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

Prevodilac: Nenad Ljubenović Lektor: Ivana Krivokuća

Carlos,

Karlos,

the Vietnam vet Marine

marinac, veteran Vijetnamskog rata

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

koji je dobrovoljno služio u tri navrata i svakog puta bio ranjavan.

In 1971, he was medically retired

Godine 1971. je penzionisan iz medicinskih razloga

because he had so much shrapnel in his body

zbog toga što je imao previše šrapnela u telu

that he was setting off metal detectors.

koji su često aktivirali detektore metala.

For the next 42 years, he suffered from nightmares,

Sledeće 42 godine je patio od noćnih mora,

extreme anxiety in public,

ekstremne anksioznosti u javnosti,

isolation, depression.

izolacije, depresije.

He self-medicated with alcohol.

Zloupotrebljavao je alkohol.

He was married and divorced three times.

Tri puta se venčavao i razvodio.

Carlos had post-traumatic stress disorder.

Karlos je imao posttraumatski stresni poremećaj (PTSP).

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

Ja sam postao psiholog kako bih pomogao u smanjenju ljudske patnje

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

i zadnjih 10 godina se bavim problemima uzrokovanim PTSP-om,

as experienced by veterans like Carlos.

kakav su iskusili ratni veterani kao što je Karlos.

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

Do skoro, jednostavno nije bilo naučnih podataka o PTSP-u.

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

Tako da nismo znali šta da radimo.

We put some veterans on heavy drugs.

Neke ratne veterane smo tretirali jakim lekovima.

Others we hospitalized and gave generic group therapy,

Druge smo hospitalizovali i uključivali u standardnu grupnu terapiju,

and others still we simply said to them,

a nekima smo jednostavno rekli:

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

„Idite kući i pokušajte da zaboravite svoja neprijatna iskustva.“

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

U poslednje vreme probali smo terapiju sa psima, terapiju u prirodi,

many things which may temporarily relieve stress,

mnogo stvari koje mogu privremeno smanjiti stres,

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

ali koje u dugoročnom pogledu ne eliminišu simptome PTSP-a.

But things have changed.

Međutim, stvari su se promenile.

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

Ovde sam da vam kažem da danas možemo u potpunosti eliminisati PTSP,

not just manage the symptoms,

ne samo da kontrolišemo simptome,

and in huge numbers of veterans.

i to kod velikog broja veterana.

Because new scientific research has been able to show,

Nova naučna istraživanja su uspela da pokažu,

objectively, repeatedly,

objektivno, više puta,

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

koji postupci zaista uklanjaju simptome, a koji to ne mogu.

Now as it turns out,

Kako se ispostavilo,

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

najbolji tretmani za PTSP koriste mnoge slične principe obuke

that the military uses in preparing its trainees for war.

koje vojska korisiti prilikom pripreme vojnika za rat.

Now, making war --

Stvaranje rata

this is something that we are good at.

je nešto u čemu smo dobri.

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

Mi ljudi smo ratovali i pre nego što smo zaista postali ljudi.

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

Od tada smo prešli put od upotrebe sirove snage i kamenja

to developing the most sophisticated and devastating weapon systems imaginable.

do razvoja najsofisticiranijih i razarajućih oružanih sistema.

A da bismo osposobili naše vojnike da koriste ovakva oružja,

And to enable our warriors to use these weapons,

we employ the most cutting-edge training methods.

koristimo najsavremenije metode obuke.

We are good at making war.

Dobri smo u vođenju rata.

And we are good at training our warriors to fight.

A dobri smo i u obučavanju naših vojnika da se bore.

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

Međutim, kada uzmemo u obzir iskustvo ratnih veterana modernog doba,

we begin to see that we have not been as good

uviđamo da nismo toliko dobri

at preparing them to come home.

u njihovoj pripremi da se vrate kući.

Why is that?

Zašto je to tako?

Well, our ancestors lived immersed in conflict,

Naši preci su živeli okruženi konfliktima

and they fought right where they lived.

i ratovali su na istom mestu gde su i živeli.

So until only very recently in our evolutionary history,

Do skoro tokom naše evolucije,

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

skoro da nije bilo potrebe da znamo kako da se vratimo iz rata

zato što se zaista nismo ni vraćali.

because we never really did.

But thankfully, today,

Srećom, danas najveći deo čovečanstva živi u mnogo mirnijim društvenim zajednicama,

most of humanity lives in far more peaceful societies,

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

a kada negde postoji konflikt, mi, naročito u SAD-u,

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

imamo mogućnosti da podvrgnemo naše vojnike naprednim treninzima,

drop them in to fight anywhere on the globe

da ih ubacimo u borbu bilo gde na planeti,

and when they're done,

a kada završe,

jet them back to peacetime suburbia.

da ih prebacimo u mirnu urbanu sredinu.

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

Zamislite samo na trenutak kako ovo zaista izgleda.

Razgovarao sam sa ratnim veteranima

I've spoken with veterans who've told me

koji su mi rekli da su jednog dana bili u ekstremnim borbama u Avganistanu

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

where they saw carnage and death,

gde su videli pokolj i smrt,

and just three days later, they found themselves

a samo tri dana kasnije su se našli u situaciji

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

da nose ručne frižidere na fudbalskim utakmicama svoje dece.

"Mindfuck" is the most common term.

„Sjebavanje uma“ je najbolji izraz.

(Laughter)

(Smeh)

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

To je najčešći termin koji sam čuo da se koristi za opis takvog iskustva.

And that's exactly what that is.

A to je zaista tako.

Because while our warriors spend countless hours training for war,

Dok naši vojnici provode bezbroj sati pripremajući se za rat,

we've only recently come to understand

mi smo tek skoro shvatili

da je mnogima potrebna obuka kako da se vrate u normalan život.

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

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

Kao i bilo koji trening, najbolji tretmani PTSP-a zahtevaju ponavljanje.

In the military,

U vojsci,

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

mi ne dajemo regrutima jednostavno minobacače Mark-19

i kažemo: „Ovde je okidač, evo ti municija i srećno.“

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

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

Ne. Obučavamo ih na strelištu u specifičnim uslovima,

over and over and over

ponovo i ponovo i ponovo

until lifting their weapon and engaging their target

sve dok držanje oružja i ciljanje mete

is so engrained into muscle memory

ne bude tako ukorenjeno u njihovu mišićnu memoriju

that it can be performed without even thinking,

da se može izvesti i bez razmišljanja,

even under the most stressful conditions you can imagine.

čak i u najstresnijim situacijama koje možete da zamislite.

Now, the same holds for training-based treatments.

To isto važi i za terapiju baziranu na treninzima.

The first of these treatments is cognitive therapy,

Prvi od ovih tretmana je kognitivna terapija,

and this is a kind of mental recalibration.

a to je jedna vrsta mentalne rekalibracije.

When veterans come home from war,

Kada se veterani vrate kući iz rata,

their way of mentally framing the world is calibrated

njihov način poimanja sveta je prilagođen

to an immensely more dangerous environment.

na strahovito opasnije okruženje.

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

Tako da, kada pokušate da primenite takav način poimanja na mirno okruženje,

you get problems.

dobijate probleme.

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

Počinjete da se davite u brigama o opasnostima koje nisu prisutne.

You begin not trusting family or friends.

Počinjete da ne verujete svojoj porodici i prijateljima,

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

Nije da ne postoje opasnosti u civilnom životu; ima ih.

It's just that the probability of encountering them

Radi se o tome da je verovatnoća susretanja tih opasnosti

compared to combat

u poređenju sa borbenim ratnim dejstvima

is astronomically lower.

astronomski niža.

So we never advise veterans to turn off caution completely.

Tako da mi nikada ne savetujemo veterane da sasvim odbace oprez.

We do train them, however, to adjust caution

Mi ih treniramo kako da prilagode svoj oprez

according to where they are.

u zavisnosti od toga gde se nalaze.

If you find yourself in a bad neighborhood,

Ako se nađete u lošem kraju,

you turn it up.

povećate opreznost.

Out to dinner with family?

Izlazak na večeru sa porodicom?

You turn it way down.

Vi je skroz smanjite.

We train veterans to be fiercely rational,

Mi učimo ratne veterane da budu veoma racionalni,

to systematically gauge the actual statistical probability

da sistematski odmere realnu statističku verovatnoću

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

susreta sa, recimo, improvizovanom eksplozivnom napravom

ovde, u mirnodopskoj Americi.

With enough practice, those recalibrations stick.

Sa dovoljno vežbe, takve rekalibracije deluju.

The next of these treatments is exposure therapy,

Sledeći od ovih tretmana je terapija izlaganjem,

and this is a kind of field training,

a to je vrsta obuke na terenu

and the fastest of the proven effective treatments out there.

i najbrži od postojećih delotvornih tretmana.

You remember Carlos?

Sećate se Karlosa?

This was the treatment that he chose.

To je bio tretman koji je on izabrao.

And so we started off by giving him exercises,

I tako smo počeli da mu zadajemo vežbe

for him, challenging ones:

koje su izazov za njega:

going to a grocery store,

odlazak u nabavku namirnica,

going to a shopping mall, going to a restaurant,

odlazak u tržni centar,

odlazak u restoran

sitting with his back to the door.

sedeći okrenut leđima ka izlaznim vratima.

And, critically --

I, ono što je ključno,

staying in these environments.

ostajanje u ovakvim okruženjima.

Now, at first he was very anxious.

Najpre je bio veoma anksiozan.

He wanted to sit where he could scan the room,

Hteo je da sedi na mestu odakle bi mogao da osmatra prostoriju,

where he could plan escape routes,

odakle bi mogao da isplanira plan bekstva,

where he could get his hands on a makeshift weapon.

odakle bi mogao da se domogne nekog improvizovanog oružja.

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

Hteo je da ode, ali nije.

He remembered his training in the Marine Corps,

Setio se svoje obuke u Marinskom korpusu

and he pushed through his discomfort.

i prebrodio je svoju nelagodnost.

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

Svakog puta kad je radio ovo, njegova anksioznost se umanjila,

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

a onda još malo i još malo

until in the end,

sve do kraja,

he had effectively relearned how to sit in a public space

kada je u potpunosti ponovo naučio kako da sedi na javnom mestu

and just enjoy himself.

i jednostavno uživa.

He also listened to recordings of his combat experiences,

Takođe je preslušavao snimke iz svojih borbi

over and over and over.

iznova i iznova.

He listened until those memories no longer generated any anxiety.

Preslušavao ih je sve dok ta sećanja više nisu uzrokovala anksioznost.

He processed his memories so much

Toliko je obradio svoja sećanja

that his brain no longer needed to return to those experiences

da njegov mozak više nije morao da se vraća na ta sećanja tokom spavanja.

in his sleep.

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

A kada sam pričao sa njim godinu dana nakon završenog tretmana,

he told me,

rekao mi je:

"Doc, this is the first time in 43 years

„Doco, ovo je prvi put u proteklih 43 godine

that I haven't had nightmares."

da nisam imao noćne more.“

Now, this is different than erasing a memory.

Ovo se razlikuje od brisanja sećanja.

Veterans will always remember their traumatic experiences,

Ratni veterani će se uvek sećati svojih traumatičnih doživljaja,

but with enough practice,

ali sa dovoljno vežbe,

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

ta sećanja nisu više toliko sirova i bolna kao što su nekada bila.

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

Oni se emocionalno ne osećaju kao da se to juče dogodilo,

and that is an immensely better place to be.

a to je nemerljivo bolje za njih.

But it's often difficult.

Međutim, to je često teško.

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

I kao i svaka druga obuka, možda neće delovati na svakoga.

And there are trust issues.

A postoje i problemi poverenja.

Sometimes I'm asked,

Ponekad me pitaju:

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

„Doco, ako niste bili tamo, kako mi možete pomoći?“

Which is understandable.

Što je i razumljivo.

But at the point of returning to civilian life,

Međutim, kada se radi o povratku u civilni život,

you do not require somebody who's been there.

nije vam potreban neko koje već bio tamo.

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

Nije vam potrebna obuka za operacije na bojnom bolju;

you require training on how to come home.

potrebna vam je obuka o tome kako da se vratite kući.

For the past 10 years of my work,

Tokom poslednjih 10 godina mog rada,

I have been exposed to detailed accounts

imao sam dodira sa detaljima

of the worst experiences that you can imagine,

najgorih iskustava koje možete da zamislite

daily.

svakodnevno.

And it hasn't always been easy.

Nije uvek bilo lako.

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

Bilo je trenutaka kada sam osetio da mi se srce slama

or that I've absorbed too much.

ili da sam se previše udubio.

But these training-based treatments work so well,

No, ovi tretmani bazirani na obuci deluju toliko dobro

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

da koliko god mi ovaj posao oduzima, on mi čak i više vraća,

because I see people get better.

zato što vidim da je ljudima bolje.

I see people's lives transform.

Vidim kako se život ljudima transformiše.

Carlos can now enjoy outings with his grandchildren,

Karlos sada može da uživa u izlascima sa svojim unucima,

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

što je nešto što nije mogao da radi čak ni sa svojom decom.

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

A ono što me zapanjuje je da mu je posle 43 godine patnje

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

bilo potrebno samo 10 nedelja intenzivne obuke da povrati svoj život.

And when I spoke with him, he told me,

A kada sam razgovarao sa njim, rekao mi je:

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

„Znam da ne mogu da vratim te godine nazad.

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

Ali koliko god dana da mi je ostalo na zemlji,

I can live them in peace."

mogu da ih proživim u miru.“

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

Takođe je rekao: „Nadam se da mlađi veterani neće čekati

to get the help they need."

da potraže pomoć koja im je potrebna."

And that's my hope, too.

A tome se i ja nadam.

Because ...

Jer...

this life is short,

ovaj život je kratak,

and if you are fortunate enough to have survived war

i ako ste imali sreće da preživite rat

or any kind of traumatic experience,

ili bilo koju vrstu traumatskog iskustva,

you owe it to yourself to live your life well.

dugujete sebi da lepo živite svoj život.

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

I ne treba da čekate da počnete sa obukom koja vam je potrebna

to make that happen.

da to ostvarite.

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

Najbolji način da se okonča ljudska patnja uzrokovana ratom

is to never go to war.

je da se nikad ne ide u rat.

But we are just not there yet as a species.

Ipak, još nismo stigli dotle kao vrsta.

Until we are,

Sve dok ne stignemo tamo,

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

psihička patnja koju stvaramo kod naših sinova i kćerki

when we send them off to fight

kada ih šaljemo u rat

can be alleviated.

može biti ublažena.

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

Međutim, moramo se postarati da nauka, količina energije, vrednosti

that we place on sending them off to war

koje ulažemo šaljući ih u rat

is at the very least mirrored

u najmanju ruku odražavaju

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

koliko kvalitetno ih pripremamo da nam se vrate kući.

This much, we owe them.

Toliko im dugujemo.

Thank you.

Hvala vam.

(Applause)

(Aplauz)