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Preparing for the worst – building resilience in soldiers going into war

 

Enhancing soldier resilience through comprehensive mental skills training, particularly focusing on preventive measures, is crucial for facing the challenges of warfare. A collaboration between the Norwegian armed forces and Walter Reed Institute of Research (WRAIR) has provided a resilience training program for Ukrainian medics that underscores NATO's leadership in modern warfare's mental skills training.



The role of mental skills training in Ukrainian military personnel


As a commander of the military branch of the Institute of military psychiatry and stress handling (IMPS), in the Norwegian Armed Forces Joint Medical Services, I try to "Solve the mission and take care of my people." That is what we as leaders and employees of the armed forces must do in peacetime, in crisis and war. As licensed psychologists and psychiatrists, our focus has always been helping people after they sustain an injury or mental illness. Recently there has been a new branch in our line of work that deals with prevention, using systematic psychological tools.


Military psychiatry and psychology


Military psychiatry and psychology in Norway in the recent years, have been more focused on preventive psychological measures. We try to bolster the soldier’s resilience by teaching mental techniques to reduce combat stress. In certain terms, we can claim that the focus has switched from repairing injuries after they occur, like traditional psychiatric post-trauma treatment of PTSD, to preventive measures. This shift in focus has been accelerated after the breakout of the largest scale military conflict seen in Europe after the second world war. Both the civilian and the military population go through intense war traumas daily. This tests and stresses the important of both civilian and military resilience. The goal is to get as many soldiers as possible ready and fit for duty. Norwegian support to Ukraine is top priority, as defined by our chief of defense and surgeon general of the medical branch. In that way we provide not only material (weapons, ammunition, and money) but also psychological support for the war-torn country of Ukraine.


Hardship of war


In the realm of warfare, soldiers face unparalleled challenges that demand not only physical prowess but also requires a robust mental fortitude. Robustness can be described as more inherent and in some cases more genetically based, compared to resilience which is a trainable skill. Institute for military psychiatry and stress handling (IMPS), is currently recognizing the pivotal role of training mental resilience in combat. Preliminary reports hints to the efficacy of such training in real combat scenarios, even if scientific evidence remains uncertain, as soldiers confront adversities ranging from the loss of comrades to prolonged psychological stress without the buffer of support units.


A collaboration between the Norwegian armed forces and Walter Reed Institute of Research (WRAIR) has provided a resilience training program for Ukrainian medics that underscores NATO's leadership in modern warfare's mental skills training. Image by Cameron E. Parks for U.S. Army (wrair.health.mil).
A collaboration between the Norwegian armed forces and Walter Reed Institute of Research (WRAIR) has provided a resilience training program for Ukrainian medics that underscores NATO's leadership in modern warfare's mental skills training. Image by Cameron E. Parks for U.S. Army (wrair.health.mil).

Training Ukrainian combat medics


The ongoing conflict in Ukraine has provided a unique opportunity for the Research division of IMPS, in the Norwegian Army’s joint medical services, in collaboration with Walter Reed Army Institute of Research (WRAIR), to develop a resilience training program tailored to the needs of Ukrainian soldiers. Since the onset of Russia's invasion in 2022, NATO forces have been rotating through Eastern Europe, not only to bolster regional security but also to train Ukrainian troops in various military competencies. Operation Gungne, initiated by the Norwegian Armed Forces, has been instrumental in providing specialized courses for Ukrainian infantry, including combat medic training. ORT is a mandatory part of the combat medics tool and skillset.


Recognizing the pivotal role of combat medics, who often serve as the primary medical resource in frontline operations, the training curriculum places significant emphasis on equipping them with mental skills to manage combat stress effectively. Drawing insights from the Walter Reed Army Institute of Research, and IMPS from the Norwegian Armed Forces, medical division have developed modules addressing combat stressors, active listening techniques, and interventions for managing acute stress reactions.


The training encompasses a holistic approach, addressing physical, emotional, cognitive, and behavioral responses to stress. Techniques such as postponing worry, grounding exercises, deliberate breathing, and self-talk are imparted to medics to maintain a psychological equilibrium and in some cases enhance their performance before, during, and after missions.


Drill to counter acute stress reaction


Moreover, soldiers are trained in iCOVER, a peer-based intervention aimed at assisting unit members in managing acute stress reactions. The iCOVER strategy originated with the Israel Defense Forces (IDF), where the strategy is mandatory training for all soldiers. The drill is designed to help soldiers get their peers out of an Acute Stress Reaction on the battlefield. This type of psychological reaction can disable the soldier even though he is not injured physically.


In the Norwegian Operative Resilience Training, we call this drill RESTART. The goal is to save lives on the battlefield, as the potential gains in a real combat situation is to get not only the person who has an ASR back into action, but also the person having to tend to him.


Unit cohesion


Unit cohesion is another module, designed to foster team cooperation. Unit cohesion is paramount in combat scenarios, where effective communication and trust are essential for mission success. To this end, the training curriculum includes modules focusing on building team cohesion, conflict resolution, and rapid cohesion establishment—critical considerations for units mobilizing in volatile environments like Ukraine.


While the core training modules are adapted from existing programs, the U.S.-Norwegian collaboration has introduced specialized modules addressing stressors unique to Ukrainian soldiers. These modules, centered on managing human remains and coping with relentless grief, provide soldiers with practical strategies to navigate the emotional challenges of warfare.


In the realm of warfare, soldiers face unparalleled challenges that demand not only physical prowess but also requires a robust mental fortitude. Image by Mike Walters for U.S. Army (wrair.health.mil).
In the realm of warfare, soldiers face unparalleled challenges that demand not only physical prowess but also requires a robust mental fortitude. Image by Mike Walters for U.S. Army (wrair.health.mil).

Field exercises


Field exercises serve as a platform for reinforcing classroom learning, allowing soldiers to apply their newfound skills in simulated combat scenarios. Feedback from Ukrainian soldiers underscores the efficacy of the training, with a significant increase in confidence reported in managing stress reactions and supporting fellow unit members.


Technological developments happen more rapid in war, as is known from many an armed conflict. Now the trenches dug in Ukraine, like the first world wars trench warfare, are the forefront of development of technology today. Not only is this development consistent on offence and defense, exemplified by unmanned drones, but also the systematic buildup of the soldier’s resilience and fortitude. The advantage of the human and mental “technology” is that it can potentially be utilized on the civilian population as well, possibly making the Ukrainian people more robust to handle everyday tragedy and brutality.


Mental skills in military training


The success of the current ORT program underscores the importance of integrating mental skills into military training, with lessons learned serving as a blueprint for future initiatives. Collaborative efforts with allies like the US and Ukraine not only enhance soldier resilience but also position NATO at the forefront of mental skills training in modern warfare. As warfare evolves, the imperative to equip soldiers with the psychological tools to adapt and thrive becomes increasingly evident, underscoring the importance of ongoing research and innovation in this domain. Norwegian resilience training is becoming an attractive export of human technology, not only for the Ukrainians currently needing this daily, but it is wanted for our close partner nations in NATO and the US to build the future generations of resilient soldiers. □

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