Hit, Kicked, Scratched, Bit…

fist hitting face…and I could go on. That’s just a partial list of physical attacks I endured while providing direct care to psychiatric patients as a  Mental Health Worker (MHW) at the Brown School’s Ranch Treatment Center circa the late 70s. Hair pulled, beard yanked, spit on, food, feces and urine thrown at me —all part of the job.

Retaliation, of course, was strictly forbidden. And the guy who had hit you in the morning most likely wanted and needed your help before lunch, so you had to just put the prior aggression behind you and calmly continue helping the guy get through his day.

We were known for taking individuals — all male at that time, mostly adolescent — with behaviors that had been problematic in less restrictive settings. I started my 15-year career at the Brown Schools on Lariat, one of 2 locked dorms with residents with a background of inappropriate and aggressive behaviors.

Combine low frustration tolerance with poor impulse control, mix in a myriad of psychiatric conditions — schizophrenia, developmental delays, borderline personality, conduct disorders, emotional disturbances  — and you’ve got a volatile concoction primed to explode with the smallest spark.

A big part of our job involved working to de-fuse the potential explosions.  So we learned some simple techniques for de-escalating situations. The basics boiled down to this:

  • Make de-escalation the focus of the intervention.
  • Use a calm voice and non-threatening body language.
  • Avoid getting drawn into a power struggle.
  • Offer reasonable options for the agitated individual.
  • Most importantly — work with your team to reduce the chances of losing control — of yourself or the situation.

Did they always work? No, but we always tried.
And they worked remarkably well most of the time, usually allowing us to avoid having to intervene physically. Regardless, we were always required to work to de-escalate potentially confrontations whenever possible.

We worked to refine our staff training as time passed, which is part of how I became a trainer. Eventually this specific training program (Management of Aggressive Behavior, or MAB), gained a widespread reputation as a therapeutic approach to dealing with individuals engaging in aggressive behaviors.

Eventually, we were invited to present our program to various conferences and groups, including the Regional Network for Children’s statewide conference, the Texas Head Injury Foundation statewide conference, the Criss Cole Rehabilitation Center for the Blind and Visually Impaired, and several classes of the UT School of Nursing. By request, I presented a modified talk called, “Anger & Aggression: Therapeutic Alternatives for the Caregiver” at the Austin Children’s Hospital.

I write of my background to preface my comments about the traffic stop turned tragically wrong recently in Waller County, Texas, when Sandra Bland was taken into custody. Watching the police officer’s dash-cam video sickened me as I saw him utterly fail to use any of our simple techniques for de-escalating the situation.

Instead, in my opinion, after the officer walked back to the stopped car, he deliberately chose to escalate the confrontation.

Screen shot from dash-cam video of Sandra Bland traffic stop

Rather than simply issuing the warning ticket he had written, the officer asked why she seems irritated, opening the door to an escalation of tension.

After Ms. Bland answered his question directly, rather than “politely”  — that is, subserviently — his voice turns from calm to confrontational. He asks, “Are you done?”  — think about the phrasing of that question — in a stern voice, basically issuing a verbal invitation to escalate.

At this point, he has lost the focus of the traffic stop and rather than attempt to de-escalate the tension, he begins to engage in a power struggle with an individual he perceives as not fully compliant with his authority.

He tells her to put out her cigarette and she asks why. He orders her out of the car, triggering a confrontation unrelated to the traffic violation. When she refuses to exit, he tries to physically remove her first, then we watch as the officer really loses control, grabbing at his taser while yelling, “I WILL LIGHT YOU UP!”

That one sentence demonstrates the entire problem with his behavior: yelling, rather than using a calm voice; threatening, rather than de-escalating; and acting alone rather than waiting for the back-up he has just called for.

There are those who argue Ms. Bland should not have reacted as she did. Given my background though, I believe the person in authority always has the chief responsibility for everyone’s safety. Had the officer chosen to de-escalate the confrontation, the whole thing would have ended as he originally intended, with a warning ticket.

Instead, we are left with the twin tragedy of an officer unnecessarily escalating a simple traffic stop — and a dead young woman.

This did not have to happen.


About bullersbackporch

I am a native Austinite, a high-tech Luddite, lover of music, movies and stories and a born trainer-explainer.
This entry was posted in behavior, Buller, mental health, work and tagged , , . Bookmark the permalink.

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