Dealing with violence

One of the more difficult aspects of being a counsellor or skilled helper is occasionally dealing with violent clients.  Violence does not have to be punching someone, sometimes it is threats, body language and tone of voice. 

It can be very intimidating and often there can be an overwhelming sense of injustice when you’re in a position of helping that person.

For those working in the field of mental health and drug addiction it is a very real threat, one that should not occur too regularly but will occur over the span of your career in that sector.

Transference:

Transference is a powerful force throughout human psychology, whereby a person projects previous experience on to current events. This powerful force causes clients in treatment to see their helpers as mother and father figures, brothers, sisters, the police, teachers and other authority figures they may have received abuse from or had very bad relationship with. 

In the heat of the moment, when emotions are raised and a person affected by this is overwhelmed by negative emotions, they begin to see you in a more sinister light. They will discard the reality that you are there to help them and begin to see you now a persecutor!

There are lots of mental health conditions, including substance use disorders, whereby the individual cannot regulate their emotions. 

Image result for drama triangle

Drama By Design

Be careful out there, not all drama is real!  In studies of Transactional Analysis dynamics, it demonstrated that some clients (or patients if you prefer) will create drama to get a rise or even get kicked out of treatment so they can prove to themselves and others that they are hopeless.  Eric Berne referred to this game as “KICK ME”.  Like the unfortunate school prank where someone puts a note on someone’s back, however, in this version the client puts the sign on their back and expects others to kick them. The client may be suffering from overwhelming feelings of hopelessness and they want the world to respond in kind.  This is done so that they no longer see themselves as having a choice in their well-being or suffering.

Those Who Are Likely to be Violent:

  • If a person uses verbal intent such as “I’ll kill that person”, “I’ll bash them”,
  • If a person has a history of violence in their criminal record
  • If you are working in prison populations or known anti-social groups
  • If a person is a known associate of criminal gangs
  • If a person has a history of being discharged for emotional outbursts
  • If a person has been diagnosed or displays traits of anti-social personality disorder
  • Extreme Narcissism
  • Withdrawing from drink or drugs and with a diagnosis of mental illness or questionable diagnosis
  • Noticeable scarring on the face which may have been caused by a blade – indication of gangland violence
  • Schizophrenia diagnosis
  • Non-compliant with medication
  • Environmental factors including the weather (Lee B, 2019, “Violence”)

*** Not a single one of these indicators is definite factor, however they do increase the probability of violence in a clinical setting***

Limitations of Your Service:

If your service does not have a good rapport with police do not admit clients who are likely to be violent. In rare occasions some clients have murdered or seriously injured those working to help them.

A golden rule of thumb in counselling is not to overstate your ability to cope with certain individuals, knowing your limits is of the utmost of importance.  If you have not been specifically trained to work with psychiatric patients who are non-compliant with medication then terminate your service to those individuals and sign post them to a clinician that can work with them.  You will cause yourself damage and possibly the client more damage.

Clients Losing Out

Clients don’t often want to butt heads with their care-givers, it is just an unfortunate event and not the primary reason why they are seeking help.  As care givers we have to give compassion but also state boundaries.  A client who has a bad experience of treatment can often withdraw from treatment for a good period of time afterwards or never return to treatment again, this is why it’s good to try and de-escalate the situation, but don’t bite off more than you can chew.

The main focus of the care-giver/helper/counsellor is to try and de-escalate the situation, if someone is overwhelmed and spitting vitriol about their circumstance, parts of their brain may be off-line due to powerful emotions. You may not get someone to rationalize around the situation, if you are the cause of the heated emotions it may be best to withdraw your presence from being there.  You are effectively talking to the rampant animal side of the brain,  instructions such as “calm down”, might add fuel to the fire.  You might not even get them to see any compassion or alternative, it might be a case of getting someone to breath deeply or focus on a technique they may be familiar with.  Try validating their experience and their feelings for the moment until they are able to de-escalate and come back to reality.

-Written By Dylan Kerr 2019

Agree or Disagree? Comment Below!

More reading:

Violence :  An Interdisciplinary Approach to Causes, Consequences and Cures by Bandy X-Lee 2019

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