Understanding Intense Emotions: What I Learned About BPD and the SET UP Technique

daramariamarin
Apr 16
3 min read

I recently read I Hate You—Don’t Leave Me by Jerold J. Kreisman and Hal Straus, and it made me reflect on something that’s often hard to admit: a lot of people don’t know how to handle someone else’s emotional outbursts — especially when they’re intense. And instead of leaning in or trying to understand, the instinct is often to pull away. This is especially true when those outbursts are connected to Borderline Personality Disorder (BPD).

BPD is one of those conditions people often shy away from. It’s intense, emotional, and misunderstood. Some even describe it as “too much” — too hard to manage, too complicated to talk about, too uncomfortable to sit with. But that’s why I wanted to write this.

I think it’s time we stop turning away from people who are hurting just because we don’t know how to help.

While I’m not a therapist (yet), I’m a psych student with a growing passion for understanding mental health in all its messy, beautiful complexity. And this book gave me a tool that I think more people should know about: the SET UP technique.

What is the SET UP Technique?

The SET UP technique is designed to help someone communicate effectively with a person experiencing a BPD-related (but can be used with anyone) emotional outburst. It combines compassion and support with honesty and accountability — something that sounds simple but is incredibly hard to do in high-stress moments. Here’s what each letter stands for:

S – Support

This step is about making it clear that you’re not abandoning the person. People with BPD often have intense fears of abandonment. Showing support doesn’t mean agreeing with everything they say — it just means saying, “I’m here,” or “I care about you,” in a grounded, calm way.

Example: “I want to help you through this. You matter to me.”

E – Empathy

Validating the person’s feelings — even if you don’t fully understand them — goes a long way. Empathy doesn’t mean fueling the emotional fire; it means acknowledging pain without judgment. However, it is important to not say something that might come off as dismissive or minimizing — even unintentionally — as this can easily trigger defensiveness or lead to a response like, “You don’t get it,” which can shut the conversation down.

Example: “I can see how upset you are. That must be really hard.”

T – Truth

This is where honesty comes in. It is important to be real, even if it is uncomfortable. Sugarcoating or enabling can lead to more instability. Speaking the truth with kindness helps set clear boundaries while still showing care. It is also important to hold the person accountable — not out of punishment, but because in emotionally heightened moments, they may not recognize when their words or actions are irrational or hurtful to others. Honesty gives them a chance to reflect and course-correct, rather than spiral further.

Example: “I care about you, but I can’t let you talk to me like that.”

U – Understanding

This part is about putting yourself in their shoes. Understanding doesn’t mean excusing harmful behavior — it means recognizing the emotional chaos they might be feeling and trying to make sense of it.

Example: “It makes sense that you’re feeling overwhelmed right now.”

P – Perseverance

This final step is about staying consistent and committed, even when it feels exhausting. Supporting someone with BPD — or anyone going through emotional turmoil — is not a one-time effort. Perseverance means continuing to show up with empathy, honesty, and patience, even when progress is slow or setbacks happen; this shows the individual you are not abandoning them. It's a reminder that real change takes time, and that consistency can help build trust in relationships that often feel unstable or uncertain.

The SET UP technique reminds us that even in the most emotionally charged moments, we can choose empathy, boundaries, and patience over blame or silence.

Mental health isn’t clean or easy, and BPD especially tends to make people uncomfortable. But the more we understand it, the less power the stigma holds. The more tools we have, the more equipped we are to show up for people — even when it’s hard.

Learning about SET UP helped me realize that you don’t need to be a therapist to approach intense emotions with compassion. Sometimes, just knowing how to respond can make all the difference.

Have you ever read something that changed the way you handle tough conversations?