Gary McClain, PhD, is a therapist, patient advocate, and writer who specializes in helping clients—as well as their family members and professional caregivers—deal with the emotional impact of chronic and life-threatening illnesses.

It can feel pretty good to say yes, at least at the moment. But here’s something to ask yourself: When you say "yes," what are you saying yes to?

Yes to accepting that second or third helping at dinner. Yes to letting yourself get dragged into someone else’s emotional drama. Yes to that additional time commitment when your day is already overscheduled. Yes to… well, you get the picture.

Sacrificing self-care to say yes

If you are living with a chronic condition, you’re already the expert on the importance of making your own self-care a priority — being aware of your own needs, and your strengths, as well as the limitations your condition may bring into your life, the good days and the not-so-good days.

So what happens on those days when your self-care ends up slipping a few notches on your list of priorities?

The way to answer that question is with another question (or three):

When you say yes, what are you bringing into your life at that moment? And by saying yes, what are you giving up? And most important, is that “yes” also a way of saying “no” to taking the best care of yourself?

Are you setting boundaries?

One important aspect of your self-care means setting boundaries. A boundary is basically rules or guidelines for what you need to have in place to be at your best — physically, mentally, emotionally, and spiritually.

Not sure if you need to take a look at the boundaries that you are setting or not setting? You might want to look at your boundaries if you:

  • Have that vague sense you could be doing something more productive or healthy;

  • Feel annoyed or resentful when you just said yes to something you know you will enjoy for the moment, but also know isn’t going to benefit you in any way;

  • Know you are going to be exhausted because you just promised away time you had planned to use to take a break;

  • Wish the energy you are using in taking care of other people was also being used to take better care of yourself.

Reinforcing Your Boundaries

Think your boundaries might need some reinforcing? Here are some ideas to get you started:

Know yourself. The starting point in setting boundaries is with you. What do you need to have in place in your life day-to-day to feel at your best? Nobody knows you like you do — your body, your emotions, your spirit.

Get specific. What does a good day look like for you? Think about what helps you to feel at your best, including your ideal activity level, the kinds of activities, amount of rest time, time with people, time alone, the kinds of foods that make you feel good. And also think about what gets in the way of what could otherwise be a good day, including overwork, lack of rest, not listening to your body on days when you don’t feel well, and people who bring drama and negativity. Knowing what you need to do to take care of yourself is empowering.

Set realistic standards. One of the biggest reasons for not enforcing your own boundaries is feeling like you need to be all things, to all people, all the time. That’s a lot to ask of yourself. Perfectionism is a trap, leading you to say yes when you should say no, and often followed by exhaustion and resentment. So look in the mirror and repeat after me: “I don’t have to be perfect.” Your value as a human being doesn’t depend on how much you turn yourself inside out by pleasing others. Give yourself permission to treat yourself with tender loving care.

Start communicating your boundaries. Let people know what you can and can’t do. You don’t have to give a big speech and hope everybody takes you seriously. Instead, communicate boundaries in the moment, like when someone asks you to do something you don’t want to do, or don’t feel like doing, or asks you to commit to a future activity when you aren’t ready to commit.

Enforce gently. Repeat as needed. Most likely, the people in your life will be taken by surprise when you start to set limits with them. Using phrases like, “Sorry, I can’t do that,” or, “That wouldn’t be good for me,” or, “I have to schedule this for later,” can get the message across without being confrontational. But remember that you may need to enforce your boundaries repeatedly, over time, to be understood. You’ve probably heard the old saying, hope springs eternal.

Leave the guilt at the door. Whether intended or not, a no may result in a guilt trip from the person you say no to. If you encounter the “But, why? question, followed by, “But I thought…” then be prepared to have your guilt button pushed. Remember you are in control here. Don’t feel like you have to make excuses for yourself or explain yourself away. Don’t push yourself to negotiate unless you want to.

Take time to prepare for problem situations. We all find ourselves in situations where setting limits with ourselves or with others will be especially difficult. It can help to have a strategy in place in advance. You might want to rehearse what you will say or do when temptations — or triggers — arise. Decide what situations you will avoid, how you will react. Have a safety plan in place, including an escape plan if needed. Enlisting someone to support you can help.

Watch the blaming. It’s easy to fall into the trap of blaming other people for making demands on us, or for putting temptations in front of us. But don’t assume other people are out to take advantage of you or distract you from your self-care goals. Sometimes they just don’t know any better. It may be that you haven’t communicated your boundaries in a way they can understand, or they need a few more gentle reminders. Let other people be who they are. Remember you can’t control their expectations but you can control how much you intend to deliver.

It starts with you

Remember, enforcing your boundaries begins with you. Give yourself some encouragement to stay within the limits you have set to take good care of yourself physically, emotionally, and spiritually. Give yourself a pat on the back for doing the best you can, and don’t criticize yourself for not being perfect.

Enforcing boundaries is a process, moment by moment, one step at a time. If you are taking good care of yourself, you will be that much better able to care for the important people in your life.