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HPRC Fitness Arena: Family & Relationships
Walk into the new facility of the National Intrepid Center of Excellence (NICoE) on the campus of Naval Support Activity Bethesda, and one of the first things you will see is a sign commemorating the center’s origins, including the fact that the $65 million facility itself was donated by the Intrepid Fallen Heroes Fund. NICoE is committed to the interdisciplinary diagnosis, treatment, and long-term healing of Warfighters, and educational support for their families, from all branches of service.
Unlike many military environments, the facility is curved, spacious, quiet, and pleasant. Some notable features are the high ceilings, artwork, and state-of-the-art treatment rooms.
Patients at NICoE typically are active-duty service members with mild traumatic brain injuries (mTBI) combined with other psychological health conditions such as post-traumatic stress (PTS), anxiety, and depression. Most have already begun treatment elsewhere, often with many medications. The tranquil environment of NICoE instantly helps put them at ease and often leads to more effective treatment with fewer medications.
Recognizing that traditional therapies can’t heal all wounds, NICoE has rooms dedicated to art therapy, virtual reality, and meditation. Beautiful masks line the entrance to the art therapy room, providing a small glimpse into Warfighters’ individual and unique roads to recovery. The virtual reality room allows Warfighters to face traumatic scenarios at a pace that makes sense, an incredibly lifelike setting full of sound, movement, scents, and images. The spirituality room lets in natural light to a space with a beautiful wood floor surrounded by natural plants and a speaker system that plays sounds of nature.
An interdisciplinary approach, combining traditional and integrative medicine, contributes to NICoE’s 99% satisfaction rate, with more than 600 patients from all different services having completed their four-week program. There is no one-size-fits-all approach to healing, and the interdisciplinary makeup of the clinical team enables patients to pursue various treatment options. Providers can collaborate regularly and have cutting edge equipment at their disposal.
Patients usually bring a non-medical attendant, often a spouse or parent. Children also are welcome at NICoE. A private family room with frosted glass includes a children’s play area, and a playground is located behind the facility.
NICoE also focuses on research to help ensure long-term treatment success. There has been discussion of opening their doors to a wider range of Warfighter patients (treating more conditions) and opening more NICoE satellite centers. Referred to as Intrepid Spirits, such centers are open already at Fort Belvoir and Camp Lejeune. The Intrepid Spirit at Fort Campbell will open this summer, and ground was broken recently for one at Fort Bragg. Other bases that may receive an Intrepid Spirit include Forts Hood, Bliss, and Carson, along with Joint Base Lewis-McCord and Camp Pendleton.
You often hear it said you should just walk away from a fight. But when it comes to your personal relationships, it’s better to learn the communication skills you need to work through your differences, with both of you coming out as the victor. Happy couples fall into three types depending on the way they handle conflicts: validators, volatiles, and avoiders.
Validators are couples who are great at communicating their feelings and opinions and talking through their problems. There is often a lot of mutual respect and compromise for these couples.
Volatile couples tend to be explosive and heated when dealing with conflict, expressing both negative and positive emotions passionately. The key to success in such relationships is that the positive has to greatly outweigh (by five times) the negative in these exchanges.
Avoiders are couples who play down their problems and avoid disagreements. They focus on the positive aspects of their relationship and can ignore any negative parts or agree to disagree.
One style isn’t better than the other, but your conflict style needs to work for both of you. This is easiest when each person’s individual conflict style matches the other’s. But sometimes they don’t. Watch for our upcoming article about what do when this happens.
Why do some people with devastating injuries do well in their recoveries and others do not? People often focus on the negative fallout, but there can be positive consequences called post-traumatic growth. Scientists use the term “disability paradox” to refer to how some people with devastating illness or injuries are still able to enjoy a good quality of life. The characteristics of these folks describe someone with a “survivor mentality.” Characteristics include:
- Subscribing meaning to one’s disability or lot in life and sharing this meaning with others.
- Not choosing to live as a victim but instead to feel empowered and motivated to deal with struggles and come out as a victor.
- Being flexible, adaptable, resilient, and rolling with the punches.
Many factors play into developing a survivor mentality. Here are some tips to help:
- Create a strong support system: family, church, community, fellow Warfighters, healthcare providers, etc. A support system should be just that—supportive, encouraging, and a promoter of independence, not an enabler for being or feeling like a victim.
- Maintain a “can do” attitude. See challenges or setbacks as an opportunity to learn and grow. Focus on strengths and abilities, not on limitations. Survivors exhibit the 4 Cs of mental toughness.
- Maintain hope and optimism; focus on the future and move from thinking about the negative aspects of injury/illness to focusing on the positives or possibilities.
Adults need seven to eight hours of sleep a day, but do you know how much sleep your children should be getting? Pre-school children (ages 3-5) need 11–12 hours a day, school-age children (ages 5-12) need at least 10 hours a day, and teens (ages 13–18) need 9–10 hours a day. But many children and teens are not getting the recommended amounts. For example, The Centers for Disease Control and Prevention (CDC) highlights how almost 70% of teens are not getting the sleep they need.
Don’t know how much sleep your child is getting? Keep a sleep diary to track his/her sleep for two weeks.
Not sure how to help your child get the best sleep possible? Try the following tips. (They’re great for adults, too.)
Make sure your child has a consistent sleep schedule, including a consistent bedtime.
Provide the same quiet, dark bedroom environment for your child every night.
Help your child or teen have a relaxing bedtime routine that helps them prepare for sleep.
Avoid stimulation near bedtime. That means no sodas or other drinks with caffeine* and no TVs or computers in the bedroom.
Exposure to daylight helps set up a sleep rhythm, so make sure your child spends some time outside every day.
Turn the lights down to help your children wind down about an hour before bed and avoid using TVs or computers during this time as well.
Provide a low-stress family environment. Read HPRC’s “Family relationships affect your child’s sleep” for more information.
* Some experts recommend not giving children any caffeine, but if your child or teen does consume some, the American Academy of Pediatrics suggests that children should not exceed 2.5 mg/kg per day and teens should not exceed 100 mg/day.
Mindfulness can help you feel better equipped to handle difficult emotions. It’s a process geared to help you tune into emotional experiences rather than try to escape from them. People can feel overcome by depression, anxiety, PTSD, addiction, or other mental health problems, which, ironically, can be exacerbated by trying to forget the cause. For example, a Warfighter afflicted with PTSD often relives difficult events through dreams, flashbacks, or unwanted memories, because he/she desperately wants to avoid experiencing those events. To illustrate this idea, right now, try NOT to think of weapons. You probably thought about them that much more.
Practicing mindfulness mediation means focusing on whatever you are experiencing in the present moment. It can be a structured meditation activity, but because mindfulness is about being present, you can purposefully engage in mindfulness anytime, anywhere. A common meditative approach is to focus on a physical experience such as your breathing, noticing where your attention wanders, and gently guiding it back to your breath; it allows you to experience sadness, anger, fear, and other unpleasant emotions, letting them pass without clinging to the idea of making them go away.”
If you have ever “white-knuckled” your way through an amusement park ride (or ridden in a car with a driver you didn’t trust), you may remember thinking, “When will this be over? Please let it be over…” This shows that focusing on how long something lasts can make it feel like an eternity. By engaging in mindfulness, you will feel less threatened by certain emotions, and you will be less likely to engage in problematic forms of escape (such as drinking, drugs, or simply spacing out).
When people experience difficult emotions, they often cope by engaging the language center of the brain, using words internally to wrestle with the experience. But when people have difficulty re-evaluating why they feel the way they do, this leads to a circular internal debate (such as “I shouldn’t feel this way, but I do, but I shouldn’t…”), which can be pointless and can actually cause more distress. Emotions can be dealt with not just through words but also by tapping into their physical elements (noticing how you feel in your body). When people engage in regular mindfulness practice, the parts of their brains tuned into physical sensations are activated while they experience hard emotions. And people who regularly have this part of their brain activated tend to be more emotionally steady.
Unfortunately, it’s difficult to escape unwanted emotions. And more problems will probably pop up as you try to escape. But if you’re willing to face hard emotions, letting them come and go like waves on a beach, then mindfulness practice can help you have a different experience. Tune in to HPRC for more mindfulness resources, and take advantage of the fact that mindfulness is everywhere now, whether part of your martial arts or yoga class or filling the self-help shelves of your local bookstore. Become more mindful, and you can feel better equipped to handle tough emotions; your mind and body will engage them more productively.
Whether you know it or not, you’ve probably engaged in “triangulation,” and not just as a kid when you ran to Mom because Dad just said “no” (or vice versa). Similar triangles can also happen with leadership or any work group, committee, or organization (including military) where two people talk about a third.
On the surface, triangulation can look pretty harmless. You vent out of frustration because someone is not acting the way you’d like. Depending on where you are in the triangle, you either receive sympathy or provide it, possibly exerting any power you have to fix the situation. These triangles tend to consist of a “victim,” a “villain,” and a “rescuer.”
Because people are often uncomfortable with conflict, they figure out ways to maintain the status quo, even if it’s a bad one, instead of addressing what the core issue is. Triangulation is one way to avoid facing things, and it can feel like a fix, but it’s temporary at best. The rescuer provides a sympathetic ear so that the victim doesn’t feel a need to take action, or tries to take charge of the situation, but inevitably, the same problems pop up between the original two people.
Next time you feel like a victim and consider going to another person with your conflict, first be clear about your goals. Do you want to be rescued, or do you want to be coached? Before reaching out, ask yourself if you can possibly self-coach your way through whatever is popping up. Prepare yourself for whatever criticism might come your way if the “villain’s” defenses get triggered. And “preparing” does not mean bracing yourself or getting ammunition ready to fire back at that person. It means getting ready to really listen and validate how the other person feels, even if you don’t agree with the content of what that person says. If that person feels listened to, he/she will become more receptive to your position.
When a triangle does occur, the best scenario for the third person (the potential rescuer) is to be a good coach. Coaches don’t play the game for their players; they help them become more self-sufficient. Similarly, good leaders ask challenging questions of the people under their command, helping them to think through situations and become better equipped to face conflict directly. If you’re the potential rescuer, resist your own impulses to fix things and instead work on enabling the victim to fix the situation directly. Know that if you dive into this triangle, any other solution is probably temporary at best.
These strategies may seem simple, but they take practice. Try letting go of triangles and use some of the same kinds of communication strategies that work for couples.
PTSD was finally recognized as a medical condition when recent advances in neuroscience showed that the brain no longer works properly after trauma. Your brain has an alarm system to help ensure your survival; it’s useful as long as it works properly. When the alarm system malfunctions because traumatic events pushed it to its limits, the part of the brain responsible for thinking and memory can’t function properly. When this happens, a person with PTSD can’t compare what’s happening now with events in the past when they were safe. However, there are treatments to help “rewire” the brain, so it can work properly again. Learn more about this in “How is your brain’s circuitry affected by PTSD?”
Fall sports are under way for many adolescent athletes, making it important for teens to know what and when to eat and drink to be at their best. HPRC has created a resource—“Fueling the Adolescent Athlete”—to help your adolescent athlete fuel his or her body for optimal performance. This table provides general guidelines for what teens need to drink and eat before, during, and after practice or workouts.
Staying hydrated goes hand in hand with peak performance. But knowing whether you are hydrated can be difficult. Check out this urine color card from the U.S. Army Public Health Command to get an idea of what to watch out for. And see if your child’s school has the chart posted in the locker rooms and nurse’s office.
For more adolescent and family nutrition information, check out HPRC’s Nutrition section.
Problem solving is a great resilience skill for families. All ages can learn or fine-tune their ability to solve problems. After all, life ensures there will be plenty of problems to solve! You can specifically help children learn how to problem solve with this easy-to-remember acronym—SNAP:
S: State the problem.
N: Name the goal.
A: Find All possible solutions.
P: Pick one option.
For example, if your child wakes up tired every morning, you can help him or her identify the problem (being tired), set the goal of getting more sleep, and discuss possible solutions (such as going to bed earlier, developing a bedtime routine, or learning a relaxation skill such as deep breathing). Then help your child pick one to try for a specific time period (such as a week) to see if it works. And instead of trying to solve the problem yourself, be a coach and help your child learn how to solve problems using SNAP.
Athletes have rituals they engage in to ensure their best performance. Warfighters have rituals around paroling, shooting, and other mission-specific tasks to create the right mindset for the situation. Families can benefit from rituals too.
Consider the types of rituals your family typically engages in. There are probably more than you think. Celebrating holidays, personal traditions such as pancakes on Saturday mornings or memorializing the death of a loved one, and simple everyday acts such as bedtime stories or morning tea are all rituals.
When a couple comes together and starts a family, each person brings along his/her own rituals. Consider it an opportunity to build something new together—a blending of histories. For example, let’s say you grew up celebrating Christmas with your family, but your partner’s family celebrated Hanukah. As a couple you can take the rituals that are meaningful to each of you personally and celebrate all of them to create a new combined holiday tradition for your own family.
Rituals certainly can help your own performance, but they also help deepen bonds and create a distinct family identity that can be supportive in both happy and stressful times.