HOSTILITY AND VIOLENT BEHAVIOR
As a medical NCO, you may encounter situations in which you need to react
promptly. For example, suppose you are assigned to provide medical coverage at the
rifle range. A soldier begins arguing with his scorer on the number of targets he hit. He
suddenly points his weapon in the direction of the other soldiers and begins shouting
obscenities. What do you do? How would you react? These questions and more will
be answered in this lesson.
a. Definition. The patient exhibiting violent behavior is the individual whose
behavior is potentially hazardous to himself or to others. The fear associated with many
psychiatric patients is caused from their actions of violence or destruction. The actual
number of such patients is greatly exaggerated. Violent behavior is not peculiar to any
type of diagnosis.
b. Causes. There are several precipitating factors to violent behavior. Included
are the following:
Medical illness for which organic brain syndrome is the common cause.
Personality disorders such as poor impulse control.
(3) True neuropsychiatric illnesses (the person experiences delusions of
persecution and "hearing voices").
MANAGEMENT OF AN UNARMED VIOLENT PATIENT
The violent, agitated patient must be controlled before attempts are made to
diagnose or to refer the patient for help.
a. Verbal Control. Verbal control should be the first attempt made. As you
approach the patient, talk calmly to him. Avoid threatening him. Tell him who you are,
where and how you plan to help him; this is called reorienting information. Ask him
questions about what is troubling him. Try to find the cause of his agitation. Asking why
he is upset often stimulates the patient to think rationally. Additionally, these questions
provide necessary information. Often, the verbal approach is enough to calm someone
who is not in a panic, anxiety state. The verbal approach is usually effective with
patients who are psychotic (person who has lost contact with reality).