Military personnel who deploy to combat zones will experience some amounts of combat and operational stress. The added stress that a deployment brings on is expected and not preventable since many demands and expectations are established and carried out to achieve the ultimately goal of defeating the enemy.  During combat war, there is never room for error and soldiers cannot let their guard down at any time.  As a result, wartime puts limits on assessing and addressing the relevance of combat stress. Reactions to stressors can affect individuals in multiple ways or areas. These areas include emotional, behavioral, physiologic and cognitive. When being deployed, soldiers are more likely to have combat stress injuries than not.

Senior leaders have to make all available resources and wellness information easily accessible to their junior leaders, to help control combat stress for their soldiers while they serve in the military. Studies show that, the sooner stress injury signs are identified, the faster a soldier may have a full recovery. If not properly addressed, a stress injury may further develop into post-traumatic stress disorder (PTSD), or other chronic illnesses (History.com Editors, 2018). If leadership is effective and has a consistent plan of action that is implemented for soldiers, it would help to lessen the effects of battle fatigue. Also, misconduct stress behaviors can be prevented in most cases.  Commanders and Senior Enlisted leaders must stay abreast of all up-to-date educational tools that will help them and their soldiers to quickly identify and treat combat stress injuries. Taking essential preventive measures will ensure that combat stress is manageable and not out of control.

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Definition

According to (V, 2018), the definition of combat and operational stress reaction (COSR; or combat stress injury) is the wide range of projected, maladaptive psychological and behavioral symptoms that can materialize in response to stressors after exposure to warfare or other very stressful military operations. Only soldiers who have COSR symptoms within 72 hours from their onset or from when first identified can have a COSR designation. The effects of battlefield stress on Soldiers has been acknowledged and identified throughout the history of warfare by many leaders.

According to (Joseph, 2011), in the early years, doctors were perplexed by the condition and used other terms to describe the syndrome. The terms used included “shell shock”, “soldier’s heart”, “battle fatigue”, and “psychoneuroses”. It was initially believed that soldiers exposed to exploding shells caused the shell shock they endured. However, doctors could not find any physical damage to explain the symptoms and ruled out the cause. In 1915, the term ‘’shell shock” was first created and used by Charles Myers.  This term best described soldiers who were involuntarily shaking, crying, suffered from anxiety and experienced memory loss.  “Shell shock” is no longer used by doctors.  However, people do still use this term loosely in casual conversations.  In 1999, the United States Army adopted the term “combat stress reaction.” Years later, it evolved to “combat and operational stress reaction (COSR)”.

Support

According to (Headquarter Department of the Army, 1994), soldiers who are skillfully trained and highly motivated are not exempt from finding themselves in difficult situations that can impact their state of well-being and combat readiness. It is vitally important that Commanders and Senior Leaders observe and identify any soldiers showing signs of combat stress. A unit’s mental health team is primarily responsible for ensuring that there is control for combat stress.  The chain of command and NCO chain of support together are accountable for the control of stress for soldiers.   However, unit leaders must still keep the unit’s mission first and foremost in his/her mind.  Thankfully, the Army has combat stress control units and personnel.  It is their responsibility to help sustain the performance level of all soldiers.  They also have to help prevent stress casualties by properly treating stress symptoms.

As defined in Army Regulation (AR) 40-216, a mental health team is comprised of Army psychiatrists, clinical psychologists, social work officers, occupational therapy officers, psychiatric nurses, and their enlisted counterparts.  By design, all mental health sections of medical companies and of divisions and brigades should be organized to include the proper personnel.  Monitoring and coordinating combat stress control support is managed by mental health staff in the medical command, medical brigade and medical group.  The medical combat stress control units provide support all throughout the army.  On occasion, they deploy to reinforce mental health section personnel in the division and brigade areas.

Arkansas’ Medical Command sends out behavioral health teams to conduct group briefings to brigade and battalion units.  During these visits, behavioral health training is facilitated for leaders and individual soldiers.  From these events, individual follow up and treatment/therapy takes place.  These site visits help establish control for combat stress.

Management

Commanders must readily identify the symptoms and signs of Combat Stress disorder in pursuit of providing sufficient support to soldiers. There are recommended guidelines soldiers should follow to help manage and reduce stress levels. Soldiers should avoid or reduce the consumption of nicotine and any caffeinated beverages or alcohol. Caffeine and nicotine are stimulants and will increase levels of stress rather than reduce them. Alcohol is a depressant when taken in large quantities, but acts as a stimulant in smaller quantities. Therefore, using alcohol as a way to alleviate stress is definitely not helpful.  Physical activity is a good tool to help metabolize excessive stress hormones.  Performing some method of physical activity is guaranteed to rejuvenate a person to optimum health (V, 2018).

Furthermore, stress is also caused by poor sleeping habits.  Studies show that adults consistently need seven to eight hours of sleep every night.  There are many ways that stress can be reduce for better management and control of it.  Routinely, soldiers should try techniques such as Yoga and Pilates to help them relax.  Both of these techniques are proven to reduce stress.  In addition, soldiers are encouraged to see a psychiatrist or therapist to help treat combat stress. It is a proven fact that therapy has many benefits.  It is known to work by either distracting a soldier from stressful thoughts or releasing built-up tension as stressful situations are discussed regularly with a therapist.  Arkansas’ Medical Command has behavioural health officers available during week and during each PHA event.  The team tracks and follows soldiers with potential stressors or with diagnosed issues.  During the PHA event, there are multiple resources shared with soldiers.    These resources are great benefits for soldiers and their families.  Such resources are: Military One Source and Military Child and Youth Services to name a few.  Other suggested tools to help control stress are keeping a stress diary, learning and using problem-solving techniques, implementing time management and learning to say no to additional and unimportant request (V, 2018).  It is not helpful for a soldier to feel overwhelmed with life’s responsibilities.

A plan of action to aid in the control of combat stress must be utilized so combat stress does not become a “war stopper” for soldiers.  No plan of action will yield a higher number of soldiers who may suffer from battle fatigue while down range.  Oftentimes soldiers may show behavior that is not becoming of a soldier.  This misconduct stress behavior can undermine the ideas and goals of the operational force at wartime.  During war, the enemy works to maximize the amount of combat stress soldiers face.  For a combat stress control program to be effective and productive, there must be buy-in and participation at all levels. Although it is executed by command authority, it’s level of effectiveness is dependent upon it being valued and reinforced by commanders, leaders, staffs, chaplains, physicians and health care providers.

Through effective actions of controlling combat stress can fulfill unit mission’s accomplishments such as:

• Identifying and controlling stress factors.
• Reducing number of battle fatigue casualties and misconduct stress behaviors.
• Reducing recovery time for battle fatigue casualties.

An effective combat stress control program targets the goal of reducing combat stress symptoms by increasing positive stress responses while decreasing disruptive stress. Most importantly, it greatly decreases the possibilities of stress becoming a war-stopper for the US (Headquarter Department of the Army, 1994).

Conclusion

In conclusion,soldiers must meet the requirements of military service every day, whether it is serving in a combat environment overseas or in garrison operations at home. As soldiers commit to the military’s mission, commanders and senior leaders must commit to the soldiers and be of assistance.  As leaders, it is critical to fully recognize the effects of combat and operational stress.  Gaining control of combat stress will ensure more victories than defeats; no matter what conflicts soldiers may face.  Soldiers must find effective ways to handle stressors. There are three areas of focus to control combat stress focus.  They are training, unit cohesion and leadership.  When these areas are used effectively, soldiers have the necessary tools needed to accomplish their mission. When controlled combat stress is implemented, soldiers may prove to be more loyal, selfless and even present themselves as the heroes that they are.

However, a unit’s mission is hindered when combat stress in uncontrolled.  Soldiers may become disruptive and cause interferences.  Service members, under the supervision of the Commander, may be hesitant about psychological treatment because they know that there is a stigma associated with such treatment. Many soldiers view the thought of receiving psychological treatment as weak and they become stagnate in pursuing help. Therefore, as a leader, it is crucial to communicate the falsehood of such perceptions.  Additionally, Commanders must also encourage soldiers to request care which will aid in his/her return to peak performance and, ultimately, optimum health while accomplishing the unit’s mission.  I think that all soldiers who return from combat war should be required to seek psychological support.  If required, it can help to eliminate any stigmas and negative perceptions.  One way the Arkansas National Guard is committed to the welfare of its soldiers is that a wellness center will soon be established in Arkansas.  The center will be the go to for soldiers and senior leaders.  All available resources will be accessible.  Educational material will be readily provided to commanders so Arkansas’ soldiers may stay informed and better supported.  Our goal is to get ahead of the combat stress injury issue to ensure that other negative ramifications are eliminated. As previously stated, the role of leadership is critical to the understanding and treatment of combat stress.  Using this information can help decrease the negative effects of combat stress.

References

• H. (1994, September/October). FM 22-51 LEADERS MANUAL FOR COMBAT STRESS CONTROL. Retrieved November 14, 2018, from http://www.patriotoutreach.org/docs/FM_22-2.pdf
• History.com Editors. (2018, August 21). PTSD and Shell Shock. Retrieved November 12, 2018, from https://www.history.com/topics/inventions/history-of-ptsd-and-shell-shock
• Joseph, S., Ph.D. (2011, November 20). Is Shell Shock the Same as PTSD? Retrieved from https://www.psychologytoday.com/us/blog/what-doesnt-kill-us/201111/is-shell-shock-the-same-ptsd
• V. (2018). Combat Stress or PTSD? How to Know the Difference. Retrieved November 14, 2018, from Combat Stress or PTSD? How to Know the Difference