Friday, October 25, 2013

Grace Under Fire: De-escalating Potentially Aggressive Individuals

Ellis Amdur MA, NCC, CMHS
10.24.2013 Training

OUR SIDE
Not about intimidation about integrity—when we manifest this and dignity, we reduce the possibility of trouble. When we control our space, we control situations. Giuliani’s “broken window” theory. Social service agency redecorates its lobby, reduces incidents by 50% because it doesn’t look like a place where rowdiness is permissible. You take care of yourself, you’re respectable. People follow suit.

The Negative Stances
We create adversarial relationships with the following:

Punitive Stance – Don’t be a person who aggravates the situation.
Be firm when you need to. Frontload sanctions. Let people know where they stand at first. Like telling people it’s a no-shoe or no-smoking house. Following, we are kind, gentle, welcoming, and helpful. Tactfully remind people of limits.

Patronizing Stance – Don’t explain slowly, do the obvious. But also avoid acronyms. Don’t talk around people with them. Most are afraid to interrupt, don’t want to look stupid by asking what OCLC means.

Saccharine Stance – Person comes in crisis. Don’t respond like the person’s a child. A strong person gets mad. A weak person believes they’re weak, regresses. Throw tantrum either way. People need assistance, not comfort. Babies need comfort. Help people self-regulate so they don’t need us.

Intimidated Stance – We fool ourselves into doing the wrong, easy thing. Violate professional ethics, we teach people that it works. We rationalize. Can be someone we like; we get played, anxiety at being disliked.

Burned-out Stance – Slow-motion PTSD. From a work environment that erodes a sense of self-respect and well-being. Brain grows to be a traumatized brain; we react to past ailments & abuses. Brain shuts down, emotional blunting. Burn-out is emotional blunting without the drama. When we treat someone like they’re not important, they will create the drama to be noticed. Lash out. A burned-out staff-member creates a more dangerous situation for everyone when they fail to assess emergency situations. You get so burned out, you no longer care for safety. Or can become provocative, “I hate this job, I’m going to make the job hate me.” Fix this by: Enlivening life outside of work. Put meaning to work.

Mercurial Stance – As a free spirit, we let people know how we feel at any point in time. Supervisors can be the touchstone of stability to help them through.

Enmeshed Stance – We ignore more quiet people for the dramatic ones (see Mercurials above), focus on how the relationship with one person is going. We must only think about relationship in regards to the service you are charged to provide. 1-3% of our population are sociopathic, and aim to create this relationship. They use our best human qualities to manipulate us.

Leveling Stance – We become client or employee’s friend. There is a power differential, if we pretend it’s not there, we’re basing the relationship on a lie and there will be a nagging problem with the person. When we have to lay down a sanction or set a limit, person feels betrayed.

Bias Stance – Biological norm; as animals, anything that is not part of our normal circle is problematic. We can’t help it. But we need to be able to question bias. People will either sink to our expectations or rise to our hopes. We shouldn’t judge. We can trap people.

 

How do we ethically deal with a staffer who exhibits any of the above?

On the Job / In the Moment We can mitigate by doing their work and creating busy work. This is not ideal or sustainable.

Talk to Them If someone is harmful or unhelpful, we talk to them (if they can take it). Be respectful.

Talk to a Supervisor Do something, doing nothing is the worst possible thing. Watch out for “the ghost,” who disrupts team solidarity by using the restroom or working on special projects, being invisible and disappearing at the moment of need.

A disorganized organization that is not unified is more dangerous. Need unity of purpose, standards.

 
Interpersonal Space
If you’re too close, person will become agitated. Look for signs – weight shifts, breathe less freely, shoulders hunch, the eyes stop dancing, start to glaze; they don’t hear what you say. Think about your warning sign, what your body physically does when threatened. This can help expose danger. What does your body do when you’re being conned. Our “lizard brain” scans for what threatens the DNA and what helps it survive. Doesn’t use words. Only physical reaction/sensation, “gut feeling,” “pain in the neck,” etc. Like road rage, you get the same feeling from blatant hostility. Don’t ignore your gut.

How Do You Live with Shame?
You eliminate self or person who did it. Neither. Pay attention. Street smarts are trainable. Just pay attention to and emulate the Lizard, they are naked and feel no shame.

Aggressors
They “interview” us for the future. Don’t lose your temper – lose edge, flexibility, and strength.  Borderline Personality – someone becomes how they feel. Don’t get thrown off balance, lose perspective, be like that. Don’t let people push the button of the things we hate about ourselves. Also recognize what we like about ourselves, which can be used against us. Vulnerability. Someone can ruin you for a month by saying something. We tense up from surprise, the “startle reflex.” Noise does it too. We let down our guard. Paranoia is bad, all-encompassing. Awareness is the goal here.

Bracketing – Remind your brain what your “buttons” are so you can roll with, rather than react to situations. Be mindful, eliminate the startle reflex. Take an inventory of your buttons, what undermines your integrity (things you hate about yourself, things you treasure, behaviors that can throw you off balance, envy, your biases). Don’t take it personally. Little things eat away, make us off-center, incapable to respond to the bigger things, aggression. Little things add up; the worst torture ever is the water drop on the forehead. Tears the nervous system up, lacerates the mind.

Centering – the mind, body, and spirit are braided. Physical change can affect the rest. Our “tightrope walker” state – we can shift with the wind, in an emergency, we drop the pole, hang on to the wire. *Circular breathing. Inhale to belt, pause, exhale around and up back—or the reverse. Brain responds to this image. Makes us more aware, more present. Spend some time every day on this, also when you come home, helps detoxify from the day. Don’t bring violence to your home. 2-3 min/day while driving. After a couple weeks, it clicks, we feel a hum. Every stressful situation, practice it, so you’re ready for it when an emergency presents itself. Demeanor will seem placid, buttons can’t be pushed.

Go Slow – Social service agents are often seen as sheep to the wolves. Kids & teens need to be big dog. Eye contact comes slow. Familiarity also. Firm & fair. Breathing helps. Eyes wide open.

 
THEIR SIDE

Manipulation
– the “tension release cycle.” You can break it. Slow down, don’t respond. Force eye contact, take it away. Called the grooming cycle. Exercise: tense until can’t stand it, relax until can’t stand it. Helps to reorganize the mind. A little like tai chi.

 

How to Communicate to Avoid Aggression (pgs 6-7, handout)
The Cycle of Aggression – our brain has 545 parts that are in conflict. Person with integrity doesn’t notice the aggressive part. Many aren’t this sophisticated. Human brain, mammal brain, and lizard brain split. Scale of escalation 1-100%.

1-20% we’re human-brain-dominant, it coordinates all parts of the brain, creates things, gives sense of identity/consistent view of self, sense of community (we give to get, make do with what we’ve got), dialog is possible.

20-95% anger manifests from frustration, forces listening. Remember, they are trying to communicate and we may not know the full story. We want to get person amenable to disengaging, to “line up.” Don’t explain or ask questions. Don’t tell them why they got the parking ticket. Don’t grill them. They feel interrogated, mammal brain hates this. Best technique at this point is paraphrasing; it won’t work for the enraged. We tactically paraphrase from our understanding. Can be as simple as “pretty confusing, huh?” Comes from good faith assumptions. Then, can help calmly explain, advise, help. If this doesn’t work, they don’t want to calm down, they’re looking for a fight.

95-99% rage, lizard brain takes over (fight-flight-freeze-rage) the transition between anger & violence. Violence comes at threat, not at being struck. Go for safety here. The 1% that stops the aggressor is consequence, morality (bible helped kick-start this), physical limitations, values (what we acquire). Use control techniques. Say “I keep it safe here” a way of talking which can bring it back to human brain. Talk slowly, soothingly, from the chest…an “alpha” voice. Keep out of personal space. Say “breathe with me,” to regulate breathing, pace it down.

(Works for terrified rage. Delirium or disorganized rage, short commands, repeated. Use name if you know it. Hypnotic induction: “sit down…sit down….sit down.” Without losing temper. “Islands of sanity,” a childhood song, etc. can help bring people out of it. Shift focus, Eliminate crisis.)

Aggression can come in many disguises – even seduction, if we don’t accede to their “come on,” we’re saying we’re smarter than them. Enrages.

 The Gift of Fear – Gavin DeBecker. Fear is a wisdom teacher. Protecting the Gift same deal, for parents.

Behavior at the Edge of Attack
“I really want to hear what you’re saying, but please take a couple steps back.” Never apologize or excuse yourself for this.
Follow with eye contact.  But if the eyes get sexually aggressive, say “the meeting’s over.” “Why?” “You know why.” End of story. Don’t define yourself as a victim. Eyes can stray. If it’s a calculated act of aggression, end it.

Power testing – Someone picks something off desk, throws it down. Banking your reaction for the future.

Displacement Activity – kicking, hitting, punching walls, things. Amping up, threatening you.

Scapegoating – Yells at kid in meeting, as an assault on morality. Their way of saying what happens at home later, “this is going to be your fault.”

Blanching is an indicator of rage. Red skin can mean drugs or rage.

Disassociating they stop talking, go blank. The 1000 yard stare indicates dehumanization. This can be the calm before the rage storm. Yell to bring back. Then escape if that doesn’t work. Eerie smile can be similar to the blank stare.

 
Hot Rage/Fury
Small, a wolverine. Big, a bear. Not anger. Well beyond.

No Ambiguity At the point of explosion. Low frustration tolerance. You may need to stop talking. Find the exit. Look for weapons on him, to protect self. How do you signal or call for help. No ambiguity. Use “ladder technique.” Say “step back, back off, etc,” whatever works. “We’ll talk about it, Mr. Anders, when you step back.” If they step back, it’s bluff rage. If they keep coming, this is an assault. Immediately go for safety. Repeat the phrase, go back to the ladder. Thinking doesn’t help. Never say “calm down.” It doesn’t work. Don’t force them to leave, they may just barrel through others. “Sit down.” “Please bring your voice down.” Stop yelling before you stop swearing. “I can’t hear you when you’re yelling.” “I can’t follow you when you’re moving around. Sit down.”

What about swearing? You made a mistake? Say: “Talk to me with the same respect I talk to you.” AND “I understand how enraged you were. I messed up. But before we talk about that, we need to talk about what you did. You came in and tipped over my desk. That can never happen.”
(note, if developmentally disabled, a lot of explaining will not be effective.)
(note, if it’s bluff, can quickly salvage the situation).

 
Every Staff Meeting – Should have a portion on safety, will at very least bring staff together, make them feel more secure. Not only for when we’re in crisis. And we may learn something that we didn’t know, that we needed to know.

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