Filed under: Mind
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’ve all heard of depression. If you’ve never experienced it, it’s easy to think that someone could just snap out of it if they wanted to. Depression doesn’t work like that. It can have an impact on a person in every way—physically, mentally, and emotionally, even extending to relationships—and can range from mild to severe. According to the American Psychological Association, “Depression is more than just sadness. People with depression may experience a lack of interest and pleasure in daily activities, significant weight loss or gain, insomnia or excessive sleeping, lack of energy, inability to concentrate, feelings of worthlessness or excessive guilt and recurrent thoughts of death or suicide.” Depression is an illness considered to be treatable with professional help.
This factsheet from afterdeployment.org details the signs and symptoms of depression. They also have an anonymous online assessment, general information, personal stories shared by those who’ve experienced depression, an interactive workbook that can help you challenge negative thoughts and identify depression triggers, and information about the link between behaviors and mood. Also take a look at the factsheet on Taking Charge of Depression, which includes helpful strategies.
For more information about depression or other mental states that can influence your performance, check out the section of HPRC’s website on depression. However, if you feel you are in crisis, contact the Military Crisis Line—someone is available 24/7 for online chat or via phone at 1-800-273-TALK.
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.
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?”
No single mental technique can do the job for you, just as no single tool is the only one in a construction project. You can’t hammer a nail with a wrench! HPRC offers nine rules and strategies for your mind’s toolbox to help you perform your best. Check out HPRC’s Performance Strategies on “Mental skills for optimal performance” to learn more.
The term “mental toughness” is often tossed about, but what is it really? And do you have it? Mental toughness is important to the success of Warfighters, athletes, business people, and others who have to overcome adversity to be successful.
Sport psychologists and others interested in optimal performance talk a lot about mental toughness, but it’s a bit complex, so it’s often misunderstood. Mental toughness is not just one trait; it’s a mixture of them.
Boiling it down, mental toughness is a strong belief in yourself and an unshakable faith that you control your own destiny. If you’re mentally tough, you can remain undaunted by adversity.
If you have these 4 Cs, you’re mentally tough:
1) Control: You feel in control of your emotions and influential with the people in your life.
2) Commitment: You embrace difficulty rather than running from it.
3) Challenge: You believe that life is full of opportunities, not threats.
4) Confidence: You know you have what it takes to be successful.
Mental toughness is a psychological edge that some are born with and others develop. It allows you to consistently cope with training and lifestyle demands better than those who don’t have it.
You can develop mental toughness through a long-term process of developing mental skills. Leaders can promote mental toughness by creating a learning environment centered on the mastery of those skills (listed above) and by being generally supportive, encouraging Warfighters to maintain positive relationships. Over the long haul, to maintain your mental toughness, you need to continue honing mental skills, and you need a self-driven, insatiable desire to succeed.
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.
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.