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1、AngryPatientEncounterAPE©A-agreeFindsomethingtoagreewith;itdissipatesangerP-pauseItallowsforcognitivereactivationE-emotionsAcknowledgeemotions(upset,distressed,bothered)--avoidlabel“angry”*expressExpressoptionsorplan,andfindamutualpurpose.“Iagree,Ialsothinkthat”,or“
2、Absolutely,,,inadditionI’venoticedthat…..”“MydecisionmayhaveupsetyouandIregretthat.TellmeifthereisanythingelseIcandothatwouldbeofhelp”(shiftsbrainbacktocortexforthinking/problemsolving).Pause“Iknowthatwasbadnews,Iexpectitwasdisappointing.Ihavetheimpressionthatyou’re
3、..”“Iwouldbegladtotalktoyounoworlaterabouthowyoufeelaboutit(don’tlabelanger).“FromthefactsI’vejustmentioned,I’mbeginningtothink….,isthatwhat’sgoingon?”“Doyouseethingsdifferently?”Pause“Iwaswonderingifpartofthereasonyou’re……….is………...,”Pause•Encountersarefragilewhent
4、hestakesarehigh,emotionsarestrong,andopinionsdiffer.•Actquickly,angerbegetsanger.Lookfornonverbalcues:eyebrowsdown,lipsthin.*(seeabove)•Dialogueisafreeflowofinformation.Personmustfeelsafetosharethoughts/feelings•Startwithfacts,objective/leastoffensive/notpersonal.Re
5、framingdisengagestheemotion.•Tellwhatyouthinkishappening,andthenaskforthemtosharetheirthoughtswithyou.•Tofixmisunderstandings,tellwhatyoudon’twantfirst,andthenlistwhatyoudowant.“Idon’twantyoutobe……..about……,howeverIdowantto…..”•Recognizetherealpurposebehindthereques
6、t/problem;itmaybesomethingverydifferent.“Whydoyouwantthat?”“I’mcurious,howwouldthatbehelpfultoyouAngerisastressresponse,ifHR>145=cognitivedysfunctionSocial-appropriatebehaviorissacrificedbyfeelingsofadirectthreatIfHR>175forebrain/cognitionshutsdownandmidbrain(primit
7、ive-dogbrain)takesover=predatoryreaction.Normal-faces/emotionsarerecognizedbyfusiformgyrus,ObjectsarerecognizedbytheinferiortemporalgyrusInautism,brainrecognizesbothfromtheinf.temperalgyrus.WithStress/angertheeffectisthesameasautism,=”temporaryautism”,hencethetermmi
8、ndblind=cannolongerreasonoractappropriatelyTX?Pause(calledwhitespace)allowsbraintoresettoforebrainfunction=returnofcognition/reasonSeroton
