MCRP 6-11C Combat and Operational Stress Control

Introduction

MCRP 6-11C Combat and Operational Stress Control is the US Marine Corp’s manual for leaders who need to recognize and understand the impact of combat and stress on those under their command. It teaches signs and symptoms, and recommends approaches to respond to this stress.

Below are some notes from MCRP 6-11C that you may use as “highlights.” You can find a link to the PDF at the bottom of this post.

Key takeaway: Know your troops and be alert for any sudden, persistent or progressive change in behavior

Most Common Combat Stress Reactions

• Slow reaction time
• Difficulty with tasks and prioritizing
• Excessive concern with minor issues
• Indecision
• A focus on familiar tasks
• Loss of initiative

Common Battle Reactions

• Mild shaking while incoming rounds is normal; post-battle intense shaking can be incapacitating
• Perspiration, chills, nausea, vomiting, loss of appetite, abdominal distress, frequent urination, incontinence all normal battle reactions
• Vivid battle dreams are a part of working through the combat experiences
• Flashbacks are normal as long as they are recognized as flashbacks

Other Battle Reactions

• Stress-related blindness/deafness, partial paralysis can improve with reassurance from comrades, unit medical personnel or battalion physician
• Panic run – Rushing about without self-control

Grieving

Open grieving can help alleviate anxiety related to the fear of death or survivor’s guilt.

Indirect Coping Techniques

• Nutrition is important. If SM drink only when thirsty they will become dehydrated.
• Aerobic fitness increases ability to handle stress
• Confidence is one of the strongest defenses against stress
• If men can’t fight back, fear will overtake; as long as they can return fire they will not fear
• Relaxation reverses the combat stress process

Stress and Coping Techniques

• Leaders should make sure all service members have mastered at least 2 stress coping techniques, a slow one for deep relaxation and a quick one for on-the-job.
• Deep breathing, progressive muscle relaxation and cognitive techniques can all be helpful

Deep Breathing

• Slow, deep inhaling, 2-5 seconds, exhale 2-5 seconds
• 5 breaths for mind-clearing, continuously to promote sleep
• Diaphragmatic breathing especially helpful for stress control

Muscle Relaxation

• Concentrating on your muscle groups one by one, tense and relax limbs to relax your entire body
• Quick version: tense all muscles simultaneously, hold for 15s, let them relax, shake out tension
• Long version: start in feet work up body part by body party

Cognitive Exercises

• Positive self talk
• Visual imgaery
• Rehearsal
• Meditation

Other Elements Related to Stress

• Most common medical problem in Op. Desert Shied/Storm was sports injury
• New members to a unit more likely to become casualty than experienced member
• “Startle reactions to sudden noise or movement, combat dreams and nightmares and occasional problems with sleeping, and feeling bored, frustrated and out of place are common” after deployment
• Remove a combat stress reacting soldier’s access to his weapon if necessary, give him simple tasks to do when not sleeping, eating, resting

Management of CSR

Better outcomes when the service member is treated close to the front

Use the BICEPS Model of Combat Stress Control

• Brief (last no more than 3-4 days)
• Immediate
• Centrality
• Expectancy (have faith he will recover)
• Proximity
• Simplicity

Sleep Deprivation

• Night time is the time to retain or gain initiative, this may lead to Marines working with less sleep
• If soldiers are wearing Mission Oriented Personal Protection (MOPP) they will need more rest and sleep breaks
• Activities that increase circulation like moderate exercise or drinking a hot beverage may shorten start-up time
• Sleep drunkenness can occur from long periods of sleeping, makes Marine less effective
• 12 hours of sleep is necessary to recover after 36-48 of complete sleep loss

Suicide Prevention

Marine Corps uses the acronym AID LIFE to describe suicide prevention:

• A – Ask if the individual is thinking about suicide
• I – Intervene immediately. Listen and let the person know they are not alone.
• D – Don’t keep their suicidal thoughts a secret. Seek assistance
• L – Locate help. This can include a supervisor, chaplain, physician, or other members of their support network. (Including crisis workers or the Emergency Room.)
• I – Inform the Chain of Command. This can help get important resources like counselling in place.
• F – Find someone to stay with the individual.
• E – Expedite. Get help now, rather than delaying it.

Bibliography

MCRP 6-11C Combat and Operational Stress Control. (2010) United States Marine Corps.