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HPRC Fitness Arena: Mind Tactics
Post-Traumatic Stress Disorder (PTSD) can tear apart your sense of what is safe and of what is good.
Part of the diagnosis of PTSD is exposure to a traumatic event: death, serious injury, sexual violence, or the threat of any of these. PTSD symptoms such as intrusive memories, avoidance of situations or feelings, problems in thinking or mood, and feeling overly amped up are common reactions to abnormal circumstances. Think of PTSD symptoms as self-preservation instincts gone haywire. One theory holds that, because you nearly died or experienced something awful or could picture it because it happened to someone close to you, your mind/body tries to sound the alarm bells to keep you safe. But the alarm bells sound at the wrong times and in the wrong ways.
However, PTSD symptoms can come from sources other than fear of bodily harm. They also can arise from inner conflict, when emotions trigger feelings such shame and guilt or when you question fundamental beliefs (such as “the world is basically good”). Witnessing or experiencing betrayal (especially by a leader in a high-stakes situation), within-ranks violence, extreme violence, and incidents involving civilians are some of what can disrupt your world view. It isn’t just an event but the interpretation of an event that causes Warfighters to experience “moral injury.”
If you suffer moral injury as part of PTSD, you start believing you live in an immoral world, or you view yourself as immoral, irredeemable, and defective. If you’re a Warfighter experiencing these feelings, you not only feel lousy, but you are more likely to isolate yourself just when you need others more than ever. Isolation can lead to self-handicapping or self-destructive behaviors.
So how do you save yourself from experiencing moral injury as a part of PTSD? Having a healthy sense of self-esteem can be one of your best protectors. There are no quick fixes. But forgiveness—of others and of yourself—can help you to let go of moral injury. With the help of a psychotherapist, you can begin to wrap your heart and mind around what happened. And pursuing positive interactions, such as getting involved with charitable groups, can give you opportunities to relearn that you are good and the other people in the world are generally good too. Last but not least, connecting with your spirituality—in whatever way is comfortable to you—can help you navigate this difficult journey.
E-cigarettes were introduced to help people stop smoking, but they are becoming a popular alternative to traditional cigarettes. But are they really a healthier substitute, as many companies claim? In short, we don’t yet have a full answer to this important question, and the U.S. Food and Drug Administration (FDA) is on a mission to find out.
On April 25th, FDA released a proposal for new regulations on e-cigarettes—a multibillion-dollar industry that so far has not been highly regulated. In fact, FDA currently lacks the authority to collect vital information about these products. Traditional cigarettes deliver thousands of chemicals, many of which are dangerous, to cigarette smokers and non-smokers around them. By comparison, e-cigarettes deliver substantially fewer chemicals. However, little is known about the potential dangers of the chemicals that e-cigs deliver.
Proposed new rules would allow FDA to collect information about the ingredients in e-cigarettes, as well as their health and behavioral effects. It also suggests that more research is needed to study the long-term health effects of these products.
E-cigarettes are now being marketed with flavors popular among young people. Preliminary studies have found that young people who say they would never use a tobacco product are experimenting with e-cigarettes. The proposed new rules also would require e-cigarette users to be at least 18 years of age to purchase these products.
Although it’s still unclear how the popularity of e-cigarettes will impact public health, but it’s certain that more research will shed some light on their long-term effects.
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.
Bad things happen. Unfortunately, you can count on experiencing different traumas, deaths, illnesses, and injuries. As a Warfighter (or military family), you can probably expect to face these kinds of situations more often than other people. That doesn’t make these experiences any more pleasant, and often it doesn’t make them any less surprising. After a major trauma, illness, or life-changing event, it is often necessary to adapt and create a “new normal.”
Studies of “post-traumatic growth” have found that trauma survivors can grow mentally, emotionally, and spiritually after horrendous experiences such as cancer, terrorism, sexual assault, plane crashes, and even combat. It’s common to react with an emotional roller coaster of denial, anger, bargaining, depression, and acceptance. Your natural instinct might be to run from these feelings. However, post-traumatic growth can be accomplished better by taking steps to approach them. The people who support you (including but not limited to therapists and family members) can do the following:
- Listen empathically, accepting and encouraging full expression of feelings.
- Avoid clichés and easy answers. Hearing “there will be brighter days” is not helpful.
- Be patient. Changing perspective won’t happen overnight.
- Offer a helpful relationship, recognizing there is no “magic technique” or “quick fix.”
You can also be an active agent in your own healing. One technique that can be useful to you is to tell and retell versions of your story in order to become more immune to the hard parts and to reach a point where you can find new meaning in it. People of any age, including Warfighters, can benefit from actively embracing a “new normal” through taking advantage of your relationships and developing a new twist on their story, even when this initially might seem far-fetched.
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.
Suicide is a complex issue with many contributing factors, including mental health issues. Focusing on treating mental health issues and strengthening mental fitness is key for suicide prevention. Currently, efforts within the military focus on education, early intervention, decreasing stigma towards mental health treatments, and adapting a holistic approach to fostering mental fitness—which includes exercise. Learn more about how physical activity and regular exercise can improve mental health in HPRC’s answer to “Can exercise be a part of suicide prevention?”
Did you know that the nature of your family relationships can impact your children’s sleep? Children in home environments with verbal and/or physical conflict do not sleep as well as children in more nurturing home environments. Children exposed to negative family interactions are likely to wake up more, stay awake longer in the middle of the night, and/or sleep less overall.
The conflict can be between parents and children as well as children observing the interactions between their parents. The kinds of behavior include yelling, name-calling, making threats, and physical assault such as slapping or hitting with a closed fist. Behavior like this is often triggered by anger and/or stress, but you can learn to control your anger and reduce family stress, which will help your child’s sleep and a whole lot more. Thus, growing up around nurturing relationships can have multiple benefits.
Stress isn’t an isolated event. It can infiltrate your life in many ways. A survey of more than 12,000 military personnel across the services revealed the impact of stress levels on Warfighter performance. Compared with those with low stress, Warfighters with high stress were much more likely to be late for work, leave work early, get hurt on the job, or miss work altogether because of illness or injury. These trends were especially strong among a smaller subset of personnel who had recently needed a mental health evaluation. Other research suggests that stress can combine with a person’s (often unknown) predispositions, sometimes triggering mental health issues.
Depending on the severity of mental health concerns, focus on performance can take a back seat. So stress, mental health, and performance often go hand in hand. Stress-management techniques and proactive approaches to mental health can help stressed Warfighters perform their best.
Reconnecting with your family when you return from deployment presents unique challenges, especially with young children. Depending on how long you were deployed—a few months to a year or more—a lot could have happened in your child’s life while you were away. If you’re finding it hard to reconnect with your child, you’re not alone. Military Parenting’s website has tip sheets that describe typical behaviors for different stages: infant, toddler, preschooler, school-aged, and teen. Just knowing what’s typical for you child’s age can help you reestablish your relationship.
Reconnection can occur in small, everyday moments when you respond to your children’s needs and provide them with support and nurturing, such as holding them when they cry, playing games or sports together, being silly and laughing, taking a walk together, or eating dinner together and talking about your day.
For more tips on reconnecting, check out “Reestablishing Your Parental Role,” also from Military Parenting, a website devoted to parenting resources for Warfighters. For more tips on returning home, check out “Building Family Resilience...During and Following Deployment.”
Listening is half of communication. The other half is what you say and how you say it. The best way to express yourself is to be assertive. Assertive communication feels neither aggressive nor passive. It’s a balance between issuing a directive and being overly cooperative.
Communication between siblings can provide some good examples. Here’s the super directive approach: “You need to call me too. Don’t make me do all the work to keep up our relationship.” That may make sense, but the other person may not take it in because it triggers defensiveness. And here’s the overly cooperative approach: When your sibling says, “I hope you don’t mind that I never call,” you reply, “No, it’s okay, whatever you want is fine” (even if it isn’t). An assertive approach would be: “I’d really like to talk with you on the phone more, and I know you’re busy. What can we do to stay in better contact?”
The approach is basically a combination of “This is what I need” and “Can you join my team in figuring out a solution?” It’s straightforward and mutually empowering, opening the door for real communication. And for the other half of the communication equation, read last week’s article about how to be a good listener.