"Detaching the self. Five of the eight nursing assistants reported actively detaching themselves from the process when they were administering manual restraint for CNF. This was predominately described by female nursing assistants and was evidenced through the use of terms such as “zoning out”, “shutting off” and “taking my mind off”. Detaching the self appeared to be a conscious response used by participants to cope with the adverse psychological outcomes of manual restraint use: I sort of try to stay focused on what I’m doing during the whole process but sort of try to take my mind out of this as well so that I can cope with it because it’s a very stressful procedure so I’m trying to think of something more calming. (Participant 1) I get to a point when I just shut off and then I’m just staring into nowhere and just trying to remain in the restraint position because it’s just too much to take in. (Participant 8) For one nursing assistant, detaching the self was a “necessary” coping strategy that guarded against the adverse psychological outcomes that could result from paying attention to the young person’s distress during restraint. Failing to “zone out”, in this participants view, was self-destructive: It becomes quite emotionally damaging to pay attention too much to what the patients are screaming and shouting about in the feed so I prefer to kind of zone out, it’s my coping mechanism . . . it’s necessary to zone out and I kick myself if I don’t do it because it’s just self-destructive not to. (Participant 5)"