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Mind fitness and mental armor: enhancing performance and building warrior
resilience

Article · January 2009

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 MIND FITNESS AND MENTAL ARMOR:
ENHANCING PERFORMANCE AND BUILDING WARRIOR RESILIENCE

Elizabeth A. Stanley and Amishi P. Jha

Joint Force Quarterly, No. 55 (October 2009): forthcoming.

Author Contact Information:

Dr. Elizabeth A. Stanley
Assistant Professor of Security Studies
Edmund A. Walsh School of Foreign Service
Georgetown University
[email protected]

Dr. Amishi P. Jha

Assistant Professor
Center for Cognitive Neuroscience
Dept. of Psychology
University of Pennsylvania
[email protected]
www.attention.psych.upenn.edu
 Mind Fitness and Mental Armor
Stanley and Jha -1-

Today’s complex, fluid, and unpredictable operational environment both demands more

from the military in terms of mission requirements and exposes troops to more stressors and

potential trauma than ever before. On the one hand, situational awareness, mental agility and

adaptability are characteristics that the military wants to cultivate to succeed in such complex

environments. In part, this complexity comes from the number and nature of the different

missions the military must concurrently fill. The military needs to be able to mix offensive,

defensive and stability operations conducted along multiple lines of operations, without the

benefit of a clearly-demarcated “front line.” Many Soldiers liken this complexity and

unpredictability to “the faucet,” that is, needing to adjust to situations that could change from

cold to hot instantaneously. Moreover, Servicemembers must navigate morally ambiguous

situations with balance and nonreactivity, while drawing on stores of cultural awareness to “win

hearts and minds.” Finally, these missions require that decisionmaking be pushed down to the

most junior levels, as the doctrine of “distributed operations” makes clear. Such challenges

require a tremendous amount of attentional capacity, self-awareness, and situational awareness.

On the other hand, because of the stressors and challenges of this operating environment,

the U.S. military today is showing signs of strain. In 2007, the Army experienced its highest

desertion rate since 1980, an 80 percent increase since the United States invaded Iraq in 2003.

The warning signs of future retention problems are increasingly apparent: suicide, post-traumatic

stress disorder (PTSD), substance abuse, divorce, domestic violence, and murder within the force

are on the rise. Recent attention has focused on the rising number of suicides, with the Marine

Corps experiencing more suicides in 2008 than since the war began and the Army its highest

monthly total in January 2009 since it began counting in 1980. Not surprisingly, PTSD rates are
 Mind Fitness and Mental Armor
Stanley and Jha -2-

highest among Iraq and Afghanistan veterans who saw extensive combat (28 percent). However,

military health care officials are seeing a spectrum of psychological issues, even among those

without much combat experience. Various surveys provide a range of estimates, with up to half

of returning National Guard and Reservists, 38 percent of Soldiers, and 31 percent of Marines

reporting mental health problems.1

It is no wonder. Troops manning checkpoints or on patrol have to make split-second

decisions on when to use lethal force, and veterans say fear often clouded their judgment. As US

Army Sergeant Dustin Flatt put it, “The second you left the gate of your base, you were always

worried. You were constantly watchful for IEDs [improvised explosive devices]…If you’ve

been in firefights earlier that day or week, you’re even more stressed and insecure to a point

where you are almost trigger-happy.”2 The perpetual uncertainty is mentally exhausting and

physically debilitating, and often its effects linger even after returning home.

What can be done to enhance the military’s capacities to operate in such complex

environments while simultaneously protecting against the stressors inherent in them? This

article proposes a new training program for both improving operational effectiveness and

building resilience to the stressors of deployment: Mindfulness-based Mind Fitness Training

(MMFT, pronounced M-Fit). This program, which Stanley created specifically for military

cohorts, includes techniques and exercises which previous research in civilians has demonstrated

to be effective at enhancing the capacities central to mind fitness, such as mental agility, emotion

regulation, attention and situational awareness. Importantly, these exercises appear to achieve

improvements in mind fitness by changing brain structure and function so that brain processes

are more efficient. Our pilot research, conducted in predeployment Marine Reservists, suggests

that MMFT is similarly successful at bolstering mind fitness and building resilience against
 Mind Fitness and Mental Armor
Stanley and Jha -3-

stressors in a military cohort. Drawing on the well-documented theory of neuroplasticity, which

asserts that experience changes the brain, this article argues that mind fitness training could

complement the military’s existing stress inoculation training by developing skills to promote

resilience against stress and trauma so that warriors can execute their missions more effectively.

STRESS CA DEGRADE PERFORMACE

A variety of research indicates that harmful conditions such as chronic stress, neglect

and abuse can produce harmful changes in the brain.3 Stress is produced by real or imagined

events that are perceived to threaten an individual’s physical and mental well-being. Today

stress is commonly understood to mean external events or circumstances, and as a result, we tend

to think of stress as something external to us. However, stress is actually a perceived, internal

response. The right amount of stress will allow a decisionmaker to function at peak

performance. However, excessive stress has biological and psychological consequences that

reduce the capacity to process new information and learn. Stress may also bias decisionmaking

more towards reactive, unconscious emotional choices.

Recent empirical research about decisionmaking in stressful military environments

demonstrates that trauma and stress lead to deficits in cognitive functioning. One large study of

Army troops found that Soldiers who served in Iraq were highly likely to show lapses in memory

and an ability to focus, a deficit that often persisted more than two months after they arrived

home.4 In the study, 654 Soldiers who deployed to Iraq between April 2003 and May 2005 did

significantly worse in tasks that measured spatial memory, verbal ability and the ability to focus

than 307 Soldiers who had not deployed. In contrast, the Soldiers who had deployed

outperformed those who had not in terms of quick reaction time (for example, how long it takes

to spot a computer icon and react). In effect, the deployed Soldiers’ brains built the capacity for
 Mind Fitness and Mental Armor
Stanley and Jha -4-

quick reaction, a function more necessary for survival in Iraq, while experiencing degradation in

other mental capacities.

In another study, Soldiers who screened positive for mental health problems after

returning home were up to three times more likely to report having engaged in unethical

behavior while deployed.5 Such behavior, including unnecessarily damaging private property or

insulting or physically harming non-combatants, is obviously counterproductive to winning the

confidence of the local population. This finding suggests a strong link between the negative

effects of stress, which degrades Soldiers’ capacity to manage their own emotions and thereby

control impulsive, reactive behavior, and a decrease in their ability to perform their mission

effectively.

Other studies of military environments have found substantial degradation in cognitive

performance when subjects experience sleep deprivation and other environmental stressors. One

recent study of sleep deprivation among Navy SEALs and Army Rangers during a field training

exercise demonstrated that the lack of sleep affected troops so badly that after a week they

performed worse on cognitive tests than if they were sedated or legally drunk. In this study, the

SEALs and Rangers showed severe degradation in reaction time, vigilance, visual pattern

recognition, short term memory, learning and grammatical reasoning skills.6

Another group of studies examined more than 530 Soldiers, Sailors and pilots during

military survival training, including time in mock prisoner of war camps, to prepare them to

withstand the mental and physical stresses of capture. In these studies, exposure to acute

stressors resulted in symptoms of dissociation (alterations of one’s perception of body,

environment and the passage of time), problem-solving deficits (as measured by objectively

assessed military performance) and significant inaccuracies in working memory and spatial
 Mind Fitness and Mental Armor
Stanley and Jha -5-

memory (as measured by eyewitness identification tests).7 These findings corroborated with

other studies that found multistressor environments lead to substantial degradation of executive

control capacity and cognitive skills, and such degradation has been linked to battlefield errors,

such as friendly fire incidents and collateral damage.8

MID FITESS TRAIIG CA EHACE PERFORMACE

Optimal combat readiness requires three things:

• mission essential knowledge and skills

• physical fitness

• mind fitness.

All three components are crucial for equipping warriors to handle the challenges and stressors of

deployment. The military devotes substantial resources to the first two categories, both in terms

of funding and time on the training schedule. However, there is virtually no focus on mind

fitness training today. The Army’s Battlemind program is a first effort to raise Soldiers’

awareness of the psychological health issues associated with deployment, but Battlemind mostly

occurs after Soldiers return home and provides no skills training. Instead, it introduces them to

the cognitive and psychological effects of being deployed, provides psychological debriefing

sessions, and helps them identify warning signs for when to seek help. In short, the military

generally lacks proactive mind fitness training programs designed to give warriors skills that

optimize performance and protect against the stressors of deployment.

Most military training is “stress inoculation training,” because it exposes and habituates

warriors to the kinds of stressors they will face while deployed. Paradoxically, however, as the

previous section demonstrated, stress inoculation training depletes warriors’ executive control

capacity – that is, the mental capacity that allows us to focus on demanding cognitive tasks
 Mind Fitness and Mental Armor
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and/or emotionally challenging situations. As we explain below, mind fitness training may

counteract this cognitive degradation that results from stress inoculation training. Therefore, it

could complement existing military predeployment training, as it helps warriors to perceive and

relate to deployment stressors differently. In other words, mind fitness training may provide

“mental armor” to protect troops as they prepare for deployment and experience the stressors of

deployment itself.

Just as stress and trauma can functionally and structurally change the brain, so too can

training, practice and expertise. The brain of an expert – such as surgeon, taxi driver or musician

– is functionally and structurally different from that of a nonexpert. In one study of London cab

drivers, for example, researchers found that cab drivers have larger hippocampi than matched

controls and that the longer an individual worked as a cab driver, the larger the hippocampus.

The hippocampus is the brain region that controls conscious memory, obviously needed to

navigate London’s circuitous streets. These differences in hippocampus size were the result of

experience and training as a cab driver, not a result of preexisting differences in the hippocampal

structure.9

The London cab driver study highlights the well-documented theory of neuroplasticity,

which states that experience changes the brain.10 Areas of the brain may shrink or expand –

become more or less functional – based on experience. In other words, the brain, like the rest of

the body, builds the “muscles” it uses most, sometimes at the expense of other abilities. This

concept is something athletes, musicians and martial artists have known for a long time: with

physical exercise and repetition of certain body movements, the body becomes stronger, more

efficient, and better able to perform those movements with ease. A similar process can occur

with the brain: with the engagement and repetition of certain mental processes, the brain
 Mind Fitness and Mental Armor
Stanley and Jha -7-

becomes more efficient at those processes. This improved efficiency arises because any time we

perform a physical or mental task, the brain regions that serve task-related functions show

increased neuronal activity. Over time, as we choose to build a new mental skill, the repeated

engagement of the brain regions supporting that skill creates a more efficient pattern of neural

activity, for example, by rearranging structural connections between brain cells involved in that

skill. In other words, experience and training can lead to functional and structural reorganization

of the brain.

Thus, there is a profound parallel between physical fitness and mind fitness. Athletes

know that with repetition, physical fitness exercises can produce training-specific muscular,

respiratory and cardiovascular changes in the body. They know that specific training will

correspond to specific benefits and promote better recovery from specific injuries. For example,

sprints can build fast-twitch muscles, while longer runs can teach the body to burn fat instead of

glucose. Similarly, specific mental exercises may allow the mind to become more “fit” and

better protected against certain types of potential challenges by neuroplastic changes in the brain.

Mind fitness, in today’s operational environment, entails having a mind with highly

efficient capacities for mental agility, emotional regulation, attention, and situational awareness

(of self, others and the wider environment). Just as physical fitness corresponds to specific

enhancements in the body, mind fitness may correspond to enhancements in specific brain

structures and functions which support these capacities. And, like physical fitness, mind fitness

may be protective: it may build resiliency and lead to faster recovery from cognitive depletion

and psychological stress. We propose that mind fitness can be maintained even under high

demand and high stress contexts by regularly engaging in certain mental exercises. These

exercises engage and improve core mental processes, such as working memory capacity, which
 Mind Fitness and Mental Armor
Stanley and Jha -8-

lead to a more mentally agile, emotionally regulated, attentive and situationally aware mode of

functioning.

This scientific understanding is starting to be recognized and applied with many recent

research studies and popular books describing training programs to bolster mind fitness.11 These

training techniques have existed for thousands of years, originating in eastern spiritual traditions.

In recent decades they have been adapted for secular use, including in medical and mental health

settings, corporations, prisons, and elementary schools. The most common and well-validated

training program is mindfulness-based stress reduction (MBSR); more than 250 US hospitals

offer MBSR programs and more than 50 research articles document its utility in many

domains.12

Mind fitness can be enhanced through a variety of training techniques, but the

foundational skill cultivated in both MBSR and Stanley’s MMFT program is called

“mindfulness.” Mindfulness has been described as a process of “bringing one’s attention to the

present experience on a moment-by moment basis”13 and as “paying attention in a particular

way, on purpose, in the present moment and non-judgmentally.”14 Mindfulness differs from a

more conceptual mode of processing information, which is often the mind’s default way of

perceiving and cognizing. In other words, paying attention is not the same thing as thinking,

although we often equate the two.

There is growing empirical scientific evidence that increasingly supports the efficacy of

mindfulness-based interventions. Clinical studies demonstrate that civilian patients who

participated in such programs saw improvement in many physical and psychological conditions

and reported a decrease in mood disturbance from and stress related to these conditions.

Similarly, numerous studies have documented how mindfulness training positively alters
 Mind Fitness and Mental Armor
Stanley and Jha -9-

emotional experience by reducing negative mood as well as improving positive mood and

wellbeing.15 Mindfulness training has also been shown to increase tolerance of unpleasant

physical states, such as pain,16 produce brain changes consistent with more effective handling of

emotions under stress, and increase immune functioning.17 Finally, many studies have shown

that mindfulness training improves different aspects of attention, which is the ability to remain

focused on task-relevant information while filtering out distracting or irrelevant information.18

While this research draws from civilian populations, its findings clearly have implications

for the military context. These techniques have already been extended to war veterans with

PTSD, and preliminary results from this work suggest a reduction in symptoms.19 In addition,

mindfulness training could help optimize warrior performance by cultivating competencies

critical for the modern battlefield, such as improved self-regulation, better attentional skills and

enhanced situational awareness.

WORKIG MEMORY CAPACITY AD METAL ARMOR

Mind fitness, as we have operationalized it here, comprises mental faculties critical for

military effectiveness, such as mental agility, emotion regulation, attention, and situational

awareness. Interestingly, the cognitive neuroscience construct of “working memory capacity”

(WMC) has also been linked to these faculties. WMC is the ability to maintain relevant

information online while resisting interference from irrelevant information. Growing evidence

suggests that working memory capacity is tied to the ability to engage abstract problem-solving

and counterfactual thinking. Recently, neuroscientists report that in addition to these “cold”

cognitive processes requiring a high degree of mental flexibility and agility, “hot” emotional

regulation processes also rely on WMC.

 Mind Fitness and Mental Armor
Stanley and Jha -10-

While individuals differ in their baseline WMC, everyone’s WMC can be fatigued and

degraded after engaging in highly demanding cognitive or emotional tasks.20 Conversely, WMC

can be improved and strengthened through training. Studies have shown that individuals with

higher WMC have better attentional skills, abstract problem-solving skills and general fluid

intelligence (that is, the ability to use rather than simply know facts). They also suffer less from

emotionally intrusive thoughts and are more capable of suppressing or reappraising emotions

when required. In contrast, individuals with lower WMC have poorer academic achievement,

lower standardized test scores, and more episodes of mind-wandering. They are more likely to

suffer from PTSD, anxiety disorders, and substance abuse, and are more likely to exhibit

prejudicial behavior towards personally disliked groups.21 Thus, WMC corresponds to an

individual’s success at willfully guiding behavior while overcoming cognitive or emotional

distractions or impulsive tendencies.

Warriors with higher WMC are more likely to have better mind fitness and thus be better

equipped for responding to the cognitive and emotional challenges that come from preparing for

and experiencing deployment. These warriors are also more likely to maintain an effective level

of performance when confronted by obstacles, setbacks, and distractions, and return to their

baseline functioning after being exposed to stressors or traumatic experiences. Nonetheless, all

warriors (even those with higher WMC) are likely to suffer from some degree of WMC

degradation through the deployment cycle because the stressors of this time period are so

depleting of cognitive and emotional resources. Moreover, an individual’s position within the

military command structure may exacerbate the problem because recent evidence suggests that

being lower in a power hierarchy reduces WMC.22

 Mind Fitness and Mental Armor
Stanley and Jha -11-

Thus, an important component of optimal combat readiness should be to maintain or

increase baseline levels of WMC, despite the increase in stressors over the deployment cycle.

Because WMC can be strengthened through training, performance on both cold cognitive

processes and hot emotional regulation can be enhanced. Maintaining or enhancing warriors’

baseline levels of WMC could have cascading effects for effective decisionmaking, complex

problem-solving, and emotional regulation processes, all of which are heavily taxed over the

deployment cycle and are crucial for mission effectiveness. In other words, training to improve

WMC may provide “mental armor” to protect against impending deployment-related degradation

in mind fitness.

MMFT

Mindfulness-based Mind Fitness Training is a 24-hour course that is taught over 8 weeks

in groups of 20-25 Servicemembers. MMFT is based on the well-established MBSR course

known to improve attentional functioning and reduce the negative effects of stress. However,

MMFT is tailored for the military predeployment training cycle, with real-world examples from

the counterinsurgency environment that show how mind fitness skills can enhance performance

and mission accomplishment. During the course, troops learn about the stress reaction cycle and

its effects on the mind and body. They also learn how mind fitness training can boost resilience

to stress. Most importantly, and unlike the Army’s Battlemind training, MMFT provides skills

training through mind fitness exercises. These exercises are practiced 30 minutes a day. Some

exercises build concentration by focusing on one object of attention, such as a particular body

sensation. Others build situational awareness and nonreactivity through wider attention on

internal and external stimuli. And some exercises use focused attention to reregulate

physiological and psychological symptoms that develop from traumatic or stressful experiences.
 Mind Fitness and Mental Armor
Stanley and Jha -12-

The exercises are incorporated into physical training and other mission essential tasks and

completed during the duty day, in groups and/or individually. Thus, an important component of

the course is engaging in MMFT training exercises each day.

We recently conducted a pilot study of MMFT with a detachment of 31 Marine

Reservists, who received the training before they deployed to Iraq. (In March 2009, they

returned home from this deployment.) While some Marines resisted the effort required by the

training, the initial exposure was relatively positive. The entire detachment received training,

and MMFT’s didactic information and group practices helped to socialize the concept. Once

deployed, the Marines personalized their approach to the MMFT exercises, differing in how they

incorporated them into their daily routines. From their anecdotal reports during and after the

deployment, it appears some Marines continued the exercises during their down time, some

incorporated them into their physical fitness regimes, some employed them as part of their

premission rehearsals, and some employed them to keep themselves alert and focused while on

missions. Many Marines reported using the exercises at bedtime, which they said helped them to

quiet their minds, fall asleep faster, and sleep more soundly.

Before and after MMFT training (before they deployed), the Marines participated in a

battery of behavioral tasks to measure their cognitive capabilities. We had predicted that the

increase in stressors during predeployment training would degrade the Marines’ cognitive

performance. However, statistical analysis shows that the Marines who spent more time

engaging in mind fitness exercises (on average, 10 hours outside of class) saw an improvement

in their cognitive performance compared to Marines who spent less time engaging in the

exercises (on average, 2 hours outside of class).23 Specifically, despite the real increase in

stressors during the predeployment period, the Marines who engaged in more mind fitness
 Mind Fitness and Mental Armor
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training maintained the same perceived stress level and preserved or even improved their

working memory capacity over their initial baseline.

In contrast, the Marines who engaged in less mind fitness training experienced an

increase in their perceived stress levels and the predicted decrease in their working memory

capacity. This degradation in their WMC produced test scores of working memory capacity on

par with populations that have suffered psychological injuries such as PTSD and major

depression.24 It is important to note that this degradation in their working memory capacity

occurred before deployment, and thus does not reflect the additional stressors of the deployment

itself. The apparent costs of the predeployment context are striking, given that the intention of

the predeployment training is to prepare Servicemembers physically, emotionally and

cognitively for the stressors of deployment. Our findings highlight the potential importance of

providing mind fitness training within the predeployment time period to buffer against WMC

depletion.

While we have not yet fully analyzed the data from their postdeployment cognitive

behavioral testing, it is clear from a postdeployment survey that the Marines continued to engage

in mind fitness training and/or use the skills they learned while deployed. Sixteen percent of the

Marines said they “practiced regularly while deployed,” while 35 percent gave neutral responses

and 48 percent said they did not practice regularly. In contrast, 26 percent of the Marines said

they practiced mind fitness exercises “after particularly stressful or traumatic experiences,” while

35 percent gave neutral responses and 38 percent said they did not. Perhaps more importantly, 54

percent of the Marines said they “used the skills learned in this course downrange,” while 27

percent gave neutral responses, and 20 percent said they did not use MMFT skills while

deployed.
 Mind Fitness and Mental Armor
Stanley and Jha -14-

Thus, while only 16 percent practiced mind fitness exercises regularly during the

deployment, more than a quarter used the practices to reregulate themselves after stressful

experiences and more than half used MMFT skills during the deployment. These findings

suggest the need for adding more structured mind fitness exercise sessions into a unit’s daily

schedule during deployment. These findings also highlight again the parallel to physical fitness:

just as building muscle requires repetitive physical exercise, improving cognitive and emotional

performance require engaging in mind fitness exercises in a sustained, disciplined manner.

While mind fitness skills are quickly and easily taught, they require ongoing commitment to

develop and strengthen over time.

We acknowledge several limitations to this pilot study. Our cohort was a convenience

sample, consisting of a detachment that agreed to receive training. There was no waitlist or

active control group, although we are currently gathering control group data for further analysis.

We think this weakness was partially mitigated by our use of well-validated cognitive behavioral

instruments shown to be stable over time. This minimizes the possibility that the observed

changes simply reflected measurement artifact. Nonetheless, the fact that all Marines started

with similar WMC scores and that changes in their WMC scores over time correlate, in a

statistically significant way, with the amount of time spent engaging in mind fitness exercises

highlights the need for further study. To this end, we have recently received $2 million in

funding from the Department of Defense to examine how mind fitness training can build

resilience and combat readiness among Army Soldiers. The first study will compare MMFT to

the Army’s Battlemind program in a predeployment context. The second study will compare

different versions of MMFT in a nondeployment context, to see which version is most effective

at producing optimal cognitive and psychological performance among warriors.

 Mind Fitness and Mental Armor
Stanley and Jha -15-

COCLUSIOS

As this article has shown, mind fitness training can immunize against stress by buffering

against the cognitive degradation of military stress inoculation training and by permitting more

adaptive responses to and interpretation of stressors. Mind fitness training can also enhance

warrior performance by cultivating competencies critical for today’s security environment.

Finally, beyond its immediate effects for managing stress and enhancing mission performance,

mind fitness training is also protective: it builds resiliency and leads to faster recovery from

cognitive degradation and psychological injury. While warriors may choose to engage in mind

fitness exercises to optimize their performance downrange, the protective effects will still be

accruing – likely leading to a decrease in psychological injury (such as PTSD, anxiety, and

depression) upon returning home. As a result, mind fitness training could also reduce the

number of warriors in need of professional help and thereby reduce caregiver burnout among the

armed forces’ chaplains and medical and mental health professionals. In other words, mind

fitness training’s beneficial effects can continue long after the deployment is over, increasing the

likelihood that warriors will be ready, willing and able to deploy again, if needed.

Acknowledgements:

This project was funded by the John W. Kluge Foundation and the Dept of

Defense (Grant # W81XWH-08-1-0715 to APJ and EAS).

1
L. Baldor, “Army desertions surge in past year,” San Jose Mercury ews (Nov. 17, 2007), 4A; C.W.

Hoge, et al., “Mental Health Problems, Use of Mental Health Services, and Attrition from Military Service

After Returning From Deployment to Iraq or Afghanistan,” Journal of the American Medical Association,

295 (2006), 1023-1032; Charles S. Milliken et al., “Longitudinal Assessment of Mental Health Problems

Among Active and Reserve Component Soldiers Returning From the Iraq War,” Journal of the American
 Mind Fitness and Mental Armor
Stanley and Jha -16-

Medical Association 298, no. 18 (2007), 2141-2148; “Alcohol Abuse Rises Among Combat Veterans:

Study,” Reuters (August 12, 2008). Available at

http://www.reuters.com/article/healthNews/idUSN1252304620080812, accessed February 19, 2009;

“Divorce Rate Up in US Army, Marine Corps,” Associated Press (December 3, 2008). Available at

http://www.iht.com/articles/ap/2008/12/03/america/NA-US-Military-Divorces.php, accessed February 19,

2009; A. Keteyian, “Suicide Epidemic Among Veterans,” CBS News (November 13, 2007). Available at

http://www.cbsnews.com/stories/2007/11/13/cbsnews_investigates/printable3496471.shtml, accessed

January 3, 2008; Tony Perry, “Marine suicides in 2008 at a yearly high since Iraq invasion,” Los Angeles

Times (14 January 2009); Lizette Alvarez, “Army Data Shows Rise in Number of Suicides,” ew York

Times (February 5, 2009); D. Sontag and L. Alvarez, “Across America, Deadly Echoes of Foreign Battles,”

The ew York Times (January 13, 2008), A1; Terri Tanielian and Lisa Jaycox, eds., Invisible Wounds of

War Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery(Santa

Monica, CA: RAND, 2008); Office of the Surgeon Multi-National Force-Iraq, Office of the Command

Surgeon, and Office of The Surgeon General United States Army Medical Command, Mental Health

Advisory Team (MHAT) V Operation Iraqi Freedom 06-08: Iraq Operation Enduring Freedom 8:

Afghanistan (14 February 2008).

2
C. Hedges and L. Al-Arian, “The Other War,” The ation (July 30/August 6, 2007), 11-31, at 23.
3
Douglas Bremner, Does Stress Damage the Brain? Understanding Trauma-related Disorders from Mind-

Body Perspective (New York: W.W. Norton, 2002); Robert Scaer, The Trauma Spectrum: Hidden Wounds

and Human Resiliency (New York: W.W. Norton, 2005).

4
Jennifer J. Vasterling et al., “Neuropsychological outcomes of Army personnel following deployment to

the Iraq War,” Journal of the American Medical Association 296, no. 5 (2006): 519-529.
5
Office of the Surgeon Multi-National Force-Iraq, Office of the Command Surgeon, and Office of The

Surgeon General United States Army Medical Command, p. 32.

6
Harris R. Lieberman et al., “Severe decrements in cognition function and mood induced by sleep loss,

heat, dehydration and under-nutrition during simulated combat,” Biological Psychiatry 57 (2005): 422-429.
7
Charles A. Morgan III et al., “Accuracy of eyewitness memory for persons encountered during exposure

to highly intense stress,” International Journal of Law and Psychiatry 27 (2004): 265-279; Charles A.
 Mind Fitness and Mental Armor
Stanley and Jha -17-

Morgan III et al., “Stress-Induced Deficits in working memory and visuo-constructive abilities in Special

Operations Soldiers,” Biological Psychiatry 60 (2006): 722-729.

8
D.R. Haslam, “The military performance of Soldiers in sustained operations,” Aviation, Space and

Environmental Medicine 55 (1984): 216-221; Harris R. Lieberman et al, “Effects of caffeine, sleep loss and

stress on cognitive performance and mood during US Navy Seal training,” Psychopharmacology 164

(2002): 250-261; K. Opstad, “Circadian rhythm of hormones is extinguished during prolonged physical

stress, sleep and energy deficiency in young men,” European Journal of Endocrinology 131(1994): 56-66;

G. Belenky et al., “Sustaining Performance during Continuous Operations: The US Army’s Sleep

Management System,” in Pennington Center utritional Series, Vol. 10, Countermeasures for Battlefield

Stressors, K. Friedl et al., eds. (Baton Rouge, LA: Louisiana State University Press, 2000).
9
E.A. McGuire et al., “Navigation expertise and the human hippocampus: a structural brain imaging

analysis,” Hippocampus 13, no. 2 (2003): 250-259.

10
Jeffrey M. Schwartz and Sharon Begley, The Mind and the Brain: europlasticity and the Power of

Mental Force (New York: Harper Perennial, 2003).

11
Sharon Begley, Train Your Mind, Change Your Brain (New York: Random House, 2007); Ryuta

Kawashima, Train Your Brain: 60 Days to a Better Brain (New York: Kumon Publishing, 2005); Joel

Levy, Train Your Brain: The Complete Mental Workout for a Fit and Agile Mind (New York: Barnes and

Noble Publishing, 2007).

12
A. Lutz et al., “Attention regulation and monitoring in meditation,” Trends in Cognitive Sciences 12, no.

4(2008): 163-169; Amishi P. Jha et al., “Mindfulness Training Modifies Subsystems of Attention,”

Cognitive, Affective and Behavioral euroscience 7, no. 2 (2007): 109-119.

13
G.A. Marlatt and J. L. Kristeller, “Mindfulness and Meditation,” in Integrating Spirituality into

Treatment: Resources for Practitioners, William R. Miller, ed. (Washington, DC: American Psychological

Association, 1999), pp. 67-84, at 68.

14
Jon Kabat-Zinn, Wherever You Go, There You Are: Mindfulness Meditation in Daily Life (New York:

Hyperion, 1994), p. 4.
15
Ruth A. Baer, “Mindfulness Training as a Clinical Intervention: A Conceptual and Empirical Review,”

Clinical Psychology: Science and Practice 10, no. 2 (Summer 2003): 125-143; P.C. Broderick,
 Mind Fitness and Mental Armor
Stanley and Jha -18-

“Mindfulness and Coping with Dysphoric Mood: Contrasts with Rumination and Distraction,” Cognitive

Therapy and Research 29, no. 5 (2005): 501-510.

16
Joshua Grant, “Pain Perception, Pain Tolerance, Pain Control and Zen Meditation,” presentation at the

Mind and Life Summer Research Institute, June 5, 2007.

17
Richard J. Davidson et al., “Alterations in brain and immune function produced by mindfulness

meditation,” Psychosomatic Medicine 65, no. 4 (2003): 564-570.

18
Jha et al; E.R. Valentine and P.L.G. Sweet, “Meditation and attention: A comparison of the effects of

concentrative and mindfulness meditation on sustained attention,” Mental Health, Religion and Culture 2

(1999): 59-70; Heleen Slater et al., “Mental Training Affects Distribution of Limited Brain Resources,”

PLoS Biology 5, no, 6 (2007): e138.

19
A.P. King et al., “Pilot Study of a Mindfulness-based Group Therapy for Combat Posttraumatic Stress

Disorder (PTSD),” poster presented to American Psychosomatic Society, Baltimore, MD (2008).

20
B.J. Schmeichel, “Attention control, memory updating, and emotion regulation temporarily reduce the

capacity for executive control,” Journal of Experimental Psychology: General 136, no. 2 (2007): 241-255;
21
A.R. Conway et al., “Working memory span tasks: A methodological review and user's guide,”

Psychonomic Bulletin & Review 12, no. 5 (2005): 769-786.

22
P.K. Smith et al., “Lacking power impairs executive functions,” Psychological Science 19, no. 5 (2008):

441-447.
23
Amishi P. Jha et al., “Examining the Protective Effects of Mindfulness Training on Working Memory

Capacity and Affective Experience” Emotion (under review).

24
C.R. Brewin, and L. Smart, “Working memory capacity and suppression of intrusive thoughts,” Journal

of Behavioral Therapy and Experimental Psychiatry 36, no. 1 (2005): 61-68; T. Dalgleish et al., “Reduced

autobiographical memory specificity and posttraumatic stress: Exploring the contributions of impaired

executive control and affect regulation,” Journal of Abnormal Psychology 117 (2008): 236-241; T.

Dalgleish et al., “Reduced specificity of autobiographical memory and depression: The role of executive

processes,” Journal of Experimental Psychology: General 136 (2007): 23-42.

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