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• W53460695 abstract "CONTROLLING COMBAT STRESS is the commander's responsibility and encompasses all the steps that the commander must take to keep an operations' strain on people within an acceptable range. Stress cannot be avoided, nor should it be, for the tension often generates productive energy. Commanders can seek to enhance those positive effects that create stress, such as esprit de corps, trust and heroism, while minimizing the negative effects, such as criminal acts, combat refusal and battle fatigue. Battle fatigue-also referred to as combat stress fatigue, stress fatigue and combat reaction-is defined as any response to the stress of combat that requires treatment.1 Signs and symptoms of battle fatigue may be present in many soldiers, but only when the soldier becomes combat ineffective is he considered to be a battle fatigue casualty and referred for treatment. Treatment, as the term fatigue would indicate, simply provides rest, reassurance, replenishment and restored confidence.2 This article will present the history of controlling combat stress and managing battle fatigue, describe the unique capabilities and role of the medical detachment, combat stress control (CSC), and through case examples, emphasize that combat stress control-trained, practiced and employed by the commander-is a combat multiplier. Historical Background Historians have long described man's response to the extraordinary stress of war. We are motivated by heroic responses to combat pressures and, at the other extreme, horrified by atrocities. Commanders manage violence in more ways than by applying appropriate force at the decisive point. They must also manage their soldiers' ability to function in the uncommonly stressful environment of war-recognizing their fear but disciplining them not to run; preparing them to kill, but not indiscriminately. The evolution of 20th-century warfare has increased awareness of this balancing act. US Army physicians in the American Civil War reported mass casualties from the stress of waging when nostalgia, a homesickness among Troops, reduced fighting forces.3 In World War I, as a condition and term was born in the trenches on the Western Front. At the time, treatment of shell shock or war consisted primarily of evacuation far from the front. However, this practice encouraged greater numbers of casualties. More important, these casualties did not improve with evacuation and were lost to combat.4 By 1917, one seventh of all medically discharged British soldiers were unfit due to mental conditions.5 Prior to deploying combat troops to Europe, the US Army sent a medical team to study British and French lessons learned. Both the British and the French ,by then had established principles of psychiatric casualty management that called for simple, immediate treatment as close to the front as possible, and both armies expected that soldiers would return to duty. From this experience developed the PIES acronym for treatment-proximity, immediacy, expectancy and simplicity. Another development from this study was the division psychiatrist position for implementing forward treatment principles, to include the recognition of battle fatigue by unit leaders and medical personnel.6 Overall, a large percentage of World War I neurosis cases were returned to duty.7 During the interwar years, rather than institutionalizing these World War I lessons about managing battlefatigue casualties, the Army looked to refine and apply early 20th-century theories of human behavior and development to screen out soldiers who would crack under the stress of battle. Relying on screening rather than training to prevent psychiatric casualties proved disastrous in early fighting in North Africa, when large numbers of battle fatigue casualties occurred among troops previously screened.8 Worse, because no provisions had been made for treatment, casualties were shipped to distant treatment facilities and lost from the theater. …" @default.
• W53460695 created "2016-06-24" @default.
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• W53460695 date "2000-05-01" @default.
• W53460695 modified "2023-09-23" @default.
• W53460695 title "Combat Stress Control Detachment: A Commander's Tool" @default.
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