The emotionally disturbed soldier has built a barrier against
fear. He does this for his own protection, although he is probably
not aware that he is doing it. If he finds that he does not have
to be afraid and that there are normal, understandable things
about him, he will feel safer in dropping this barrier. Persistent
efforts to make him realize that you want to understand him will
be reassuring, especially if you remain calm. Nothing can cause
an emotionally disturbed person to become even more fearful than
feeling that others are afraid of him. Try to remain calm. Familiar
things, such as a cup of coffee, the use of his name, attention
to a minor wound, being given a simple job to do, or the sight
of familiar people and activities will add to his ability to overcome
his fear. He may not respond well if you get excited, angry, or
abrupt.
a. Ventilation. After the soldier becomes calmer, he
is likely to have dreams about the stressful event. He also may
think about it when he is awake or even repeat his personal reaction
to the event. One benefit of this natural pattern is that it helps
him master the stress by going over it just as one masters the
initial fear of jumping from a diving board by doing it over and
over again. Eventually, it is difficult to remember how frightening
the event was initially. In giving first aid to the emotionally
disturbed soldier, you should let him follow this natural pattern.
Encourage him to talk. Be a good listener. Let him tell, in his
own words what actually happened (or what he thinks happened).
If home front problems or worries have contributed to
the stress, it will help him to talk about them. Your patient
listening will prove to him that you are interested in him, and
by describing his personal catastrophe, he can work at mastering
his fear. If he becomes overwhelmed in the telling, suggest a
cup of coffee or a break. Whatever you do, assure him that you
will listen again as soon as he is ready. Do try to help put the
soldier's perception of what happened back into realistic perspective;
but, DO NOT argue about it. For example, if the soldier
feels guilty that he survived while his teammates were all killed,
reassure him that they would be glad he is still alive and that
others in the unit need him now. If he feels he was responsible
for their deaths because of some oversight or mistake (which may
be true), a nonpunishing, nonaccusing attitude may help him realize
that accidents and mistakes do happen in the confusion of war,
but that life, the unit, and the mission must go on. (These same
principles apply in civilian disaster settings as well.) With
this psychological first aid measure, most soldiers start toward
recovery quickly.
b. Activity.
(1) A person who is emotionally disturbed as the result of combat
action or a catastrophe is basically a casualty of anxiety
and fear. He is disabled because he has become temporarily
overwhelmed by anxiety. A good way to control fear is through
activity. Almost all soldiers, for example, experience
a considerable sense of anxiety and fear while they are poised,
awaiting the opening of a big offensive; but this is normally
relieved, and they actually feel better once they begin to move
into action. They take pride in effective performance and pleasure
in knowing that they are good soldiers, perhaps being completely
unaware that overcoming their initial fear was their first major
accomplishment
(2) Useful activity is very beneficial to the emotionally disturbed
soldier who is not physically incapacitated. After you help a
soldier get over his initial fear, help him to regain some self-confidence.
Make him realize his job is continuing by finding him something
useful to do. Encourage him to be active. Get him to carry litters,
(but not the severely injured), help load trucks, clean up debris,
dig foxholes, or assist with refugees. If possible, get him back
to his usual duty. Seek out his strong points and help him apply
them. Avoid having him just sit around. You may have to provide
direction by telling him what to do and where to do it. The instructions
should be clear and simple; they should be repeated; they should
be reasonable and obviously possible. A person who has panicked
is likely to argue. Respect his feelings, but point out more immediate,
obtainable, and demanding needs. Channel his excessive energy
and, above all, DO NOT argue. If you cannot get him interested
in doing more profitable work, it may be necessary to enlist aid
in controlling his overactivity before it spreads to the group
and results in more panic. Prevent the spread of such infectious
feelings by restraining and segregating if necessary.
(3) Involvement in activity helps a soldier in three ways:
- He forgets himself.
- He has an outlet for his excessive tensions.
- He proves to himself he can do something useful. It is amazing
how effective this is in helping a person overcome feelings of
fear, ineffectiveness, and uselessness.
c. Rest. There are times, particularly in combat, when
physical exhaustion is a principal cause for emotional reactions.
For the weary, dirty soldier, adequate rest, good
water to drink, warm food, and a change of clothes, with
an opportunity to bathe or shave may provide spectacular
results.
d. Group Activity. You have probably already noticed
that a person works, faces danger, and handles serious problems
better if he is a member of a closely-knit group. Each individual
in such a group supports the other members of the group. For
example, you see group spirit in the football team and in
the school fraternity. Because the individuals share the same
interests, goals, and problems, they do more and better work;
furthermore, they are less worried because everyone is helping.
It is this group spirit that wins games or takes a strategic hill
in battle. It is so powerful that it is one of the most effective
tools you have in your "psychological first aid bag."
Getting the soldier back into the group and letting him see its
orderly and effective activity will reestablish his sense of belonging
and security and will go far toward making him a useful member
of the unit.
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