We train soldiers for war. Let's train them to come home, too | Hector Garcia

Translator: Sara Vilarelle Reviewer: Xosé María Moreno

Carlos,

Carlos,

the Vietnam vet Marine

un marine veterano do Vietnam,

who volunteered for three tours and got shot up in every one.

foi voluntario en tres destinos e nos tres recibiu un disparo.

In 1971, he was medically retired

En 1971 foi dado de baixa por razóns médicas

because he had so much shrapnel in his body

debido a que tiña tanta metralla no seu corpo

that he was setting off metal detectors.

que disparaba os detectores de metal.

For the next 42 years, he suffered from nightmares,

Nos 42 anos seguintes sufriu pesadelos,

extreme anxiety in public,

ansiedade extrema en público,

isolation, depression.

illamento, depresión.

He self-medicated with alcohol.

Automedicouse con alcohol.

He was married and divorced three times.

Casou e divorciouse tres veces.

Carlos had post-traumatic stress disorder.

Carlos tiña trastorno de estrés postraumático (TEPT).

Now, I became a psychologist to help mitigate human suffering,

Eu fíxenme psicólogo para axudar a mitigar a dor humana,

and for the past 10 years, my target has been the suffering caused by PTSD,

e nos últimos 10 anos, centreime no sufrimento causado polo TEPT,

as experienced by veterans like Carlos.

que sofren os veteranos coma Carlos.

Until recently, the science of PTSD just wasn't there.

Ata hai pouco, non existían estudos científicos sobre TEPT.

And so, we didn't know what to do.

E polo tanto non sabiamos que facer.

We put some veterans on heavy drugs.

Receitamos medicamentos fortes a algúns veteranos.

Others we hospitalized and gave generic group therapy,

A outros hospitalizámolos e démoslles terapia de grupo,

and others still we simply said to them,

e a outros tan só lles dixemos:

"Just go home and try to forget about your experiences."

«Marcha para a casa e intenta esquecer o que viviches».

More recently, we've tried therapy dogs, wilderness retreats --

agora probamos a terapia con cans, escapadas á natureza...

many things which may temporarily relieve stress,

moitas cousas que poderían reducir temporalmente o estrés,

but which don't actually eliminate PTSD symptoms over the long term.

pero que non eliminan os síntomas de TEPT a longo prazo.

But things have changed.

Pero as cousas cambiaron.

And I am here to tell you that we can now eliminate PTSD,

Estou aquí para dicirvos que agora podemos terminar co TEPT,

not just manage the symptoms,

non só controlar os síntomas,

and in huge numbers of veterans.

e nun gran número de veteranos.

Because new scientific research has been able to show,

Porque a investigación científica puido demostrar,

objectively, repeatedly,

obxectiva e repetidamente,

which treatments actually get rid of symptoms and which do not.

qué tratamentos eliminan realmente os síntomas e cales non.

Now as it turns out,

Resulta que

the best treatments for PTSD use many of the very same training principles

os mellores tratamentos para TEPT usan

moitos dos mesmos principios de formación

that the military uses in preparing its trainees for war.

que o exército usa ao preparar os seus recrutas para a guerra.

Now, making war --

Agora ben, facer a guerra...

this is something that we are good at.

iso dásenos ben.

We humans have been making war since before we were even fully human.

Nós, os humanos, levamos facendo a guerra

dende antes de ser completamente humanos.

And since then, we have gone from using stone and sinew

E dende entón, pasamos de usar pedras e tendóns

to developing the most sophisticated and devastating weapon systems imaginable.

a fabricar os sistemas de armas máis avanzados e destrutivos imaxinables.

And to enable our warriors to use these weapons,

E para que os nosos guerreiros usen estas armas,

we employ the most cutting-edge training methods.

utilizamos métodos de adestramento de vangarda.

We are good at making war.

Facer a guerra dásenos ben.

And we are good at training our warriors to fight.

E formar guerreiros para a loita dásenos ben.

Yet, when we consider the experience of the modern-day combat veteran,

Aínda así, considerando a experiencia dos veteranos de combate actuais,

we begin to see that we have not been as good

comezamos a ver que non se nos deu tan ben

at preparing them to come home.

preparalos para volver á casa.

Why is that?

Por que?

Well, our ancestors lived immersed in conflict,

Os nosos devanceiros viviron inmersos no conflito,

and they fought right where they lived.

e loitaban alí onde vivían.

So until only very recently in our evolutionary history,

Así que ata hai ben pouco na nosa historia evolutiva,

there was hardly a need to learn how to come home from war,

case non había necesidade de saber volver á casa da guerra,

because we never really did.

porque nunca o fixeramos.

But thankfully, today,

Pero afortunadamente, hoxe

most of humanity lives in far more peaceful societies,

a maioría da humanidade vive en sociedades moito máis pacíficas,

and when there is conflict, we, especially in the United States,

e cando hai un conflito, nós, especialmente nos Estados Unidos,

now have the technology to put our warriors through advanced training,

temos os medios para darlles aos nosos guerreiros formación avanzada,

drop them in to fight anywhere on the globe

deixalos na loita en calquera lugar do mundo

and when they're done,

e cando terminan,

jet them back to peacetime suburbia.

levalos de volta a un barrio tranquilo.

But just imagine for a moment what this must feel like.

Pero, por un momento imaxinádevos como debe de ser iso.

I've spoken with veterans who've told me

Falei con veteranos que me dixeron

that one day they're in a brutal firefight in Afghanistan

que un día están nunha loita brutal en Afganistán

where they saw carnage and death,

onde ven matanzas e morte,

and just three days later, they found themselves

e tan só tres días máis tarde, estaban

toting an ice chest to their kid's soccer game.

levando unha neveira portátil ao partido do seu fillo.

"Mindfuck" is the most common term.

"Fodida mental" é o termo máis común.

(Laughter)

(Risas)

It's the most common term I've heard to describe that experience.

É o termo máis común que oín para describir esa experiencia.

And that's exactly what that is.

E é exactamente iso.

Because while our warriors spend countless hours training for war,

Porque mentres os nosos guerreiros pasan horas e horas preparándose para a guerra,

we've only recently come to understand

nós aínda acabamos de comprender

that many require training on how to return to civilian life.

que moitos precisan de preparación para a volta á vida civil.

Now, like any training, the best PTSD treatments require repetition.

Como calquera aprendizaxe,

os mellores tratamentos de TEPT requiren repeticións.

In the military,

No exército,

we don't simply hand trainees Mark-19 automatic grenade launchers

non lles damos sen máis aos recrutas lanzagranadas Mark-19

and say, "Here's the trigger, here's some ammo and good luck."

e dicímoslles: «Aí está o gatillo e aquí tes munición, boa sorte».

No. We train them, on the range and in specific contexts,

Non. Preparámolos, en contextos variados e específicos,

over and over and over

unha e outra e outra vez

until lifting their weapon and engaging their target

ata que ergueren a súa arma e identificaren o inimigo

is so engrained into muscle memory

está tan gravado na memoria muscular

that it can be performed without even thinking,

que poden facelo sen pensar sequera,

even under the most stressful conditions you can imagine.

mesmo nas condicións máis estresantes que poidades imaxinar.

Now, the same holds for training-based treatments.

O mesmo aplícase aos tratamentos baseados na preparación.

The first of these treatments is cognitive therapy,

O primeiro destes tratamentos é a terapia cognitiva,

and this is a kind of mental recalibration.

e esta é un tipo de recalibración mental.

When veterans come home from war,

Cando os veteranos volven,

their way of mentally framing the world is calibrated

o seu marco de percepción do mundo está calibrado

to an immensely more dangerous environment.

para un contorno inmensamente máis perigoso.

So when you try to overlay that mind frame onto a peacetime environment,

De modo que se tentas aplicar ese marco a un contorno pacífico,

you get problems.

terás problemas.

You begin drowning in worries about dangers that aren't present.

Comezas a afogarte en preocupacións sobre perigos que nin sequera están aí.

You begin not trusting family or friends.

Comezas a desconfiar de familia e amigos.

Which is not to say there are no dangers in civilian life; there are.

O cal non quere dicir que non haxa perigos na vida civil; hainos.

It's just that the probability of encountering them

É só que a probabilidade de enfrontarte a eles

compared to combat

comparada cun combate

is astronomically lower.

é astronomicamente menor.

So we never advise veterans to turn off caution completely.

Así que non aconsellaremos aos veteranos que esquezan a cautela.

We do train them, however, to adjust caution

Preparámolos, porén, para calibrar a cautela

according to where they are.

en relación ao lugar onde están.

If you find yourself in a bad neighborhood,

Se te atopas nun mal barrio,

you turn it up.

activas a alerta.

Out to dinner with family?

Saes cear coa familia?

You turn it way down.

Desactívala.

We train veterans to be fiercely rational,

Preparamos aos veteranos para ser extremadamente racionais,

to systematically gauge the actual statistical probability

para avaliar sistemáticamente a probabilidade estatística real

of encountering, say, an IED here in peacetime America.

de enfrontarse, por dicir algo, a unha bomba oculta aquí, nos pacíficos EE.UU.

With enough practice, those recalibrations stick.

Coa práctica, esas recalibracións permanecen.

The next of these treatments is exposure therapy,

O seguinte tratamento é a terapia de exposición,

and this is a kind of field training,

e este é un tipo de adestramento de campo,

and the fastest of the proven effective treatments out there.

e o máis rápido dos tratamentos dispoñibles de eficacia probada.

You remember Carlos?

Lembrádesvos de Carlos?

This was the treatment that he chose.

Este foi o tratamento que escolleu.

And so we started off by giving him exercises,

Así que comezamos dándolle exercicios

for him, challenging ones:

que foron desafiantes:

going to a grocery store,

ir a un supermercado,

going to a shopping mall, going to a restaurant,

ir a un centro comercial, ir a un restaurante,

sitting with his back to the door.

sentar dándolle as costas á porta.

And, critically --

E, o máis crucial...

staying in these environments.

permanecer nestes contornos.

Now, at first he was very anxious.

Ao principio estaba tenso.

He wanted to sit where he could scan the room,

Quería sentar onde puidese analizar o cuarto,

where he could plan escape routes,

onde puidese planear rutas de escape,

where he could get his hands on a makeshift weapon.

onde puidese conseguir unha arma improvisada.

And he wanted to leave, but he didn't.

E quería marchar, pero non o fixo.

He remembered his training in the Marine Corps,

Lembrouse do seu adestramento na Marine Corps,

and he pushed through his discomfort.

e aguantou pese ao seu malestar.

And every time he did this, his anxiety ratcheted down a little bit,

E cada vez que facía isto, a súa ansiedade reducíase un pouco,

and then a little bit more and then a little bit more,

e outro pouco máis, e outro pouco máis,

until in the end,

ata que ao final,

he had effectively relearned how to sit in a public space

aprendera eficientemente como sentar nun espazo público

and just enjoy himself.

e gozar sen máis.

He also listened to recordings of his combat experiences,

Tamén escoitou gravacións das súas experiencias en combate,

over and over and over.

unha e outra e outra vez.

He listened until those memories no longer generated any anxiety.

Escoitou ata que eses recordos xa non lle provocaban ansiedade.

He processed his memories so much

Procesou os seus recordos ata tal punto

that his brain no longer needed to return to those experiences

que o seu cerebro non necesitaba regresar a esas experiencias

in his sleep.

mentres durmía.

And when I spoke with him a year after treatment had finished,

E cando falei con el un ano despois de que terminase o tratamento,

he told me,

díxome:

"Doc, this is the first time in 43 years

«Doutor, é a primeira vez en 43 anos

that I haven't had nightmares."

que non tiven pesadelos».

Now, this is different than erasing a memory.

Agora ben, isto non é o mesmo que borrar un recordo.

Veterans will always remember their traumatic experiences,

Os veteranos recordarán sempre as experiencias traumáticas,

but with enough practice,

pero coa suficiente práctica,

those memories are no longer as raw or as painful as they once were.

eses recordos non son tan fortes ou tan dolorosos como eran nun principio.

They don't feel emotionally like they just happened yesterday,

Emocionalmente, non parece que ocorreron onte,

and that is an immensely better place to be.

e iso é unha mellora inmensa.

But it's often difficult.

Pero a miúdo é difícil.

And, like any training, it may not work for everybody.

E, coma calquera adestramento, pode que non lles funcione a todos.

And there are trust issues.

E hai desconfianza.

Sometimes I'm asked,

Ás veces pregúntanme:

"If you haven't been there, Doc, how can you help me?"

«Se non che ocorreu a ti, como podes axudarme?»

Which is understandable.

O que é comprensible.

But at the point of returning to civilian life,

Pero no momento de volver á vida civil,

you do not require somebody who's been there.

non necesitas alguén que pasase polo mesmo.

You don't require training for operations on the battlefield;

Non necesitas adestramento para operacións no campo de batalla,

you require training on how to come home.

necesitas adestramento sobre como volver á casa.

For the past 10 years of my work,

Nos meus últimos 10 anos de traballo,

I have been exposed to detailed accounts

expúxenme a relatos detallados

of the worst experiences that you can imagine,

das peores experiencias que vos poidades imaxinar,

daily.

diariamente.

And it hasn't always been easy.

E non foi sempre fácil.

There have been times where I have just felt my heart break

Houbo veces que sentín que se me partía o corazón

or that I've absorbed too much.

ou que absorbera demasiado.

But these training-based treatments work so well,

Pero estes tratamentos baseados no adestramento funcionan tan ben

that whatever this work takes out of me, it puts back even more,

que por moito que este traballo me quite, sempre me achega máis,

because I see people get better.

porque vexo a xente recuperarse.

I see people's lives transform.

Vexo as vidas da xente transformarse.

Carlos can now enjoy outings with his grandchildren,

Agora Carlos pode gozar de excursións cos seus netos,

which is something he couldn't even do with his own children.

algo que non puido facer cos seus propios fillos.

And what's amazing to me is that after 43 years of suffering,

E o que me parece marabilloso é que tras 43 anos de sufrimento,

it only took him 10 weeks of intense training to get his life back.

só con 10 semanas de tratamento intensivo recuperou a súa vida.

And when I spoke with him, he told me,

E cando falei con el, díxome:

"I know that I can't get those years back.

«Sei que non podo recuperar eses anos.

But at least now, whatever days that I have left on this Earth,

Pero polo menos agora, os días que me quedan neste mundo,

I can live them in peace."

podo vivilos en paz».

He also said, "I hope that these younger veterans don't wait

Tamén dixo: «Oxalá os veteranos novos non esperen para recibir

to get the help they need."

a axuda que necesitan».

And that's my hope, too.

E eu tamén o espero.

Because ...

Porque...

this life is short,

esta vida é curta,

and if you are fortunate enough to have survived war

e se es suficientemente afortunado para sobrevivir á guerra

or any kind of traumatic experience,

ou a calquera tipo de experiencia traumática

you owe it to yourself to live your life well.

é o teu deber contigo mesmo ter unha boa vida.

And you shouldn't wait to get the training you need

E non deberías esperar para recibir o tratamento

to make that happen.

que o faga posible.

Now, the best way of ending human suffering caused by war

O mellor modo de terminar co sufrimento humano causado pola guerra

is to never go to war.

é non ir á guerra nunca.

But we are just not there yet as a species.

Pero aínda non chegamos aí como especie.

Until we are,

E ata que cheguemos,

the mental suffering that we create in our sons and in our daughters

o sufrimento psicolóxico que creamos nos nosos fillos e fillas

when we send them off to fight

cando os enviamos a loitar

can be alleviated.

pode aliviarse.

But we must ensure that the science, the energy level, the value

Pero debemos asegurar que a ciencia, o nivel de enerxía, o valor

that we place on sending them off to war

que depositamos en envialos á guerra

is at the very least mirrored

estea, como mínimo, igualado

in how well we prepare them to come back home to us.

co ben que os preparamos para cando volvan á casa con nós.

This much, we owe them.

Todo isto, debémosllelo.

Thank you.

Grazas.

(Applause)

(Aplausos)