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Tuesday, August 11, 2015

COMMUNICATION: S.E.T. technique @ BPD FamilyForums

"S.E.T. - Support, Empathy and Truth
An Important Communication Tool

The S.E.T. communication pattern was developed by Jerold J. Kreisman, MD and Hal Straus for communication with a person with BPD (pwBPD). It consists of a 3 step sequence where first Support is signaled, then Empathy is demonstrated and in a third step Truth is offered.

Few tools are easier to learn as S.E.T. and are as effective in getting across to a pwBPD. Few tools are as universal in everyday life with anyone. It is sort of an walking-on-eggshell antidote.

In this workshop we would like to discuss the use of communication tools.

1) When should you use SET

2) What are the tricks and traps of using such a tool. What has worked and what does not work.

3) What do you do if your partner calls you on it "Stop using those psychology tools on me"

Please feel free to ask questions on the how to do it in your own situation - we are often blind when it comes to our own setting. Always helpful for S.E.T. is to have some context e.g. what situation (facts & emotions) and what you want communicate.

Thanks for participating in this workshop!"

"How do you do S.E.T?

S.E.T. starts with signaling Support.
Words like  "Let me help you,..."
Helping gesture with your hands
Friendly, open facial expression

It continues with demonstrating Empathy.
Expressing the emotion the pwBPD is momentarily feeling like "..., you are exhausted, ..."
is very useful for S.E.T. if you have some basic experience with validation as this can help to build confidence in your ability to change your behavior and trust in your instincts to read a situation.
Plenty of material on validation found in  LESSONS: Tools for communication, validation, and reinforcement of good behavior on the staying board.

It concludes with expressing Truth.
In a non judgmental way "..., lack of sleep accumulates. The last three nights you were in bed after midnight."



Not all truth is pleasant to the receiver as is the message above for someone neglecting to sleep in order to escape their pain. You may be afraid to tell what you truly believe as in the past telling your view resulted in rage. And if you would do it in a controlling manner i.e. you pushing the other person to change the truth will not be appreciated. However when someone is tired and is blaming everything and everyone around them - the truth can be eye opening (here eye closing wink ) for that person and a gift. The truth is offered - not pushed.

Some concepts behind S.E.T

Anyone when very excited (angry or also very happy) will not be able to think calmly and logical. This is especially true for a person suffering from BPD who is (a) very sensitive and (b) tends to be more emotional. The S.E. in S.E.T. help the pwBPD to listen in a less defensive and calmer manner. The Truth will then be more easily accepted without triggering (which is also the reason one needs to avoid being judgmental or controlling).

Truth is stubborn and does not change if we ignore it - a pwBPD needs to deal with it too. Walking on egg-shells is us contributing to the dysfunction by shielding the pwBPD from the sometimes harsh realities of life and depriving the person of feedback vital for functioning. A partnership which disconnects from reality for a longer period of time will sooner or later drift into Oz. So getting back to Kansas requires to some degree a re-grounding in reality.

As a non you repeatedly experienced that unpleasant statements are not welcome by the pwBPD - often triggering a rage. Without understanding how and what triggered (often invalidation) you resorted to egg-shell walking. Overcoming your fear and trained response patterns is not easy. But it can be helped by sticking to the robust structure of S.E.T."

"Support

Support refers to an initial statement which indicates the loved one supports the person with borderline personality. It is a statement that begins with “I” and demonstrates concern and a desire to help. It can be anything that establishes a foundation for the relationship or interaction: “I want to try to help you feel better,” “I care about you,” or “I am worried about how you are feeling.”

The support statement is meant to reassure the BP that the relationship is a safe one, and that her needs matter even during this difficult moment.

Empathy

Empathy refers to communicating that the loved one understands what the BP is feeling, and focuses on “you.” It is not a conveyance of pity or sympathy, but instead a true awareness and validation of the feelings of the BP: “I see you are angry, and I understand how you can get mad at me,” “How frustrating this must be for you.”

It is important not to tell the BP how she is feeling, but instead put her demonstrated feelings into words. The goal is to convey a clear understanding of the uncomfortable feelings she is having and that they are OK to have, thus validating her feelings. Without such a statement of empathy, the BP may feel that her feelings are not understood. It is important to use feeling words, as in the examples above.


Truth

Truth refers to a realistic and honest assessment of the situation and the BPs role in solving the problem. It is an objective statement that focuses on the “it” — not on the subjective experience of the BP or Non-BP. Often the BP may seem to be asking, or demanding, something impossible, not taking an active role or responsibility in resolving the issue, or even presenting you with a “no-win” situation. The truth statement is meant to clearly and honestly respond to the difficult demand or behavior of the BP, while placing responsibility appropriately: “This is what I can do…,” “This is what will happen…,” “Remember when this happened before and how you felt so bad about it later.”

It is important to use the support and empathy statements first, so that the BP is better able to hearwhat you are saying, otherwise the truth statement may be experienced as little more than another, and expected, rejection creating even more defensiveness or anger.
Validation and Support Are Not Agreement

When first learning about SET, it can seem that you are being asked to agree with the BP. It important to clarify that validating feelings does not mean that you agree with them, only that you recognize that the BP is feeling them. The supportive communication described in the SET model does not mean that you are letting the BP off the hook, instead you are focusing on honest communication and ensuring that you are being heard, not just reacting to and defending against what is being said."

See entire thread @ BPD Family