a. Up to this point the discussion has been primarily
about the feelings of the emotionally distressed soldier. What
about your feelings toward him? Whatever the situation, you will
have emotional reactions (conscious or unconscious) toward this
soldier. Your reactions can either help or hinder your ability
to help him. When you are tired or worried, you may very easily
become impatient with the person who is unusually slow or who
exaggerates. You may even feel resentful toward him. At times
when many physically wounded lie about you, it will be especially
natural for you to resent disabilities that you cannot see. Physical
wounds can be seen and easily accepted. Emotional reactions are
more difficult to accept as injuries. On the other hand, will
you tend to be overly sympathetic? Excessive sympathy for an incapacitated
person can be as harmful as negative feelings in your relationship
with him. He needs strong help, but not your sorrow. To overwhelm
him with pity will make him feel even more inadequate. You must
expect your buddy to recover, to be able to return to duty, and
to become a useful soldier. This expectation should be displayed
in your behavior and attitude as well as in what you say. If he
can see your calmness, confidence, and competence, he will be
reassured and will feel a sense of greater security.
b. You may feel guilty at encouraging this soldier to
recover and return to an extremely dangerous situation, especially
if you are to stay in a safer, more comfortable place. Remember
though, that if he returns to duty and does well, he will feel
strong and whole. On the other hand, if he is sent home as a psycho,
he may have self-doubt and often disabling symptoms the rest of
his life.
c. Another thing to remind yourself is that in combat
someone must fight in this soldier's place. This temporarily battle
fatigued soldier, if he returns to his unit and comrades, will
be less likely to overload again (or be wounded or killed) than
will a new replacement.
d. Above all, you must guard against becoming impatient,
intolerant, and resentful, on one hand, and overly solicitous
on the other. Remember that such emotion will rarely help the
soldier and can never increase your ability to make clear decisions.
e. As with the physically injured soldier, the medical
personnel will take over the care of the emotionally distressed
soldier who needs this specific care as soon as possible. The
first aid which he has received from you will be of great value
to his recovery.
f. Remember that every soldier (even you) has a potential
emotional overload point which varies from individual to individual,
from time to time, and from situation to situation. Because a
soldier has reacted abnormally to stress in the past does not
necessarily mean he will react the same way to the next stressful
situation. Remember, any soldier, as tough as he may seem, is
capable of showing signs of anxiety and stress. No one is absolutely
immune.
8-15. Tables.
See Tables 8-1, 8-2, and 8-3 for more information.
Table 8-1. Mild Battle Fatigue
| PHYSICAL SIGNS*
| EMOTIONAL SIGNS*
|
|---|
1. Trembling, tearful
2. Jumpiness, nervous
3. Cold sweat, dry mouth
4. Pounding heart, dizziness
5. Nausea, vomiting, diarrhea
6. Fatigue
7. "Thousand-yard stare" | 1. Anxiety, indecisive
2. Irritable, complaining
3. Forgetful, unable to concentrate
4. Insomnia, nightmares
5. Easily startled by noises, movement
6. Grief, tearful
7. Anger, beginning to lose confidence in self and unit
8. Difficulty thinking, speaking, and communicating
| | SELF AND BUDDY AID |
|---|
1. Continue mission performance, focus on immediate mission.
2. Expect soldier to perform assigned duties.
3. Remain calm at all times; be directive and in control.
4. Let soldier know his reaction is normal, and that there is nothing seriously wrong with him.
5. Keep soldier informed of the situation, objectives, expectations, and support. Control rumors.
6. Build soldier's confidence, talk about succeeding.
7. Keep soldier productive (when not resting) through recreational activities, equipment maintenance.
8. Ensure soldier maintains good personal hygiene.
9. Ensure soldier eats, drinks, and sleeps as soon as possible.
10. Let soldier talk about his feelings. DO NOT "put down" his feelings of grief or worry. Give practical advice and put emotions into perspective.
| |
*Most or all of these signs are present in mild battle fatigue. They can be present in any normal soldier in combat yet he can still do his job. |
Table 8-2. More Serious Battle Fatigue
| PHYSICAL SIGNS*
| EMOTIONAL SIGNS*
|
|---|
1. Constantly moves around
2. Flinching or ducking at sudden sounds and movement
3. Shaking, trembling (whole body or arms)
4. Cannot use part of body, no physical reason (hand, arm, legs)
5. Cannot see, hear, or feel (partial or complete loss)
6. Physical exhaustion, crying
7. Freezing under fire, or total immobility
8. Vacant stares, staggers, sways when stands
9. Panic running under fire
| 1. Rapid and/or inappropriate talking
2. Argumentative, reckless actions
3. Inattentive to personal hygiene
4. Indifferent to danger
5. Memory loss
6. Severe stuttering, mumbling, or cannot speak at all
7. Insomnia, nightmares
8. Seeing or hearing things that do not exist
9. Rapid emotional shifts
10. Social withdrawal
11. Apathetic
12. Hysterical outbursts
13. Frantic or strange behavior
| | TREATMENT PROCEDURES** |
|---|
1. If soldier's behavior endangers the mission, self or others, do whatever necessary to control soldier.
2. If soldier is upset, calmly talk him into cooperating.
3. If concerned about soldier's reliability:
- Unload soldier's weapon.
- Take weapon if seriously concerned.
- Physically restrain soldier only when necessary for safety or transportation.
4. Reassure everyone that the signs are probably just battle fatigue and will quickly improve.
5. If battle fatigue signs continue:
- Get soldier to a safer place.
- DO NOT leave soldier alone, keep someone he knows with him.
- Notify senior NCO or officer.
- Have soldier examined by medical personnel.
6. Give soldier tasks to do when not sleeping, eating or resting.
7. Assure soldier he will return to full duty in 24 hours; and, return soldier to normal duties as soon as he is ready.
| *These signs are present in addition to the signs of mild battle fatigue reaction.
**Do these procedures in addition to the self and buddy aid care. |
Table 8-3. Preventive Measures to Combat Battle Fatigue
1. Welcome new members into your team, get to know them quickly. If you are new, be active in making friends.
2. Be physically fit (strength, endurance, and agility).
3. Know and practice life-saving self and buddy aid.
4. Practice rapid relaxation techniques (FM 26-2).
5. Help each other out when things are tough at home or in the unit.
6. Keep informed; ask your leader questions, ignore rumors.
7. Work together to give everyone food, water, shelter, hygiene, and sanitation.
8. Sleep when mission and safety permit, let everyone get time to sleep.
- Sleep only in safe places and by SOP.
- If possible, sleep 6 to 9 hours per day.
- Try to get at least 4 hours sleep per day.
- Get good sleep before going on sustained operations.
- Catnap when you can, but allow time to wake up fully.
- Catch up on sleep after going without.
|
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