Tuesday, February 5, 2013

Emotional Resilience: Bulletproofing the Mind

NY Times   I first met Miller last December in Kandahar. We had several conversations, but he was under strict orders not to discuss his job. Yet his job -- that of a new kind of soldier -- interested me. The Special Forces soldiers in Afghanistan looked different, with their thick beards, fleece jackets, wraparound sunglasses and high-tech weaponry. Did they think and feel differently than the traditional foot soldier? Earlier this fall, I caught up with Miller at Fort Campbell, Ky., where the Special Forces Fifth Group is based. Safely back from battle, Miller was allowed to discuss his brand of warfare -- and how he was built to carry it out.

Miller's dawn assault on the Qaeda fighters in Kandahar, I learned, was but one step away from hand-to-hand combat. It involved grenade exchanges from a distance of just a few feet, and it finished with Miller and his men standing amid their dead and bloodied foes. ''They fought to the last minute,'' he recalled. ''For these guys, surrender was not an option.'' He later added, ''It was amazing to see the carnage.''

The attack was the kind of urban warfare American soldiers will be engaged in should the United States have to shoot its way into Baghdad and other Iraqi cities. When the Cold War ended, many thought that C.Q.B. would become a thing of the past. Conflicts would be fewer, and any interventions undertaken would rely on overwhelming force and precision munitions, not house-to-house fighting. Yet since 9/11 we have begun a war that may draw our soldiers into many battles involving intimate killing. What will that mean for Miller and his men?

The last time this kind of fighting occurred on a grand scale, in Vietnam, 50,000 Americans died, and many survivors had injuries that were not just physical but emotional. The clunky phrase ''post-traumatic stress disorder'' entered the national lexicon. Today, the military believes, the United States is fighting an intimate war in the right way, because soldiers have been prepared and equipped in a manner that increases the prospect of their victory and decreases the prospect of their injury -- whether physical or psychological. Just as smart bombs are less likely to go astray, 21st-century warriors are more lethal than before, yet less likely to suffer P.T.S.D., according to military instructors and psychologists. Dave Grossman, a former Army Ranger and West Point professor of psychology, refers to this phenomenon as ''the bulletproof mind.''

Such confident assertions may seem surprising, considering what happened this summer at Fort Bragg, N.C. Four soldiers there murdered their wives; three of the soldiers had Special Forces training and had served in Afghanistan. The news media rushed to link the murders to post-combat stress, although there is little proof and investigations continue. Military officers, not surprisingly, doubt the idea that P.T.S.D. played a significant role, and they may have a point. Fatal spouse abuse, sadly, plagues the military even in peacetime. As they see it, the furor over this incident has obscured a broader truth. Today's Special Forces soldiers, they claim, have been unusually well trained to succeed not only at war -- but also after war. [...]

Indeed, Special Forces officers openly discuss the use of ''stress inoculation'' -- in which they are exposed to heartbeat-racing drills that raise their threshold for staying calm. It doesn't mean Special Forces soldiers are immune to stress or the mistakes that stress causes, but it takes a lot more to rattle one of them than an old-time draftee.


An important dose of stress inoculation occurs during a three-week training nightmare that comes at the end of the Schoolhouse course. It goes by the acronym SERE, which stands for survival, evasion, resistance and escape. SERE teaches Special Forces soldiers how to avoid and endure capture by the enemy. The exercise places them in a ''resistance-training laboratory'' that is, essentially, a prisoner-of-war camp, with guard towers, barbed-wire fences, blindfolds, putrid food, irregular sleep intervals, abusive guards and brutal interrogations. Details about SERE, such as the types of punishment inflicted on the ''prisoners,'' are classified; Special Forces officers told me that torture is not practiced, though they did not deny that physical pressure is applied. The unpleasantness apparently includes being buried in wood barrels. When I asked Miller about SERE, he shook his head and said, ''It is imprinted on my brain.''

17 comments:

  1. accountabilityinourschoolsFebruary 5, 2013 at 6:36 PM

    I know you've suggesting trauma-proofing our children. But let me point out one major difference between trauma-proofing soldiers and trauma-proofing children: Choice. The element of choice which is present for soldiers who choose to enlist and choose to put themselves in harm's way is entirely absent in the case of children. We would be trauma-proofing them for situations that they do not choose to enter and from which they cannot choose to opt out. Lack of choice and control is itself a most significant component of trauma.

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    1. important distinction. However are suggesting that the approach to dealing with children is primarily to try to stop stressful experiences?

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    2. accountabilityinourschoolsFebruary 5, 2013 at 7:23 PM

      "Stressful Experiences" cannot all be lumped into one category. Even *trauma* cannot be lumped into just one category. Obviously, there are many stressful experiences that are a normal part of a normal life. These can and should be prepared for, age- and developmentally-appropriately, of course.

      If by *trauma* you mean on the same scale as combat, then yes, I believe it is our primary responsibility to prevent those kinds of traumas to the extent that we can. Obviously things like war and even sexual abuse will happen, but my goodness, it sounds like you are advocating just accepting things like rape as a normal part of a normal life which, to my mind, sends the message that rape is acceptable. Clearly you don't mean that but if something is unacceptable then it cannot be accepted. At least not in my world. You gotta choose.

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    3. At this stage while I am exploring the topic I don't have to chose. It seems clear from some of the mainstream Jewish literature that ideally all experiences should be accepted and not be traumatic. I am now trying to find reasons for making the differentiation you are making - from within this literature.

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    4. In case you're interested while doing your research on various Jewish views on this topic: In his Garden of Gratitude, R' Shalom Arush argues that one should not only accept bad experiences, but one should actually thanking G-d for all one's experiences, even the negative or traumatic ones (based on the hashkafic view that everything is sent from Hashem for the best). He seems to argue that this is important for emotional healing.

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    5. accountabilityinourschoolsFebruary 5, 2013 at 9:47 PM

      I meant you gotta choose between "accepted and thus acceptable" or "unacceptable and therefore not accepted." Put another way, accepting all experiences goes hand-in-hand with saying that those experiences, or acts such as rape for example, are acceptable.

      If rape is unacceptable, which it is and should be, it cannot be accepted. To accept it is to say that it is acceptable. This will have far reaching consequences on a society far beyond the traumatic aspect.

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  2. Honestly comparing the "trauma-proofing" of spec ops soldiers to "trauma-proofing" children is really comparing apples to oranges.

    First spec ops undergo an extremely rigorous selection process meant to weed out those lacking sufficient mental toughness.

    After that there are a multitude of training regiments and protocols that they put these soldiers through in order to keep them from suffering mental trauma.

    Honestly though the stress inoculation is probably the least conducive to trauma proofing children, though it is an important part. If you really want I can dig up old DOD studies on this, but the primary cause of PTSD, especially amongst SpecOPs troops was a result of what the individual soldiers viewed as unjust killings. Meaning that they were initially trained to respond to any threat with lethal force, and the innate psychological barriers that need to be crossed first to kill another human being, much less one that is unarmed ect, would during the course of an extended armed conflict(or numerous engagements) build to unbearable levels.

    The first thing that the military did was to institute graduated response. Thus giving soldiers justifiable uses of force. For instance, if a group were to kick a door in, in the middle of the night in Falluja, where you have a high level terrorist, his armed body guard, grandpa and four grandchildren, instead of shooting anyone that posed any level of threat, the soldiers were not trained to deploy different options. If the unarmed grandpa charges the soldiers because someone kicked his door in in the middle of the night, they were no longer going to shoot him dead, instead they would barrell strike him(less than leathel force) in order to subdue him, and take necessary force against those who posed real life threatening threats.
    That reduced PTSD some, but what they found was no matter how much or how intensive the training was, until a soldier had been through a minimum of three firefights, they were little better than an untrained civilian.
    Thus was eventually born the various systems of stress inoculation. The idea was never to make the person trauma proof, in and of itself, it was to simulate to the greatest extant possible real-life high stress events, so that they would be able to access their training in real life.
    For instance the military started using something called simunitions, which are essentially paint filled wax bullets shot from real guns, that make real booms and hurt real bad if you are hit with them. In this way they could simulate to the highest level possible a firefight.
    All of that to say that you cannot replicate a specops system amongst children. Starting from the selection process you are undone in any attempt. How do you deselect 90% of the children(actually when you think about it the military deselects far more than that, but the training is such that roughly 90% of those that the volunteers and military think are capable of making it through cannot)...
    Simply put it is a fine model for what it does, but if you want to protect children you are going to need to find another.

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    1. yes I would interested in your studies.

      I still think it is useful to talk about stress innocuation for students in a similar fashion to that of soldiers.I think the processes will be similar. Obviously a student doesn't need to be trained to resist torture and the threat of death of to get over the resistance to kill another human being. We are talking afterall about the mind of a soldier and that of a child - I think they have much more in common than differences

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  3. There is a way of reducing anxiety/ depression/ trauma etc. called "Innate Health" or "Three Principles", that has helped me greatly--though I wouldn't say that my problems were too extraordinary. It's based partly on the idea that, no matter what has happened in the past, we can dismiss negative thoughts about it, which automatically dismisses our negative emotions about it, and find our innate health. Dr. Richard Carlson ("Don't Sweat the Small Stuff") based his books on this approach. Rabbi Shaul Rosenblatt, formerly of Aish UK, started an organization called "Tikkun" in the UK, that promotes this approach, together with education in Torah. They put a whole multiple-day seminar, with top experts in this, on their website, for free download. It includes a testimonial from a hero Israeli soldier, who says this helped him greatly with PTSD. Might be worth Googling, downloading, and listening. (I'll post the exact website URL, if you want it---let me know.) -----avi

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    1. sounds interesting - please post the URL

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  4. accountabilityinourschoolsFebruary 6, 2013 at 8:48 AM

    Let's take the example of a teacher who shouts and calls students names, like stupid and lazy (BTDT, btw).

    If I'm using your model of trauma-proofing my children in advance, then before they even start their schooling, I'm teaching them that people shouting at other people and calling them names is okay. That makes my messages of "don't shout at people and call them names" a much harder sell, yes?

    In this example, I actually have the best chance at reframing the situation for my kids once it has already happened. They've already seen how the teacher looks and sounds while losing control and it isn't very attractive. I can then point out that losing it at someone else is not okay, what the teacher did is not okay, clearly he/she has an interpersonal problem but that is no reflection on them. They are still okay. They can pick themselves up, dust themselves off, take him/her down a few notches in their esteem and move on.

    The crucial element here is that my kids talk to me and tell me what happened so I can address it for them, reframe it with context and perspective. Not by normalizing the teacher's behavior, which runs the risk of creating a society in which that kind of behavior is normal. I don't want that.

    So I'd say the most crucial factor in *trauma-proofing* kids is strong adult attachments and an openness to discuss anything that comes up. I'd say that's what we need to invest in in order to *trauma-proof* our kids.

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  5. accountabilityinourschoolsFebruary 6, 2013 at 9:09 AM

    Now let's take child sex abuse. I am close to a young boy who was molested by a principal for 2 or 3 years. He told his parents, reported to the police, guy was arrested and removed from the school.

    Using your model of trauma-proofing in advance, we would essentially be telling our children that it is okay to touch another person sexually without their consent. No thanks, I'll pass. Not for reasons of trauma but for reasons of social, relationship and sexual values completely independent of trauma.

    After the big reveal this boy received cognitive-based therapy by an excellent therapist who specializes in child sex abuse. He did not have to relive his trauma at all, ever. The therapist dealt with every emotion and reaction on a cognitive level, helping him to reframe by giving him context and perspective. As well, both the therapist and the boy's parents addressed the subject of sex and sexuality, to give him a healthy understanding and a healthy context, as he clearly had been exposed to an unhealthy sexual model.

    Almost 2 years later, he shows few signs of trauma, if any, does not think he is damaged and is moving forward quite successfully, but he also knows with certainty that it is inappropriate for one person to touch another sexually without consent.

    In this case, I'd say again that the most crucial factor in moving past the trauma in a health way was the strong relationship he had with his parents, which was an anchor and allowed him to reveal what was happening and to have the related issues properly addressed through a cognitive approach.

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  6. accountabilityinourschoolsFebruary 6, 2013 at 9:37 AM

    In both my examples above, I would maintain the importance of preventing people from using their size and position of authority to take advantage of those who are smaller and weaker, verbally, emotionally and physically.

    In your example of trauma-proofing soldiers for war, I think all would agree that a state of war is a b'dieved; it is not meant to be the natural state of the world. Simultaneous efforts at making peace are almost always pursued. Similarly, in my examples of adults who exploit children through various means, with various degrees of unpleasantness or trauma, while we acknowledge that the situation currently is what it is, it is a b'dieved. Simultaneous efforts at prevention must also be pursued so as not to create a society wherein wanton exploitation is the natural state of affairs.

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  7. accountabilityinourschoolsFebruary 6, 2013 at 9:49 AM

    Further to my example of teachers who are nasty to their students, you have less of a problem with, say, a math teacher (alright, so the kids won't love math, or may even be averse to math forever due to association, nu nu) but much more of a problem with Torah teachers. The messages are just too confusing. To guard against being traumatized by a nasty teacher, a parent must reduce the importance of the teacher and the child's esteem for the teacher. But then you've got an unrespectable teacher who is a terrible personal role model teaching your child Torah, which is meant to be a guide for us to follow in all areas of our lives, interpersonal conduct included, and is not quite as black-and-white as algebra or fractions. You need trust to learn Torah from a teacher, and with the aforementioned teacher, there just cannot be any. This is a situation that is occurring daily in classroom all across the world. It is a disaster that I believe we really do need to focus on preventing, trauma or no trauma.

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  8. You are setting up a straw man. I never stated what my approach to trauma proofing children was. It is definitely not saying that abusive behavior is acceptable.

    There are clearly a number of approaches including what you are suggesting to prevent trauma or damage . I am not saying it is ok to molest kids because they have been innoculated against trauma - chas v'shalom.

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  9. "It seems clear from some of the mainstream Jewish literature that ideally all experiences should be accepted and not be traumatic."

    Well in an ideal world, there is trauma, because there are no evildoers, so there is no-one to traumatise people. But we do not live in this theoretical, ideal world.

    You have to make a distinction between the things a person can say to themselves and things other persons can say to victims of trauma.

    If a victim of trauma has strong faith and bitachon and can cope with the trauma only based on faith and bitachon, ma tov. But it is not for outsiders, other person, to tell a victim of trauma "stop whining, if you had real faith and bitachon you would not suffer from trauma". This would be callous and therefore contrary to jewish religion which asks us to be rachmanim beney rachmanim.

    Therefore, I think that those elucubrations are quite futile.

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  10. accountabilityinourschoolsFebruary 6, 2013 at 10:59 AM

    By "your approach to trauma proofing" I am referring to the posted article on trauma-proofing soldiers. I realize that you are floating a topic for discussion and this is not your method of trauma-proofing. Poor wording on my part.

    I know you don't mean to say that and you don't think you are saying that. I am arguing that by normalizing certain acts, behaviors, and experiences, through advance desensitizing, the unavoidable result is... that act, behavior and experience becomes normal in that society and will become more prevalent.

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