Welcome to the HPRC Blog. We've got lots of information here, from quick tips to in-depth posts about detailed human performance optimization topics.
HPRC Fitness Arena: Mind Tactics
Think of mental health treatment as a blend of science and art: scientifically proven treatment from a skilled psychotherapist who engages each patient as an individual. In standardized treatment, practitioners follow a specific protocol dictated by research studies. But even standardized approaches need wiggle room for the differences between human beings, both patients and practitioners. A lot of successful psychotherapy comes down to the relationship between the practitioner and the patient rather than the techniques, so there has to be some flexibility to it.
Evidence-based practice blends the best research evidence available (studies that have met certain criteria) with practitioners’ own clinical expertise, while also considering the patient’s values and preferences. Thus, good healthcare practitioners ask questions of their patients and pay attention to their perspectives. While it can feel vulnerable to lay it all out there, it is important to give honest responses. On the flip side, it is reasonable (and empowering!) for patients to ask providers why they are doing what they are doing. When the process is evidence-based, the provider will be able to describe his or her rationale while tuning into what makes sense for you as an individual.
Money issues tend to be a major source of stress for Americans, and military families are no exception. Financial stress can increase your risk for poor health and have a negative impact on productivity and mood. Stress over money can reverberate through your relationships too. For example, couples who are under financial stress are more likely to be hostile and aggressive with each other and less secure and happy in their relationships. So what can you do to reduce your stress over money?
Here are some tips from Building Resilience in the Military Family:
- Have each family member discuss his/her financial dreams, how to make money decisions, and who will manage the money. (If there are differences, try the tips on HPRC’s “Making Decisions” card)
- Save at least $1,000 for unexpected expenses and, ideally, six months of your total monthly expenses.
- Work on paying off debt. Figure out a plan to pay off your debts, no matter how long it will take to get rid of them.
- Create and use a budget. This planning tool from Military OneSource can help you make a financial management plan.
- Save for retirement. A good rule is to save 10–15% of your gross income in retirement accounts annually.
- Check your credit. Knowing your credit history and credit number can help you spot identity theft and/or motivate you to stay (or become) responsible.
- Create a will. Setting up a will is important no matter your age.
Think about whether you have the insurance your family needs. Do you have health insurance, auto insurance, home/renters insurance, and life insurance?
Anger can be helpful in combat situations, and it can help individuals engage in quick, decisive action. It also can help keep emotions such as guilt and sadness at bay so you can accomplish things you need to do. Anger has its place. In relationships, anger is bound to make its way into interactions sometimes. When regulated, it can help you solve problems or motivate you to talk about important things, including hurt feelings. When unregulated, however, it can damage your relationship and increase your unhappiness with your loved one. Increased levels of anger can even increase your risk for physical health problems, especially coronary heart disease. It isn’t possible to avoid anger completley, but you can learn how to manage it well. Read more in HPRC’s “Performance Strategies: Five Steps to Managing Anger.”
Pain can be unpredictable, uncontrollable, and unrelenting, so even the most resilient Warfighters can be vulnerable to it. Because of pain, you may experience symptoms of anxiety or depression; your mind may even exaggerate the intensity and awfulness of pain. Socially, you might experience criticism, rejection, and negative interactions with family, spouse, or peers. Even if interactions are generally positive, you may want to withdraw from people or difficult situations
Chronic pain, which lasts longer than three months and is unresponsive to treatment, can affect quality of life for many. At least 100 million adults in the U.S. suffer from chronic pain. Unfortunately, combat and other situations make Warfighters especially susceptible to experiencing injury and pain. One study of an infantry brigade found that three months after return from Afghanistan, 44% of the soldiers reported chronic pain.
The American Psychological Association has shared evidence that relief from pain is more likely when mind and body are both treated. The National Center for Complimentary and Alternative Medicine has also indicated that continued study of non-drug approaches to pain management is a priority.
The latest trend in treating pain is the “biopsychosocial model,” which focuses on exercise and sleep (not just meds and surgery) as important biological influences. Important psychological factors include thoughts, emotions, behaviors, and attention. And impactful social factors involve healthcare, family, and work. All of these factors can contribute to understanding and mitigating the impacts of pain.
The American Psychological Association shares concrete advice to manage pain, including these tips:
- Distract yourself.
- Stay active and exercise.
- Know your limits.
- Follow prescriptions carefully.
- Make social connections.
- Don’t lose hope.
Whether on the playing field or on a mission, of course you want to succeed. Dreaming of positive outcomes can drive you to train hard. But you may have noticed that when you only focus on the outcome, you’re distracted from the important ingredients for success. Your successes will unfold more easily if you develop goals centered on what’s in your control rather than how you compare to others. Learn more about setting different kinds of goals in this HPRC article on sport psychology goals.
“Sport psychology” uses the principles of psychology to help optimize performance in athletics. These concepts can be applied to just about anybody (including Warfighters) in any setting where performance matters, so sport psychology often gets dubbed “performance psychology.” Regardless of the name, this focus on the mental aspect of performance fits into a holistic approach to Human Performance Optimization (HPO).
A major focus of sport or performance psychology is mental skills training, building a “toolbox” of mental skills based on sport science and clinical/counseling psychology techniques. These scientifically based methods can be applied to Warfighter performance too. Some basic tenets of performance enhancement within military and sport settings include maintaining high awareness, motivation, and self-control, either by reducing how “amped up” you get or by learning to interpret these feelings as either meaningless or helpful to performance. A well-trained Warfighter can either calm down and think, “I’ve got butterflies, but no big deal,” or “I am psyched up and ready!”
Mental skills are important, but they’re only part of a performance psychology package. Performance psychology looks to fix or improve performance by: 1) training skills to proactively address problems, 2) improving resilience to avoid problems in the first place, 3) enhancing performance, and 4) reducing stigma around getting help with problems after they’ve appeared. In applying performance psychology to Warfighters, training is customized to meet the needs of specific groups, focused on real-life applications, and taught in a way such that skills are learned for optimal functioning both at work and at home. HPRC endorses holistic training programs that include performance psychology, such as One Shot One Kill (OSOK), a platform that helps Warfighters to customize their own systematic training.
We all have goals—to lift a certain weight, to cycle a century, or to run a marathon in a certain amount of time. Of course, not all goals are fitness oriented; maybe you want to climb in rank at your job or finish college by a certain date. Whatever your goals are, keep in mind that they’re easier to accomplish when they’re SMART goals: Specific, Measurable, Achievable/Action-oriented, and Time-sensitive. Goals are not just about dreaming big; they’re about achieving.
HPRC’s printable SMART goals worksheet will help you to get on target. Using this tool will help you to:
- think through exactly what you’re aiming for;
- determine if the goal is a good fit for you;
- measure and monitor your success;
- pay attention to the language that you use; and
- break down the overall goal into chunks.
And for more guidance on making your goals achievable, you can check out HPRC's Answer on SMART goal setting.
Having good social support is beneficial in many ways and can come in a furry package! Pets are wonderful companions, and you benefit by having one (or more) in so many ways: They get you out exercising, increase your self-esteem, decrease a sense of isolation, and help you through tough times. If that’s not enough, there’s a growing amount of research on the use of dogs providing therapeutic benefits to individuals coping with post-traumatic stress disorder and traumatic brain injury. Dog owners are also more likely than those who don’t have dogs to meet physical activity guidelines. So if you have a furry creature at home, remember to give them a big pat for enhancing your life. Indeed, one researcher described these relationships as truly “friends with benefits.”
For Warfighters about to be deployed, pets also can come with the added stress of needing to find a temporary home. To get some tips about what to do with your pet while you’re on deployment, check out this article from HPRC and/or this Department of Defense blog.
The “relaxation response” is your body’s counterpart to the stress response you feel during critical situations. As the name suggests, the relaxation response has a calming effect on your mental and physical state, with benefits that include less anxiety, a more positive mood, a sense of calmness and well-being, and reduced heart rate, breathing and metabolic rates, blood pressure, and muscle tension.
Sound good? You can learn how to use your body’s relaxation response for health and well-being. Various mind-body techniques such as deep-breathing exercises, guided imagery, meditation, progressive muscle relaxation, yoga, tai-chi, and qigong all train you to turn this response on. Practicing these mind-body techniques has been found to help with anxiety and depression, as well as physical conditions such as hypertension, cardiovascular disease, and types of cancer that are exacerbated by stress.
To learn more about mind-body techniques, check out HPRC’s Mind-Body Skills section.
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.