Talking to BPD

The SET Communication Framework

Posted Jan 01, 2017

“Does this dress make me look slimmer?”

     “Yes”

“Oh, so you think I’m fat!”

     “No.  You look fine in any of your dresses.”

“Oh, so you really don’t care at all how I look!”

It can be challenging for a partner to deal with this no-win dilemma in interactions with someone with borderline personality.  So can responding to severe mood changes, angry outbursts, abandonment insecurities, self-destructive threats, and other expressions of borderline behavior.  The SET framework described in our two books can sometimes be a basic model to keep in mind when distressed interactions emerge.

SET stands for Support, Empathy, and Truth statements, expressed in equal proportions.  Support is an “I” statement, expressing personal concern--”I am concerned about you.”  Empathy is a “you” statement, acknowledging the borderline individual’s pain--”You must feel terrible going through all this.”  Truth is an objective reality expression, describing the situation and the logical need to address it.

Ideally, a partner keeps all 3 parts of the triangle in mind and balances the three messages as she addresses the borderline person.  The partner should listen for signs that one side isn’t being heard, and then reinforce it.  A borderline response suggesting you don’t care, signifies that Support isn’t being accepted.  A response that you don’t understand, implies that Empathy statements should be reinforced. But if these subjective declarations aren’t balanced by also acknowledging reality concerns (Truth), substantive issues may remain unresolved.

When faced with a serious concern, framing this tripartite model can help when needing to think on your feet.  

Dick calls Jane, “to say goodbye,” since he has decided to overdose on his pills.  He admonishes her not to try to call for help, threatening that if she does, he will never trust her again.  Jane replies that she is very concerned about Dick and wants to help (Support).  She also expresses her understanding that he is in great emotional pain (Empathy).  Jane then explicates her dilemma:  Naturally, she doesn’t wish Dick to be upset with her and not trust her, but, also, she cares for him and certainly doesn’t want to lose him.  She understands that Dick is saying to her that if she truly cares about him, she will respect his demand to let him be self-destructive.  But if she cares about him, how can she not try to prevent harm?  Jane explains that, of course, she will take the logical approach, and call for help (Truth).

In less dramatic situations SET may also maintain balance in conversations with others who are distraught.  The model may also help the partner refrain from being dragged into more emotional and unproductive interactions.  Although SET is not intended to be a treatment approach, it may be helpful in acute settings, when communication must remain open and productive.