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Stress Inoculation

Stress inoculation is primarily a psychology term.  Much like being inoculated with a vaccine against a disease, stress inoculation seeks to relieve current and prevent future acute stress-related problems.  The most common use of stress inoculation in psychology is dealing with PTSD and its long-term effects.  Through stress inoculation, the patient becomes more able to manage stress in healthy ways.  As it pertains to psychology, stress inoculation is done after a major stressful event.  Stress inoculation in that case is a form of training, with its own processes and steps to achieve better coping skills.  As we use it in the fire service training community, stress inoculation is not the training, but it can be a major component of our training.  Like psychologists, we want to prevent stress-related issues and establish good stress management skills.  However, we use stress inoculation like a true vaccine, prior to, instead of after, the stressful event.  In this manner, we prepare our firefighters and fire officers to handle decision making and performance under pressure, with positive outcomes.

Stress inoculation is extremely important to quality training, but there are steps to reaching the point where outside stress is added to the evolution.  If someone is training or learning at a beginner or less advanced level, stress inoculation prevents the proper uptake of information.  Mastery of basics and advanced tactics and skills must be ensured prior to adding additional stressors to a scenario.  As an example, you wouldn’t teach someone to drive by putting them behind the wheel of a stock car at the Daytona 500.

Stress inoculation is about making a scenario as real as possible within reasonable safety limitations.  I say reasonable because we cannot safety ourselves out of training.  We do a terribly unsafe job, and only through education and lifelike, realistic training can we make it safer.  It just so happens that when we train, we get better.  And getting better makes us safer.

So for stress inoculation to be effective, you have to make the scenario realistic.  Our performance under stress is similar to the way an old card-style Rolodex works.  We get hit with a stressful situation, and our brains start flipping through the memories until they hit one that seems similar to the situation at hand.  The more of those we have on file, the better the odds are that we make the right call.  If the brain doesn’t have a previous record of the situation, it can sometimes keep flipping for quite a while, making decisions at a slower pace than the situation requires, or making a call at random just stop flipping. 

Stress inoculation also helps with off-the-wall situations for which no Rolodex card could ever be made in training.  Our brains are adaptive.  Even if we don’t have a perfect situational example to reference, if our brains are used to making good, pressured decisions, they start to make stress itself into a memory.  We begin to make better decisions under pressure, because, in general, we are used to making decisions under pressure. 

What I have seen NOT work is trying to train proper decision making and tactics without the proper input necessary to really formulate correct strategy or to correctly apply good tactics.  You can train stress inoculation in this manner, but be very careful that you don’t confuse decision making under pressure with good decision making under pressure.

Coaching Success

When it comes to realistic training, firearms instructors are at the tip of the spear, leading the charge.  Force on Force (FoF) firearms training involves using firearms that look, feel, and function just like the real thing, but they use either a plastic BB or a paint round instead of live ammunition.  The training involves real scenarios, with real props and real people reacting to real situations and sometimes shooting at each other.  This kind of training is not taken lightly, nor is it instructed by anyone without a VERY in-depth knowledge of not only firearms training, but also coaching and educating successful decision making.  FoF training is as close to real as one can get without using actual bullets against each other.  It is also very dangerous, because the risk of someone bringing a live weapon, knife, or something else into the scenario means that under pressure, that real weapon could be unintentionally deployed against a training partner.  Students are patted down several times to ensure that only training weapons are brought into the scenario.  Because of the highly controlled environment, the instructors are able to apply the stress exactly as they know it should be for each student in order to create failure and success that is conducive to learning and improvement.  That’s the extremely high level of quality we should be achieving in our training.

It’s not just about making people make mistakes so they learn. That’s only one part.  It’s really about making people make correct decisions and reinforcing good habits and good decision making until they are second nature. 

In military special operations training, we can look at how they select and mold elite warfighters for a great example of “coaching success.”  They don’t just take a soldier, Marine, sailor, or airman and toss him into high-level training until after a selection process that is designed to foster and support teamwork and success.  The process IS used to weed out those candidates who are of weak mind and body, but not through failure to complete complex tasks under pressure.  They start with very basic things, but assign those tasks under pressure.  The key is basic.  PT is done to the point of physical failure to test the point of mental failure.  They don’t start with demolitions training; they start with push-ups in cold, muddy water and team-carrying huge logs. 

Only after this basic selection phase do most programs begin more complicated training.  Some special ops jobs don’t even start their individual discipline training until months in.  And that training can take a year or more to reach the level of mastery that sets a warfighter up for success on the battlefield.  Compare that to the six months or so that most firefighters spend in recruit school learning and mastering the basics before making it to the field.  Once out in an operations division, firefighters start to receive their technician-level training in specialized disciplines like hazardous materials, technical rescue, ARFF, and so forth.  Our pattern already closely matches that of the military.  What we often lack is the stress-based reinforcement of these advanced skills and tactics to induce not failure, but success.

Sensory Stimulation

Many times in training we use sensory deprivation as our stressor.  Blacked out facepieces and smoke are the most common methods of sensory deprivation.  Sensory overload is also a good practice.  The fireground is chock full of sensory overload: the sound of the rigs, the sounds of tools and work being done, the radio, being bumped into in a crowded hall or room, etc.  The mind tends to tunnel vision under stress, but it also tends to tunnel listen.  Auditory exclusion is a well-documented side effect of acute stress.  Stress hormones are almost like psychotropic drugs; they alter our perceptions of time, what we see, what we hear, and what we remember.  In addition to coaching decision making under pressure, stress inoculation seeks to expose the participant to the distortion of reality.  Without this prior experience, the first time someone finds themselves in a highly stressful, dynamic situation, they are likely to be distracted not only by the stimuli around them but also by the altered perceptions themselves.  These distractions can interrupt the decision making process so significantly that it stops altogether.  Many first-time survivors of stressful encounters report embarrassment from being caught off guard by these perceptual distortions.

Even for people who are experienced and good at handling stressful events, there are certain cognitive effects that are almost imperceptible.  Negative content specificity is when an individual unknowingly focuses on the negative.  Negative events are perceived as more common, ambiguous situations are perceived as negative, and negative words are more easily remembered than others.  Basically, during stress, most people have a tendency to think things are worse than they are.  An individual may also have an altered sense of control over the situation; he may believe he has more or less control or ability than he really does.  Put all of that together and it’s easy to see how stress causes poor perception of reality, which in turn causes poor decision making.

The physiological effects are also a major factor of stress response and performance.  When catecholamines (stress hormones) act on the body, they cause an increase in heart rate, blood pressure, and blood sugar.  The eyes become dry and lacrimal (tear) production stops, making vision more difficult, especially when dealing with smoke and dust that usually cause tearing.  Shivering, shaking, or tremors are not uncommon during and after a stressful event.  Tunnel vision and auditory exclusion are in fact physiological effects, but unlike most other effects of catecholamine release, those two sensory effects can be overcome by the mind. 

Starting Points

A lot of the classes that we seek out and go out of our way to attend don’t teach us the mastery of most skills.  They show us what we need to work on.  They show us our flaws, our gaps, our weaknesses.  There’s almost no way that you can master even a single task in one 8 or 16 hour class.  But you can take it back to the station and show the guys.  You can go back and use what you’ve learned about what you didn’t even know that you didn’t know, and you can develop that mastery, as a team and as a department.

  • Don’t expect students to imagine anything that they would normally be able to see on scene.  We are primarily influenced by what we see when making fireground decisions.  Telling a student to imagine a downed power line, a victim, or any number of infinite possible problems is not going to teach them to look for those problems on scene.  It only teaches them to go through the motions, and that someone will verbalize all the important stuff.
  • Don’t make students practice critical skills out of context.  Give them a reason to CHOOSE to use that skill in the scenario.
  • Make scenarios challenging, but not unrealistic.  Even if a problem is able to be overcome, if it is not reasonably possible to encounter such an issue on the fireground, it serves no purpose.  Again, this goes back to context.  When the Rolodex starts flipping, having a contextual reference makes finding the answer much easier for the brain.
  • Stress should be individualized as necessary and possible.  Even at the same skill level, students are at different stress handling capabilities.  Some beginners to a new skill or tactic are extremely good already at handling outside stress.  As they master new things, they can handle more stress, and in fact NEED more stress applied in training to see improvement in their ability to cope with challenges.

To borrow and paraphrase an analogy from firearms and mindset instructor James Yeager: your life is an investment, like a house.  A long term, almost never ending path to the future.  To keep working toward that goal, you must keep making payments on that investment. 

Go make some payments.

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