- So a couple of things that we need
to think about throughout this whole training
is changing the mindset of how we think.
We want to be alert without being hypervigilant,
and that's a really, really hard balance.
How can you have awareness and be prepared,
but not be scared?
You know, I could've come into this training today,
could tell you guys all kinds of really,
really scary stories.
That's actually not gonna help you be prepared.
What is gonna help you be prepared
is this knowledge of what is actual violence,
how do you work with it or not work with it,
and how do you get yourself to a safe situation?
So it's not to scare you; it's just to make sure
that you guys walk out of here today,
you go into your placements, and you have
a healthy awareness of the potential.
You want to find a balance between prudent courage
and reasonable caution.
We're helpers, but we're not rescuers.
We're not the police,
so there are some situations where...
we're gonna have the instinct to stay and help,
and that's actually not our job in that moment
because it's unsafe and we need to leave and get help.
And we've gotta remember that,
because we're social workers; we're not the police.
And that's hard, it's hard to change your mindset,
especially when you're in a situation
and you feel like, "Oh, I've got to preserve
"my therapeutic relationship with this individual right now.
"If I leave or cut the session short,
"that's gonna damage the relationship."
Your safety has to come first.
You have to think about that first.
So dangerousness is not a diagnosis,
and this is really, really important
because we don't want to label people.
Dangerousness is a situation, and anybody,
given the right set of circumstances can become dangerous,
and that's important to know because
that's true for us, as well.
It's not just the clients that we're working with,
it's not just people that have a diagnosis through the DSM,
it's anybody can become dangerous
in the right set of circumstances.
So we think about it from that framework
because, that way, we're prepared always,
not just in certain situations.
So something that we're gonna talk about
throughout this training, and I like to kind of
go over this right at the beginning
'cause if kinda gives you the overarching idea
of what we talk about today is the difference
between anger and rage, and that's really,
really important because we can work with anger,
and we can't work rage.
So if you think about the brain,
this is a very healthy brain, well-developed,
the brain starts developing in the limbic system,
in the back here by your spine,
and it finishes developing up here
in your prefrontal cortex.
In a healthy brain, so this is an individual
who has had a normal development,
no trauma, no abuse, no neglect.
They've had a very healthy brain development.
This part of the brain develops
between the ages of 18 and 22.
So some of you may not have your brain fully developed yet,
depending on how old you are.
A brain that has had trauma or neglect
develops much slower.
It will reach its full potential,
but it develops much, much slower.
So what we need to keep in mind is that
this prefrontal cortex, this is responsible for
logic, and reasoning, and decision making,
and judgement.
If it's not developed yet, then people can't access that,
so that's really important to think about
depending on the age that you're working with
and the history of the people that
you're working with, as well.
So when somebody is experiencing rage...
Do you have a question?
When it does?
It's really individual, and so it really depends on
the level of neglect, the level of trauma,
any kind of healing or therapy that's been going on.
At the end of the day, some brains will fully develop,
some won't.
There's always neurological reasons for that, as well,
so every individual is different, so you never can be sure.
So it's just good to have the awareness
that there might be impairment in the prefrontal cortex
that people are not aware of.
That just helps you kind of understand things
from a different standpoint.
So when somebody is experiencing rage,
that prefrontal cortex actually shuts off.
And the amygdala, this part of the brain over here
on the side, that turns on, and the amygdala
is responsible for fight or flight.
Everybody's heard that expression before, right?
Yeah, that's a primal response.
That's something that just physically happens
when you feel afraid.
Animals have the same response.
It's primal; it just automatically happens.
So when somebody becomes enraged,
that part of the brain gets turned on,
this part of the brain gets turned off,
and so now you're not able to use logic,
and reasoning, and good judgement,
because they're just using this primal response.
So when somebody is enraged, that's what happens.
When you're experiencing and you're watching
somebody enraged, the difficult thing
is that that also happens for you because you feel afraid.
So now you've got two people: one who's enraged
and another one who's standing there experiencing it,
and both of you are just...
it's just your amygdala, it's just this fight or flight,
like, "Oh, my God," deer in the headlights,
you're frozen, you're not sure what to do.
So it can be a really scary situation
if you're not able to use the part of your brain
where you can access logic.
Does that make sense?
Okay.
And please, like she just did,
please answer questions throughout 'cause,
like I said, I really do want this to be interactive.
Don't feel like we have to formally wait
for questions at the end.
If you guys have questions, raise your hand.
So we want to think about emotion of anger
as being on the continuum.
Starting with irritation, how many of you
have been irritated today?
Be honest.
You're at school on a Sunday.
(laughing)
Anybody move past irritation on the continuum today
and felt a little angry about something?
Okay, thank you for being honest.
Couple of you.
Anybody experience rage today?
Maybe one in the back.
I saw a hand kinda go up.
Okay, so anger is on a continuum,
and it starts kind of with annoyance
and irritation, you know, something's bothering you,
alarm clock didn't go off, you're late for this,
you're late for that.
It can go to anger, to extreme anger,
and then to rage.
Raise your hand if you guys think
you've seen somebody who's experiencing rage.
Anywhere.
(laughing.)
Anywhere.
It's really scary, isn't It?
Yeah.
You can physically see it.
It's not just something that you can tell
by the words that they're saying,
you can actually physically see somebody
who is enraged.
They actually look different.
Anger can be recognized.
So you can see, I see you're angry.
You can say that to somebody,
that's a validating statement to say somebody,
"I see you're angry."
You can acknowledge it.
"You have a right to be angry,"
or "I don't blame you for being angry."
Those are really supportive statements.
For somebody who's angry, they likely
can hear those statements.
For somebody who's experiencing rage,
they cannot.
You can also set limits on anger,
and that's important.
Because when you set a limit on anger
and they follow that limit, you're in control
of the situation.
When you set a limit on anger and they don't
follow that limit, you have to go to plan b,
which is probably that you're gonna need
to get some help.
So when I've had to set limits on anger before,
I've had to say people, "I really want to be supportive
"and help you right now, but when you're shouting at me,
"it makes me hard to be able to help you.
"I want to continue this conversation,
"but I need you to stop shouting at me."
If they can do that, then I'm in control
and I know that we can move forward
and we can have a good conversation.
If they're not able to do that,
then they're gonna go further on that continuum.
We can always work with anger,
but the thing about it is that when you start
working with anger, you have to abandon it quickly
if it's not working 'cause you don't want to try
to deescalate a situation too long
and have that go into rage, 'cause at that point,
it's too late.
Rage is not a social emotion in the same way
that anger is.
It's accompanied by a physical state
that will only bring relief to the person
through physical action, usually violent action.
With rage, all capacity for empathy is temporarily gone.
So I want to talk about that for a minute
because that's important.
That goes back to that brain development.
It has nothing to do with the relationship
that you have with an individual
because the home-based worker
who walked into the client's home,
she had been working with this family for years.
She knew this client very, very well,
and this client certainly did not want
to hurt this social worker, but he was enraged
and he had no ability to access the part of his brain
that would allow him to use his relationship with her
to be able to calm down.
We have to remember that because we get stuck in that,
"Oh, I know this person, I can deal with this,
"I can work with this."
When you do that, you're actually putting yourself
in a really unsafe situation because they can't depend
on the relationship that you have with them.
They just can't access that part of their brain.
Question.
Yeah.
(indistinct)
Mmhmm.
Yeah.
Mmhmm.
Yeah, that's tricky.
What she's asking is sort of for a timeframe
of when somebody can go from rage to anger,
and the truth of that is that it really is individual.
It can be back and forth very quickly,
and it could go from rage and stay there
for an extended amount of time
in sort of this really hyper-aroused state,
or they could deescalate really quickly.
The difference is you've got to be able to see
if they're deescalating or not.
If they're not, then you have to think about
your own safety.
In the situation of family continuity,
after the client had killed his worker,
his therapist, he realized what he had done immediately
and actually tried to commit suicide,
so that rage...
you get release from that with a physical state,
so that physical state was when he stabbed her
and then that release came after he realized
what he had done, so it is individual,
but that's an important question.
The thing is that you guys have to be aware
and you have to be monitoring that,
and you'll know 'cause you can work with one
and not the other so you'll know
when they're experiencing one or the other.
Can't deescalate rage or work with it.
Our only goal should be to get away to safety
and call for help.
The thing about this, too,
I've had a lot of unsafe situations like I said earlier.
They've all been in the latter part of my career.
The more experienced I am, the less safe I have become,
and that's interesting, but the reason for that is
is that I let my guard down.
I rely on my experience, I rely on my relationships,
and I think, "Oh, I'm a safety trainer.
"I got this," and I put myself in some
really tricky situations, and I think sometimes
our experience can actually hurt us.
So for those of you who've been in the field
for a little while, I want you to think about that.
You really want to make sure that you're not
letting your guard down.
You want to be, not hypervigilant,
but you want to have this good awareness always,
and when you rely on your experience
and you forget that you can be in an unsafe situation,
that's when your risk increases.