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Editorial
Resilience Training for Armed Forces Personnel: Need of the Hour Introduction A combatant’s life is the epitome of uncertainty. Controlling adverse neuroendocrine surges in battle is the mark of a seasoned soldier. Every combatant undergoes general and skill‑specific training to contribute to victory in war. What is equally or maybe more important is to inculcate the capability to bounce back from adversity. Victory does not always go to the strongest or the most capable but to those who have resilience.[1]
What is Resilience? Resilience is defined as the capacity to recover quickly from difficulties. Physical resilience involves fitness. In the case of combatants, a very high degree of combat fitness is desirable. The fitter the soldier, the higher is his/her physical resilience and the greater his/her combat capability. An aspect of fitness which is not given due recognition is that of mental resilience. Regular regimes and assessment of physical fitness is an essential component of the life of a combatant. More difficult to impart and assess is mental resilience. In highly volatile situations, this can make the difference between defeat and victory. Stress is not confined to battlezones but is part of the reality of everyday life. Resilience training therefore will not only prepare our soldiers, airmen, and sailors for war but would also prepare them to be winners in everyday life. For resilience training to be effective, a sustained and proactive approach incorporating stress management regimes, coping strategies, and early interventions is mandatory.
Natural Development of Resilience Congenital and inherited factors influence resilience. There are genetically inherited personality traits that confer the characteristic of resilience to some individuals. However, the environment too plays a significant role in the evolution of coping skills. The balance of threats and support systems which a person encounters in early life forges resilience. In 1989, Emmy Werner, a developmental psychologist, published a longitudinal follow‑up in 698 children in Hawaii. Two‑third of children exposed to negative influences including poverty and violence developed mental health‑related problems, delinquency, or teenage pregnancies. However, one‑third attained academic, domestic, and social success. The support of one stable caregiver during development was seen to be critical in laying of foundations of resilience in childhood. This could be a teacher, parent, or supportive adult figure. 4
Religion and cultural tradition also play a role in the development of resilience. A combination of support systems, faith, and a sense of control is important for developing resilience. A positive social orientation and perceived “internal locus of control” characterize those who succeed despite an unstable environment in childhood.
Resilience Training “Potentially Traumatic Events” is important when we consider resilience training. Acute stress is a common phenomenon in everyday life. Acute stressors however often contribute to improved performance. When stress becomes chronic, it registers as a traumatic event. This is the zone of negative stress and is associated with mental and physical sequelae. Negative stress or distress invites physical and mental consequences which prevent optimal functioning. Stress results from an imbalance between demands and resources. The aim of resilience training is to enhance an individual’s cognitive and coping capabilities.
The Psychophysiology of Resilience A definite state of psychophysiological coherence is associated with optimal cognitive functioning and emotional stability which are critical components of resilience.[2] Heart rate variability (HRV), which is mediated by vagal fibers, reflects our capability for self‑regulation.[3] Improved physiological coherence modulates our response to challenges and our ability to bounce back to normalcy. The incidence of posttraumatic stress disorder has been found to be higher in soldiers with lower HRV than in those with a higher HRV exposed to the same combat‑related stress.[4]
Quantification of Potentially Traumatic Event and Resilience in Stress Stress scales are available which describe life events as life change units to offer a rough quantification of stress levels. The Holmes and Rahe Stress Scale was evolved and utilized to study the adverse effects of stress on health. Self‑perceived stress levels can also be used as a technique of quantification. The Depression Anxiety Stress Scale uses 42 self‑reported negative emotion states to quantify depression and anxiety. Measurement of physiological parameters such as skin temperature, blood pressure, and pulse rate offer objective insights into an individual’s stress responses. Levels of cortisol, the stress hormone, can be estimated from the hair to evaluate levels over a 60–90 days period.
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Techniques of Resilience Training The Comprehensive Soldier and Family Fitness program of the US army describes policies, procedures, and responsibilities for army resilience building and performance evaluation. The program was established by Gen George W Casey in 2008. It is focused on giving life skills to help individuals cope with adverse events and evolves through phases of self‑development, training, and evaluation.
Resilience Training in the Indian Navy Although there is no formal resilience training program, there are many opportunities that men can avail of to develop emotional, social, spiritual, and family strengths. The naval divisional system traditionally provides emotional support to young sailors while the Naval Wives Welfare Association provides a similar support system to families. Lectures and workshops on marital health and counseling of those whose relationships are under stress are a regular feature in all naval stations. The mental health program of the Indian Navy has brought in traditional methods to improve resilience building such as Yoga and Vipassana. These augment our ability to cope in stress situations.[5]
The Science and Art of Stress Regulation Stress regulation techniques including Yoga and Vipassana result in activation of positive emotions and improve our resilience capacity. Vipassana helps to control one’s physiology and mental responses by exploring the mind‑body technique. It involves mindfulness and appreciation of the nuances of one’s own breathing. Vipassana and Yoga have a proven beneficial impact on improving resilience. A study on flight simulator in 41 fighter pilots significantly lowered levels of frustration in those competent in self‑regulatory techniques.[6] In another study conducted on 69 students in an industrial area, it was observed that the students who underwent mindfulness training had significantly higher Five Factor Mindfulness Questionnaire scores at 8 weeks than baseline.[7] Relaxation techniques have a host of effects on a spectrum of physiological parameters. Significant metabolic benefits and blood pressure control effects have been documented.[8] Stress management is based on the premise that a person’s perceptions of his or her capabilities to manage stress is amenable to change. The ability to cope is enhanced by resilience training, and the stress response can be changed. Support systems in the family and organization are a force multiplier in resilience development. The role of social support systems in regulating anxiety and improving mental resilience has been amply illustrated by elegant neuroradiological documentation using functional magnetic resonance imaging.[9]
Autogenous training is a biofeedback technique which can help restore the balance between sympathetic and parasympathetic branches of the autonomic nervous system. In cognitive behavioral therapy, individuals are taught behavioral modification techniques which help them to break the vicious cycle of self‑prophesy of failure. Surg Vice Adm Alhad Anant Pawar, VSM, PHS Director General Medical Services, (Navy), New Delhi, India. E‑mail:
[email protected]
References 1. Windle M. Critical, conceptual and measurement issues in the study of resilience. Int J Occup Saf Ergon 1999;2:161-76. 2. McCraty R, Atkinson M, Tomasino D, Bradley RT. The coherent heart‑brain interactions, psychophysiological coherence and the emergence of system‑wide order. Integral Rev 2009b;5:10‑115. 3. Thayer JF, Hansen AL, Saus‑Rose E, Johnsen BH. Heart rate variability, prefrontal neural function, and cognitive performance: The neurovisceral integration perspective on self‑regulation, adaptation, and health. Ann Behav Med 2009;37:141‑53. 4. Ginsberg JP, Berry ME, Powell DA. Cardiac coherence and posttraumatic stress disorder in combat veterans. Altern Ther Health Med 2010;16:52‑60. 5. Tiller WA, McCraty R, Atkinson M. Cardiac coherence: A new, noninvasive measure of autonomic nervous system order. Altern Ther Health Med 1996;2:52‑65. 6. Li W, Chiu FC, Kuo YS. Wu KJ. The Investigation of Visual Attention and Workload by Experts and Novices in the Cockpit. In: Harris D, editor. Proceedings of the 10th International Conference on Engineering Psychology and Cognitive Ergonomics: Applications and Services. Heidelberg, Berlin: Springer; 2013. p. 167‑76. 7. Pawar AA, Panda JK, Bobdey S. Effectiveness of mindfulness based mental fitness training: An impact evaluation study. Int J Res Med Sci 2016;4:3433‑9. 8. Alabdulgader AA. Coherence: A novel nonpharmacological modality for lowering blood pressure in hypertensive patients. Glob Adv Health Med 2012;1:56‑64. 9. Maresh EL, Beckes L, Coan JA. The social regulation of threat‑related attentional disengagement in highly anxious individuals. Front Hum Neurosci 2013;7:515. This is an open access article distributed under the terms of the Creative Commons Attribut ion‑NonCommercial‑ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non‑commercially, as long as the author is credited and the new creations are licensed under the identical terms. Access this article online Quick Response Code:
Website: www.marinemedicalsociety.in
DOI: 10.4103/jmms.jmms_46_17
How to cite this article: Pawar AA. Resilience training for armed forces personnel: Need of the hour. J Mar Med Soc 2017;19:4-5.
Journal of Marine Medical Society ¦ Volume 19 ¦ Issue 1 ¦ January-June 2017
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