WASHINGTON– The Naval Center for Combat and Operational Stress Control is teaching sailors and Marines how to deal with everyday and combat-related stress starting at the beginning of their military careers, a senior Navy official said. The center recently was established at Naval Medical Center San Diego to address the issues of psychological health by improving care for post-traumatic stress disorder and traumatic brain injury, but also how to effectively teach sailors and Marines to recognize the signs of stress.

“The idea of the center is … not only to help sailors and Marines in distress, but to promote good stress management and promote psychological health so it starts when … people come into boot camp and [lasts] all of the way until they graduate from war college,” Navy Capt. (Dr.) Paul Hammer, the center’s director, said Aug. 7 in an interview on Dot-Mil-Docs radio show hosted on

“The idea is that we get past the concept of just dealing with things when they are in crisis and hopefully promote a system of addressing stress and addressing our ability to cope with it so we rarely get into a crisis mode,” Hammer said.

He added that the routine stressors that sailors and Marines undergo on a routine basis, not looking at when they are in a combat zone, are extremely dangerous at times and require that leaders manage their stress well.

One of the center’s missions is to determine where officials might have the most impact to help educate sailors and Marines, for example in the curriculum they are taught in military training, Hammer said.

“One of the things that I like to look at, when people are training and they go through drills is, ‘How can we incorporate stress training into that so that they are more aware of when they are dealing with stress?’” Hammer said.

The center is the first of its kind in the Navy to incorporate stress training during both pre- and post-deployment periods. With more than 14,000 sailors and Marines currently serving as individual augmentees around the world in combat areas, learning how to recognize operational stress is important for everyone’s’ well-being.

“When we talk about operational stress, we’re talking about that unique set of circumstances that people have when they are deployed or when they are in the jobs that they do,” Hammer said. “For example, somebody who works on the deck of an aircraft carrier has a much different level of stress than someone who is a civilian and works in an office building downtown.”

According to the Navy Bureau of Medicine’s Combat/Operational Stress Cell, the signs of operational stress can be sudden or build up over time. Combat stress can happen suddenly when a sailor or Marine encounters immediate danger or it can build up from things such as lack of adequate sleep, loud or constant noise, extreme heat or cold — things that make life in combat stressful. Stress can have harmful effects on a sailors’ or Marines’ bodies, minds and actions, he said. It also can directly affect how sailors or Marines deal with others—friends or enemies.

“Combat stress, of course, is the stress that occurs when you are in combat — the extreme set of circumstances when your life is in danger and when you have to [make] life and death … decisions quickly … and when you are under extreme pressure,” Hammer said.

Some common signs of combat stress can include extreme restlessness, staring into the distance, shallow breathing, trembling or sweaty hands, and feeling detached from others or even feeling sick or nauseated.

Dealing with both routine and operational stress is handled by the center’s four major divisions to address how to recognize stress and look at methods to improve treatment. “The center has four major divisions: knowledge management, programs, research facilitation, and strategic communications,” Hammer said.

Knowledge management looks at what is currently known about PTSD and TBI; programs looks at ways to improve the level of care provided to servicemembers; research facilitation is designed to examine causes of stress; and strategic communications focuses on ways to communicate and educate servicemembers about these issues, he explained.

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