Combat Stress Control

In our own Soldiers and in the enemy combatants, control of stress is often the decisive difference between victory and defeat across the operational continuum. Battles and wars are won more by controlling the will to fight than by killing all of the enemy combatants. Uncontrolled combat stress causes erratic or harmful behaviors, impair mission performance, and may result in disaster and defeat of COSC preventive measures. The COSC preventive measures are aimed at minimizing maladaptive stress reactions while promoting adaptive stress reactions, such as loyalty, selflessness, and acts of bravery. This manual provides doctrinal guidance for controlling excessive stress in combat and other operational environments. It identifies command and leadership responsibilities for COSC. It identifies COSC consultation, training, and education assistance available for units. This manual provides definitive guidance to BH personnel and CSC units for their COSC mission and for management of COSR and other behavioral disordered patients (BDPs). It identifies the requirements for COSC consultation, planning, coordination, rehearsal, and implementation of the COSC plan contained in the FHP annex of the operation order (OPORD). Many stressors in a combat situation are due to deliberate enemy actions aimed at killing, wounding, or demoralizing our Soldiers and our allies. Other stressors are due to the operational environment. Some of these stressors can be avoided or counteracted by wise command actions. Still other stressors are due to our own calculated or miscalculated choice, accepted in order to exert greater stress on the enemy. Sound leadership works to keep stressors within tolerable limits and prepares the troops mentally and physically to endure them. Some of the most potent stressors can be due to personal organizational problems in the unit or on the home front. These, too, must be identified and, when possible, corrected or controlled. Unit needs assessments (UNAs) can help BH providers identify specific stressor in a unit and develop interventions to help unit personnel cope. This manual identifies MH sections and medical units, CSC, that provides COSC support to units. It identifies the requirements for COSC assistance, as a unit transitions through the different phases of a deployment. Chaplains, commander, leader and COSC Soldier mentors provide assistance with afteraction review (AAR) and traumatic events management (TEM).