8-11. Application of Psychological First Aid

Table of Contents

The emotionally disturbed service member has built a barrier against fear. He does this for his own protection, although he is probably not aware that he is doing it. If he finds that he does not have to be afraid and that there are normal, understandable things about him, he will feel safer in dropping this barrier. Persistent efforts to make him realize that you want to understand him will be reassuring, especially if you remain calm. Nothing can cause an emotionally disturbed person to become even more fearful than feeling that others are afraid of him. Try to remain calm. Familiar things, such as a cup of coffee, the use of his name, attention to a minor wound, being given a simple job to do, or the sight of familiar people and activities, will add to his ability to overcome his fear. He may not respond well if you get excited, angry, or abrupt.

• a. Ventilation. After the service member becomes calmer, he is likely to have dreams about the stressful event. He also may think about it when he is awake or even repeat his personal reaction to the event. One benefit of this natural pattern is that it helps him master the stress by going over it just as one masters the initial fear of parachuting from an aircraft by doing it over and over again. Eventually, it is difficult to remember how frightening the event was initially. In giving first aid to the emotionally disturbed service member, you should let him follow this natural pattern. Encourage him to talk. Be a good listener. Let him tell, in his own words, what actually happened. If home front problems or worries have contributed to the stress, it will help him to talk about them. Your patient listening will prove to him that you are interested in him, and by describing his personal problem, he can work at mastering his fear. If he becomes overwhelmed in the telling, suggest a cup of coffee or a break. Whatever you do, assure him that you will listen again as soon as he is ready. Do try to help put the service member’s perception of what happened back into realistic perspective; but DO NOT argue about it.
• b. Activity.
• • (1) A person who is emotionally disturbed as the result of a combat action is a casualty of anxiety and fear. He is disabled because he has become temporarily overwhelmed by his anxiety. A good way to control fear is through activity. Almost all service members, for example, experience a considerable sense of anxiety and fear while they are poised, awaiting the opening of a big offensive; but this is normally relieved, and they actually feel better once they begin to move into action. They take pride in effective performance and pleasure in knowing that they are good service members, perhaps being completely unaware that overcoming their initial fear was their first major accomplishment.
  • (2) Useful activity is very beneficial to the emotionally disturbed service member who is not physically incapacitated. After you help a service member get over his initial fear, help him to regain some selfconfidence. Make him realize his job is continuing by finding him something useful to do. Encourage him to be active. Get him to help load trucks, clean up debris, or dig fighting positions. If possible, get him back to his usual duty. Seek out his strong points and help him apply them. Avoid having him just sit around. You may have to provide direction by telling him what to do and where to do it. The instructions should be clear and simple and should be repeated. A person who has panicked is likely to argue. Respect his feelings, but point out more immediate, obtainable, and demanding needs. Channel his excessive energy and, above all, DO NOT argue. If you cannot get him interested in doing more profitable work, it may be necessary to enlist aid in controlling his overactivity before it spreads to the group and results in more panic. Prevent the spread of such infectious feelings by restraining and segregating if necessary.
  • (3) Involvement in activity helps a service member in three ways; he —
  • • • Forgets himself.
    • • Has an outlet for his excessive tensions.
    • • Proves to himself he can do something useful.
• c. Rest. There are times, particularly in combat, when physical exhaustion is a principal cause for emotional reactions. A unit sleep plan should be established and implemented. When possible, service members should be given a safe and relatively comfortable area in which to sleep. Examples would be an area away from heavy traffic, noise, and congestion or a place that is clean and dry and protected from environmental conditions. The more uninterrupted sleep a service member gets the better he will be able to function in the tactical environment.
• d. Hygiene. Field hygiene is an important ingredient in a service member’s morale. A service member who is dirty and unkempt will not function as well as a service member who has had the opportunity to bathe and put on clean, dry clothing. During combat, unit leaders should stress the importance of personal hygiene. Good personal hygiene not only improves morale, it also is a preventive measure against disease and nonbattle injury (DNBI).
• e . Group Activity. You have probably already noticed that a person works, faces danger, and handles serious problems better if he is a member of a closely-knit group. Each service member in the team supports the other team members. Esprit de corps is built because the service members have the same interests, goals, and mission, and as a result they are more productive; furthermore, they are less worried because everyone is involved. It is this spirit that takes a strategic hill in battle. It is so powerful that it is one of the most effective tools you have in your psychological first aid bag. Getting the service member back into the team or squad activities will reestablish his sense of belonging and security and will go far toward making him a useful member of the unit.