WEBVTT

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- So a couple of things that we need

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to think about throughout
this whole training

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is changing the mindset of how we think.

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We want to be alert without
being hypervigilant,

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and that's a really, really hard balance.

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How can you have
awareness and be prepared,

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but not be scared?

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You know, I could've come
into this training today,

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could tell you guys all kinds of really,

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really scary stories.

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That's actually not gonna
help you be prepared.

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What is gonna help you be prepared

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is this knowledge of
what is actual violence,

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how do you work with
it or not work with it,

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and how do you get yourself
to a safe situation?

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So it's not to scare you;
it's just to make sure

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that you guys walk out of here today,

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you go into your placements, and you have

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a healthy awareness of the potential.

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You want to find a balance
between prudent courage

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and reasonable caution.

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We're helpers, but we're not rescuers.

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We're not the police,

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so there are some situations where...

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we're gonna have the
instinct to stay and help,

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and that's actually not
our job in that moment

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because it's unsafe and we
need to leave and get help.

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And we've gotta remember that,

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because we're social workers;
we're not the police.

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And that's hard, it's hard
to change your mindset,

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especially when you're in a situation

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and you feel like, "Oh,
I've got to preserve

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"my therapeutic relationship
with this individual right now.

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"If I leave or cut the session short,

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"that's gonna damage the relationship."

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Your safety has to come first.

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You have to think about that first.

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So dangerousness is not a diagnosis,

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and this is really, really important

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because we don't want to label people.

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Dangerousness is a situation, and anybody,

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given the right set of
circumstances can become dangerous,

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and that's important to know because

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that's true for us, as well.

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It's not just the clients
that we're working with,

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it's not just people that have
a diagnosis through the DSM,

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it's anybody can become dangerous

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in the right set of circumstances.

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So we think about it from that framework

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because, that way, we're prepared always,

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not just in certain situations.

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So something that we're gonna talk about

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throughout this training,
and I like to kind of

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go over this right at the beginning

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'cause if kinda gives
you the overarching idea

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of what we talk about
today is the difference

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between anger and rage, and that's really,

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really important because
we can work with anger,

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and we can't work rage.

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So if you think about the brain,

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this is a very healthy
brain, well-developed,

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the brain starts developing
in the limbic system,

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in the back here by your spine,

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and it finishes developing up here

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in your prefrontal cortex.

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In a healthy brain, so
this is an individual

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who has had a normal development,

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no trauma, no abuse, no neglect.

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They've had a very
healthy brain development.

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This part of the brain develops

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between the ages of 18 and 22.

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So some of you may not have
your brain fully developed yet,

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depending on how old you are.

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A brain that has had trauma or neglect

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develops much slower.

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It will reach its full potential,

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but it develops much, much slower.

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So what we need to keep in mind is that

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this prefrontal cortex,
this is responsible for

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logic, and reasoning, and decision making,

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and judgement.

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If it's not developed yet,
then people can't access that,

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so that's really important to think about

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depending on the age
that you're working with

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and the history of the people that

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you're working with, as well.

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So when somebody is experiencing rage...

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Do you have a question?

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When it does?

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It's really individual,
and so it really depends on

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the level of neglect, the level of trauma,

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any kind of healing or
therapy that's been going on.

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At the end of the day, some
brains will fully develop,

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some won't.

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There's always neurological
reasons for that, as well,

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so every individual is different,
so you never can be sure.

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So it's just good to have the awareness

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that there might be impairment
in the prefrontal cortex

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that people are not aware of.

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That just helps you kind
of understand things

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from a different standpoint.

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So when somebody is experiencing rage,

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that prefrontal cortex actually shuts off.

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And the amygdala, this
part of the brain over here

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on the side, that turns
on, and the amygdala

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is responsible for fight or flight.

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Everybody's heard that
expression before, right?

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Yeah, that's a primal response.

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That's something that
just physically happens

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when you feel afraid.

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Animals have the same response.

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It's primal; it just
automatically happens.

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So when somebody becomes enraged,

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that part of the brain gets turned on,

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this part of the brain gets turned off,

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and so now you're not able to use logic,

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and reasoning, and good judgement,

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because they're just using
this primal response.

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So when somebody is enraged,
that's what happens.

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When you're experiencing
and you're watching

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somebody enraged, the difficult thing

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is that that also happens for
you because you feel afraid.

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So now you've got two
people: one who's enraged

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and another one who's standing
there experiencing it,

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and both of you are just...

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it's just your amygdala, it's
just this fight or flight,

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like, "Oh, my God,"
deer in the headlights,

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you're frozen, you're not sure what to do.

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So it can be a really scary situation

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if you're not able to use
the part of your brain

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where you can access logic.

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Does that make sense?

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Okay.

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And please, like she just did,

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please answer questions throughout 'cause,

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like I said, I really do
want this to be interactive.

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Don't feel like we have to formally wait

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for questions at the end.

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If you guys have
questions, raise your hand.

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So we want to think about emotion of anger

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as being on the continuum.

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Starting with irritation, how many of you

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have been irritated today?

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Be honest.

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You're at school on a Sunday.

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(laughing)

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Anybody move past irritation
on the continuum today

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and felt a little angry about something?

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Okay, thank you for being honest.

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Couple of you.

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Anybody experience rage today?

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Maybe one in the back.

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I saw a hand kinda go up.

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Okay, so anger is on a continuum,

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and it starts kind of with annoyance

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and irritation, you know,
something's bothering you,

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alarm clock didn't go
off, you're late for this,

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you're late for that.

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It can go to anger, to extreme anger,

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and then to rage.

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Raise your hand if you guys think

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you've seen somebody
who's experiencing rage.

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Anywhere.

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(laughing.)

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Anywhere.

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It's really scary, isn't It?

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Yeah.

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You can physically see it.

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It's not just something that you can tell

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by the words that they're saying,

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you can actually physically see somebody

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who is enraged.

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They actually look different.

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Anger can be recognized.

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So you can see, I see you're angry.

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You can say that to somebody,

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that's a validating
statement to say somebody,

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"I see you're angry."

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You can acknowledge it.

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"You have a right to be angry,"

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or "I don't blame you for being angry."

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Those are really supportive statements.

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For somebody who's angry, they likely

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can hear those statements.

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For somebody who's experiencing rage,

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they cannot.

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You can also set limits on anger,

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and that's important.

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Because when you set a limit on anger

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and they follow that
limit, you're in control

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of the situation.

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When you set a limit
on anger and they don't

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follow that limit, you
have to go to plan b,

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which is probably that you're gonna need

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to get some help.

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So when I've had to set
limits on anger before,

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I've had to say people, "I
really want to be supportive

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"and help you right now, but
when you're shouting at me,

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"it makes me hard to be able to help you.

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"I want to continue this conversation,

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"but I need you to stop shouting at me."

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If they can do that, then I'm in control

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and I know that we can move forward

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and we can have a good conversation.

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If they're not able to do that,

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then they're gonna go
further on that continuum.

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We can always work with anger,

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but the thing about it
is that when you start

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working with anger, you
have to abandon it quickly

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if it's not working 'cause
you don't want to try

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to deescalate a situation too long

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and have that go into
rage, 'cause at that point,

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it's too late.

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Rage is not a social
emotion in the same way

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that anger is.

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It's accompanied by a physical state

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that will only bring relief to the person

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through physical action,
usually violent action.

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With rage, all capacity for
empathy is temporarily gone.

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So I want to talk about that for a minute

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because that's important.

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That goes back to that brain development.

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It has nothing to do with the relationship

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that you have with an individual

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because the home-based worker

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who walked into the client's home,

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she had been working with
this family for years.

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She knew this client very, very well,

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and this client certainly did not want

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to hurt this social
worker, but he was enraged

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and he had no ability to
access the part of his brain

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that would allow him to use
his relationship with her

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to be able to calm down.

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We have to remember that
because we get stuck in that,

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"Oh, I know this person,
I can deal with this,

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"I can work with this."

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When you do that, you're
actually putting yourself

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in a really unsafe situation
because they can't depend

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on the relationship
that you have with them.

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They just can't access
that part of their brain.

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Question.

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Yeah.

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(indistinct)

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Mmhmm.

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Yeah.

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Mmhmm.

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Yeah, that's tricky.

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What she's asking is
sort of for a timeframe

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of when somebody can
go from rage to anger,

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and the truth of that is
that it really is individual.

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It can be back and forth very quickly,

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and it could go from rage and stay there

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for an extended amount of time

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in sort of this really
hyper-aroused state,

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or they could deescalate really quickly.

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The difference is you've
got to be able to see

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if they're deescalating or not.

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If they're not, then
you have to think about

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your own safety.

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In the situation of family continuity,

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after the client had killed his worker,

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his therapist, he realized
what he had done immediately

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and actually tried to commit suicide,

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so that rage...

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you get release from that
with a physical state,

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so that physical state
was when he stabbed her

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and then that release
came after he realized

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what he had done, so it is individual,

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but that's an important question.

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The thing is that you
guys have to be aware

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and you have to be monitoring that,

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and you'll know 'cause
you can work with one

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and not the other so you'll know

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when they're experiencing
one or the other.

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Can't deescalate rage or work with it.

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Our only goal should be
to get away to safety

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and call for help.

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The thing about this, too,

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I've had a lot of unsafe
situations like I said earlier.

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They've all been in the
latter part of my career.

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The more experienced I am,
the less safe I have become,

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and that's interesting,
but the reason for that is

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is that I let my guard down.

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I rely on my experience, I
rely on my relationships,

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and I think, "Oh, I'm a safety trainer.

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"I got this," and I put myself in some

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really tricky situations,
and I think sometimes

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our experience can actually hurt us.

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So for those of you
who've been in the field

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for a little while, I want
you to think about that.

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You really want to make
sure that you're not

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letting your guard down.

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You want to be, not hypervigilant,

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but you want to have this
good awareness always,

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and when you rely on your experience

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and you forget that you can
be in an unsafe situation,

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that's when your risk increases.