“That which does not kill us, makes us stronger”
Nietzsche’s famous dictum still resonates today. But what does his theory mean for psychological resilience? This blog explores evidence which suggests Nietzsche’s 19th Century dictum has utility for enhancing contemporary resilience programmes.
There is increasing recognition of the performance-multiplying benefits of a resilient workforce. Military organisations are especially focused on leveraging resilience to gain the competitive edge in an increasingly volatile and complex defence and security environment. The United States Army’s Comprehensive Soldier Fitness (CSF) resilience programme is a case-in-point. At a cost of £1.3 Billion, the CSF programme is the most expensive and expansive resilience programme to date.
UK Defence is demonstrating its own commitment to resilience via the central ‘Stress and Resilience Training Centre’ and resilience programmes across the single Services. On the surface, Defence’s approach to resilience appears comprehensive and robust. However, when you probe beyond the glossy policy and snappily titled resilience initiatives, are these programmes actually working? Looking at the evidence objectively, the answer appears to be “no”.
The UK’s ‘Defence People Mental Health and Wellbeing Strategy’ provides key performance indicators for assessing the impact of resilience programmes. Notably, 4 of the 8 indicators relate directly to measures of mental health across the workforce.
Using Defence’s own metrics for success, current programmes are objectively falling short. UK Defence Statistics shows a deteriorating trend in mental health across the Armed Forces since 2012, with the 2020 mental health report showing 12.7% of military personnel required mental health services.
The shortfalls of current UK Defence resilience initiatives are further evidenced through research conducted on Armed Forces personnel. A 2018 study examining “resilience-based intervention for UK military recruits” found that current intervention measures provided no benefit to mental health or well-being.
In short, UK Defence resilience programmes may be well intentioned, but the absence of a robust evidence-base is a serious cause for concern.
What can Nietzsche teach us?
The ‘Challenge Model’ is a leading conceptual theory in the field of resilience research. The model provides the following hypothesis for developing resilience:
“A risk factor, provided it is not too extreme, can actually enhance a person’s adaption and prepare them for the next challenge.” O’Leary, 1998.
O’Leary’s Challenge Model clearly captures the premise of Nietzsche’s dictum and implies ‘what doesn’t kill us, makes us more… [resilient].’
The concept of taking an individual out of their comfort zone to develop resilience is recognised more broadly. For example, the theory of ‘Post Traumatic Growth’ suggests individuals thrive and grow following exposure to adversity or trauma. Similarly, ‘Stress Inoculation Training’ relies on deliberate exposure to trauma for developing resilience. Furthermore, Nixon’s ‘Human response to stress curve’ demonstrates the need for stress to illicit high performance.
What are the implications for UK Defence?
Given current resilience programmes have questionable efficacy, UK Defence might want to consider if it is harnessing the resilience-building potential of Nietzsche’s philosophy. There have been multiple studies to monitor the mental health of Armed Forces personnel. Noting that mental health is a recognised key performance indicator for resilience, this blog proposes that existing research data can be repurposed to identify which factors influence workforce resilience. Furthermore, this blog argues that this data can form evidence to drive changes to extant programmes.
The ‘Academic Department of Military Mental Health’ at King’s College London have conducted a body of research on the mental health of service personnel. This research gathered data from 4,261 subjects deployed on operations in Iraq and Afghanistan between 2009–2014. The study generated data to support an ‘Operational Mental Health Needs Evaluation’ (OMHNE). The OMHNE was originally designed to examine the relationship between operational deployments and common mental health disorders. However, given that the survey recorded 61 variables, the data has enormous potential for analysis beyond the original study objectives. For the purposes of this blog, the data has been used to examine resilience.
Applying the Challenge Model
The Challenge Model hypothesis suggests that Service personnel exposed to the most stressful, arduous and demanding training pathways will develop the highest levels of resilience. Therefore, according to the Challenge Model, cohorts who have experienced the most psychologically demanding training pathway should record lower incidence of common mental health disorders.
A subject’s training pathway can be worked out from their ‘deployed role’. Defence training doctrine, states that military employment and pre-deployment training is designed to “progressively develop a Service Person’s resilience,” with physical and psychological demands of respective training pathways calibrated for the risks, stresses and environments of a role. Accordingly, it is possible to broadly define the psychological stress associated with the three recorded deployed roles:
Combat: force elements that engage the enemy directly. Subjects who fulfilled a combat role on operations undergo the most psychologically demanding training pathway in preparation for their specialist role. Notably, the preponderance of subjects filling combat roles comprised frontline infantry.
Combat Support: force elements that provide operational assistance, including fire and manoeuvre support to combat force elements. Combat support subjects are judged to have undergone similar training pathways to combat subjects, but slightly less arduous. This is based on their role being predominantly combat facing.
Combat Service Support: primarily administrative and logistical roles which provide organisational support. Subjects filling combat service support roles are judged to have undergone the least psychologically demanding training pathway and therefore encountered the least training stress prior to deployment. This judgement is based on their role being non-combat facing.
Do the results support the Challenge Model?
The results clearly demonstrate that subjects performing combat and combat support roles have a significantly lower incidence of common mental health disorder than their counterparts fulfilling combat service support roles. 19.1% of subjects in combat service support roles recorded symptoms of common mental health disorder, whereas combat and combat support roles recorded 15.7% and 15.4% respectively.
These findings support the challenge model hypothesis, as subjects exposed to the more arduous training pathways (combat and combat support roles) demonstrated lower incidence of common mental health disorder and therefore greater levels of resilience.
The OMHNE data can be manipulated to adjust for potential complicating factors, such as trauma exposure, home stressors, and unit cohesion. This adjustment provides a greater level of confidence that it is the training pathway which influences resilience rather than other factors. The graph below shows Adjusted Odds Ratios for common mental health disorder, with combat role assigned a probability of 1.
“individuals exposed to the more arduous combat training pathways were 25% less likely to suffer resilience failure”
Again, the results demonstrate a strong correlation between an individual’s military training pathway and their level of resilience. Specifically, the results demonstrate that individuals exposed to the more arduous combat training pathways were 25% less likely to suffer resilience failure than their counterparts from the combat service support cadre. It appears Nietzsche was right all along!
What does this mean for UK Defence?
Data from the OMHNE study provides compelling evidence that military training pathways can be leveraged to promote resilience. Current Defence doctrine eludes to the importance of military training for developing resilience. However, worrying defence statistics for mental health suggests current training is falling short. This blog concludes that the Challenge Model hypothesis could be better exploited through military training to promote resilience across the wider workforce.
Specifically, the OMHNE data provides an evidence-base to support wider incorporation of psychologically demanding training within resilience programmes. To refine and corroborate this evidence further, UK Defence could implement a dedicated longitudinal study to examine which precise factors within training pathways promote resilience. Once isolated, these factors could be applied more broadly across the workforce to promote resilience. Accordingly, Nietzsche’s dictum might very well be the key for unlocking resilience.
Wing Commander Phil Holdcroft is a Royal Air Force officer and helicopter pilot with 18 years experience and a professional interest in resilience.
This BLOG is an academic study conducted as part of the KCL Master by Research programme on the Advanced Command and Staff Course at the Defence Academy of the United Kingdom. The views expressed are those of the author; they do not constitute the opinion of, or a representation by the Royal Air Force or the Defence Academy of the United Kingdom.
