ACTitude- Case scenarios of verbal violence

This project (2017-1-FR01-KA202-037338) has been funded with support from the European Commission.

This publication reflects the views only of the author, and the Commis­sion cannot be held responsible for any use which may be made of the information contained therein

TABLA DE CONTENIDO CASE 1 - EXILED STUDENT .................................................................................................................................................................... 3 CASE 2 - UNSPEAKABLE MENTAL ILLNESS .................................................................................................................................... 5 CASE 3- BODY SHAMING ......................................................................................................................................................................... 7 CASE 4 - RELATIONSHIP ISSUES WITH PARENTS ....................................................................................................................... 9 CASE 5 - EMOTIONAL VIOLENCE PERPETRATED BY IGNORING AND REJECTING A PERSON WITH MENTAL HEALTH ISSUES ....................................................................................................................................................................................... 11 CASE 6 - EMOTIONAL VIOLENCE PERPETRATED BY USING PATRONISING AND CONTROLLING ATTITUDES TOWARDS A PERSON WITH MENTAL HEALTH ISSUES ......................................................................................................... 13 CASE 7 - LACK OF AUNOTOMY PROVOKED BY OTHERS IN PEOPLE WITH MENTAL HEALTH ISSUES ............. 15 CASE 8 - VERBAL VIOLENCE PERPETRATED BY INSULTING AND IGNORING AT THE SAME TIME A YOUNG STUDENT WITH MENTAL HEALTH ISSUES ................................................................................................................................. 17 CASE 9 - THE MONOLOGUE ................................................................................................................................................................ 19 CASE 10 - THIS IS MY HOME…TOO!................................................................................................................................................. 22 CASE 11 - I NEVER GET ANGRY… ..................................................................................................................................................... 25 CASE 12 - WHY DON’T YOU LEAVE ME ALONE! ........................................................................................................................ 28

CASE 1 - EXILED STUDENT William is a fifteen-year old, student with Autism. William is, basically, a very happy and pleasant young man. He has a wonderful sense of humor and is a pleasure to be around.

The humorous side of William made him able to get a few friends in his class.

William wants to do well in school. He is a perfectionist and expects to earn straight A’s in his classes.

But William needs reminders to pay attention during class. William also tends to rush through schoolwork, not fully reading directions and questions in his hurry to complete the assignment. William also becomes easily frustrated and angry, although his behavior has improved this year; he still becomes occasionally agitated and yells, hits himself, throws things or cries.

This temperament side is more often shown and makes his friends feel annoyed, especially in weeks full of assignments. His classmates were so annoyed so that in their group assignments no one wanted to partner with him anymore and they excluded him.

Theoretical background Aggression type Example of relational aggression – exclusion, ostracism.

Emotions: anger Coping/Stressors related to mental illness/social rejection Coping/Functional coping strategies

Questions and answers 1st Question At what point in the scenario do you find that the protagonist was a victim of violence? To what kind of violence does the scenario refer to?

1st Answer

When none of his classmates wanted to be friends with him anymore and excluded him from group assignments and left him alone like he was before he entered that class.

It refers to emotional violence, most probably verbal and non-verbal with gestures and mimic carried out.

2nd Question Do you think that the thoughts, the actions, the feelings and the attitudes adopted by the protagonist of the scenario helped him/her to cope with this situation? Are there any alternative ideas?

2nd Answer No, with his mental conditions he is not able to cope with the situation. If William's emotional break downs do not get special intervention regarding the management of his negative emotions, then the pressure that William faces in the social sphere will become more severe.

3rd Question What other interventions and actions could further help the protagonist to deal with this incident and with any potential similar incidents in the future?

3rd Answer •

Figure out the reasons for the emotional break down.

•

Create a safe zone for him

•

Behavioral and developmental interventions

•

Family-based interventions

•

Therapy-based interventions and medical interventions

•

Alternative interventions (ex.: elimination diets)

CASE 2 - UNSPEAKABLE MENTAL ILLNESS The protagonist is a man with mental health issues. He goes to a therapist, but he does not tell anyone about it, neither his closest friends nor his family. He doesn’t want them to change their attitudes towards him and he is afraid they would judge him in a bad way if they discover he is mentally ill. As a result, the people around him continued to treat him as usual. In fact, in his workplace he was given many responsibilities in the work that drained his mind. Eventually, he became more stressed and lost his job. His friends stayed away from him; even his family blames him for being unprofessional and nonresistant at work for a tiny bit of more responsibility.

Theoretical background Aggression type Fear of social stigma - resulting in relational aggression.

Emotions: shame, fear Coping/Stressors related to mental illness/social stigma

Questions and answers 1st Question At what point in the scenario do you find that the protagonist was a victim of violence? To what kind of violence does the scenario refer to?

1st Answer 

When his friends stay away from him.



When his family blames him for being unprofessional at work.



It refers to emotional violence.

2nd Question

Do you think that the thoughts, the actions, the feelings and the attitudes adopted by the protagonist of the scenario helped him/her to cope with this situation? Are there any alternative ideas?

2nd Answer No, he isn’t able yet to react to it honestly and protect himself. If he doesn't open up, neither he will get help from the people around him regarding his mental illness, nor will they be able to understand the situation and react accordingly.

3rd Question What other interventions and actions could further help the protagonist to deal with this incident and with any potential similar incidents in the future?

3rd Answer •

Therapeutic interventions

•

Medical interventions

•

Vocational interventions

•

Social care interventions

CASE 3- BODY SHAMING Chester, a tall, skinny teenager who excels in math and science classes, feels embarrassed when he has to change into gym clothes in the boy’s locker room at school because he lacks muscularity and size.

Other, more athletic, and well-built teens notice Chester’s shyness and decide to exploit it. Using their phones, they covertly take pictures of Chester without his shirt on and in his boxer shorts. These pictures are then circulated among the rest of the student body via WhatsApp. Soon enough, boys and girls are pointing, snickering, and laughing at Chester as he walks down the school hallways. He overhears comments such as “There goes Bird-Chested Chester”, “Big Wus,” and “Pansy.” These words hurt him deeply, and the perception that his classmates have of him begins to affect his math and science grades.

Theoretical background Aggression type Relational aggression – resulting in bullying.

Emotions: shame Coping/Stressors related to mental illness/victimization Coping/Functional coping strategies

Questions and answers 1st Question At what point in the scenario do you find that the protagonist was a victim of violence? To what kind of violence does the scenario refer to?

1st Answer When his friends decide to exploit his lacks muscularity and size and take secretly pictures of Chester without his shirt on and in his boxer shorts and circulate among the rest of the students via WhatsApp. It refers to cyberbullying and body shaming.

2nd Question

Do you think that the thoughts, the actions, the feelings and the attitudes adopted by the protagonist of the scenario helped him/her to cope with this situation? Are there any alternative ideas?

2nd Answer No. If Chester still feels embarrassed then he will feel alienated over time and this will disrupt his academic achievement in school. Chester's friends need special attention in this case.

3rd Question What other interventions and actions could further help the protagonist to deal with this incident and with any potential similar incidents in the future?

3rd Answer 

serious talks with bullies and victims



serious talks with the parents of bullies and victims



role playing of non-aggressive behavior with bullies



role playing of assertive behavior with victims

CASE 4 - RELATIONSHIP ISSUES WITH PARENTS Franziska is an 18 years old girl who belongs to a middle-class family. She is currently pursuing her high school. She is currently in her second year. As a person, Franziska is a little reserved and has a small friend circle. She takes some time to open up to people. Franziska noticed that as soon as she entered the high school, there was a drastic change in her parent’s attitude towards her. According to Franziska, her parents had become over-protective, suspicious, and argued with her almost on a daily basis. Her parents didn’t like her meeting school friends and especially boys and kept a check on her calls and messages. She was not at all comfortable with the restrictions her father had put on her. Franziska was increasingly feeling restless and agitated. At times, she used to also answer them back which lead to further conflicts and fights. Franziska was scared of her father and believed that her father would never listen to her. Franziska assumed that talking to him was of no use. Due to the constant conflicts with her parents, Franziska became stressed and realized that she is not able to concentrate properly on her studies and she is lagging behind in her academics as well. Since she was not able to deal with the situations and her studies were getting impacted really badly.

Theoretical background Aggression type Relational aggression with elements of verbal aggression and even emotional violence.

Emotions: anxiety, anger Coping: functional coping strategies

Questions and answers 1st Question At what point in the scenario do you find that the protagonist was a victim of violence? To what kind of violence does the scenario refer to?

1st Answer

When her parents had become over-protective, suspicious, and argued with her almost on a daily basis.

It refers to emotional and verbal violence.

2nd Question Do you think that the thoughts, the actions, the feelings and the attitudes adopted by the protagonist of the scenario helped him/her to cope with this situation? Are there any alternative ideas?

2nd Answer No, it didn’t she couldn’t deal with the situation and in fighting back with her parents she also made the whole situation worse. As a result Franziska started feeling depressed, her depressed mood got worse and will get worse in this vicious cycle. In this case the family is instrumental in the healing of Franziska’s psychic.

3rd Question What other interventions and actions could further help the protagonist to deal with this incident and with any potential similar incidents in the future?

3rd Answer •

Behavioral interventions

•

Developmental interventions

•

Family-based interventions, a therapy altogether

•

Therapy-based interventions

•

Medical interventions just to get over the depression and being able to focus on strategies to

deal with the situation

CASE 5 - EMOTIONAL VIOLENCE PERPETRATED BY IGNORING AND REJECTING A PERSON WITH MENTAL HEALTH ISSUES M is a middle-aged man, diagnosed with mental health issues, who has a poor social life and does not have many friends. He goes sometimes to a day care center, but he has difficulties with accepting his mental health issue, and that is the reason why he does not usually talk to anyone about it. However, he has recently started taking the suggested medication and he seems feeling a bit better than before.

Hence, his sister manages to convince him to go out with her and some of her friends, who are aware of the man´s illness. They meet in a pub and start talking about everything and anything, laughing while sharing common daily events. However, nobody is addressing to the Man, nor taking his interventions into consideration: they totally ignore him, as if he were not there. The Man feels angry and upset and, after some further meetings with them, he tells his sister he would rather stay by himself and then he exclaims: “That is why I don´t tell people! This is so frustrating... And I will stop taking the medication: it doesn’t change anything…”

Theoretical background Aggression type Fear of social stigma and denial of it - resulting in relational aggression and escapism from relations.

Emotions: anger, disappointment Coping/Stressors related to mental illness/social stigma and self-stigma Coping/Functional coping strategies

Questions and answers 1st Question At what point in the scenario do you find that the protagonist was a victim of violence? To what kind of violence does the scenario refer to?

1st Answer

The emotional violence is perpetrated by the sister´s friends during the meetings, since they ignore and emotionally reject the protagonist.

2nd Question Do you think that the thoughts, the actions, the feelings and the attitudes adopted by the protagonist of the scenario helped him/her to cope with this situation? Are there any alternative ideas?

2nd Answer He feels frustrated, angry, upset and embarrassed and he thinks he should stop taking his medication, since it does not change the way people treat him. The fact that he does not fully accept his mental health issue does not help him, since he is the first person who negatively judge himself. He should not be ashamed of his illness and he should work with a professional on it.

3rd Question What other interventions and actions could further help the protagonist to deal with this incident and with any potential similar incidents in the future?

3rd Answer Improving self-esteem, encouraging him not to be shy and talk with people, and making him understand that it is not his fault if some people ignore him or do not want to speak to him because of his illness.

This is a type of discrimination due to the lack of knowledge related to mental health issues.

Furthermore, he could be encouraged he should continue taking his medication since it benefits himself: he should not take such a decision because of people´ judgements or believes.

CASE 6 - EMOTIONAL VIOLENCE PERPETRATED BY USING PATRONISING AND CONTROLLING ATTITUDES TOWARDS A PERSON WITH MENTAL HEALTH ISSUES

The protagonist is a young man with mental health illness who has been a user of a day care center for the past few months.

The social service professionals are working to improve the man’s autonomy and decisiveness, since he has problems of self-esteem and emotional dependence to his parents. The latter are highly controlling and possessive and they leave no space for his autonomy. By fearing that he might “get himself into troubles” or “get hurt”, they do not let the protagonist go out alone. When he has activities at the day care center, they take him there and they come to pick him up. During the day, they call the professionals at the center to make sure that the young man is still there. He is making progresses and he is achieving good results. Notwithstanding that, when his parents are present, he blocks up and he seems to lose his ability to express himself and to communicate his needs. He becomes suddenly more indecisive, unconfident and anxious. After a while, the mental health professionals working in the day care center decide to talk to the parents about the progress their son has made. However, they do not seem to care about the good news they are informed about and they continue using patronizing attitudes towards him. On the other side, the protagonist keeps on showing a sudden lack of autonomy only when his parents are around.

Theoretical background Aggression type Relational aggression - emotional violence.

Emotions: anxiety, sadness Coping/Stressors related to mental illness/social stigma Coping/Functional coping strategies

Questions and answers 1st Question At what point in the scenario do you find that the protagonist was a victim of violence? To what kind of violence does the scenario refer to?

1st Answer The parents of the protagonist patronize and control him. They treat him as he is not able to be independent, even if he has proved the contrary. The violence is perpetrated by the parents during the whole period the story refers to.

2nd Question Do you think that the thoughts, the actions, the feelings and the attitudes adopted by the protagonist of the scenario helped him/her to cope with this situation? Are there any alternative ideas?

2nd Answer He feels powerless and not able to be independent. However, he is “indecisive, unconfident and anxious” only at the presence of his parents. He has improved his autonomy and self-esteem, but he is afraid of failing in front of his parents. He should always remind himself that he is able to take his own decisions and that the others have to respect them.

3rd Question What other interventions and actions could further help the protagonist to deal with this incident and with any potential similar incidents in the future?

3rd Answer.

The professionals should keep on validating the protagonist and leading him to the awareness that everyone can fail: there is no learning without making mistakes.

CASE 7 - LACK OF AUNOTOMY PROVOKED BY OTHERS IN PEOPLE WITH MENTAL HEALTH ISSUES

The protagonist is a middle-aged man having mental health issues. He is aware about his condition and he wants to find out the best medication to feel better. He has a great social life, many friends surround him and he is autonomous in his daily routine. Some days are harder for him because he doesn’t feel like to get out of the bed and he spends most of the time lying on it. He also recognizes how much help his mother gives to him; therefore, he wants to pay her back by starting an “intervention plan”. One day he goes to a day care center with his mother. While the protagonist is talking to the professional regarding the “intervention plan” to be put into practice, his mother continuously insults him by saying things such as “You do nothing” or “You spend all day smoking” or “I have to do everything for you”. Consequently, his lack of autonomy may have been provoked by the controlling attitudes of the mother itself.

Therefore, the protagonist believes in what she says and he feels inferior, impotent and incapable of being very independent, especially when he is home, even if he handles his life properly. His mother attitude will not help him during the recovery, and the professional is aware about it. The man is determined to improve his life; however, it will not work if his mother keep telling him that he cannot do anything without her help.

Theoretical background Aggression type Relational aggression - emotional violence.

Emotions: guilt, shame Coping/Stressors related to mental illness/victimization and self-stigma Coping/Functional coping strategies

Questions and answers

1st Question At what point in the scenario do you find that the protagonist was a victim of violence? To what kind of violence does the scenario refer?

1st Answer The protagonist is a victim of verbal and mental violence when his mother starts to insult him, in front of the professional, by telling that he doesn’t do anything during the day and that she is the only one that does.

2nd Question Do you think that the thoughts, the actions, the feelings and the attitudes adopted by the protagonist of the scenario helped him/her to cope with this situation? Are there any alternative ideas?

2nd Answer The protagonist justified the attitude of his mother because he thinks she is right since he is totally aware that the depression forces him to stay in bed. However, he should change his mind and start to believe he can do. He is autonomous during his daily routine; moreover, he is the one who decided to start the action plan. All this shows his independence in making decisions and in taking actions 3rd Question What other interventions and actions could further help the protagonist to deal with this incident and with any potential similar incidents in the future?

3rd Answer The professional should propose a path to recovery together with his mother because the latter has to support his son and she has to understand he is capable of doing and that he wants change this situation to pay her back. She has to help him with nice words; on the contrary, the action plan would not have positive effects. They have to work together and she has to accept her son condition.

CASE 8 - VERBAL VIOLENCE PERPETRATED BY INSULTING AND IGNORING AT THE SAME TIME A YOUNG STUDENT WITH MENTAL HEALTH ISSUES The protagonist is a man with mental health issues. During his life, he started different medications; in the beginning, he always handled the situation pretty well and he always felt much better but every time the professionals changed his cure by eliminating the pills assumption, he always fell down once again. He remembers that when he was at school he had a professor who did not know how to deal with him nor with his mental health illness. The professor used to attack the protagonist by insulting him when he gave the wrong answer to the questions and, at the same time, by ignoring him when he wanted to know more about the lesson or when he wanted to intervene during a debate. The boy felt so angry and frustrated that he preferred leaving the class. Luckily, during the other lessons he has always been treated well from all the professors; however, he started to feel uncomfortable and always less important for the class. Moreover, at a point, has lost his interest in studying and this led him to give up with his educational life. The protagonist keep remembering all the embarrassed situations he had to deal and his final decision. Every time he starts a new medication, he forget about it but as soon as he stopped taking the pills, all the memories come up once again in his mind bringing him down. However, the professionals still believe in him therefore they suggest him a different recovery even if the protagonist still believes he would never heal.

Theoretical background Aggression type Pervasive memories of verbal aggression – emotional violence resulting in the total lack of self-efficacy, and self-destruction.

Emotions: anger, shame Coping/Stressors related to mental illness/victimization and self-stigma Coping/Functional coping strategies

Questions and answers 1st Question At what point in the scenario do you find that the protagonist was a victim of violence? To what kind of violence does the scenario refer to?

1st Answer The protagonist is victim of verbal and emotional violence during his early life when he was studying at the college. The professor didn’t know how to treat him therefore he did everything to push the young boy out of the class. The teacher discriminated and humiliated him in front of the rest of the classmates 2nd Question Do you think that the thoughts, the actions, the feelings and the attitudes adopted by the protagonist of the scenario helped him/her to cope with this situation? Are there any alternative ideas?

2nd Answer The man during his early age felt frustrated and angry. He tried to change his educational path by following other classes but, due to the mental pressure exercised by his previous professor he started to feel inadequate, moreover he become more afraid in intervening during the classes’ debates. The protagonist should have not felt embarrassed in keep going to take the class since the professor is the only one to be blamed,. With his presence he would have shown he was determined and able as any other student.

3rd Question What other interventions and actions could further help the protagonist to deal with this incident and with any potential similar incidents in the future?

3rd Answer It would be essential that the professional explain to the men that everything he feels is given by old memories and that right now he is totally able to overcome it. It is important to work with the protagonist so that he understands that the self-esteem and self-confidence has to be built from the inside. Furthermore, would be a good advice to suggest to the protagonist to take some lessons again. In that way he will demonstrate to himself he can do it and, consequently, he can also bring to end his medication and never felt down again.

CASE 9 - THE MONOLOGUE Leonidas is a 42-year-old man diagnosed with paranoid schizophrenia in 2001. He had this diagnosis from the X psychiatric hospital when he was voluntarily hospitalized due to some auditory hallucinations. He was hearing voices criticizing him as "useless", “loser” and other derogatory comments. He had also some annoying thoughts. After his hospitalization, his employer fired him from the café, where he worked as a waiter, citing financial difficulties that did not allow him to have many employees. Since then he has been unable to find a new job.

While he was looking for a job, he became very depressed because he couldn't find employment. His mother said him that it was worthless to look for a job, because a person with a mental disorder could hardly be accepted for work. Finally he accepted what his mother told him and he remained unemployed. He lives with his parents in a house in a suburb of Athens and visits a day center three times a week, where he is examined in a regular basis by a psychiatrist and participates in various groups, such as a group of artistic activities, a poetry group etc.

One day while he was walking to the day center for the poetry group, he was narrating a poem loudly.

Passing out of school, some high school students began to make comments, such as "you are crazy", "where are you going old man", "you are smoking like chimney" etc. and they laughed loudly. Leonidas kept walking to his destination, giving no attention. He thought that the students had this behavior because they were children and it was a big mistake to talk alone. He attended the meeting with the poetry group, and when he was invited to recite a poem, he politely refused.

He kept going to poetry groups, following a different path. He tried to stop his habit of narrowing on the street. After three meetings, he stopped joining the group, saying “he cannot make it”.

Theoretical background Aggression type Social stigma, reinforced with episode of verbal aggression.

Emotions: sadness, shame Coping/Stressors related to mental illness/social stigma and self-stigma Coping/Functional coping strategies

Questions and answers 1st Question At what point in the scenario do you find that the protagonist was a victim of violence? To what kind of violence does the scenario refer to?

1st Answer The point at which Leonidas was subjected to violence was where the children described him with various comments. The various derogatory comments he received, can be possibly regarded as verbal violence.

Also in the scenario where Leonidas' mother tells him that it is difficult for a person with a mental disorder to be accepted for a job, it can be possibly considered as discrimination. The same may occurs with his employer's decision to fire him after his hospitalization (in the event that his employer did this because of his hospitalization and simply referred to financial problems as an excuse).

2nd Question Do you think that the thoughts, the actions, the feelings and the attitudes adopted by the protagonist of the scenario helped him/her to cope with this situation? Are there any alternative ideas?

2nd Answer Leonidas in the incident with the children did not get angry. The scenario does not report that he experienced specific intense emotions. The scenario gives the impression that he “isolated” his emotions. He also seemed to rationalize their behavior. He accepted the situation as it was. The rationalization of the children's behavior may help to prevent him from behaving aggressively towards the children, thus he avoided a potential trouble. Possibly the suppression of his emotions about the event (his feelings were not even expressed in the group at the center of the day), may have possibly contributed to his drop out from the poetry group.

3rd Question What other interventions and actions could further help the protagonist to deal with this incident and with any potential similar incidents in the future?

3rd Answer

Not responding to aggressive behaviors may help but he could express his feelings to a group or to a daycare mental health professional.

CASE 10 - THIS IS MY HOME…TOO! Mr. Pantelis is a 32-year-old gentleman who has been living in a psychosocial rehabilitation unit (sheltered apartment) since October 2018. He went there after his involuntary hospitalization, due to a suicide attempt, at a Psychiatric Hospital where he was diagnosed with manic disorder. He works in protected work in the evenings as a catering waiter and likes to work out in the mornings.

Mr. George, a 45-year-old gentleman, diagnosed with schizophrenia, has been living in the sheltered apartment for 10 years, working as a cleaner at a cleaning service in the late afternoon hours, and likes to sit at home and relax in the mornings. He calms down by reading his book, drinking his coffee and smoking (admits of being a frantic smoker).

Mr. Pantelis and Mr. George are sleeping in the same room. They also have two other men roommates, aged 55, in the protected apartment who attend a Day Care Center.

Coexistence could be described as calm and harmonious, without particular problems. Each of the tenants adheres to their own routine. They have split up the housework and each has his own outdoor program.

But lately, Mr. Pantelis and Mr. George have been in constant dispute over the fact that Mr. Pantelis complains that he cannot follow the daily exercise program he does at home because Mr. George smokes constantly and the atmosphere at home is stuffy.

Mr. George constantly says nervously: "I am here long before you came, I will not change my habits for you, this is my home, stop acting like a baby all the time!"

In their latest quarrel, Mr. Pantelis addressed Mr. George by mocking him: "this is my home too, you’re going to get cancer, you crazy monkey!"

After that fight, Mr. Pantelis had stopped exercising and stopped talking to his roommate, whilst Mr. George kept smoking every day with a sad look on his face and told the other two roommates that he is sorry, but he won’t apologize to him!

Theoretical background Aggression type

Verbal aggression, escalating into relational aggression.

Emotions: anger, disgust Coping: functional coping strategies

Questions and answers 1st Question At what point in the scenario do you find that the protagonist was a victim of violence? To what kind of violence does the scenario refer to?

1st Answer Mr. Pantelis was being a victim of emotional violence every time Mr. George was smoking (although he knew that it was irritating for his roommate), and he suffered from verbal violence when he was told that he was acting “like a baby” and when it was said that this is Mr. George’s home.

Mr. George has been verbally attacked when said to him: "you’re going to get cancer, you crazy monkey!"

2nd Question Do you think that the thoughts, the actions, the feelings and the attitudes adopted by the protagonist of the scenario helped him/her to cope with this situation? Are there any alternative ideas?

2nd Answer Mr. Pantelis should have fought for his right; he shouldn’t have stopped training neither stopped talking to his roommate as an act of protest.

On the other hand, Mr. George should apologize to his roommate after he realized he was wrong.

Both of them should act with a greater sense of solidarity and humanity, friendship and understanding.

Talking is always the best way to deal with misunderstandings 3rd Question What other interventions and actions could further help the protagonist to deal with this incident and with any potential similar incidents in the future?

3rd Answer

Mr. Pantelis should work on his self – esteem and be more confident in defending himself. He should also be more careful when referring to others about health matters.

Professionals should encourage him and help him cope with his shy character in order to find ways of dealing with issues like these.

Mr. George should not be so rude and so strict when someone has different views about a matter such as smoking. He should also apologize when feeling like and not avoiding because of his pride.

Professionals should help him by making him realize the importance of reducing smoking for his wellbeing as well as the others, trying to raise awareness of his roommates particularities and how to express his feelings when necessary.

CASE 11 - I NEVER GET ANGRY… Panos is 50 years old resident of a psychosocial rehabilitation unit diagnosed with paranoid schizophrenia.

One morning he got permission from the unit to visit a bank to do some procedures related to his bank account. When it was his turn to be served, the bank employee gave him a form to fill in. Panos had several questions about completing the application. At one point the bank employee was angry and shouted to Panos, asking him why is so difficult to fill out the application. When the bank employee found that the address of residence referred to in the application was the address of a psychosocial rehabilitation unit, the bank employee said in an ironic tone "now I understand".

This comment by the employee caused laughter in the queue of people waiting behind him. Panos did not comment on the behavior of the employee. He was angry at first but then thought that it was not a very important incident, he considered the employee's reaction reasonable and justified his behavior as normal, taking into account his fatigue. Returning to the unit where he lives, he met another resident of the psychosocial rehabilitation unit, who asked for some money.

Panos then replied that he has nothing to give him because he has not been able to finish process at the bank he visited. The other resident called him "useless" and left. Panos did not answer, bowed his head, went to the yard of the unit and smoked. Shortly thereafter, a staff member approached him and told him that he smoked a lot and this habit may cause him a lot of health problems in the future. Then Panos made a loud burst of anger, shouting and screaming. He eventually asked for extra medication in order to calm down.

Theoretical background Aggression type Episodes of verbal aggression, reinforcing social stigma.

Emotions: anger, guilt Coping/Stressors related to mental illness/social stigma and victimization Coping/Functional coping strategies

Questions and answers 1st Question At what point in the scenario do you find that the protagonist was a victim of violence? To what kind of violence does the scenario refer to?

1st Answer The comments of the bank employee were an insult and a reaction that stigmatized Panos. The laughing of the other bank customers was a derogatory reaction.

Also the behavior of the other resident of the unit could be characterized as verbally violent.

2nd Question Do you think that the thoughts, the actions, the feelings and the attitudes adopted by the protagonist of the scenario helped him/her to cope with this situation? Are there any alternative ideas?

2nd Answer Panos was angry at first but did not act according to his feelings. He then considered the behavior of the bank employee reasonable. In the second incident with the other resident of the unit, Panos seems to have taken a “passive attitude”.

The fact that in neither of the two cases, he did not adopt aggressive behavior (although he was angry at first), may have helped him to avoid a possible trouble. On the other hand, an accumulation of some feelings may possibly have caused an intense anger episode.

3rd Question What other interventions and actions could further help the protagonist to deal with this incident and with any potential similar incidents in the future?

3rd Answer An alternative attitude he could adopt, may perhaps be to express his dissatisfaction with the attitude of the bank employee and the other resident (calmly). Also, instead of reacting in this way to the staff member of the structure, he could talk to him about the incidents that made him feel uncomfortable, so that he would be emotionally relieved.

CASE 12 - WHY DON’T YOU LEAVE ME ALONE!

Mr. Mathew is a 20-year-old man facing mental health issues.

He lives with his mother; he doesn’t work and the only thing that he enjoys doing is going walks and attending social events because he likes being surrounded by people.

Last Saturday he attended a food festival organized in a village nearby the town he lives in.

After having a great time there by tasting different foods from other countries and socializing with people from the fest he started walking to reach the closest bus stop feeling grateful for this peaceful and fulfilling evening.

Thinking of all the things he would recite to his mother he lit a cigarette.

During his walk, he was approached by a group of youngsters, who asked him ignobly for a cigarette.

Feeling uncomfortable by their attitude he refused to give them one, letting them realize that he was annoyed by their behavior.

Acting normally, they started shouting and laughing at him, making rude comments and mocking him.

Feeling humiliated, Mathew, decided to ignore them.

Then, they started throwing stones towards him.

With the feeling of fear and anger at the same time he decided to hide around the corner and wait until the youngsters had gone, mumbling “why don’t you leave me alone!”

Theoretical background Aggression type Episodes of verbal, postural and physical aggression.

Emotions: fear Coping/Stressors related to mental illness/social stigma and victimization Coping/Functional coping strategies

Questions and answers 1st Question At what point in the scenario do you find that the protagonist was a victim of violence? To what kind of violence does the scenario refer to?

1st Answer Mathew has been a victim of verbal violent from the moment the youngsters asked him ignobly for a cigarette, when making rude comments and mocking him.

He was emotionally violated when they started shouting and laughing at him. Emotionally violated should have felt when, probably desperately, trying to avoid the stones.

2nd Question Do you think that the thoughts, the actions, the feelings and the attitudes adopted by the protagonist of the scenario helped him/her to cope with this situation? Are there any alternative ideas?

2nd Answer Instantly, these actions helped him. Not for managing the situation but for avoiding being further emotionally and verbally hurt.

In his situation and with his psychological status, maybe it was the right thing to do at the specific time.

He was alone and he felt humiliated not to mention helpless.

3rd Question What other interventions and actions could further help the protagonist to deal with this incident and with any potential similar incidents in the future?

3rd Answer Maybe he should make these long walks along with some friends. He should learn to cope with rude people.

He should work with his therapists’ self-esteem and self-confidence issues.