How Setting Boundaries Can Benefit Physical and Mental Health

The COVID-19 pandemic has pushed many individuals to improve their practice of setting boundaries with family and friends. From the beginning — when citizens were advised to stay home and practice social distancing — to the current state in which phases of restrictions are being lifted on a state-specific basis, many families have been forced to have difficult conversations with relatives and friends to set boundaries in regards to which social activities they feel comfortable participating in. 

The practice of setting boundaries for physical and mental health has always been important and will continue to be necessary post pandemic. From individuals with chronic diseases, to cancer survivors in early recovery, to parents with a newborn at home, there are a number of reasons that families may need to have stricter guidelines for social interaction. It is vital to be able to communicate these needs in order to stay healthy, maintain emotional well-being, and build strong relationships.When setting these guidelines, it can be helpful to know how to identify boundaries, how to establish boundaries, and how to talk about setting boundaries with family and friends.

A family or individual may have to set boundaries for health reasons. The COVID-19 pandemic serves as one example — while the number of people who are fully vaccinated against the coronavirus has increased, resulting in less restrictions for masking in public and social distancing, not everyone is healthy or safe enough to return to “normal.”

Anxiety and other mental health issues may affect the comfort level of individuals. In a 2021 Stress in America poll from the American Psychological Association, approximately half of respondents said they “feel uneasy about readjusting to in-person interaction post pandemic.”

Additionally, some individuals are unable to return to more relaxed protocols because of their physical health. Disabilities and chronic diseases can affect an individual’s immune system, making it more difficult to navigate public spaces and social events.

“This is yet another example of how disabled or chronically ill people are forgotten about,” said Ellen Gurung, an individual with lupus, in an article about COVID-19 and disability. “There’s so much focus on the impact of the pandemic on able-bodied people, the economy, and businesses, and there’s just very little focus on people who are at the most risk health-wise.”

According to the Centers for Disease Control and Prevention, 6 in 10 adults in the United States have a chronic disease, and 4 in 10 have at least two chronic diseases. These conditions include: 

Beyond the pandemic, the need for setting boundaries to promote physical and mental health may still arise. Immunodeficiency is linked to several health conditions ranging from autoimmune disorders to cancer. Having a weakened immune system puts individuals at higher risk for infections and other health issues, which may require extra precautions when engaging in public events and social gatherings.

As another example, new parents are also often tasked with setting social boundaries for their infant. Because a newborn’s immune system is early in development, certain practices, such as hand-washing before holding the baby, are necessary to protect their health. Setting boundaries can also be “an important tool to help us feel secure in our surroundings,” which can mean better mental health outcomes, according to the Depression and Bipolar Support Alliance.

In an article on the importance of setting boundaries, Ilene Strauss Cohen, PhD, said this: “Before you begin to set boundaries with others, you need to know what your boundaries actually are.” This crucial first step can help individuals better understand their needs, as well as those of their family, so that appropriate guidelines can be set.

How to Identify Boundaries  

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Reflect on individual needs. Individuals can think about what rules they would like to set for themselves and their family using the five things method to list five behaviors that:

• they wish people would stop doing around them or their family
• they would like people to stop doing to them or their family
• people may no longer say to them to them or their family

Do some research. Given an individual’s needs and their family’s circumstance, they can search for activities that are lower risk and a better fit. For example, the CDC offers a safer activities guide for families that provides guidance on COVID-19 risks.

Seek out credibility. Individuals should make sure they are utilizing credible and authoritative resources, such as the CDC and state health departments.

Talk to a health professional. An individual’s health care provider can be a beneficial resource for health information and advice. Clinicians, nurses, and others who regularly provide care to an individual and their family can pair their expertise with their knowledge of the patient’s personal information to give individualized guidance.

How to Establish Boundaries

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Write it down. Processing one’s thoughts on paper first can help to determine how to best communicate information with others.

Be straightforward. When having a conversation with a friend or family member, individuals can benefit from being direct and stating their needs clearly.

Establish consequences. When setting a boundary, it can be helpful to follow with what the outcome will be if they do not respect the boundary. 

Have a plan. Because conversations around boundaries can be sensitive, it is a good idea to have a plan of action on how to safely exit the conversation if someone gets upset.

Don’t feel guilty. Individuals should remember that it is not their fault if a friend or family member is unhappy. Boundaries are meant to protect the individual’s physical and mental health.

Be consistent. Individuals should try to maintain set boundaries as much as possible so learned behaviors can be established.

Sources:
“How To Set Boundaries With Family — And Stick To Them,” NPR. January 26, 2021. Accessed July 6, 2021. “Setting Boundaries During Coronavirus,” Psychology Today. July 27, 2020. Accessed July 6, 2021.“The Importance of Personal Boundaries,” PsychCentral. Accessed July 6, 2021.

How to Talk About Setting Boundaries With Family and Friends 

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The following examples can serve as a point of reference on how to communicate boundaries, what to say when a boundary is not respected, and other scenarios that may need to be addressed.

How to state a boundary clearly

• “Because of our child’s health condition, we cannot come over to your place if there will be multiple families present.”
• “I’m not comfortable going to a new restaurant without checking to see if they have outdoor seating. Can you check before you make a reservation?” 

How to establish consequences for crossing a boundary

• “I’m not comfortable with hugs. If you don’t respect my space, I won’t be able to spend time with you right now.”
• “Until you are fully vaccinated, we cannot bring the grandchildren over to your house to visit.”

How to ask questions with empathy to understand their perspective

• “I know you are hesitant to get vaccinated. Can you explain why?”
• “I understand that you are excited to meet the baby, but we are holding off on having any visitors. Can you share how you are feeling?” 

How to exit a conversation if it is not productive

• “I think it would be best for us to revisit this topic another time.” 
• “I understand that you are upset. Let’s table this discussion for now.”

Citation for this content: Nursing@Georgetown, the online MSN program from the School of Nursing & Health Studies