SET Communication Skills and Borderline Personality

When borderline personality disorder (BPD) makes communicating with your loved one difficult, following the support, empathy and truth (SET) method can help. It can be a way for you to talk with a friend or family member who is struggling with BPD and make her feel heard and understood.

Why SET Works

The symptoms of borderline personality disorder (BPD) can result in a person with BPD asking for conflicting things or being unable to recognize that another person cares for them, especially during times of stress. They may be unable to experience conflicting feelings at the same time and may see things in black and white with very little shades of gray.

The SET method allows you to honestly address your loved one's demands, assertions or feelings, while still maintaining appropriate boundaries. Because each step builds on the last, it is important to do these steps in order.

Support

Support refers to an initial statement that indicates that you support the person with BPD. 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 supporting statement is meant to reassure the other person that the relationship is a safe one and that her needs matter even during this difficult moment.

Empathy

Empathy refers to communicating that you understand what the other individual 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 other person, such as, "I see you are angry, and I understand how you can get mad at me," or "How frustrating this must be for you."

It is important not to tell BP how they are feeling, but instead, put their demonstrated feelings into words. The goal is to convey a clear understanding of the uncomfortable feelings they are having and that they are OK to have, reassuring them. Without a statement of empathy, they may feel that their 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 other person's role in solving the problem. It is an objective statement that focuses on the "it," not on the subjective experience of either you or them. They 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 her demand or behavior while placing responsibility where it belongs. Examples include, "This is what I can do…," "This is what will happen…" and "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 they are better able to hear what you are saying, otherwise, the truth statement may be experienced as another rejection, creating even more defensiveness or anger.

Validation vs. Agreement

When first learning about SET, it can seem that you are being asked to agree with the person with BPD. It is important to clarify that validating feelings does not mean that you agree with them, only that you recognize that they are feeling them.

The supportive communication method 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.