Sorry I was trying to illustrate what I wanted to do which is to create a region that excludes those interior shapes.
I've been trying to use the method GetIntersectionShapesFromRegion but I'm not 100% sure this is the right method.
The code I've tried to write is something like:
Dim eenum As ElementEnumerator Dim outlineElement As ClosedElement Set eenum = rect.GetIntersectionShapesFromRegion(elements(), Nothing) While eenum.MoveNext Set outlineElement = eenum.Current ActiveModelReference.AddElement outlineElement Wend RedrawAllViews