self defence for mental health professionals graham martin, ed heffernan, james scott, rod martin,...

Self Defence for Mental Health Professionals

Self Defence for Mental Health Professionals

Graham Martin, Ed Heffernan,

James Scott,Rod Martin,

Malwina Martin, Sarah

George

Graham Martin, Ed Heffernan,

James Scott,Rod Martin,

Malwina Martin, Sarah

GeorgeLi Tieh Kuai (Iron Crutch Li), most ancient of the 8 ‘Immortals’Born 2nd Century AD (Han Dynasty)Li Tieh Kuai (Iron Crutch Li), most ancient of the 8 ‘Immortals’Born 2nd Century AD (Han Dynasty)

DisclaimerDisclaimer

• Today I am not trying to teach Karate; the focus is on quick and dirty ways of defending yourself, prior to running away.

• None of what we work on today should be too physically arduous; we will protect you from injury; we want you to be able to enjoy the rest of your Congress.

• However, we cannot accept liability for any loss or any personal injury

• Today I am not trying to teach Karate; the focus is on quick and dirty ways of defending yourself, prior to running away.

• None of what we work on today should be too physically arduous; we will protect you from injury; we want you to be able to enjoy the rest of your Congress.

• However, we cannot accept liability for any loss or any personal injury

We live in dangerous timesWe live in dangerous times• Before Grade 1, the average child has seen over

8,000 murders on television and over 100,000 violent acts. By schoolies week, the numbers will double (American Academy of Child and Adolescents Psychiatry, 1995)

• An average TV program contains 5 acts of violence An average TV program contains 5 acts of violence per hour, the average kid’s program shows 25 per per hour, the average kid’s program shows 25 per hour. (hour. (Center for Media & Public Affairs)

• Lyrics from Michael Mather (Eminem) talk about sticking nails through eyelids and slitting parents’ throats.

• Children have access to video games like Doom, Diablo, and Kingpin (“multiplayer gang bang death” and “see the damage done including exit wounds”)

• Before Grade 1, the average child has seen over 8,000 murders on television and over 100,000 violent acts. By schoolies week, the numbers will double (American Academy of Child and Adolescents Psychiatry, 1995)

• An average TV program contains 5 acts of violence An average TV program contains 5 acts of violence per hour, the average kid’s program shows 25 per per hour, the average kid’s program shows 25 per hour. (hour. (Center for Media & Public Affairs)

• Lyrics from Michael Mather (Eminem) talk about sticking nails through eyelids and slitting parents’ throats.

• Children have access to video games like Doom, Diablo, and Kingpin (“multiplayer gang bang death” and “see the damage done including exit wounds”)

Team Sports may not help much

Why I wanted to do this presentation

Why I wanted to do this presentation

• We have a responsibility to ourselves and to others to have reflected on our experience and prepared for the future as well as we can.

• Christopher L.• Mary K.• Dr. Nandadevi Chandraratnam, who died on

3rd December 1992• Dr. Margaret Tobin, who died on 15th

October 2002

• We have a responsibility to ourselves and to others to have reflected on our experience and prepared for the future as well as we can.

• Christopher L.• Mary K.• Dr. Nandadevi Chandraratnam, who died on

3rd December 1992• Dr. Margaret Tobin, who died on 15th

October 2002

FactoidFactoid

• Health care workers experience close to 40% of non-fatal assaults on employees in the United States.

• Health care workers experience close to 40% of non-fatal assaults on employees in the United States.

Victims of Patient AssaultVictims of Patient Assault• Physicians• Nurses• Social workers and other allied health

personnel• Other patients• Visitors• Emergency team members• Administrators• Police• Staff in Corrections

• Physicians• Nurses• Social workers and other allied health

personnel• Other patients• Visitors• Emergency team members• Administrators• Police• Staff in Corrections

Brasic JR, Ainsworth J: Clinical safety in neurology. eMedicine Neurology Journal [serial online]. 2005 . Available at http://www.emedicine.com/neuro/topic713.htm.Crilly, et al.: Violence towards emergency department nurses by patients. Accid Emerg Nurs 2004; 12: 67-73

Brasic JR, Ainsworth J: Clinical safety in neurology. eMedicine Neurology Journal [serial online]. 2005 . Available at http://www.emedicine.com/neuro/topic713.htm.Crilly, et al.: Violence towards emergency department nurses by patients. Accid Emerg Nurs 2004; 12: 67-73

Staff members who have developed a systematic approach to the treatment, understanding and management of assaultative behaviour are less likely to injure or be injured during an assaultative incident than those who haven’t.

Staff members who have developed a systematic approach to the treatment, understanding and management of assaultative behaviour are less likely to injure or be injured during an assaultative incident than those who haven’t.

Gun Deaths in AustraliaGun Deaths in Australia

Results: In the 18 years before the gun law reforms, there were 13 mass shootings in Australia, and none in

the 10.5 years afterwards. Declines in firearm-related deaths before the law reforms accelerated after the

reforms for total firearm deaths (p = 0.04), firearm suicides (p = 0.007) and firearm homicides (p = 0.15), but

not for the smallest category of unintentional firearm deaths, which increased. No evidence of substitution

effect for suicides or homicides was observed. The rates per 100 000 of total firearm deaths, firearm

homicides and firearm suicides all at least doubled their existing rates of decline after the revised gun laws.Results: In the 18 years before the gun law reforms, there were 13 mass shootings in Australia, and none in

the 10.5 years afterwards. Declines in firearm-related deaths before the law reforms accelerated after the

reforms for total firearm deaths (p = 0.04), firearm suicides (p = 0.007) and firearm homicides (p = 0.15), but

not for the smallest category of unintentional firearm deaths, which increased. No evidence of substitution

effect for suicides or homicides was observed. The rates per 100 000 of total firearm deaths, firearm

homicides and firearm suicides all at least doubled their existing rates of decline after the revised gun laws.

Categories of Workplace Violence (US)

Categories of Workplace Violence (US)

• Type I- Stranger vs. Employee -

(example:armed robbery)

Accounts for 60%

• Type II- Client vs. Employee

(example: social worker attacked by client)

Accounts for 30%

• Type III- Employee vs. Employee

Accounts for 10% of workplace attacks and/or

homicides

Small Group Workshop Exercise

Small Group Workshop Exercise

Your Personal ExperienceYour Personal Experience

Is there a profile?Is there a profile?

Dr. Tobin’s killer(prevention may not have been

possible)

Dr. Tobin’s killer(prevention may not have been

possible)• “In his closing argument in the SA Supreme

Court, Prosecutor Peter Brebner said there was too much evidence linking Jean Eric Gassy with the victim for it to be discounted as a coincidence. Gassy owned pistols like the one used…. And Gassy had travelled to Adelaide in October 2002…. Gassy also harboured resentment towards Dr Tobin for the role she played in having him deregistered in 1997…. Gassy, 48, was diagnosed as suffering a delusional disorder prior to his deregistration ” (The Age)

• “In his closing argument in the SA Supreme Court, Prosecutor Peter Brebner said there was too much evidence linking Jean Eric Gassy with the victim for it to be discounted as a coincidence. Gassy owned pistols like the one used…. And Gassy had travelled to Adelaide in October 2002…. Gassy also harboured resentment towards Dr Tobin for the role she played in having him deregistered in 1997…. Gassy, 48, was diagnosed as suffering a delusional disorder prior to his deregistration ” (The Age)

“I remember the time he gave to my Dad. He would come around at the drop of a hat. He was a marvelous GP…

apart from the fact that he killed my father”

“I remember the time he gave to my Dad. He would come around at the drop of a hat. He was a marvelous GP…

apart from the fact that he killed my father”

Quote from Christopher Rudo -son of a victim killed by mass murderer Dr Harold Shipman

Quote from Christopher Rudo -son of a victim killed by mass murderer Dr Harold Shipman

Dr. Chandra’s killer (prevention may have been possible)

Dr. Chandra’s killer (prevention may have been possible)

• "There is no doubt that Mr. Tzeegankoff has a history of impulsive behaviour with violence which ante-dates the onset of his psychotic illness in the mid 1980’s. The psychotic illness has at times been difficult to delineate, but on balance it would appear that he has a paranoid schizophrenic illness.” (Prof. Robert Goldney)

• “There is little evidence before me about whether there was a specific treatment plan formulated in relation to his illness.” (Coroner Wayne Chivell)

• "There is no doubt that Mr. Tzeegankoff has a history of impulsive behaviour with violence which ante-dates the onset of his psychotic illness in the mid 1980’s. The psychotic illness has at times been difficult to delineate, but on balance it would appear that he has a paranoid schizophrenic illness.” (Prof. Robert Goldney)

• “There is little evidence before me about whether there was a specific treatment plan formulated in relation to his illness.” (Coroner Wayne Chivell)

Principle 1 Principle 1

• most mentally ill are not violent

• violence committed by the mentally ill may be due to reasons not directly related to their psychiatric impairment

• most mentally ill are not violent

• violence committed by the mentally ill may be due to reasons not directly related to their psychiatric impairment

Most criminal violence is not committed by the mentally illMost criminal violence is not committed by the mentally ill

The next 5 slides courtesy of Dr. Ed HeffernanThe next 5 slides courtesy of Dr. Ed Heffernan


• mental illness COMORBID with substance abuse and personality pathology dramatically increases risk

• more disorders = higher risk

• subs abuse > psychosis > neurotic

• mental illness COMORBID with substance abuse and personality pathology dramatically increases risk

• more disorders = higher risk

• subs abuse > psychosis > neurotic

Mental illness alone is a modest risk factor for violenceMental illness alone is a modest risk factor for violence

Principle 3Principle 3

• predictors of violent recidivism in any mental illness are strikingly similar to those of offenders without illness

• violence committed by the mentally ill may be due to reasons not directly related to psychiatric impairment– Hx of violence– Hx of criminality – Younger age, male, lower SES– substance use

• predictors of violent recidivism in any mental illness are strikingly similar to those of offenders without illness

• violence committed by the mentally ill may be due to reasons not directly related to psychiatric impairment– Hx of violence– Hx of criminality – Younger age, male, lower SES– substance use

Shared risk factorsShared risk factors


That is:• more likely to be family or

acquaintances

That is:• more likely to be family or

acquaintances

Victims are more like to be knownVictims are more like to be known


• individuals with mental illness alone are most likely to be violent when acutely unwell

• non-compliance with therapy may be a factor

• individuals with mental illness alone are most likely to be violent when acutely unwell

• non-compliance with therapy may be a factor

Active symptoms increase riskActive symptoms increase risk

Relevant History to alert youRelevant History to alert you• Previous history of violence to self or

others• History of family violence• Substance abuse and/or dependence• Antisocial personality disorder• Borderline personality disorder• Bipolar disorder• Dementia• Head injury (with history of

disinhibition) • Impulsivity• low frustration tolerance• inability to tolerate criticism

• Previous history of violence to self or others

• History of family violence• Substance abuse and/or dependence• Antisocial personality disorder• Borderline personality disorder• Bipolar disorder• Dementia• Head injury (with history of

disinhibition) • Impulsivity• low frustration tolerance• inability to tolerate criticism

Relevant History (2)Relevant History (2)• Male gender• Single• Learning disability or Intellectual

Disability• History of physical and/or sexual abuse• Violence at home • Lower socioeconomic status • Lower income• Homelessness• Poor social networks• Sex offender• Fire setting and other history of

Delinquency (eg torture of animals)

• Male gender• Single• Learning disability or Intellectual

Disability• History of physical and/or sexual abuse• Violence at home • Lower socioeconomic status • Lower income• Homelessness• Poor social networks• Sex offender• Fire setting and other history of

Delinquency (eg torture of animals)

• Acute confusional state• Acute organic psychosis• Alcohol intoxication• Delirium• Delusional• Grandiose• Agitation• Anger

• Acute confusional state• Acute organic psychosis• Alcohol intoxication• Delirium• Delusional• Grandiose• Agitation• Anger

Current Status which may be important

Current Status which may be important

• Deep belief that they are the victim of the organization• Self centered moral righteousness • Access to guns and other lethal weapons• Participation in gangs• Tattoos and old scars• Recklessness or Risk-taking• Verbalization of command auditory hallucinations

to perform violence• Verbalization of intent to kill• Verbalization of plan to take revenge

• Deep belief that they are the victim of the organization• Self centered moral righteousness • Access to guns and other lethal weapons• Participation in gangs• Tattoos and old scars• Recklessness or Risk-taking• Verbalization of command auditory hallucinations

to perform violence• Verbalization of intent to kill• Verbalization of plan to take revenge

Factors increasing your suspicion of likely

violence

Factors increasing your suspicion of likely

violence

Assessing for +ve historyAssessing for +ve history

• Brief Psychiatric Rating Scale (BPRS) (Overall and Gorham, 1962)– Hostility Scale

(hostility, suspiciousness, and uncooperativeness)– Negative Symptom Scale

(flat affect, emotional withdrawal, and motor retardation)– Positive Symptom Scale

(concept disorganization, hallucinatory behavior, and unusual thoughts)

• Empathy Tasks (Abu-Akel and Abushua’leh, 2004) • Modified Overt Aggression Scale (Kay et al,

1988)• Maudsley Violence Questionnaire (Walker, 2005)

• Brief Psychiatric Rating Scale (BPRS) (Overall and Gorham, 1962)– Hostility Scale

(hostility, suspiciousness, and uncooperativeness)– Negative Symptom Scale

(flat affect, emotional withdrawal, and motor retardation)– Positive Symptom Scale

(concept disorganization, hallucinatory behavior, and unusual thoughts)

• Empathy Tasks (Abu-Akel and Abushua’leh, 2004) • Modified Overt Aggression Scale (Kay et al,

1988)• Maudsley Violence Questionnaire (Walker, 2005)

Times when things can go wrong

Times when things can go wrong

• Seasonal variations (High Summer, Early Spring and Deep Winter)

• Temporal variation (eg, evenings, nights, weekends)

• Staff variation (eg, students, new staff, temp staff)

• Nursing unit variation (eg, admission, maximum security, violent patients)

• Copycat or Clustering Effects (Impact of Media or Local Events)

• Seasonal variations (High Summer, Early Spring and Deep Winter)

• Temporal variation (eg, evenings, nights, weekends)

• Staff variation (eg, students, new staff, temp staff)

• Nursing unit variation (eg, admission, maximum security, violent patients)

• Copycat or Clustering Effects (Impact of Media or Local Events)

Triggers for Violent EpisodesTriggers for Violent Episodes• Job loss• Relationship

Breakdown• Long wait to be

assessed• Anxiety• Fear• Frustration• Hunger• Noise• Pain• Sleep deprivation

• Job loss• Relationship

Breakdown• Long wait to be

assessed• Anxiety• Fear• Frustration• Hunger• Noise• Pain• Sleep deprivation

• Denial of patient request for admission

• Involuntary hospitalization

• Disrespect, actual or imagined

• Lack of privacy

• Denial of patient request for admission

• Involuntary hospitalization

• Disrespect, actual or imagined

• Lack of privacy

• Absence of escape routes• Inadequate staff• Malfunctioning equipment• Portable furniture• Portable objects• Unobserved patients• Untrained protective services

• Absence of escape routes• Inadequate staff• Malfunctioning equipment• Portable furniture• Portable objects• Unobserved patients• Untrained protective services

Contexts Associated with ViolenceContexts Associated with Violence

Know your environmentKnow your environment

Exercise: Draw your rooms or where you work.

Where could you get trapped?Where are the escape routes?

How do you let people know you are in trouble?

Exercise: Draw your rooms or where you work.

Where could you get trapped?Where are the escape routes?

How do you let people know you are in trouble?

• Flushed facies• Hostility• Impulsivity• Loud outbursts• Name calling• Obscene or Profane language• Opening and closing the fist• Pacing• Pointing• Pulling out a weapon

• Flushed facies• Hostility• Impulsivity• Loud outbursts• Name calling• Obscene or Profane language• Opening and closing the fist• Pacing• Pointing• Pulling out a weapon

Signs of Impending Violence

Signs of Impending Violence

• Tension• Restlessness• Smell of alcohol on breath• Pushing furniture• Staring or widened eyes• Sudden movements• Slamming or throwing objects• Uncooperativeness

• Tension• Restlessness• Smell of alcohol on breath• Pushing furniture• Staring or widened eyes• Sudden movements• Slamming or throwing objects• Uncooperativeness

Signs of Impending ViolenceSigns of Impending Violence

Sometimes you are certain you can manage

Sometimes you are certain you can manage

Other times you just know you are in trouble

Other times you just know you are in trouble

Assessing RiskAssessing Risk

• Take all threats of violence seriously.• If you feel apprehensive, tense or afraid in

a clinical situation, then follow your instincts and guard your personal safety. Take steps to either remove yourself or get help.

• Experienced clinicians follow their gut reactions that something serious is imminent.

• Take all threats of violence seriously.• If you feel apprehensive, tense or afraid in

a clinical situation, then follow your instincts and guard your personal safety. Take steps to either remove yourself or get help.

• Experienced clinicians follow their gut reactions that something serious is imminent.

Create a Safety Plan(personal or system based)Create a Safety Plan

(personal or system based)

Exercise:What will you do when you get back?

Exercise:What will you do when you get back?

Administrative ApproachesAdministrative Approaches

• Make it clear to patients, clients, and employees that violence will not be tolerated or permitted

• Establish face to face liaison with local police and ask them to review your premises for problems.

• Require employees to report all assaults and threats

• Consider setting up an emergency response team

• Make it clear to patients, clients, and employees that violence will not be tolerated or permitted

• Establish face to face liaison with local police and ask them to review your premises for problems.

• Require employees to report all assaults and threats

• Consider setting up an emergency response team

• Closed circuit television monitoring• Panic buttons in all clinical areas• Two-way communication systems

• Closed circuit television monitoring• Panic buttons in all clinical areas• Two-way communication systems

Technology to prevent violence:Awareness, Vigilance, Communication, Action

Technology to prevent violence:Awareness, Vigilance, Communication, Action

Context Monitoring Context Monitoring

• Establish a violence reporting system and regular review of reports

• Review staff meeting reports on safety issues

• Analyze trends in illness/injury or fatalities caused by violence

• Measure improvement based on lowered frequency and severity of violence

• Establish a violence reporting system and regular review of reports

• Review staff meeting reports on safety issues

• Analyze trends in illness/injury or fatalities caused by violence

• Measure improvement based on lowered frequency and severity of violence

Staff Training and Education

Staff Training and Education

• Ensure that all staff are aware of potential security hazards and ways of protecting themselves

• Train in recognition of risk factors that cause or contribute to assaults, and

• Early recognition of escalating behavior or warning signs

• Workplace violence prevention policy:– Ways to prevent volatile situations– Standard response action plan for violent situations– Location and operation of safety devices

• Ensure that all staff are aware of potential security hazards and ways of protecting themselves

• Train in recognition of risk factors that cause or contribute to assaults, and

• Early recognition of escalating behavior or warning signs

• Workplace violence prevention policy:– Ways to prevent volatile situations– Standard response action plan for violent situations– Location and operation of safety devices

Tips: Staff ProtectionTips: Staff Protection

• Tuck ties in shirt.

• Don’t wear necklaces or earrings.

• Don’t divulge personal information about yourself.

• Give yourself access to exit.

• Tuck ties in shirt.

• Don’t wear necklaces or earrings.

• Don’t divulge personal information about yourself.

• Give yourself access to exit.

Tips: Alternative Devices

Tips: Alternative Devices

• Name badges can be on break-away clips. Don’t use around-your-neck lanyards.

• Stethoscopes can be clipped to the belt instead of around the neck.

• Scissors can be used as a weapon. Be aware of where they are in relation to your patient.

• Name badges can be on break-away clips. Don’t use around-your-neck lanyards.

• Stethoscopes can be clipped to the belt instead of around the neck.

• Scissors can be used as a weapon. Be aware of where they are in relation to your patient.

Prevention is better than something unexpected and nasty happening

Prevention is better than something unexpected and nasty happening

• Do not interview or examine patients in your home.• Do not interview dangerous patients in offices without a security guard.• Install windows in the doors of examination rooms.• Avoid furniture that can block exits from rooms.• Equip examination rooms, offices, and nursing stations with panic buttons.

IN THE FUTURE WE MAY HAVE TO CONSIDER:• Requiring patients (and ? even staff) to pass through metal detectors before entering clinical areas.

• Do not interview or examine patients in your home.• Do not interview dangerous patients in offices without a security guard.• Install windows in the doors of examination rooms.• Avoid furniture that can block exits from rooms.• Equip examination rooms, offices, and nursing stations with panic buttons.

IN THE FUTURE WE MAY HAVE TO CONSIDER:• Requiring patients (and ? even staff) to pass through metal detectors before entering clinical areas.

Personal Strategies to avoid violence

Personal Strategies to avoid violence

Defusing TechniquesDefusing Techniques

• Attend to client before things get out of hand

• Walk/Stand confidently• Maintain eye contact• Avoid arguing or defending previous actions

• Avoid threatening body language (don’t stand with arms crossed).

• Attend to client before things get out of hand

• Walk/Stand confidently• Maintain eye contact• Avoid arguing or defending previous actions

• Avoid threatening body language (don’t stand with arms crossed).

• Calmly but firmly state the limits.

• Communicate information about any delays etc.

• Give some choices.• Seek a family member or friend to support• If situation continues to escalate, with

louder, more agitated verbalizations, reduce stimulation from setting…eg. bring from waiting room to exam room.

• Calmly but firmly state the limits.

• Communicate information about any delays etc.

• Give some choices.• Seek a family member or friend to support• If situation continues to escalate, with

louder, more agitated verbalizations, reduce stimulation from setting…eg. bring from waiting room to exam room.

Defusing Techniques (2)Defusing Techniques (2)

Your Personal Safety Depends On….

Your Personal Safety Depends On….

Two Rules!1. React quickly.2. Make a decision.

Two Questions!1. My situation?2. Best options available?

Two Objectives! 1. Survive.2. Escape.

Two Rules!1. React quickly.2. Make a decision.

Two Questions!1. My situation?2. Best options available?

Two Objectives! 1. Survive.2. Escape.

Acting in Self DefenceActing in Self Defence

Confronting an AttackerConfronting an Attacker• You are walking in a

dark alley when you find yourself in a bad situation. Standing in front of you is a male figure. Without warning he moves quickly towards you.

• What do you do??

• You are walking in a dark alley when you find yourself in a bad situation. Standing in front of you is a male figure. Without warning he moves quickly towards you.

• What do you do??

Confronting an AttackerConfronting an Attacker

• Recent studies show that females who fight back are less likely to be killed or seriously hurt.

• A majority of attackers are seeking an easy target. The harder you make it for them, the better chance you have to survive.

• Recent studies show that females who fight back are less likely to be killed or seriously hurt.

• A majority of attackers are seeking an easy target. The harder you make it for them, the better chance you have to survive.

Fighting BackFighting Back

• Everything you do should be setting up to allow you to escape (ie run away)

• It’s not what you can do that’s important, but what you are willing to do.

• Everything you do should be setting up to allow you to escape (ie run away)

• It’s not what you can do that’s important, but what you are willing to do.

• Keep an attacker in your visual field.• Maintain eye contact• Do not turn your back on an attacker.• Make sure that an attacker does not

invade

your personal space within 4 to 6 feet• Be prepared, but not provocative

• Keep an attacker in your visual field.• Maintain eye contact• Do not turn your back on an attacker.• Make sure that an attacker does not

invade

your personal space within 4 to 6 feet• Be prepared, but not provocative

Behaviour to Abort ViolenceBehaviour to Abort Violence

Short VideoShort Video

Taken from 100 Techniques of Self Defence, these 2

segments can give you some ideas

Taken from 100 Techniques of Self Defence, these 2

segments can give you some ideas

RESPONSERESPONSE

Question:

When we are responding to a person who is threatening or attempting to injure, will we be able to match our response to the level of injury threatened?

Question:

When we are responding to a person who is threatening or attempting to injure, will we be able to match our response to the level of injury threatened?

Definition of Reasonable Force:

Definition of Reasonable Force:

“A reasonable amount of force is just enough force for effective

protection of self and others and no more than is absolutely necessary”

(Smith, P., 2004. P.A.R.T. Trainers Manual)

“A reasonable amount of force is just enough force for effective

protection of self and others and no more than is absolutely necessary”

(Smith, P., 2004. P.A.R.T. Trainers Manual)

Selecting a self defense strategy


• What is my goal?

• If you decide to fight back, what is the best technique for you?

• What is my goal?

• If you decide to fight back, what is the best technique for you?



• Am I willing to get physical?

• Can I bring myself to hit someone?

• Could I deliberately and knowingly cause damage?

• Am I willing to get physical?

• Can I bring myself to hit someone?

• Could I deliberately and knowingly cause damage?

What might you need to know?

What might you need to know?

• Martial Arts and self-defense are not synonymous.

• Traditional martial arts have skills that are not designed, nor are they realistic for a self-defense situation.

• The idea that someone can do a high kick to a person’s face on an icy street is not realistic.

• In this workshop we seek to teach what is simple, direct, and uses gross motor skill moves.

• Martial Arts and self-defense are not synonymous.

• Traditional martial arts have skills that are not designed, nor are they realistic for a self-defense situation.

• The idea that someone can do a high kick to a person’s face on an icy street is not realistic.

• In this workshop we seek to teach what is simple, direct, and uses gross motor skill moves.

Key Points to Fighting Back


• Don’t panic• Don’t freeze-up, react quickly• Do start yelling, make lots of noise !• Commit and go hard• Recognize and utilize escape

opportunities• Do whatever it takes!

• Don’t panic• Don’t freeze-up, react quickly• Do start yelling, make lots of noise !• Commit and go hard• Recognize and utilize escape

opportunities• Do whatever it takes!



Neverever

give

up!

Neverever

give

up!

Active DemonstrationsActive Demonstrations

1. Someone pointing and shouting abuse

• Maintain eye contact

• Move sideways on

• Keep hands up, but do not provoke

ESCAPE….

1. Someone pointing and shouting abuse

• Maintain eye contact

• Move sideways on

• Keep hands up, but do not provoke

ESCAPE….


2. The Wrist Grab

• Pull away (reinforced)• Offer food• Wave at your Mum• Pull arm across body and push

shoulder

ESCAPE….

2. The Wrist Grab

• Pull away (reinforced)• Offer food• Wave at your Mum• Pull arm across body and push

shoulder

ESCAPE….


3. The lapel grab (single hand)

• Same hand over top to cover, grab and turn hand over

• Try the same thing with pressure on elbow

• Turn in and ‘push’ under jaw

ESCAPE….

3. The lapel grab (single hand)

• Same hand over top to cover, grab and turn hand over

• Try the same thing with pressure on elbow

• Turn in and ‘push’ under jaw

ESCAPE….


4. The Lapel Grab (2 hands)

• Bowling Arm• Goal Umpire• Strike to Brachio-Radialis

ESCAPE….

4. The Lapel Grab (2 hands)

• Bowling Arm• Goal Umpire• Strike to Brachio-Radialis

ESCAPE….

Active DemonstrationsActive Demonstrations5. On being strangled from in front

• Grab hands (natural) and turn to side• If up against a wall sweep with 1 arm

and twist• Turn and push away (or strike to

throat)• Hit to ear or ears with cupped hand• Knee

ESCAPE….

5. On being strangled from in front

• Grab hands (natural) and turn to side• If up against a wall sweep with 1 arm

and twist• Turn and push away (or strike to

throat)• Hit to ear or ears with cupped hand• Knee

ESCAPE….


6. The Hay Maker Punch

• Cover up• Wave at your Mum• Body weight Dinosaur

ESCAPE….

6. The Hay Maker Punch

• Cover up• Wave at your Mum• Body weight Dinosaur

ESCAPE….


7. The Strangle from Behind

• Head Butt• Twist head to give an airway, grab the

hand, strike and pull your head through…

• Groin Strike• The Wrist Grab

ESCAPE….

7. The Strangle from Behind

• Head Butt• Twist head to give an airway, grab the

hand, strike and pull your head through…

• Groin Strike• The Wrist Grab

ESCAPE….


8. Bear Hug

• Breathe in, Drop down• Bum Strike• Strike to the Groin

ESCAPE….

8. Bear Hug

• Breathe in, Drop down• Bum Strike• Strike to the Groin

ESCAPE….


9. On the Ground

• Hands on head and roll away• Strike to the groin• Kicking with legs

ESCAPE….

9. On the Ground

• Hands on head and roll away• Strike to the groin• Kicking with legs

ESCAPE….


10 The attack with a knifeNo Illusions - this is hard….

• Cover up an arm and try to block• Groin kick• Grabbing the wrist

Escape….

10 The attack with a knifeNo Illusions - this is hard….

• Cover up an arm and try to block• Groin kick• Grabbing the wrist

Escape….


11 The attack with a gun

It’s all too lateChance

[ESCAPE….]

11 The attack with a gun

It’s all too lateChance

[ESCAPE….]

Confronting an AttackerConfronting an Attacker


• Did you change what you might do??


• Did you change what you might do??

After the EventAfter the Event

After something horrible happens….

After something horrible happens….

Adverse Consequences of Violence

Adverse Consequences of Violence

• Feeling upset• Feeling irritable• Headache• Anger• Blaming self• Fear of caring for

isolated patients• Insecurity

• Feeling upset• Feeling irritable• Headache• Anger• Blaming self• Fear of caring for

isolated patients• Insecurity

• Refusal to identify self to patients

• Lost time from work

• Career change • Low worker

morale• Poor job

satisfaction• Poor worker

retention

• Refusal to identify self to patients

• Lost time from work

• Career change • Low worker

morale• Poor job

satisfaction• Poor worker

retention

Coping and Survival Strategies

Coping and Survival Strategies

• Denial • Hiding • Calling police• Seeking advice or help from others• Fighting back / self-defense• Leaving• Self-medicating

• Denial • Hiding • Calling police• Seeking advice or help from others• Fighting back / self-defense• Leaving• Self-medicating

Post-Incident ResponsePost-Incident Response

• Provide comprehensive treatment for victimized employees and employees who may be traumatized by witnessing a workplace violence incident• Critical incident stress debriefing• Trauma-crisis counseling• Employee assistance programs to assist

victims

• Provide comprehensive treatment for victimized employees and employees who may be traumatized by witnessing a workplace violence incident• Critical incident stress debriefing• Trauma-crisis counseling• Employee assistance programs to assist

victims

self defence for mental health professionals graham martin, ed heffernan, james scott, rod martin,...

Documents

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average child

acts of violence

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violent acts

personal injury slide