As a police officer, I often encountered people who were in crisis. In the police academy and elsewhere, we were given a wide array of tools and training to protect ourselves. Verbal de-escalation of people in crisis, not so much. Our mandate was “command presence,” to take charge of every situation we encountered. This, of course, resulted in all sorts of wacky hijinks.
Eventually, the PD brass realized that we needed to be a little more versatile in our approach to the people we were serving. The result was a block on police-community relations in our annual training. Officers disparagingly called these blocks “the flavor of the year,” since they seemed to change every time. One year it was something called “Signature Service.” One year it was “Verbal Judo,” which was pretty good but never had any followup or refresher training. One year, the first thing we were assigned to do was write down all of the derogatory names we could think of for people of different races, cultures, genders, etc. I turned in a blank sheet of paper. The lieutenant teaching the course got on me for that and I told her I would never put my name on a document containing such language; besides, I never used those words myself. I never got the point of this particular class.
Besides being inconsistent and desultory, none of the courses (except Verbal Judo) taught any techniques for verbally de-escalating people in crisis. Some officers learned techniques on their own or improved through experience, others basically were bulls in china shops their entire careers.
Since, except on Halloween, you won’t find a nurse with the same equipment as a police officer,* nurses take verbal de-escalation a lot more seriously. One of the courses in nursing school was something called “therapeutic communication”; Mental health and emergency nurses also take continuing classes on recognizing and diffusing crisis behavior. The main thing that you learn is there are no “magic words” that will calm everyone in crisis. Every individual and situation is different and your best efforts will not work 100 percent of the time. Instead of magic, learn to recognize the different types of crisis behavior and how to diffuse them.
That’s not to say that there are no magic words. As a cop, I knew that could say things that would turn someone from calm to a raging jerk in ten seconds flat. Here are words not quite as outrageous that you also should never use:
“Why?”: The question “why?” by its very nature is accusative. You are implying that someone has done something wrong and needs to justify their behavior. It’s also a useless question. In the midst a potential crisis situation, you don’t need to know the background causes to resolve the crisis.**
Instead of “Why?”: Focus on outcomes. Some of the techniques you can use are:
- Interrupt and redirect: “We can discuss your reasons for not mowing the lawn later, after you mow the lawn.”
- When and then: “When you take out the trash, then you can go back to playing Sexy Ninjas IV.”
- If and then: “If you clean out the garage, then you can go have a beer with your buddies. If not, well, I have your keys.”
“Calm down, Chill out***, Cool it!”: It’s a historical fact**** that no one who is freaking out has calmed down after being screamed at to calm down.
Instead of “Calm Down”: Give the person time and space, keep them safe, and, most importantly remove the audience. Someone can only shout into a void for so long. Stay quiet until the person has control of themselves and do not let yourself be provoked.
“You can’t say that to me!”: This is an indication that you have let yourself be provoked.
Instead of “You can’t say that to me”: Practice rational detachment. There was saying we had when I was an officer: “it’s not you, it’s the blue.” This works for nurses as well. The patient is not screaming obscenities at you; anyone with a blue uniform would get the same treatment. You need to ask yourself why you are letting this person get to you and chill out. If necessary, ask your pod partner or the charge nurse to give you a break.