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Combat and Operational Stress reaction COSR

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(Preventive Maintenance Checks and Services) for your inner machine ... significant sleep disturbance, but so may the eerie quiet of American streets. ... – PowerPoint PPT presentation

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Title: Combat and Operational Stress reaction COSR


1
Combat and Operational Stress reaction(COSR)
  • By CPT Alison Crane, RN, MS
  • Mental Health Observer-Trainer
  • 7302nd Medical Training Support Brigade

2
Think of this hour as PMCS (Preventive
Maintenance Checks and Services) for your inner
machine
  • LIKE EVERYTHING ELSE, THE HUMAN MIND
    AND BODY NEED PREVENTIVE MAINTENANCE OR THEY RUN
    A HIGH RISK OF
  • BREAK DOWN

3
The art of war aims to impose so much stress on
the enemy soldiers that they lose their will to
fight. Both sides try to do this and at times
accept severe stress themselves in order to
inflict greater stress on the enemy. To win,
combat stress must be controlled. US Army
Combat Stress Control Handbook, 2005
4
What is Combat Stress?
  • Stress is the bodys and minds response
  • to uncertain change.
  • Combat stress is a combination of physical,
    emotional, cognitive, and behavioral stressors in
    the combat zone which can produce changes in any
    Soldier that will impact performance either
    positively or negatively.

5
NOT ALL COMBAT STRESS IS BAD OR DAMAGING!
6
COSR vs PTSD (Just more alphabet soup?)
  • Pretty much everyone comes home from Iraq and
    Afghanistan with COSR. We consider it a normal
    reaction to an abnormal experience.
  • Very few have it long enough or bad enough for it
    to be called PTSD, which is a formal diagnosis in
    the DSM IV.

7
WHY CARE?
  • It will help keep
  • YOU and YOUR UNIT
  • mission capable
  • and therefore improve
  • everyones chances
  • of survival

8
What does it look like?
  • Withdrawn, secretive
  • Detached, controlling
  • Angry, argumentative, impatient
  • On alert, tense (hypervigilant)
  • Avoids talking about experience
  • Speeding tickets (once home)
  • Drinking or using illegal drugs to fall asleep

9
Whats really going on?
  • Withdrawn, Secretive Feels that no one can or
    does understand war experience used to keeping
    all information closely guarded may feel
    damaged, permanently changed American culture
    may seem alien at first, a lot of nonsense
    Others have changed, disorienting.
  • ANTIDOTE Spend time alone with each person
    Acclimate slowly Courageously accept and
    provide support

10
Whats really going on?
  • Detached, controlling Tight control over
    emotions, details, weapon and gear is critical
    during war for survival and mission success.
    But, with enough practice, we get stuck there.
  • ANTIDOTE Remember that the small details are no
    longer vitally important. If you overreact,
    forgive yourself, apologize, and explain.

11
Whats really going on?
  • Angry, argumentative, impatient Lived under the
    premise of Kill or be killed chemical brain
    storm wages its own war May be angry over
    injustices and losses may see American culture
    as being caught up in a lot of nonsense.
  • ANTIDOTE Talk about the anger with someone safe
    (clergy, battle buddy, spouse, counselor, MD,
    me) use prayer and/or meditation to help slow
    down brain chemistry medication walk away,
    count to 10, stop speaking and just think.

12
Whats really going on?
  • On alert, tense, hypervigilant Highly chemical
    and neurological endless stream of shocks crank
    up chemistry, which is tough to shut off can
    show up as intense startle response, difficulty
    sleeping, nightmares, tense or panicky in large
    groups or open spaces.
  • ANTIDOTE Gradual elimination of all caffeine
    regular, sustained exercise see MD re sleep
    give yourself time to disengage from war think
    ahead, be proactive about possible trigger (7/4)

13
Whats really going on?
  • Avoids talking about war deployment Emotions
    from memories may make it too difficult
    anxiety, shame, guilt, regret, anger, fear, pain,
    grief, frustration, etc.
  • ANTIDOTE Talk when you feel like talking and
    feel safe to do so write in a journal look
    into TFT or EMDR to help relieve intense
    emotions. (If intrusive thoughts become more
    frequent, call a Vet Center for suggestions on
    what to do.)

14
Whats really going on?
  • Speeding tickets In Iraq, 100 mph is a Sunday
    drive going 65 mph in America may make soldier
    feel extremely anxious and vulnerable.
    Consequence lots of speeding tickets.
  • ANTIDOTE Work consciously to slow driving down
    and to deal with resulting anxietywith a
    counselor, if necessary.

15
Whats really going on?
  • Drinking, using illegal drugs to fall asleep
    chemical brain storm may be causing significant
    sleep disturbance, but so may the eerie quiet of
    American streets.
  • ANTIDOTE If you need help falling and staying
    asleep, get a prescription drug that will be
    managed carefully by a doctor. Alcohol is a
    depressant, pot could be laced with other drugs,
    and the others are just plain dangerousmedically
    and professionally.

16
Its time to get outside help when
  • youre drinking or using drugs several days a
    week
  • youre thinking about committing suicide or
    homicide
  • there seems to be a lot of conflict in your
    relationships
  • youre having trouble meeting your commitments at
    work or home
  • your spouse, buddy, or boss suggests you need
    help
  • youre feeling low or unable to enjoy life

17
Why Soldiers Didnt Get Help
  • Would be seen as weak 65
  • Feared that unit leaders would treat them
    differently 63
  • Feared other unit members would have less
    confidence 59
  • Would get blamed by leader for problem 51
  • Would harm career 50
  • Too embarrassing 41
  • Didnt trust mental health professionals 38
  • Did think mental health care would work 25
  • Didnt know where to get help 22
  • Had no transportation 18

18
Quietly Getting Help
  • Clergy
  • MilitaryOne Source (800-342-9647)
  • Vet Centers and VA Hospitals
  • Civilian mental health professionals
  • Me
  • CPT Alison Crane, 7302nd MTSB
  • (847) 942-3802 cell

19
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