When undergoing certification to become a personality disorder treatment provider, I was taught of the S.E.T. technique that was developed by Jerold J. Kreisman, M.D. and Hal Straus, and which is used with borderline personality disorder (BPD) clients. This useful tool relates to support, empathy, and truth.
“Support” refers to an “I” statement that confers an intention to help someone. As an example, “I want to help you work through this issue.”
Per one source, “This is basically any statement that conveys a fundamental level of respect or caring. There are ways to do this even in situations where you vehemently disagree with the other person.”
Support may be expressed through use of mutual respect and without necessarily condoning behavior or advocating the beliefs of an individual. I consider my role as a Rational Emotive Behavior Therapy (REBT) practitioner supportive of a person while also challenging in relation to irrational beliefs.
“Empathy” relates to an expression of awareness and validation of one’s emotional and bodily sensation experience—collectively referred to as “feelings.” For example, “You seem quite upset, and I understand how you could be.”
According to one source, “It is important not to tell BP [borderline personality] 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.”
I maintain that colloquial understanding of empathy, regarding the ability to feel what another person feels, is impossible. Therefore, I use rational compassion in my practice of REBT so that I may better understand what emotional and sensory discomfort people experience.
“Truth” alludes to the honest and realistic role a person maintains in relation to personal responsibility and accountability regarding a problem. As an example, “When you behaved in a similar fashion last time, you had the same result, so it’s probable that if you continue to behave this way the outcome won’t change.”
One source states, “It is important to use the support and empathy statements first, so that the BP is more likely to ‘hear’ what you are saying, otherwise the truth statement may be experienced as little more than another, and expected, rejection creating even more defensiveness or anger.”
Use of S.E.T. reminds me of the “shit sandwich” technique I learned in the Marine Corps, whereby the truthful and unpleasant content targeted for behavior modification is sandwiched between two complimentary statements. The idea is that a person may better digest truth when support and empathy are served to an individual at the same time.
When presenting the S.E.T. technique to the personality disorder training cohort, the trainer provided a straightforward example he uses with his clients. He stated, “I want this relationship to work for you, ‘cause it’s clearly important to you, and if you keep doing this you’re going to wreck it.”
While S.E.T. was developed for use with BPD clients, I think it’s a useful technique for communication in general. What do you think, dear reader? Do you foresee yourself using this tool to improve how you interact with others?
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As a psychotherapist, I’m pleased to help people with an assortment of issues ranging from anger (hostility, rage, and aggression) to relational issues, adjustment matters, trauma experience, justice involvement, attention-deficit hyperactivity disorder, anxiety and depression, and other mood or personality-related matters.
At Hollings Therapy, LLC, serving all of Texas, I aim to treat clients with dignity and respect while offering a multi-lensed approach to the practice of psychotherapy and life coaching. My mission includes: Prioritizing the cognitive and emotive needs of clients, an overall reduction in client suffering, and supporting sustainable growth for the clients I serve. Rather than simply helping you to feel better, I want to help you get better!
Deric Hollings, LPC, LCSW
References:
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