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Army leaders: Soldiers can build strength from self-care

Col. Jim Czarnik, left, then the command surgeon for U.S. Army Africa, presents a certificate of appreciation to Lt. Fatou Kine Dieng, an emergency room doctor at the Hospital Military De Ouakam, Dakar, Senegal, Jan. 29, 2016. Photo: Capt. Charles An

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WASHINGTON - Jim Czarnik turned swiftly to his three-year-old daughter as she ran into a neighbor's yard on a sunny spring afternoon.

"Sasha, stop!" Czarnik shouted angrily to his child, who had spotted a ball to play with. His mind had flashed back to his three-month deployment and suddenly he imagined his toddler running across a minefield instead of a green lawn. He pivoted to his battlefield instincts where he remembered that moving on hard packed roads usually meant safety from mines.

When he saw Sasha step off the sidewalk that spring day in 2002, it sparked a reaction in Czarnik, who instinctively tried to protect his daughter as if she were one of his soldiers.

"Jim," his wife said. "It's a ball."

Czarnik, then a young emergency medicine physician and Army officer who had just returned from his second overseas mission, stood perplexed. After visiting an ice cream parlor, Czarnik wanted to spend a relaxing day with his family in Southern Pines, North Carolina.

He suddenly felt ashamed that his outburst had terrified his three-year-old.

"The environment triggered a reaction that was already well rehearsed in my body," Czarnik recalled during the University of Southern California's 2021 Virtual Body Computing Conference on Oct. 22. "So I reacted without thinking. I think that's what struck me. After it happened, I recognized immediately it was the wrong reaction and I knew why I reacted that way."

Later that week, Czarnik's three-year-old left a blanket in the middle of the family's living room, trigging the ire of her father.

"Hey!" Jim said. "You know that doesn't belong here."

"She's three!" his wife said.

Stunned by his reactions, Jim realized he had failed to transition from his deployment mindset and to separate his military training from his home life in the spring of 2002. He would later acknowledge he had experienced the first signs of post-traumatic stress disorder.

He had taken the war home.

Czarnik had been in the middle of Special Operations unit rotations to Afghanistan following the events of 9/11. He had spent two months in the Middle Eastern nation in late 2001 and another three in early 2002. "You knew you were going back so it wasn't like mentally you could relax," Czarnik said.

He struggled transitioning back to his home life for the brief few weeks he had with his family as he awaited his next deployment to go back to Afghanistan.

"What happens over the course of time, is combat becomes normal," Czarnik said. "We got praised for it, we got awarded for it, and when we went back into our house, many of us failed to actively, mentally transition into our civilian habits.

"And it's our family that bears the brunt of that," he added.

Nearly 20 years later, Czarnik, now a colonel and command surgeon of U.S. Army Special Operations Command at Fort Bragg, North Carolina, joined a panel hosted by the USC Center for Body Computing.

Czarnik said soldiers returning from deployments often face a battle within themselves, as he did. That week in 2002 marked the start of what would become a difficult nine years for Czarnik and his family.

Czarnik became distant and withdrawn at home. He grew irritable when approached by his peers, his family or strangers.

He said soldiers must be willing to admit they need to seek assistance for their behavioral health in order to actively transition back to home life. Finally, in 2011, his symptoms had grown worse.

He decided to seek help for his symptoms at the Supreme Headquarter Allied Powers Europe clinic, where he served as commander.

"What takes real courage is stepping out of your comfort zone and stepping into a zone of vulnerability," said Czarnik, who was the DoD senior physician on the ground for the multi-nation response to the 2016 Ebola outbreak in West Africa. "And allowing yourself to be transparent so that you can become stronger, faster and perform better. That's where the real courage lies."

If soldiers fail to take care of themselves, the effect could have a spiraling impact on soldier readiness that could spread throughout their units. Czarnik has participated in research to help optimize and understand the cognitive cues that lead to battlefield success. Czarnik didn't begin to fully heal until he took part in a 10-week outpatient program in 2019 at Landstuhl Regional Medical Center Germany.

Special Operations Command-Pacific's commander, Maj. Gen. Joshua Rudd, said during the panel that despite technological advances in warfighting, the service must prioritize soldiers over machines.

"We use a lot of equipment, hardware and technology to enhance the performance of the human," Rudd said. "But ultimately, it's about the individual. It's about the teams, it's about the formations that fight our nation's wars. And at Special Operations Command, we try to never lose sight of that."

The focus falls in line with the Army's People Strategy, which focuses on optimizing soldier and civilian talent to create cohesion and promote diversity within its ranks.

Rudd said it's important to care for the mental health of soldiers which effectively enhances warfighting capabilities. To help prioritize soldiers and their families, Special Operations Command launched an initiative called Preservation of the Force and Family to develop longevity and performance through integrated and holistic human performance programs.

Without taking care of a soldier's mental health, maintaining readiness can be a daunting challenge, as soldiers continue to be heavily tasked with training and overseas duties, he added.

"[Warfighting] is physically demanding, it's emotionally demanding," Rudd said. "As much as the environment is changing ... you got to be tough. You got to really want to do this, or ... you're probably going to fail when it matters most."

The Army added holistic health guidelines to its doctrine in October 2020. The service introduced its Holistic, Health and Fitness System, or H2F to its field manual, to further invest in soldier readiness and lethality and reduce rehabilitation rates and injury recovery times.

The branch designed H2F not only to optimize soldier health and performance, but to develop adaptive leaders who promote readiness and build units designed to enable readiness and support soldier optimization in tactical environments.

HSF uses an evidence-based approach and utilizes embedded and specialized performance professionals. The model focuses on multiple domains: physical, psychological, cognitive, spiritual and social and family.

"[Warfighting] is going take a toll on the individual, physically, cognitively, spiritually, psychologically, and socially," Rudd said. "By extension, our relationships, and our families are going to be impacted."

Retired Marine Corps Col. Clarke Lethin said that the military must be more accepting of troops who struggle to resume normal life after returning from a deployment or mission. He added that the U.S. military must train its junior leaders and front-line supervisors to identify when one of their troops appears to be struggling.

"We're recognizing that it's okay to have our folks identify that they may or may not be right," he said.

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