82. Boundaries, Burnout, and the Right to Walk Away

Hey Doc,

This one’s different.

In format and in focus.

In this episode, I’m sharing excerpts from a book that reshaped the way I think about boundaries.

It’s called Boundaries After a Pathological Relationship by Adelyn Birch.

Yes, it’s about toxic romantic relationships... but when I read it, it felt like it captured everything I’ve experienced while in medicine.

The way we’ve been trained to tolerate mistreatment, to deny our needs, to believe we can’t leave... It’s the very definition of a dysfunctional relationship.

And most of us are still in it.

You’ll hear some of the most soul-shaking passages from the book and I’ll unpack them through the lens of physician motherhood. Because boundaries aren’t just about saying no. They’re about reclaiming your time, your worth, and your right to want more.

In this episode, you’ll hear:

• Why confrontation isn’t a character flaw, and what it actually signals
• The radical idea that your wants and needs are legitimate (yes, even as a doctor, even as a mom)
• How medicine gaslights physicians into forgetting their power — and how to take it back
• A list of your basic human rights in relationships that will stop you in your tracks

If you’ve ever felt stuck, dismissed, or just deeply tired this conversation is for you.

Not to fix it all.

But to remind you that your truth matters.

And you don’t need permission to honor it.

🎧 Tap play. Then send this to another physician mom who’s been silently questioning everything.

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Transcript

Hey Doc, this episode I'm gonna do something a little bit different. I'm going to say some things that I want to just provoke thought. I'll give some context, I'll give my opinions, but I really want you to hear these things and see if and how. It relates to your life.

So we're gonna talk about boundaries, but very specifically, I'm going to read a couple things from. One of my all time favorite personal development books, which I don't know if the author would describe it as that, but I took it as that it is called Boundaries After a Pathological Relationship by Adeline Birch.

And yes, the book is about romantic relationships, toxic romantic relationships. But when I read it and it was, I read it on the recommendation of my coaching mentor, who's also a relationship coach, because she thought that it would be helpful for my clients and I, I read it. And I was like, oh my gosh. Yes, but not in the way you would think.

Not because most of my clients are married and they may be in a toxic relationship. It was actually because I believe that many of us are in toxic relationships, pathological relationships with medicine, and I saw so much of my own journey with medicine, burnout and all of that. In this book and all of my colleagues and all of us who have been employed and have to navigate what medicine has become.

So I'm gonna read a couple things. I'm going to give my own opinions, but I really want you to. See if and how any of this relates to you, and then have it like provoke some, some thought and maybe put some attention there and see what, what needs to change because. The way I approach this book is the way I approach most things that I read in this space.

It's like I take what is related to me. I take what I need and I leave everything else. So I feel like, eh, that's not really related to me. Then just leave it. But I am pretty sure there's stuff that you're gonna be like, oh, well, damn right, because, you know, boundaries is like a hot, hot topic. Everybody's like, oh, you need to have stronger boundaries.

And they didn't respect my boundaries but I think this is going to present the idea of boundaries and what they mean and what they're for in a very different way. Certainly the, the most unique way that I had ever heard it presented. And I, I, I really liked it and I think it will be helpful for you.

Okay. So yes, I'm going to be reading directly from a book. If you are interested, you could definitely go ahead and get it and read it yourself, but I know you're busy, so I'm gonna do it for you. And it's a really short read. It's like 50 something pages, I think it's good to get the entire thing.

'cause of course I'm just gonna do small snippets. and it's a very quick listen as well. Okay, so I wanna start off with definitions because you know, you hear people talk about boundaries, but if somebody asked you right now how would you define a boundary?

What would you say? I don't know that I would necessarily have like a definition. I would go into like a description or something, but I really like how. She references it in this book, and she references a lot of other people and stuff, and I made it very clear. I'm reading directly from her book, so I'm not going to cite every single person, but this description I thought was really good.

So they describe boundaries as limits you set to protect the integrity of your day, your energy, your home. Your money, your health, your children, your priorities, the health of your relationships and the pursuits of your heart is not amazing. Like boundaries protect all of those things. So if that's the case, why don't people like to have boundaries?

Because you know, some people think, oh, well I don't wanna have boundaries at. Sets people away from me. I, I don't wanna be mean. So she goes on and talks about that. And even if that's not a direct thought, the actions of some people of not holding firm boundaries says that they believe that boundaries are not important or it's a mean thing to have or defend and causes lack of intimacy.

So, um. She goes on to say, many of us find it hard to set boundaries and defend them because we fear doing so will cause rejection or abandonment. We may wish to avoid confrontation. We may feel guilty if we say no or think we might hurt someone's feelings if we do. So I just wanna pause there because one of the most common things that I hear is I am a non-confrontational person and there's this.

I don't wanna go off too much on a tangent. You know, I like tangents, but there's this idea that all confrontation is bad, and all confrontation is negative, and therefore, being a non-confrontational person is of virtue when confrontation is necessary. And it doesn't mean that you're angry and like nobody likes to be around you.

And it, it doesn't mean all of that. It can just mean that you are defending a boundary. It can just mean that you are addressing an issue that you have. It could be calmly, it could be funny, it could be a joke, it could be whatever, right? But there's, there's this idea that confrontation must be avoided at all costs.

And if that's the case, then are you willing to defend your boundaries? Because that would often. Need a confrontation. So again, something to think about. So she goes on to say, if we're afraid to have boundaries, it means we care more about what others think, about what others might think of us than what we think about ourselves.

In doing so, we lose respect for ourselves and our self-worth suffers.

That was a dramatic pause. Sometimes overly conscientious people equate acting in their own best interest with being selfish, nothing can be further from the truth. Taking time and care to tend to your own legitimate wants and needs, while not unnecessarily inflicting harm on others, IE self assertion is perfectly healthy and desirable.

So I just wanna talk about that a bit this idea of legitimate wants and needs and the denial of one's own wants and desires is how you may hear me talk about it. Because there are a lot of us who feel like our wants and needs are illegitimate, that they don't deserve to be honored, that we are not allowed to have wants and needs as mothers and as physicians.

That is something else that I want you to reflect on, like do you think. That your wants and needs are legitimate, and if so, then taking the time and the care to tend to them is perfectly healthy. So when I say to take a vacation by yourself or honor whatever other desire that you have, and your reaction is like, oh, I could never do that,

then are you setting yourself up for a way of thinking that cause you to not have boundaries or have weak ones or not defend the ones that you have because remember. Boundaries are the limits that you set to protect the integrity of your day, your priorities, your money, your home, and the pursuits of your heart.

Those are your legitimate wants and needs, so it's all related. And if you have an issue with boundaries, I hope that this may be illuminating for you to really point and see. Okay, well. Maybe this is, this is what it is. Maybe. I don't think my wants and knees are legitimate. Maybe. I do think that honoring them is selfish.

Maybe I worry too much about confrontation. okay, there's this other really great quote. When we don't have boundaries, we neglect who we are and what we want. As a result, we see the skewed image of ourselves reflected in the eyes of those to whom we give our power, and we mistake them for the truth.

So Doc, when your employer says that you are dispensable. Indirectly or directly when they say you are nothing more than a secretary, IE, you have to manage his inbox. You have to stay late to do it. You have to work through lunch. When they say that you have no transferable skills, and when we believe them and say things like, well, I can't leave. I have golden handcuffs. I can't be hired anywhere else. I can't leave medicine. I have no transferable skills. Every place is like that. They, they won't change. We are giving them our power and we are mistaking this skewed image that corporate medicine has, or current medicine, I should say, of physicians.

And we are accepting it as the truth. If we say no, well, that's not who I am as a physician. My worth is way higher than that. I do not need to be drowning in notes and admin work.

This needs to change.

and the change comes with holding and defending firm boundaries.

But we neglect who we are and what we want and stay beholden to these jobs that really believe us to be worthless and would switch us out with a a PP just like that. Which actually I hate that term with a mid-level, right? So. Just like, think about it,

are you giving away your power? Are you believing what they are saying about you? And Jess is like, well, this is how it is. I mean, what else am I gonna do? Every way is like this. You know, the only other option to start a practice, and I don't wanna start a practice or whatever else it is that you are telling yourself that is causing you to neglect who you are and what you want, and accepting the skewed image of yourself as the truth.

Okay, so let's, let's move on. So this is my actual favorite. Part about your human rights,

and this is a way to talk about boundaries that I had never heard before, and I was just like, oh my gosh. Yes. So basic human rights are the foundation of our boundaries. All of us have these rights within our relationships with others.

Unfortunately, they often get trampled or forgotten as we make our way through life. And some of us never knew these rights belonged to us in the first place.

So I'm going to read this list of basic human rights in relationships and stop at the ones that I feel like are particularly. Relevant for us as physicians and physician moms. So these are your basic human rights and relationships. I have the right to my own needs and feelings and to have them be as important as anyone else's.

I just wanna pause for a second because I just like, every time I read this parts of this book, I'm just like, oh, it's so good. the fact that these are written as I statements. I think a very powerful, I'm sure she did it on purpose because I've talked about this before. When you say an I statement, it is a powerful thing for you, for your subconscious, for your identity.

'cause your mind does not know or care whether you believe what you're saying or not. It accepts it as the truth. So when you say I have, I am, it's instructions. To order your steps to and how you live your life and how you show up in the world, the decisions that you make, which is why we have to be so careful about the things we say about ourselves to ourselves.

If you're saying, I'm a bad mom, if you're saying I'm an idiot, if you're saying whatever else that starts with I, it is affecting you. It may seem like a one-off statement, but it, it is affecting you in some way, shape, or form. So. We have to be so, so careful with these statements. So it is very powerful to read these lists of basic human rights.

As I statements. It really makes it hit home right, because as she said, basic human rights are the foundation of our boundaries. Okay, so I'll read that first one again. I have the right to my own needs and feelings and to have them be as important as anyone else's. I have the right to experience my feelings and to express them if I want to.

I have the right to express my opinions. I have the right to decide what my priorities are. I have the right to be independent if I want to be. I have the right to decide how I spend my time. I have the right to choose how I live my life. I have the right to change myself, my behaviors, my values, my life situation, and my life.

How many of us feel like we set off on this path? We wanted things in the past.

We had our plan for our life. We are, we are planners, type A planners, end. At all. You feel like, well, this is not what I wanted. This is not what I thought it would be. There's this resistance to changing, like we are not allowed to change. We set off on this path. This is what you wanted.

This is what you work for, but you have the right to change yourself, to change your behaviors, your values, and your life situation and your life. It is a right. Okay. I have the right to change my mind very closely related to that one before. Right? Just think of the things that are going on in your life right now, and when you have said, well, this is what I wanted.

my family will judge me if, how do I explain this? But you have the right. To change your mind. I have the right to make mistakes. Now, this one, I feel like is particularly difficult for physicians because in one realm, if we make mistakes, people die. So to believe that you have the right to make mistakes seems like a foreign idea.

Right, because these stakes are so high, and I think we allow that to translate into every other part of our lives because of the perfectionist tendencies. And you know, medicine takes up so much about lives, but there are other relationships there, other situations even within your practice in medicine, because you're human that allow you to be human and give you the right to make mistakes so you are not less worthy. You are not a failure if you make a mistake because it is a basic human right. I have the right to ask for what I want. Now, this is one of my favorites because I'm big on asking and. I know so many. It may even be you, doc, so many physician moms who have trouble with asking for whatever reason, either feeling like they're not allowed to, not, not wanting to, because of what it would mean, not wanting to admit to.

You need help needing to prove to yourself and others that you can do it alone for whatever reason. Asking for help is a big barrier for a lot of us, but I'm telling you, it is a basic human right. I have the right to ask for what I want, and if what you want is help, then ask for it. If what you want is a raise, then ask for it.

If what you want is to work part-time and somehow. Make the same amount of money. Ask for it. It is your basic human right. I have the right to walk away from relationships that I determine are not good for me. Now, doc, this is the one. This is the one that I think hits the closest to the relationship a lot of us have with medicine.

I have the right to walk away from relationships that I determine are not good for me. How many of us are staying in toxic job situations? Not even toxic, just ones that don't align, that don't allow for your life as a mother who may not have as much support, who may not have an involved partner, who may not have family around it may not be good for you.

You have the right to walk away, And your wants and needs are legitimate, so protect them, right? I have the right to have my boundaries respected and. Having your boundaries respected is actually not anybody's responsibility. So I hear a lot of people get really upset that others are not respecting their boundaries, and she talks about this in, in the book,

the good people in your life are going to respect your boundaries. People that are bent on taking advantage of you, who you are in a a pathological relationship with, they, they're not gonna respect them and they're actually going to make you feel as though you're wrong for having them. But it is up to you to defend your boundaries, and if somebody is not respecting them, it is up to you to give them consequences because.

If they don't respect them and you don't do anything about it, then they're gonna be like, cool, this is okay. And they're going to continue. So if you don't remove yourself from the, the relationship, if you don't give a warning consequence, if nothing ever happens, then they're going to continue. And unfortunately, doc, that's on you, right?

So hopefully hearing about boundaries in this way as a protection of the things you hold there as a protection of your rights, then you will realize the importance of having and defending. Your boundaries and it'll give you kind of some context to maybe some relationships that you have going on in your life right now or some insight into past relationships.

And maybe it will give you what you need to say, I'm leaving this job and you can check out my How to Leave Your Job episodes that came out in the last two weeks, I hope it was illuminating, and that you start thinking about boundaries and confrontation and the rights that you have and your wants and needs in a different way, and that there can be some. Positive changes in your life if they need to be.

Or you could hear all this and be like, oh, well I'm doing pretty well. I knew all that stuff. Great. It's something that when I go through it with my clients, it's always like a mind blown type of thing, which is, that was the main reason that I wanted to do it on the podcast. 'cause you all know I give, I give you everything that my clients get, um, on this podcast because. This is information we should all have this.

These are lessons we should all learn. This is growth that should be available to all of us because this is not how we are taught, not as women, not as physicians. And this type of knowledge is empowering. 'cause the only people who don't want you to really learn about boundaries are people that are gonna take advantage of you.

Right? And when you think about society at large and the position that women have had in it, it is helpful for women to not know about boundaries and not uphold them. It is certainly helpful for the medical system for us to, as physicians, not honor our boundaries, not have them have weak ones, not defend them.

So this is, this is empowering information that I want you to have so that we can be free and live the lives that we want. That is, that is my goal for you. It's a goal for all of my clients, and that is why I do this. That's why I show up on this podcast, and I have my private coaching and my group coaching.

This is it. So if you are like, I need some, some help with this, I need to get out of this job. I what you said, when you read those, those passages really hit home. Schedule a call with me. Let's talk about how we can get you empowered and taking control of your life because you deserve it, doc. You deserve it.

Go ahead and share this episode with another physician mom who needs to hear more about boundaries and her rights and her legitimate wants and needs,. You know, she needs to hear it. All right, and of course, don't forget to leave a five star review on Apple Podcasts, a five star rating everywhere else.

It helps bump us up on the algorithm so more physician moms can find this podcast and get these lessons and be empowered and be free, right? So I'll see you on the next episode of Stethoscopes and Strollers.