Physicians Anonymous

Boundaries self care medicine

Setting boundaries for self care in medicine

Reflections from a (former) self-compassion and boundary setting skeptic

Self-compassion does not make you soft. Boundaries do not make you closed off nor selfish.  

I had to repeat this many times before I started to understand how true and how essential self-compassion and boundaries are in our lives.

I did not realize how much I maintained my resistance to these ideas until I heard Dr. Brené Brown share her research findings at the SmileCon conference (Houston, 2022). Dr. Brown discussed her findings that “at the core of mental toughness is self-compassion,” and the people who are most compassionate maintain strong boundaries.

At the core of mental toughness is self-compassion.

Strong boundaries and self-compassion


Tears welled up in my eyes. Dr. Brown’s words landed in a way I had never honored, before, and I felt my wall of resistance start to crumble down.  

Grief overcame me as I reflected on all the years I had neglected myself of self-compassion and boundaries due to beliefs that self-compassion would make me soft and boundaries would make me come across cold. 

Neither of those beliefs are accurate, but the beliefs became habitual and my behaviors followed- constantly beating myself up and people pleasing which I thought was necessary in order to become tougher, avoid conflict, and be seen as a team player. 

Can you relate?

Relate? How many of us have been led to believe that, in contrast to giving ourselves compassion, grinding ourselves down and then working to build ourselves back up is necessary to develop mental toughness? How many of us have difficulty setting boundaries?  

If you relate- what beliefs are at the core for you and where did they originate? 

The reality for me is that lack of self-compassion has driven my thoughts about myself into the “you are worthless” category over and over again. What happens for us when we believe those thoughts? 

How much do you value yourself?

“The world reflects back to you how much you value yourself.” - Danielle LaPorte

A quote by Danielle LaPorte hit home for me when I observed how my beliefs impacted my life: “The world reflects back to you how much you value yourself.” 

When I was in a state of mind that believed I am worthless and lack value, I accepted treatment that validated those beliefs and often pushed away the people who truly cared for my best interests-  afraid that if people got too close, they would be disappointed in the reality of what I believed about myself to be true. The better someone treated me, the more uncomfortable I would get.

Feeling unworthy of love, I lacked boundaries and defaulted to people-pleasing in order to reduce the likelihood that people would disapprove of me. 

My sense of unworthiness led me to reject the life I craved full of love and surrounded by a supportive community, and, if left unchallenged, would mostly likely have repeated itself until I was on my deathbed full of regrets. 

Fortunately, a shift in my beliefs and actions got me off that destructive merry-go-round, and I am grateful for the community I surround myself with, today. If you are still on the merry-go-round, my hope is that this reflection may invite you to hop off, too.

Step 1: acknowledging

I share here, because many of us are somewhere along the path of acknowledging that we have been beating ourselves up for years, know we need to make changes, and are trying to understand how to unlearn to relearn.  

But how do we unlearn a way of thinking and being that we have practiced for so long? 

Here, we have already completed Step 1. Acknowledging. 

Then what?

I’ve heard the “fake it to you make it” mantra, but my mission on the journey to reclaiming life has been to live authentically. Is faking anything really a good idea? 

With my mission to live with integrity and help others to do the same, the caveat for this next lesson is to not fake something you do not want to ultimately believe or become. Which leads into a comment from Amy Cuddy’s TED talk on presence titled “Your body language may shape who you are” where she suggested that rather than faking it until we make it, “fake it until you become it.”

How do you do that? 

In our quick fix society, we often hear grand plans to make drastic changes all at once, however, sustainable, long-term results come from small changes compounded over a long period of time. 

Leading us to Step 2. Identify the next best (small) step for you.

Step 2: the next best step

An initial step may be observing when your inner critic is not serving you.  

Then, stop and reframe the thoughts into more productive considerations. 

For me, this change has resulted in creation of meaningful growth opportunities rather than self-sabotaging spirals. It’s a change you can test, today, by observing your thoughts and becoming in tune with how they make you feel and act. 

If the thoughts are not serving you, stop and reframe- it may be helpful to solicit the support of a therapist and/or coach during this relearning depending on your needs. 

When you reframe your self-talk into more compassionate, growth oriented thoughts, tune into how the reframe makes you feel and act. 

When we create a more self-compassionate dialogue and boundaries within our own minds, we may better position ourselves to identify where we need to create boundaries in other areas of life. 

When I stopped bullying myself, I no longer tolerated poor treatment from others. Self-compassion organically led to firmer boundaries.

Boundaries lead to self-compassion

How do boundaries help with improving our ability to provide compassion? For me, firmer boundaries increased my level of psychological safety, feeling more capable of protecting myself from harmful comments. This allowed me to become more vulnerable and open to truly connecting with people while managing my time and energy. Results? I have been much more available to provide compassion to others.  

Like me, many resist leaning into self-compassion for fear of looking soft or self-centered. Many resist boundaries for fear of coming across cold.


It’s time to challenge those beliefs. 

As people who rely on evidence, ask yourself what lies at the core of mental toughness and what are the key traits of people who are most compassionate? And then refer to the wonderful work of Dr. Brené Brown, whose messages I have validated over and over again in my unofficial case study titled- my life (wink). 

Let me know how the messages land in yours.

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