• (1) Historical perspective
• (2) Contributing factors
• (3) Stress reactions
• (4) BICEPS principles
• (5) Combat Stress Control Management

Identify facts and principles about combat stress control

• (a) Civil war – called “nostalgia” or “homesickness”
• (b) World War I – called “shell-shock” from constant exposure to bombing
• (c) World War II – called “combat fatigue” resulting from participation in many battles

• (a) Problems at home
• (b) New/first exposure to combat
• (c) Loss of buddies
• (d) Sleep deprivation
• (e) Lack of information/support
• (f) Physically run-down
• (g) Inadequate fitness
• (h) Dehydration/hunger
• (i) State of being wet, cold or hot
• (j) Loss of confidence

• (a) Vary from mild to extreme
• (b) Psychological reactions
• 1 Fear (normal reaction for everyone)
• 2 Hyper-alertness
• 3 Poor concentration
• 4 Nightmares/insomnia
• 5 Anxiety/crying
• 6 Emotional withdrawal
• 7 Feelings of guilt
• 8 Hysterical blindness or paralysis
• (c) Physical signs and symptoms
• 1 Exhaustion – predominant factor
• 2 Hyperventilation
• 3 Increased blood pressure/heart rate
• 4 Anorexia, nausea, and/or diarrhea
• 5 Urinary frequency
• 6 Gross body tremors/poor body posture

• (a) BICEPS approach uses six elements to aid in recovery
1 Brevity

• a Brief treatment, no longer than three days
  
• b Usually at second echelon facility
  2 Immediacy
  
• a Identify the need for care early – don't wait
  
• b Provide care as soon as possible
  3 Centrality
  
• a Treat in separate location (not in hospital)
• b Not physically sick, they just need rest
4 Expectancy
• a Member must understand verbally and non- verbally they are returning to duty
• b Patient is not ill
• c Symptoms are passing reactions
• d Recovery is rapid e Wear of uniform while performing details allows member to maintain self-image/military bearing
5 Proximity
• a Treat as close to home unit as possible
• b Allow unit and friends to visit and offer support
6 Simplicity
• a Keep treatment directed to patient’s return to duty
• b No medications unless necessary and only under doctor’s supervision
(5) Combat Stress Control Management
• (a) Treatable if recognized and treated early
• (b) Principle of reconstruction

• a Basic needs/rest
• b Hygiene
• c Food

• a Stress management
• b Anger control
• c Assertiveness training
• d Relaxation techniques
• e Goal setting

• a Preparation for return to duty
• b Work assignments in applicable areas
• (c) Individual’s role
• 1 Don't be a loner
• 2 Help others
• 3 Know your limits
• 4 Get at least four hour uninterrupted sleep. Nap when you can
• 5 Eat enough food
• 6 Drink water/stay hydrated
• 7 Good personal hygiene
• 8 Stay active
• (d) Supervisor’s role
• 1 Build esprit de corps
• 2 Build morale before entering combat
• 3 Build strong, cohesive, capable unit
• 4 Assign new troop with older troop
• (e) Medical personnel’s role
• 1 Provide non-threatening environment
• 2 Undisturbed rest
• 3 Nourishing, appetizing meals
• 4 Give patient chance to talk to others who are recovering
• 5 Explain others feel the same way but continue to work
• 6 Help patient build self confidence
• 7 Maintain self image/military bearing by having them wear uniform, not pajamas
• (t) Occupational therapy
• 1 Function: to provide evaluation and treatment of personnel who show a decrease in performance proficiency and combat effectiveness due to stress or other mental health conditions
• 2 During Desert Shield/Storm, teams deployed to combat units to disarm any potential problem situations.
• Given instruction, students will be able to identify facts and principles about combat stress control
  • (1) Historical perspective
  • (2) Contributing factors
  • (3) Stress reactions
  • (4) BICEPS principles
  • (5) Combat Stress Control Management

  Revised Mar 2002