Operational Stress Control and Reintegration

1Operational Stress Control and Reintegration JUL 2013

Operational Stress Control and Reintegration

FACILITATOR’S NAMEDATE


• Recognize the type and scope of issues impacting reintegration for Service Members, family members, and others.

• Identify helpful tools and resources for coping with the challenges of reintegration.

• Facilitate a successful transition for yourself and/or your loved ones.

Objectives


• Reentry into pre-deployment life or into a new civilian life.

• History has taught us reunions are more stressful than separations.

Goals of Reintegration

Why do you think that is?


Seeing Others Perspective

Positive and negative feelings -• Part 1 – Service Member• Part 2 – assigned individual


All Service Members

•Sense of relief•Proud of accomplishment•Happiness•Contentment

Service Member Perspective

Single Service Members•Wanting to reestablish living situation•Social Life/ Significant other•Changes in friends•Often overlooked!

Married Service Members•Wonder how spouse may have changed•Wonder how the children will react •Possible loss of importance to the family

• Financial worries• Loss of freedom• Work reunion• Irritability, Guarded• Resentment• Overwhelmed• Frustration


• Relieved!• Proud of accomplishment• Excitement• Apprehension• Appreciation• Supportive• Comfortable• Elation

Spouse Perspective

• Wonder how they are perceived by returning spouse

• Loss of freedom• Wonder how will children react • Stability of relationship• Possible resentment• Nervousness• Restlessness• Irritability• Anxiousness• Role confusion


• Happy!• Excited• Hesitant• Shy• Anticipation

Child Perspective

• Possibly resentful• Wonder if Dad/Mom will leave again• Clinging• Will want to “talk your ear off”• Worry about how things will change• Anger• Confusion• Fear, Scared• Regression

Remember kids are still developing!


• Relieved!• Proud of accomplishment• Excitement• Apprehension• Appreciation• Supportive• Comfortable• Elation

Extended Family Perspective

• Possibly resentful• Overwhelmed• Frustration• Readjustment• Nervousness• Anxiousness


• Happy … friend returns• Relieved due to more help• Excitement• Anticipation

Co-Worker Perspective

• Possibly resentful• Feel under appreciated• Change in work roles• Personnel changes• Readjustment


• Be Realistic!

• Show appreciation to and for each other

• Respect changes that have occurred

• Allow for dedicated couple / children time

• Reestablishing intimacy

• Avoid the “who had it worse” game

Communication and Patience are the Key !

Considering Different Perspectives


Common Areas of StressCommon Areas of Stress

Thinking/Feeling

BoredomRoutineDisillusion

Thrill SeekingIrritabilityAngerGuiltShameHatred

RelationshipsSpouseChildrenFriendsGrowthChange

ConflictIrritabilityAngerDetachmentWithdrawalControl

Spirituality

Understanding WhyLoss of Trust in OthersLoss of Trust in SelfLoss of Trust in higher power

Environment

TrafficCrowdsMoneyAlcoholSecurity

Aggressive DrivingAggressionControlHyper-vigilance


Stress Continuum ModelStress Continuum Model

READYREADY(Green)

REACTINGREACTING(Yellow)(Yellow)

INJUREDINJURED(Orange)(Orange)

ILLILL(Red)(Red)

• Good to go• Well trained• Prepared• Fit and

focused• Cohesive

units & ready families

• Ready to go!

• Mild and temporary distress or impairment

• Anxious, irritable, or sad

• Physical or behavioral changes

• Mild and reversible!

• More severe or persistent distress or impairment• May leave lasting

memories, reactions, and expectations• Temporarily non-

mission ready!

• Stress injuries that don’t heal without help• Symptoms persist

for >60 days, get worse, or initially get better and then return worse• Only diagnosed by

health professionals!

Caregiver Responsibility


Individual, Service Member, Family Responsibility


Unit LeaderResponsibilityUnit LeaderResponsibility


• Common• Always temporary• Mild distress or loss

of function• Self-correcting

• Less common• May leave a scar• More severe distress or loss

of function• May heal faster with help

Stress InjuriesStress Injuries

Stress Reaction vs Stress InjuryStress Reaction vs Stress Injury


Causes Results

Impact Trauma

Wear and tear Fatigue

Loss Grief

Inner conflict Injury to core beliefs

Stress injuries are wounds to the mind or brain caused by intense or prolonged stress.

These have four possible causes and associated results:

Stress InjuriesStress Injuries


Reacting SM Reacting Families Good to go Trained, prepared Calm, steady Confident,

competent, in control

Sleeping, eating right

Active socially, spiritually

Getting job done

Good to go Ready, prepared

for deployment Functioning OK

socially, spiritually, vocationally

Sleeping, eating right

Sense of humor In control

Stress Reduction Retain good

coping skills Remain calm,

steady, confident Eat healthfully,

exercise regularly Get proper sleep Keep sense of

humor Remain active

socially, spiritually

Green Ready ZoneGreen Ready Zone


Reacting SM Reacting Families Feeling anxious,

irritable, worrying Cutting corners on

the job Poor diet or trouble

sleeping Apathy, loss of

interest Poor focus Short tempered Keeping to self

Children having trouble in school

Fighting more amidst siblings

Couple not communicating effectively

Loss of interest in normal activities

Reduced intimacy Anxious or irritable

Stress Reduction Spending time with

family or friends Adequate

exercising, sleeping

Getting outside Manage home

front stressors Discuss issues

with others

Yellow Reacting ZoneYellow Reacting Zone


Reacting SM Reacting Families Loss of control Can’t fall or stay

asleep Recurrent vivid

nightmares Intense guilt or

shame Attacks of panic or

rage Inability to enjoy

activities Disruption of moral

values Serious suicidal or

homicidal thoughts

Children having failing grades and discipline problems at school and/or home

Reduced intimacy Feeling of chaos Constant fighting Silence/no

communication Verbal or physical

abuse Can’t sleep,

disruptive nightmares

Stress Reduction Seek assistance Spending time with

family or friends Adequate

exercising, sleeping Getting outside Keep safe and calm 24-72 hr rest and

recuperation Refer to chaplain Provide and seek

social support

Orange Injured ZoneOrange Injured Zone


Reacting SM Reacting Families Symptoms that

last for more than 60 days

get worse over time instead of better

get better for awhile but then come back worse

PTSD, major depression, certain anxiety disorders, substance abuse

Persistent stress or loss of function

Stress gets worse instead of better

Stress lasting several weeks

Serious suicidal behavior

Uncharacteristic outbursts of rage or panic

Inability to control emotions

Stress Reduction Refer for medical

evaluation Assist treatment

compliance Provide social

support Mentor back to unit

if possible Reintegrate with

unit Get caregiver

assistance

Red Ill ZoneRed Ill Zone


Appropriate InterventionsAppropriate Interventions

• Where on the continuum did you place your individual?

• What signs or symptoms led you to choose that zone?

• What types of intervention may be needed to help this individual move to the Green/Ready zone?

READYREADY(Green)

REACTINGREACTING(Yellow)(Yellow)

INJUREDINJURED(Orange)(Orange)

ILLILL(Red)(Red)







Get to GreenGet to Green

Caregiver ResponsibilityCaregiver Responsibility




READY READY (Green) REACTING REACTING (Yellow)(Yellow) INJUREDINJURED(Orange)(Orange)

ILLILL(Red)(Red)

The Goal is to move towards GREEN


Avoidance

• Numbing and withdrawal

• Response to intense emotions

• Response to shame and guilt

Alienation

• From those who had not shared their experience

• Feeling of being misunderstood

Personal Meaning

• Unique effect of traumatic event

Keep this in mind: Everyone experiences deployments differently. Deployments can and have changed people for the better. Its okay to be different and it makes you special.

Barriers to Successful IntegrationBarriers to Successful Integration


• Each Service Member’s military experience and self concept are unique.

• To feel good about themselves, veterans must continue to feel like honourable warriors.

• Not all stress problems are mental illnesses.

• Not all stress problems are PTSD.

• You are not alone.

• Where do you get help?

Assistance is AvailableAssistance is Available

Other Service Members, family member, friend, command leadership, Chaplain, doctor, nurse or other medical staff member, counselor ….


• Recognize the type and scope of issues impacting reintegration for Service Members, family members, and others.

• Identify helpful tools and resources for coping with the challenges of reintegration.

• Facilitate a successful transition for yourself and/or your loved ones.

Objectives


Operational Stress Control and Reintegration

FACILITATOR’S NAMEDATE

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Operational Stress Control and Reintegration

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