The Struggle to Set Boundaries: A Cognitive Behavioural Perspective on Adults with Experiences of Childhood Neglect

Leah Fung – EMDR & CBT Therapist, CBT Supervisor in Guildford, London Bridge and Online

Childhood experiences profoundly influence how we relate to ourselves, others and the world as adults. For many who grew up in environments of neglect, particularly emotional neglect, setting boundaries and saying no can feel daunting or even impossible. From a cognitive behavioural therapy (CBT) and trauma-informed perspective, difficulties with boundaries can stem from deep-rooted beliefs and patterns that were shaped in childhood. These struggles can manifest across various areas of life, such as work, friendships and romantic relationships and can significantly impact mental health. Understanding the origins of these difficulties can provide context and compassion which can support developing alternative ways of responding and learning to assert boundaries.

What Is Childhood Neglect?

Childhood neglect involves the failure of caregivers to meet a child’s basic emotional, physical or developmental needs. Neglect can range from subtle, often unnoticed forms to extreme circumstances that result in significant harm.

These experiences can occur with caregivers who may be doing their best with the skills and resources that are available to them and a child may unintentionally experience neglect.

Subtle Forms of Neglect:

• Emotional unavailability: A caregiver may provide for their child’s physical needs (e.g., food, shelter, clothing) and remain emotionally distant. They might not respond to the child’s emotional cues, fail to offer comfort when the child is distressed or dismiss the child’s feelings altogether.

• Inconsistent attention: A caregiver may occasionally be warm and responsive but inconsistently so. The child may experience moments of connection followed by periods of indifference, which can lead to confusion and insecurity.

Overt Forms of Neglect:

• Chronic emotional neglect: This occurs when a caregiver consistently ignores or minimises a child’s emotional needs, leaving the child to manage difficult feelings on their own without guidance or support.

• Physical neglect: Failing to provide adequate food, clothing, or medical care. While emotional neglect is often less visible, physical neglect can leave lasting emotional scars.

• Extreme circumstances: In cases of severe neglect, the child might be left entirely unattended for long periods, lack supervision or live in dangerous or unsanitary conditions. These situations may lead to chronic feelings of insecurity, fear and powerlessness.

The Impact of Neglect on Core Beliefs and Assumptions

Childhood neglect, whether subtle or extreme, can lead to the development of dysfunctional beliefs about oneself, others and the world. These beliefs often operate unconsciously and shape behaviour in adulthood, especially when it comes to setting boundaries.

Beliefs About the Self:

“I am unworthy of love or care.” Children who have experienced neglect may grow up believing that they are unlovable or that their needs are not important. This belief can make it difficult to assert oneself in adulthood, as they may feel undeserving of respect or consideration from others.

“My feelings don’t matter.” When a child’s emotions are routinely dismissed or ignored, they may learn that expressing feelings is futile or burdensome to others. As adults, they might suppress their emotions, leading to an inability to advocate for their own needs.

Beliefs About Others:

“Others will reject me if I assert myself.” Adults who grew up with neglect fear that asserting boundaries or saying no will lead to rejection, abandonment or danger. These beliefs may be rooted in experiences in childhood where they may have spoken up for themselves and this led to caregivers giving them the silent treatment for hours or days, shouting back at them or punishment. 

“Other people’s needs are more important than mine.” In relationships, they may prioritise others’ desires over their own, a strategy that has been developed from childhood patterns of seeking approval or avoiding conflict.

Beliefs About the World:

“The world is unsafe.” Children raised in unpredictable or neglectful environments may develop a worldview where the world feels threatening or unreliable. This can result in hypervigilance and difficulty trusting others.

“I must be self-reliant.” Adults who experienced neglect may have learned early on that they cannot depend on others for support, leading them to take on too much responsibility or avoid asking for help.

The Role of Compensatory Strategies

Core beliefs shape rules for living life through the lens of those beliefs or as ways to prevent them from being activated. Individuals may develop compensatory strategies, which are patterns of behaviour that help them navigate the world and they may also reinforce their difficulties with boundaries. These strategies can include:

• People-pleasing: Saying yes to requests even when they feel uncomfortable or overwhelmed to avoid conflict or rejection.
  
• Over-functioning: Taking on excessive responsibilities at work or in relationships to maintain a sense of control or to prove their worth.
  
• Conflict avoidance: Avoiding difficult conversations or boundary-setting to minimise the risk of rejection, disapproval or threats.

While these strategies may provide short-term relief, they often come at the expense of emotional wellbeing, leading to exhaustion, resentment, and emotional burnout.

Signs in Work and Relationships

These difficulties can show up in various ways across different aspects of life:

Workplace Challenges:

In a professional setting, individuals who struggle with boundaries may take on too much work, agree to unreasonable deadlines or find it difficult to ask for support. They may also have trouble advocating for promotions or fair treatment.

Friendships and Romantic Relationships:

In friendships, individuals may feel responsible for others’ happiness, making it difficult to say no to requests for help or emotional support. In romantic relationships, they might avoid addressing their own needs or desires leading to imbalanced dynamics.

Family Relationships:

Boundaries can be particularly difficult in relationships with family members, especially if the neglectful caregivers are still part of the person’s life. The ingrained patterns from childhood or cultural beliefs may perpetuate feelings of guilt or obligation, making it hard to assert boundaries even in adulthood.

The Impact on Mental Health

Over time, difficulties with boundary setting and saying no can affect mental health. The individual may experience:

Anxiety: Constant worry about pleasing others, fear of rejection or upsetting others can result in chronic anxiety.

Depression: Neglecting one’s own needs and feeling unworthy of care can increase feelings of hopelessness, sadness and low self-worth.

Burnout: Overcommitting and over-functioning can lead to emotional and physical exhaustion, as the individual continually prioritises others over themselves.

How CBT Can Help with Setting Boundaries

The process of Cognitive Behavioural Therapy (CBT) can help individuals recognise beliefs and assumptions about themselves, others and the world that may be maintaining the difficulties with setting boundaries.  The therapeutic relationship in itself can also help someone experience a different way of relating to others in a safe and unconditional environment. The nature of CBT is focused on developing a range of different ways to respond to thoughts, feelings and behaviours to make changes, in this context, to set boundaries so that the difficulties have less on an impact on day to day life.

For adults who experienced childhood neglect, learning to set boundaries and saying no can feel deeply uncomfortable, but it is essential for healthy relationships and emotional wellbeing. Through understanding the origins of their difficulties and engaging in the therapeutic process of CBT, individuals can begin to break free from the patterns that have kept them from asserting their needs. Developing the ability to set boundaries is not just an act of self-care, it is a vital step toward building on one’s worth and creating a more fulfilling life.

For more information about Cognitive Behavioural Therapy with Your Therapy With Leah take a look at this blog on An Integrative Approach to CBT https://yourtherapywithleah.co.uk/what-is-cbt/