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Grace Under Fire: De-escalating Potentially Aggressive Individuals

Brief Training

Ellis Amdur M.A., N.C.C., C.M.H.S.

Author’s Note

The information in this resource does not stand alone. The author takes no

responsibility for anyone attempting to implement the methods outlined in this

booklet without training by either the author or one of his certified

representatives (listed on the Edgework website).

Edgework intellectual property, both written materials and information

presented in training seminars, may not be used in teaching without express

written permission. No part of this manual may be reproduced or transmitted

in any form or by any means, electronic or mechanical, including photocopy,

without permission in writing from:

Ellis Amdur

20126 Ballinger Way NE, PMB 85

Shoreline, WA 98155-1117

(206) 781-3588

[email protected]

www.edgework.info

Contact www.edgeworkbooks.com for books on de-escalation of

aggression and communication with mentally ill individuals by Ellis

Amdur

Participants in this workshop are welcome to contact Edgework Staff by e-

mail with any questions or requests for consultation

© 2015 by Ellis Amdur 2

http://www.edgeworkbooks.com/

Skills for the Assessment, De-escalation and Calming of Hostile or Aggressive Individuals

OCEACT WORKSHOP – 6/21/2016

I. The Cycle of Aggression & The Guiding Principals in Dealing with

the Cycle of AggressionWe can best distinguish between “anger” and “rage” by our own reaction. Properly trained, you will not be afraid of an angry person. You will be aware, focused and hopefully centered. You may have any number of other emotional reactions – some less elegant or functional – but not FEAR. With the enraged person, you should experience fear. Not debilitating fear, or a sense of helplessness. But, essentially, the “animal” in you senses that this person desires to harm you – now – and is working himself up towards it. Fear is not a measure of competency or even courage. It is simply a demand that – right now – you must and will pay absolute and total attention to the threat. Some people, particularly trained professionals or those with a long history of facing aggression, sometimes pass through fear into “tactical cool,” so quickly they hardly notice the sensation of “fear.”

1. Baseline – simply communicate – all cultural rules apply (1% - 20%)

2. Anger (the 20% - 95% of escalation) – “Line up” with the angry person –

use culture as a tool to assist in lining-up. Remember: the angry person

is trying to communicate with you, however, unpleasant a way they have

chosen and will escalate as long as he believes he is not “getting through”

to you


3. Rage (the last 95% - 99%) of escalation – a transitional state between

anger and violence) – the Enraged person is trying to disinhibit himself –

trying to eliminate that which holds him back from committing violence.

Even though words may be uses, this is not communication. It is a self-

generated tool to further Disinhibition. You must establish control over

the person – more specifically their “disinhibiting” activities so that they do

not further escalate into violence.

4. Violence – establish safety, as best you can, within the circle you are

responsible. Safety is determined by the circumstances and whom we

must protect. This includes escape, misdirection, manipulation, fighting

back – whatever is required to protect yourself and those for whom you

are responsible.

5. Post-crisis – this can include reassurance, limit setting, future planning,

etc. See “The Aftermath – What Happens After a Crisis of Rage or

Violence?” below

II. What do people do when they become Aggressive? What can

Escalation Look Like?1. MOOD AND AFFECT

Nervous, anxious, mistrustful, even frightened.

Hostile, seductive or sarcastic

Atypically withdrawal

Overwhelmed or disorganized

Emotional lability (sudden or rapid mood swings)

Mood is incongruent with their affect.

Hypersensitive to correction or disagreement.

Frustrated or outraged with limits or refusal

Distractibility – possibility that they are hearing voices

“Electric” tension,

2. COGNITIVE CHANGES


The person starts to engage in interpersonal “cognitive distortions” –

hearing the worst possible message in what you are saying

The person is unable to verbally explain their feelings, or even identify

them – without words, all that is left is acting out

They become less and less amenable to conciliation or negotiation –

they cannot conceive of a win-win outcome

Concentration deteriorates – they cannot focus on what might help

them out of the situation. They increasingly can only pay attention to

their own perceptions and ideas, no matter how irrational or distorted

Memory decreases – they forget past negative outcomes and/or how

they solved such problems in the past

The angrier the person is, the lower their ability to listen.

Judgment deteriorates

3. VERBAL INTERACTIONS

They become increasingly illogical, misunderstanding or going off on

tangents

They become loud and demanding

They can become deliberately provocative or play word games,

distorting what you are saying

Some people present with a sarcasm or cold hostility

Abusive or obscene language.

They make repeated demands or complaints, not even hearing when a

solution is offered – even when it is what they desire

Other people’s speech become clipped, pressured or over-controlled.

4. PHYSICAL ORGANIZATION - DISORGANIZATION

The person’s body becomes tense. Sometimes they try to

discharge the tension by pacing, by rapid jerky movements, or even

exercise that clearly is not for fun or body toning.

The belligerent tend to squarely confront the victim, whereas the

more predatory tries to move on the victim’s corner


A clenched jaw, or teeth edge-to-edge

Some people sweat as their sweat glands are stimulated

Across the spectrum of all types of aggressive behavioral, facial

expressions can include clenched teeth, frowning, staring eyes, a

flushed or blanched face biting or tightened lips, quivering lips,

pulsating veins in the neck, dilated pupils in the eyes, or avoiding all

eye contact. The nostrils can flare, both to facilitate deep breathing

and also as part of a dominant/threatening facial expression.

Some people experience pain in their chest, their joints and

headaches as there is increased blood flow to the skeletal muscles

Nausea, vomiting, a need to urinate or diarrhea can occur as the

primitive fight/flight response is activated and the body tries to void

for combat

Breathing will be either deep in the chest or very fast. The person

may hyperventilate so deeply that they go into a panic state

During the anger/posturing phase, many people push their chest

out and their chin forward (“head pecking”). They inflate their upper

body and hold their arms out from their sides. This can be

accompanied by a stereotypical “war dance:” pacing, stomping,

glaring, hitting oneself, pounding one’s fist

Other people move in quick jerky starts-and-stops.

Predators and others comfortable with or enjoying aggression are

usually relaxed.

6. BEHAVIOR AT THE EDGE OF ATTACK

Increasing trespass on your personal space – this can include physical

proximity, eye contact, running the eyes over your body (usually male

to female), and verbal intrusions

“Power testing” – provocative actions that demand you respond

Displacement activity

Scapegoating


A red or flushed face is very angry. A blanched or ashy face signals

that the attack is just about to happen.

Breathing that is shallow, rapid and irregular, almost like panting or

gasping. Their body can begin shaking and a general sense of

agitation increases

Calm before the storm – The “thousand yard” stare, where they

suddenly “go away”

“Eerie smile” – frequently with psychotic people

III. Introduction to Techniques for Dealing with Angry People –1. The sooner you intervene, the better. People do not “vent” out the tension

making it easier to deal with them later.

2. Deal with the Problem, not the cause - the cause cannot be addressed

until after the person is de-escalated

3. Techniques “work” through humanity and respect – you must exemplify

the behavior you expect in others.

IX. Physical Organization in the Face of Aggression1. Circular breathing. (See Section IV. Above)

2. Stand and/or sit at an angle to the upset person. People can tolerate

more proximity when not in direct confrontation.

3. Using the stillness of your hands as a calming agent. Generally

speaking, your hands are clasped, one hand to one wrist. Do not “talk”

too much with your hands, as this can be seen by the angry person as

aggressive or confusing. Furthermore, you may betray your own anxiety

through your hands

4. Using your hands as a fence. If escalation continues, raise both hands in

a fence.

5. Move slowly and smoothly.


6. Do not touch the angry person unless you have to

7. Note signs of physical agitation in yourself

8. The art of eye contact. In almost all cases, we should make direct eye-

contact with the aggressive individual. Exceptions:

Look between the eyes when you can’t look into their eyes

Limit eye-contact with psychotic individuals or otherwise paranoid

individuals, when they are at low levels of agitation. Nonetheless, if

they escalate, you will have to make eye-contact with them as well

Manipulative individuals – (see Section XV for specialized non-eye

contact strategy for such people)

IV. Tone and Quality of Voice1. Generally, try to pitch your voice a little lower than is usual for you.

2. This slightly lower-pitched tone should also be “matter-of-fact.”

3. It is often useful to speak a little slower than they are speaking

4. Do not use a sugary sweet voice.

5. Sometimes, you can use a dramatic voice. This is a contrarian strategy

where you “jump out of the system,” acting in a way that is simply not

within the “fight-flight” paradigm.

6. With only one exception (“battle cry”), used to suddenly startle and freeze

the other person to disrupt their attack there are almost no situations

where you should be yelling at the other person.

V. Following the Access Route1. People live by codes. When people talk about themselves, their codes of

living are woven through their speech.

2. Angry people will very often proclaim their values and code for living in

their explanation or tirade


3. The core metaphor is the access route to the person. Once you are

aware of their code of living, you must frame solutions in that context.

Otherwise, you will be communicating at cross-purposes

VI. Paraphrasing – The Gold Standard – This is the most important

method of de-escalating ANGRY people. IT WILL NOT WORK UPON

ENRAGED PEOPLE

Paraphrase simply sums up in a phrase or sentence your perception of

what the person has just said in a paragraph – short or long. If you paraphrase it

up accurately, you’ve established that you’ve “gotten” him or her that far, so they

don’t have to say it again. It is like peeling off a single layer of an onion so that

they can show you the next one. WARNING: Do NOT simply repeat what they

say – this is experienced as “mocking,” and can elicit rage.

VII. Paranoia

Paranoid individuals can exhibit traits of fear, frustration, intimidation,

and manipulation. With their focus, however, they are rarely disorganized.


They are, at core level, very frightened, but they cover this up with suspicion

and aggression. Imagine a porcupine - quills to the world, hiding a soft

underbelly close to the ground.

1. A paranoid always searches for evidence to confirm a belief already set.

2. The paranoid person assumes that others are conspiring towards him,

talking about him, laughing at him, and their actions in response to this

delusion often evokes the behavior that they fear. 3. Internally, they are in a state of fear, but this is masked by harsh defenses.

4. When feeling fear, paranoid individuals often attack. If they sense fear in

you, they expect you to attack, and they will then "counterattack first."

5. When they care about someone, they can easily shift to a sense of

betrayal if the person does not conform to their desire (which requires that

they be in perfect control) or in jealousy (which includes fears of

abandonment, revolt, and the possibility that their secrets will be shared).

DE-ESCALATION TACTICS

The paranoid feels safest when you differentiate yourself from them, so

that you are not interwoven in their delusional fears. Therefore, it is

actually better not to be too friendly. Rather, keep a “correct” distance,

both physically and emotionally. If they attempt to get close, even in a

gesture of friendship, you have to move back so that you maintain that

crisp, professional relationship. At the same time, if you purely

withdraw into cold disinterest, the paranoid person will likely assume

that you are planning to harm them in some way – because you are

inaccessible and thus unpredictable.

Tell a paranoid individual what you are doing, and why, unless you

have a very good reason for not doing so.


Whether sitting or standing, turn your body at a slight angle, so that

physical "confrontation" is a choice rather than a requirement. (Blade

Stance)

Other tactics are determined by what mode of aggression the person

is displaying (See later sections)

VIII. Forewarned is Fore-armed: What to Look for with Opportunistic

and Manipulative Individuals

1. Professionals are no better than lay-people in detecting lying. In fact,

once some sort of rapport is established, (or so the professional, at least,

believes), professional can easily tend to give the individual the benefit of

the doubt if they do not stay mindful.

2. Manipulative people will put you on the spot – asking for a decision in front

of others (family members, for example) where your refusal will cause

disappointment or distress.


3. Often their lies are “Lies of Omission.” They will tell you reassuring

aspects of a situation, but not include their intention to harm.

4. Too much information – one way manipulative individuals manage the

perceptions of others is to talk too much, too elaborately. They will use

charm to keep their victim’s attention focused on the relationship, rather

than what they are doing.

5. One sign of coercion is a reassuring promise when none was asked for. “I

know you might be concerned. I’ll only stay five minutes, I promise.”

6. They will ask for personal information. This is not only intimate

information, but everyday stuff. This becomes leverage – they can use

this information to further conversational topics, to “find” points in

common, and thereby, to enlist the officer in a positive view of the

manipulator. Simply establishing a “personal relationship” between

inmate and staff or officer and suspect area always out of professional

bounds. Being able to display personal information about a staff person

can be embarrassing. In the interest of avoiding the embarrassment, the

staff person may give in to further requests. At a certain point, these

requests are illegal or unethical and the staff member can be blackmailed.

Any innocuous question – even what kind of car you drive, what brand

beer you might drink, is leverage.

7. They make many behavioral observations. They are particularly

interested in who is intimidated, easily frightened, or overly macho.

8. Quid-pro-quo – if someone does us a favor, we humans feel like we owe

them. Manipulative people deliberately do favors to set up an opportunity

for a demand in return. One way of doing this is flattery. Another is

“conceding” that the professional is the decision-maker, the powerful one.

Many manipulators frame openness is a favor. By deliberately making it

very hard, and then offering information that was long awaited, they can

actually be trying to set up some kind of return favor that they claim (and

might believe) that they are owed.


9. Blame – if a manipulator doesn’t get what he wants, he may complain

bitterly how he trusted the professional, and this is what happens.

10. Remember, the manipulator will attack you not only through your weak

points, but also your best points. If you are religious, you very likely have

a faith in the redemption of people. Showing contrition, even in a non-

religious context may lead you to let down your guard. The manipulator

scans his or her victim looking for leverage – anything, strong or weak,

that they can use.

11. Splitting – manipulators consciously split, by spreading rumors or stories

about other staff or clients/residents. This may be lies, but it is even more

effective when it’s true.

12. The manipulator says something over the line, and then when confronted,

laughs and says they were just joking.

13. Staring, intimidation, mumbling, etc., to elicit a negative response which

then justifies their aggression.

14. Manipulators will often use a victim role – even a real history – as

leverage, trying to elicit “privileged guilt”

“You don’t understand”

“You’ve never lived our kind of life”

15. “Yes, Boss” – an over-ingratiating smiling presentation. Interestingly, this

type of individual is also often “accident prone”

16. Blamers – the more responsibility is theirs, the more they blame others.

Sometimes such people will blame or attack, and then when confronted,

will straight-facedly deny it OR, ask a question like, “How come you are so

sensitive.”

17. Flirtation – if you do not address flirtation, come-on’s right away, it is

viewed as implicit acceptance. You are now open to blackmail, and/or at

minimum, an escalation of such approaches.

18. Manipulative phrases include:

“You wouldn’t understand”


“I got caught up in something” _ (denying responsibility)

“You know what I mean” – (Or you would, if you were hip)

“I don’t know” – (said so the wise social worker will explain to them

what they already knew – a kind of control)

“Nobody told me”

“I should have known you wouldn’t understand – I guess you are like

all the rest.”

19.Grooming behavior – the manipulative person may set up a situation

where he creates in you a little anxiety, and then relieves it while making a

request you would have granted anyway. For example, he stands too

close – just a little – and then, as he pulls back, he asks for a drink of

water. This will be repeated until the “victim” begins to associate a sense

of relief and relaxation when they are granting a favor. This can escalate

until the favors are over an ethical or professional line. The groomed

victim may rationalize this, because they are so used to feeling very good

when granting favors.

IX. Control of HOT RAGE - It is sometimes claimed that hot rage is a result

of frustration, but this emotion does not usually create rage in normal people.

It is when frustrated desires are coupled with something “personal” – one is

impeded by another person in getting one’s desires – that the person

becomes aggressive. Their rage is their own justification for the “justice” that

is their due.

GENERAL DE-ESCALATION STRATEGY

The most central method of de-escalation for hot rage is named: “The Ladder Technique” IMPORTANT: The “ladder technique” is only useful with the enraged individual. If you use this with a merely angry person, they will escalate. It is, thus, imperative, that people continue to train and practice in the methods outlined here, so that they can clearly perceive these two different emotional states. A follow up study


on another method, similar to the Ladder Technique, saw an increase in assaults in the agency after implementing the procedure. This is almost surely due to using this rarely needed technique upon angry individuals who, now frustrated that they weren’t getting through to the other person, further escalated into rage and violence. Used properly, however, it is invaluable.

1. Use a short sentence, with no more than four or five words.

2. Choose the most dangerous behavior and repetitively demand that it

cease.

3. After a couple of repetitions, always add, “We’ll talk about it when you . .. “

4. Once the dangerous behavior stops, choose the next level down of

problematic behavior and use the same technique.

5. Continue until they are de-escalated. This technique is only effective

right before, during and after the peak of the crisis.

6. Once de-escalated, THEN and only then set a firm and direct limit, as

befits the situation.

7. If the person re-escalates to a higher and more dangerous activity, simply

go up to that “rung” of the ladder and begin repeating again.

8. Tripwire principle - If they do not de-escalate and cease threatening

behaviors, and instead, continue or start even more threatening behaviors,

then you are in DANGER. Shift into establishing your safety and those

you are responsible for as your prime objective

Hot Rage subtype – Fury


9. The furious person is very tense. They look like they are about to

explode. If they are big in stature, think of a grizzly bear. If they are

smaller, think of a wolverine. Their energy is “pent up” and explosive

Their voice, be it loud, or low and quiet, has a menacing and

belligerent tone.

They often pace, inflate their upper body, and hit things or their own

hands.

They tend to stare directly in the eyes – or under the brows

These people have a low frustration tolerance.

During periods of aggression, physical arousal - blood pressure,

muscular tension - is increased.

Sometimes they will have a smile that shows no humor or joy.

The eyes are enraged.

They are very impulsive – unconcerned with future consequences.

Their breathing is often loud, and straining.

People with head injuries frequently show this kind of rage

They can claim to be disrespected, humiliated or shamed.

At the danger point, they can get “calm,” break off eye contact, or go

into the thousand-yard stare, with paling of skin, shallow respiration.

DE-ESCALATION STRATEGY

You must embody control for the individual until they can achieve it

themselves. The Ladder Technique is the main method

Your posture and tone should be commanding, imposing.

Stand out of range of an immediate blow, but directly in front of them.

Your voice is strong, forceful - do not, however, shout.

Use direct eye contact, and frequently use their name

NOTE: When these individuals comply with the command to step back,

they usually do so yelling – “You can’t tell me what to do!!!!!”


Hot Rage subtype #2 – Bluffing

This person, like the gorilla beating his chest, displays aggression to keep you

at a distance. There is a sense of bluster rather than the pent-up pressure of the

enraged person. They are like a wind blowing against a stonewall, rather than

pent-up explosiveness under the rock. Such individuals frequently display this

type of aggression in the presence of family or friends or another audience.

Some, metaphorically, carry the audience in their own head.

1. Such an individual can be profoundly dangerous. But in addition to your

“fear/adrenaline” reaction, you will also, very likely, be irritated. By

“fronting,” they put themselves (and you) in a situation that it is hard to

back down from. On other occasions, you will find yourself wary, perhaps,

but somehow not threatened by his or her behavior. The irritation,

however, will still likely be there, unless they are no threat due to their

profound lack of size and power. Then, you may find yourself amused.

2. They look the same (hence the terrifying image of the enraged gorilla), but

they would prefer to be left alone, not be in combat.

3. If they do succeed in working themselves up, they become enraged. This

is why it is essential to short-circuit their behavior before escalation.


4. Bluffers are often displaying aggression for the benefit of friends or family.

Inside, they are frightened that they will be found out as frightened.

5. Such people can be quite dangerous, however, despite their bluff, if they

feel exposed, or forced to act.

6. When they are frightened, they move forward, not back, so that no one will

see how scared they are

DE-ESCALATION STRATEGY.

They are not really in confrontation with you - they are pretending that

they are.

De-escalate much as one would with the enraged individual, using the

ladder technique, but with a softer, much more matter-of-fact tone,

almost as if having a conversation.

Your eye contact, too, is matter-of-fact, as if you are having a

conversation rather than a confrontation.

When these individuals “back off,” they often strut back with a smirk.

When they are somewhat calmer, or if they did not escalate so high:

Include in one's strategy some information and re-assurance.

Do not explicitly point out their fear to others’ attention - they will feel

the need to defend their honor.

Do not overwhelm them, or their fear may require them to strike out.

When you set a limit at the end of the confrontation, include some ego

building. These individuals are most dangerous when they are

depending on others to feel strong.


OCEACT KEYNOTE PRESENTATION – 6/21/2016

X. The Texture of Relationship – A Study of Interpersonal Space 1. Be aware of you spacing with another person. If you are too close,

they will be agitated

2. If YOU find them too close, tell them, with firm diplomacy to move back

so you can continue the conversation

XI. Bracketing – The Art of not Offering Weapons to your Aggressor

to Use Against You - Personal attacks are not personal unless

you make them so. 1. Recognizing the things you detest about yourself that others can use

against you

2. Recognizing the things you treasure that others can use against you

3. Recognizing the things that someone can use to throw you off balance –

certain words or behaviors that either “make” you lose control or, you

believe, legitimize you becoming aggressive in turn.

4. Recognizing your bias’ and keeping them “to the side”

5. SOLUTION – take inventory of your vulnerabilities – a daily ritual


XII. The Art of Circular Breathing: The Development of Mindful

Awareness Amidst Chaos

1. Circular Breathing Method #1 – Down the front and up the back

Sit comfortably, feet on the floor, hands in lap. Your posture should

be centered, rather than twisted or askew. (Once you have

mastered this breathing, you can use it in any posture whatsoever).

The spine can curve forward slightly, rather than being held stiffly or

erect.

The eyes should be open. You are training for emergencies – not

mere stress reduction where you close your eyes and “go away”

from the problem

Breathe in through the nose.


Imagine the air traveling in a column down the front of your body,

through your throat and neck, underneath your sternum and solar

plexus, going to a point two inches below the navel.

Pause slightly, but do not strain or forcefully hold the breath. Some

people envision a rotating wheel of fire or energy at this center

point, but this is not necessary. If you do use this image, it should

be a quiet, banked fire, not a flame of high energy.

Imagine the air traveling through your groin and looping around

your lower body, between your legs, and up through the base of

your spine.

Continuing to exhale, imagine the air going up each vertebrae,

through the neck, around the skull, and down and out either your

nose, or your mouth and nose together.

NOTE: It can be helpful to either imagine inhaling light (of any color) or to

scratch a line down the front and back centerlines of your body to focus

your attention.

2. Circular Breathing Method #2 – Down the back and up the front

Sit comfortably, feet on the floor, hands in lap. Your posture should

be centered, rather than twisted or askew. (Once you have

mastered this breathing, you can use it in any posture whatsoever).

The spine can curve forward slightly, rather than being held stiffly or

erect.

The eyes should be open. You are training for emergencies – not

mere stress reduction where you close your eyes and “go away”

from the problem

Breathe in through the nose.

Imagine the air traveling up the face and around the head, looping

down through the neck, falling down each vertebrae, continuing

down past the base of the spine to the perineum and looping again,


this time up through the groin and the front of the body to a point

two inches below the navel.

Pause slightly, but do not strain or forcefully hold the breath. Some

people envision a rotating wheel of fire or energy at this center

point, but this is not necessary. If you do use this image, it should

be a quiet, banked fire, not a flame of high energy.

Imagine the air ascending up the center line of the body, through

the solar plexus, under the sternum, up through the throat and then

out either your nose, or your mouth and nose together.

NOTE: It can be helpful to either imagine inhaling light (of any color) or to

scratch a line down the front and back centerlines of your body to focus

your attention.

3. When Should You Use this Breathing?


Documents

Edgework - oceact.org€¦ · Web viewThey can become deliberately provocative or play word games, distorting what you are saying Some people present with a sarcasm or cold hostility