Saturday, May 9, 2009


I started (almost finished) reading the book:

I HATE YOU-don’t leave me by Jerold J. Kreisman, M.D. & Hal Straus.

First allow me to say this book must be a best reader because this copy gave from the library falling apart...

Anyway, one part of the book explain how to communicate to a BP called SET. This was developed by the staff of the Comprehensive Treatment Unit of Saint John’s Mercy Medical Center in St. Louis.

“SET”-Support Empathy Truth-is a three-part system of communication. During confrontations of destructive behavior, important decision-making sessions, or other crises, interactions with the borderline should invoke all three of these elements.
The “S” stage of this system, “Support,” invokes a personal statement of concern. “I am sincerely worried about how you are feeling” is an example of a Support statement. The emphasis is on the speaker’s own feelings and is essentially a personal pledge to try to be of help.

With the “Empathy” segment, one attempts to acknowledge the borderline’s chaotic feelings: “How awful you must be feeling.....” It is important not to confuse Empathy with sympathy (“I feel sorry for you....”), which may elicit rage over perceived condescension. Also, Empathy should be expressed in a neutral way with minimal personal reference to the speaker’s own feelings. The emphasis here is on the borderline’s painful experience, not the speaker’s. A statement like “I know just how bad you are feeling” invites a mocking rejoinder that, indeed, you do not know, and only aggravates conflict.

The “T” statement, representing “Truth” or reality, emphasizes that the borderline is ultimately responsible for his/her life and that others’ attempts to help cannot preempt this primary responsibility. While Support and Empathy are subjective statements acknowledging how the principals feel, Truth statements show recognition that a problem exists and address the practical issue of what can be done to solve it. “Well, what are you doing to do about it?” is one essential Truth response. Other characteristic Truth expressions refer to actions that the speaker feels compelled to take in response to the borderline’s behaviors, which should be expressed in a matter-of-fact, neutral fashion (“Here’s what happened... These are the consequences... This is what I can do... What are you going to do?...”) But they should be stated in a way that avoids blaming and sadistic punishing (“This is a fine mess you gotten us into!”). The Truth part of the “SET” system is the most important and the most difficult for the borderline to accept since so much of his world excludes or rejects realistic consequences.

Communication with the borderline should attempt to include all three messages. However, even if all three parts are stated, the borderline may not integrate all of them. Predictable responses result when one of these levels is either not clearly stated or is not “heard”.

The writer goes on to state that we can use the “SET” system whenever we are dealing with a relationship in crisis and/or if we are dealing with a person who we wish to help but not allow them to use us by emotional “blackmail”. I for one believe I can use it in my personal life and will start doing so. The “SET” system was developed for BP but can be used for others we care about and want to help. Will the “SET” system worked on sociopathic people? No, because one element of the system is truth. Something some of those that suffer from personality disorders have the biggest problem with, Truth. So those who are NPD and/or ASPD would have a very hard time hearing the full statements.

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