Leadership Training on Preparing for
Combat/Operational Stress
Pre-Deployment StressPre-Deployment Stress
Choices• Family again
– Separation: SO/kids/parents
– Financial
• Mission– Safety– Mission objectives
• Fatigue
Coping• Family
– Spend time, talk with family
– Learn from the past, plan
• Mission– More certainty: no WMD,
less unknowns, time frame
– Take pride in your work
• Get Rest, PT, eat right
History of Combat StressHistory of Combat Stress
• Combat stress has been a common enemy
Operational/Combat StressOperational/Combat Stress
• “I look upon the spiritual life of the soldier as even more important than his equipment… The soldier’s heart, the soldier’s spirit, the soldier’s soul are everything. Unless the soldier’s soul sustains him, he cannot be relied upon and will fail himself and his country in the end.”
General George C. Marshall
Operational/Combat StressOperational/Combat Stress
– “The majority of analysts have arrived at the opinion that the course and outcome of modern war in large part, will depend upon the psychological condition of servicemen, their ability to endure an ever-increasing psychological load, overcome fear in battle, and preserve their will to win.”
Russian Officer reflecting on the Chechen Conflict
quoted in U.S. Army Medical Department Journal
Operational/Combat StressOperational/Combat Stress
• “Combat stress reaction… has the potential to disable the most courageous service member and influence the success or failure of a unit in accomplishing its mission. The small unit leader must understand how to recognize, prevent, and personally contend with reactions to combat stress when it occurs in members of his unit. Effective small‑unit leadership reduces the impact of stress. ”Marine Corps Reference Publication (MCRP) 6-11CCOMBAT STRESS
Stresses
Extreme risk and fear
What is Combat/Operational Stress
Ways to Fight ItEffective leadershipUnit CohesionPhysical Conditioning and Realistic TrainingReassure, Instill ConfidenceImpart pride, Lead by example
Stresses
The “fog” of war
What is Combat/Operational Stress
Ways to Fight It
Keep everyone informed
Quell Rumors
Get Facts
Debrief after mission
Clarify misunderstandings
Stress• Discomfort and fatigue
What is Combat/Operational Stress
Ways to Fight It
Hydration and Food
Dry off, cool off, warm up
Wash up, shave, change clothes
Sleep when possible, set sleep schedules
Stress• Combat Casualties
Ways to Fight It• Plan regular debriefings• Use appropriate memorial• Look for stressed Marines• Stress is normal• Allow for feelings then
focus on the mission
What is Combat/Operational Stress
StressBoredomFeelings of IsolationFNGs
Ways to Fight ItKeep Marines focused on the missionEnsure physical fitnessHumor is a flak jacketEncourage unit cohesionKnow your Marines (Birthdays, Families etc.)Welcome new MarinesNO HAZINGDon’t Intimidate, Inspire
What is Combat/Operational Stress
Stress ResponseStress Response
0102030405060708090
100
High
Arousel (Stress) Level
Performance Efficiency
Heavy Muscle Work
Fine Judgement MotorCoord.
Overlearned Drill
InterventionIntervention
• Regardless of the best prevention and leadership efforts serious Dysfunctional Combat Stress Reactions may occur.
• When this happens, Marine leaders (Squad Leaders, Co Gunny, Platoon CO), Medical and Psychiatric personnel and Chaplains work to intervene with simple principles.
Handling StressHandling Stress
Dysfunctional Stress Response
• Muscles• Sleep• Stomach• Cardiovascular• Neurological• Brain• Behavior/Misconduct
Ways to Cope • Take care of yourself:
sleep, eat, talk• Use Relaxation Steps
– Take deep slow breaths
• Think about succeeding• Maintain Discipline• Swift/Form punishment
for misconduct
Principles of Intervention Principles of Intervention
• Proximity– Manage the service member as close to their unit as
possible. Utilize maximum unit cohesion to promote recovery.
• Immediacy– Treat as soon as possible. Prevent mishaps and misconduct.
• Expectancy– Give positive expectations for full recovery and return to duty.
Normalize reactions.
• Simplicity– Use brief, simple methods to restore physical well-being, and
self-confidence. “3 hots and a cot.” Avoid Psychiatric Labels. Segregate from medical patients.
Regimental Recuperation CentersRegimental Recuperation Centers
When stress responses become too great or do notrespond to measures in the unit, refer Marine to theBAS for evaluation and possible referral to theRegimental Recuperation Center
Regimental Recuperation CentersRestores Marine through 24-72 hours of rest, and reassuranceOperated by Marines with assistance from Chaplains and Medical/Mental Health Staff Prevents unnecessary evacuation of Marines past the Regiment where there is little hope of him returning
***THIS MUST MATCH WITH YOUR UNIT PROCEDURES***
***Change this slide as necessary to match your procedures***
ConclusionConclusion
• Preserve Combat Power
• Stress is Normal • Goal is Control • Leadership
Responsibility• Brilliance in the
Basics• Use Support
ResourcesResources
• Medical Personnel/Chaplains/RRCs• FMFM 4-55 Combat Stress
• FM 8-51, Combat Stress Control in a Theater of Operations• FM 22-51, Leader’s Manual for Combat Stress Control
• FM 8-55, Planning for Health Service Support• “A War of Nerves” by Shepherd• “Achilles in Vietnam” by Shay
• Army Pamphlets and Pubs : COL Jim Stokes3151 Scott Road
San Antonio,TX 78234DSN 471-6985 or 210-221-6985
www.armypsychiatry.com• Stress Management Classes at Interventional Treatment Branch
• Division Psychiatrist Combat Stress Briefings• Virtual Naval Hospital Online
• Military Medicine Textbook Series
QuestionsQuestions
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MCFTB ResourcesMCFTB Resources
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