Brain Function under high Stress

[WillBrink]

My info on the topic not nearly as in depth as others have posted here, but some brief thoughts that may be value added to what's in this thread already:

Your Brain On Stress

I'd be interested to hear others opinion of the info as posters in this thread are clearly well read on the topic.

A doc I'll recommend is: "Assessment of Humans Experiencing Uncontrollable Stress: The SERE Course" by Dr. C.A. Morgan III and Major Gary Hazlett, 2000 Edition of the The Professional Bulletin of the John F. Kennedy Special Warfare Center and School

I found the above interesting info

[Arctic1]

I think your article touches on some key points, some of which have been mentioned here. It all boils down to training:

-How training is conducted
-Progression of training

If you don't add any stress during training, you will not be used to it when it happens for real. Stress factors can be anything from accuracy standards, time standards, actions that must be completed to pass, to doing combatives before shooting a drill, or running, doing push-ups etc before shooting.

If your training does not progress, ie only shoot double taps in 4 seconds with ok accuracy, then you won't perform to a better standard when faced with a stressful situation.

Something that I also agree with in your article, is that the better physical shape you are in the more able you are to cope with the stress of a real situation, and better able to utilize cognitive processes during stress.

One example of how stress during training helped me out:

I mentioned performing tactical field care on a pt earlier. I experienced tunnel vision (I was VERY focused on what I was doing) as well as sense of time distortion (I thought I spent 2 hours with the pt, turned out the MEDEVAC arrived after 45 mins).

Anyways, before my deployment I spent 3 weeks at ISTC ( International Special Training Center, in Pfüllendorf Germany) attending their Patrol Medical Course (now called Advanced Medical First Responders (AMFR) Course). One of the instructors was an 18D, and he was extremely adamant about the standards he expected from us. There was no half assing it.

We had 4 scored moulages, 4 scored theory tests, as well as a final moulage and final theory exam. You needed to have a score of 70% or better to pass the course. If you did not have an average of 70% when the first week was done, you were sent home. If you were not at 70% after week two, you were allowed to complete the course but would not get a pass. For each moulage, there were specific tasks or actions you had to complete in order to get a pass.

One of these tasks was to establish an IV on the pt (except one case where circulation was sufficient). If you failed getting the IV in, in two tries, you got an automatic 60% and failed the clinic. This was all done in front of your peers in the group, inside in hot, small rooms, with full gear on. We also had a time limit to complete the survey of the pt. Combine this with the stress of failing the course and beeing sent home, or failing and not get a pass, it was quite stressful. I don't know how elevated my pulse was, but I would imagine it was pretty high even though I barely moved during these moulages.

Back to the pt. When I was establishing an IV on this guy, a slightly heavy-set ANA soldier with veins that were difficult to locate in pretty bad shape, I clearly remember being as calm as I have ever been. Easiest puncture I have ever done. It was extremely more stressful establishing IV's during the Patrol Medic Course, than doing it on a live pt.

I believe that the standards established by this SF medic, and the stress experienced by fearing I would fail, really helped me in building my skills as a medic, and applying them in less than ideal situations.


Maybe a poor example, but it illustrates how applying various stress factors affected us during training and how that training was successfully applied in real life.
------------------------------------------

And to a subject touched on in the article posted by 26 Inf, namely cognitive ability under stress (football players). I strongly disagree with the notion that we are not able to apply cognitive processes to our decision making under stress. Sure, we might develop some kind of intuitive ability by training the way we do, but being in a fire-fight cleary involves decision making that is the result of our cognitive ability. No one can assault an enemy position with coordinated fire and maneuver on intuition or some unconscious cues.

[WillBrink]

I think your article touches on some key points, some of which have been mentioned here. It all boils down to training:

-How training is conducted
-Progression of training

If you don't add any stress during training, you will not be used to it when it happens for real. Stress factors can be anything from accuracy standards, time standards, actions that must be completed to pass, to doing combatives before shooting a drill, or running, doing push-ups etc before shooting.

If your training does not progress, ie only shoot double taps in 4 seconds with ok accuracy, then you won't perform to a better standard when faced with a stressful situation.

Something that I also agree with in your article, is that the better physical shape you are in the more able you are to cope with the stress of a real situation, and better able to utilize cognitive processes during stress.

One example of how stress during training helped me out:

I mentioned performing tactical field care on a pt earlier. I experienced tunnel vision (I was VERY focused on what I was doing) as well as sense of time distortion (I thought I spent 2 hours with the pt, turned out the MEDEVAC arrived after 45 mins).

Anyways, before my deployment I spent 3 weeks at ISTC ( International Special Training Center, in Pfüllendorf Germany) attending their Patrol Medical Course (now called Advanced Medical First Responders (AMFR) Course). One of the instructors was an 18D, and he was extremely adamant about the standards he expected from us. There was no half assing it.

We had 4 scored moulages, 4 scored theory tests, as well as a final moulage and final theory exam. You needed to have a score of 70% or better to pass the course. If you did not have an average of 70% when the first week was done, you were sent home. If you were not at 70% after week two, you were allowed to complete the course but would not get a pass. For each moulage, there were specific tasks or actions you had to complete in order to get a pass.

One of these tasks was to establish an IV on the pt (except one case where circulation was sufficient). If you failed getting the IV in, in two tries, you got an automatic 60% and failed the clinic. This was all done in front of your peers in the group, inside in hot, small rooms, with full gear on. We also had a time limit to complete the survey of the pt. Combine this with the stress of failing the course and beeing sent home, or failing and not get a pass, it was quite stressful. I don't know how elevated my pulse was, but I would imagine it was pretty high even though I barely moved during these moulages.

Back to the pt. When I was establishing an IV on this guy, a slightly heavy-set ANA soldier with veins that were difficult to locate in pretty bad shape, I clearly remember being as calm as I have ever been. Easiest puncture I have ever done. It was extremely more stressful establishing IV's during the Patrol Medic Course, than doing it on a live pt.

I believe that the standards established by this SF medic, and the stress experienced by fearing I would fail, really helped me in building my skills as a medic, and applying them in less than ideal situations.


Maybe a poor example, but it illustrates how applying various stress factors affected us during training and how that training was successfully applied in real life.
------------------------------------------

And to a subject touched on in the article posted by 26 Inf, namely cognitive ability under stress (football players). I strongly disagree with the notion that we are not able to apply cognitive processes to our decision making under stress. Sure, we might develop some kind of intuitive ability by training the way we do, but being in a fire-fight cleary involves decision making that is the result of our cognitive ability. No one can assault an enemy position with coordinated fire and maneuver on intuition or some unconscious cues.

Great info and feedback, thanx.

[pingdork]

A sympathetic response can entail any combination of the following physiological reactions:

• Acceleration of heart and lung action
• Paling or flushing, or alternating between both
• Inhibition of stomach and upper-intestinal action to the point where digestion slows down or stops
• General effect on the sphincters of the body
• Constriction of blood vessels in many parts of the body
• Liberation of metabolic energy sources (particularly fat and glycogen) for muscular action
• Dilation of blood vessels for muscles
• Inhibition of the lacrimal gland (responsible for tear production) and salivation
• Dilation of pupil (mydriasis)
• Relaxation of bladder
• Inhibition of erection
• Auditory exclusion (loss of hearing)
• Tunnel vision (loss of peripheral vision)
• Disinhibition of spinal reflexes
• Shaking

Here is a link describing the chemical process:

http://learn.genetics.utah.edu/conte.../fight_flight/

One of the more common discussion topics in regards to performance under stress is the notion that fine motor skills are lost, and that you can only use gross motor skills. This is completely untrue.

Now I have experienced some of these physiological symptoms during times of high stress. Mainly tunnel vision,loss of hearing, face turns bright red during the event, and violent shaking and urges to defecate afterwards. Is it possible to train away these phys responses?

[Arctic1]

It is, to my knowledge, not possible to train away these physiological responses. They are triggered by a system that we have no influence over, and the effects are helpful to us.

[Neville]

The huge misconception in the training community is that humans can learn new things under stress. It makes no sense to show students
a drill, have them repeat it 3-4x and then "test" it. That is an invitation for failure. And often Stress Inoculation Training (SIT) is cited as a
reason for this- which is 100% nonunderstanding of what SIT is:

http://www.apa.org/divisions/div12/r...it_stress.html

In order to enhance individuals' coping repertoires and to empower them to use already existing coping skills, an overlapping three
phase intervention is employed. In the initial conceptualization phase a collaborative relationship is established between the clients and the therapist
(trainer). A Socratic-type exchange is used to educate clients about the nature and impact of stress and the role of both appraisal processes and
the transactional nature of stress (i.e., how clients may inadvertently, unwittingly, and perhaps, even unknowingly, exacerbate the level of stress
they experience). [...]

The second phase of SIT focuses on skills acquisition and rehearsal that follows naturally from the initial conceptualization phase. The coping skills that
are taught and practiced primarily in the clinic or training setting and then gradually rehearsed in vivo are tailored to the specific stressors clients may
have to deal with (e.g., chronic illness, traumatic stressors, job stress, surgery, sports competition, military combat, etc.). The specific coping skills
may include emotional self-regulation, self-soothing and acceptance, relaxation training, self-instructional training, cognitive restructuring, problem-solving,
interpersonal communication skills training, attention diversion procedures, using social support systems and fostering meaning-related activities.

The final phase of application and follow through provides opportunities for the clients to apply the variety of coping skills across increasing levels of
stressors (inoculation concept as used in medical immunization or in social psychology to prepare individuals to resist the impact of persuasive messages).
Such techniques as imagery and behavioral rehearsal, modeling, role playing, and graded in vivo exposure in the form of "personal experiments" are
employed.

[Arctic1]

Care to expound a bit? Not completely sure what you are getting at here.

If put in the context of the Crawl-Walk-Run methodology, and you are saying that instructors start with the "Run" phase, after little or no time spent on the "Walk" or "Crawl" phase, I somewhat agree.

It depends on what is being taught, however, and the intent of the exercise.

[26 Inf]

Neville - I think were are thinking in different areas here, the APA paper you quoted deals with recognizing stressors and developing coping skills to mitigate their impact.

I see that as being a different 'discipline' (if you would) than the performance under stress we are talking about.

A good book to read to acquaint yourself with Reality Based Training (RBT) is 'Training At The Speed Of Life' by Ken Murray.

[TheTick]

Instinct is an impulse or powerful motivation from a subconscious source. For instance, if you were crossing the street and a car comes speeding towards you, you would try to jump out of the way before it even 'registers' with your conscious mind that a car is coming.

The part of your brain that is associated with these types of reactions is the amygdala. As you may know, different parts of the brain receive different signals and make them consciously known. The auditory cortex, for example, is responsible for hearing. The amygdala has its own set of 'receivers' for sensory intake. In the aforementioned scenario, it will take in information from the surroundings, like the sight on the car coming at you, and make a decision on what to do before you consciously think about it.

While this response is very important for survival, it is very primitive. It's commonly called the fight or flight response, for obvious reasons. This response makes us "downshift" and use only our lower brain. That means we sometimes cannot think of a logical solution to a problem. Anger makes many people with anger control problems downshift. They cannot think of a moral solution, so they do something destructive. When you are downshifted you become less at efficient at less things. This is why a dangerous school environment keeps children from reaching their learning potential.
(this is from an article I copied to a file and I can not source it.)

Incredibly useful thread and a solid post above. That is the best explanation of what I say to the guys I teach in the academy when I say, "It's the things you do before your mind asks you for permission".

When in my capacity on SWAT, I know we try our best to "strip everything away" and get to this instinct level when doing our Force-On-Force training. Another sidebar to it is that it appears that some guys appear to, whether through life experience or natural ability, function at a higher level then other guys even when both are receiving the exact same training. Some people are just "better".

It was also interesting to read about the hormonal vs excercise induced stress. It's funny to read that and think about it; it's absolutely true. I can feel my body react very differently when I induce stress during training by doing "burpees" with a gas mask on as opposed to confronting an armed subject while on patrol.

Good topic gentlemen.

Thanks for the links Artic1.

[T2C]

Original post deleted due to pending civil litigation.

Don't discount Col. Grossman's work, because some scientists working in a sterile environment say that he does not have any quantitative data to support his conclusions. I have attended three of his presentations and both police and miiltary veterans who attended the presentations feel his opinions about operating under stress are on point.