TRADOC Pam 525-3-7-01 - TRADOC - U.S. Army

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TRADOC Pam 525-3-7-01One-and-a-half million Americans have served in Iraq andAfghanistan. Not one of them came home unchanged. Noone comes back unchanged.COL (Dr.) Tom BurkeDOD Director of Mental Health Policy134
TRADOC Pam 525-3-7-01Chapter 6Combat and Operational Stress—A Continuing Challenge6-1. Introduction and Historical BackgroundNo matter how well the Army develops men and women of stellar character, superb physicalconditioning, armed with the knowledge and intellect essential to the profession, prolongedexposure to stress, particularly that of the trauma associated with combat, can wear Soldiersdown, and reduce the effectiveness of their units. Stress, of course, exists all of the time. It is notlimited to combat nor is its effects limited to Soldiers. Families experience stress because ofprolonged and repeated deployments, and the strain on the family in turn produces anotherstressor taxing the Soldier. Combat stress represents one of the more extreme conditions Soldiersexperience in war. Some, perhaps most, Soldiers learn to cope with the effects of combat stress,but it is increasingly evident that the effects of stress, whatever the source, can be cumulative,and remain hidden for a long time. Stress occurs and has effects in the moral, physical, andmental components of the human dimension. This chapter addresses the sources of combat andoperational stress, their effects on Soldiers, Army civilians, and contractors, and the implicationsthey have on the human dimension.The development of the railroad, breechloaders, barbed wire, the machinegun, indirectartillery fire, the airplane, tank, and wireless radio, changed tactics and introduced the concept ofoperational art. These technological innovations contributed to a Revolution in Military Affairsthat continues to have important implications for the human dimension. The battlefield impact ofmore lethal direct and indirect fire systems forced greater dispersion among Soldiers and unitsthat led to increased C2 difficulties for leaders at all levels as Soldiers advanced in individualrushes to successive covered positions. Voice command, visual signals, or even messengerscould no longer control the increased decentralization of units effectively. Future concepts callfor a continued increase in the dispersion of individuals and units and for ever-increasingautonomy. This trend presents a significant challenge to the Army.Leadership pressure emphasizing duty and offensive action in the face of battlefield lethalityand strong defenses were among the many factors that contributed to the massive losses of WorldWar I and the emergence of significant numbers of psychological casualties referred to then asshell shock. The occurrence of such large numbers of psychological casualties, and incidents ofunit-wide indiscipline, spawned a surge of interest within the medical profession and popularculture in the factors affecting the Soldiers will to fight. 150 For the most part, efforts to determinethe causes succeeded only in differentiating between cowards and heroes. Better training, rest,and treatment among the Soldier’s comrades, relying on group cohesion as therapy to provide themotivation to recover, treated perceived cowardice and malingering successfully.Well into World War II, many military leaders continued to regard a Soldier’s breakdowndue to combat fatigue as evidence of weak character as the infamous Patton slapping incidentsillustrate. As the American Army continued to experience large numbers of combat stresscasualties, evidence emerged linking both the prevention of stress casualties and combatmotivation to Soldier morale and unit cohesion. Psychiatrists, behavioral scientists, and militarytheorists reached similar conclusions as to why “a tired cold, muddy rifleman goes forward with135
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