Here at Maryland Addiction Recovery Center we value the relationships we have with our colleagues in the field and understand the need for individuals, families and communities to be educated about mental health and addiction, treatment and recovery. We believe the more education takes place, the more stigma is lessened and the more people will look and find the help they need. We have started a “Guest Blog” segment that will allow experts in field to offer their insight on a number of different topics that will educate, enlighten and begin conversation. We hope you enjoy.


“Boundaries: Inside and Out”


One of the first things I notice when providing counseling to any couple or family unit – whether it’s a husband and wife, parent and child, or any other configuration of family members – is the personal boundaries that exist between them.  People with weak boundaries tend to have unsatisfactory relationships: they can’t properly moderate how much the other person intrudes upon or demands from their own individuality, and they are left feeling a lack of control over themselves and the relationship, either smothered or drained by their family member.


Take for example my client Beth (names and details changed).  Beth is married to Michael, whom she loves but also sometimes fears.  He can be very forceful, and, while not violent, he somehow manages to get his way every time.  Beth acknowledges that she doesn’t know how to say no, and that is one of the major goals we have adopted for our work together.  Indeed, she believes this is a key to many of the things she doesn’t like about her life, including her weight problem, which she attributes to her inability to resist junk food. She cannot say no to herself any more than she can to others.


Beth and I have been working on boundary-setting.  The first step was for Beth to learn to recognize when her boundaries were being crossed.  To do this, she needed to tune in to her inner voice, to pay attention to that gut feeling that would come on whenever Michael started being quietly coercive.  Beth often heard herself saying, “this isn’t right” – but the thought was quickly drowned out by her worries, fears, and guilty feelings. Now she has begun to catch that comment inside her head and look at the situation.  For instance, if Michael pushes her to go out for dinner when she is really too tired, she will hang on to the “this isn’t right” thought when it comes along and she’ll continue down that path of thinking: Why isn’t right? And she tells herself, I need to take care of myself; I am too tired to go out; I am not obligated to go out just because Michael wants to; and so on.  This helps her feel confident that she can say no and does not have to capitulate.  It takes practice, but she’s working on it.  Meanwhile, she feels less like she’s being dragged around by her husband and more in control of her life.


The next step for Beth will be to work on the boundaries she wants to set for herself. (For some people it’s easier to work from the outside in, and for others it’s easier from the inside out.  Different strokes for different folks!)  To take on her infatuation with junk food, or any of the other areas she wants to have better boundaries and better control, she will need to get a clear sense of what boundaries she would like to have.  Does she want to cut out junk food entirely?  Does she want to keep it to one snack a day?  What is realistic? What is helpful?  These are questions that need to be answered – if you don’t have a goal, it’s hard to achieve it!


Achieving the goal, of course, rarely happens overnight.  If Beth believes that totally getting rid of junk food is a realistic goal, she’s going to have to break it up into smaller pieces – trying to go cold turkey may work for some, but for a lot of people it’s unlikely to succeed; it’s too much change to handle at once.  Lasting change almost always happens in stages.  This means that first she will have to reduce by a small amount the number of times she snacks in a day, or cut down slightly the quantity of junk food she eats at a sitting, or eliminate one particularly unhealthy food from her diet – any small step that moves her in the right direction.  Similarly, learning to stand up for herself in the face of Michael’s pressure will happen one step at a time, one new behavior at a time.  As she succeeds at abiding by one limitation, she will strengthen her ability to stick with future ones as well – without creating a major backlash that wants to blast right through them, either from the less mature part of herself or from the people around her.


I am not suggesting that this is an easy process.  It takes work, often over an extended period, to succeed.  But the end result is that a person can feel much more comfortable with the choices they make, and make them consciously, rather than being dragged around by another force, whether it’s their own compulsions or a person they are close to.  Setting up good boundaries is vital to good relationships – with oneself and with one’s loved ones.


Raffi Bilek, LCSW-C, is the director of the Baltimore Therapy Center, where he enjoys working with couples and families and offers workshops on a variety of family-related issues.  Learn more at


If you or someone you know is in need of an intervention or help because of drug and/or alcohol abuse, please give us a call. Maryland Addiction Recovery Center offers the most comprehensive addiction treatment in the Baltimore City, Baltimore County and entire Maryland and Washington, D.C. area. If we aren’t the best fit for you or your loved one, we will take the necessary time to work with you to find a treatment center or provider that better fits your needs. Please give us a call at (410) 773-0500 or email our team at Contact us today. For more information on all of our drug addiction and alcohol addiction services and recovery resources, please visit our web site at


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