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Mind Matters: What are normal boundaries?

August 27, 2018 GMT

It started as any initial encounter does. I introduced myself, walked the patient down the hall to my office, motioned them to one of the chairs along the back wall by the window, and then took my place behind my desk at my computer keyboard. I placed my hands just so, looked at the screen then back toward the patient and was ready to begin the interview. Then, it happened.

My patient grabbed the arms of one of the chairs, quickly drew it across the floor toward me, parked it directly in front of the desk, sat down and leaned in, elbows-on-table, chin-in-hands, looking straight at me, not quite three-feet away.

I was caught off guard. I was used to having a certain amount of space between me and my patients, just close enough to encourage talking and sharing of their story, but just far enough away so that they (and I) would feel safely separated and individual as we started to get to know each other. Now, I am not shy about typing in front of others, and I have made my career out of asking questions, thinking rapidly a step or two ahead and translating the dialogue to the written word on the page, but somehow this made me uneasy. Why, I thought to myself, even as I felt my hands shift the keyboard an inch back as my feet did the same for the chair I sat on. Why did this make me uncomfortable? Did I think that my patient was going to read the papers sitting on my desk under her nose, the tiny, faded print hard enough for me to read right side up, much less for her to read upside down? Did I think she was going to lean in and see what I was typing on the screen? That would not be a problem, as collaborative documentation usually means that I am tying what patients are telling me in real time, sometimes reading things back to them verbatim to make sure I have captured exactly what they wanted me to hear.

I think that I can sense a few of you smiling as you read this, as you have been in this same predicament. What I was feeling, the uncomfortable experience I was having, was not so much a boundary violation as a boundary encroachment. The patient was not hostile. She was not intoxicated. She was not responding to hallucinations that told her to reach across the desk and throttle me. She was not being seductive. She was simply setting the boundaries, literally, for the encounter within the physical distance wherein she felt most comfortable.

Think about this in your own world of family, friends, work, and play. What are normal boundaries? That is, what is the distance that feels most comfortable between you and your spouse, a close friend, a coworker and an acquaintance? Why do some close encounters feel just right and at other times make us feel that we need our space? Many things influence boundaries and what makes them feel appropriate. Cultural differences are huge, as we shall see shortly. Situations, settings and contexts are also instrumental in how we perceive boundaries. A physically close conversation that feels perfectly natural between spouses may be uncomfortable in an encounter with a coworker. An intimate exchange during a physical examination with your family doctor might be wholly inappropriate with your college professor or your plumber. Comfortable physical distance when encountering a complete stranger might be even more rigid and structured.

A Nov. 2017 article in Psychology Today by M. G. Knittel, Ed. D asked the question, “Why is it important to have personal boundaries?” In it, three types of personal boundaries were discussed.

Healthy boundaries are when you value your own opinion, you don’t compromise your values, you share personal information appropriately, and you can accept others when they say no to you.

Rigid boundaries find you avoiding intimacy and close relationships, not asking for help when it is needed, having few close relationships, seeming detached to others, and distancing yourself to avoid rejection.

Porous personal boundaries are evidenced by oversharing, having trouble saying no, becoming overly involved with the problems of others, and tolerating abuse.

The article went on to describe how one could set good personal boundaries. Trusting and believing in yourself, feeling that you are just as important as others, learning to say no, and setting clear and decisive limits were all ways that strong personal boundaries could be established and maintained.

What part do culture, age or gender play in the establishment of personal boundaries?

A April 24, 2017 article in the Washington Post titled “What Personal Space Looks Like Around the Globe”, by Amanda Erickson, looked at these variables. One fascinating item was looking at what the appropriate interpersonal distance was, in feet, between people and strangers versus those they considered close relationships. A distance of 2.5 feet between you and a stranger was considered appropriate in Argentina, whereas 4.6 feet was the perceived correct distance in Romania. Close relationships could tolerate a mere 1.3 foot gap between parties in Argentina, whereas in Saudi Arabia this distance between close relations averaged 3.2 feet.

Other variables that influence the closeness of personal boundaries include ambient temperature, gender, age and interestingly, where one was raised. Women preferred more personal space, and older people also were found to favor standing farther away from strangers.

In summary, personal boundaries are important, help us to respect ourselves and help us set appropriate limits with others. They are related to many variables including gender, ambient conditions, cultural background, setting and context, relationship to others, and personal preferences. Even more important is that when setting boundaries, we need to establish good healthy relationships with others that also encompass all of these variables. Appropriate eye contact, respectful and engaging speech, helpful gestures and appropriate, positive touch can also be part of the communication that we all need to lead productive lives.