A TIME OUT FROM THE TOXIC.

(4) A ‘NO EXPLANATIONS’ APPROACH

You don’t have to justify your boundaries further than the compassionate communication outlined above. Explanations are often about anticipating and/or managing other people’s emotions. If you find yourself worrying that you might disappoint an important figure in your life by saying NO, you may needlessly over explain your boundary. You may feel the need to exaggerate your explanations to the point of lying to avoid being interrogated about your boundary. Fighting this urge is hard work and success varies depending on the situation and/or relationship.

In the spirit of full disclosure, I only recently got good at the ‘no explanations’ approach. Below is one of my success scenarios.

My then boyfriend asked me to come hang out with his friends while they watched the UFC fights on PPV. There were a number of reasons why I didn’t feel like going, but rather than list them all, I chose to say, “No babe. I’m good. You have fun with the boys.” He immediately asked me what I was going to do on a Saturday night alone. His assumption that I couldn’t possibly have any other plans or things to do was enough to trigger some irritation, but I managed not to react. I smiled and told him, “I’ll be fine. You enjoy the fights.” My lack of explanation started to trigger some mind reading from his end. “You probably want to go out to some club, don’t you? Yeah, I know what you girls do. That’s cool. You go let some bro feel up on you instead of hanging out with your man.” At this point, I wanted to punch him in the face and/or leave the room, but I maintained my calm and restated my original response with a little “sass” to reframe his mind-reading. “I’m going to miss you too baby. You have fun tonight.” I rubbed up on him like an exaggerated club dancer to drive home how ridiculous he was being. He laughed. I laughed. All was good and no more questions were asked.

If only they all worked out this way. What I will say about all the not so successful attempts is that they highlighted my triggers and vulnerabilities. Understanding where and why I got derailed helped me to revise my approach in order to react differently next time. I have several ‘no explanation’ tactics at the ready for interactions with my parents because I know from many a trial and error how my frustration and anger gets the best of me. The worst part of those exchanges was knowing I had gone off the rails, but not being able to bring myself back. When I would hear “relax, it was just a question” I knew I had failed. Prepare your ‘no explanation’ strategies before challenging situations to increase your success and reduce distress (rhyming intentional).

(5) TAKE A TIME OUT FROM THE TOXIC

If you find that your boundaries are being tested over and over again with certain individuals despite all your congruent compassionate communication and ‘no explanations’ attempts, give yourself permission to take distance. If you can’t do that for yourself, then I give you permission to take distance. You don’t have to respond to their texts, DM’s, or any attempts at contact immediately or at all. You can choose the terms by which you will engage with them and interact accordingly. They will almost definitely feel a certain kind of way about your distance, but don’t let their reactions make you feel that you’re “ghosting” them. If your relationship is one-sided and co-dependent, it is not healthy. Your silence is self-care. And speaking of self-care…

(6) REWARD YOUR BOUNDARIES

Setting boundaries that put your needs first is an act of self-love. For those of us who have trouble saying NO to others, work with the YES and recognize that boundaries can be an act of saying YES to yourself. For people with rigid boundaries, look at the ability to say YES as being in control of the gate between yourself and others. You get to choose what and who you let it. Say YES only to what feels good to your being; nothing else gets through the gate.

As you build healthy boundaries, people who do not serve you will start to exit your life. Those exits may be dramatic and may hurt for a period of time; however, you will start to be surrounded by people who not only support your boundaries, but will also have boundaries of their own. You will get to experience what it feels like for someone to communicate a boundary with you, and learn to appreciate their openness and honesty. If we all communicated our needs directly and with compassion to each other, we probably wouldn’t even need to call boundaries boundaries. They would become more like lines of contact connecting individuals to each other in a sort of collective relationship tapestry. We aren’t there yet, but it’s worth imagining.

 

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Psychosomatic Medicine

Acupuncture chart from Chinese medical text circa 1340s A.D.

There is nothing worse than going to a doctor with a host of symptoms and being told there is nothing wrong with you. Many people who appear on the program, Mystery Diagnosis, (my second Discovery Health obsession next to the The Food MD) have had this experience. I recall one particularly disturbing episode, where a young woman complaining of extreme gastrointestinal distress was prescribed an anti-depressant by one of the many doctors she sought answers from. Confused, she asked how these would help her to which the doctor responded that her condition was basically all in her head. When a physical illness or condition is caused by or aggravated by a mental factor it is termed psychosomatic. Essentially, that is how this young woman’s doctor viewed her illness. Many years later, she was properly diagnosed with severe endometriosis, a condition where the cells of the uterus grow in other places of the body causing cramping, severe bleeding and infertility to name a few. In her case, the cells had grown into and over parts of her GI tract. She had a full hysterectomy and a section of her large intestine removed in order to reclaim some quality of life. Take that, anti-depressants!

As you can glean from the above story, defining an illness as psychosomatic carries with it an intense social stigma here in the west, even though almost all physical illnesses have mental factors that determine their onset, presentation, maintenance, susceptibility to treatment and resolution. When doctors dismiss symptoms like in the case of this young woman, the rest of the world follows suit. The person who is suffering internally and externally is labeled “dramatic” or even worse, a liar. For thousands of years, Chinese medicine viewed the psychosomatic as the greatest key to diagnosing deeper illness and imbalance in the body. The strength of the nervous system and physical state of the individual (including their environment) is assessed in order to understand the degree in which an organ or a system is affected. Every symptom is taken into account and treated seriously, with the objective being to restore balance. Moreover, the eastern approach considers how interconnected the body and mind are.

The biggest physical bully is emotional stress, which can infiltrate suddenly or slowly, over a long period of time. Even from a western perspective, stress can be incredibly destructive, wreaking havoc on connective tissues, digestion, vascular integrity and the body’s restorative sleep cycles if not managed properly i.e. not just a script for anti-depressants. In Chinese medicine, if the nervous system of the individual is weak, the symptoms of illness will be more psychological. On a physical level, the organ most affected by the emotional stress will be the weakest/dysfunctional one. Whatever the natural emotions associated with this organ are, they will become stronger and more destructive to the nervous system overall. As the organ breaks down, it takes the system it is associated with along for the ride, leading ultimately to disease. If the emotional stress comes on suddenly, it will affect the Heart and the Lungs. If it is gradual and long term, it will take a toll on the Liver, Spleen and Kidneys. Even more specific is the type of emotional stress broken down into these 5 categories: tense/chronic, shock/sudden, sadness, rumination and fearful emotion. This gives an even more precise view of the affected organs/systems in the body, further honing the treatment approach.

Our young woman with endometriosis would have been assessed as having a strong nervous system in the beginning, as her symptoms were predominantly physical. By the time she had gone to see the doctor who prescribed the anti-depressants, she was exhibiting a combination of physical and mental symptoms. This would signify that her nervous system was deteriorating. If she had also gone to see an eastern doctor from the get go, much of her later suffering might have been alleviated, as the weakest organ, her large intestine would have been addressed immediately with herbs and acupuncture/bodywork. Since organs are partnered in the Chinese system of yin/yang (solid/hollow), the untreated large intestinal dysfunction would have affected her lungs. This woman developed an eczema like rash all over her trunk and extremities that would get worse every time she had a violent bout of diarrhea. The skin is considered the 3rd lung of the body in Chinese medicine. This symptom developed 5 years after her initial bout of gastrointestinal distress. After ten years, she began to bleed copiously during her period, which lasted over two weeks. Initial blood tests had already indicated she was mildly anemic, but this massive blood loss rendered her immobile. Ironically, during this time, her large intestine dysfunction seemed to dissipate; however, as soon as the period would end, the violent diarrhea would return. At this point in her illness, the Spleen had become involved. Responsible for creating Blood/Qi and keeping things upright and in their proper place, it’s no wonder that when she finally got her diagnosis 15 years in the making, this was the most affected organ. (Note: One could even argue that the Spleen could have been the weakest organ overall, but I won’t complicate things for the reader) The cells of the uterus growing out of control outside of their proper place is demonstrative of Spleen weakness. The uncontrollable bleeding led to a massive loss of Qi that just couldn’t be replaced by her depleted system. The only solution, at that point, was to remove the uterus and large intestine to prevent the out of control cell growth from migrating elsewhere. While organ removal can have detrimental affects on the Spleen, it proved more harmful to keep the stagnation in there than to remove it. If I were this young woman, I would seek out an acupuncturist to help me keep my nervous system strong and balance the loss of the organs that were surgically removed. They would be able to recommend herbs and dietary changes to support her treatment. After watching this episode, it made me all the more fired up about Integrating Eastern and Western medicine. If East met West from the beginning, she and others like her would have been spared a lifetime of suffering. We would all have a better understanding of our body-mind relationship and keep the stigmatic tongue wagging at bay.

SOURCES & ADDITIONAL READING:

http://www.dragonrises.edu/learning-opportunities/articles-books/

http://www.psychosomaticmedicine.org/

Anger Management

Even the most balanced person in the world, when triggered, can completely lose it. Anger is a strong, uncomfortable emotional response to something or someone that has provoked you. It is how we psychologically interpret an offense, wrongdoing or denial that is often met with a desire to retaliate. It is our immediate response to stop a threatening behavior or situation that many psychologists believe has a primal function to ensure survival. However, in excess, anger can have many physical and mental consequences. Think of a pressure cooker. You can only let the steam inside build up for so long before the whole thing explodes.

One Flew Over the Cuckoo’s Nest…a pressure cooker meltdown in action.

For the last few weeks I have been functioning in a fog of anger resulting from an unfortunate series of events outside of my control. All attempts to go with the flow are challenged on a daily basis as I try to weather this Category 5 Super Cell ravaging my life. With my blood already boiling in its channels, add the 90 plus degree weather and humidity here in NYC, and I feel like I am being cooked from the inside out/outside in. Therefore, it is no surprise that my digestion, skin and sleep have all gone awry. In Chinese medicine, emotions and physical illness are closely tied. Anger causes excess heat in the body, so my feeling of being cooked is spot on. The emotion itself is tied into the Wood element, whose governing organs are the Liver and Gall Bladder per Chinese 5 Element Theory. Physiological functions aside, these organs function to drive us forward in life, set goals and get things done. Despite my best efforts though, I have been feeling like all my attempts at forward movement and reasoning are met by impenetrable brick walls that hit back. The buildup of anger causes an imbalance of excess manifesting in digestive dysfunction, headaches (especially behind the eyes, as is the case with a migraine), muscle tension and tendonitis especially in the pathways of the organs (lateral leg, flanks of the torso, shoulders and neck). These are just some defining symptoms for these organs, but as we all know, when one thing is out of whack, other areas of the body will be affected.

All the elements in Chinese 5 Element Theory have a generational and controlling/controller relationship. This means that each element and its organs have the capacity to nurture and be nurtured by other elements. They also have the ability to pull energy back from other elements and vice-versa as a sort of system of checks and balances to keep everything harmonious. In the case of Wood, the Liver and Gallbladder are nurturers of Fire (there’s the HEAT again) which is comprised of the Heart, Pericardium (the bodyguard of your Heart), Triple Energizer (your Immune system and temperature regulator) and Small Intestine (the almighty discerning organ of what should stay and what should be eliminated both in your body and in your life). So you see, if there is an imbalance in Wood, some of that excess is going to visit the child. The best way to address this would be to make the nurturer of Wood stronger, in order to suck some of the energy out. That would be the Water element, comprised of Bladder and Kidney. These meridians run from the head down the spine into the back of the legs and then up the interior legs starting from the middle of the sole of your foot all the way up to your clavicle. It’s a good amount of somatic topography to cover and has a major role in all our life functions. What do you need most if faced with adversity? A good strong back bone and inner resilience. What do you need if there is a FIRE a-brewing internally? A whole lot of WATER.

The excess of anger in Wood has the potential of over controlling the Earth element, which includes the Stomach and Spleen. Appetite and digestion would be affected, as I am seeing in myself. What is typical is a feeling of fullness which translates to a lack of appetite and a total aversion to hot food. In my case, despite the excess heat in my system, all my body craves is spice. This, I learned recently, is a huge no-no because it will only serve to feed the overheated beast. When in doubt, food should be lightly cooked and no extreme of temperatures should be entering one’s mouth. There are many “cooling” foods that aren’t necessarily cold. If anything, they are more water rich, which quells the fire and also detoxifies. Some examples are lemon, orange, watermelon, celery, Daikon (Chinese radish), kelp, tomato, chrysanthemum tea and seaweed. The Metal element consisting of Lung and Large Intestine are the controllers of Wood and are greatly affected by the buildup of heat, which rises. My normally clear complexion has seen some eruptions and with the skin being the 3rd Lung of the body, it is clear how the heat is trying to escape. Hello, inflammation! Large Intestine, the great eliminator of waste in the body, can’t do such a great job under these circumstances. Bouts of constipation and poop with undigested bits demonstrate this. Hence, why it is important to adjust your diet. And apparently, some of the biggest builders of heat in the body aside from spice are caffeine, certain vitamin B supplements, sugar, alcohol and adrenaline (stress hormone produced in times of high alert, kind of like now).

So what do I do with all this HEAT? Aside from the adjustments to my diet, I sought out some bodywork to bring my nervous system down. Two hours of point work and muscle release specific to the organs involved in my excess heat and I finally felt a still point in the madness. A day later, I was boiling again over yet another uncontrollable situation. In my mind I tried to go back to the still feeling I had when my practitioner’s hands came off of my head, but it was hard. There were moments during our work together, where he had me breathe with a deep long “oooooo” sound which tied into the release of my Large Intestine. I channeled that sound, thought of a song that I could sing under my breath as I walked the streets of NY and much later, at work between clients that would settle me down. And, it kind of worked. Sort of ironic that therapeutic touch and music, my two loves in life, were exactly what smoothed my feathers out.

ADDITIONAL SOURCES

“Between Heaven and Earth – A Guide to Chinese Medicine” by Harriet Beinfield, L.Ac. & Efrem Korngold, L.Ac. O.M.D (c) 1991 Ballantine/Wellspring

“Dragon Rises, Red Bird Flies” by Leon Hammer, M.D. revised version (c) 2010 Eastland Press

http://www.pingminghealth.com/article/581/warming-and-cooling-characteristics-of-common-foods/