The Challenges of Boundary Setting in Addiction Recovery (and What to Do About It)
You have heard it many times in recovery. Whether during therapy sessions, in groups, or from loved ones, you need to establish better boundaries.
You know you need to do this. You know it when you feel that familiar tightening in your chest whenever someone asks for something that you are unable to give at the moment. You feel it when you agree to do something you desperately want to refuse because the resentment builds up. It is essential to remember that your recovery depends on you taking proper care of your time, energy, and mental peace. Nonetheless, when the moment comes, you end up saying yes again.
That is not a question of willpower or lack of character. And it certainly will not be solved by motivational quotes. There are many factors that make boundary-setting a challenge, and all of them can be connected to the psychological issues involved in addiction and dual diagnosis.
How Boundaries Relate to Dual Diagnosis
For people living with mental disorders related to drug abuse, boundary-setting is not merely about personal growth. It is a clinical priority.
According to some studies, poor boundary management is a risk factor for substance abuse and relapse. The tendency to agree when you need to say no leads to problematic social interaction, enablership, and high levels of stress that jeopardize recovery. At the same time, in the context of co-occurrence of mental disorders and substance use, problems with boundary-setting often happen due to complex emotional experiences related to both conditions.
When working with patients at Dunham House, the issue of difficulty setting boundaries frequently arises. A patient may come prepared to make certain changes within the realm of their relationships. But once they attempt to introduce those changes, they face obstacles not in their mind but their emotions. It is not as though they are not aware of their situation. It is as though they fail to take necessary steps because of certain emotions.
Let us name them.
Guilt: The Idea of Saying No Is Unethical
Guilt is the experience of being responsible for doing something wrong. In relation to boundary-setting, guilt is associated with seeing saying no as immoral. In other words, you feel that you should say yes because a person who cares and loves should be nice. You override your natural instinct and act against your better judgment just because of your desire to feel good about yourself.
For people in recovery, the issue of guilt may arise out of the guilt for causing harm to their loved ones. The reasoning may seem quite simple and logical: I have done so much damage, so now the least I could do is always say yes and offer my help. As a result, patients find themselves spending a lot of unnecessary time trying to assist someone or meet unreasonable expectations.
According to cognitive-behavioural therapy (CBT), such thoughts are distortions. Saying yes always is not an objective truth; it is a belief. And since beliefs can be questioned, it means that there is a way to get rid of your unhealthy patterns.
Shame: The Idea of Not Being Worthy of Anything
There is a difference between guilt and shame. Guilt concerns an action. Shame concerns oneself as a person. In relation to boundary-setting, the latter means that the reason behind your failure to stand your ground may be the perception of your inherent unworthiness. If you think that your needs are less important than the needs of others, you will never advocate for your rights because you believe that you do not deserve anything.
As it has been mentioned earlier, people struggling with co-occurrence often have certain shame issues. This emotion may manifest itself due to isolation and self-perception as unique and particularly broken people incapable of seeking help from others. Working on these issues requires more than just changing thoughts.
It requires experience and support provided by therapists. People need to be surrounded by an environment where they are treated properly and where expressing their feelings will only lead to more care and kindness. Residential treatment facilities can play a crucial role here.
People-Pleasing: The Desire to Please Others
Human beings are social creatures. Our nature makes us uncomfortable about disappointing other people. People-pleasing is a behavioural issue that involves agreeing with other people even though they have the right to disagree because of the fear of causing harm to someone they care about.
One can say that in childhood, people-pleasing was a survival strategy. When you felt that love and respect were not unconditional in the family, you started prioritizing the needs of other people. However, in adults who are supposed to have developed certain life skills, the desire to satisfy everyone around becomes a significant obstacle to recovery.
That is why dialectical behavior therapy (DBT), a technique widely used at Dunham House, includes skills training to improve interpersonal relationships and learn how to set boundaries.
Fear of Conflict: The Idea of Breaking Relationships
When you have spent years trying to avoid conflicts at any cost, setting boundaries becomes a challenge. Every new opportunity to say no to someone means a potential problem, so you end up neglecting your own needs to prevent something worse from happening. However, the result is obvious. Resentment starts building up inside you until it finds a way to escape through passive-aggressive attitude or relapse.
It appears that many patients have a false belief concerning the impact of conflict on their relationships. In fact, the lack of disagreement indicates that these connections are fragile. Saying no is neither a sign of disrespect nor a reason for breaking a bond. On the contrary, the absence of boundaries and the inability to communicate freely is what makes people leave.
Clinical work can help you understand how to tolerate the discomfort associated with confrontation and communicate your needs without damaging other people's feelings.
Fear of Losing Control: The Idea of Taking Everything into Hands
Another paradoxical aspect of boundary issues is the fear of losing control over something. It is as though the more responsibilities a person wants to shoulder, the greater the feeling of power and authority. For individuals recovering from substance abuse, it may appear that taking care of everything alone means taking control of their destiny and refusing to rely on anyone else.
As a result, these people end up struggling with managing themselves. They refuse to follow schedules suggested by clinicians and believe that they can cope with their problems single-handedly. Moreover, some of them try to handle others' problems as well. Instead of focusing on their rehabilitation and attending therapy sessions, they become informal councillors for people in similar positions.
However, trying to take too much upon yourself is the way of losing control. It is impossible to manage your schedule, energy, and psychological state without boundaries. So, you may find yourself exhausted by constant attempts to meet unrealistic standards.
Fear of Consequences: What Will Happen if I Set a Boundary?
Sometimes the unwillingness to put yourself first in the process of building healthy relations is based on rational ideas about what can happen if you say something that goes against the will of other people. If someone relies on you financially, emotionally, and professionally, it is natural to assume that your decision to set boundaries may cause adverse reactions.
These concerns can be addressed in the context of therapeutic work. First of all, it may require separating realistic expectations from distorted thoughts and learning ways of handling difficult situations safely. Second, you may be introduced to the method of setting boundaries gradually so that they do not feel overwhelming. Last but not least, clinical support may help you decide which people need you to say yes regardless of your needs.
Building Boundary Skills in Recovery
As it has been mentioned, knowing what you need to do and actually doing it are two different things. In other words, it is impossible to change your behavior just because you know what you have to do. The ability to set boundaries is formed through work on underlying emotions in a carefully controlled therapeutic environment where patients receive the proper support of highly skilled professionals.
At Dunham House, setting boundaries is part of the entire recovery process. It comes up during various sessions and helps patients learn about the importance of protecting their time, energy, and feelings in the process of building healthy relations.
If you or someone you care about is ready to build the skills that lasting recovery requires, call us at 450-263-3434 or visit dunhamhouse.cato learn more about our residential programs.
Dunham House
About Dunham House
Located in Quebec's Eastern Townships, Dunham House is a residential treatment centre specializing in addiction and providing support to individuals with concurrent mental health challenges. We are the only residential facility of our kind in Quebec that operates in English.
Our evidence-based programs include a variety of activities such as art, music, yoga, and equine-assisted therapy. In addition to our residential services, we offer a full continuum of care with outpatient services at the Queen Elizabeth Complex in Montreal.