Do you work with patients, clients, or students who get physically aggressive?
When a person acts out physically—either by engaging in self-harm or by injuring others—it’s often a result of fear, anxiety, trauma, or any number of stress-related factors that affect how the person’s brain is working in the heat of the moment.
“The inability to connect with someone this angry, upset or startled has a lot to do with the fact the reasoning function of their brain is not really engaged,” writes Alec John Gardner, Clinical Director for Stratford Health Support. “The more ‘instinctual’ parts of the brain, not congruent with assessing outcomes or gauging risk, have ‘hi-jacked’ brain function; areas such as the amygdala, thalamus and ‘especially the hypothalamus’” respond on a primal level.
That’s why even a supportive hand on an escalating person’s shoulder might set them off further, and it’s why a “hands-off” approach is the safest strategy to take with an exceptionally violent person.
As a CPI Certified Instructor, Gardner trains his coworkers in the
Nonviolent Crisis Intervention® program, which advocates avoiding physical intervention in order to reduce the risk of injury for the person in crisis, staff responders, and any bystanders.
In moments of anger and violence, Gardner says, oxygenated blood retreats from the frontal lobe of the brain, the area that controls reason. Additionally, “the now fully activated primitive brain is generating no end of cortisol, unchecked adrenaline and other fight-or-flight neuro-transmitters.”
So what can you do when you're running out of verbal intervention options, and it’s not safe to physically intervene? If you can, leave the person alone until help arrives, Gardner recommends. Remove objects that can be used as weapons; get responders, other clients, and bystanders to a place of safety; and await help from the police, paramedics, or other appropriate professionals.
Learn more in
“Why a ‘Hands-Off’ Approach in Crisis Intervention?”