**3. Decompression: an ally in reconstruction**

In this article, we will introduce to the readers the concept of *decompression*, its relevance in the pandemic times especially in managing post-traumatic stress and other psychological issues which come part and parcel with the pandemic. Borrowing from their own experiences in the highly-dramatic theatre of war, and the potential

#### *Perspective Chapter: Decompression as a Safety Valve during Pandemic DOI: http://dx.doi.org/10.5772/intechopen.104648*

benefits of decompression, will guide us in how this can be used as a strategic approach as we move toward post-pandemic reorganization. The authors propose the '*9-R Model of Decompression*' [1], which provides insight into decompression aims to reduce the unsolicited pressures emanating from the pandemic, how decompression can result in better psychological well-being; backed with empirical data. Lastly, in concluding remarks, the authors throw light on the direction for further psychosocial research in the military and non-military contexts.

A conceptual understanding of psychological decompression finds most mention in military literature; it refers to a process that allows soldiers returning from theatre of military operations and duties in war zones, to adapt to the home environment gradually, in a systematic manner with the aim to reduce the potential for maladaptive psychological well-being [2, 3]. Decompression is viewed as a period of transition between high-stress operational environment and home environment perceived to be relatively less stressful [3]. This organised period of transition is also known as third location decompression or TLD [4].

Psychological health issues experienced by soldiers returning from combat zone are well researched and documented. Highly volatile, ambiguous environments that theatre of operations are, exert mental pressure and stress on soldiers in spite of being trained in the use of arms and technological advances of militaries. Whether returning home victorious or mere deployment under volatile uncertain conditions or even peace-keeping operations, some amount of stress is innate and places them at higher risks for post-traumatic stress disorder, depression, alcohol or drugs abuse, and other co-morbidity conditions [5–10]. Thus, with high vulnerability to post-traumatic stress disorders and related adjustment issues it seems reasonable that there is a period of relative adjustment to reduce the risks of full-scale disorders.

A period of psychological decompression with a focus on rest, cognitive and emotional reappraisal may a-part solution for soldiers after deployment along with psycho-educational interventions. In one of the studies [11], it was found that soldiers returning from war who got little time to decompress between off-operational duties and enrollment into inherently stressful academic environments, showed higher levels of academic stress than soldiers who got plenty or enough time to 'get back to the center'. Shea [11] noted that soldiers who did not get time to adjust to roles like that of a parent, husband, kin in their families, if were put through additional pressures of academic stress, would experience stress the most and not perform as per expectations. In another study, [though not documented as an empirical study] of how decompression got charted into after-deployment or homecoming programs for militaries across the globe, is after the Falklands War in 1982, British military personnel reached back home by either of two ways—entirely by sea, meant an additional week to return home or they ferried their journey by sea and air. Press reports of the time suggested that the soldiers who travelled by sea route, and spent more time between the war and homecoming had better psychological health than those who made the trip in a shorter time [12].

#### **3.1 Value of decompression**

While engaging with the enemy on the ground, in the skies or even at sea are challenging environments, where military personnel go through immense psychological and mental changes, what could be as challenging, is to transition to environments that place different needs on their mental and psychological resources- like playing different roles, being available for their families, adjusting to non-combat

environment. To successfully tread, they must bring about physical and psychological changes [13]. A line of thought also suggests that personnel returning from operational environments may in fact be happy about being home right after, however, at the cost of signs of mental health symptoms getting masked [14].

Though there is perhaps no absolute consensus on definitions of decompression and what comprises decompression programs, there is a general understanding that this period consists of rest, and restoration and should have psychologists or trained mental health professionals conduct psychological debriefing. There is a general belief that decompression should be closer or in close proximity to the unit or teams that were together in the operational tasks. We will discuss some of the aims of decompression in this section, namely, providing opportunity for emotional settling, a safe place to de-acclimatise, and an opportunity for structured debriefing to release tension.


*Perspective Chapter: Decompression as a Safety Valve during Pandemic DOI: http://dx.doi.org/10.5772/intechopen.104648*

be—identification of lessons learned during operations which can direct actions in the future, resolve any misconceptions there could be, help soldiers paraphrase their battle experience positively, reduce sense of isolation and also make soldiers better aware of possible psychological symptoms resulting from stressful battle conditions.

Similar directions for the use or structure of debriefing are found in the work of Everly and Mitchell [2], who coined the term 'critical incident stress debriefing'. According to CISD model [2], debriefing promotes emotional wellbeing by allowing opportunities for dialog to the soldier, where they can vent and work on their emotions, perceptions and appraisals of the critical events in the theatre of war. However, it is important to acknowledge that such expression of emotions can be overwhelming to soldiers, perhaps risking them to relive the events. Thus, the aim of psychological debriefing should be established and affirmed by psychologists and team leaders [or those who are close to the trauma context] before use to prevent this technique from being detrimental [27]. Post-mission debriefing sessions typically involve talking about critical or traumatic incidents during tour of duty [4]. While psychological debriefing may be seen as a viable technique for emergency responders, caregivers especially in the COVID times, the authors recommend the use of debriefing under strict vigilance and with caution, simply because pandemic has resulted in limited or depleted resources and the technique could in fact prove to be detrimental if missed shot. Debriefing could perhaps well be replaced with more effective techniques like cognitive therapy, mindfulness training [28, 29].

4.Fostering post-traumatic growth attitude: Decompression period can also be looked as a window of opportunity to foster growth-attitude among soldiers. Post-traumatic growth defined as positive and meaningful psychological change that an individual can experience after they have experienced a traumatic incident or event and are coping from it [30]. Though events like wars, or even calamities get associated with negative consequences, and changed worldviews, some may see these as opportunities to review their perceptions of world view before and after the events, restructure their thoughts and emotions and direct their action in order to grow, revitalize their self-concepts and relationships with others, from having experienced the events [31]. Thus, post-traumatic growth is essentially moving away from the baseline and toward growth in refurbishing the worldview, sense of control over what the future holds [31]. Research suggests that post-traumatic growth thoughts and attitudes are inversely related to posttraumatic stress symptoms [32, 33]. Decompression thus can be an important period when psychologists or professionals or team leaders can facilitate development of post-traumatic growth attitudes and cognitions. Post-traumatic growth perspective could prove useful in the post-COVID times with the virus having caused loss of enthusiasm and change in worldview with prolonged experiences of isolation, social distancing and uncertainty. For example, recent studies suggest emotional creativity, may result in post-traumatic growth attitude, thereby reduces the chances of full-blown post-traumatic stress disorder [34].

COVID-19 pandemic has brought about tectonic changes beyond the realm of imagination of most of societies, even for those who have experienced WW II, which so far was thought to be the most ravaging event of the century. Other epidemics [like SARS, plague, Ebola] and calamities have not had the magnitude of impact and consequences that COVID-19 has caused. Thus, it becomes essential that the available knowledge of the past from crisis management experiences be remodeled, reinvented and re-adapted to suit what may fit the bill for reconstruction post-COVID crisis.

#### **3.2 Psychological consequences of covid-19 pandemic**

Why a discussion on decompression becomes important lies in the spectrum of psychological, social and interpersonal impact COVID-19 virus has brought about. COVID-19 presents before us the most-multifaceted crisis the human race has seen, a battle where the enemy is unknown and unseen. No amount of intelligence and force mobilization can fully avert the mayhem that the virus resulted in. With some common knowledge or best described as available knowledge of how spread of the virus can be curtailed, governments across the world imposed lockdown of economies, restrictions on movement, curb of social and interpersonal interactions and what seemed to be business as usual was no longer the same. Medically, the rapid infection and contagion resulted in strained medical systems. Economically, it meant businesses were thrown into fiscal deficits and societies were propelled into threats of destabilisation and loss of normalcy. Beyond the socio-economic disaster that the pandemic has been, psychological impact has been beyond comprehension and indisputable [35, 36]. Research suggests that fear of the pandemic and its uncertain nature could be a precursor to stress disorders, anxiety and other related problems, depression and even substance abuse [37]. With businesses being affected, it has resulted in people losing their source of livelihood and thereby adds to the stress of managing families. These could have potentially triggered related problems of substance abuse and panic disorders [38]. For emergency responders, this has been a period of turmoil, both professionally and personally. Long working hours, limited resources, worries about those affected, fear of being infected, inadequate access to basic resources, not being allowed to meet own families, being continuously in the line of action, suddenly being forced into harm's way has all resulted in psychological distress [39].

A general environment of despair and loss of hope has resulted from the experience of loss of loved ones or witnessing death in close proximity or sense of being lost. Being home bound or quarantined has resulted in sense of loneliness and isolation and curtailed scope of human-to-human interaction or social support. Measures put in place as first reaction to curb spread of virus like lockdown and social distancing are likely to result in far-reaching psychological problems which may keep brewing on the inside and erode the very fabric of human civilisation more than the damage caused by the virus itself. Thus, it has been nothing short of a psychological warfare.

Yet, in all this, it is important to acknowledge that survival instinct is innate in the human race and while the pandemic might have bogged down the spirit, the ability to bounce back higher and with far greater strength also are innate. Further to the discussion on post-traumatic growth, the application of the same may be exemplified in times to come. New learning gathered from the pandemic can be put to use to develop habits and systems which are resilient as well wean off behaviors (like addictions, behaviors detrimental to general hygiene, burnout at work, pollution, etc.) which are detrimental in survival of the species.

### **4. 9-R model of decompression for war-at-hand**

Most of decompression programs, as they exist in military organisations, agree on some of the core fundamentals like—belief that soldiers need some time-off after
