Guide to Coping with 

Deployment and Combat Stress

Guide to Coping with 

Deployment and Combat Stress

TG 320 JAN11
>>>>>[2]

For more information access:

https:// www.militaryonesource.com
>>>>>[3]

>>>>>[ Index ]

Combat & Operational Stress 

Reactions (COSR).................................................[4]

Coping with Stress in Stability and 

Support Operations ............................................ [12] 

OIF/OEF TIPS - Providing Support to 

Soldiers in Distress: Battle buddy Aid ................. [16] 

OIF/OEF TIPS – Helping a Soldier 

in Distress for leaders......................................... [22] 

Coping with Deployment Separation 

(Deployed Parent and Caregiver) ....................... [26] 

Sleep Management and Soldier Readiness: 

A Guide for Leaders and Soldiers........................ [32] 

The Injured and Dead ......................................... [38]
>>>>>[4]

>>>>>[ ] Know the signs of combat and 

operational stress and how to 

manage the reactions.
>>>>>[5]

Combat & Operational Stress 

Reactions (COSR)

Combat is more stressful than any training. The 

enemy will try to stress and confuse you. Security 

and support operations can also involve heavy stress, 

even without combat. Mental and physical fitness will 

help you endure the stress of combat and military 

operations. Know the signs of combat and operational 

stress and how to manage the reactions.

Individual Preventive Actions to Combat Stress 

• try to stay calm and in control

• focus on the mission

• follow SOPs

• focus on success

• breathe deeply and relax

• know COSRs are normal

• keep open communication with your team

• gather facts

• avoid rumors

• avoid alcohol

• drink plenty of fluids

• eat well balanced meals

• maintain personal hygiene

• practice quick relaxation techniques

• sleep at least 7-8 hours in each 24 hours, 

if possible

• debrief after unusually stressful events

• share grief with a friend, a leader, or a chaplain
>>>>>[6]

• keep active

• welcome new team members

• stay physically fit

• know and practice self aid/battle buddy aid

• support each other

• see the example of an ethical, moral soldier

Leaders Preventive Actions to Combat Stress

• Be decisive and assertive; demonstrate 

competence and fair leadership.

• Preserve Soldier’s welfare, safety, and health.

• Enforce sleep discipline.

• Be aware of environmental stressors such as light 

level, temperature, and precipitation.

• Learn the signs of stress in yourself and others.

• Recognize that fear is a normal part of 

combat stress.

• Rest minor stress casualties briefly, keeping them 

with their unit.

• Help Soldiers to address any family concerns and/

or separation, economic problems.

• Provide an upward, downward, and lateral 

information flow of communication.

• Allow open communication with Soldiers.

• Understand that stress in response to threatening 

or uncertain situations is normal.

• Create a spirit to win under stress.

• Conduct tough, realistic training.

• Ensure training includes understanding of combat 

and operational stress and how to deal with it.
>>>>>[7]

• Look for stress signs and a decreased ability to 

tolerate stress.

• Practice and master stress-coping techniques.

• Ensure the best possible shelters are available.

• Keep Soldiers well supplied with food, water, and 

other essentials.

• Provide mail, news, and information avenues.

• Provide the best medical, logistical, and other 

support available.

• Maintain high morale, unit identity, and 

esprit de corps.

• Keep unit members together and build cohesion.

• Encourage experienced unit members to mentor 

and teach new members.

Common Combat & Operational Stress Reaction (COSR)

Physical Emotional

Tension: aches, pains Anxiety: keyed up, 

worrying, 

expecting 

the worst

Jumpiness: easily 

startled, 

fidgety, 

trembling

Irritability: complaining, 

easily 

bothered

Cold sweats: dry mouth, 

pale skin, 

eyes hard to 

focus

Attention: poor; unable 

to focus or 

remember 

details
>>>>>[8]

Common Combat & Operational Stress Reaction (COSR)

Heart: pounding; 

may feel 

dizzy or 

light-headed

Thinking: unclear; 

trouble 

communicating

Breathing: rapid; outof-breath; 

fingers and 

toes start 

to tingle, 

cramp and 

go numb

Sleep: troubled; 

awakened 

by bad 

dreams

Stomach: upset: may 

vomit

Grief: crying for 

dead or 

wounded

Bowels: diarrhea or 

constipation

Guilt: self-blame 

for errors or 

what had to 

be done

Bladder: frequent 

urination, 

urgency

Anger: feeling let 

down by 

leaders or 

others in unit

Energy: tired, 

drained; 

takes effort 

to move

Confidence: low; loss of 

faith in self 

and unit

Eyes: distant, 

haunted 

“1000-yard” 

stare
>>>>>[9]

Combat & Operational Stress Behaviors

Adaptive Stress Reaction Misconduct Stress 

Behaviors and 

Criminal Acts

• Unit cohesion

• loyalty to battle buddies 

and leaders

• identification with unit 

tradition

• sense of uniqueness

• sense of mission and 

purpose

• alertness, vigilance

• strength, endurance

• tolerance to hardship

• ignoring pain or injury

• increased faith, 

confidence

• courage, heroic acts

• Mutilating enemy dead

• Killing enemy prisoners

• Killing noncombatants

• Torture, brutality

• Killing animals

• Fighting with allies

• Alcohol and drug abuse

• Recklessness, 

indiscipline

• Looting, pillage, rape

• Fraternization

• Excessive sick call

• Negligent disease, injury

• Shirking, malingering

• Combat refusal

• Self-inflicted wounds

• Threatening/killing own 

leaders(“Fragging”)

• Going absent without 

leave, desertion
>>>>>[10]

Management of Combat & Operational 

Stress Behaviors

COSRs are inevitable but COSR casualties are not. 

Good leadership counts. COSR casualties can be 

restored to duty quickly if rested close to their units 

and treated positively.

Keep with battle buddies

Symptoms: any amount or type of combat 

operational stress reaction symptoms that does not 

endanger the soldier or others or interfere with the 

current mission

Actions: reassure of being normal, rest, clean up, 

feed, sleep, and keep on duty with battle buddies

Rest in parent or support unit

Symptoms: warning signs that indicate the soldier is 

not too much of a risk or burden to stay with his or her 

own battle buddies

1. section can provide safe, stable environment 

for recovery

2. soldier is not disruptive or dangerous

3. no urgent medical evaluation is needed

Actions: assign less critical duty in safer areas for 

6-36 hours of rest and work
>>>>>[11]

Take to aid station or medical company

Symptoms: warning signs

1. soldier is disruptive or potentially dangerous to 

self, others or the mission

2. soldier could need urgent medical treatment for 

illness or injury

3. warning signs do not improve

Actions: 

1. take to aid station or medical treatment facility

2. maintain contact or visit solider if not returned 

in hours

3. welcome soldier back into unit upon return (65-

85% return to original unit in 1-3 days; 15-20% to 

limited duty in 1-2 weeks)
>>>>>[12]

>>>>>[ ] The day-to-day stress that comes 

with stability and support operations 

(SASOs) can, at worst, be as bad as 

that of major combat. 
>>>>>[13]

Coping with Stress in Stability and 

Support Operations

The day-to-day stress that comes with stability and 

support operations (SASOs) can, at worst, be as 

bad as that of major combat. The danger may be as 

high, the mission less clear, some civilians hostile, 

and stricter rules of engagement. Threats are hard to 

recognize. Steady progress is difficult to see. There 

is boredom, no privacy, restricted movement, and 

separation from home with poor communication. 

Under these conditions, anyone can begin to show 

signs of distress, and knowing how you can help 

yourself and your battle buddy is important.

Learn effective relaxation techniques:

• play cards or sports • talk with friends

• write a letter or keep a diary • read a book

• take slow, deep breaths • imagine a 

favorite place

Relaxation techniques can help you refocus in action, 

recharge you after grueling or boring work, and can 

help you get to sleep. Request training on relaxation 

techniques from mental health or combat stress 

control teams and unit ministry teams in your area.

What to do for yourself:

• Remind yourself that the way you are feeling is 

normal given the situation;

• Make certain that you get enough sleep, food, 

water, and exercise – if you are physically stressed, 

your ability to deal with the day-to-day SASO 

stressors is reduced;
>>>>>[14]

• Focus on the mission at hand – break down 

objectives into smaller tasks and reward yourself 

with rest breaks after each task is accomplished;

• Stay tied in with battle buddies in your unit;

• Maintain contact with friends and Family at home 

whenever you can – if something at home is 

bothering you, talk about it with your battle buddies, 

your leaders, or anyone else you trust;

• If things start to feel out of control, contact with 

your unit sergeant, chaplain, medic, or commander 

immediately.

What to do for your battle buddies:

• Know the members of your team and welcome 

newcomers when they arrive—help them learn 

skills they need;

• Be on the lookout for sudden changes in how your 

battle buddies act – if you see such a change, ask 

them about it;

• Include your battle buddies and newcomers in 

opportunities to relax;

• Offer encouragement and recognition when your 

battle buddies do something well;

• If you’re concerned for your battle buddies, talk to 

them about how they’re doing;

• If you think that your battle buddy may be having a 

really hard time and won’t talk to you, contact your 

supervisor and let them know about your concern.
>>>>>[15]

What to do for your subordinates:

• Keep your team informed of new developments as 

they come up but be careful not to pass on rumors 

– say you don’t know and will tell them when 

you do.

• Be on the lookout for changes in behavior or 

performance and act to address issues before they 

become problems.

• Organize team events to help your Soldiers relax 

and have some fun; give them some private time 

when you can.

• Check in with team members on how they’re 

handling the deployment and how things are going 

back home;

• Assure they get a fair share of MWR 

communication.

• Talk with any Soldier you are concerned about and 

listen to them;

• Conduct sensing sessions as frequently as 

possible, and make sure Soldiers’ feelings are 

expressed and heard;

• Refer Soldiers to unit chaplains, mental health or 

combat stress control (CSC) team assets for help if 

they need it.
>>>>>[16]

>>>>>[ ] If you see a battle buddy upset, 

fuming or brooding alone, you can 

help your battle buddy 
>>>>>[17]

OIF/OEF TIPS 

Providing Support to Soldiers in Distress: 

Battle buddy Aid

In Operation Iraqi Freedom and Operation 

Enduring Freedom, any Soldier can run into rough 

times. Examples of difficult situations include: seeing 

destroyed homes; dead bodies; hostile reactions from 

civilians; being ambushed; small arms fire; IEDs; 

knowing someone is seriously injured or killed; long 

deployments; lack of privacy and personal space; 

separation from family; difficult communication 

back home. 

The fact is that all of us can sometimes feel down, 

hurt, or angry. If you see a battle buddy upset, 

fuming or brooding alone, you can help your 

battle buddy through what may be a painful and 

sometimes risky time. Emotionally distracted Soldiers 

can endanger the mission, the unit, and themselves. 

Often, just talking, listening, and focusing on their 

strengths is all that a battle buddy needs to find their 

own answers. Try the following suggestions:

1. Be a good friend, talk with your battle buddy 

and find out what’s wrong. Listen and be 

understanding. Be compassionate. For example, 

say, “Something seems to be bothering you. How 

can I help? I can listen without being upset.”

2. Listen and encourage your battle buddy to talk 

about what is bothering him or her. Listen not 

merely to the words, but the feeling content. Stay 

calm and objective. Maintain vigilance.
>>>>>[18]

3. Don’t criticize or argue with the Soldier’s ideas 

and feelings. Encourage your battle buddy to 

continue to tell you what’s wrong. Allow time for 

your battle buddy to find words. 

4. Acknowledge your battle buddy’s grievances

against others, but don’t make it worse by agreeing 

too strongly.

5. Ask questions to understand the problem and 

the feelings. If the talking stalls, summarize what 

has been said and ask if you have it right.

6. Don’t give a lot of advice. It is okay to plant the 

seeds of new ideas but don’t drive them in with a 

hammer. Remember you don’t need to have all the 

answers for the Soldier’s problems.

7. Praise your battle buddy for the work he/she has 

been doing under such difficult circumstances and 

for talking with you.

If your battle buddy gives any hints or clues of 

thinking about suicide, or seriously harming or 

killing someone else, remember your Suicide 

Prevention Training! 

Signs of Suicide: Soldiers will show a wide range of 

behaviors/emotions, it is up to you to recognize the 

behaviors that are different. Be aware of Soldiers who 

suddenly become quiet and show significant change 

of behavior. Other signs to watch for:

• Recent break-up in a relationship

• Excessive use of alcohol or drugs

• significant financial problems
>>>>>[19]

• poor work performance

• recent administrative or legal action

• Appears depressed: sad, tearful, poor sleep, 

poor appetite, hopeless

• Threatens suicide

• Talks about wanting to die

• Deliberately injures self

• Gives away possessions.

What to do if you’re concerned about suicide 

Follow the acronym ACE.

“Ask” your battle buddy: Ask your battle buddy 

questions that will give you a better idea of what 

he/she is thinking. Ask your battle buddy directly 

about his or her suicidal thoughts. Such as: “Are 

you thinking about killing yourself or someone 

else?” I see how distressed you are. Do you wish you 

were dead?” Have you thought of how you would kill 

yourself?” 

• Know the warning signs you might see in yourself 

or battle buddy if he or she is suicidal. 

• Look for any outward sign that shows a deviation 

from your battle buddy’s usual self.

• Talk openly about suicide. Be willing to listen 

and allow your battle buddy to express his or 

her feelings.

“Care” for your battle buddy: Care for your battle 

buddy by understanding that your battle buddy may 

be in pain.
>>>>>[20]

• Active listening may produce relief. Calmly control 

the situation: do not use force.

• Take action by removing any lethal means, such as 

weapons or pills. If your battle buddy is armed, 

say, “Let me unload your weapon and keep it safe 

for you while we talk.”

“Escort” your battle buddy: Escort your battle buddy 

immediately to your chain of command, Chaplain, or 

behavioral health professional.

• After your battle buddy has talked as much as 

he or she wants, say, “I need to get you help for 

this. People here can help you.”

• Don’t keep your battle buddy’s suicidal behavior 

a secret.

• Adopting an attitude that you are going to help your 

battle buddy will save his or her life.

• Stay with your battle buddy until he or she receives 

appropriate help. Don’t leave your battle buddy 

alone. 

In OIF/OEF, the Army has fielded additional helpers 

for Soldiers with such problems. Beyond the 

immediate sergeant and officer leaders, you can 

encourage the Soldier to talk about problems with the 

following:

• Unit Medic

• A Chaplain or chaplain assistant

• BN Aid Station or medical companies’ medical 

care providers. These resources and the 

Chaplain should know where the Mental Health 

helpers are and how to contact them. 
>>>>>[21]

• Mental Health officers, NCOs, and Specialists 

at the medical companies or in Combat Stress 

Control teams in your area.

Get help immediately! A suicidal person needs 

immediate attention.

For more information access:

https:// www.militaryonesource.com

National Suicide Prevention Lifeline 

1-800-273 TALK (8255)
>>>>>[22]

>>>>>[ ] Emotionally distracted Soldiers 

can endanger the mission, the unit 

and themselves. 
>>>>>[23]

OIF/OEF TIPS: Helping a 

Soldier in Distress

Leader’s Hip Pocket Training Guide

In Operation Iraqi Freedom and Operation 

Enduring Freedom, any Soldier can run into rough 

times. It could be any combination of:

• Seeing destroyed homes, dead bodies, human 

remains;

• Hostile reactions from civilians;

• Being ambushed, receiving small arms fire, 

improvised explosive devices;

• Knowing or seeing someone killed or seriously 

injured; having close calls;

• Long deployments; lack of privacy and personal 

space;

• Separation from Family, difficulty communicating 

with Family members at home.

All of us can feel badly at times. If you see a fellow 

Soldier who is upset, fuming or brooding alone, 

you can help him or her through a painful and 

sometimes risky time. Emotionally distracted 

Soldiers can endanger the mission, the unit and 

themselves. Often, just talking to a friend (or 

leader) who listens, tries to understand, and praises 

their strengths, is all people need to find their own 

answers. The following can be useful ways for a 

Soldier to help a battle buddy: 

1. Be a good friend. For example, say, “Something 

seems to be bothering you. How can I help? I can 

listen without being upset.”
>>>>>[24]

2. Listen attentively and encourage him or her 

to continue telling you what’s wrong. Stay calm 

and objective. Don’t criticize or argue with the 

Soldier’s thoughts and feelings, but listen and allow 

silent time for him/her to find words. 

3. Acknowledge the Soldier’s grievances against 

others, but don’t amplify them by agreeing with 

them too strongly.

4. Ask questions to help you understand the 

problem and the feelings. If the talking stalls, try 

to summarize what has been said and ask if you 

have it right.

5. Delay offering different perspectives or 

practical advice until you believe your Soldier 

knows that you really know the situation and 

understand why he/she is upset. 

6. Plant the seeds of new ideas. 

7. Praise the soldier for the work he/she has been 

doing under such difficult circumstances and for 

talking with you.

Sometimes the problems are too big to resolve 

after one talk or without additional outside help. 

Remember the Army deploys additional help for 

Soldiers with such problems. Help for Soldiers, 

beyond yourself and other military leaders 

includes:

• Unit Ministry Teams in the maneuver battalion, 

brigade HQs, hospitals, and area support in Corps 

areas and Kuwait.
>>>>>[25]

• The primary medical providers in battalion aid 

stations and medical companies should know 

where these helpers are and how to contact them, 

as well as being helpers, too. 

• Mental Health Officers, NCOs, and Specialists 

at the brigade, division and area support medical 

companies.

• Mental Health officers and enlisted in Combat 

Stress Control teams that cover those areas and 

can come forward to battalions and companies.

If the Soldier seems preoccupied with death, hints 

at having thoughts of suicide, or makes threats 

toward others, remember your Suicide Prevention 

Training! 

• Say something like, “I can see that you feel 

distressed.” “Have you thought of hurting yourself 

or someone else?” or, “Do you wish you were 

dead?”

• Then “Have you thought of how you could kill 

yourself?” (or whomever);

• Don’t act shocked or alarmed! Encourage the 

Soldier to talk using the techniques on this card.

• If the Soldier is armed, say, “Let me unload your 

weapon and keep it safe for you while we talk.”

• After the Soldier has talked as much as he or 

she wants, say, “I need to get you help for this. 

There are people nearby who can help you.”

• Don’t leave this person alone. Secure any 

weapons. Immediately take the Soldier to your 

chain of command, chaplain, or to medical care.
>>>>>[26]

>>>>>[ ] Operation Iraqi Freedom and 

Operation Enduring Freedom can 

be an emotionally difficult time for all 

Family members
>>>>>[27]

OIF/OEF Tips - Coping with 

Deployment Separation Tips 

Separation from a loved one who is deployed to 

Operation Iraqi Freedom and Operation Enduring 

Freedom can be an emotionally difficult time for 

all Family members. Symptoms resulting from 

separation can include low energy levels, feelings of 

sadness, anger, excitement, restlessness, tension, 

frustration, resentment, and depression. Additionally, 

there are many challenges for military Families to 

overcome during deployments. It is important to 

recognize, understand, and face these challenges in 

order to effectively cope with the separation during 

deployment:

Avoid the pitfalls that are often associated 

with deployments:

• Realize that arguments prior to deployment are 

common. Generally, this is the result of stress due 

to upcoming separation. Try not to take them 

too seriously. 

• Discuss family concerns such as child rearing, 

financial management, or intimacy issues prior to 

deployment. Attempting to resolve disagreements 

around family concerns from long distance will not 

be effective.

• Avoid trying to resolve marital issues that precede 

deployments. This is very difficult over long 

distance and is best left until the Soldier 

returns home.
>>>>>[28]

• Understand that dates of departure and return 

often “slip” forwards and backwards.

• Avoid listening to or spreading rumors. It is 

best not to repeat the rumor. Because of rapid 

communication, rumors can spread unchecked 

causing great psychological harm to Soldiers and 

Family members. An example of a rumor is one 

Family Readiness Group (FRG) member spreading 

allegations of infidelity about another group 

member. Such rumors cause harm to Soldiers, 

Family members, FRGs, and unit cohesion. 

• It is important to accept change and growth by all 

Family members. It is unrealistic to be reunited 

and expect everything to be the same as before 

the deployment. 

Some general tips to help the spouse/Family cope 

while the Soldier is deployed:

• If disagreements arise, leave the issue until you are 

face-to-face with your spouse. 

• Establishing and maintaining a support network 

helps the Family cope.

• Include breaks in the daily routine. This may 

include weekly get-togethers with other Family 

members and monthly outings for the children to a 

favorite park, restaurant, picnic, etc.

• The parent at home will need time away from the 

children. A regular “Mommy’s or Daddy’s day out” 

is important to maintain sanity.
>>>>>[29]

• Encourage all Family members to share 

feelings, reassure your partner of your love and 

commitment, and try to see the deployment as a 

challenging opportunity for growth.

• Communication is important between the Soldier 

and Family member. Use all available avenues 

of communication (e.g., telephone calls, e-mails, 

letters, etc.). It is important to keep in touch; 

however, try to end phone conversations and 

letters on a positive note.

Some general tips for caregivers to help children 

cope while the Soldier (parent) is deployed:

• Be honest with children about Daddy’s or Mommy’s 

deployment. Share information about the Soldier’s 

work and what the parent is doing for our country. 

Answer questions openly and honestly using words 

your children can understand. 

• Give children a method of measuring the passage 

of time. Provide a calendar to help your child count 

the days the parent has been deployed. 

• Make sure your spouse’s parents are kept 

informed. The Soldier’s parents share your 

concerns about the health and welfare of their 

deployed son or daughter. Grandparents 

and spouse can support each other during 

the deployment. 
>>>>>[30]

• Continue to provide a structured, stable and safe 

environment for your children. Children require 

reassurance that they are loved, cared for, and 

safe while the other parent is away. 

• Make sure the deployed parent is part of everyday 

conversations.

• Help your children sort out what they hear and 

see in news reports. Find out what your children 

know and understand and talk with them about 

their feelings. Follow your child’s lead. Give a small 

piece of information at a time and see how your 

child responds before deciding what to do next.

• Provide your children with a method to 

communicate to the deployed parent i.e., letter 

writing or e-mail access.

• Try to maintain Family routines and traditions 

during the other parent’s absence.

• Keep children involved with outside activities and 

maintain constant communication with schools. 
>>>>>[31]

>>>>>[ ] For more information access:

https:// www.militaryonesource.com

National Suicide Prevention Lifeline 

1-800-273 TALK (8255)
>>>>>[32]

>>>>>[ ] To sustain performance over the long 

haul, you and your Soldiers need 7-8 

hours of sleep out of every 24. 
>>>>>[33]

Sleep Management and 

Soldier Readiness 

A Guide for Leaders and Soldiers 

Like food, water, and air—sleep is a necessity. When 

we don’t get enough sleep, our performance suffers, 

and we put both ourselves and our fellow Soldiers 

at risk. We react slower, it’s harder to stay focused, 

it’s harder to think, and we get stressed more easily. 

We make more mistakes and make poor decisions 

and judgments. To make matters worse, the effects 

of sleep deprivation sneak up on us. In other words, 

when we don’t have enough sleep, we are not good 

judges of the impact that sleep deprivation is having 

on our abilities and performance.

A sleep-deprived Soldier might fall asleep at the 

wheel and cause a vehicle roll-over. A sleep-deprived 

Soldier-medic might administer the wrong dose of 

medicines. A sleep-deprived Soldier on guard duty 

might not notice a threat or might react too slowly to 

it. A sleep-deprived Soldier might transpose digits 

while entering coordinates into a fire-control system. 

More generally, a sleep-deprived Soldier might make 

wrong tactical decisions. The bottom line is that sleep 

deprivation can get Soldiers killed!

Sleep Deprivation and Performance

This chart shows the relationship between sleep 

deprivation and performance. You can use this chart 

to gauge your sleep status or the sleep status of 

your Soldiers. Essentially, the longer we go without 
>>>>>[34]

sleep, the poorer our performance on any number of 

tasks. In general, we can sustain normal performance 

without noticeable impairment (the Green zone) for 

about 16 hours after waking up. After 16 hours without 

sleep, we begin to see a noticeable decrease in our 

performance (the Amber zone). By the time we have 

been awake for 24 hours, our reaction time is worse 

than if we were legally intoxicated. After 28 hours 

without sleep, our performance becomes significantly 

impaired with the likelihood of critical errors rising to 

an unacceptable level (the Red zone).

figure 1.

Sleep Management

To sustain performance over the long haul, you and 

your Soldiers need 7-8 hours of sleep out of every 

24. When Soldiers get less sleep than this, their 

performance will degrade over time. Getting 4-6 

hours of sleep every 24 hours will keep Soldiers in 

the Amber zone (where the risk for mission critical 

HOURS WITHOUT SLEEP 16 28 28+

PERFORMANCE

Significant Impairment - 

Risk of mission critical arrows is 

HIGH

Low to Moderate Impairment -

Risk of mission critical errors is 

MODERATE

No Impairment -

Risk of mission critical errors is 

LOW
>>>>>[35]

errors is moderately increased) for periods of up to 

several weeks. Getting less than 4 hours of sleep 

will keep Soldiers in the Red Zone (where the risk for 

mission critical errors is unacceptably high). Sleep 

doesn’t have to be continuous to be effective. While 

it is preferable to give Soldiers uninterrupted sleep 

time, several shorter sleep periods that add up to 

between 7 and 8 hours can also sustain alertness and 

performance.

Tips for Sleep Management

• Tips for Soldiers

h Don’t sleep in areas where there is regular 

activity

h When sleeping, minimize exposure to noise and 

light - wear ear plugs and use blackout shades or 

a sleep mask

h Avoid over-the-counter “sleep aids,” – they cause 

grogginess but do not improve actual sleep

h Sleep whenever you can – even a little sleep 

is better than none, and the benefits of several 

“catnaps” can add-up quickly

• Tips for Leaders

h Develop a unit sleep management program that 

gives Soldiers enough time off so they obtain 7-8 

hours to sleep out of every 24

h Soldiers trying to sleep during the day require 

longer (or more frequent) opportunities to sleep 

to compensate for the body’s normal reaction to 

sleep cycle disruption
>>>>>[36]

h Never put your Soldiers in a position where they 

must choose between adequate sleep and other 

important off duty activities (personal hygiene, 

calling home, etc.) They will always sacrifice 

sleep in these situations.

h Arrange sleep schedules that give Soldiers 

opportunities to sleep at a consistent time

• Remember...

h Your performance begins to suffer as soon as you 

start losing sleep 

h If you are struggling to stay awake, your ability to 

function is already impaired 

• If Sleep Loss Can’t be Avoided...

h Use caffeine – drink the equivalent of two cups of 

coffee (~200 mg of caffeine) every 2 to 4 hours;

h Caffeine use as described above will help 

maintain performance even in the face of 

moderate sleep loss
>>>>>[37]

>>>>>[ ] For more information access:

https:// www.militaryonesource.com

National Suicide Prevention Lifeline 

1-800-273 TALK (8255)
>>>>>[38]

>>>>>[ ] These techniques and coping skills 

cannot make a horrible and tragic 

event acceptable or easy, but they 

can help you and your teammates 

better cope with the stress in order to 

complete the mission.
>>>>>[39]

The Injured and Dead

In combat or disaster situations, you may see, hear, 

smell, and perhaps have to handle injured and dead 

people. They may be men and women of all ages. 

You may be struck with combinations of feelings 

that include pity, horror, repulsion, and anger at the 

senselessness or malice of the event. You may feel 

guilty for failing to prevent it, for surviving it, or for not 

helping enough. These reactions are a normal part of 

being human. You may blame yourself or the U.S.A. 

It hurts most when a victim reminds you of someone 

you love or yourself. 

Keep in mind that these feelings are honorable and 

confirm your humanity. At times, however, you may 

feel emotionally numb and may use “graveyard 

humor” to make the suffering and deaths seem 

less terrible. Whatever you feel, remember that the 

mission must continue. 

The following are lessons learned by people who 

faced such horrible experiences. These tips can help 

you do the mission and live with the memories without 

being haunted by them. 

1. Remember the larger purpose of what you 

must do. You are showing care, giving hope, 

and preventing disease for the living. You are 

recovering the bodies for registrations and 

respectful burials.

2. Limit exposure to the stimuli: don’t sightsee; use 

screens, poncho curtains, partitions, covers, body 

bags, and barriers to keep away anyone who 

does not need to see. 
>>>>>[40]

3. Wear gloves and disposable uniforms if available.

4. Mask odors with disinfectants, deodorants, airfresheners. Save perfumes or aftershaves for 

afterwards. Do not be surprised when odors 

trigger memories.

5. Be compassionate, but AVOID FOCUSING on 

any individual victims, especially those you most 

identify with. Do not focus on personal effects. 

6. Have people who did NOT search the body 

examine the personal materials collected for 

identification of the body or intelligence.

7. Remind yourself the body is not “the person,” just 

the remains.

8. Keep humor alive, even “graveyard humor” with 

battle buddies who understand it, but don’t get too 

gross or too personal (e.g., no picking on each 

other). 

9. Don’t desecrate or steal from the victims—those 

are UCMJ crimes.

10. Say silent prayers; ask unit or local ministers to 

conduct memorial services.

11. Schedule frequent breaks; maintain hygiene, drink 

plenty of fluids, and eat good food. Command 

should arrange facilities for washing hands and 

face, and later for showers and fresh clothes. 

12. Have your team get together for mutual support 

and encouragement. Acknowledge horrible 

aspects, but don’t dwell on these memories of 

details.
>>>>>[41]

13. Help battle buddies or subordinates in distress by 

being a good listener. Do not jump in with “off the 

shelf” answers. Do not mistake his/her feelings 

as weakness. Tell them they are normal and 

honorable. Remind them that the mission must go 

on, and the team needs everyone.

14. If forewarned of the mission, prepare yourself for 

what you will see and do; take the supplies and 

equipment mentioned above.

15. Afterwards, do not feel guilty about having 

distanced yourself mentally from the suffering or 

tragic deaths of individuals. 

16. Do not be disheartened by horrible dreams, 

feeling tense, or intrusive memories. Those are 

normal, and it is better to have them now than to 

suppress them. Do not keep them hidden. Share 

them with your battle buddies, and keep that 

positive humor alive. 

17. One to three days after exposure, participate in a 

critical event debriefing with trained people from 

your supporting unit ministry and/or behavioral 

health/combat stress control team.

These techniques and coping skills cannot make 

a horrible and tragic event acceptable or easy, but 

they can help you and your teammates better cope 

with the stress in order to complete the mission. Be 

proud of what you have done, and use these lessons 

learned to take care of yourself, your battle buddies, 

and your family when you get home.
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