As a young child and adolescent I had dutifully put all the money I had received from my parents, grandparents, aunts and uncles and other relatives for birthdays and holidays into a savings account for COLLEGE. When I was very young I didn’t quite know what college was; all I knew was that it was somewhere important that I’d be going that was very expensive and that I would be going to learn important things. As I grew older and after my father lost his job due to his alcoholism, I came to realize (and I kept it to myself) that I wouldn’t be attending the elite private schools that most of my friends from high school were applying to.

When the time came to actually apply to various colleges, I was told by my mother that I need only apply to state schools because that was all that I would be able to afford with grants and loans. “What about all the money from Grandpa and Grandma and Aunt Lorraine and everyone else?” I asked. “How much do I have in my savings account?”

“Oh we had to use that,” my mother told me nonchalantly. I started to protest, meekly, but was told by my mother that the family had needed it.

I learned from that experience that I had no control over what I thought was mine; what I had put away for my so-called education was fodder for the taking.

To this day, I have trouble setting limits on saving for the long-term and setting limits with spending for immediate gratification. I often feel that if I put something away, despite the fact that I am an adult, someone is going to find a way, a reason to wrestle it away from me.

Setting limits is difficult. Whether in a personal or professional situation, establishing firm boundaries and maintaining them with the people who are in our lives is hard work.

At my job I will gladly take on work and more work that I know will stretch my capacities. Just as I could not stand up to my mother, I have difficulty approaching my boss and telling her that I am pushed beyond my limits. I am fearful that she will view me as less than; less than willing, less than capable and in these hard economic times, I don’t want to give her any reason to see me that way. But how much is too much? How much is reasonable?

I see my patients having difficultly setting limits in their relationships as well. Some of them are verbally or emotionally abused, yet are reluctant to confront their abuser on his or her behavior, or even ask them to come in for a joint session. He or she may fantasize about moving out, but the reality is frightening. Even when the couple is not legally married and don’t have children to consider, the pattern of interaction is so ingrained that the possibility of a shift is scary.

With some of them the abuse is more subtle. They may be the ones doing all the housework and the yard work in the summer, shoveling the snow in the winter, despite their gender or their fragile health. A patient is reluctant to disrupt the “balance” of the household for fear that it will disturb the carefully orchestrated peace that the couple feels they have reached. They may not even realize that they are being taken advantage of — this pattern has gone on for so long.

Others work incredibly hard, often having to cancel sessions at the last minute, because their bosses have “asked” them to work late and they are afraid to decline. I can see the stress of their jobs evident in other ways; depression, anxiety, physical illness, insomnia, irritability and others, but because they are afraid of losing their jobs, they remain fearful of bringing the fact that they are overloaded up to their supervisors.

They could be part-time workers who often don’t know their schedule almost until the last minute, or full-time salaried employees who don’t receive compensation when they work overtime. Many don’t have health insurance (or pay a significant chunk out of their salary for it), or live constantly on the edge of making over the income allowed by Medicaid. The stress takes its toll.

What’s the answer? It’s not always as straightforward as “confront your partner,” or “approach your boss.” It’s understandable why people are hesitant to upset relationships they may be holding on to for a number of reasons. Additionally, we have grounds to be concerned about our jobs in this economic climate but we also have to take care of ourselves. If we don’t take care of ourselves, no one else will.

It’s a matter of learning by doing, of practice, of sticking up for ourselves and remembering that we are valuable. The ability to set limits, where we haven’t always been able to do so isn’t going to come overnight, but I believe that we can get there.

The consequences of failing to achieve some sort of equilibrium is a situation to which we don't want to become accustomed.

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