COMMUNICATION: S.E.T. technique

[an0ught]

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!

an0ught

PS: Here is the BPDFamily video on SET:

[an0ught]

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 ) 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.

[Asad]

I have to admit that I struggle to find when it is appropriate to utilize SET.  

In particular, what Truth are we talking about?  Is it something about the pwBPD that they don't want to address (e.g., lack of sleep as mentioned above)?  Something about me (e.g., I will have to go out of town on a trip)?  Some conclusion that the pwBPD will not otherwise consider (i.e., something that anyone else would consider to be a Truth except for the pwBPD, e.g., responding with violence is never acceptable)?  Are there only certain kinds of Truth that SET works well with?  I'm eager to hear other's comments...

[united for now]

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.

[shatra]

Hi---
  "Empathy" here sounds similar to validation  ("I know it can be frustrating for you" sounds empathic as well as validating). I have been reading that it is unwise to share a "truth" with a BP while validating. As Asad wrote, how do we handle sharing a truth such as "violence is never acceptable" "It wasn't your fault your parents abused you" when the BP doesn't see these things as truths?
I'm curioius about the difference between validation and SET.

Have a nice day
Shatra

[jardin]

I'll try because this is one of those tools I really need to implement more often...

We are NOT going to spend money on sending the kids to ballet.
S = I care about your opinions regarding the kids and our financial situation.
E = I understand you've been working really hard lately and are worried about finances.
T = I feel like I have the things I need for awhile and am willing to forego some of my clothes shopping to ensure the children can pursue their interests.  This way we just reallocate the money we already have coming in.  (and I would probably say thanks for working so hard...and of course I would need to feel ok with the arrangement and really mean it ). 

I need to buy that new $2000 booster set for my game to improve.
S = I want to find ways to help you improve your game too.
E = I know how important this sport is to you and how much it helps you relax after long days. 
T = Because $2000 is quite a bit of money and may make it hard to pay the mortgage next month, I'd like to spend some time looking for sales and figuring out how we can pay for it before we go ahead with this purchase. 

[united for now]

Here's a real life one...

Background info...
Bf's health insurance was going up and up and up last year. He wasn't working a lot and it was getting to be too much to pay for. He suggested we cancel it and he would look for a different policy. I said "OK" and didn't pay it. He never bothered to look for replacement insurance, even with repeated reminders over this last year.

Fast forward to now....
He's having stomach issues that could become very serious (life threatening) if not treated. His feelings are focused on blaming me for canceling his insurance, rather than on the fact that he did nothing about it for the past 16 months. He forgets that it was "his" idea to not pay it or that it is "his" responsibility to get new insurance. None of that matters now that he is in pain and stuck. His feelings equal his facts.

My options...
#1 - I can go the logical route and explain my side of things to him.  Since right now he is focused on finding blame instead of solutions he likely won't hear or accept my explanations/justifications/excuses/reasons. No amount of arguing or proving my facts will budge him from feeling like a victim. Using logic against his emotions is pretty much a guarantee to make things worse.

#2 - I can express my support and my empathy for the situation he finds himself in - then I can offer the truth that he needs to find insurance.


I'll let you know how it goes 

[Asad]

I guess I'll be brave like jardin and try this out, too:

We are NOT going to spend money on sending the kids to ballet.
S = I want to help you in your efforts to keep the family finances above water.
E = I can see that you're working really hard to try to accomplish this even though we don't have a lot of money coming in.
T = Dance IS very important to the kids development and this particular school is very reasonably-priced and can fit in our budget.

I need to buy that new $2000 booster set for my game to improve.
S = I do want to help you to get better in your game.
E = I can see that you feel that this booster set is an important way to accomplish that.
T = Since money is tight, let's see if there is an installment plan or maybe we can find it on the internet for cheaper.

Now here's one that I just thought of that might've come in handy last Friday night.  Is this how I'm supposed to use SET?

Background info:  I answered a call from my Mom in our bedroom.  I thought that my W was asleep so I went outside the room to talk, it was a 30-second conversation (just a reminder to do my taxes this past weekend ), and when I came back into the bedroom I saw that my W was awake.  I didn't mention the call but instead started talking to her about something else, and she apparently thought that I was hiding something when in fact I didn't want to bore her about taxes.

After a lot of talking/escalating (on her part, I was trying to keep things calm, validating, etc)

W: You are just too stubborn to apologize to me!
Me: (Confused, I still don't know exactly what I did that needed apologizing because she wouldn't tell me -- but I knew it had to so something about her being respected)
S: I love you and want to be respectful of you at all times.
E: I can see that something I have done has really upset you and made you feel that I don't respect you.
T: I'm having trouble understanding exactly what I did.  Can you tell me in a different way the specifics of what I did that was wrong? I want to learn from this and not repeat it in the future.

Is that how it is supposed to work?  And as an aside, what do you do when you find out that the thing that's upsetting her is something that most people wouldn't get bent out of shape over? (In my case, she wants me to tell her who called if I ever receive a call and then walk outside the room -- even if I did it because I thought that she was asleep at the time).

[jardin]

Fast forward to now....
He's having stomach issues that could become very serious (life threatening) if not treated. His feelings are focused on blaming me for canceling his insurance, rather than on the fact that he did nothing about it for the past 16 months. He forgets that it was "his" idea to not pay it or that it is "his" responsibility to get new insurance. None of that matters now that he is in pain and stuck. His feelings equal his facts.

My options...
#1 - I can go the logical route and explain my side of things to him.  Since right now he is focused on finding blame instead of solutions he likely won't hear or accept my explanations/justifications/excuses/reasons. No amount of arguing or proving my facts will budge him from feeling like a victim. Using logic against his emotions is pretty much a guarantee to make things worse.

#2 - I can express my support and my empathy for the situation he finds himself in - then I can offer the truth that he needs to find insurance.


I'll let you know how it goes 

Whoa.  His response feels/sounds/is SHOCKINGLY familiar.  I just went through a similar dynamic the other day with S - she is in the hole financially and blamed me for a myriad of reasons all the while 'forgetting' all of the choices she made that allowed this stuff to develop.  I won't lie - I tried really hard to do #2 and talk about the truth of the current situation and what needs to happen...made it for awhile...but she did wear me down and I did throw in some comments from #1.  So, I think the lesson was - when you get to the end of the T, be done?  I let her keep going and eventually some of the stuff you described in #1 started coming out.  Not nearly as badly as it used to and I did shut myself down pretty early in, but yeah - I did spend some minutes explaining...and it did lead to her arms crossing and frustration...

[an0ught]

shantra, let me help you here,
it sure will feel like splitting hairs initially,
but then pwBPD are masters in nuances and splitting - so we have to pay attention to detail.

I'm curioius about the difference between validation and SET.

Well, you could look at it as S.V.T. but try to pronounce that  

I have been reading that it is unwise to share a "truth" with a BP while validating.

"while" is not "after". For validation quality matters. Mixing other intentions than listening and reflecting your partners emotions while validating is not helpful.

"violence is never acceptable"
"It wasn't your fault your parents abused you"

Are these facts - free of judgment?

My judgment is - not really, could be done better. The T part needs thinking. A lot of what we think is the TRUTH is at least surrounded by and connected to judgment. And are these truths standing on their own feet - or do they have a controlling touch - got to be very, very careful here.

If we take "violence is never acceptable" then the word "acceptable" carries some judgment. The word "never" is an absolute - also questionable. And "violence" is quite generic and implies also some judgment. The intention of the sentence may be perceived as to pass judgment, to cause self judgment/shame. A possibly more neutral way could be to relate a concrete act and link it to impact or possible consequences like: "The blow you dealt caused this exact damage and 2 days of pain for me." or "Taking standard criteria a blow like the one would be deemed  in a typical expert witness as causing grievous bodily harm associated with a mandatory jail sentence." (<-- a bit problematic) or just to demonstrate it is possible to keep things short: "Another blow like this and I will quit the relationship." (<-- got to mean it otherwise it is threat/controlling).

If we take "It wasn't your fault your parents abused you" then again the "abuse" is fairly generic and judgmental. The "wasn't .. fault" is a double negative and thus also not so great. The feeling faulty is also more a matter of s.E.t.. So maybe (E.S.E.T.):
E:  Your're sad and confused.
S:  Let me help you here.
E:  You are blaming yourself and are feeling guilty.
T:  Parents are adults and have responsibilities - over and outside the control of their children. Restraint when punishing is one. You reverse roles here and feel responsibility for what your parents did.

[Crystal Ball]

Am I the only one getting a headache?  It’s going to take me 10 minutes to formulate a response ~ which I guess is ok.  Better to take 10 minutes with a good SET response than being in another arguement.  I'm really trying hard to follow these examples since I want to learn to communicate the proper way to avoid conflict, but I'm having difficulty following the details of SET in a non-involved 'sample' situation yet than in an actual live discussion.  I know this technique is imporant to learn and will benefit us if we do it correctly.  It takes practice to get it right and that for these examples it’s important to critique every word so we can learn what is best and how to make what we say as effective as possible. 

But, I’m feeling frustrated.  I’m guessing that’s coming from being tired of doing all the work in an effort to keep things calm while they just say or do whatever they want. 

[an0ught]

Hi Crystall Ball,

let me explain. You seem frustrated. When members are frustrated I'm getting very concerned.  

You got a very good point. The most important aspect of S.E.T. is that it is simple. When I do S.E.T. I really focus only on the E.T. (reducing it somewhat to a two-step) since I feel in my relationship a formal "S" would feel artificial and the way I do "E" the "S" is implicit. Besides anything else than binary is too complicated for my simple mind and I am still in fear of implementing DEARMAN in real life - seriously - 7 letters to steer a conversation along  . Back to S.E.T.

Assuming you got validation the challenge is with the "T". The reason S.E.T. works is that "T" is non judgmental and aiming at not exciting directly the emotions but address the higher functions of the brain not so reachable in a pwBPD when emotionally excited. Still there is no such thing as an emotionless message and if we send one it will not be believed.

The emotion which needs to be associated with "T" is our belief that these are the facts are true and that they need to be known by the other person and we offer them and not push them. So we need to be very sure about it. And we need to be fearless (otherwise we associate fear with the facts). We got to have the truth solid, exact, strongly believe in it. Cleanse ourself of judgment. Preparation is about working through our emotions. To get them out of the way. This may take time.

When it then comes to execution the words will come out differently. That is why good preparation and solid commitment matter. Even with S.E.T. our emotions make at least 50% of our message. And it is important not to let them get into the way.

Good preparation does mean well thought through. It does not mean over-rehearsed. I recently heard a director saying that amateur actors get worse with every take while professional actors get better with every take. So we amateurs do really well from the start  


It is also worth noting that S.E.T. is comparatively easy when the stakes are lower and we are less emotional. So it pays to play around with other people. The challenge with S.E.T. and a pwBPD is primarily overcoming our FOG.

[Nicci]

Thanks for this I could definitely use it in future

[Annaleigh]

I had a real life one, a while back but it still bugs me.  

I wanted to replace the kitchen counter ( 30 yrs old, off white, dinged up )  H says, we are not replacing it because you always have stuff on it, you can't even see the counter so there is no point.

It has stuff on it because I'm always doing something...cooking, going through mail, put a vase of flowers there, might have some schoolwork of daughter's, a bowl of fruit.  It's like 'my home office'.

Needless to say, I didn't get my new counter but still irked everytime I wipe it down, it looks like crap because it's so beat up.

How could I have used SET on that?

[an0ught]

Annaleigh,

if you would use SET here (not sure whether there are better alternatives like starting with DEARMAN) then step one would be letting go of persuading and pushing the other person. Right now the way I see it: There is him, you and the table between you two. You are pushing and he is pushing against you.

SET would be would be about positioning him and facts and taking your ego out of the picture. Not everything of you. Just your ego wants, not your emotions. Let me explain:

Truth 1: It is 30 year old and stained etc. That is the typical life cycle of kitchen furniture.

Truth 2: It is important to you. Yes YOU. YOU. All logic can not make up for the fact that the table is functional and it is your want. This is a decision driven by YOUR emotions. No point in hiding behind objective facts as there is surely other critically important outdated equipment in your home (read PC, TV, game console or other men stuff). Hiding wants behind facts and logic is easily picked up by a pwBPD.

Truth 3: You need his help otherwise you would have done it yourself. Which if you can do it yourself may be an option as it is you who wants it.

While you are fairly certain of your emotions (irked, crappy...) there is little about the emotions of your H in your post. Except that he does not get it. Now is it that he feels this is unnecessary (and behind - worry of work, dirt, drama, money, escalating renovations - you see I can well put myself in his shoes   ) or is he just thick or does he just feel controlled when you push? Let us assume for the time being the money is there and he is just worried about the inconvenience, dirt and drama that comes with it.

S: difficult here as you want him to support you here... Not sure here but possibly an inversion works : "I'd like your help here..."

E: You will find this inconvenient and will be worried about me freaking out while you do it.

T: I really want this while board renewed as it is 30 year old and at the end of it's life.
E: You are irritated by me feeling so strongly as you feel it is still good and usable and would be a waste to throw out.
T: I spend most of my time in front of it and it never feels clean and always iffy.
E: To your eyes it is off-white. I get that.
T: I feel very strongly about it, silly but it affects very much how I feel about our home. I'd change it myself but can't do it alone.
not T but to take away the controlling edge: Give the idea some consideration.

In SET you would not do a "please" at the end. It is not controlling at all. Which means letting go of the outcome. There is a touch of respect for the boundaries of the partner in it. It is his decision to support you here or not. His alone.

[Crystal Ball]

not sure whether there are better alternatives like starting with DEARMAN

aO ~ would you please explain DEARMAN or provide a link.  Thanks!  xoxox

[Annaleigh]

Oh, Ok, SET is more for their concerns.

H:

S: we have a counter?  Never noticed.

E:  you have so much crap on it, you can't see the countertop anyhow

T:  the counter is not getting replaced

H is horrible at SET!

I feel invalidated. Arrgh!

[an0ught]

not sure whether there are better alternatives like starting with DEARMAN

aO ~ would you please explain DEARMAN or provide a link.  Thanks!  xoxox

Gladly. We don't have dedicated workshops for all these tools yet (hence this one for SET ). But there is a combined tool workshop:

TOOLS: Communication tools (SET, PUVAS, DEARMAN)
The idea behind all these tools is that a BPD has to have trust reinforced and fears of inadequancy soothed before they can listen or hear.  The non-BP validates that the feeling are real feelings (not that they justified).  The non-BP then shifts the discussion on what the real issue is and what can be done about it. These tools put a lot of responsibility of the non-BP to bridge the communication/emotional inadequacy. The assumption is that that non-BP is the emotional caretaker in these situations.   Learn these important skills.   
http://bpdfamily.com/message_board/index.php?topic=69272.0

[shatra]

Hi---
  The feedback is helpful and clarifying. Here is a personal example. It's about push-pull though, so I am unsure whether SET would fit. In this case it might flare up an argument. I am wondering whether SET is best for avoiding arguments, or for times when the truth must be laid out? So that DEARMAN, valdiating and others  might be better for push-pull.
---He often pushes me away due to "family responsiblities". While there is truth to this and he is very responsible, i feel there is some BPD behavior here too, keeping me distant.  So my "pre-Bpdfamily board" statements would be
"I'm really mad. You have so little time. Other people have kids and jobs and they have a love life, why can't you?"

SET approach:
S: I want to improve our relationship
E: I understand that you have 3 kids, work full-time arnd are very busy. I know you feel stressed about your responsibilities.
T: This lack of time seems to put a damper on our relationship at times. I wish you were more available
       
  In reality, for right now he physically cannot stretch much more time thann he already spends with me. SO I wonder if SET would not be the best approach (i.e.--the pwBPD really can't respond to the "truth" right now anyway)
Have a nice day
Shatra

[Asad]

an0ught,

Thank you so much for this thread, I think I am finally beginning to understand SET and how/when to use it!    I especially want to thank you for your examples where you had multiple ET cycles, ESET, etc.  That really helped me to understand what SET is really used for.  When I first was learning the communication techniques, I think I approached it like this: I want to get them to understand XYZ, let's see how I can use SET to do that.  I thought that it was kind of like a manipulation technique and I realize now that this isn't the way to approach SET -- at least, not if I want it to be effective.

I now see SET as a way to deal with an inconvenient truth in the course of a conversation that might be hard for the pwBPD to take.  In other words, I see it being used more in the spur of the moment rather than all thought out ahead of time.  At one point I thought that doing this would be impossible because it seemed to require so much thinking.  But I think I'm beginning to get the hang of it and have used it several times since your thread started on my W and it has been useful.

The key to my understanding (besides yours and others examples/critiques) is to realize that the initial S not only stands for Sympathy, but also for Sincerity.  In other words, whatever I pick for the S has to be something that I sincerely want for the relationship and my SO.  I also need to say it with sincerity, and I've found that the very act of doing that changes my heart subtly so that my message really starts to get through.  If my initial "S" is logically correct but lacks sincerity, then my efforts will fail.  My W is too tuned in to my body language, etc., that she will see through any mechanical attempt to apply SET.  In those cases, it just sounds like BS to her, and she will point it out to me.

Here's a personal example of how I used SET this weekend.  My W and I were talking about an incident where I had received a phone call in the presence of my W from a former mutual friend whom my W had blacklisted a while ago.  The reason for the call was that a week prior I had hit the wrong name on my phone and it accidentally dialed this person's number.  I immediately canceled the call but the person called back a week later to see why I had called (it was on the caller id) and as luck may have it, it was in the presence of my W.  I was so shocked at receiving the call (I didn't check who it was from before I answered, my mistake) and I stammered a bit before the other person realized that I couldn't talk freely at the moment.  From that point onward, I began to get the silent treatment from my W.

The next morning I asked to talk about the call with my W (I let the sleeping bear lie the previous night).  I thought about what I should say, and I decided that I wanted to really emphasize that I wanted to be trustworthy for her in the r/s (I do), so I started out with something like this:

"I want to be a person whom you can trust in this r/s.  I know that the phone call last night and my behavior made it seem like I was hiding something and was not trustworthy.  I just want to tell you that the phone call was an accident and I was not hiding anything from you."

She said some things about how she wanted to believe me in her mind, but a part of her still didn't trust me.  I validated that and then told her some more.

"I know that I want to be trustworthy to you.  I understand that it looked like I was hiding something.  I was just caught off-guard and didn't know what to say, that's why I was stammering, awkward, etc."

She then asked why didn't I say "Sorry, <name>, this isn't the right time to talk now".  I said:

"I know that how I responded was awkward and was frustrating to you.  I didn't want to mention the name of the person because I was scared of what you might do."

She then asked me why, and I had to do yet another SET to tell her that she had hit me, bit me, threw water on me, etc., in the past.  She dealt with that statement matter-of-factly (kind of dismissing it, actually, but then was not the time to deal with that), and eventually we were able to talk about what to do next time, etc.  It ended up salvaging the weekend.

So I'm finally beginning to get it.  And use it.  And I think Sincerity is a key part of SET, at least for it to  work on my W.  Thanks again for this excellent thread.