A female bus driver choked a mentally ill student after he engaged in a screaming tirade and threw a can at her. You can watch the video here.
Broadly speaking I view violence in two major categories. Emotional Violence is the lashing out physically due to a build-up of anger, anxiety and/or other emotional states. "Crimes of Passion" are put into this category as are many instances of domestic violence where a partner strikes another during a heated dispute. There is often regret and/or embarrassment at the action. Most mental health professionals believe that this type of violence is amenable to intervention.
Instrumental Violence, on the other hand, is considered by many to be a pre-meditated, less emotionally-aroused action. It's not a function of one going off the handle; rather, it seems like the individual gets off on it. A husband who backhands his wife, unprovoked, could fall into this category. Sociopaths who are violent are often considered to be instrumentally violent and many practitioners believe this type of behavior is not likely to be helped by therapeutic intervention.
After watching the video, my interpretation was that the woman's behavior had elements of both types of violence. The student was clearly unruly, loud and having an attack of distress. Hell, he even threw a can at her. There was a build-up of emotion and she reacted poorly. And yet I sensed hints of Instrumental Violence as well. She engaged in a prolonged choke rather than a knee-jerk slap or kick, and her voice sounded calm at one point. She even asked him if he wanted his ass beat. Finally there was what might have been an element of bragging about her behavior after she returned to the driver's seat, all of which suggest an undercurrent of Instrumental Violence.
I railed against the hospital that let the mentally ill woman die on the waiting room floor (and then went on a small tirade in the Comments thread), but this situation isn't quite so cut and dry. Did the woman act with poor judgment? Of course. But why? Is she a sociopath? Does she have an anger management problem? Was she poorly trained to handle children with mental illness and, if so, would that have even mattered? Also, was the child on any medications, or should he have been? Was the driver warned about the child's behavioral problems earlier in the day, if any? Has this child ever had similar problems when there is only one adult on the bus?
I don't have extensive experience working with children who might need to be restrained or controlled. A colleague of mine does, however, and agreed to share some thoughts on the topic. For reasons that will become obvious this person has requested complete anonymity:
"Original Applied Behavioral Analysis (ABA) practitioners got pretty violent with the autistic children with whom they were working. There was a lot of slapping and yelling and they even used electric shock to stop some of the self-harming behaviors--some old videos show the data charts on the electric shock administration and there is pretty compelling evidence in support of pain-inducing aversives when it comes to changing behavior.
ABA has evolved so that currently we don't use too much physical intervention, but this isn't 100% the case. I had an eleven year-old who used to spit upwards of 300 times per session. We got him to stop by applying tabasco sauce every time he spit (this is an 'aversive'). It was pretty effective unless he was in a really pissy mood and then nothing would work (we tried vinegar, Wasabi paste and a number of other things, but nothing would deter this kid if he was in a certain mood). He was also pretty violent (frequent punching or clawing of the face--he drew blood from me a couple times) and would sexually violate female therapists. In these instances we would usually do a 'response cost' where we physically blocked him and made him do calisthenics until he was on a behavioral momentum and under control. There was definitely a lot of physical involvement in terms of maneuvering him. When he got really violent (throwing furniture, punching really hard, etc.) we were instructed to do a hold, which is a physical maneuver to prevent him from moving. I know the other therapist who worked with this particular child once slammed his head into a desk because he was behaving so badly (that was her version of a hold), and I probably overdid it on the blocking during response costs.
One thing that really influenced the outcome in the above situation was medication. This kid's parents were pretty low socio-economic status and had awful healthcare and limited access to services. A Psychiatrist at _______ Hospital put him on Risperdal (an antipsychotic) and it was awesome--like all of his violent behaviors stopped overnight--but the doctor neglected to tell the parents that they couldn't stop the medication without her supervision and once the prescription ran out they didn't refill it. He had a super-sensitive rebound and his previously manageable behaviors escalated to the point at which he was physically hurting everyone around him. Add to that the shadiness of the agency I worked for (a lot of the agencies that cater to low-income families are in it for the benefits and couldn't give a fuck about the kids), and I was left completely without assistance for this child because all of his other therapists quit. I would have to go into a lot more detail about the way ABA works, but essentially this kid was screwed once it got to this point. He was approaching puberty and was getting physically bigger than most of his therapists so none of the standard ABA responses really worked anymore.
As far as the parents of this kid were concerned, they encouraged whatever it took to get him back on track. They were cool with the tabasco sauce and with the physical manipulation because nothing else worked. Basically it was either that or institutionalization, and I wouldn't be surprised if I heard that he was living in a home at this point. He had to wear physical restraints on the bus ride to school and his bus driver gave the parents a ton of shit. I wouldn't be surprised if she smacked him around at times like the woman in the video.
One more thing--on the flip side there are lots of parents who wouldn't hear of physical interventions with their children, but what I described to you above isn't unheard of with very severe cases."
The point here is that even doctoral-level mental health professionals are capable of violent outbreaks with patients. This doesn't vindicate the bus driver of anything; rather, it exposes the limits of human restraint, as well as the limits of my field. We clearly do not know enough, both from a psychiatric and psychological perspective, how to treat these extreme cases. And until we do, events like these are inevitable.
A female bus driver choked a mentally ill student after he engaged in a screaming tirade and threw a can at her. You can watch the video here.
Broadly speaking I view violence in two major categories. Emotional Violence is the lashing out physically due to a build-up of anger, anxiety and/or other emotional states. "Crimes of Passion" are put into this category as are many instances of domestic violence where a partner strikes another during a heated dispute. There is often regret and/or embarrassment at the action. Most mental health professionals believe that this type of violence is amenable to intervention.
Instrumental Violence, on the other hand, is considered by many to be a pre-meditated, less emotionally-aroused action. It's not a function of one going off the handle; rather, it seems like the individual gets off on it. A husband who backhands his wife, unprovoked, could fall into this category. Sociopaths who are violent are often considered to be instrumentally violent and many practitioners believe this type of behavior is not likely to be helped by therapeutic intervention.
After watching the video, my interpretation was that the woman's behavior had elements of both types of violence. The student was clearly unruly, loud and having an attack of distress. Hell, he even threw a can at her. There was a build-up of emotion and she reacted poorly. And yet I sensed hints of Instrumental Violence as well. She engaged in a prolonged choke rather than a knee-jerk slap or kick, and her voice sounded calm at one point. She even asked him if he wanted his ass beat. Finally there was what might have been an element of bragging about her behavior after she returned to the driver's seat, all of which suggest an undercurrent of Instrumental Violence.
I railed against the hospital that let the mentally ill woman die on the waiting room floor (and then went on a small tirade in the Comments thread), but this situation isn't quite so cut and dry. Did the woman act with poor judgment? Of course. But why? Is she a sociopath? Does she have an anger management problem? Was she poorly trained to handle children with mental illness and, if so, would that have even mattered? Also, was the child on any medications, or should he have been? Was the driver warned about the child's behavioral problems earlier in the day, if any? Has this child ever had similar problems when there is only one adult on the bus?
I don't have extensive experience working with children who might need to be restrained or controlled. A colleague of mine does, however, and agreed to share some thoughts on the topic. For reasons that will become obvious this person has requested complete anonymity:
"Original Applied Behavioral Analysis (ABA) practitioners got pretty violent with the autistic children with whom they were working. There was a lot of slapping and yelling and they even used electric shock to stop some of the self-harming behaviors--some old videos show the data charts on the electric shock administration and there is pretty compelling evidence in support of pain-inducing aversives when it comes to changing behavior.
ABA has evolved so that currently we don't use too much physical intervention, but this isn't 100% the case. I had an eleven year-old who used to spit upwards of 300 times per session. We got him to stop by applying tabasco sauce every time he spit (this is an 'aversive'). It was pretty effective unless he was in a really pissy mood and then nothing would work (we tried vinegar, Wasabi paste and a number of other things, but nothing would deter this kid if he was in a certain mood). He was also pretty violent (frequent punching or clawing of the face--he drew blood from me a couple times) and would sexually violate female therapists. In these instances we would usually do a 'response cost' where we physically blocked him and made him do calisthenics until he was on a behavioral momentum and under control. There was definitely a lot of physical involvement in terms of maneuvering him. When he got really violent (throwing furniture, punching really hard, etc.) we were instructed to do a hold, which is a physical maneuver to prevent him from moving. I know the other therapist who worked with this particular child once slammed his head into a desk because he was behaving so badly (that was her version of a hold), and I probably overdid it on the blocking during response costs.
One thing that really influenced the outcome in the above situation was medication. This kid's parents were pretty low socio-economic status and had awful healthcare and limited access to services. A Psychiatrist at _______ Hospital put him on Risperdal (an antipsychotic) and it was awesome--like all of his violent behaviors stopped overnight--but the doctor neglected to tell the parents that they couldn't stop the medication without her supervision and once the prescription ran out they didn't refill it. He had a super-sensitive rebound and his previously manageable behaviors escalated to the point at which he was physically hurting everyone around him. Add to that the shadiness of the agency I worked for (a lot of the agencies that cater to low-income families are in it for the benefits and couldn't give a fuck about the kids), and I was left completely without assistance for this child because all of his other therapists quit. I would have to go into a lot more detail about the way ABA works, but essentially this kid was screwed once it got to this point. He was approaching puberty and was getting physically bigger than most of his therapists so none of the standard ABA responses really worked anymore.
As far as the parents of this kid were concerned, they encouraged whatever it took to get him back on track. They were cool with the tabasco sauce and with the physical manipulation because nothing else worked. Basically it was either that or institutionalization, and I wouldn't be surprised if I heard that he was living in a home at this point. He had to wear physical restraints on the bus ride to school and his bus driver gave the parents a ton of shit. I wouldn't be surprised if she smacked him around at times like the woman in the video.
One more thing--on the flip side there are lots of parents who wouldn't hear of physical interventions with their children, but what I described to you above isn't unheard of with very severe cases."
The point here is that even doctoral-level mental health professionals are capable of violent outbreaks with patients. This doesn't vindicate the bus driver of anything; rather, it exposes the limits of human restraint, as well as the limits of my field. We clearly do not know enough, both from a psychiatric and psychological perspective, how to treat these extreme cases. And until we do, events like these are inevitable.