Aggression

It occurred to me today that almost all my posts are about our suicidal/depressed/self-injuring patients. I don't really know why that is; I suppose it may be because they are the ones that I think need so much support and love. But they are only half of the residents.

They other half, they are aggressors.

These are the children that , when they are first admitted, will kick you, then wait. They will yank your hair, and wait. They will slap, spit, yell, curse, threaten......and wait. They wait to see what you will do, how you will react. They are testing the waters. They want to know how much they can get away with before you lost your temper. They run hot or cold; either these patients will flare up with fury, or wait, spreading hatred like ice across a lake, slowly but deadly.

These are the children who will toss racial slurs at their peers, make death threats, even attack them for no reason. They keep us on our toes, and they make the other patients, the ones who would never harm anyone but themselves, nervous.

These boys and girls are, quite frankly, nasty. They are admitted for burning down their homes, attacking their family members, even bringing guns to school. They are angry, and they want to spread their anger.

Unfortunately for them, we've seen it all before.

The Achilles Heel of these children is not punishment or negative reinforcement, it is kindness. When someone kicks you, kicks you hard, you want to kick them back. But that is what they want. What they can't stand is a disappointed look and a gentle voice asking them why they would disrespect someone who is trying to help them. To see if it's genuine, often a few more vulgar insults have been thrown into the air. A reminder that you are not disrespecting them, but they are most certainly disrespecting you, will make them feel ashamed. Any human in the world hates that feeling.

Some will try to hide their shame by acting out more, and when more patience, more kindness, is offered, they will simply throw up their hands and storm off to sulk. Others will apologize. Some will suddenly decide they like you, and then the aggression is pointed elsewhere.

These children are far more complicated than those who hurt themselves, but I believe that most, if not all, of them loathe themselves so much that they turn their anger outward, a shield against the world. Some have been heavily abused; others are the abusers. All of them are still children.

Kill them with kindness, I think as I stare at my bruises. Kill them with kindness.

And hide your surprise when they greet you with a smile and a hug on your next shift.

And maybe be sure they aren't holding a shank.