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293: The Five Secrets with Violent and Angry Individuals, Featuring Heather Clague, MD

293: The Five Secrets with Violent and Angry Individuals, Featuring Heather Clague, MD

FromFeeling Good Podcast | TEAM-CBT - The New Mood Therapy


293: The Five Secrets with Violent and Angry Individuals, Featuring Heather Clague, MD

FromFeeling Good Podcast | TEAM-CBT - The New Mood Therapy

ratings:
Length:
59 minutes
Released:
May 23, 2022
Format:
Podcast episode

Description

293: The Five Secrets with Violent and Angry Individuals, Featuring Heather Clague, MD Heather Clague MD is a Level 5 TEAM therapist and trainer with a practice in Oakland, California and consult-liaison psychiatrist at Highland Hospital in Oakland. In addition to running an online consultation group for TEAM therapists, she is faculty for All Things CBT,  teaches for the Feeling Good Institute, and has taught the Five Secrets of Effective Communication to medical staff. Her writing can be found at psychotherapy.net. With Dr. Brandon Vance, Heather co-leads the Feeling Great Book Club, a book club for everyone, everywhere who wants to learn the magic of TEAM. In today’s podcast, Rhonda and David speak with Dr. Heather Clague who describes her working in the psychiatric emergency room at Highland Hospital in Oakland, California, and other emergency facilities including Fairmont Hospital in San Leandro, California, interacting with hostile and psychotic individuals who often have to be held against their will because they are a danger to themselves or others, or unable to care for themselves. Although today’s podcast will be of special interest to mental health professionals, it will also be of great interest to anyone having to interact with strangers, friends or family members who are angry and abusive. She explained that In these types of settings, we often have to give patients the opposite of what they want. For example, if they’re involuntarily hospitalized for dangerous behavior, we have to restrain them, or keep them in the hospital, when they desperately want out. Or, if they want to stay in the hospital, we may have to discharge them. Many of these patients are psychotic and lack judgment, so they may shout and act out in anger and frustration. The Five Secrets (LINK) have been a godsend, and when it works, the results are amazing. For example, if a patient is screaming for us to release them, the natural instinct to get defensive just agitates them more and is rarely or never effective. If in contrast, you say, “You’re right, we are holding you against your will and you have every right to be angry,” they usually feel heard and calm right down. In one recent case, an agitated and confused homeless woman needing dialysis was near death because she was refusing treatment and refusing to take her medications. She was manic, agitated, and talking rapidly, non-stop. I said, “I think you’re really upset because we’re keeping you against your will.” The patient shouted “Yes!” Then I said, “And you’re telling us that you do have a place to go to if we let you out.” The patient said, “yes,” in a softer voice, and let the nurse come in and give her her medications, which she took. Heather described phrases she uses to get into each of the Five Secrets in high-secrets situations when you don’t have much time to think and have to respond quickly, including these: For the Disarming Technique: “You’re right,” followed by a statement affirming the truth in what the patient just said. Thought Empathy: “What you’re telling me is” followed by repeating what the patient just said. This is helped greatly by writing down what the patient said. Without writing things down, this technique tends to be impossible for mental health professionals OR the general public. In spite of this, most people refuse this advice! Feeling Empathy: “Given what you just told me, I can imagine you might be feeling X, Y, and Z” where X, Y and Z are feeling words, like “upset,” “anxious,” or “angry,” and so forth. Inquiry: Heather emphasizes two productive lines of Inquiry: “Am I getting it right?” “Can you tell me more about how you’re feeling?” “I Feel” Statements: “I’m feeling X, Y, and Z right now,” where X, Y, and Z are feeling words like sad, concerned, awkward, and so forth. When done skillfully, this technique adds warmth and genuineness, and facilitates the human connection. Heather cautions against saying “I feel like you . . . ” since this ends up no
Released:
May 23, 2022
Format:
Podcast episode