In 1985, while making the very difficult descent after summiting the 21000 foot  Siula Grand Mountain in the Peruvian Andes, Two British mountaineers, Joe Simpson and Simon Yates ran into a catastrophe when Simpson suffered a broken leg; basically a death sentence above 19000 feet on the completely uninhabited, snow-covered mountain in Peru. Simpson had to do something to stop his mind from descending towards death. He knew he had screwed up big time. Then something clicked in him. He stayed silent. He knew “if he said a word he would panic, he could feel himself on the edge of it. He took cognitive control. He had successfully put his thinking brain in balance with his emotional brain so that the two could help him to function. Yates rappelled down to Simpson and examined him. He gave him some pain medicine. Neither spoke. As Simpson put it, “In an instant an uncross able gap had come between us.” They were both working on shifting decisions out of the amygdala and into the neocortex. In such a dire emergency, the amygdala would urge instant action without thought. It has the chemical authority to do that, too. So it took energy, balance, and concentration to shift control to the executive functions of the neocortex. Time was of the essence. They had run out of water and fuel. They had to get down fast of they would both die. There approach was orderly, bold yet cautions, inventive; in a moment it would also become playful as well. Simpson was learning what it meant to be playful in such circumstances: “A pattern of movements developed after my initial wobbly hops and I meticulously repeated the pattern. Each pattern made up of one step across the slope and I began to feel detached from everything around me. I thought of nothing but the pattern.” His struggles had become a dance, and the dance freed him from the terror of what he had to do. “ I knew I was done for,” Simpson wrote later, “It would make difference in the long run, but I kept going because of the pattern”. “ I had forgotten my partner was even there, I lost track of time, I had even almost forgotten why I was even doing the pattern for a while.” Then Simpson went over the edge again, and this time Yates had no choice but to cut the rope, almost certainly killing his friend. Simpson fell for a long time, and much to his surprise woke up very much alive. On the almost impossible climb out of the crevasse, Simpson returned to his old friend, the patterns and rhythms of the dance. He’d place his ice tools, plant his good foot, then pull hard while hopping upward to plant the foot a bit higher up. “Bend, hop, rest; bend, hop, rest…” He found that once more concentrating on the pattern helped him ignore the pain. At the same time that he took the greatest risk, he was also safe-guarding himself. “I resisted the urge to look up or down. I knew I was making desperately slow progress and I didn’t want to be reminded of it by seeing the sunbeam still far above me.” This poses an interesting question: How can you know something and still keep from reminding yourself of it? Indeed, when Simpson said he “knew”, he means that his hippocampus contained a short-term memory pattern about his situation. But the visual perception of how far he had to go would be sent straight down through the thalamus to the amygdala to be screened, and that it was he wished to avoid, because it might trigger a whole new set of emotions that he didn’t need right now. He could bump what was in his working memory out by concentrating on something else: his pattern. It was a wise choice. Keep the perceptual input to a minimum right now. Don’t feed the amygdala any scary raw data.

We can learn a lot from Joe Simpson we can use to get us through those tough runs & rucks. I personally have adopted Dean Karnazes mantra of "Smooth, Long, Strong". Basically ever time my left foot hits the ground I say "Smooth", then "Long", then "Strong", I say nothing the next time my left foot hits the ground, then start all over again. This mantra works for me for about 17 miles, then I have to change it up. Recently, at the Spartan Death Race, I simply went with "Pick It Up, Put It Down", obviously just instructing my body what I should be doing with my feet.  Even if your skeptical, I encourage you to try it out. Say the mantra out loud or too your self. I have found this to be one of the most effective interventions that I can give a Soldier on the spot during a ruck march and it works almost immediately by not only getting their mind off what ever misery that they are experiencing, but also helps to get their breathing, heart rate, and brain waves in rhythm.

 
 
Under extreme and stressful conditions, humans don’t rise to the occasion, they sink to their training. Extreme environments are characterized as those situations which place a high demand on the physiological, affective, cognitive, and/or social processing resources of the individual. Extreme environments strongly perturb the body and mind, which in turn initiate complex cognitive and affective response strategies. Different types of extreme environments may share some aspects but can also have unique demand characteristics. For example, exposure to the cold and isolated environment of an Antarctic expedition may result in extreme social and sensory deprivation, whereas exposure to military combat operations may entail extreme sensory overload. It is clear that there are many different types of extreme environments or situations, but it is less clear that an individual’s cognitive and affective responses are as varied as the different types of extreme environments. From a systems neuroscience perspective, optimal performance under extreme conditions can be conceptualized as goal-oriented task completion during a high demand context. This conceptualization highlights the importance of stress-related neural processing, of cognitive control, and of learning for the adaptation to extreme environments. There is little doubt that rigorous physical trailing has the capacity to strengthen and build an individual’s cognitive and affective response to stressful conditions and extreme environments; however, research suggests that it needs to include building mental as well as physical strength as its primary goals.

OPTIMAL PERFORMANCE EXPLAINED FROM A NEUROSCIENCE POINT OF VIEW

Research suggests that there are two cognitive processes which can be examined experimentally and that are critical for top-down control and learning and may be critical for optimal performance. These two cognitive processes are: (1) feedback of an adverse outcome, which is necessary for adjusting behavioral strategies in decision-making; and (2) top-down modulation of ascending sensorimotor information to predict future states, which is an important evolutionary advantage associated with the development of complex cortical circuitry. The top-down modulatory ability is fundamentally related to the cognitive appraisal notion introduced above and to learning associations between stimuli and future pleasant or aversive outcomes. For example, the rate of reward learning depends on the discrepancy between the actual occurrence of reward and the predicted occurrence of reward, the so-called ‘reward prediction error’ (Schultz, Dayan, & Montague, 1997). Below we briefly review aspects of stress, the key neural substrates in performing under stressful conditions, and the proposed role of two brain areas that may contribute to optimal performance in extreme conditions. Neuroscientists have developed a preliminary model of optimal performance in extreme environments (Paulus et al, in press) that starts with the observation that these environments exert profound interoceptive effects. Interoception is (a) sensing the physiological condition of the body (Craig, 2002), (b) representing the internal state (Craig, 2009) within the context of ongoing activities, and (c) initiating motivated action to homeostatically regulate the internal state (Craig, 2007). Interoception includes a range of sensations such as pain (LaMotte, Thalhammer, Torebjork, & Robinson, 1982), temperature (Craig & Bushnell, 1994), itch (Schmelz, Schmidt, Bickel, Handwerker, & Torebjork, 1997), tickle (Lahuerta, Bowsher, Campbell, & Lipton, 1990), sensual touch (Vallbo, Olausson, Wessberg, & Kakuda, 1995; Olausson et al., 2002), muscle tension (Light & Perl, 2003), air hunger (Banzett et al., 2000), stomach pH (Feinle, 1998), and intestinal tension (Robinson et al., 2005), which together provide an integrated sense of the body’s physiological condition (Craig, 2002). These sensations travel via small-diameter primary afferent fibers, which eventually reach the anterior insular cortex for integration (Craig, 2003b). The interoceptive system provides this information to (1) systems that monitor value and salience (orbitofrontal cortex and amygdala); (2) are important for evaluating reward (ventral striatum/extended amygdala); and (3) are critical for cognitive control processes (anterior cingulate). Moreover, the more anterior the representation of the interoceptive state within the insular cortex the more “textured”, multimodal, and complex the information that is being processed due to the diverse cortical afferents to the mid and anterior insula. Scientists have hypothesized that the anterior insula not only receives interoceptive information but is also able to generate a predictive model (Paulus & Stein, 2006), which provides the individual with a signal of how the body will feel, similar to the “as if” loop in the Damasio somatic marker model (Damasio, 1994).

SO HOW DO OPTIMAL PERFORMERS USE THEIR BRAINS?

The interoceptive information is thus “contextualized”, i.e. brought in relation to other ongoing affective, cognitive, or experiential processes, in relation to the homeostatic state of the individual, and is used to initiate new or modify ongoing actions aimed at maintaining the individual’s homeostatic state. In this fashion interoceptive stimuli can generate an urge to act. Thus individuals who are optimal performers: (1) have developed a well “contextualized” internal body state that is associated with an appropriate level to act. In contrast, sub-optimal performers either receive interoceptive information that is too strong or too weak to adequately plan or execute appropriate actions. As a consequence, there is a mismatch between the experienced body state and the necessary action to maintain homeostasis. Therefore, a neural systems model of optimal performance in extreme environments includes brain structures that are able to process cognitive conflict and perturbation of the homeostatic balance, i.e. the anterior cingulated and insular cortex. Thus, ultimately, engagement of these brain structures is likely to be predictive of performance and may also be used as an indicator of efficacy of an intervention.

Resilience refers to (1) the ability to cope effectively with stress and adversity and (2) the positive growth following homeostatic disruption (Richardson, 2002) and is an important psychological construct to examine how individuals respond to challenging situations and stay mentally and physically healthy in the process (Tugade, Fredrickson, & Barrett, 2004c). The ability to regulate and generate positive emotions plays an important role in the development of coping strategies when confronted with a negative event (Bonanno, 2004b). In particular, resilient individuals often generate positive emotions in order to rebound from stressful encounters (Tugade, Fredrickson, & Barrett, 2004b). Nevertheless, the experimental assessment of resilience is challenging and requires novel behavioral and neural systems techniques (Charney, 2006). Despite the increasingly common and not all together correct use of the term within the military today, resilience is a complex and possibly multidimensional construct (Luthar, Cicchetti, &Becker, 2000). It includes trait variables such as temperament and personality as well as cognitive functions such as problem-solving that may work together for an individual to adequately cope with traumatic events (Campbell-Sills, Cohan, & Stein, 2006b). Here, we focus on resilience in terms of a process through which individuals successfully cope with (and bounce back from) stress (e.g., after being fired from a job, an individual adopts a proactive style improving his job hunting and work performance), rather than a simple recovery from insult (e.g., job loss causes a period of initial depressive mood followed by a return to affective baseline without attempting to modify habitual coping mechanisms to prevent its reoccurrence). The use of mental toughness training in conjunction with military physical training is based on research that aimed to show that resilience, which is a critical characteristic to perform optimally in extreme environments, has significant effects on brain structures that are thought to be important for optimal performance.

As elaborated above, neuroscientists hypothesize that limbic and paralimbic structures play an important role in helping individuals adjust to extreme conditions. Thus, the activation in amygdala and insular cortex are critically modulated by the level of resilience. In particular, if the anterior insular plays an important role in helping to predict perturbations in the internal body state, one could hypothesize that greater activation in this structure is associated with better resilience. Moreover, if one assumes that the amygdala is important in assessing salience in general and the potential of an aversive impact in particular, one could also hypothesize that greater resilience is associated with relatively less activation in the amygdala during stressful events. The involvement of the insular cortex supports our general notion that this brain structure may be critically involved in assessing ongoing internal body states as they relate to challenges in the outside world. Activation of insular cortex has been reported in a number of processes including pain (Tracey et al., 2000), interoceptive (Critchley, Wiens, Rotshtein, Ohman, & Dolan, 2004), emotion related (Phan, Wager, Taylor, & Liberzon, 2002), cognitive (Huettel, Misiurek, Jurkowski, & McCarthy, 2004), and social processes (Eisenberger, Lieberman, & Williams, 2003). In reward-related processes the insular cortex is important for subjective feeling states and interoceptive awareness (Craig, 2002; Critchley et al., 2004) and has been identified as taking part in inhibitory processing with the middle and inferior frontal gyri, frontal limbic areas, and the inferior parietal lobe (Garavan, Ross, & Stein, 1999).

WHY HOW USE A NEUSROSCIENCE APPROACH TO A BUILDING MENTAL TOUGHNESS & RESILIENCE THROUGH A MILITARY PHYSICAL TRAINING PROGRAM?

The neuroscience approach to understanding optimal performance in extreme environments has several advantages over traditional descriptive approaches. First, once the roles of specific neural substrates were identified, they could be targeted for interventions. Second, studies of specific neural substrates involved in performance in extreme environments could be used to determine what cognitive and affective processes are important for modulating optimal performance. Third, quantitative assessment of the contribution of different neural systems to performance in extreme environments could be used as indicators of training status or preparedness. The observation that the insular cortex and amygdala are modulated by levels of resilience were a first step in bringing neuroscience approaches to a better understanding of what makes individuals perform differently when exposed to extreme environments. The application of this systems neuroscience approach helps to extend findings from specific studies with individuals exposed to extreme environments to develop a more general theory. As a consequence, one can begin to develop a rational approach to develop strategies to improve performance in these environments.

SO HOW DO WE USE CSF-PREP DURING MILITARY PHYSICAL TRAINING TO INCREASE MENTAL TOUGHNESS & RESILIENCY?

Resilient individuals are able to generate positive emotions to help them cope with extreme situations (Tugade, Fredrickson, & Barrett, 2004a). According to Fredrickson’s broaden-and-build theory, positive emotions facilitate enduring personal resources and broaden one’s momentary thought of action repertoire (Fredrickson, 2004). That is, positive emotions broaden one's awareness and encourage novel, varied, and exploratory thoughts and actions which, in turn, build skills and resources. For example, experiencing a pleasant interaction with a person you asked for directions turns, over time, into a supportive friendship. Furthermore, positive emotions help resilient individuals to achieve effective coping (Werner & Smith, 1992) serving to moderate stress reactivity and mediate stress recovery (Ong, Bergeman, Bisconti, & Wallace, 2006). Neuroscientists suggest that individuals that score high on self-reported resilience may be more likely to engage the insular cortex when processing salient information and are able to generate a body prediction error that enables them to adjust more quickly to different external demand characteristics. In turn, a more adapt adjustment is thought to result in a more positive view of the world, and that this capacity helps maintain their homeostasis. This positive bias during emotion perception may provide the effective thinking strategies that resilient individuals use to interpret the world and achieve effective ways to bounce back from adversity (Bonanno, 2004a) and maintain wellness.

 
 
 Myth: You know how much stress your body can take.
•Mythbuster: Craig Weller •

During Special Operations selection training, you're subjected to a brutal series of physical and mental tests. Depending on the program and the time of year, between 60 and 90 percent of candidates won't finish. Fun stuff. •But it taught me something important: Pain does not stop the body. There's nothing that hurts so badly that you can't keep going just a little longer. •Extreme and continuous stress teaches you to break daily life down into short, measurable goals. You make it to breakfast, and then you focus on making it to lunch. Sometimes your mind refuses to project beyond the immediate future: running one more step, swimming one more stroke, grinding out just one more push-up. •Everybody hits bottom at some point. You get to a place where you'd do anything to make the pain stop. If your mind breaks first and you stop running, or wave for a support boat on a swim, or raise your hand during a beat-down to say that you're done, you're officially "weeded out." You've quit. You're part of the majority, but you still feel like a loser. •Fortunately, there's a loophole: If your body breaks first, they won't hold it against you. Every guy in my squad had the same perverse thought at some point: "If I can just push myself hard enough to black out, I'll crash in the sand, take a nap, and wait for the medics to revive me. I'll get a nice little break, and then rejoin the pack." •So we ran harder. We pushed. But we hardly ever got those naps. •  •I remember being on a run, soaking wet and covered with sand. We'd just gotten back to our feet after calisthenics in the surf and a series of sprints up and down a sand dune. Then the instructors took off sprinting again. •I didn't think I could make it any farther, but I knew I could never live with myself if I stopped running. So I put my head down and sprinted as hard as I could through the soft sand. Pain surged through my body, and the only conscious thought I can remember was that the air I was gasping into my lungs had turned to fire. •I focused my eyes on the heels of the instructor. The pain was getting worse, but I kept going. I could hear another member of my class behind me, struggling to keep up with the pack while puking between strides. •Guys who went through the training with me had similar experiences. They'd hit bottom one day, and think they could finally reach their breaking point if only they pushed a little bit harder. But it never worked. The agony would only increase. But so would their capacity to keep going. Pain, in other words, never actually broke our bodies. •  •Which isn't to say we weren't incapacitated from time to time by hypothermia, hypoxic blackout, hypoglycemic shock, or some other things you find in the dictionary a few pages past "hell." But passing out was acceptable. Quitting wasn't. •I'm a civilian now, running a facility and training people. Every now and then, I hear someone say, "I can't." •Frankly, that's bull****. Next time you're tempted to say you "can't," remember that what you're really saying is, "I don't want to." •
__________________
 •Champions are built brick by painful brick and that can take a lifetime. Sometimes it can happen without anyone even bothering to notice. Take heart. The mountains you climb can't always be seen by an audience... Still, you must not stop climbing. •For, in all their sophomoric hubris, whatever actions men take, or do not take, the mountain remains. • 
•To effect change in any place, at any time, one need only stand up and occupy a space. •Fight Harder, Dig Deeper, Last Longer •  • 
•Max out!
 •S/F