Article 053 – Developing Pre-Traumatic Stress Resilience – Part 2
Proposing a model for understanding stress-related neural processing in tactical settings.
By Dustin Salomon and John Prucha
In May we published the first article in this series. It introduced the idea that some of our existing methods of preparing people for combat via stress exposure training may have unintended consequences. Specifically, placing students in very high stress training environments using simulated operational events may cause or contribute to the formation of neurological and psychological trauma.
Taking a mechanical view of the brain, trauma is defined here as long-term brain change with a negative consequence. Neuroscience research indicates that this type of brain change (analogous to scar tissue formation) can occur when very high concentrations of stress-related hormones are saturating brain tissue during exposure to certain stimuli and/or contexts.
It is true that stress exposure training methods have proven to be effective at producing better operational performance—when compared to the aggregate operational performance that occurs without it. It is also probable, however, that some of these training practices contribute to detrimental long-term mental health outcomes for armed professionals.
Given the unique, life and death, nature of the work conducted by military, law enforcement, and the like, long-term concerns may in some cases correctly be considered secondary to those which impact short-term operational performance. After all, the deceased have no long-term outlook.
We should also acknowledge, however, that trauma is not the same thing as stress and that damage done to students during training, however well-intentioned, has consequences—both operational and otherwise. These will also be farther reaching than the impacts just to personnel who are subsequently exposed to traumatic events in the field. Consequences will also impact other personnel involved (including training washouts) and the institution as a whole.
In our efforts to further advance the training industry’s understanding of these issues, in this article we will propose a model for stress-related neural processing in tactical settings.
During Dustin’s literature review research for the book Building Shooters, one of the most intriguing items he identified was the symbiotic and reciprocal link between procedural memory (unconscious access, long-term memory) and emotional response. Emotional responses can be used effectively to improve training value and the consolidation to procedural memory (this is discussed in detail in Building Shooters).
Likewise, the developmental state of procedural memory can significantly impact a person’s emotional responses. These impacts closely match our collective experiences and observations in both training and real-world operations.
It appears that emotional responses to combat-related stimuli, whether in training or in the field, can be heavily influenced by the state of any given person’s procedural memory system at the time they are exposed to the stimulus. The corresponding level of emotional response significantly impacts the chemical saturation levels of the person’s brain tissue. In turn, this significantly impacts the formation and degree of traumatic “scarring” that forms in response to the environment.
The key seems to be how the content of procedural memory lines up with the stimuli experienced.
Author and trainer Ken Murray, author of Training at the Speed of Life, co-founder of Simunition, and one of the world’s leading innovators in training design and foremost practitioners of reality-based training, has observed that human beings generally have two fundamental reactions when presented with a problem-set in tactical settings. These are broadly defined as anxiety and exhilaration. The determining factor for which of these responses occurs is whether or not the person has the ability to definitively solve the problem.
If the problem can be solved, the response is exhilaration at the opportunity—leading to the release of pleasure-related hormones into the brain tissue. If it cannot, the response is a downward spiral of anxiety—resulting from the release of stress-related hormones.
Here we expand on this hypothesis and blend it with the memory model from the book Building Shooters. The result is a proposed model of the brain’s tactical stress-related processing function. The model’s purpose is to allow us to understand the impacts of exposure to stressful stimulus in both training and operational settings.
This model provides a theoretical framework for understanding the stress response
generated from a stimulus or dynamic environment
Within the model’s framework, there are two avenues for processing a tactical problem. The first is declarative, or conscious/cognitive, processing. The second is procedural, or unconscious, processing.
It is tempting to consider that the problem must be processed only by one system or the other. However, this is not how the brain functions. Its processing is not sequential, where one thing must be processed in a specific way, while everything else waits, then another. Rather it is a complex system of multiple, independent, often redundant, processing centers that ultimately feed together to generate consciousness and action.
It is perfectly possible for the brain to process and respond to a problem with both processing systems at the same time which is, tactically, what we want to happen. There are many rabbit holes to dive into on this subject; however, simply consider here that the more of the brain’s capability that is dedicated to solving a problem, the better and more effective the solution is likely to be.
Within the cognitive processing system, the brain retrieves information from conscious access memory and evaluates it against the problem. If a solution is found, the emotional response is exhilaration. This causes release of pleasure chemicals into the brain tissue.
If a solution is NOT found, the emotional response is anxiety. Stress chemicals are released into the brain tissue. Then, the brain repeats the processing. It looks again for a solution, likely accessing additional information and memory storage (Have you ever heard the phrase, “My life flashed before my eyes?” from someone who suffered a near-death experience? This is why this phenomenon occurs. The brain is looking through everything it has available, searching for a solution.)
If a solution is not found in the second search iteration, additional anxiety results. More stress chemicals are released. The process then repeats itself.
Scientific research indicates that high levels of stress (high levels of brain tissue saturation with stress-related chemicals) act as a sort of “switch” in the brain. Access is precluded to declarative memory and cognitive processing. Meanwhile, a highway into procedural (unconscious access) memory is opened.
This means that, as the cognitive processing repetitively fails to produce a valid solution, and stress chemicals are repeatedly released into the brain, the brain’s ability to perform the cognitive/declarative side of the model starts to fail. Once this failure occurs, all processing now happens within the procedural (unconscious) system.
It is likely that the reader has observed (and most likely experienced) this before. Have you ever seen a person be asked a question or presented with a simple, even non-consequential, problem to which they do not know the answer or which they cannot solve? Often persons in this situation either vapor lock with inaction or, alternatively, may do something extreme and patently ridiculous.
This model may explain why. As the brain repeatedly fails to find an acceptable solution and therefore re-starts its search, it continues releasing stress chemicals until the tissue saturation reaches a point where cognitive processing and declarative memory access become impossible. When there is also nothing to access in the procedural system—frozen inaction is the likely result.
When there is something to access in procedural memory that the unconscious brain associates as relevant to the problem—whether it makes cognitive sense or not—that is what involuntarily comes out.
On the other side of the model, procedural memory, a similar process is in play—unconsciously. Unlike declarative processing, procedural processing is disassociated from cognitive control. It cannot be controlled in the moment.
If unconscious processing finds a matching solution, it produces exhilaration and the release of pleasure chemicals. If a solution is not found, the result is anxiety and the release of stress-related chemicals.
The brain will then continue searching for a matching solution as the stress chemical levels increase. As a person’s stress hormone levels continue to elevate, he or she can spiral quickly towards what is commonly referred to as “condition black.”
In this state a person becomes tactically non-functional. This is also what the model considers the “danger area” in terms of the probability of generating traumatic neurological and psychological injury.
Let us consider the meaning and implications. There are three primary points we would like to highlight.
First, the model indicates that the level of stress hormones present at any given time are based on the brain’s ability to match not only existing information, but also well-practiced (procedural) solutions to the stimuli and problems presented.
Neither the subject matter, nor the environment, are particularly relevant to whether the person responds effectively, locks up into condition black, or receives a traumatic injury (ie. it does not matter whether this occurs in training or in the real world). Instead, what is relevant is whether or not the brain can determine a viable solution to the problem that allows it to stop (unsuccessfully) iterating its information search and therefore releasing stress-related chemicals into the brain tissue.
Second, when procedural memory receives a problem, it performs an automatic, unconscious search for a solution, which (if present) is selected based on the brain’s own set of parameters (such as context, prior-association, memory dominance, and energy performance requirements). Note that these are the brain’s criteria based on physics and chemistry. They are NOT what might afterwards appear to be the optimal (or even a reasonable) response.
Unlike actions that are pulled and performed from declarative memory (which is under conscious control), those pulled from / performed from procedural memory can be thought of being similar to an executable file on a computer. They are equivalent to pre-written computer programs which the brain automatically selects, then presses the “run button” for. Once this button is pressed, the program will run to completion. It cannot be stopped or interrupted.
Third, both success in solving problems and avoiding the both tactically ruinous and neurologically injurious “condition black” depend on whether or not the solutions to the problem(s) presented exist in procedural memory.
In some training environments, operationally relevant stimuli (such as explosions, physical attack etc.) are used to purposefully create very high stress levels in students who may not have the ability to actually “solve” the tactical problem. When done on purpose, this is typically intended to provide experience and also to teach recovery from condition black as a skill. However, the model indicates that generating condition black this way, even in training, may create permanent injuries that are associated directly with operationally relevant stimuli—potentially leading to severe negative consequences.
In future articles we will discuss the application of these concepts to improve training design in detail. However, it is worth briefly addressing several issues here to avoid generating confusion.
First, it is important to make clear that we are NOT making recommendations against either reality-based training or against using operationally related stimulus such as explosions and attacks in training settings.
In an attempt to separate trauma from adversity, Krupnik (2019) defines trauma as involving, “events that pose a significant threat (physical, emotional, or psychological) to the safety of the victim or loved ones/friends and are overwhelming and shocking” (p.256). She recommends that trauma be looked in the context of a stress response (or traumatic stress) which she further delineates into three categories: a) normative (healthy) stress response, b) pathogenic stress response, and c) traumatic stress response.
A separate study into a small sample of 15 police officers conducted neuroimaging scans. Note that there was no control group for this study, and since the sample size is so low, its statistical meaning is limited. However, it did find that, “the frequency of traumatic exposures was related to MRI measures of atrophy and increased PTSD symptomology. These findings suggest that chronic reexperiencing of traumatic events may result in volumetric reductions on brain structures associated with automatic arousal and the acquisition of conditioned fear” (Shucard, Cox, Shucard, Fetter, Chung, Ramasamy, & Violanti, 2012, p.25).
According to the research, it is trauma that damages the brain. Its source is not particularly relevant and therefore trauma in training may also have the same effect as that in real life. Therefore, it is not the exclusion of combat related stimuli but rather the elimination of training induced trauma that should be our objective.
To use a fitness analogy, we would certainly not advocate to reduce long-distance running performance or physical and mental endurance capability in military units nor, likely, would the reader. Everyone nevertheless can agree that reducing cases of debilitating shin splints, stress fractures, and joint injuries in military training is a worthy objective.
Second, we are also not recommending that controlled “condition black” experience and recovery skills necessarily be excluded from training programs. These experiences and skills are important. Furthermore, it is not a foregone conclusion that simply experiencing condition black by itself in a training setting results in traumatic injury.
It is rather our objective to provide tools and methods through which trainers can better understand the impact of training events on the students, both short-term and long-term.
Finally, note that the “solution” both the conscious and unconscious brain systems search for is intended to satisfy the brain’s criteria for solving the problem. The brain must be satisfied so that it can cease looking for a solution.
It is very important to understand that this is different than actually solving the problem.
Deciding that the problem is not going to be solved, or is optional, and stopping the solving process DOES solve the brain’s “problem.” F’ it Dude. Let’s go bowling… (For any fans of the Coen Brother’s classic comedy, The Big Lebowski).
In this case, the brain no longer needs to keep processing information, looking for the solution, and dumping more stress chemicals into its tissue. The brain may be satisfied; however, this approach will not solve the actual problem—especially in the real world.
This is one reason why it is so important to train people to win—and ensure that they both can and do, especially in scenario-based training. You do not want the brain to establish quitting as a viable alternative to engaging in lethal combat.
In the next article we will use our proposed model to discuss how we may be able to form better pre-traumatic stress resilience (without sacrificing operational performance) through improved training design.
References:
Harvard Health Publishing, (2011, 2018). Understanding the stress response: Chronic activation of this survival mechanism impairs health. Harvard Health Publishing.
Krupnik, V. (2019). Trauma or adversity. Traumatology, 25(4), 256-261.
Shucard, J. L., Cox, J., Shucard, D. W., Fetter, H., Chung, C., Ramasamy, D., & Violanti, J. (2012). Symptoms of posttraumatic stress disorder and exposure to traumatic stressors are related to brain structural volumes and behavioral measures of affective stimulus processing in police officers. Psychiatry Research: Neuroimaging, 204, 25-31.
Mr. Salomon is a former naval officer. He is the Founder of Building Shooters Technology LLC, and Author of, Building Shooters: Applying Neuroscience Research to Tactical Training System Design and Training Delivery. Mr. Prucha is a former member of the 3rd Ranger Battalion. He graduated cum laude with degrees in Religion – Christian Counseling, and Marriage & Family, and has completed advanced graduate studies in Crisis Response & Trauma. Currently he is completing the requirements to become a Licensed Professional Counselor in the State of Georgia.
