Working with Aggression and Resistance in Social Work

Brian J. Taylor

• Publisher: Learning Matters
• Year: 2011
• Print ISBN: 9780857254290
• eBook ISBN: 9780857254306
• Edition: 1
• Topic: Social Sciences
• Subtopic: Social Work
• Index: Social Sciences

Social workers have roles that require them to engage with clients and families who may be ?reluctant clients?, ambivalent or resistant towards those seeking to help and protect. This includes safeguarding roles in relation to children and vulnerable adults, and work to engage with marginalised groups such as young offenders and those with mental health and substance misuse problems. The text addresses issues in relation to the main client groups, and specific chapters take an overview of issues such as understanding and defusing aggressive behavior and keeping yourself safe from assault.

Chapter 1
Defining key concepts: Aggression, ambivalence and resistance

Aisling Monds-Watson

ACHIEVING A SOCIAL WORK DEGREE

This chapter will help you to meet the following National Occupational Standards for Social Work in the UK including the following.

Key Role 1: Prepare for, and work with individuals, families, carers, groups and communities to assess their needs and circumstances.

Key Role 2: Plan, carry out, review and evaluate social work practice, with individuals, families, carers, groups, communities and other professionals.

• Interact with individuals, families, carers, groups and communities to achieve change and development and to improve life opportunities.
• Develop and maintain relationships with individuals, families, carers, groups, communities and others.
• Work with individuals, families, carers, groups, communities and others to avoid crisis situations and address problems.
• Apply and justify social work methods and models used to achieve change and development, and to improve life opportunities.
• Work with individuals, families, carers, groups, communities and others to identify and evaluate situations and circumstances that may trigger the behaviour.
• Work with individuals, families, carers, groups and communities on strategies and support that could positively change the behaviour.

Key Role 3: Support individuals to represent their needs, views and circumstances.

Key Role 4: Manage risk to individuals, families, carers, groups, communities, self and colleagues.

Key Role 6: Demonstrate professional competence in social work practice.

It will also introduce you to the following academic standards as set out in the 2008 social work subject benchmark statement.

5.1.3 Values and ethics.

5.1.4 Social work theory.

5.5.3 Analysis and synthesis.

5.6 Communication skills.

5.8 Skill in personal and professional development.

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Introduction

When the social anthropologist Catherine Lutz (1988) researched the remote Micronesian Ifaluk people in the late twentieth century, she discovered they had five different words for anger. Nguch referred to the anger experienced when a friend or family member had let you down; tipmochmoch was the bad temper and irritability experienced when tired or convalescing from illness and tang described the anger experienced when feeling helpless or trapped into unwelcome commitments. Anger which results from the culmination of a series of negative experiences was called lingeringer, and moral anger in response to injustice was known as song.

Lutz theorised that because the Ifaluk people distinguished between different types of anger and regarded each as a discrete and individual emotion, they were able to be more sensitive to each other’s emotional states, and manage and respond to anger in a more intelligent and empathetic manner.

Lutz’s theory about the Ifaluk people is similar to the relatively recent notion of emotional intelligence, which David Howe (2008, p12) neatly summarises as the ability to understand both ourselves and other people as emotional beings. However, this sounds deceptively simple. An aptitude for emotional intelligence depends on multiple factors:

the capacity to reason about emotions, and of emotions to enhance thinking … the abilities to accurately perceive emotions, to access and generate emotions so as to assist thought, to understand emotions and emotional knowledge, and to reflectively regulate emotions so as to promote emotional and intellectual growth.

(Mayer et al., 2004, p197)

This book aims to increase the emotional intelligence of its readers by offering knowledge and understanding of the more challenging emotional states likely to be both encountered and experienced by social workers, so that like the Ifaluk, we too can manage and respond in a sensitive, intelligent and empathetic fashion.

Social work practice is routinely undertaken with service users during the most traumatic and challenging periods of their lives, when they are subject to high degrees of social, emotional and environmental stress. Service users are also likely to have experienced levels of adversity, discrimination, oppression or disadvantage, which may have led them to acquire behaviours that create barriers to therapeutic or productive work. Alternatively they may have developed ways of managing their feelings which make it difficult for you as a social worker to engage with them. They may also be experiencing high levels of emotions which they have difficulty containing, and which are expressed in actions that are threatening, intimidating, frightening or which present an actual risk of physical or emotional harm.

Working with service users who display challenging behaviours for a variety of reasons and in a variety of contexts is a common aspect of social work practice. Therefore it is vital that social workers have the knowledge to practise ethically, safely and effectively in these situations. This requires a clear understanding of:

• the definitions and terms used to label and describe challenging behaviours;
• the most relevant theoretical explanations to help understand and anticipate challenging behaviours;
• the practical skills required to deal with challenging behaviours in various practice settings.

This chapter will examine and clarify the terms used to label and describe a range of challenging behaviours you are likely to encounter in practice. Some of these labels are attached to behaviours (such as aggression and violence), and some refer to feelings (such as anger and ambivalence). These are things that are sometimes easier to describe than define, so some time will be spent illustrating these concepts and offering commonly accepted definitions. The chapter will begin by looking at anger, aggression, hostility and violence, before exploring the concepts of ambivalence and resistance. The following case study about Mary, Jim and family will be used to illustrate the various terms, and will be referred to in subsequent chapters to exemplify some of the theories and interventions applicable to working in situations characterised by aggression and/or resistance.

CASE STUDY

Mary (46) and Jim (54) have three children: their sons Frank (2 years old) and Tom (15 years old), and their daughter Alice (12 years old). Mary has a part-time job as a care assistant in a home for older people near where they live. Jim had been employed as a sheet metal worker since leaving school at 16. Jim enjoyed his work; he was an active union member, an industrious employee and had attained a senior position on the factory floor. He was also both popular and well respected by his workmates with whom he often socialised outside work. Unfortunately Jim was made redundant 18 months ago when the factory went out of business, and has been unemployed since.

Initially Jim enjoyed his redundancy; he thought it was a temporary setback and was optimistic that he would soon find another job. The redundancy package was generous and both Jim and Mary were pleased to be able to afford a family holiday and still have some money left over. Jim enjoyed having time to catch up with DIY in the home and the company of his friends, many of whom had also been made redundant. However, Jim has now been actively seeking work for 14 months without success, the firms he has approached prefer to take on ‘school leavers’ as apprentices at a minimum wage, and he has been told that his skills and training are ‘out of date’.

Mary is now the primary wage earner and the family are struggling financially. Mary is hoping that she will be offered full-time work in the care home, before Jim’s redundancy package runs out.

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ACTIVITY 1.1

Jim and his family are facing a difficult situation which is challenging them on personal, social, financial and emotional levels. The status quo within the home has shifted, and potential changes in Jim’s sense of who he is, what he does, and how he feels are likely to be having far-reaching consequences for the entire family. Consider how Jim might be feeling at this point in his life. How might redundancy be threatening his sense of self worth? Make a list of all the things that Jim might feel he has lost along with his job.

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COMMENT

It is important to integrate new knowledge with what you already know, and to understand theoretical ideas that you have been considering in the light of practical situations such as this one. Consciously make connections between social processes faced by clients and concepts from human growth and development.

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What do the terms anger, aggression, hostility and violence actually mean?

Anger

Anger is a normal human emotion, which is experienced by everyone to varying degrees in varying circumstances. It serves multiple objectives, and is a motivating drive which can energise us to challenge injustice, change our behaviours, adjust our lifestyle, or protect ourselves and others. Defined by the Oxford English Dictionary as a strong feeling of annoyance, displeasure, or hostility, anger is an unpleasant feeling to which we can all relate. But how much do we really know about anger and what makes it different to hostility and aggression?

Various theories exist which try to explain why we experience anger, and we shall explore these in detail in Chapter 2. For now we will look at the origins, physiological effects and expression of anger.

During the 1960s and 1970s the social anthropologist Paul Ekman (2004) undertook research into the facial expression of emotion, to try to establish that emotions were expressed differently in different cultures. Most scientists at this time believed that the facial expression of emotion was learnt, and therefore culturally unique. Ekman showed pictures of different facial expressions to tribesmen in Papua New Guinea and other culturally diverse locations. However, instead of confirming that emotional expression was culturally specific, Ekman established that six basic emotions were universally recognisable: anger, fear, sadness, surprise, disgust and joy. This implied that the expression of these emotions was biological rather than socially conditioned, and that humankind had evolved to collectively express and recognise these primary emotions for very specific reasons.

Humanity’s shared evolutionary history means that all human bodies are alike, and so too are all human minds; Dylan Evans (2001, p10) calls this the psychological unity of humankind. Not only are the six basic emotions universal, they are also instinctual and innate biological responses over which we have little conscious control. This means that we are hard-wired to respond to certain stimuli in certain ways. Our brains automatically appraise our experiences as they occur and create emotional responses to correspond with that unconscious appraisal. This means that these emotional responses occur without us having thought about them. Paul Ekman (2004) talks about autoappraisers, the automatic appraisal mechanisms which occur unconsciously in response to visual, auditory and sensory triggers, and create the physiological responses we call emotions. Basically this means that when confronted by something which we find threatening, humans unconsciously respond in particular physical and emotional ways. The sensations we experience as anger are the physiological preparations the body makes in order to protect itself.

ACTIVITY 1.2

Think about occasions when you’ve felt angry. What provoked your anger? How did your body feel? What did you do? What were you unable to do? What would have helped you to manage how you were feeling? What would have made you feel worse?

Think about a time when you were with someone who was angry. How did their anger make you feel? Did you want to be there?

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COMMENT

When we feel angry our heart rate increases, our muscles tense up, blood flows to our face, and we feel agitated and restless. This is known as the ‘fight or flight’ response, and is a physiological survival reaction which occurs in all mammals exposed to threatening situations, although it occurs in humans in response to both fear and anger. Essentially this means that the body is physically and psychologically preparing itself to either run or fight. This process involves the body drawing on its reserves of strength and agility to survive, and it does this via a mixture of chemical and physical transformations.

The central nervous system triggers a hormonal response in the brain for the body to take action. Adrenaline and excess cortisol are released into the bloodstream, wh...

Table of contents

• Cover
• Title
• Copyright
• Contents
• Editor and Contributors
• Series Editors’ Preface
• Acknowledgements
• Introduction
• Chapter 1: Defining key concepts: Aggression, ambivalence and resistance
• Chapter 2: Understanding aggression and resistance
• Chapter 3: Avoiding assault and defusing aggression
• Chapter 4: Working in situations of domestic violence
• Chapter 5: ‘I don’t want your help’: Ambivalence and resistance in adult protection
• Chapter 6: Assessing the risk to children despite parental resistance
• Chapter 7: Working with irrationality and dangerousness in mental health
• Chapter 8: Coping, challenge and conflict in groups
• Chapter 9: Managing conflict in maintaining standards in social care service provision
• Conclusion
• Appendix: Subject Benchmark for Social Work
• Glossary
• References
• Index