Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Why setting consistent boundaries is important

Alex Lickerman, MD
Conditions
June 9, 2013
Share
Tweet
Share

A few weeks ago my wife, my son, and I went out for dinner. My son, though usually well-behaved and pleasant, was boisterous and disruptive, alternately leaping off his seat to crawl under the table and banging his silverware on his water glass to see what different volume of sound he could make it produce. Our tolerance for disciplining him patiently having been exhausted in us both by our respective challenging days, we decided to do something we almost never do while eating a meal: allow him to play a game on my smartphone.

My wife and I both feel strongly not only that the amount of time we allow him to do that should be limited in general, but also that during a family meal we’re all careful to remain present with one another and aren’t allowed to disappear into our electronic devices (including she and I!). Yet that night we gave in to him.

Though the games immediately took over his attention and allowed my wife and I to enjoy the peaceful meal we craved, at almost every meal since he’s asked to play a game on my phone. When we say no, he pouts and acts out, continuing to cite that one time we said yes. “I did it then!” he cries. “Why can’t I do it now?”

My son is just five. He’s only beginning to learn how to regulate his emotions. Reasoning with him works only when he’s in a certain mood—that is, not activated by boredom, hunger, or a strong desire (which is to say, rarely). He usually respects the boundaries we set for him not because they’re (mostly) reasonable but because we set them (mostly) calmly and firmly. He sometimes tests them, of course, but he usually backs off quickly when we refuse to change our minds having learned over time that we rarely give in to whining.

This is because every time we have, we inevitably face days afterward of increased reluctance to respect the limits we set. Like almost all children, he’s a master of probing his parents’ weaknesses, searching for and taking advantage of any openings that lie exposed. This isn’t malicious on his part, of course. It’s how children learn to get what they want—to fulfill their desires—as their parents typically represent the main obstacles in the way of their doing so. As parents, we must constantly make judgments about those desires—about their safety, the message that allowing them to be fulfilled communicates, and so on. It may seem mean—or, at the very least, arbitrary—to anyone observing a parent-child interaction in which a child is being denied something he wants, but wise parents understand the importance of placing limits on their children. That, after all, is how you teach them appropriate behaviors and attitudes.

The challenge here isn’t figuring out what boundaries are appropriate to set. It’s setting those boundaries consistently. Because when you set them inconsistently, you create not only a more difficult child but also a more confused one. How can you justify to a child, who after a certain age not only understands fairness but demands it, why he can play a game on a smartphone at one meal but not at another? You can tell the truth—that you’re a flawed human being who’s sometimes just too tired to be consistent—which is what my wife and I ended up doing in the week that followed our misstep, but that rarely satisfies either parent or child.

The reasons for parents finding themselves lacking the will to set boundaries consistently are many. But the reason they must strive to do so anyway has to do with only one: the difference between psychological reinforcement schedules. Positive reinforcement is generally accepted to be superior to negative reinforcement in changing behavior as it leads to more lasting behavioral modification. In a positive reinforcement schedule, a reward is given after a desired behavior occurs (e.g., a dog gets praise after pooping outside). The most powerful positive reinforcement schedule is called the variable ratio schedule where rewards are given after a random number of responses (meaning a rat will get food after pressing a bar once, then five times, then seven times, then three times, then eight times, etc.).

This, then, is exactly the reinforcement schedule that giving in to a child’s demands on an occasional basis yields. You are in effect priming your child to continue to challenge what you’ve already set as appropriate boundaries. On the other hand, if you were to schedule exceptions on a regular basis, it would reinforce his challenging behavior far less. (In fact, my wife and I do just that by allowing our son to watch cartoons on weekend mornings only and half an hour of iPad “movies” on weeknights, limiting his total number of hours in front of a screen to 7.5/week. By scheduling exceptions to our basic rule of “no television” we limit his screen time to reasonable levels and he feels like he’s getting what he wants.)

The same is true of setting boundaries with adults. Many of us, of course, have great difficulty doing so for a variety of reasons. But what we may not realize is how we set ourselves up to have our boundaries tested more often in the future when we allow random exceptions in the present. This isn’t to say such exceptions shouldn’t sometimes be made. But even when they’re appropriate to make, the effect is the same. The point here isn’t that we should never make exceptions. It’s that we should be prepared, when we do, to have our boundaries challenged even more. Because when we are prepared, we’re better able to return to setting them consistently.

Alex Lickerman is an internal medicine physician at the University of Chicago who blogs at Happiness in this World.  He is the author of The Undefeated Mind: On the Science of Constructing an Indestructible Self.

Prev

How to know if your baby has autism

June 8, 2013 Kevin 0
…
Next

HPV and oral sex: Is Michael Douglas correct?

June 9, 2013 Kevin 22
…

Tagged as: Pediatrics

Post navigation

< Previous Post
How to know if your baby has autism
Next Post >
HPV and oral sex: Is Michael Douglas correct?

ADVERTISEMENT

More by Alex Lickerman, MD

  • The main difference between functional medicine and evidence-based medicine

    Alex Lickerman, MD
  • Is too much care as harmful as too little?

    Alex Lickerman, MD
  • a desk with keyboard and ipad with the kevinmd logo

    The art of compromising is the key to a healthy relationship

    Alex Lickerman, MD

More in Conditions

  • When doctors don’t talk: a silent failure in modern medicine

    Cesar Querimit, Jr.
  • The many faces of physician grief

    Annia Raja, PhD
  • How early care saved my life from silent kidney disease

    Charlie Cloninger
  • Why GLP‑1 drugs should be covered beyond weight loss

    Rodney Lenfant
  • When recurrent UTIs might actually be bladder cancer

    Fara Bellows, MD
  • How chronic stress harms the heart in minority communities

    Monzur Morshed, MD and Kaysan Morshed
  • Most Popular

  • Past Week

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • Could antibiotics beat heart disease where statins failed?

      Larry Kaskel, MD | Conditions
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why palliative care is more than just end-of-life support

      Dr. Vishal Parackal | Conditions
    • How Filipino cultural values shape silence around mental health

      Victor Fu and Charmaigne Lopez | Education
    • How Japan and the U.S. can learn from each other to strengthen health care [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • COVID-19 was real: a doctor’s frontline account

      Randall S. Fong, MD | Conditions
    • Why primary care doctors are drowning in debt despite saving lives

      John Wei, MD | Physician
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • mRNA post vaccination syndrome: Is it real?

      Harry Oken, MD | Conditions
  • Recent Posts

    • How Japan and the U.S. can learn from each other to strengthen health care [PODCAST]

      The Podcast by KevinMD | Podcast
    • Will longevity medicine put doctors out of work?

      Tomi Mitchell, MD | Physician
    • When doctors don’t talk: a silent failure in modern medicine

      Cesar Querimit, Jr. | Conditions
    • The many faces of physician grief

      Annia Raja, PhD | Conditions
    • Why the doctor-patient relationship needs a redesign

      Alexandra Novitsky, MD | Physician
    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • Could antibiotics beat heart disease where statins failed?

      Larry Kaskel, MD | Conditions
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why palliative care is more than just end-of-life support

      Dr. Vishal Parackal | Conditions
    • How Filipino cultural values shape silence around mental health

      Victor Fu and Charmaigne Lopez | Education
    • How Japan and the U.S. can learn from each other to strengthen health care [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • COVID-19 was real: a doctor’s frontline account

      Randall S. Fong, MD | Conditions
    • Why primary care doctors are drowning in debt despite saving lives

      John Wei, MD | Physician
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • mRNA post vaccination syndrome: Is it real?

      Harry Oken, MD | Conditions
  • Recent Posts

    • How Japan and the U.S. can learn from each other to strengthen health care [PODCAST]

      The Podcast by KevinMD | Podcast
    • Will longevity medicine put doctors out of work?

      Tomi Mitchell, MD | Physician
    • When doctors don’t talk: a silent failure in modern medicine

      Cesar Querimit, Jr. | Conditions
    • The many faces of physician grief

      Annia Raja, PhD | Conditions
    • Why the doctor-patient relationship needs a redesign

      Alexandra Novitsky, MD | Physician
    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...