1. Working with strong emotions: ANGER

2. Please define: 1. Anger 2. Aggression 3. Violence 1. Anger 2. Aggression 3. Violence How are they different? And how are they the same? How are they different? And how are they the same?

3. ANGER A subjective emotional state defined by the presence of physiological arousal and cognitions of antagonism. AGGRESSION A disposition that may lead to constructive or destructive actions, a willingness to inflict harm. It maybe verbally expressed in threats to harm or result in actual harm. VIOLENCE A harmful and unlawful act(s) where there is use of physical force which is intended to hurt or injure another person What does anger look like? What does anger look like?

4. NON VERBAL PROXEMICS (Body Space) BODY MOVEMENTS POSTURE GESTURE FACIAL EXPRESSION EYE MOVEMENTS VERBAL TONE CONTENT SWEARING THREATS

6. Everyone thinks about anger and aggression differently... think about you own reactions to people losing their temper. What might you think about someone who starts shouting?

7. Assessing risks… PERSON Relatively permanent aspects (history / psychological / emotional influences). Temporary aspects TASK Bad news, refusing the person something they want? Is there a discrepancy between what the client expects and what we can provide? ENVIRONMENT / SETTING

8. Group Activity: Please mark the following examples between 1-5 on the following scales. a. How angry is the person? (1 = OK up to 5 = Furious). b.How acceptable do you find their emotion? (1= appropriate up to 5 = out of proportion). c. Please choose one word to describe your response to each of the examples.

9. “Anger is linked to a perception of damage or hurt and to a belief that important rules have been violated. We become angry if we think we have been treated unfairly, hurt unnecessarily, or prevented from obtaining something we expected to achieve. Notice the emphasis on fairness, reasonableness and expectation. It is not simply the hurt or damage that make us angry, but the violation of rules (Padesky & Greenberger., 1995). “We have to learn how to work with strong emotions compassionately, recognizing that we didn’t design them, choose them or ask for them to be shaped the way they are, but also not to be simply passive in the face of them or blindly act them out” (Gilbert 2009). Anger and aggression are a part of human nature and it is impossible and inappropriate to screen this out of human experience. This does not mean that you should expect or tolerate abuse in the course of your work. “We have to learn how to work with strong emotions compassionately, recognizing that we didn’t design them, choose them or ask for them to be shaped the way they are, but also not to be simply passive in the face of them or blindly act them out” (Gilbert 2009). Anger and aggression are a part of human nature and it is impossible and inappropriate to screen this out of human experience. This does not mean that you should expect or tolerate abuse in the course of your work.

10. True or False 1.Anger is inherited. 2.You can be aggressive without being physical. 3.It’s ok to be angry. 4.Anger automatically leads to aggression. 5.People may be aggressive to get what they want. 6.Venting anger is always desirable.

11. Self or Staff Lack of permanent staff Male / Female ratio Inadequate handover Poor communication and or attitude Self or Staff Lack of permanent staff Male / Female ratio Inadequate handover Poor communication and or attitude Service User Mental state Peer pressure Boredom Alcohol / Drug use Physical illness Frustration Lack of information Situation Temperature Lack of activities Overcrowding Noise Time of day Situation Temperature Lack of activities Overcrowding Noise Time of day Factors Violence SituationSUSelf

13. Communication - Do s and Don’t s

14. Core inter-personal skills: EMPATHY RESPECT GENUINE SPECIFIC LISTEN REPLY PROBLEM SOLVE

15. Therapeutic listening responses: Minimal cues Clarification Paraphrasing Restatement Reflection Summarisation Silence

16. Roadblocks To Communication Ordering Warning Arguing Blaming Judging Sarcasm Threaten Ordering Warning Arguing Blaming Judging Sarcasm Threaten Timing Language Personal factors Physical factors

17. De-escalation Strategies Keep yourself reasonably calm Move away if necessary (check your exits) Don’t be afraid to admit your fear Direct requests Matching Delay

18. Tactics for Defusing Be aware of how to get help Maintain adequate distance – Avoid corners, move towards a safe place Be aware of where and how you are standing. Ensure your own non-verbal communication is non-threatening. Check your posture; don’t touch the person if it can be avoided. Appear calm, self-controlled and confident, take deeper slow breaths. Manage the pitch tone and volume of your voice. Acknowledge the person’s anger, feelings and concerns. You may choose to sit down, but only if you are in no immediate danger. Ask for facts, encourage reasoning, avoid defend / attack spiral. If you feel your safety is compromised leave the area

19. De-escalation Strategies Maintain a non-threatening body posture. Avoid corners. Know your exits. Distraction. Remain alert.

20. Mental Illness And Violence 95% of homicides are committed by people without diagnosed MH Issues. People with mental illness are far more likely to be victims of violence than perpetrators of it. (Swedish study, 2013 found having a MH issue increased the likelihood of you being murdered x5!) The British Crime Survey found 47 % people attacked stated the offender had been drinking, 17% on drugs, only 1% thought Mental Distress played a part. 95% of homicides are committed by people without diagnosed MH Issues. People with mental illness are far more likely to be victims of violence than perpetrators of it. (Swedish study, 2013 found having a MH issue increased the likelihood of you being murdered x5!) The British Crime Survey found 47 % people attacked stated the offender had been drinking, 17% on drugs, only 1% thought Mental Distress played a part.