karyn shanks md functional medicine healing creating personal boundaries self-care healing

Learning to Say “No” and “Yes” to Heal Our Lives

Creating Boundaries is Part of Good Self-Care

I used to not know how to say “no” to the people in my life–my clients, my family and friends. I didn’t want to disappoint them. I felt that to be the perfect everything (ha) and to earn the love and approval of the people in my life, I had to take care of everything, always be available, never ruffle feathers, and meet everyone’s demands and needs. I look back on this now and have to catch my breath. That was such a pathological way to think. It sapped my energy and strength and stole from the gifts I had to give to this world. I had to make drastic changes in the way I operated in my life.

Healing my own life meant learning to say “yes” to myself, to create boundaries, as a reverent act of self-care. I had to embrace that I am a sensitive human being with limitations and I cannot be all things to all people.  My energy is precious. My loving self-care preserves my energy and makes me the very best I can be. It means I stand alone at times, but I feel better and have more to give to the people in my life. I’ve had to let go of my fear that I will offend the people who want my attention and energy, or that I won’t be good enough if I’m not always available. Strong personal boundaries have made me a happier, healthier, and a better member of the human community.

Poor Personal Boundaries is an Epidemic

I see how poor personal boundaries effects the health of my clients as well. In fact, I am dumbfounded by the lives of many of them, who serve others so selflessly and tirelessly and yet reserve no time, energy or attention for themselves. They spend long days at the office, mostly sitting, continue to stay plugged into their work through email and texts after hours and give endlessly to their family members. Their phones are to their ears constantly, while driving, while in the store, while picking the kids up from school. They go to bed late and get up early and often sleep poorly in between. Many of them exist on fast food, eaten on the run, and caffeine, lots of caffeine, and sugar. They may move very little. There may be no time for reflection, rest or play and no hobbies, community or lunch with friends. They’ve given all of their energy away to others and saved nothing for themselves.

Many of my clients live in their heads, creating and reacting to their own and others’ drama and are completely disconnected from their bodies. They are anxious, their bowels are sluggish and they are exhausted. But they push on.

And there is always fear somewhere beneath the surface: of not being enough, of not doing enough, of not carrying enough weight, of being guilty and imperfect, of being shamefully something other than what they think they should be.

Many of us have poor personal boundaries because we are driven by insecurities, trying to be good enough, trying to prove ourselves, to become successful in the world. And yet this is not the way any one of us would treat another living thing. We save the very worst treatment for ourselves.

Sound familiar? Just a bit?

Treating ourselves this way is self-violence, pure and simple, and it is far too common. It stands squarely in the way of all opportunity for healing. This cycle must stop for healing to begin.

We Must Create Strong Personal Boundaries to Heal Our Lives

Creating strong personal boundaries protects our energy and makes us better people, with more to contribute to our world. This is a crucial aspect of self-care that will lead to healing.

How to Recognize When You Need  Stronger Personal Boundaries:

  1. When your self-care practices consistently fall by the wayside in favor of everyone else’s needs. This includes setting aside enough time for good sleep, nourishing food, movement, and play.
  2. When you end each day feeling exhausted and depleted.
  3. When you find yourself saying “yes” to everything, when you really want to say “no.”
  4. When you find yourself becoming easily overwhelmed with your daily life.
  5. When you find yourself feeling angry or resentful for what you do for others.

Saying “yes” to any of these statements may mean that your tank of energy is being depleted in favor of what you do for others. If this becomes a long-standing pattern, you are at major risk for burn-out, exhaustion, and illness. It’s time to make yourself more of a priority.

Creating Strong Boundaries for Me Starts With Self-Care

It’s taken many years, and I am still a work in progress, but I’ve been able to establish healthy boundaries in my life. For starters, I am militant about my self-care. This is the foundation to my life and is the only way I can feel my best and deliver the best of me to the people in my life. I make sure I get enough sleep even if I have to be a party-pooper when everyone else in the house wants to stay up. I get up by 6 am every morning and get my tea, write in my journal and meditate. I go to my gym for class or do yoga every day during the week and hike on the weekends. I take the time to prepare healthy food and stay well hydrated. I set my work hours the way I need them to be, clarify my important tasks and schedule them in. This includes checking email and phone messages. I try my best to avoid multi-tasking, which makes me feel stressed.

I’ve had to work especially hard to set boundaries with my clients at work. Many of them are working hard to recover from chronic complex illness, need a great deal of support, and I empathize strongly with them. I used to spend a great deal of time on the phone with them, as well as going back and forth through long emails. This was a highly inefficient use of my time, already tightly scheduled with other clients and tasks that needed my attention, and it sapped my energy. I also learned that email is not a good way to communicate about complex and important issues. I came to realize that if the problem is urgent, it is always best to talk, and rather than trying to squeeze these conversations in willy-nilly, I started insisting on scheduled time together, when I can be one hundred percent present for them and we can focus all of our energy during that time on their healing. It’s been a challenge to say “no” in this way, but it’s better for me and far better medicine for my clients.

How to Create Strong Personal Boundaries and Recover Your Energy:

  1. Begin by saying “yes” to yourself through self-care: create a plan for the essentials: sleep, food, movement and play.
  2. Understand that creating boundaries and making self-care a priority is not selfish–it’s our obligation to ourselves and those who love and depend on us.
  3. Listen carefully to your wise inner voice. What does she/he have to say about what is best and true for you? 
  4. Prioritize where your energy goes each day. Stick with the activities that have the most meaning for you, and say “no” to the rest.
  5. Ready yourself for the backlash. Those who love you will support you, but there may be an adjustment period as they get used to having less access to you. Fear not, as it will be worth it for them!
  6. Avoid people with negative energy. You know who they are–they’re the ones who deplete our energy or feel toxic to be around.
  7. Take heed of what your body tells you. The persistent fatigue, headaches or gut symptoms are how your body is letting you know that things are out of balance and require your attention now.
  8. Practice. It might be hard at first, and scary. Practice will always make progress.

We practice self-love when we establish strong personal boundaries. When we step up to this challenge, we do heal, and we inspire others to do the same. We’re all desperate for the call to rest and care for ourselves mindfully.

Self-love means letting go of the fear that we have to stay hooked-in to everything and everyone, all around us, all the time.

We must let go of that, at least some of the time, and surrender ourselves to the vulnerability of just being, just us, honoring ourselves, just as we are, by creating strong, positive, protective boundaries.

I love the words of Marianne Williamson, from her famous quote, that so many of us have heard or read, from A Return to Love: Reflections on the Principles of A Course in Miracles. I think she’s nailed the origin of our fear–our fear about self-care, having boundaries, and becoming our best selves:

“Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure. It is our light, not our darkness that most frightens us. We ask ourselves, ‘Who am I to be brilliant, gorgeous, talented, fabulous?’ Actually, who are you not to be? You are a child of God. Your playing small does not serve the world. There is nothing enlightened about shrinking so that other people won’t feel insecure around you. We are all meant to shine, as children do. We were born to make manifest the glory of God that is within us. It’s not just in some of us; it’s in everyone. And as we let our own light shine, we unconsciously give other people permission to do the same. As we are liberated from our own fear, our presence automatically liberates others.”

Our boundaries help us shine our brightest light. There is no more profound gift we can give to ourselves, the people we love, and to the world.

Share your personal boundary story with us. How have you said “yes” or “no” to step up for yourself?

Karyn Shanks MD


Karyn Shanks, MD, is a physician who lives and practices in Iowa City. Her work is inspired by the revolutionary science of Functional Medicine, body-mind wisdom, and the transformational journeys of thousands of clients over her twenty-eight year career. She believes that the bones of healing are in what we do for ourselves.


    As I was reading your message, I had noticed on my phone that I had missed a phone call and then a text from the same person, wanting to connect with me. I had already opted to not reply as I had been providing a listening ear and support for the past week regarding both her personal and professional life. In fact, I practiced saying a mantra to myself that essentially was reminding me that her problems were hers, not mine. I had provided possible solutions but until she is ready to change her behaviors, her surroundings, and her choices, nothing I say or do will make a positive difference or help our relationship. For both her mental health and mine, I am choosing to give her time and distance to process the options and choose for herself what would benefit her the most. If she chooses to continue complaining without changing, than my boundaries will become stronger. If she chooses to change what she can, I will support and encourage her. The decisions is hers to make, not mine. That gives me the freedom to say “yes” or “no” and abide by my decision.


    Sue, you made a deeply positive contribution to her by being present and listening. She benefits from that whether she chooses to make changes right now or not. And ou are right, her problems are not yours. But they are “sticky” aren’t they? Maintaining strong personal boundaries with people who are suffering and in need is so challenging! Stay strong.


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