Operational Stress Control and Reintegration

1. Operational Stress Control and Reintegration FACILITATOR’S NAME DATE

2. Objectives • Recognize the type and scope of issues impacting reintegration for Service Members, family members, and others. • Identify helpful tools and resources for coping with the challenges of reintegration. • Facilitate a successful transition for yourself and/or your loved ones.

3. Goals of Reintegration • Reentry into pre-deployment life or into a new civilian life. • History has taught us reunions are more stressful than separations. Why do you think that is?

4. Seeing Others Perspective • Positive and negative feelings - • Part 1 – Service Member • Part 2 – assigned individual

5. Service Member Perspective • All Service Members • Sense of relief • Proud of accomplishment • Happiness • Contentment • Financial worries • Loss of freedom • Work reunion • Irritability, Guarded • Resentment • Overwhelmed • Frustration • Married Service Members • Wonder how spouse may have changed • Wonder how the children will react • Possible loss of importance to the family • Single Service Members • Wanting to reestablish living situation • Social Life/ Significant other • Changes in friends • Often overlooked!

6. Spouse Perspective • Relieved! • Proud of accomplishment • Excitement • Apprehension • Appreciation • Supportive • Comfortable • Elation • Wonder how they are perceived by returning spouse • Loss of freedom • Wonder how will children react • Stability of relationship • Possible resentment • Nervousness • Restlessness • Irritability • Anxiousness • Role confusion

7. Child Perspective • Happy! • Excited • Hesitant • Shy • Anticipation • Possibly resentful • Wonder if Dad/Mom will leave again • Clinging • Will want to “talk your ear off” • Worry about how things will change • Anger • Confusion • Fear, Scared • Regression Remember kids are still developing!

8. Extended Family Perspective • Relieved! • Proud of accomplishment • Excitement • Apprehension • Appreciation • Supportive • Comfortable • Elation • Possibly resentful • Overwhelmed • Frustration • Readjustment • Nervousness • Anxiousness

9. Co-Worker Perspective • Happy … friend returns • Relieved due to more help • Excitement • Anticipation • Possibly resentful • Feel under appreciated • Change in work roles • Personnel changes • Readjustment

10. Considering Different Perspectives • Be Realistic! • Show appreciation to and for each other • Respect changes that have occurred • Allow for dedicated couple / children time • Reestablishing intimacy • Avoid the “who had it worse” game • Communication and Patience are the Key !

11. Environment Thinking/Feeling Aggressive Driving Aggression Control Hyper-vigilance Traffic Crowds Money Alcohol Security Boredom Routine Disillusion Thrill Seeking Irritability Anger Guilt Shame Hatred Relationships Spirituality Spouse Children Friends Growth Change Conflict Irritability Anger Detachment Withdrawal Control Understanding Why Loss of Trust in Others Loss of Trust in Self Loss of Trust in higher power Common Areas of Stress

12. Caregiver Responsibility Stress Continuum Model • Good to go • Well trained • Prepared • Fit and focused • Cohesive units & ready families • Ready to go! • Mild and temporary distress or impairment • Anxious, irritable, or sad • Physical or behavioral changes • Mild and reversible! • More severe or persistent distress or impairment • May leave lasting memories, reactions, and expectations • Temporarily non-mission ready! • Stress injuries that don’t heal without help • Symptoms persist for >60 days, get worse, or initially get better and then return worse • Only diagnosed by health professionals! Unit Leader Responsibility Individual, Service Member, Family Responsibility

13. Stress Reaction vs Stress Injury Stress Reactions Stress Injuries • Common • Always temporary • Mild distress or loss of function • Self-correcting • Less common • May leave a scar • More severe distress or loss of function • May heal faster with help

14. Stress Injuries Stress injuries are wounds to the mind or brain caused by intense or prolonged stress. These have four possible causes and associated results:

15. Green Ready Zone Reacting SM Reacting Families Stress Reduction • Good to go • Ready, prepared for deployment • Functioning OK socially, spiritually, vocationally • Sleeping, eating right • Sense of humor • In control • Good to go • Trained, prepared • Calm, steady • Confident, competent, in control • Sleeping, eating right • Active socially, spiritually • Getting job done • Retain good coping skills • Remain calm, steady, confident • Eat healthfully, exercise regularly • Get proper sleep • Keep sense of humor • Remain active socially, spiritually

16. Yellow Reacting Zone Reacting SM Reacting Families Stress Reduction • Spending time with family or friends • Adequate exercising, sleeping • Getting outside • Manage home front stressors • Discuss issues with others • Children having trouble in school • Fighting more amidst siblings • Couple not communicating effectively • Loss of interest in normal activities • Reduced intimacy • Anxious or irritable • Feeling anxious, irritable, worrying • Cutting corners on the job • Poor diet or trouble sleeping • Apathy, loss of interest • Poor focus • Short tempered • Keeping to self

17. Orange Injured Zone Reacting SM Reacting Families Stress Reduction • Seek assistance • Spending time with family or friends • Adequate exercising, sleeping • Getting outside • Keep safe and calm • 24-72 hr rest and recuperation • Refer to chaplain • Provide and seek social support • Children having failing grades and discipline problems at school and/or home • Reduced intimacy • Feeling of chaos • Constant fighting • Silence/no communication • Verbal or physical abuse • Can’t sleep, disruptive nightmares • Loss of control • Can’t fall or stay asleep • Recurrent vivid nightmares • Intense guilt or shame • Attacks of panic or rage • Inability to enjoy activities • Disruption of moral values • Serious suicidal or homicidal thoughts

18. Red Ill Zone Reacting SM Reacting Families Stress Reduction • Symptoms that • last for more than 60 days • get worse over time instead of better • get better for awhile but then come back worse • PTSD, major depression, certain anxiety disorders, substance abuse • Persistent stress or loss of function • Stress gets worse instead of better • Stress lasting several weeks • Serious suicidal behavior • Uncharacteristic outbursts of rage or panic • Inability to control emotions • Refer for medical evaluation • Assist treatment compliance • Provide social support • Mentor back to unit if possible • Reintegrate with unit • Get caregiver assistance

19. Caregiver Responsibility Appropriate Interventions • Where on the continuum did you place your individual? • What signs or symptoms led you to choose that zone? • What types of intervention may be needed to help this individual move to the Green/Ready zone? Unit Leader Responsibility Individual, Service Member, Family Responsibility

20. Caregiver Responsibility Get to Green The Goal is to move towards GREEN Unit Leader Responsibility Individual, Service Member, Family Responsibility

21. Barriers to Successful Integration • Avoidance • Numbing and withdrawal • Response to intense emotions • Response to shame and guilt • Alienation • From those who had not shared their experience • Feeling of being misunderstood • Personal Meaning • Unique effect of traumatic event • Keep this in mind: Everyone experiences deployments differently. Deployments can and have changed people for the better. Its okay to be different and it makes you special.

22. Assistance is Available • Each Service Member’s military experience and self concept are unique. • To feel good about themselves, veterans must continue to feel like honourable warriors. • Not all stress problems are mental illnesses. • Not all stress problems are PTSD. • You are not alone. • Where do you get help? Other Service Members, family member, friend, command leadership, Chaplain, doctor, nurse or other medical staff member, counselor ….

23. Objectives • Recognize the type and scope of issues impacting reintegration for Service Members, family members, and others. • Identify helpful tools and resources for coping with the challenges of reintegration. • Facilitate a successful transition for yourself and/or your loved ones.

24. Operational Stress Control and Reintegration FACILITATOR’S NAME DATE