[Book Reviews] "The Thin Blue Lifeline"
I have had Ellis Amdur and Sgt. John Hutching's "The Thin Blue Lifeline: Verbal De-escalation of Mentally Ill and Emotionally Disturbed People" on my desk to read for a couple months, but this most recent plane trip got me to tackle it. It's one of a series of highly overlapping books aimed at different roles in the helping professions, covering essentially the same subject material for people in different contexts and roles. The first author is the martial arts instructor of one of my good friends; I've read his work and respected it before, though I have not had the pleasure of meeting him myself. Being mildly impatient, I decided that I didn't want to wait for the EMS-specific version of this book to come out and picked the cops version as the next closest thing. (Also, I really wanted to see how they'd tackle use of force in this context.) It was an easier read than I was expecting -- the subject matter is engrossing, it's well written and sensible, and both authors bring considerable direct personal experience to the table. It's going on my A-list of books I'll recommend between Gavin de Becker and Rory Miller. Also, I had horrible nightmares after reading this book. (I am not normally prone to nightmares, or dreams in general.) Fair warning.
In addition to being a certified counselor specializing in crisis intervention, Mr. Amdur is also a classical Japanese martial artist. His co-author Sgt. Hutching is a police officer down in Olympia, and a former Fulbright Scholar. They had this book vetted by ten experienced police officers and clinical psychologists, all of whose names and brief bios are right up front. So, they do an excellent job of letting you know that the people signing off on this approach to crisis handling and de-escalation have relevant experience, and that they have fairly broad consensus from professional men and women from several countries who have read this and think it works. That's a pretty impressive start. I can see why they framed it that way, too, because some of the techniques they advocate are likely to seem a bit woo-woo to a cynical and hard-bitten audience. So unless you really trust the people telling you that how you breathe is crucially important to how you handle a crisis, you're probably going to blow them off. They do a good job of establishing that trust and the appearance of honesty right off the bat.
The book is organized by section, and proceeds fairly logically. There is some memorization that's required, but in many cases the advice is similar. (Learn to breathe well, deeply, and regularly as your response to stress. Slightly angle your body so you're not looking confrontationally at the person, but you can still see them and move if you have to. Bring and exude calm and a quiet grace to the situation, unless it becomes time to use command voice or things become violent. Don't take what the person says personally; you're not here to become part of the problem.) Much of it resonated with things that I already knew or had already encountered, whether in martial arts, EMS contexts, or in the wild. I was surprised (though I shouldn't have been) and pleased to find it so affirming -- there's a lot that I was already doing right, and things that my friends do that are also very good ideas. (smjayman, your "You have a choice to make, you can $foo or you can $bar" framing was suggested as particularly helpful, a way to make people feel like they have some power over their lives and give them back some face without making things more combative than they needed to be.) But there were specific techniques suggested that I didn't know, and that I intend to incorporate. (Dealing with latency was particularly helpful... I'm used to going straight to "head injury and/or altered mental status, treat!" there.)
There were the things I expected out of this book. The sections on communicating with people with severe mental illness or disability, suicide, patterns of aggression, de-escalation of anger, and managing rage and violence were pretty much what I thought this book was going to be about. They are good, specific, useful, and backed up with plenty of anecdotal examples that help illustrate the points well. I did not expect (but was pleased to read) the sections on dealing specifically with mentally ill, emotionally disturbed, or drug-affected youth, recognizing the strategies of manipulative or opportunistic people, and dealing with people with unusual or intense communication styles. Those are all things I felt in retrospect I should have thought of and didn't. [grin] Good stuff.
Also fascinating was the insight into police behaviour when you're looking at force decisions from the cop's side. It's a difficult balance to strike well, and the authors address it with humanity and compassion. It's not a book about how all cops are angels and also always correct -- among the scenarios they address are cases where your idiot partner rushes in and enthusiastically brains someone just as you've talked them down, and preventing that. They talk about whether a given type of officer should respond to particular calls, or whether that undermines each officer's ability to present with enough confidence and calm that they can handle the situation. (Without that last, you're pretty screwed in a crisis... your keyed-up or uncertain body language is not likely to make that go better for you.) They discuss how bad you'll feel about yourself if you go to force on a developmentally disabled person who's freaked out and unable to communicate, with the clear understanding that this happens and should be avoided whenever possible. When writing to an audience of mostly cops, I find it admirable that they're tackling that rather than taking the party line that of course that would never happen. I definitely got the lay person's insight into police use of force that I was looking for there, and I think that better understanding of police concerns and tactics will allow me to interact with them with better nonverbal communication in future.
After having read the sections on psychopaths and on the transition between rage and violence, I cannot help but be impressed by people who knowingly show up to walk into that day after day. I'm pretty fearless in the face of biological trauma, but damn, that's got to be a grind. (I also appreciated the sections on stress management, self care, and leaving it outside your home so you don't bring the drama of a job like that to your family. The swift allusions to what you do if someone's stalking and threatening your family, though? Also horrifying in their implications. Short and terrible.)
I would recommend this one to anyone who works in health care or law enforcement; you may have more patience than I did, and be able to wait for the appropriate-to-you version. [grin] I would also strongly recommend it to martial artists and psych geeks. If you have a self defense library, this one should be in it. Five carryable islands of Zen out of five.
This entry was originally posted at http://ivy.dreamwidth.org/190303.html and has
comments there. Please feel free to comment on either site; comments rock.
In addition to being a certified counselor specializing in crisis intervention, Mr. Amdur is also a classical Japanese martial artist. His co-author Sgt. Hutching is a police officer down in Olympia, and a former Fulbright Scholar. They had this book vetted by ten experienced police officers and clinical psychologists, all of whose names and brief bios are right up front. So, they do an excellent job of letting you know that the people signing off on this approach to crisis handling and de-escalation have relevant experience, and that they have fairly broad consensus from professional men and women from several countries who have read this and think it works. That's a pretty impressive start. I can see why they framed it that way, too, because some of the techniques they advocate are likely to seem a bit woo-woo to a cynical and hard-bitten audience. So unless you really trust the people telling you that how you breathe is crucially important to how you handle a crisis, you're probably going to blow them off. They do a good job of establishing that trust and the appearance of honesty right off the bat.
The book is organized by section, and proceeds fairly logically. There is some memorization that's required, but in many cases the advice is similar. (Learn to breathe well, deeply, and regularly as your response to stress. Slightly angle your body so you're not looking confrontationally at the person, but you can still see them and move if you have to. Bring and exude calm and a quiet grace to the situation, unless it becomes time to use command voice or things become violent. Don't take what the person says personally; you're not here to become part of the problem.) Much of it resonated with things that I already knew or had already encountered, whether in martial arts, EMS contexts, or in the wild. I was surprised (though I shouldn't have been) and pleased to find it so affirming -- there's a lot that I was already doing right, and things that my friends do that are also very good ideas. (smjayman, your "You have a choice to make, you can $foo or you can $bar" framing was suggested as particularly helpful, a way to make people feel like they have some power over their lives and give them back some face without making things more combative than they needed to be.) But there were specific techniques suggested that I didn't know, and that I intend to incorporate. (Dealing with latency was particularly helpful... I'm used to going straight to "head injury and/or altered mental status, treat!" there.)
There were the things I expected out of this book. The sections on communicating with people with severe mental illness or disability, suicide, patterns of aggression, de-escalation of anger, and managing rage and violence were pretty much what I thought this book was going to be about. They are good, specific, useful, and backed up with plenty of anecdotal examples that help illustrate the points well. I did not expect (but was pleased to read) the sections on dealing specifically with mentally ill, emotionally disturbed, or drug-affected youth, recognizing the strategies of manipulative or opportunistic people, and dealing with people with unusual or intense communication styles. Those are all things I felt in retrospect I should have thought of and didn't. [grin] Good stuff.
Also fascinating was the insight into police behaviour when you're looking at force decisions from the cop's side. It's a difficult balance to strike well, and the authors address it with humanity and compassion. It's not a book about how all cops are angels and also always correct -- among the scenarios they address are cases where your idiot partner rushes in and enthusiastically brains someone just as you've talked them down, and preventing that. They talk about whether a given type of officer should respond to particular calls, or whether that undermines each officer's ability to present with enough confidence and calm that they can handle the situation. (Without that last, you're pretty screwed in a crisis... your keyed-up or uncertain body language is not likely to make that go better for you.) They discuss how bad you'll feel about yourself if you go to force on a developmentally disabled person who's freaked out and unable to communicate, with the clear understanding that this happens and should be avoided whenever possible. When writing to an audience of mostly cops, I find it admirable that they're tackling that rather than taking the party line that of course that would never happen. I definitely got the lay person's insight into police use of force that I was looking for there, and I think that better understanding of police concerns and tactics will allow me to interact with them with better nonverbal communication in future.
After having read the sections on psychopaths and on the transition between rage and violence, I cannot help but be impressed by people who knowingly show up to walk into that day after day. I'm pretty fearless in the face of biological trauma, but damn, that's got to be a grind. (I also appreciated the sections on stress management, self care, and leaving it outside your home so you don't bring the drama of a job like that to your family. The swift allusions to what you do if someone's stalking and threatening your family, though? Also horrifying in their implications. Short and terrible.)
I would recommend this one to anyone who works in health care or law enforcement; you may have more patience than I did, and be able to wait for the appropriate-to-you version. [grin] I would also strongly recommend it to martial artists and psych geeks. If you have a self defense library, this one should be in it. Five carryable islands of Zen out of five.
This entry was originally posted at http://ivy.dreamwidth.org/190303.html and has
comments there. Please feel free to comment on either site; comments rock.