For many years after I became chronically ill, I blamed myself for failing to recover my health. I told myself: “You get sick; you get better. It’s as simple as that.” As a result of this stubborn attitude, I refused to set limits, even though it would have been a tremendous help, not only in managing my symptoms but in keeping them from flaring.

Learning to set limitations

I have a background in Buddhism (which I practice as a practical path, not a religion). In the first noble truth, the Buddha offers a list of unpleasant experiences we’ll all encounter at some time in life. I’d read that list many times but had never paid attention to these words from the list: pain and illness.

Seeing those words on his list helped me realize chronic illness (which includes chronic pain) is not an aberration. It wasn’t my fault I was struggling with my health. Those struggles are a normal part of the human life cycle. And so, I decided to take chronic illness as my starting point and build a new life from there. That’s when I started to set limitations. Here are those that I’ve found to be essential.

1. Limit the number of things you commit to in a row

I have an online calendar. When I make a doctor’s appointment or agree to an interview or a visit from a friend, I do everything I can to make sure that, on the day before and the day after the commitment, my calendar is empty.

Of course, I can’t always pull this off because, as John Lennon famously said, “Life is what happens to you while you’re busy making other plans.” Some weeks get away from me—my calendar might be empty on a day that I’ve left blank, but if the plumbing backs up, I’m going to call—and then “host”—the plumber!

2. Limit your activities to what you can handle without your symptoms flaring

What constitutes “too much” varies with each person. Some people who are chronically ill can travel, so long as they schedule rest periods. Other people, like me, are mostly housebound.

Enforcing this limitation is much harder than making sure my calendar has commitments spread out across the week. Limiting activities to what I can reasonably handle takes discipline; I have to work at it every day.

I’m better at it than I used to be because, over the years, I’ve seen the consequences of not limiting myself. I remember the day when my granddaughter was visiting from out of town. She was still a toddler then. I wanted so badly to take her by myself to the park next door that I told everyone to stay in the house. I was in a defiant mood: “I’m tired of being restricted by pain and illness; I’m going to stay at the park as long as she wants.”

And so I did—pushing her on the swings, going on the slides with her. I stayed until she was ready to come home. Not surprisingly, I paid dearly for my defiance. It landed me in bed for days. And it had all been unnecessary because anyone in the family would have been glad to come with us so I could leave when I needed to. Now I’ve stopped pretending that I’m not limited by chronic illness.

When it comes to important events, such as a wedding or holiday festivities, each of us must decide if the exacerbation of symptoms is worth going over our limitations. Sometimes it is. I recently attended a wedding of two good friends. I only stayed for the ceremony. Yes, I was sad to leave before the reception started, but I was already over my limit and knew there would be payback. There was, but it was worth it. That said, I don’t have the option to ignore some limitations, such as my inability to travel.

3. Limit what you agree to contribute to events and family gatherings

This is related to #2. I raise it separately because it can be such a big challenge to say “no” to loved ones. I suggest that you think ahead of time about what you can comfortably contribute to a gathering. Perhaps you can bake a pie, but can’t do more. Perhaps you can help set the table for a holiday dinner, but can’t help with clean-up.

It’s hard to say “no,” but it gets easier with practice. Let feelings obligation or guilt give way to your need for self-care. If your loved ones don’t understand, try to educate them about your limitations. If they still don’t understand, file it away as yet another instance of those who, not being chronically ill themselves, are ignorant about the effect it has on a person’s life.

4. Limit your negative self-talk

Many people believe that being chronically ill is proof of some personal failure. As a result, they become extremely self-critical. This negative self-talk is often fed by comments from others, such as: “I’m tired too” or “You’re too young to be in pain.” One way to limit negative self-talk is to resolve never to side with others against yourself no matter what they say to you. Their comments reflect their ignorance about chronic pain and illness, so don’t take those comments personally. Trust your own judgment.

If you’re not already doing so, I hope you’ll start setting limitations this very day.

Toni Bernhard was a law professor at the University of California—Davis. She is the author of How to Be Sick: A Buddhist-Inspired Guide for the Chronically Ill and Their Caregivers (Second Edition), How to Wake Up: A Buddhist-Inspired Guide to Navigating Joy and Sorrow, and How to Live Well with Chronic Pain and Illness: A Mindful Guide. She can be reached at her self-titled site, Toni Bernhard.  

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