How to Set Boundaries as a Woman Physician Attending Workbook by Tamara Chang

BOUNDARIES WORKBOOK HOW TO SET BOUNDARIES AS A WOMAN PHYSICIAN ATTENDING

WHAT ARE “BOUNDARIES”? As a physician, and especially as a woman physician attending, we have countless

responsibilities and demands on our time, attention and energy. Everyone and everything

constantly demands something from us, from our patients, staff, colleagues, email, in-basket

messages, telephone calls and lab results to our aging parents, our spouses and partners, our

children, pets, household chores, dry cleaning, grocery shopping, neighbors and bringing

home baked cookies for our child’s class party at school. From the moment we wake up to

the moment our exhausted heads hit the pillow, we are bombarded by countless demands on

our most precious and most undervalued resource, our life energy.

How does this resonate for you? Can you relate to this feeling of having an endless to-do list,

of having pressures and demands on your time pulling you in every direction, leaving you

feeling depleted, exhausted and burnt out at the end of the day?

Many of us resort to catching up on much-needed sleep and exercise on weekends, or our

one day off, only to start the endless cycle again a day or two later.

We thought our lives would get easier after we finished our grueling and often inhumane

residency and fellowship training years, only to find that our lives as attending physicians

were to be no better -- and in many instances even worse -- than during our training.

I was first introduced to the concept of boundaries as a first year attending physician, at the

large and rigorous academic hospital where I completed my fellowship training. I had never

understood what boundaries meant, having always dutifully fulfilled the role of the eager,

pleasing, hardworking and reliable medical student, resident and fellow. Not until I became a

young attending physician did I learn, the hard way, what lacking clear boundaries could

mean for me and my own quality of life, at work, at home, and everywhere in between.

Drs. Henry Cloud and John Townsend present a helpful metaphor in their excellent book

“Boundaries.” They describe our physical world as having clear boundaries, in the form of a

fence, property lines, and moats with alligators. Our personal boundaries are invisible to the

eye, but just as crucial and necessary to our survival. They help us to define ourselves: what is

us, and what is not us. Knowing what is our responsibility, and even more importantly what is

not, gives us freedom.

And freedom is what I want for YOU!

In this workbook, I will take you through a series of exercises to explore and define what

having boundaries means and could look like for you. I most love the metaphor of the simple,

beautiful but sturdy picket fence around the perimeter of our home. Our fence provides a

line, a boundary, but there are also several doors in our fence that you can choose to open

and close when you wish. You, and only you, have the power to open these doors to your

fence. Otherwise, your protective and loving pet dog (I will let you fill in your favorite breed

and name) will come out to ward off unwanted visitors…STAT!!

Let’s Do This…!!

WHERE DO I FEEL ENERGY? WHAT DRAINS MY ENERGY? One way to begin to understand where we need to work on setting clearer boundaries is building

our own internal self-awareness of what brings energy, and what zaps our energy. I know, deep

down, that you know this intuitively!

In this worksheet below, brainstorm and make a list of every task, person and activity that

demands your time and energy, from the time you wake up until the time you go to sleep. In the

right column, there is a box to check “yes, this gives me energy,” a box to check “no, this zaps my

energy,” and a box to check “meh, somewhere in between.”

ACTIVITY, PERSON OR TASK

GIVES ME ENERGY

ZAPS MY ENERGY

SOMEWHERE IN BETWEEN (“MEH”)

WHERE DO I FEEL ENERGY? WHAT DRAINS MY ENERGY? (CONTINUED)

ACTIVITY, PERSON OR TASK

GIVES ME ENERGY

ZAPS MY ENERGY

SOMEWHERE IN BETWEEN (“MEH”)

BRAINSTORM Now take every activity, person or task that you marked as zapping your energy, and put

these items in the list below.

Now brainstorm in the column to the right about where you need to set boundaries and what

boundaries you can set for this specific item.

MY ENERGY ZAPPERS

ACTIVITY, PERSON OR TASK

WHAT BOUNDARIES DO I NEED TO/CAN I SET HERE?

BRAINSTORM MY ENERGY ZAPPERS (CONTINUED)

ACTIVITY, PERSON OR TASK

WHAT BOUNDARIES DO I NEED TO/CAN I SET HERE?

REFLECTION: WHAT ARE YOU NOTICING? What have you noticed so far about the items that zap your energy, and the kind of

boundaries you’ve identified that you might need to make?

What is important to you about these boundaries?

What is

not setting boundaries in each activity, situation or interaction costing you?

BRAINSTORM

What can we do about the items in your “Meh” column? Do the same exercise below as you did for your Energy Zappers. What do you notice as you

fill out the table below?

MY ENERGY “MEH” ITEMS

ACTIVITY, PERSON OR TASK

WHAT BOUNDARIES DO I NEED TO/CAN I SET HERE?

BRAINSTORM MY ENERGY “MEH” ITEMS (CONTINUED)

ACTIVITY, PERSON OR TASK

WHAT BOUNDARIES DO I NEED TO/CAN I SET HERE?

REFLECTION: AGAIN, WHAT ARE YOU NOTICING? What have you noticed about the items that feel like “meh” to you, and the kind of boundaries

you’ve identified that you might need to make?

What is important to you about these boundaries?

What is

not setting boundaries in each activity, situation or interaction costing you?

EXERCISE: NARROWING IT DOWN Now, go back and look at your table of Energy Zappers, and your table of “Meh” items.

Circle all of the ones that you most want to be rid of.

Now look at the ones you’ve circled. Pick one, the top one, that you want to commit to

changing

today, right now.

Write this one below. What are the steps you will take to make this needed change and

boundary in your life?

MY TOP NUMBER 1 ENERGY ZAPPER/MEH:

BOUNDARIES I NEED AND HAVE TO MAKE:

BRAINSTORM: ALLIES FOR CHANGE We all know that we don’t live in a vacuum. Often it’s other people in our lives who

unintentionally contribute to zapping our energy when we don’t have clear boundaries.

When you are making a change, or creating a new boundary in your life, this can be

confusing for other people who aren’t used to you saying “no.” What, you’re saying “no” to

baking six dozen homemade treats for your child’s 3rd grade bake sale (post call, after being

up for the last 40 hours performing emergency surgery)??!!

When we are making a change, it helps to be clear about this change to others. This helps

avoid unnecessary confusion, resentment, or hard feelings. It’s all about communicating our

needs and wants to others. Always be clear, because it treats others with love and respect,

and treats you with love and respect. It helps others treat you with the love, compassion,

kindness and respect that you want and deserve. Just as I know you would do for others.

Below, brainstorm who in your life you need to make an “Ally” in your quest to set a clear

boundary for your #1 Energy Zapper. What do you need to communicate to these people, or

what do you need from them, to make your new boundary a success?

ALLY

WHAT DO I NEED TO COMMUNICATE TO THIS PERSON? WHAT DO I NEED FROM THIS PERSON?

BRAINSTORM: ALLIES FOR CHANGE (CONTINUED)

ALLY

WHAT DO I NEED TO COMMUNICATE TO THIS PERSON? WHAT DO I NEED FROM THIS PERSON?

MY BOUNDARY GAME PLAN: PUTTING IT ALL TOGETHER.

Print out a copy of page & fill in.

POST

Now post this somewhere you will see it often, wherever you need this boundary most in your life. This could be tacked on a corkboard above your desk, taped to your computer monitor, or taped to your refrigerator door. My personal favorite is taping reminders to my bathroom mirror!

HONORING MY BOUNDARIES

MY TOP NUMBER 1 ENERGY ZAPPER/MEH:

BOUNDARIES I WILL SET:

MY ALLIES:

CONGRATULATIONS! You’ve now successfully created a game plan for setting clear boundaries on your top number one energy zapper/meh!!

You can go back and work through this workbook, one item and one boundary at a time, as many times as you want, as often as you want to. I recommend that you go through a similar process periodically, as our energy and interest in an activity or task can change over time. I view this as taking an inventory of your life energy, to help you determine where you need to create more clarity around your own boundaries, time and energy.

We all have created goals and game plans before. Now, what I challenge you to do is to find someone (or several someones) in your life to hold you accountable. Someone who will be tough on you and call you out when you aren’t following the plan you’ve created, but also someone who knows deep down that you are a naturally strong, creative, and resourceful badass woman who is fully capable of tackling any task or challenge. And ultimately, I challenge you to find someone who will love you and help you to have love and compassion for yourself, regardless of the outcome.

If you want a loving, kind but firm partner to help you be accountable, to recognize you as naturally strong, creative and whole, and to hold you to your promises to yourself, I am here for you. Nothing brings me more joy, or moves and motivates me more, than helping other brilliant women physicians step into their most powerful, joyful and authentic selves. Learning how to set boundaries, one boundary at a time, is the first step to allowing you to truly become the most fulfilled and powerful version of you.

To find more free resources, and to learn more about how I can help support you, visit me at www.tammiechangmd.com.

With awe and full belief in YOU..!

EXTRA NOTES Space to write extra thoughts: