Leader's Manual for Combat Stress Control

 FM 22-51

CHAPTER 1: Overview of Combat Stress Control

1-1. Introduction
This chapter presents the concept and scope of combat stress control. It reviews historical experiences with stress casualties in different intensities of conflict and looks et the potential stressors in high-tech battles. It lists the responsibilities for combat stress control of all junior (direct) and senior (organizational) leaders, staffs, chaplains, and health care providers. It also discusses the responsibilities of specialized combat stress control/ mental health personnel.

Battle fatigue and misconduct stress behaviors are preventable with strong effective leadership.

1-2. Combat Stress Control
a. Controlling combat stress is often the deciding factor-the difference between victory and defeat-in all forms of human conflict. Stressors are a fact of combat and soldiers must face them. It is controlled combat stress (when properly focused by training, unit cohesion, and leadership) that gives soldiers the necessary alertness, strength, and endurance to accomplish their mission. Controlled combat stress can call forth stress reactions of loyalty, selflessness, and heroism. Conversely, uncontrolled combat stress causes erratic or harmful behavior that disrupts or interferes with accomplishment of the unit mission. Uncontrolled combat stress could impair mission performance and may bring disgrace, disaster, and defeat.

b. The art of war aims to impose so much stress on the enemy soldiers that they lose their will to fight. Both sides try to do this and at times accept severe stress themselves in order to inflict greater stress on the enemy. To win, combat stress must be controlled.

c. The word control has been chosen deliberately to focus thinking and action within the Army. Since the same word may have contrasting connotations to different people, it is important to make its intended meaning clear. The word control is used (rather than the word management) to emphasize the active steps which leaders, supporting personnel, and individual soldiers must take to keep stress within the acceptable range. This does not mean that control and management are mutually exclusive terms. Management is, by definition, the exercise of control. Within common usage, however, and especially within Army usage, management has the connotation of being a somewhat detached, number-driven, higher echelon process rather than a direct, inspirational, leadership process.

d. Stress is the body's and mind's process for dealing with uncertain change and danger. Elimination of stress is both impossible and undesirable in either the Army's combat or peacetime missions.

e. The objectives of stress control are as follows:

(1) To keep stress within acceptable limits for mission performance and to achieve the ideal (optimal) level of stress when feasible.

(2) To return stress to acceptable limits when it becomes temporarily disruptive.

(3) To progressively increase tolerance to stress so that soldiers can endure and function under the extreme stress which is unavoidable in combat.

f. How can stress be controlled? Stress is controlled in the same ways other complex processes are controlled.

(1) Monitor the signs of stress and recognize when and if they change. To be effective, this recognition should come well before the stress becomes disruptive and causes dysfunction.

(2) Identify and monitor the causes of stress; that is, the stressors. Stress and stressors are defined in detail in Chapter 2.

(3) Classify the stressors into those which can be controlled (increased, decreased, avoided, or otherwise changed) versus those which cannot be controlled.

(4) Control those stressors which can be changed by focusing the stress in the desired direction, either up or down.

(5) Help soldiers adapt to the stressors which cannot be changed.

(6) Learn (and teach) how to directly lower (or raise) the stress level within the individual soldier as needed, at specific times, in specific situations.




Chapter 1: Overview of Combat Stress Control

Chapter 2: Stress and Combat Performance

Chapter 3: Positive Combat Stress Behaviors

Chapter 4: Combat Misconduct Stress Behaviors

Chapter 5: Battle Fatigue

Chapter 6: Post-Traumatic Stress Disorder

Chapter 7: Stress Issues in Army Operations

Chapter 8: Stress and Stressors Associated with Offensive/Defensive Operations

Chapter 9: Combat Stress Control in Operations Other than War

Chapter 10: War and the Integrated (Nuclear, Biological, and Chemical) Battlefield

Chapter 11: Prevention of Battle Fatigue Casualties and Misconduct Stress Behaviors

Appendix A: Leader Actions to Offset Battle Fatigue Risk Factors

Appendix B: Organization and Functions of Army Medical Department Combat Stress Control Units

Appendix C: United States Army Bands

Appendix D: The Unit Ministry Team's Role in Combat Stress Control and Battle Fatigue Ministry

Appendix E: Example Lesson Plan





Washington, DC, 29 September 1994

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