Tuesday, June 21, 2011

Battle "hardening"

There's this study out about raising the battle readiness of soldiers using virtual reality to desensitize them to combat so they can handle it better once they get there. It works! The study shows they can indeed make soldiers more tolerable to stress. One problem: the study stops there.

I was in the car with my father and he'd recently taken the family on a road trip to Graceland. We went to the museums, took the tours, went to the house he was born in (a tiny little shack of a house...) and emmersed ourselves in Elvis's world. My dad was talking about Elvis's manager and "TCB" (Taking Care of Business) on the side of Elvis's plane. I though about Elvis's tragic death and remarked: "He could get him to the moon, but he couldn't bring him back."

Yes, I am battle hardened to my health crises in the moment. I have practice. I'm an old hand at this. I know where my levels are and when the truly dangerous times are. I'm savvy.

But put me in a normal population of non-sick folk, and I'm at a loss. I don't care about what they care about. I don't react the same way to the same things. I'm a different person than my peers, and that alienates me. Sure, I'm a professional patient. I've got expertise. But what about the rest of my life?

I make sure to spend time reading and watching the news. Otherwise, I've found, I don't have polite dinner conversation. Even though I used to love current events, I really don't care anymore unless it impacts me directly. But that myopic point of view closes me off from other people. So I work at it. I read online news to makes sure I have at least 2 "did you hear about" stories per one hour of visitation. I make sure I know enough that I can repeat the story if they haven't heard so I can bring them into the converstation. I make sure the topic is broad and general enough for anyone yo be interested. I'm a science geek, but not everyone is.

I have to do this with effort because it doesn't come naturally to me anymore. We're all interested in the details of our own situation. That makes sense. It's our life. But my life is so alien from the general population that I may as well be speaking Greek. I'm *great* when a crisis strikes, but this is Colorado, not Beruit.

Yes, I function very well in limited circumstances. Yes, you can train a soldier to handle combat better. But when you mix them back in with the general population, our peaceful society labels their acutely honed skills as part of Post Traumatic Stress Disorder: hyper-awareness, extreme alarm response, hyper-vigilance, etc. Yeah, and it's a bad idea to put a bull in a china shop too!

What the psychologists are missing is the real-world conditions that military analysists like Dr. Tom Barnett understand. The problem isn't making soldiers battle-hardened, the problem is "they can't go from shooting people one week to handing out aid the next." ("The Pentagon's New Map" C-SPAN presentation 2002).

We can look to other psychological studies that show that getting yelled at actually improves critical thinking skills. It's a natural survival mechanism! But the psychologists in this study were wise enough to show that people that are frequently stressed like that also have negative impacts like.... Wait for it....: hyper-awareness, extreme alarm response, hyper-vigilance, etc.

D'oh!

Yes, we can get them to the moon... But can we bring 'em back? Currently, we suck at this. Not just with soldiers, but with all trauma survivors. We have a therapy system that can handle this, but unless a person becomes a danger to themselves or others, it's purely voluntary. And who is the person most likely to be blind to my behavior? Me.

People specialize for the events they most encounter. We can train people ahead of time to better meet these challenges head on. This idea is nothing new. We call it school. That we can do this with soldiers and patients is really no surprise. But just because we can handle the stressfull situation doesn't necessarily mean we can handle the aftermath.

Just because we can do a thing doesn't make it a good idea.

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