Boundaries are so important - in our lives and in our recovery. This is a two-part episode with Dr. Amanda Ihlenfeld, licensed clinical psychologist here at Melrose.. In part one, we will more generally discuss boundaries - the different types - and how difficult it can sometimes be to practice healthy boundaries. In part 2, we'll discuss the relationship between eating disorder recovery and healthy boundaries.
Boundaries are so important - in our lives and in our recovery. This is a two-part episode with Dr. Amanda Ihlenfeld, licensed clinical psychologist here at Melrose.. In part one, we will more generally discuss boundaries - the different types - and how difficult it can sometimes be to practice healthy boundaries. In part 2, we'll discuss the relationship between eating disorder recovery and healthy boundaries.
For a transcript of this episode click here.
Dr. Karen Nelson - [00:00:00] Eating disorders thrive in secrecy and shame. It's when we create a safe space for honest conversation that we'll find the opportunity for healing. Hi there, I'm Dr. Karen Nelson, licensed clinical psychologist at Melrose Center, welcoming you to Melrose Heals, a conversation about eating disorders. A podcast designed to explore, discuss, and understand eating disorders and mental health.
On today's episode, I'm joined by Dr. Amanda Ihlenfeld, licensed clinical psychologist here at Melrose. Amanda and I will talk about boundaries. Building healthy personal boundaries can help each of us be happy, safe, and successful. Not only in our lives, but in eating disorder recovery as well. Now, before I begin, I invite you to take a deep breath and join me in this space.
I had such a [00:01:00] great conversation with Dr. Amanda Ihlenfeld that we decided to split this episode into two parts. On this episode, we'll more generally discuss boundaries, the different types, and how difficult it can be to sometimes practice healthy boundaries. In part two, we'll discuss the relationship between eating disorder recovery and healthy boundaries.
Now, before we dive in, Amanda, I would love it if you could introduce yourself and tell us about your role here at Melrose.
Dr. Amanda Ihlenfeld - Thanks, Karen. I'm Dr. Amanda Ihlenfeld. I have been with Melrose for a little over six years now, I think. I started off doing outpatient treatment in Maple Grove, and I have absolutely loved that experience. Recently, I transitioned to doing part time work in Maple Grove still, but then part time work in our higher level of care, which has been a really cool experience. I liked the ability to work at all different levels of care and kind of see the [00:02:00] trajectory of people through all of the different phases and it's been really rewarding work.
Dr. Karen Nelson - Oh, it sounds so cool. Right, because it is different between outpatient and inpatient. There's different goals. Treatment plan might look a little bit different.
Dr. Amanda Ihlenfeld - Yeah. You're working on different skill sets as well, which is so important because we need to have different skill sets for different times in recovery. So, being able to differentiate that and make sure people are getting what they need when they need it is so cool to see and be a part of.
Dr. Karen Nelson - Oh, so cool. Well, today, as I mentioned, you know, we're going to be talking about boundaries. And so I think, you know, as people hear that word probably resonates with them a lot. It's kind of a word that's in our culture. We might talk about boundaries, but let's be clear about what does that even mean?
Dr. Amanda Ihlenfeld - Yeah, boundaries is one of those things that I think people don't always understand fully what it means to set boundaries. There’s something about it where I think people get [00:03:00] this idea that setting boundaries can be unkind or mean at times and really what I find is that setting boundaries is an incredibly kind thing to do. It helps people to understand where limits are in parameters, in situations, and so it helps to facilitate better communication and more comfort in relationships. And so when we talk about setting boundaries, what we're really talking about is making it clear what works for us, where our limits are, what we feel comfortable with and might want more of, or less of, so that other people can be aware of what our needs are. We're not asking them to take care of our needs with boundaries, what we're doing is we're just letting them know how we're going to take care of our own needs.
Dr. Karen Nelson - Beautifully, beautifully put. What is important to acknowledge, and I share with patients all the time, is that boundaries are personal.
Dr. Amanda Ihlenfeld - Yes!
Dr. Karen Nelson - Right? So wait, I might have a different boundary than you, right, [00:04:00] Amanda? I mean, it sounds silly, but they're very personalized.
Dr. Amanda Ihlenfeld - They are! And boundaries are impacted by so many different things. Sometimes they're impacted by our family of origin, how we've grown up, experiences we've had. Boundaries can also be very tied to our own value systems. And so based on what our values are, we are going to hold boundaries in different ways. There are going to be no two people that have the exact same value system, especially, you know, we might have values that are similar, like on a bigger level, but when you really break them down and kind of get into the nitty gritty of it, everybody has a different value system.And so using boundaries to uphold that value system tends to really help us to walk in the world in a way in which we are prioritizing our self respect.
Dr. Karen Nelson - Oh, it's so perfect. I love how you describe it. You were mentioning some of the things that can impact the development of boundary. Do you think culture plays a part in that?
Dr. Amanda Ihlenfeld - Absolutely. I think there [00:05:00] are different expectations culturally, in terms of what boundaries we hold, how we uphold boundaries, how we communicate them. Whether it's cross culturally, between genders, I mean, there's so many different layers for which boundaries might look different. And so being aware that those things can impact how we feel about holding boundaries, our comfort level with holding boundaries, really is important to be aware of at the end of the day.
Dr. Karen Nelson - So, so important to acknowledge that. Well, and I think too, right, you know, societal messages about what's appropriate, or the word that I often kind of interchange with boundaries for people kind of helps solidify the idea, is that idea of a limit. Right? What am I comfortable with? I like how you described that, and sometimes it potentially can feel scary if something is happening where it feels like, oh no, I'm starting to feel uncomfortable. Do I have the right to set [00:06:00] a limit?
Dr. Amanda Ihlenfeld - Right.
Dr. Karen Nelson - That's a boundary, right?
Dr. Amanda Ihlenfeld- Absolutely. And I think that's one of those things that oftentimes I see coming up based on what we learned growing up from the people around us. We learn boundaries and we learn how to communicate with others, most often, you know, at our earliest ages from the people who are our direct caregivers. So how they model boundaries can really impact how we feel comfortable modeling boundaries. And so, depending on that experience, we can see, how that really impacts people into adulthood and where they end up holding boundaries
Dr. Karen Nelson - That’s right.
Dr. Amanda Ihlenfeld - …or struggle to hold boundaries.
Dr. Karen Nelson - Amen. Well, and I think, you know, exploring that origin of where might I have started to develop some of these ideas about limits, we grow up within this system that sometimes overtly, we have like overt, open messaging about what limits are [00:07:00] okay and appropriate in families. Sometimes there's covert messages, right?About what's okay.
Dr. Amanda Ihlenfeld - When I even just think of kids, right? One of the boundaries that kids need to learn is bodily autonomy. That's an example of a boundary, right?
Dr. Karen Nelson - What's that mean? Wait, what's that mean?
Dr. Amanda Ihlenfeld - Right, so bodily autonomy means that they're in charge of their bodies and they get to make decisions around their own bodies. And so I think of the situations which kids are oftentimes put in where it is, you know, oh, you know, go give this person a hug or say goodbye, give them a hug and kiss, something like that. Or don't be worried about being with this person, and so they feel uncomfortable, right? They want to set a boundary and their body is telling them to set a boundary, but they're being told by the people that they trust and the caregivers around them that, hey, don't set this boundary.
Dr. Karen Nelson - That's it. Beautiful. I mean, such a good example. And then, what we know is having those [00:08:00] early experiences deeply informs how I make sense and show up in the world. So, then I evolve through potential teenage years, early adulthood…
Dr. Amanda Ihlenfeld - Right.
Dr. Karen Nelson - …and we potentially work with patients who, you know, share comments. “I sometimes feel forced into doing things that I don't want to do” or “I physically am in situations where I'm uncertain” or “I don't have practice saying no or setting a limit.” Does that resonate for you?
Dr. Amanda Ihlenfeld - Oh, absolutely. I think that there are a lot of times where we can get messages when we're younger that the limits that we want to set are wrong in some way because maybe somebody else doesn't want us to hold that limit or they want us to do something else. And so we have this inner wisdom that's saying, this doesn't feel right, or I need to set a limit around this, a boundary. And then there's the second guessing that comes in, because they've been told that they're not right when it comes to setting limits and [00:09:00] boundaries. And that can make them worried about doing that in other relationships.
Dr. Karen Nelson - Absolutely.
Dr. Amanda Ihlenfeld - Yeah. I think there's also the experience of having relationships where you're told that things are better when, you know, it's peaceful.
Dr. Karen Nelson - Totally.
Dr. Amanda Ihlenfeld - Right?
Dr. Karen Nelson - Don't rock the boat.
Dr. Amanda Ihlenfeld - Don't rock the boat. And so that can be an example of where we might learn at a young age not to hold healthy boundaries because we're trying to keep the peace, and that was what was reinforced, that was what was praised. And so we might, as adults, want to hold boundaries, but we get really worried about what that's going to do to others, to our relationships. We end up caretaking more often then. There are two things we really cannot do at the same time. We can't set boundaries and caretake at the same time. It does not work.
Dr. Karen Nelson - Wait, oh, that is genius. I'm making a post-it. It's going on my wall, Amanda. [00:10:00] If my need is opposite from what that other person needs, I'm going to either choose them or choose me.
Dr. Amanda Ihlenfeld - Right.
Dr. Karen Nelson - Wow.
Dr. Amanda Ihlenfeld - Right. I think people get put in, is that they want to set a boundary, but then they are worried about how that boundary is going to make other people feel, and if you choose caretaking, if you choose to pay more attention to how you want to make other people feel, by default, you will not end up setting the boundaries that you need to set.
Dr. Karen Nelson - That's right.
Dr. Amanda Ihlenfeld - On the flip side, if we choose boundaries over caretaking, we have to accept that people are not going to always be happy with the boundaries that we're setting, even if they are really important for us.
Dr. Karen Nelson - There can be repercussions…
Dr. Amanda Ihlenfeld - Yes.
Dr. Karen Nelson - …or we might talk about the collateral damage that happens, right? When I choose me, when I say, this isn't comfortable for me, I'm going to set a limit, there may be kind of ripples that happen. Right.
Dr. Amanda Ihlenfeld - And it's hard for people to [00:11:00] choose that boundary.
Dr. Karen Nelson - 100%. Well, let's talk about some of the kind of more clinical terms that we might use. So some of the examples of boundaries are physical, intellectual, emotional, sexual, material, and time. So that's a lot of words kind of all together, but let's kind of dissect that a little bit. We were talking about physical boundaries. I love that you bring up body autonomy. Almost like, good touch, bad touch type of thing, being able to decipher that, right?
Dr. Amanda Ihlenfeld - Yes.
Dr. Karen Nelson - Absolutely. Any other examples that you could share with us or how does that come up in conversations with clients where they may be exploring, “is it okay for me to set a limit around physical touch?”
Dr. Amanda Ihlenfeld - Right. I think that is something that can be challenging, especially when body image concerns come up…
Dr. Karen Nelson - Good point.
Dr. Amanda Ihlenfeld - …for our patients who struggle with eating disorders, right? Wanting to maybe [00:12:00] take care of their bodies in certain ways, or move their bodies in certain ways, and perceiving, like, what is deemed appropriate, like culturally, social media gives us a lot of information for better or worse, for how we set boundaries. And so, having those comparisons that maybe we see in social media, for example, might change how we hold physical boundaries with others because we see other people doing things that maybe we're not comfortable with, but we feel like, oh, well, I should be comfortable with this because other people are.
Dr. Karen Nelson - And I think too, as we're talking about boundaries, other words that we may use is limits. I think sometimes it's also helpful to acknowledge that. Kind of setting the limit or setting the boundary. Sometimes I might have some strength to do that very kind of rigidly, or I might be good at kind of establishing the boundary, right? Other times a word that we might use is kind of porous, where it's kind of a loose [00:13:00] boundary or people might kind of push through it. We call them boundary busters. Sometimes we try and make a limit of like, no, I don't think I want to do that. Oh, come on, do it anyway. What's wrong with you? Thoughts on that? Or what do you notice?
Dr. Amanda Ihlenfeld - Yeah, that is something that comes up so frequently with patients that I work with and part of the way I describe the importance of working towards the skill set of holding healthy boundaries is talking about what it looks like when we don't.
Dr. Karen Nelson - Yeah.
Dr. Amanda Ihlenfeld - One of the ways in which I describe holding boundaries and the challenges around creating new boundaries, if we've had porous boundaries, is every relationship we have tends to have kind of an established, unsaid flow to it.
Dr. Karen Nelson - You got it.
Dr. Amanda Ihlenfeld - Right?
Dr. Karen Nelson - There's rules.
Dr. Amanda Ihlenfeld - There's rules and it tends to be like a well choreographed dance. You don't, you know, sit down and say, okay, this person is going to be the person who explodes. This person's going to be the [00:14:00] person who avoids conflict. Nobody actively sets out those rules, but it just happens or people fall into them. And we know this because oftentimes, I'll say to people, well, what if you said this to this person? And they say, Oh, let me tell you.
Dr. Karen Nelson - I cannot say that.
Dr. Amanda Ihlenfeld - I can't because if I say this, then they're going to say this, then this person's going to try to intervene. They can tell me all of the steps of the dance.
Dr. Karen Nelson - They already know it.
Dr. Amanda Ihlenfeld - They already know it.
Dr. Karen Nelson - Wow.
Dr. Amanda Ihlenfeld - And so when we're talking about setting boundaries, what our goal is, is to essentially step out of the dance so that we can hold those firmer, rigid boundaries that are there to take care of us. That's really the purpose of boundaries, is to help take care of ourselves. What we have to also understand is that when we step out of that dance, people are going to notice.
Dr. Karen Nelson - That's right.
Dr. Amanda Ihlenfeld - Right? I kind of explain it to people as if it's kind of like one of those 80s movies where when you do [00:15:00] something different, it's like the record screeches…
Dr. Karen Nelson - Exactly!
Dr. Amanda Ihlenfeld - …and everybody turns…
Dr. Karen Nelson - Looks at you!
Dr. Amanda Ihlenfeld - …to look. Right? Because it's so out of character. You're supposed to be doing this thing. This is your role.
Dr. Karen Nelson - That's right.
Dr. Amanda Ihlenfeld - So when you don't, even if that role isn't functional and that dance isn't functional, it's familiar.
Dr. Karen Nelson - That's right.
Dr. Amanda Ihlenfeld - So people will oftentimes try to pull you back into that role. Sometimes we see that as being passive aggressive. Sometimes it's guilt tripping. I mean, it can be a lot of different things.
Dr. Karen Nelson - Anger, yelling, what's wrong with you? Why are you doing that?
Dr. Amanda Ihlenfeld - Absolutely. Those things are an attempt to pull us back into that role because that's where everybody's most comfortable. That's where everybody knows things are predictable, even if they're not effective or functional. They're predictable. And so when we want to set more firm boundaries, rather than kind of going in and out of these boundaries, having porous boundaries, like you described, we need to keep stepping out of that dance. [00:16:00] over and over and over again until there's a new pattern that's established.
Dr. Karen Nelson - That's right.
Dr. Amanda Ihlenfeld - We need to let people know that this is the new thing we're going to be doing. And eventually they will shift the dance around that. It might not look the way we want it to…
Dr. Karen Nelson - True.
Dr. Amanda Ihlenfeld - …but it will happen. We just have to be consistent about that. Which, is hard because people are really trying to pull us back to that comfortable place.
Dr. Karen Nelson - Absolutely. Well, and I often, one of the comments that I usually will make to patients is that, you know, when I potentially am working to create a new boundary, establish a new boundary, set a limit which protects my emotional well being, it sometimes feels like I'm trying to speak a foreign language.
Dr. Amanda Ihlenfeld - Yes!
Dr. Karen Nelson - Right? If everybody's doing the waltz, and I'm over here doing the Macarena, I'm going to look weird, right? They're like, what are you, what literally are you doing? Like you're crazy. You're weird. What's wrong with you? You become the problematic one.
Dr. Amanda Ihlenfeld - Yes!
Dr. Karen Nelson - So of course [00:17:00] I might get scared, overwhelmed, and I slip back into that dance. And therapy becomes a way where we just have a space to notice…
Dr. Amanda Ihlenfeld - Yeah.
Dr. Karen Nelson - …acknowledge. Never are we judging. We're always working to be curious. I love how you describe having patients almost become an observer in their own family. Tell me the roles. You know, who's the aggressor or who's the, you know, main character? Who are the supporting characters, right? I love that. And that often feels a little less overwhelming when we can kind of step out and observe rather than all the emotion that happens when we're kind of right in the dance.
Dr. Amanda Ihlenfeld - Absolutely. Yes. And that's where the power comes from in being able to then set those boundaries.
Dr. Karen Nelson - Examples of rigid boundaries, or what might that look like? Anything kind of come to mind, or how might you explain [00:18:00] that to a patient?
Dr. Amanda Ihlenfeld - So, rigid boundaries, I don't know if I love the word rigid.
Dr. Karen Nelson - Yeah, nice. I like that you brought that up. Why do you love yourself so much, Amanda, that you got to tell someone to stop?
Dr. Amanda Ihlenfeld - When I hear rigid, like it kind of feels like inflexible…
Dr. Karen Nelson - Good point
Dr. Amanda Ihlenfeld - …and that is something that I think sometimes people do struggle with boundaries.
Dr. Karen Nelson - Yeah.
Dr. Amanda Ihlenfeld - Where they will be very rigid or inflexible. And that's a really good way to keep ourselves safe, you know, which is part of the goal of boundaries. If we are very rigid and inflexible, though, it also can contribute to loneliness.
Dr. Karen Nelson - Good point.
Dr. Amanda Ihlenfeld - So, I do prefer, you know, talking about having firm boundaries. I think boundaries can move over time, right? You know, as we learn things, as we get a better sense of ourselves, but in general, when we're talking about a firm boundary, a healthy boundary, we're [00:19:00] talking about something that is not going to be wishy-washy. It's going to be consistent, kind of across the board. There is some room for input in it because, I mean, that is how we adapt and change and how relationships work. But it's saying, Hey, you know what, this is a pretty consistent thing you can expect from me.
Dr. Karen Nelson - That’s right.
Dr. Amanda Ihlenfeld - In this situation, I'm going to respond like this. And people kind of know.
Dr. Karen Nelson - That’s right.
Dr. Amanda Ihlenfeld - Right? There's no guessing about it. I think good examples of that are boundaries around time, for example. And so, you know, I have time that I know in my personal life that is blocked for family time. I'm not scheduling a lot of stuff around that time because that's really important. And there are people in my life who know, Oh, on this day I know that you're doing family stuff, so, what about this other day? And it's consistent and they know it. And that allows them to be respectful of it and for it to not be a [00:20:00] problem. I think other boundaries that we can have are around information about ourselves. Right? We get to choose the information that we share with others. which is one of the things that I really work with people on in therapy as they are working through some really challenging parts of recovery and how the eating disorder has manifested. There might be times when they want to hold boundaries around what they tell people close to them about what recovery is looking like or what they're talking about in therapy. And we really want to be able to hold good boundaries around that because that makes people feel safe.
Dr. Karen Nelson - That's right.
Dr. Amanda Ihlenfeld - Right? We tend to feel more vulnerable when we're not holding firm boundaries, and that can lead to a lot of problems.
Dr. Karen Nelson - I'm so glad that you brought up that kind of differentiation between rigid and firm. I think, you know, there is a lot of, kind of emotion attached to the word rigid. [00:21:00] One thing that I notice with patients who may have struggled with more porous boundaries or kind of looser boundaries, is that when they do start to attempt to make more firm boundaries, they're accused of being rigid.
Dr. Amanda Ihlenfeld - Yeah.
Dr. Karen Nelson - And so some of that exploration that we might do in therapy about, is it okay if I set a limit? Is it okay if I tell a friend, I can't go out on Tuesday night at five because I go to soccer with my daughter.
Dr. Amanda Ihlenfeld - Right.
Dr. Karen Nelson - Like, is that okay? Those pieces. Because again, if I have been from a place where maybe I got information around boundaries where I don't set a lot of limits, starting to set limits can feel uncomfortable to the people around us so they can accuse us of being like, why are you being so inflexible? What's wrong with you?
Dr. Amanda Ihlenfeld - Yes. And I think the one that gets people the most is being accused of being selfish.
Dr. Karen Nelson - Yeah.
Dr. Amanda Ihlenfeld - When people are holding firm [00:22:00] boundaries that don't serve others…
Dr. Karen Nelson - That's right.
Dr. Amanda Ihlenfeld - …they are oftentimes labeled as selfish or that they don't care about others, which is incredibly hurtful to so many people because they are caring people. They do care about what others think. These are the people who typically struggle with wanting to overly caretake others.
Dr. Karen Nelson - Yes!
Dr. Amanda Ihlenfeld - And so to have that pointed out can really make it harder to, like, get in that place where they hold those healthy boundaries.
Dr. Karen Nelson - Absolutely. Well, and I think how, of course, if I, you know, one thing that I think I really have figured out about the human experience is just the power of connection. We just know how deeply important it is for us to be in relationship with others. And when I may be potentially accused of not being gentle or kind of observing that connection, it can feel deeply painful.
Dr. Amanda Ihlenfeld - Absolutely.
Dr. Karen Nelson - And so then I might overcorrect or I then I think, well, maybe [00:23:00] I shouldn't have needs. Maybe I should minimize what I need and want.
Dr. Amanda Ihlenfeld - Right.
Dr. Karen Nelson - And just as you said, you're going to be on a post-it in my office, we cannot take care of someone else and set our own boundaries, because they potentially will compete.
Dr. Amanda Ihlenfeld - Right.
Dr. Karen Nelson - And so having space to say, I deserve to feel comfortable in this relationship and that might mean setting a limit with someone.
Dr. Amanda Ihlenfeld - Right.
Dr. Karen Nelson - Huge.
Dr. Amanda Ihlenfeld - Yeah. One of the things that we talk about oftentimes is when we are in relationship with other people, rightfully so, we want to maintain those relationships. Connection feels really good…
Dr. Karen Nelson - That's right.
Dr. Amanda Ihlenfeld - …but when push comes to shove, I kind of always want to encourage people if they have to choose what's the important thing in the relationship, I really want my patients to be able to default to self respect and taking care of themselves as the priority in any interaction.
Dr. Karen Nelson - That's right. That's right.
Dr. Amanda Ihlenfeld - Even if that damages the relationship, [00:24:00] that's how we take care of ourselves.
Dr. Karen Nelson - That's true. I think Acknowledging some of those aspects of multiple things can be true at the same time is really important and can kind of enrich the conversation. If my only option is to either only take care of myself, Or take care of the relationship, I can feel pretty stuck.
Dr. Amanda Ihlenfeld - Absolutely.
Dr. Karen Nelson - And in the same breath, I can respect myself and care for the relationship by setting a limit.
Dr. Amanda Ihlenfeld - Yes.
Dr. Karen Nelson - That is care also.
Dr. Amanda Ihlenfeld - Yeah.
Dr. Karen Nelson - It's not ignoring the limit.
Dr. Amanda Ihlenfeld - Boundaries are actually kind.
Dr. Karen Nelson - They are.
Dr. Amanda Ihlenfeld - People think that they are uncaring and unkind. They really are kind.
Dr. Karen Nelson - Yeah.
Dr. Amanda Ihlenfeld - Because they are letting people know where things stand. They take the ambiguity out of things…
Dr. Karen Nelson - Good word.
Dr. Amanda Ihlenfeld - …which is really helpful in relationships.
Dr. Karen Nelson - That’s right.
Dr. Amanda Ihlenfeld - I think having boundaries decreases distress and anxiety.
Dr. Karen Nelson - A hundred percent. Yes.
Dr. Amanda Ihlenfeld - [00:25:00] Yeah. Even if other people don't like the boundaries.
Dr. Karen Nelson - That's right. At least they know they're there.
Dr. Amanda Ihlenfeld - Yeah. There’s less anxiety and worry about what might happen in the situation, because the boundaries are kind.
Dr. Karen Nelson - I love that.
Dr. Amanda Ihlenfeld - They are clear.
Dr. Karen Nelson - For sure. Absolutely. We're kind of moving through some of the examples of boundaries. We've talked about physical boundaries. You brought up a beautiful example of a boundary around time. Let's talk about intellectual boundaries or boundaries around thoughts or maybe perspectives. Tell us, what comes up for you around that?
Dr. Amanda Ihlenfeld - You know, I think that this is a challenging one, because right now I think in general there is a…
Dr. Karen Nelson - A firestorm around this?
Dr. Amanda Ihlenfeld - Yeah, I don't know, yeah, I don't know another way to say that. There is not a lot of healthy discourse that is happening.
Dr. Karen Nelson - Yeah.
Dr. Amanda Ihlenfeld - And so, when we talk about intellectual boundaries, everybody gets to have their own [00:26:00] thoughts and beliefs about things and the way they have decided they want to interact in the world and connect with the world.And it can be really challenging, because I think I feel like we are sometimes in a state where if people disagree, it's no longer a matter of how can we be understanding of each other. It's, let me explain to you why what you're thinking is incorrect.
Dr. Karen Nelson - Right.
Dr. Amanda Ihlenfeld - And well, the way that I'm thinking is the way you should be thinking.
Dr. Karen Nelson - For sure. So you got to agree with me and then we're all good.
Dr. Amanda Ihlenfeld - Right! Yeah. And so I think that's a lost art when it comes to holding healthy boundaries, intellectual boundaries in particular of saying, it's okay that we disagree.
Dr. Karen Nelson - That's right.
Dr. Amanda Ihlenfeld - It's okay that we have different experiences, because we know that these things are impacted by our experiences. Everyone has different experiences, and so that's okay. We don't have to agree. We don't even have to understand, and holding [00:27:00] boundaries means we can be respectful.
Dr. Karen Nelson - That's right. That I don't have to be a boundary buster and kind of push my agenda or opinion or belief on someone.
Dr. Amanda Ihlenfeld - Right.
Dr. Karen Nelson - Yeah, absolutely. Which can feel kind of scary, I think. You know, sometimes patients share with me the intensity of emotion that's attached in some of these conversations that they may have with family or friends. You know, if they're talking about something that they are on opposite ends of, it can feel sometimes scary.
Dr. Amanda Ihlenfeld - Oh, and incredibly invalidating as well.
Dr. Karen Nelson - Good point.
Dr. Amanda Ihlenfeld - I think that comes up oftentimes when we talk about mental health. People who have never struggled with mental health challenges, and that is wonderful for them.
Dr. Karen Nelson - We're so happy for you.
Dr. Amanda Ihlenfeld - Yeah. They have not had that experience. But the lack of experience that they have means that when they maybe are interacting with someone who does have that profound struggle or [00:28:00] challenges that have come up with their mental health, that they can be invalidating, and they can maybe make assumptions about things. Like, well, if I was feeling depressed, I would handle it like this, you know, so maybe you should try to do it like this. And that can make somebody who's in that place not want to share what's going on, not want to share the thoughts that they're having. If somebody's feeling really anxious about something, sometimes it feels vulnerable to share those thoughts. And if we have somebody who isn't really good at being respectful of intellectual boundaries and understanding that people can have different thought patterns, if we have anxiety, for example, we might get the feedback, well, don't worry about it it's not a big deal. Right?
Dr. Karen Nelson - So invalidating.
Dr. Amanda Ihlenfeld - Which is so invalidating and it takes away from the experience and it makes it where maybe somebody has to hold more firm or rigid boundaries with that person because they're not getting the [00:29:00] support that they need and they know that person won't be respectful if the boundaries aren't more firm or rigid.
Dr. Karen Nelson - Absolutely. Well, and we were talking about emotional boundaries is what really comes up for me, right? Kind of holding emotion that aspect of disclosure, I think so often comes up in therapy. Sometimes, again, based on experiences of family of origin, you know, maybe I got a lot of messages that I'm not supposed to express anger…
Dr. Amanda Ihlenfeld - Right.
Dr. Karen Nelson - …or frustration or sadness. Maybe there were rules in my family about no keeping secrets. We have to share everything…
Dr. Amanda Ihlenfeld - Right.
Dr. Karen Nelson - …even if it feels uncomfortable. And that, again, my limit may be different than someone else's.
Dr. Amanda Ihlenfeld - Right. That actually I think to some degree comes back to that question of culture.
Dr. Karen Nelson - Good point.
Dr. Amanda Ihlenfeld - In the state of Minnesota, I think there is a culture around not being angry or not being upset about things and so we have people who oftentimes [00:30:00] will struggle with being like saying, I don't like that happened.
Dr. Karen Nelson - Yeah.
Dr. Amanda Ihlenfeld - Right? Or, I don't feel comfortable with that because we're supposed to be fine. Right?
Dr. Karen Nelson - Always.
Dr. Amanda Ihlenfeld - We always have to be fine. I always make the joke that I'll ask people, how do you throw away your plate at a potluck? And they will tell me like, Oh, well, you throw it away upside down. Right. And without even thinking about it.
Dr. Karen Nelson - Of course.
Dr. Amanda Ihlenfeld - And I say, Why? And they say, well, because you don't want to offend somebody if you didn't like what they made or you didn't eat all of it.
Dr. Karen Nelson - The Jello salad didn't do you good?
Dr. Amanda Ihlenfeld - And it's so instinctual that we are not supposed to be upset maybe.
Dr. Karen Nelson - That’s right
Dr. Amanda Ihlenfeld - Or that we’re not supposed to be ungrateful. Or unhappy about something.
Dr. Karen Nelson - Yes!
Dr. Amanda Ihlenfeld - And so we have this cultural phenomena…
Dr. Karen Nelson - Absolutely.
Dr. Amanda Ihlenfeld - that, you know, when I said that, you knew exactly what I was talking about.
Dr. Karen Nelson - 100%
Dr. Amanda Ihlenfeld - Right? Because that’s an emotion that maybe isn’t as widely accepted or expressed.
Dr. Karen Nelson - For sure. So, I’m supposed to, again, based on some of these experiences, suppress or minimize or somehow try to eradicate this emotion that naturally, rightfully, appropriately is showing up.
So I'm supposed to, again, based on some of these experiences, suppress or minimize somehow try to eradicate this emotion that naturally and rightfully, appropriately is showing up.
I'm taught, no, I'm supposed to minimize that.
Dr. Amanda Ihlenfeld - Right. And that is where we see the eating disorders oftentimes coming in.
Dr. Karen Nelson - That's right.
Dr. Amanda Ihlenfeld - And this is how it, unfortunately is helpful for people to some degree.
Dr. Karen Nelson - Yeah.
Dr. Amanda Ihlenfeld - Not long term.
Dr. Karen Nelson - That’s right.
Dr. Amanda Ihlenfeld - We know it's not long term helpful, but we know in the short term, we have people who are wanting to hold boundaries. They're feeling uncomfortable about how they are told to be, the messaging that they're getting and they don't know what to do with that discomfort.
Dr. Karen Nelson - That’s right.
Dr. Amanda Ihlenfeld - They're being told that they're wrong.
Dr. Karen Nelson - Yeah.
Dr. Amanda Ihlenfeld - And so they turn to something that's going to distract them from these uncomfortable emotions, and the eating disorder does a wonderful job of that. Now, again, we know that long term that's not going to be effective and it doesn't actually solve the problem. But for [00:32:00] somebody who's really uncomfortable with these conflicting feelings and experiences, they just want a distraction.
Dr. Karen Nelson - That's right.
Dr. Amanda Ihlenfeld - They need a break.
Dr. Karen Nelson - Nobody wants to feel bad, so of course I want to feel better.
Dr. Amanda Ihlenfeld - Right.
Dr. Karen Nelson - Let's just touch on one last aspect of boundaries is sexual boundaries. I think it's so important to talk about. I think there's so much shame and discomfort when, you know, talking about sex, sexuality, sexual health, oftentimes, you know, patients of mine share that they feel a lot of discomfort and fear around the aspects of, you know, sex and sexuality, being intimate with someone can feel really intense and overwhelming. I'd love to hear your thoughts and what do you notice about, you know, boundaries around sex or sexuality. Help me know about that.
Dr. Amanda Ihlenfeld - Yeah, I think that when it comes to the topic of sex, there's something that inherently feels very vulnerable about that, and that [00:33:00] definitely adds another layer of emotion to it.
Dr. Karen Nelson - You got it.
Dr. Amanda Ihlenfeld - There is this expectation, I think, that people have in relationships that if you're in a relationship with someone, maybe you don't feel feel empowered to hold the boundaries that you want to, because we're in an intimate relationship or we've agreed to be in this intimate relationship. I think where that goes awry is that it gives the message that boundaries are inflexible, again, and that they're not allowed to change. And that's one of the things I talk with people about so often is that just because you set a boundary once doesn't mean you have to set that same boundary the next time. So, you might feel comfortable doing something intimate with a partner, and that might feel totally fine, and the next time you're with that partner, it might not feel okay. So, you have every right…
Dr. Karen Nelson - That’s right.
Dr. Amanda Ihlenfeld - …you absolutely have the right to change that [00:34:00] boundary and that limit and say, yep, I know we've done this before, and right now I'm not feeling comfortable with that, so that's not an option.
Dr. Karen Nelson - So, so important. I think also, too as we work with so many people who are in this process of eating disorder recovery, you know, a lot of my patients talk about that aspect of vulnerability or shame that comes up around their body. And then having to be potentially intimate with a partner can feel overwhelming. And I think sometimes there's expectations around, well, this is how I'm supposed to function in this intimate relationship. So, is it okay if I say I'm not interested or I'm not in the mood? How do I say that? Many times what my patients share, they suppress it all.
Dr. Amanda Ihlenfeld - Yep.
Dr. Karen Nelson - They don't talk about it and they can end up feeling really scared and overwhelmed and it can create a lot of potential distress in their relationship.
Dr. Amanda Ihlenfeld - Absolutely. [00:35:00] I think that is, and again, when we talk about boundaries, we're talking about this is a real skill set…
Dr. Karen Nelson - That’s right.
Dr. Amanda Ihlenfeld - …that we need to develop. Boundaries are about taking care of ourselves.
Dr. Karen Nelson - That’s right.
Dr. Amanda Ihlenfeld - In order to have any sort of healthy relationship, we need to be able to express our needs and have our needs be met.
Dr. Karen Nelson - That’s right.
Dr. Amanda Ihlenfeld - And so our needs are going to be different day to day, week to week, and that is going to change. Being in a safe relationship means that people can be respectful of those needs changing.
Dr. Karen Nelson - That's right.
Dr. Amanda Ihlenfeld - That doesn't mean they can't have their feelings about those needs changing. I would expect them to have their feelings and different feelings about those changing. But it means that it is still valid.
Dr. Karen Nelson - That's right.
Dr. Amanda Ihlenfeld - That you take care of where you're at in the moment by setting the boundaries and limits that you need.
Dr. Karen Nelson - For sure. Well, and sometimes, you know, patients will bring up to me like, well, you know, Karen, if I, you know, tell my partner that I'm not interested in being intimate or, [00:36:00] I just don't want to do that at the moment, well, what if they tell me that they have a need that they want to? And I say, okay, well, what do you think? Many times our patients will say, well, then I need to just do what they need, right? No. Right. I'm going to take a deep breath and as your therapist, tell me more about that, right? It's okay if we have differing needs and kind of the hallmark of a healthy relationship is to acknowledge that there may be differing needs and work to develop a solution that meets both.
Dr. Amanda Ihlenfeld - Absolutely.
Dr. Karen Nelson - I don't have to pick which, whose need is more important.
Dr. Amanda Ihlenfeld - Right. And knowing that there are different ways to get our needs met.
Dr. Karen Nelson - That's right.
Dr. Amanda Ihlenfeld - I think this is one of the things in relationships that becomes really challenging and where boundaries get really muddled, is that there's this expectation that other people, or the person in the relationship, the partner, is the one who's responsible for getting your needs met.
Dr. Karen Nelson - Yes!
Dr. Amanda Ihlenfeld - And when it feels like that's the [00:37:00] expectation, it's going to be really uncomfortable to set boundaries then, because that's a big responsibility. So I think there is real value in taking that responsibility off of another person and saying, let's work together.
Dr. Karen Nelson - That's right.
Dr. Amanda Ihlenfeld - You're not responsible for getting my needs met. I'm not responsible for getting your needs met, but we are responsible for working together because we've decided to be in this partnership as a team to figure out how both of us get our needs met.
Dr. Karen Nelson - 100%. And I think, again, you know, having the ability to sometimes even just identify what my own needs are. It is not uncommon that many times patients will arrive in my office and we will spend a long time identifying what their own needs are, because again, they may have had messages that their needs are not a priority, that the priority might be taking care of the family or making sure mom [00:38:00] and dad is okay, making sure my partner is okay. So it can, it's kind of this radical form of self care.
Dr. Amanda Ihlenfeld - Yeah, the one of the things I tell my patients is that saying the word no is a boundary in and of itself and it's valid.
Dr. Karen Nelson - That's right.
Dr. Amanda Ihlenfeld - Even if you are capable of doing something doesn't mean you have to do it.
Dr. Karen Nelson - For sure! Absolutely. I don't have to have like a particular reason why I don't want to do it?
Dr. Amanda Ihlenfeld - No!
Dr. Karen Nelson - That's right.
Dr. Amanda Ihlenfeld - No, we don't have to have a reason. In fact, I oftentimes coach people not to explain.
Dr. Karen Nelson - Nice. Exactly. I don't have to justify why I'm saying no.
Dr. Amanda Ihlenfeld - Yeah. Saying no is okay in and of itself.
Dr. Karen Nelson - That's right. Absolutely. And again, when I'm in a relationship with someone who is there to really love and support me just as much as I'm loving and supporting them, they can hold that.
Dr. Amanda Ihlenfeld - Right.
Dr. Karen Nelson - They can say, I get it. I wouldn't want to pick myself up at the airport at 3am. Right.
Dr. Amanda Ihlenfeld - Exactly.
Dr. Karen Nelson - You know, [00:39:00] I thought I just throw it out there, see what happens, right? But my girlfriends will be like, are you crazy? Yeah! I'm sorry. I don't know. Whatever. I'll just get an Uber. Right? That. But I think having that space of developing, the assuredness that I can say no and that I don't have to have a reason or an explanation really can take some practice. And that practice can be really hard and it is actually so important to practice self care through maintaining healthy boundaries. Amanda, actually this feels kind of like a nice place for us to pause. First of all, reminding our listeners that it is absolutely okay to say no. And that actually is a skill in developing healthy boundaries. And as we pause here, we'll just remind our listeners that we'll pick up this conversation next time around healthy boundaries.
We'd love to hear your feedback on our [00:40:00] episodes, the topics we cover, and anything you'd like to hear me discuss on the show. Our email address is melrose at parknicollet.com. If you or a loved one are suffering from an eating disorder, we're here to help. Call 952-993-6200 to schedule an appointment and begin the journey towards healing and recovery. To learn more about Melrose Center, please visit melroseheals.com.
Melrose Heals, a conversation about eating disorders, was made possible by generous donations to the Park Nicollet Foundation.