Controlling someone who's got a tantrum

[ChingChuan]

Hi everyone,

I hope my request doesn't sound too strange... Does someone know something about restraining mentally disabled people (autistic) who are in a tantrum?
I recall reading something about it - there seem to be courses etc. on it in America - but I wasn't able to find anything useful (it was all about drugging etc.) and I live in the Netherlands anyway.

I'm asking this because I have an autistic sister. She's very sweet and when she's not in a tantrum she's just... normal (not violent or anything) but when she's in a tantrum she can be quite violent. Usually it isn't a problem - we just leave her alone until she calms down. However, she also gets tantrums in public places - airports, in the car, on the street, you know. Then she starts grabbing for other people's throats etc. So, well, we need to hold her for a while, until she gets calm again and then everything's right.
The problem is: She's growing up! Now she's stronger than the three or four of us and it's getting quite annoying (and painful) when she is in a tantrum because she pulls at our clothes, glasses, necks, hair etc. Also, it can be dangerous when she, for instance, starts pulling on my dad (who's driving) and we can't break her grip etc. etc.
When the situation got really dire, I used a uh, joint lock that I know from Pencak Silat but I was terribly afraid that I'd dislodge her schoulder because she's immune to pain when she's in a tantrum. And well, the people in the airport don't really like the look of us trying to get her to walk to the next gate while I try to keep her from hurting us.

So - we need a way to uhm, restrain without accidentally hurting her or something... Are there martial arts / courses etc designed for that purpose? And are they taught in the Netherlands?
A google search term that gives me results that AREN'T about drugging is also welcome.

Thanks in advance.

(I hope this doesn't sound too stupid, but I couldn't find any useful information and since this is remotely connected with martial arts...)

 

[Kacey]

No worries. You are far from the only person to have this problem.

This isn't really a martial arts question, so much as it is a safety question; the restraints are similar (I've had training in both), but the purpose is different, especially as your goal is to NOT injure your sister, whereas if someone is willfully attacking me, I'm not too worried about incidental injuries.

Have you talked to an Autism support group in your area? Or perhaps your sister's school? Both of those types of organizations should have some idea of what local resources might be available to you - and what types of training programs might be available in your area.

I teach special education students in a middle school (grades 6-8, ages 11-14), including some who are potentially (or not so potentially) violent, and the school district sends us to trainings run by the Crisis Prevention Institute - the main thrust of the training is how to talk people down, but the restraint training is also quite useful and aimed at teaching restraints that allow the person to be restrained without hurting the restrainees or the restrainers, and they are a global organization. They didn't list the Netherlands, but they did list various places in Europe, so it's certainly possible they have a training program - or could arrange one - somewhere in your vicinity; it's certainly worth asking about, anyway.

Good luck to you and your family.

 

[MA-Caver]

Tantrums (by regular and autistic people) are usually brought on when one or more triggers are activated. What are her triggers? If you know that then you know how to cut off a tantrum before it starts... (usually) or at least you'll know when one is coming on. You probably already do know by now but it's something to consider.

:asian: to you for your love, patience and understanding.

 

[Andrew Green]

IMO the best bet is either on the ground, or against a wall. Pinning techniques from Judo / Jujitsu, or against a wall (Watch what MMA fighters do when pinning someone against the cage.

Wall would probably be best if you have one, as taking a person down in that state may risk injury to them.

Don't use joint locks, use pinning techniques or wrestling style tie ups, underhooks / overhooks most likely. Get tight and don't give any space for her to move. No movement = no leveredge = nobody gets hurt.

Put a mat up against a wall and train it though. With them trying to hit, pinch, pull hair, grab throats, everything she might do in that state. Learn what to watch out for and how to control the person so that they can't do any of it.

 

[jks9199]

There are a variety of restraints and locking movements that you can use to restrain your sister; many arts contain them, and Dr. Gyi is sharing the Bando Monk System, which he describes as a "non-violent martial art". The Monk System contains a lot of holds that are more gentle than some of the more common locks.

You can also soften a lot of the more common locks and holds by changing the focus. For example, instead of the common "goose neck" wrist lock, you can sometimes use a similar positioning higher up on the forearm and elbow, with less chance of injury to the person you're restraining.

As others have mentioned, learning to recognize and prevent the triggers is also important, as is working with support groups and others who can share more specific, practical guidance from experience.

 

[Andrew Green]

I wouldn't use any sort of lock or pain based retraint in this situation.

Assume they will be stronger and indifferent to pain, work from that.

 

[shesulsa]

I also wouldn't recommend joint locking in this situation - many with autism are either hypotonic and very flexible or hypertonic and not flexible enough to make these techniques effective without injury. I've been able to get a wing lock but only for a few seconds.

What we've done with my autistic teen boy is pin against a wall and pinning to either the floor or bed.

You're going to need a lot of behavioral interventions. Also - if she's not medicated, you might consider it. If she IS medicated, you might want to look into something called "autistic catatonia." A search on the web will be very revealing.

Not a dumb question - this is a sad situation many of us have to deal with. Feel free to PM me ... if not, please keep us updated.

 

[IcemanSK]

I'm with Kacey on this one. It's not an MA question. There are professionals in that field who can help you. I'd really encourage you to go to them.

 

[Andrew Green]

I'm with Kacey on this one. It's not an MA question. There are professionals in that field who can help you. I'd really encourage you to go to them.

Partially, yes. When dealing with a disability there are special considerations. As someone who also has a severely autistic sister I'll certainly not argue that.

But the question of "How do you safely restrain a person so that they cannot hurt themselves, you or anyone else without injuring them" I would call a martial arts question.

Martial arts is not always about hurt them as much as possible, that is a shallow approach to training IMO. If self-defence is your goal, or even general fighting skills, then you should train for all levels of conflict, and response. Everything from avoiding to restraining without hurting to causing serious injury and weapons.

 

[IcemanSK]

Partially, yes. When dealing with a disability there are special considerations. As someone who also has a severely autistic sister I'll certainly not argue that.

But the question of "How do you safely restrain a person so that they cannot hurt themselves, you or anyone else without injuring them" I would call a martial arts question.

Martial arts is not always about hurt them as much as possible, that is a shallow approach to training IMO. If self-defence is your goal, or even general fighting skills, then you should train for all levels of conflict, and response. Everything from avoiding to restraining without hurting to causing serious injury and weapons.

I do agree that MA training can be of some benefit here. However, the wisdom of how to deal with this situation is found in expertise in others areas.

 

[bluekey88]

I, too, am going to side with Kacey on this. We're not really talking about a martial arts situation (though there are some similarities).

Quickly, let me just speak to my expereince and where I am coming from. I've been working with individuals with intellectual disability (including autism) for 14 years. For the past 6 years I;ve worked as a clinician (i.e. psychologist) with children with idd and autism through the Devereux foundation. Devereux was the place that the CPI program referenced earlier was developed. As part of my job, I'm often called on to figure out why a person is engaging in "challenging behaviors" and craft behavior support plans to address the situation. I'm also a certified CPI trainer. Finally, I'm the foster parent of an autistic child with explosive behaviors... so I know how difficult and painful things can get on the home front when everything goes pear shaped.

In my expereince, 90% of my martial arts training would get me fired if I were to use it on the job. Even some of the gentlest of my Aikido techniques could get me fired as they go against joints and the like. Your knowledge of how to stay cool under pressure, handle adrenaline dump, cover vital areas when approaching someone, etc is all good...but a lot of "techniques" , even wrestling and jiu-jitsu techniques, are more than what would be called for int his situation.

A previous poster mentioned identifying triggers. That really is a large part of it. You probably alreadyknow (certainly better than we do) what your sister lieks and dilikes. Triggers could be environmental (smells, sounds, etc.), situational (denied access to preferred items or activities, presence or absence of preferred people, etc), internal (co-morbid psychiatric issues such as depression, bipolar disorder, etc)...really anything. If you know what your sister aboslutely needs to keep things together, what sorts of things get her upset, etc., then you and your family can work to make sure things are conducive to your sister staying calm. Furthermore, things can be done to teach your sister coping skills to manage her anger and frustration. Unfortunately this can take a lot of time and effort. If you aren't hooked up with your local MH/MR agencies...you should be. They can help provide support and evem in-home assistance in doing some of this stuff. However, it's up to you and your family to advocate for these services as they are not often put forth freely (even though you and your family are entitled to them).

As to learning how to safely restrain your sister when she is in crisis. I'm not going there here. Anytime you have to put your hands on another...its a very risky situation. Even when done properly, CPI techniques carry risk and people get hurt. If necessary get face to face training through your local MH/MR agencies and devlop crisis plans to address specific situaitons.

I've seen some pretty serious injuries resulting from restraints. It's not pretty. Possible risks include joint and tissue damage, contusions, broken bones, possitonal asphyxia (suffocation due to compression of the chest..often happens when someone is holding someone down on the floor with theur weight). Also, significant mental trauma results from physical restraint.

At my job...the rule is serious danger ot self or others. Restraint is a last resort and we really go out of our way to avoid such things. Again, you should look into what other options you have before trying something like this.

Some things I use are to give the person space. When you'e upset, you tend to need more personal space (this is particularly true for autistic individuals). Sometimes it is better to hang back and let the person get themselves together or just let teh tantrum run it;s course. I'd rather replace some broken stuff than have to take a child to the ER with injuries due to a restraint. Also, ,aybe try contracting with yourt sister so that you come up with a simple code. SOmething she can say or do to indicate to you and your family that she is frustrated. Often, communication can be difficult to some who is upset...maybe something simple and unobtrusive can take that place. Furthermore, you can agree as to what will be done when the code word or behavior is used...this way your sister can communicate she is upset and maybe get the help she needs before a tantrum happens.

I know it's a tough situation. I also know how hard it is to see someone you love upset like that. i guess what I'm saying is make sure you examine ALL your options before going for physical restraints. Yes, sometimes I find they are necessary....but not as often as many think. It's a serious thing to consider and should be approached with caution and thoughtfulness (as well as proper training and preparation).

Good luck.

Peace,
Erik

 

[qi-tah]

Hi everyone,

I hope my request doesn't sound too strange... Does someone know something about restraining mentally disabled people (autistic) who are in a tantrum?
I recall reading something about it - there seem to be courses etc. on it in America - but I wasn't able to find anything useful (it was all about drugging etc.) and I live in the Netherlands anyway.

I'm asking this because I have an autistic sister. She's very sweet and when she's not in a tantrum she's just... normal (not violent or anything) but when she's in a tantrum she can be quite violent. Usually it isn't a problem - we just leave her alone until she calms down. However, she also gets tantrums in public places - airports, in the car, on the street, you know. Then she starts grabbing for other people's throats etc. So, well, we need to hold her for a while, until she gets calm again and then everything's right.
The problem is: She's growing up! Now she's stronger than the three or four of us and it's getting quite annoying (and painful) when she is in a tantrum because she pulls at our clothes, glasses, necks, hair etc. Also, it can be dangerous when she, for instance, starts pulling on my dad (who's driving) and we can't break her grip etc. etc.
When the situation got really dire, I used a uh, joint lock that I know from Pencak Silat but I was terribly afraid that I'd dislodge her schoulder because she's immune to pain when she's in a tantrum. And well, the people in the airport don't really like the look of us trying to get her to walk to the next gate while I try to keep her from hurting us.

So - we need a way to uhm, restrain without accidentally hurting her or something... Are there martial arts / courses etc designed for that purpose? And are they taught in the Netherlands?
A google search term that gives me results that AREN'T about drugging is also welcome.

Thanks in advance.

(I hope this doesn't sound too stupid, but I couldn't find any useful information and since this is remotely connected with martial arts...)

Man, i really feel for you and yr family. I hope that you don't have to deal with these episodes too often. Are you in touch with a carer's orginisation? As well as yr sister, you also need to take care of yr own needs to protect yrself from carer's burnout. Many apols if i'm telling you something you already know btw.
I don't know if someone else has already suggested this (as i don't know the technical term for the hold) but i have been able to prevent a friend of mine who has schizophrenia from harming herself or others during an acute episode by hooking my arms over the front of the elbows and then up behind her back, and then just hanging on for dear life. It was just about all i could do as she is nearly 6 foot and twice my weight, but it worked quite well 'cause she wasn't that fit at the time and had exhausted herself by the time the emergency services got there. I guess you would have more options if you have yr family around to help out. Anyway, good luck and best wishes to you and yr family. :asian:

 

[redfang]

I spent 15 years working in residential treatment working with disturbed teens and SBH schools. Physical restraints were used in both locales. First, there are some good and effective systems. CPI is what we used for the last few years, but there are other systems, I've used a few and they were all pretty much alike. With non-violent physical restraint, its not a good idea to try to restrain someone by yourself, unless you have at least a fair size advantage. Depending on the severity of the acting out, there is always a risk of someone getting hurt. If you have someone else to assist you restrain, communication is essential. Practice doing it, but mostly practice talking through it. Its when one person tries to go to the floor and the other doesn't that things get hairy. Good luck with your problem.

 

[Shotochem]

Hi everyone,

I hope my request doesn't sound too strange... Does someone know something about restraining mentally disabled people (autistic) who are in a tantrum?
I recall reading something about it - there seem to be courses etc. on it in America - but I wasn't able to find anything useful (it was all about drugging etc.) and I live in the Netherlands anyway.

I'm asking this because I have an autistic sister. She's very sweet and when she's not in a tantrum she's just... normal (not violent or anything) but when she's in a tantrum she can be quite violent. Usually it isn't a problem - we just leave her alone until she calms down. However, she also gets tantrums in public places - airports, in the car, on the street, you know. Then she starts grabbing for other people's throats etc. So, well, we need to hold her for a while, until she gets calm again and then everything's right.
The problem is: She's growing up! Now she's stronger than the three or four of us and it's getting quite annoying (and painful) when she is in a tantrum because she pulls at our clothes, glasses, necks, hair etc. Also, it can be dangerous when she, for instance, starts pulling on my dad (who's driving) and we can't break her grip etc. etc.
When the situation got really dire, I used a uh, joint lock that I know from Pencak Silat but I was terribly afraid that I'd dislodge her schoulder because she's immune to pain when she's in a tantrum. And well, the people in the airport don't really like the look of us trying to get her to walk to the next gate while I try to keep her from hurting us.

So - we need a way to uhm, restrain without accidentally hurting her or something... Are there martial arts / courses etc designed for that purpose? And are they taught in the Netherlands?
A google search term that gives me results that AREN'T about drugging is also welcome.

Thanks in advance.

(I hope this doesn't sound too stupid, but I couldn't find any useful information and since this is remotely connected with martial arts...)

Hi CC.,

Definately not a dumb question. I can relate as I have a teenage son who on rare occassion has what are described as rage fits due to a neurological disorder and chemical imbalance. I too find it getting to be more difficult to safely subdue him as he is getting bigger and stronger.

The ideal situation is to have him calm down or safety in numbers. With 2 caring people it is easier than one. Try to stay away from the flailing limbs and head. Try to bring her down as gently as possible then we tend to have one of us wrap up the arms and the other the legs.

My wife and I have been on the recieving end of his flailing limbs and it hurts physically and emotionally.

Feel free to pm me if you wish as this is a pretty rough subject for me on a public forum. I wish you and your family the best.

-Marc-

 

[ChingChuan]

Thanks everyone!

Tantrums (by regular and autistic people) are usually brought on when one or more triggers are activated. What are her triggers? If you know that then you know how to cut off a tantrum before it starts... (usually) or at least you'll know when one is coming on. You probably already do know by now but it's something to consider.

Indeed. Usually (at home, at a quiet place) her tantrums aren't a problem but when we're in public... As all autistic people, she doesn't like unexpected things etc. so that triggers tantrums. It's gotten a lot better since we started therapy etc. but when we're on holiday she's a little bit stressed and tantrums come easier...
Recent examples:
1. In the airport security check line. She wanted to go so badly to the airplane (she really likes it!) that she started tantrumming and didn't want to walk anymore.

2. In the car while waiting for the ferry. Same story, she really wanted to go in the boat and we had to wait for another hour... so that became quite an energetic hour for us.
3. In Oxford in one of the main streets. We accidentally dropped the fact that we were going back and then she can't wait anymore and starts screaming, thinking everything will go faster then.


When she was small, we could just pick her up and ignore the screaming. But now she's 1. become too big for us to handle (she's almost taller than I am and I'm 1.55 m & my mother is 1.65m) and 2. people almost always start thinking something is wrong. Well, something is wrong but we don't need people threatening to call the police or something (like happened in Germany, argh!).

Put a mat up against a wall and train it though. With them trying to hit, pinch, pull hair, grab throats, everything she might do in that state. Learn what to watch out for and how to control the person so that they can't do any of it.

I don't think it'd be a good thing to practise such things without an instructor or someone who really knows their stuff... I'm absolutely NOT familiar with grappling arts etc.

You're going to need a lot of behavioral interventions. Also - if she's not medicated, you might consider it. If she IS medicated, you might want to look into something called "autistic catatonia."

Yup, we did (still do) that. Do you know Steven Wertz's Special Solutions (or something) program? We went to him twice & my mother also had lots of telephone consults with him. My sister has tremendously improved & her tantrums have decreased (before, she'd also have them at home a lot), only not when in public places / stressful situations. Also, we are doing something called biomedical intervention, like replenishing vitamins, gluten-free & casein free diets etc, which has also worked - she gets worse when she doesn't get her supplements or in the wrong dosage.
She was medicated before but we feel that that's not the right approach for her... It isn't like she's tantrumming all the time, it's just that we need to be able to safely hold her when she does get one on the wrong time/ spot. But thanks anyway .

There are professionals in that field who can help you. I'd really encourage you to go to them.

Hm... Most doctors in the Netherlands (and also in the rest of the world) tend to refuse to see biomedical intervention as a legitimate way to treat autism... They'd rather drug her, but that's not the thing we want .

If you know what your sister aboslutely needs to keep things together, what sorts of things get her upset, etc., then you and your family can work to make sure things are conducive to your sister staying calm. Furthermore, things can be done to teach your sister coping skills to manage her anger and frustration.

Well, we see it like this - we're not going to let our entire lives be dedicated to my sister. I mean, we're going on holiday by plane if we want to, we're not going to stay home because she'll start tantrumming. Of course, we won't upset her intentionally or anything, but it's not like we're going to walk around on eggshells (is that the idom?) only because she doesn't like unexpected situations. Usually it works to tell her 'that's the way it's supposed to be' (like: "Why don't I get an orange for breakfast?" "Well, it's always like that when you're in America (or something)). or to just have her 'adjust' for a few moments.


Oh, I think I forgot to tell you all that she's also blind & mentally disabled, so I don't think she's able to control her anger or something. I just remembered that she's also on the website of Steven Wertz - look here http://autism-programs.com/nynke.htm. The things on there are a little outdated (they're from 2002 or something...) and well, regarding the tantrums - she's now bigger and stronger than in 2002 so if she loses control now... .

I've seen some pretty serious injuries resulting from restraints. It's not pretty. Possible risks include joint and tissue damage, contusions, broken bones, possitonal asphyxia (suffocation due to compression of the chest..often happens when someone is holding someone down on the floor with theur weight). Also, significant mental trauma results from physical restraint.

Hm, I was thinking about that too. I mean, we absolutely don't know how to restrain her without hurting her and I think that the risk of uhm, breaking something would be greatly decreased if we actually know what to do (likespecific techniques etc.)

i guess what I'm saying is make sure you examine ALL your options before going for physical restraints.

Indeed. However, as I said above - it's not always possible to just let her sit & scream & pull at us for a while... In home situations we don't have problems with dealing with her . It's quite annoying that we can't really control her anymore when we go somewhere else.

Anyway, good luck and best wishes to you and yr family. :asian:

Thanks!

The ideal situation is to have him calm down or safety in numbers. With 2 caring people it is easier than one. Try to stay away from the flailing limbs and head. Try to bring her down as gently as possible then we tend to have one of us wrap up the arms and the other the legs.

Hm, this sounds interesting. But in most travel situations (like in the car, aircraft...) you wouldn't be able to do it. However, I don't think that there are many techniques designed to keep people down in a car, are there?

Feel free to pm me if you wish as this is a pretty rough subject for me on a public forum. I wish you and your family the best.

Thanks! I (we) don't really mind putting this online .