Developing “mental toughness”

  • Published
  • By Dr. (Lt. Col.) Jeffrey J. Freeland
  • 49th Aerospace Medicine Squadron commander
The Department of Defense and the U.S. Air Force have been investing millions of dollars and manpower to help prepare warriors for the stress and mental fatigue of deployment. The Air Force uses deployment resiliency programs to help Airmen understand and cope with the mental and physical strains of stress in combat situations.

These programs are preventive efforts designed to minimize long-term mental health issues like post-traumatic stress disorder. However, it doesn't take a war to be exposed to high stress and traumatic situations.

Modern everyday life in the Air Force can be a recurring source of stress. Traumatic events like motor vehicle accidents, major injuries or illnesses, and the loss of loved ones are much more common in the lives of Airmen than in combat.

As many as 4.7 percent of warriors returning from Operation Iraqi Freedom report one or more PTSD symptoms, and one percent go on to be diagnosed with PTSD. The national prevalence of PTSD is eight percent, and among trauma victims it can be as high as 20 to 30 percent.

As Airmen, we can use many of the same preventive mental techniques used to train modern warriors to deal with the high-paced stress of combat to deal with everyday stress and trauma on station and develop a long-term "mental toughness."

"Mental toughness" is a process of dealing with stress that helps minimize its impact in our lives and prevent emotional events from progressing to physical disease. Those with "mental toughness" recognize that stress will cause physical and mental symptoms, but these symptoms are recognized as a normal part of the stress response and healthy coping mechanisms.

"Mental toughness" does not mean we don't cry, feel sad, feel anxious or feel inadequate; it does mean that we learn to cope with these feelings and move on. No matter how powerful an aircraft is in the air, properly-functioning landing gear is necessary to safely launch and recover. All Airmen must be able to recognize the signs of stress and know when to seek help. Effective risk recognition and help-seeking are the functional equivalent of landing gear or "mental toughness" for an Airman.

The first step to achieve "mental toughness" is good general health and nutrition. Dealing with stress is exponentially more difficult if we are not remaining physically fit, achieving adequate sleep, or maintaining a healthy diet. Regular exercise boosts endorphins and builds physical reserve.

When we regularly stress our bodies physically during exercise, we are better able to deal with unexpected physical and emotional trauma. Sleep deprivation significantly lowers our mental and emotional defenses against stress. Even the toughest warrior becomes irritable, less attentive, and cognitively impaired without sleep. Good nutrition gives us the fuel to effectively deal with adverse events.

The second step to build "mental toughness" is pre-exposure preparation. Adversity is part of life; we know stressful events are going to happen. Running mental exercises on how we would respond to potential life-changing disasters helps prepare our minds to deal with adversity.

It gives us a frame of reference to build upon questions, including:
· How would you respond if you were in a motor vehicle accident or natural disaster?
· How would you deal with the death of a loved one?
· Do you have a plan to deal with a prolonged illness or disability?
· How would you deal with any unforeseen setbacks or rebukes in your professional career?
· What would you do if you lost your job? How would you cope emotionally, physically or spiritually?

These types of mental exercises are not pleasant, but they give us a preview of the emotional and physical responses we may need to endure in a crisis and it allows us to prepare to meet these challenges before crisis develops. Pre-exposure preparation will not prevent stress and emotional pain, but it will help us better adapt and cope with situations with agility and less long-term impact.

Third, avoid falling into the trap of the "victim mentality." Always blaming others for your misfortune is a poor coping mechanism. Feelings of victimization lead you to ignore areas where you have control or responsibility. "Victim mentality" focuses on self pity and not on solutions. Be willing to accept responsibility and focus on what you can control. Avoid feelings that suggest someone else is to blame and shun the notion that your government, institutions, or family should solve your problems for you. Taking responsibility for your life builds self confidence, self reliance, and "mental toughness."

Fourth, know the typical reactions to stress and emotional trauma. When people are exposed to high stress they often exhibit symptoms that are normal and helpful in dealing with crises, but if these symptoms persist or are not addressed, they can progress into prolonged mental and physical manifestations.

Stress isn't always bad. In small doses, it can help you perform under pressure and motivate you to do your best. But when you're constantly running in emergency mode, your mind and body pay the price. Normal responses to stress include anxiety, increased heart rate, elevated blood pressure, sweating, hyper-alertness, mild nausea, and lightheadedness. These physical changes increase your strength and stamina, speed up your reaction time, and enhance your focus - preparing you to either fight or flee from the danger at hand.

If stress-coping mechanisms are poor, these symptoms can progress into chronic irritability, digestive problems, poor concentration, sleep disorders, chest pain, eating disorders, hypertension, depression, and PTSD. Stress can also make it difficult for us to deal with pain issues.

Poor stress coping mechanisms include:
· Procrastination
· Over eating
· Smoking
· Blaming others
· Withdrawal
· Anger
· Nail biting

Good coping mechanisms include:
· Learning to set limits and say "no" when appropriate
· Channel energies toward hobbies or exercise
· Develop relaxation techniques
· Help others or volunteer
· Call a friend or wingman
· Go for a walk

Fifth, being mentally tough does not mean you do not seek help. On the contrary, those with good mental toughness are acutely aware of helpful resources. "Mental toughness" means you have the self confidence to ask for help when needed.

Sources of help include:
· Mental health clinic
· Stress reduction classes
· Chaplain
· Co-workers, wingmen
· Airmen and Family Readiness Center
· Physician
· Commanders, first sergeants
· Legal, finance, security forces services

Things that influence your stress tolerance level
· Your support network - A strong network of supportive friends and family members is an enormous buffer against life's stressors. On the flip side, the more lonely and isolated you are, the greater your vulnerability to stress.
· Your sense of control - If you have confidence in yourself, the ability to influence events and perseverance through challenges, it's easier to take stress in stride. People who are vulnerable to stress tend to feel like things are out of their control.
· Your attitude and outlook - Stress-hardy people have an optimistic attitude. They tend to embrace challenges, have a strong sense of humor, accept that change is a part of life, and believe in a higher power or purpose.
· Your ability to deal with your emotions - You're extremely vulnerable to stress if you don't know how to calm and soothe yourself when you're feeling sad, angry or afraid. The ability to bring your emotions into balance helps you bounce back from adversity.
· Your knowledge and preparation - The more you know about a stressful situation, including how long it will last and what to expect, the easier it is to cope. For example, if you go into surgery with a realistic picture of what to expect post-op, a painful recovery will be less traumatic than if you were expecting to bounce back immediately.

Learn to develop your "mental toughness." Combat is not the only source of stress in an Airman's career. Developing a comprehensive approach is your best defense. Am I in control or is stress controlling me? Know the resources that can help you deal with stress and have the courage to use them.