Military Psychologist Helps Troops Combat Fear

Despite their bulky Kevlar and hardened expressions, soldiers on the battlefield and police officers patrolling tough streets still face some level of fear, and it can impact all parts of their lives.

The key to managing that fear, especially for those who operate under extreme stress on a near-daily basis, is to acknowledge it, says Lt. Col. Dave Grossman, a retired West Point psychology professor.

"If they know these things are going to happen, they are far less traumatized by it," Grossman, who wrote the book On Combat: The Psychology and Physiology of Deadly Conflict in War and Peace, tells NPR's Andrea Seabrook.

Grossman is one of a growing number of psychologists who train military and police officers how to deal with their fears. A large number of veterans have been diagnosed with post-traumatic stress disorder (PTSD) upon returning from the wars in Iraq and Afghanistan. Their experiences demonstrate how psychological scars from conflict can be as devastating for individuals and their families as physical ones.

People in highly stressful situations can experience profound and disturbing physical and mental effects, Grossman says, such as:

Vision — Loss of near and peripheral vision and depth perception. The eyes revert to what Grossman calls the "default survival position."

Hearing — Even loud sounds like that of gunfire may seem muted or are not heard at all.

Movement — Loss of bowel and bladder control. Loss of fine motor control, which can be marked by shaking, and complex motor control. Remaining calm is crucial for personnel such as bomb technicians or military pilots. "If our pilots lose one iota of fine motor control skill on a close approach ... we're all having a bad day," Grossman says.

Thought — A slowed sense of perception and time. People may literally become scared out of their wits as blood drains from the forebrain. This leaves the midbrain, which Grossman calls "the part of your brain that's the same as your dog," as dominant.

As a way to prepare for that, he utilizes a technique called "stress inoculation." This works much the same way as a vaccine that protects people against a disease by exposing them to the disease in a controlled manner. Then if they are truly exposed to disease, it won't kill them because they have already built up a natural resistance.

For example, police officers use paint pellets in drills that replicate what they encounter on the street. The stressful situations seem real — the flash and bang and smell of gunfire — though the consequences are not.

"You're holding a real gun and a real gunpowder projectile comes out of one side," Grossman said.

But it's not a matter of life and death. The bullets leave only a smattering of paint and maybe a welt.

Grossman trains soldiers using what he calls a "no macho, no pity party" strategy. He doesn't think they should expect that combat will destroy or traumatize them, though there's a tendency to believe that.

However, he says, if they are having ongoing problems, they shouldn't be afraid to seek help.

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