Dangerous Thinking

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This is the blog of Dr Iain Bourne, specialist trainer in crisis mental health. It represents no more than occasional, random and personal reflections on all issues on violence, suicde, self-harm, psychosis and trauma – and life! I hope you (friends, colleagues, course participants, clients and people I may never meet) may find the time to contrtibute.

The blood is boiling …

Despite my violent antics during training courses and my more mysterious side – I am now genuinely on the warpath! I’m in Trowbridge and although its hot here – the group I’m working with are a pleasant and genuine group of people – it has nothing to do with them. Someone, however,  has crossed me tonight – a bully – and I am on the warpath!

I can feel my fingers tingling, and I know I won’t sleep tonight. Goodness knows what state I’ll be in by tommorrow morning.  Unfortunately (or fortunately – however you see it) I can’t get to this person (people) right now as I’m not in Bristol. I have, however, called them and told them that I’m on my way and I’ll call on them tommorrow when I get back.

While I feel like letting rip, I think the COLD approach may be more effective. These days I tend to scream and shout a lot, causing a lot of fear and flurry. But I recall when I ran St. Elizabeth’s – no one could ever recall me screaming or shouting, but many recalled the coldness of my anger.

It was, as it is now (with my training) all an act.

But now it’s for real and it’s not the time for ranting – that’s what they’re expecting. Instead I’ll let them squirm – say little and stare a lot – and when they’ve backed themselves into a corner, I’ll go for the kill! These guys are way out of their depth!

Listen to me – Gangsta Bourne! Well may be I’m a bit of a scaredy cat – but I they don’t know that and I think I’m a far better actor than them – and this is my business!

And actually, I am angrier and more upset right now than I can recall for a long time.

It leads me on to who could be in danger. No-one, other than those involved,  so most of you are safe. But if someone crossed my path and wouldn’t back of, there might be a war. I think about being in Belfast – most people, even during the Troubles – were probably safer there than they would be in most parts of the UK.  But if you were in the wrong place at the wrong time …

When I go to war – sorry – looking for reconcilliation – tommorrow night, it has to be tactical. I also need to know what I require to withdraw. I can be silent and menacing, but they have to have let out too.

You can catch up with this thrilling next installment – if I’m still alive – tomorrow!

Personally, I hate this stuff, I hate the feeling that hangs around, and I just wish this stuff didn’t have to happen. It’s my business – violence – but but I wish it’d stop and people  could just be left alone to get on with their lives.

Filed under: General, Violence, , , , , , , ,

Fight, Flight, Freeze?

A large part of responding to highly charged and potentially very frightening and dangerous situations lies in our ability or otherwise to harness our body’s emergency systems. Failure to do so can lead to either panic, tonic immobility, or unchannelled and uncontrolled reactions. Coloquially we often talk about Fight, Flight or Freeze Responses as an potentialy inevitable and unavoidable outcomes.

However, if we look at what ethologists have found, it would seem that the picture is somewhat different and more complex. In the first instance it appears that the order is wrong. The first autonomic reaction is not Fight, but Freeze, then Flight and then Fight. Well, I hear you say, “how are Flight or Flight possible when you are already in a Freeze state?” The answer seems to be that what we colloquially refer to as Freeze is actually something else altogether – Fright, or tonic imobility, the body shutting down and becoming rigid.

What ethologists call Freeze is actually a state of heightened awareness or hyper-vigilence where the body temporaily “freezes” while information about the threat is gathered – a state of heightened awareness and readiness, rather than immobility. The normal reaction following is that of  Flight – and Fight only takes places when Flight is not an option (note, that with humans, pride and other psychological processes may prevent flight).  However, if fight is also not a realistic option, then Fright or tonic immobility sets in.  Finally Faint becomes the last option.

Faint,  however, occurs under situations of prolonged duress and refers  to situations where the pain or horror becomes so overwhelming that the brain disconnects as an act of survival. Distancing, blunting, avoidance, denial, pretence – dissociative processes.

So what we call Freeze, is actually Fright and our primary instinct is not Fight or Freeze/Fright but Flight (get me outta here). These reactions appear to be spontaneous and autonomic – and out of our control. DDDB training, however, is based not on cortical thinking, but limbic processing – and suddenly it becomes clear that the protocol must be about managing oneself rather than the aggressor. The skill has to be about managing internal processes in micro-seconds.

Filed under: Violence, , , , , , , , ,

Violence or Suicide Training?

Tomorrow, in Southampton, and then on Monday and Tuesday next week in Nottingham I am delivering “Razor’s Edge: Responding to Suicide and Self-harm.” That’s fine – but actually almost 75% of the training I deliver is on Violence.

I’m still in my hotel room so I’ll have to recheck this later, but I am sure that you are far more likely to be killed by yourself than by someone else. Indeed, although I have worked in, and visited some very violent places – actually the more everyday and persistent encounter is suicidal ideation. So you would think that mostly I’d be providing “suicide/self-harm” related training – but that’s not the case.

Suicide is probably (to many) more emotionally evocative than violence and my guess is that most organisations would rather be seen as negligent following an assault on a staff member than for the self-inflicted death of a service-user. Furthermore, in my experience, most people feel far more out of their depth in dealing with suicidal and self-destructive behaviour than they do with violent behaviour.

Well, you could say (this is me answering and refuting my own questions – because I know there is no one out there listening anyway) that this is because I am better known for my work on violence that suicide. This may be truse but if you google a bit, you will realise that there is much more information (I mean of a helpful kind) on suicide than violence, but when you look for training the picture reverses.

I don’t know. My first thought was that organisations believe that “if a person wants to kill themself they will do it” – no blame. But actually in my experience there is a lot more blame all around after a suicide (self, colleagues, family, organisation and even the person who died) – and it persists (you can’t ask the dead person “why”). A team can bond together after a colleague has been attacked, but can fall apart after a suicide – it’s the same with families.

That’s clearly the wrong track. Right now I do still think it has to do with culpability – but in a different way. I think organisations are wary of Suicide Prevention Training for a number of reason – all understandable:

  • If you train a care-worker to deal with a suicidal crisis – will that give the message that they are expected and equipped to deal with a suicidal crisis (pay and responsibility implications)?
  • If you provide suicide awareness training (for example in schools – best place for it)  what happens if a suicide happens afterwards?  Who will point the finger and who will take the blame? I’m sure if one of my sons killed themselves and I found out that there had been a suicide awareness class the week before, I’d want to point the finger – but the truth may be that many young people kill themselves because they couldn’t talk to anyone. And their best friend didn’t know what to say or do either

Now I was reaching some kind of conclussion, but that would be like suicide. Thankfully with all the interuptions, I lost the thread. May be I’ll return to it, or you can turn this into a debate?

Filed under: Suicide, Training, Violence, , , ,

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