Boundary-Setting Beyond “No”

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More Than A “No”

A lot of people struggle with boundary-setting, and it’s not always the way you might think.

The person who “can’t say no” to people probably comes to mind, but the problem is more far-reaching than that, and it’s rooted in not being clear over what a boundary actually is.

For example: “Don’t bring him here again!”

Pretty clear, right?

And while it is indeed clear, it’s not a boundary; it’s a command. Which may or may not be obeyed, and at the end of the day, what right have we to command people in general?

Same goes for less dramatic things like “Don’t talk to me about xyz”, which can still be important or trivial, depending on whether the topic of xyz is deeply traumatizing for you, or mildly annoying, or something else entirely.

Why this becomes a problem

It becomes a problem not because of any lack of clarity about your wishes, but rather, because it opens the floor for a debate. The listener may be given to wonder whether your right to not experience xyz is greater or lesser than their right to do/say/etc xyz.

“My right to swing my fist ends where someone else’s nose begins”

…does not help here, firstly because both sides will believe themself (or nobody) to be the injured party; for the fist-swinger, the other person’s nose made a vicious assault on their freedom. Or secondly, maybe there was some higher principle at stake; a reason why violence was justified. And then ten levels of philosophical debate. We see this a lot when it comes to freedom of expression, and vigorous debate over whether this entails freedom from social consequences of one’s words/actions.

How a good boundary-setting works (if this, then that)

Consider two signs:

  • No trespassing!
  • Trespassers will be shot!

Superficially, the second just seems like a more violent rendition of the first. But in fact, the second is more informationally useful: it explains what will happen if the boundary is not respected, and allows the reader to make their own informed decision with regard to what to do with that information.

We can employ this method (and can even do so gently, if we so wish and hopefully we mostly do wish to be gentle) when it comes to social and interpersonal boundary-setting:

  • If you bring him here again, I will refuse you entrance
  • If you bring up that topic again, I will ask you to leave
  • If you do that, I will never speak to you again
  • If you don’t stop drinking, I will divorce you

This “if-this-then-that” model does the very first thing that any good boundary does: make itself clear.

It doesn’t rely on moral arguments; it doesn’t invite debate. For example in that last case, it doesn’t argue that the partner doesn’t have the right to drink—it simply expresses what the speaker will exercise their own right to do, in that eventuality.

(as an aside, the situation that occurs when one is enmeshed with someone who is dependent on a substance is a complex topic, and if you’re interested in that, check out: Codependency Isn’t What Most People Think)

Back on track: boundary-setting is not about what’s right or good—it’s about nothing more nor less than a clear delineation between what we will and won’t accept, and how we’ll enforce that.

We can also, in particularly personal boundary-setting (such as with sexual boundaries’ oft-claimed “gray areas”), fix an improperly-set boundary that forgot to do the above, e.g:

“How about [proposition]?”
“No thank you” ← casually worded answer; contextually reasonable, and yet not a clear boundary per what we discussed above
“Come on, I think you’d like it”
“I said no. No means no. Ask me again and I will [consequences that are appropriate and actionable]”

What’s “appropriate and actionable” may vary a lot from one situation to another, but it’s important that it’s something you can do and are prepared to do and will do if the condition for doing it is met.

Anything less than that is not a boundary—it’s just a request.

Note: this does not require that we have power, by the way. If we have zero power in a situation, well, that definitely sucks, but even then we can still express what is actionable, e.g. “I will never trust you again”.

“Price of entry”

You may have wondered, upon reading “boundary-setting is not about what’s right or good—it’s about nothing more nor less than a clear delineation between what we will and won’t accept, and how we’ll enforce that”, can’t that be used to control and manipulate people, essentially coercing them to do or not do things with the threat of consequences (specifically: bad ones)?

And the answer is: yes, yes it can.

But that’s where the flipside comes into play—the other person gets to set their boundaries, too.

For all of us, if we have any boundaries at all, there is a “price of entry” and all who want to be in our lives, or be close to us, have to decide for themselves whether that price of entry is worth it.

  • If a person says “do not talk about topic xyz to me or I will leave”, that is a price of entry for being close to them.
  • If you are passionate about talking about topic xyz to the point that you are unwilling to shelve it when in their presence, then that is the price of entry for being close to you.
  • If one or more of you is not willing to pay the price of entry, then guess what, you’re just not going to be close.

In cases of forced proximity (e.g. workplaces or families) this is likely to get resolved by the workplace’s own rules (i.e. the price of entry that you agreed to when signing a contract to work there), and if something like that doesn’t exist (such as in families), well, that forced proximity is going to reach a breaking point, and somebody may discover it wasn’t enforceable after all.

See also: Family Estrangement: More Common Than Most People Think

…which also details how to fix it, where possible.

Take care!

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  • The Mindful Body – by Dr. Ellen Langer

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Fear not, this is not a “think healing thoughts” New Age sort of book. In fact, it’s quite the contrary.

    The most common negative reviews for this on Amazon are that it is too densely packed with scientific studies, and some readers found it hard to get through since they didn’t find it “light reading”.

    Counterpoint: this reviewer found it very readable. A lot of it is as accessible as 10almonds content, and a lot is perhaps halfway between 10almonds content in readability, and the studies we cite. So if you’re at least somewhat comfortable reading academic literature, you should be fine.

    The author, a professor of psychology (tenured at Harvard since 1981), examines a lot of psychosomatic effect. Psychosomatic effect is often dismissed as “it’s all in your head”, but it means: what’s in your head has an effect on your body, because your brain talks to the rest of the body and directs bodily responses and actions/reactions.

    An obvious presentation of this in medicine is the placebo/nocebo effect, but Dr. Langer’s studies (indeed, many of the studies she cites are her own, from over the course of her 40-year career) take it further and deeper, including her famous “Counterclockwise” study in which many physiological markers of aging were changed (made younger) by changing the environment that people spent time in, to resemble their youth, and giving them instructions to act accordingly while there.

    In the category of subjective criticism: the book is not exceptionally well-organized, but if you read for example a chapter a day, you’ll get all the ideas just fine.

    Bottom line: if you want a straightforward hand-holding “how-to” guide, this isn’t it. But it is very much information-packed with a lot of ideas and high-quality science that’s easily applicable to any of us.

    Click here to check out The Mindful Body, and indeed grow your chronic good health!

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  • Delicious Quinoa Avocado Bread

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    They’re gluten-free, full of protein and healthy fats, generous with the fiber, easy to make, and tasty too! What’s not to love? Keep this recipe (and its ingredients) handy for next time you want healthy burger buns or similar:

    You will need

    • 2½ cups quinoa flour
    • 2 cups almond flour (if allergic, just substitute more quinoa flour)
    • 1 avocado, peeled, pitted, and mashed
    • zest and juice of 1 lime
    • 2 tbsp ground flaxseed
    • 1 tsp baking powder
    • ½ tsp MSG or 1 tsp low-sodium salt
    • Optional: seeds, oats, or similar for topping the buns

    Method

    (we suggest you read everything at least once before doing anything)

    1) Preheat the oven to 350℉/175℃.

    2) Mix the flaxseed with ⅓ cup warm water and set aside.

    3) Mix, in a large bowl, the quinoa flour and almond flour with the baking powder and the MSG or salt.

    4) Mix, in a separate smaller bowl, the avocado and lime.

    5) Add the wet ingredients to the dry, slowly, adding an extra ½ cup water as you do, and knead into a dough.

    6) Divide the dough into 4 equal portions, each shaped into a ball and then slightly flattened, to create a burger bun shape. If you’re going to add any seeds or similar as a topping, add those now.

    7) Bake them in the oven (on a baking sheet lined with baking paper) for 20–25 minutes. You can check whether they’re done the same way you would a cake, by piercing them to the center with a toothpick and seeing whether it comes out clean.

    8) Serve when sufficiently cooled.

    Enjoy!

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  • Slow-Cooker Moroccan Tagine

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Tagine (طاجين) (tā-jīn) is a traditional dish named after, well, the traditional dish that it’s cooked in. Here’s an example tagine pot on Amazon. It’s a very nifty bit of kit, and while it’s often used for cooking over charcoal, one of its features is that if you have a hot sunny day, you can just leave it out in the sun and it will cook the contents nicely. Today though, we’re going to assume you don’t have one of these, and are going to give instructions for cooking a tagine-style dish with a slow cooker, which we’re going to assume you do have.

    You will need

    • 2 large red onions, finely chopped
    • 2 large red peppers, cut into 1″ chunks
    • 2 large zucchini, cut into ½” chunks
    • 1 large eggplant, cut into ½” chunks
    • 3 cups tomato passata
    • 2 cups cooked chickpeas
    • 16 pitted Medjool dates, chopped
    • ½ bulb garlic, finely chopped
    • 1 tbsp ras el-hanout
    • A little extra virgin olive oil

    Method

    (we suggest you read everything at least once before doing anything)

    1) Let your slow cooker heat up while you chop the things that need chopping

    2) Add a splash of olive oil to the slow cooker; ensure the base is coated and there’s a little oil spare in there too; a thin coat to the base plus a couple of tbsp should do it nicely.

    3) Add the onions and garlic, and leave for an hour.

    4) Add the passata, dates, ras el-hanout, stir it and leave for an hour.

    5) Add the chickpeas, peppers, and eggplant; stir it and leave for an hour.

    6) Add the zucchini, stir it and leave for an hour.

    7) Serve—it goes great with its traditional pairing of wholegrain couscous, but if you prefer, you can use our tasty versatile rice. In broader culinary terms, serving it with any carb is fine.

    Enjoy!

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  • Encyclopedia Of Herbal Medicine – by Andrew Chevallier

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    A common problem with a lot of herbal medicine is it’s “based on traditional use only”, while on the other hand, learning about the actual science of it can mean poring through stacks of Randomized Clinical Trials, half of which are paywalled.

    This beautifully and clearly-illustrated book bridges that gap. It gives not just the history, but also the science, of the use of many medicinal herbs (spotlight on 100 key ones; details on 450 more).

    It gives advice on growing, harvesting, processing, and using the herbs, as well as what not to do (with regard to safety). And in case you don’t fancy yourself a gardener, you’ll also find advice on places one can buy herbs, and what you’ll need to know to choose them well (controlling for quality etc).

    You can read it cover-to-cover, or look up what you need by plant in its general index, or by ailment (200 common ailments listed). As for its bibliography, it does list many textbooks, but not individual papers—though it does cite 12 popular scientific journals too.

    Bottom line: if you want a good, science-based, one-stop book for herbal medicine, this is a top-tier choice.

    Click here to check out the Encyclopedia of Herbal Medicine, and expand your home remedy repertoire!

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  • We created a VR tool to test brain function. It could one day help diagnose dementia

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    If you or a loved one have noticed changes in your memory or thinking as you’ve grown older, this could reflect typical changes that occur with ageing. In some cases though, it might suggest something more, such as the onset of dementia.

    The best thing to do if you have concerns is to make an appointment with your GP, who will probably run some tests. Assessment is important because if there is something more going on, early diagnosis can enable prompt access to the right interventions, supports and care.

    But current methods of dementia screening have limitations, and testing can be daunting for patients.

    Our research suggests virtual reality (VR) could be a useful cognitive screening tool, and mitigate some of the challenges associated with current testing methods, opening up the possibility it may one day play a role in dementia diagnosis.

    Where current testing is falling short

    If someone is worried about their memory and thinking, their GP might ask them to complete a series of quick tasks that check things like the ability to follow simple instructions, basic arithmetic, memory and orientation.

    These sorts of screening tools are really good at confirming cognitive problems that may already be very apparent. But commonly used screening tests are not always so good at detecting early and more subtle difficulties with memory and thinking, meaning such changes could be missed until they get worse.

    A clinical neuropsychological assessment is better equipped to detect early changes. This involves a comprehensive review of a patient’s personal and medical history, and detailed assessment of cognitive functions, including attention, language, memory, executive functioning, mood factors and more. However, this can be costly and the testing can take several hours.

    Testing is also somewhat removed from everyday experience, not directly tapping into activities of daily living.

    Enter virtual reality

    VR technology uses computer-generated environments to create immersive experiences that feel like real life. While VR is often used for entertainment, it has increasingly found applications in health care, including in rehabilitation and falls prevention.

    Using VR for cognitive screening is still a new area. VR-based cognitive tests generally create a scenario such as shopping at a supermarket or driving around a city to ascertain how a person would perform in these situations.

    Notably, they engage various senses and cognitive processes such as sight, sound and spatial awareness in immersive ways. All this may reveal subtle impairments which can be missed by standard methods.

    VR assessments are also often more engaging and enjoyable, potentially reducing anxiety for those who may feel uneasy in traditional testing environments, and improving compliance compared to standard assessments.

    A senior woman sitting on a bed with her hand to her face.
    Millions of people around the world have dementia.
    pikselstock/Shutterstock

    Most studies of VR-based cognitive tests have explored their capacity to pick up impairments in spatial memory (the ability to remember where something is located and how to get there), and the results have been promising.

    Given VR’s potential for assisting with diagnosis of cognitive impairment and dementia remains largely untapped, our team developed an online computerised game (referred to as semi-immersive VR) to see how well a person can remember, recall and complete everyday tasks. In our VR game, which lasts about 20 minutes, the user role plays a waiter in a cafe and receives a score on their performance.

    To assess its potential, we enlisted more than 140 people to play the game and provide feedback. The results of this research are published across three recent papers.

    Testing our VR tool

    In our most recently published study, we wanted to verify the accuracy and sensitivity of our VR game to assess cognitive abilities.

    We compared our test to an existing screening tool (called the TICS-M) in more than 130 adults. We found our VR task was able to capture meaningful aspects of cognitive function, including recalling food items and spatial memory.

    We also found younger adults performed better in the game than older adults, which echoes the pattern commonly seen in regular memory tests.

    A senior man sitting outdoors using a laptop.
    Adults of a range of ages tried our computerised game.
    pikselstock/Shutterstock

    In a separate study, we followed ten adults aged over 65 while they completed the game, and interviewed them afterwards. We wanted to understand how this group – who the tool would target – perceived the task.

    These seniors told us they found the game user-friendly and believed it was a promising tool for screening memory. They described the game as engaging and immersive, expressing enthusiasm to continue playing. They didn’t find the task created anxiety.

    For a third study, we spoke to seven health-care professionals about the tool. Overall they gave positive feedback, and noted its dynamic approach to age-old diagnostic challenges.

    However, they did flag some concerns and potential barriers to implementing this sort of tool. These included resource constraints in clinical practice (such as time and space to carry out the assessment) and whether it would be accessible for people with limited technological skills. There was also some scepticism about whether the tool would be an accurate method to assist with dementia diagnosis.

    While our initial research suggests this tool could be a promising way to assess cognitive performance, this is not the same as diagnosing dementia. To improve the test’s ability to accurately detect those who likely have dementia, we’ll need to make it more specific for that purpose, and carry out further research to validate its effectiveness.

    We’ll be conducting more testing of the game soon. Anyone interested in giving it a go to help with our research can register on our team’s website.The Conversation

    Joyce Siette, Research Theme Fellow in Health and Wellbeing, Western Sydney University and Paul Strutt, Senior Lecturer in Psychology, Western Sydney University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Lost for words? Research shows art therapy brings benefits for mental health

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Creating art for healing purposes dates back tens of thousands of years, to the practices of First Nations people around the world. Art therapy uses creative processes, primarily visual art such as painting, drawing or sculpture, with a view to improving physical health and emotional wellbeing.

    When people face significant physical or mental ill-health, it can be challenging to put their experiences into words. Art therapists support people to explore and process overwhelming thoughts, feelings and experiences through a reflective art-making process. This is distinct from art classes, which often focus on technical aspects of the artwork, or the aesthetics of the final product.

    Art therapy can be used to support treatment for a wide range of physical and mental health conditions. It has been linked to benefits including improved self-awareness, social connection and emotional regulation, while lowering levels of distress, anxiety and even pain scores.

    In a study published this week in the Journal of Mental Health, we found art therapy was associated with positive outcomes for children and adolescents in a hospital-based mental health unit.

    An option for those who can’t find the words

    While a person’s engagement in talk therapies may sometimes be affected by the nature of their illness, verbal reflection is optional in art therapy.

    Where possible, after finishing an artwork, a person can explore the meaning of their work with the art therapist, translating unspoken symbolic material into verbal reflection.

    However, as the talking component is less central to the therapeutic process, art therapy is an accessible option for people who may not be able to find the words to describe their experiences.

    Art therapy has supported improved mental health outcomes for people who have experienced trauma, people with eating disorders, schizophrenia and dementia, as well as children with autism.

    Art therapy has also been linked to improved outcomes for people with a range of physical health conditions. These include lower levels of anxiety, depression and fatigue among people with cancer, enhanced psychological stability for patients with heart disease, and improved social connection among people who have experienced a traumatic brain injury.

    Art therapy has been associated with improved mood and anxiety levels for patients in hospital, and lower pain, tiredness and depression among palliative care patients.

    A person painting.
    Studies suggest art therapy could support people with a range of health conditions. mojo cp/Shutterstock

    Our research

    Mental ill-health, including among children and young people, presents a major challenge for our society. While most care takes place in the community, a small proportion of young people require care in hospital to ensure their safety.

    In this environment, practices that place even greater restriction, such as seclusion or physical restraint, may be used briefly as a last resort to ensure immediate physical safety. However, these “restrictive practices” are associated with negative effects such as post-traumatic stress for patients and health professionals.

    Worryingly, staff report a lack of alternatives to keep patients safe. However, the elimination of restrictive practices is a major aim of mental health services in Australia and internationally.

    Our research looked at more than six years of data from a child and adolescent mental health hospital ward in Australia. We sought to determine whether there was a reduction in restrictive practices during the periods when art therapy was offered on the unit, compared to times when it was absent.

    We found a clear association between the provision of art therapy and reduced frequency of seclusion, physical restraint and injection of sedatives on the unit.

    We don’t know the precise reason for this. However, art therapy may have lessened levels of severe distress among patients, thereby reducing the risk they would harm themselves or others, and the likelihood of staff using restrictive practices to prevent this.

    A black tree sculpture made of clay, with pink and purple dots in the centre.
    This artwork was described by the young person who made it as a dead tree with new growth, representing a sense of hope emerging as they started to move towards their recovery. Author provided

    That said, hospital admission involves multiple therapeutic interventions including talk-based therapies and medications. Confirming the effect of a therapeutic intervention requires controlled clinical trials where people are randomly assigned one treatment or another.

    Although ours was an observational study, randomised controlled trials support the benefits of art therapy in youth mental health services. For instance, a 2011 hospital-based study showed reduced symptoms of post-traumatic stress disorder among adolescents randomised to trauma-focussed art therapy compared to a “control” arts and crafts group.

    A painting depicting a person crying.
    Artwork made by a young person during an art therapy session in an in-patient mental health unit. Author provided

    What do young people think?

    In previous research we found art therapy was considered by adolescents in hospital-based mental health care to be the most helpful group therapy intervention compared to other talk-based therapy groups and creative activities.

    In research not yet published, we’re speaking with young people to better understand their experiences of art therapy, and why it might reduce distress. One young person accessing art therapy in an acute mental health service shared:

    [Art therapy] is a way of sort of letting out your emotions in a way that doesn’t involve being judged […] It let me release a lot of stuff that was bottling up and stuff that I couldn’t explain through words.

    A promising area

    The burgeoning research showing the benefits of art therapy for both physical and especially mental health highlights the value of creative and innovative approaches to treatment in health care.

    There are opportunities to expand art therapy services in a range of health-care settings. Doing so would enable greater access to art therapy for people with a variety of physical and mental health conditions.

    Sarah Versitano, Academic, Master of Art Therapy Program, Western Sydney University and Iain Perkes, Senior Lecturer, Child and Adolescent Psychiatry, UNSW Sydney

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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