Abstract
This chapter looks at the often overlooked yet vitally important steps of mental preparation for first responders, emergency and disaster management personnel, and command center staffs. This chapter will delve into the importance of using simulations and exercises to focus on the mental well-being of our responders to prevent future incidents of post-traumatic stress disorder and other health issues. The past 19 years of war against terrorism starting with the attacks on 9/11 coupled with the recent outbreak of COVID-19 has brought to the forefront the necessity to mentally prepare our warriors, our first responders, and our medical personnel to operate effectively in the toxic environment of a disaster or emergency. This chapter aims to help build that awareness and facilitate planning.
TopIntroduction
Whatever you would make habitual, practise it; and if you would not make a thing habitual, do not practice it, but habituate yourself for something else. - Epictetus 1st century A.D.
You do not rise to the occasion in combat, you sink to the level of your training (Grossman, 2008).
I started my career in the Army after graduating from West Point in 1994. I had never worn body armor during my time at West Point nor in my first assignment as an infantry lieutenant. It was not until we were training up to deploy to Kosovo in mid-1999 that I first experienced wearing body armor. Unlike the old “flak jackets” of the Vietnam era, our unit was issued Ranger Body Armor (RBA)…a combination of ceramic protective plates strategically placed on the chest and back, encased in a weave made of Kevlar. The plates were designed to stop bullets and protect vital organs. But here’s the thing…the body armor was heavy! I recall the first day I wore the body armor as we conducted pre-deployment training. It was exhausting. Even though I was in good shape and conducted physical training every day, I would rapidly find myself out of breath while walking or running in body armor. After our first day of training, I remember thinking to myself, “I will never adjust to wearing this heavy body armor.”
I knew its protective nature was critically based on the threats we would face when we went to Kosovo. The body armor was designed to stop bullets and shrapnel, but how would I ever adjust to wearing this extra 10 pounds of gear, which felt incredibly restrictive? The Army already had a solution to my problem: we trained in body armor constantly. Whether marching to training, firing at the range, or practicing vehicle movements, we were always encased in our body armor. Before long, wearing it became second nature. My mind and body adjusted to the extra weight, and before long, it felt strange when I did not have the body armor on.
Since 9/11, I’ve worn body armor to all of our deployments to places such as Iraq and Afghanistan. We train with it in the United States, and it becomes a part of us, despite the extra weight and heat it adds to a combat load. I could not imagine today going into a combat zone without that vital protection: body armor saves lives.
TopBody Armor For The Mind
The need to be mentally prepared to work as a first responder or EM requires a level of mental health preparedness. This is important for a variety of reasons. First, the first responder or emergency management (EM) worker must rapidly evaluate a dangerous situation while keeping themselves out of harm’s way. Next, a first responder must then take immediate steps to save lives, often in situations in which no normal person ever wants to find themselves. Third, and equally important, post-traumatic stress disorder (PTSD) is a genuine challenge for first responders. A responder helps limit PTSD once an incident is over by mentally preparing for these life or death situations.
Inoculation is another great approach to why training for stressful situations is so vital. Inoculation is a long-time medical practice used to prevent diseases from destroying the human body. From the flu shot to anthrax vaccinations, using the weakened form of the disease to prevent a full-blown outbreak has been around for centuries. We need to do the same for stress.
Key Terms in this Chapter
Inoculation: Developing immunity to a threat, germ or disease through limited and/or repeated exposure to the threat.
After Action Review: A formal process used to evaluate how an event, exercise or training went to capture lessons learned while preparing to improve performance for future iterations.
Body Armor: Ballistic protection from stab wounds and bullets. Can be worn under or over clothing. Usually an integration of ceramic plates and ballistic materials to limit penetration of weapons against the individual wearing the armor.
Resiliency: Traditionally a engineering term referring to the ability of a physical material to withhold external stress through hardness, flexibility, and strength. Used in a mental health capacity, it refers to the ability of an individual to handle stress and adversity. Sometimes referred to as being able to “bounce back” from a difficult or traumatic event.
Post-Traumatic Stress Disorder (PTSD): A mental health condition triggered by a traumatic or terrifying event – either experienced or witnessed. Symptoms may include nightmares, flashbacks, severe anxiety and/or uncontrolled thoughts about the event.
Kevlar: A strong, synthetic fiber developed by DuPont with a high tensile strength to weight ratio five times stronger than steel. Used in the manufacture of bulletproof vests and body armor along with many commercial applications.
Muscle Memory: A form of memory involving a developing a motor task into memory through repetition. When a movement is repeated overtime, a long term muscle memory is created allowing it to be performed with little to no conscious effort.