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Hector Garcia: We train soldiers for war. Let's train them to come home, too
हेक्टर गार्सिया: आओ सैनिकों की घर वापसी की भी तैयारी कराएं
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कठिन परिस्थितियों का सामना करने के लिए सैनिकों को युद्ध में भेजने से पहले कड़ा प्रशिक्षण दिया जाता है. मनोवैज्ञानिक हेक्टर गार्सिया कहते हैं की, घर वापसी करने वाले सैनिकों को असैन्य जीवन जीने का प्रशिक्षण देना भी उतना ही ज़रूरी है. जिन तकनीकों का इस्तिमाल सैनकों को युद्ध के प्रशिक्षण में किया जता है, हेक्टर गरसिया उन्ही तकनीकों का उस्तिमाल करके पी टी इस डी से पीड़ित पूर्व सैनिको को एक सुखी असैनिक जीवन बिताने में मदद मर रहे हैं.
Hector Garcia - Psychologist
Hector A. Garcia has spent his career as a frontline psychologist delivering evidence-based psychotherapies to veterans with posttraumatic stress disorder (PTSD). Full bio
Hector A. Garcia has spent his career as a frontline psychologist delivering evidence-based psychotherapies to veterans with posttraumatic stress disorder (PTSD). Full bio
Double-click the English transcript below to play the video.
00:12
Carlos,
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कार्लोस,
00:14
the Vietnam vet Marine
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एक पूर्व सैनिक हैं
00:16
who volunteered for three tours
and got shot up in every one.
and got shot up in every one.
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जिन्हें विएतनाम की लड़ाई में
तीन अवसरों पर गोलियाँ लगी
तीन अवसरों पर गोलियाँ लगी
00:20
In 1971, he was medically retired
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उनके शरीर में कारतूस के
00:22
because he had so much
shrapnel in his body
shrapnel in his body
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इतने छर्रे इकट्ठे हो गये थे
कि १९७१ में उनको
कि १९७१ में उनको
00:25
that he was setting off metal detectors.
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सेवा निवृत्त कर दिया गया
00:28
For the next 42 years,
he suffered from nightmares,
he suffered from nightmares,
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अगले ४२ साल तक उन्हें
00:31
extreme anxiety in public,
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अकेलेपन उदासी और बेचैनी
00:33
isolation, depression.
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का सामना करना पड़ा
00:35
He self-medicated with alcohol.
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उन्होने शराब का सहारा भी लिया
00:37
He was married and divorced three times.
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उनकी तीन बार शादी और तलाख भी हुआ
00:40
Carlos had post-traumatic stress disorder.
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कार्लोस को पोस्ट ट्रमॅटिक
सिंप्टम डिसॉर्डर था
सिंप्टम डिसॉर्डर था
एक मनोवैज्ञानिक होने के नाते मैं पिछले
00:44
Now, I became a psychologist
to help mitigate human suffering,
to help mitigate human suffering,
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00:47
and for the past 10 years, my target
has been the suffering caused by PTSD,
has been the suffering caused by PTSD,
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१० सालों से पी.टी.एस.डी. से पीड़ित
00:52
as experienced by veterans like Carlos.
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मरीजों का इलाज़ कर रहा हूँ.
00:55
Until recently, the science of PTSD
just wasn't there.
just wasn't there.
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पी.टी.एस.डी. विज्ञान का एक नया विषय है
01:01
And so, we didn't know what to do.
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हमें इसके बारे में ज़्यादा नहीं पता था
01:03
We put some veterans on heavy drugs.
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कुछ मरीजों को हमने तेज़ दवाइयां दी
01:05
Others we hospitalized
and gave generic group therapy,
and gave generic group therapy,
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कुछ को अस्पताल में आम इलाज़ दिया
01:08
and others still we simply said to them,
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और कुछ को तोह बस यह कहा
01:10
"Just go home and try to forget
about your experiences."
about your experiences."
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की घर जाओ और सब भूलने की कोशिश करो
01:15
More recently, we've tried therapy dogs,
wilderness retreats --
wilderness retreats --
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हाल ही में हमने इलाज के नए प्रयोग किये
01:18
many things which may
temporarily relieve stress,
temporarily relieve stress,
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जैसे मरीजों को सुंदर जगहों पे भेजना,
01:21
but which don't actually eliminate
PTSD symptoms over the long term.
PTSD symptoms over the long term.
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घर में पालतू जानवर रखना,
लेकिन यह सब कारगर सिद्ध नहीं हुए
लेकिन यह सब कारगर सिद्ध नहीं हुए
01:26
But things have changed.
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लेकिन अब हालात बदल गए हैं
01:28
And I am here to tell you
that we can now eliminate PTSD,
that we can now eliminate PTSD,
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और आज में आप सब से
यही जानकारी बांटने
यही जानकारी बांटने
01:33
not just manage the symptoms,
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आया हूँ, की हम पी.टी.एस.डी से
01:35
and in huge numbers of veterans.
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कैसे निजाद पा सकते हैं
01:37
Because new scientific research
has been able to show,
has been able to show,
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आधुनिक वैज्ञानिक तकनीकों से अब हम
01:40
objectively, repeatedly,
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पता लगा सकते हैं की कौन कौनसी
01:42
which treatments actually
get rid of symptoms and which do not.
get rid of symptoms and which do not.
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तरकीबें कारगर सिद्ध हो रही हैं
01:45
Now as it turns out,
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पी.टी.एस.डी ठीक करने में
01:47
the best treatments for PTSD use
many of the very same training principles
many of the very same training principles
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वही तकनीकें काम आती हैं जो
01:52
that the military uses
in preparing its trainees for war.
in preparing its trainees for war.
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युद्ध के प्रशिक्षण में इस्त्माल होती हैं
01:58
Now, making war --
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पारंपरिक रूप से
02:00
this is something that we are good at.
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हम युद्ध की कला में माहिर रहे हैं
02:02
We humans have been making war
since before we were even fully human.
since before we were even fully human.
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हम युद्ध पौराणिक काल से लड़ते आ रहे हैं
लेकिन तब से अब तक हमने युद्ध की तकनीकों
02:08
And since then, we have gone
from using stone and sinew
from using stone and sinew
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और अस्त्र-शस्त्र में बड़ी प्रगति की है
02:11
to developing the most sophisticated
and devastating weapon systems imaginable.
and devastating weapon systems imaginable.
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02:16
And to enable our warriors
to use these weapons,
to use these weapons,
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और इन अस्त्रों का उपयोग करने के लिए
02:18
we employ the most cutting-edge
training methods.
training methods.
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हम अपने सिपाहियों को
नवीनतम प्रशिक्षण देते हैं
नवीनतम प्रशिक्षण देते हैं
02:20
We are good at making war.
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हम युद्ध में माहिर हैं
02:22
And we are good at training
our warriors to fight.
our warriors to fight.
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हम प्रशिक्षण में माहिर हैं
02:26
Yet, when we consider the experience
of the modern-day combat veteran,
of the modern-day combat veteran,
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लेकिन अगर हम युद्ध से
लौटने वाले सैनिकों पर ध्यान दें,
लौटने वाले सैनिकों पर ध्यान दें,
02:30
we begin to see that we
have not been as good
have not been as good
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हम उनको उनकी वापसी के लिए
02:33
at preparing them to come home.
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उचित रूप से तैयार नहीं कर पाए हैं
02:35
Why is that?
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आखिर क्यों?
02:37
Well, our ancestors lived
immersed in conflict,
immersed in conflict,
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हमारे प्राचीनकालीय पूर्वज
02:41
and they fought right where they lived.
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द्वंद्व वहीँ करते थे जहाँ वे रहते थे
02:44
So until only very recently
in our evolutionary history,
in our evolutionary history,
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इस ही कारण से,
पहले कभी युद्ध से लौटने के
पहले कभी युद्ध से लौटने के
02:47
there was hardly a need to learn
how to come home from war,
how to come home from war,
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बाद के जीवन से सामना करने का
02:50
because we never really did.
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प्रशिक्षण किसी को नहीं दिया जाता था
02:53
But thankfully, today,
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लेकिन आजकल
02:54
most of humanity lives
in far more peaceful societies,
in far more peaceful societies,
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आधुनिक तकनीकों के द्वारा
02:57
and when there is conflict,
we, especially in the United States,
we, especially in the United States,
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हम अपने अमरीकी सैनिकों को
03:01
now have the technology to put
our warriors through advanced training,
our warriors through advanced training,
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लड़ने के लिए दुनिया में कहीं भी
ले जा सकते हैं
ले जा सकते हैं
03:05
drop them in to fight
anywhere on the globe
anywhere on the globe
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और युद्ध पूरा होने पर
03:08
and when they're done,
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सुरक्षित देश वापिस
03:09
jet them back to peacetime suburbia.
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ला सकते हैं
03:12
But just imagine for a moment
what this must feel like.
what this must feel like.
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पर सोचिये एक सैनिक पे
क्या बीत ती होगी
क्या बीत ती होगी
03:17
I've spoken with veterans who've told me
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कुछ पूर्व सैनिकों ने मुझे बताया की
03:19
that one day they're in a brutal
firefight in Afghanistan
firefight in Afghanistan
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उदाहरण के तौर पे
किसी दिन वे अफगानिस्तान
किसी दिन वे अफगानिस्तान
03:22
where they saw carnage and death,
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में घमासान लड़ाई लड़ रहे थे,
03:25
and just three days later,
they found themselves
they found themselves
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और तीन दिन में घर वापिस आकर
03:28
toting an ice chest
to their kid's soccer game.
to their kid's soccer game.
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बच्चों के स्कूल में जा कर
उनका खेल देख रहे थे
उनका खेल देख रहे थे
03:32
"Mindfuck" is the most common term.
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यह पागलपन से कम नहीं था
03:35
(Laughter)
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(श्रोता काहकहाते हुए )
03:36
It's the most common term
I've heard to describe that experience.
I've heard to describe that experience.
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इस अनुभव का
यह उचित वर्णन है
यह उचित वर्णन है
03:39
And that's exactly what that is.
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यह बिल्कुल सटीक हैं
03:41
Because while our warriors
spend countless hours training for war,
spend countless hours training for war,
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हमारे सैनिक युद्ध में
03:45
we've only recently come to understand
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प्रशिक्षित हैं, लेकिन कइयों को असैनिक
03:47
that many require training
on how to return to civilian life.
on how to return to civilian life.
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जीवन बिताने का भी प्रशिक्षण चाहिए
03:51
Now, like any training, the best
PTSD treatments require repetition.
PTSD treatments require repetition.
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पी टी इस डी चिकित्सा को
बार बार करवाना पड़ता है
बार बार करवाना पड़ता है
03:55
In the military,
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सेना में
03:56
we don't simply hand trainees
Mark-19 automatic grenade launchers
Mark-19 automatic grenade launchers
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जब सैनिक भर्ती होते हैं
04:00
and say, "Here's the trigger,
here's some ammo and good luck."
here's some ammo and good luck."
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उन्हें विस्तार में प्रशिक्षण मिलता है
04:03
No. We train them, on the range
and in specific contexts,
and in specific contexts,
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उन्हें बार बार है
04:08
over and over and over
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कई तरह की परिस्थितियों का
04:09
until lifting their weapon
and engaging their target
and engaging their target
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प्रशिक्षण दिया जाता
04:12
is so engrained into muscle memory
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जब तक वे शस्त्र और हथियार को
04:14
that it can be performed
without even thinking,
without even thinking,
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किसी भी परिस्थिति में पूरी सक्षमता से
04:16
even under the most stressful
conditions you can imagine.
conditions you can imagine.
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इस्तिमाल करना ना सीख जाएँ
04:20
Now, the same holds
for training base treatments.
for training base treatments.
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उनके इलाज में भी ऐसा
ही कुछ करना पड़ता है
ही कुछ करना पड़ता है
04:23
The first of these treatments
is cognitive therapy,
is cognitive therapy,
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इन में सबसे पहले
आती है संज्ञानात्मक चिकित्सा
आती है संज्ञानात्मक चिकित्सा
04:27
and this is a kind
of mental recalibration.
of mental recalibration.
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यह मानसिक अंशशोधन की तरह है
04:31
When veterans come home from war,
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जब पूर्व सैनिक घर लौट के आते हैं,
04:32
their way of mentally framing
the world is calibrated
the world is calibrated
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वह दुनिया और परिस्थितियों को एक
04:35
to an immensely
more dangerous environment.
more dangerous environment.
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युद्ध स्थल की तरह ही भांपते हैं
04:38
So when you try to overlay that mind frame
onto a peacetime environment,
onto a peacetime environment,
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उनके इस नज़रिये को साधारण अवस्था
04:44
you get problems.
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में लाना आसान नहीं होता
04:45
You begin drowning in worries
about dangers that aren't present.
about dangers that aren't present.
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उन्हें खतरा दिखता है
04:49
You begin not trusting family or friends.
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वे सब पे शक करते हैं
04:53
Which is not to say there are no
dangers in civilian life; there are.
dangers in civilian life; there are.
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वैसे आम जीवन में खतरे होते हैं
04:58
It's just that the probability
of encountering them
of encountering them
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लेकिन युद्ध के मुकाबले
05:01
compared to combat
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आम जीवन में खतरों की
05:02
is astronomically lower.
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सम्भावना कम होती है
05:05
So we never advise veterans
to turn off caution completely.
to turn off caution completely.
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हम उनको अचानक बदलने को नहीं कहते
05:08
We do train them, however,
to adjust caution
to adjust caution
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हम उन्हें उनकी स्थिति के हिसाब से
05:11
according to where they are.
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सतर्क रहने को कहते हैं
05:13
If you find yourself
in a bad neighborhood,
in a bad neighborhood,
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जैसे अगर आप सुनसान जगह पे हैं तोह
05:16
you turn it up.
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ख़ास सावधानी बरतें
05:17
Out to dinner with family?
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लेकिन परिवार के साथ
05:19
You turn it way down.
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खाने जाएं तोह चिंता ना करें
05:21
We train veterans to be fiercely rational,
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हम उन्हें विचारपूर्ण होना सिखाते हैं
05:25
to systematically gauge
the actual statistical probability
the actual statistical probability
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ताकि वह खतरे के हिसाब से
05:28
of encountering, say, an IED
here in peacetime America.
here in peacetime America.
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ही सावधानी बरतें
05:33
With enough practice,
those recalibrations stick.
those recalibrations stick.
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अभ्यास करने से आदत दाल जाती है
05:39
The next of these treatments
is exposure therapy,
is exposure therapy,
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अगला प्रशिक्षण, एक्सपोजर थेरेपी,
05:41
and this is a kind of field training,
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एक कारगर और
05:44
and the fastest of the proven
effective treatments out there.
effective treatments out there.
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तेज़ तकनीक है
05:47
You remember Carlos?
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आपको कार्लोस याद होगा
05:49
This was the treatment that he chose.
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उसने यही उपचार चुना था
05:51
And so we started off
by giving him exercises,
by giving him exercises,
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हमने उसकी शुरुआत कुछ
05:54
for him, challenging ones:
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चुनौतीपूर्ण अभ्यासों से करी, जैसे
05:55
going to a grocery store,
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दरवाज़े पर पीठ करे हुए
05:57
going to a shopping mall,
going to a restaurant,
going to a restaurant,
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दुकान में खड़े रहना
06:00
sitting with his back to the door.
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या रेस्तरां में बैठना
06:03
And, critically --
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और इस प्रकार के वातावरण
06:05
staying in these environments.
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ज़्यादा समय बिताना
06:07
Now, at first he was very anxious.
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शुरुआत में वह कुछ घबराये
06:09
He wanted to sit
where he could scan the room,
where he could scan the room,
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वह ऐसी जगह
06:12
where he could plan escape routes,
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बैठना चाहते थे जहाँ से वो
06:13
where he could get his hands
on a makeshift weapon.
on a makeshift weapon.
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दरवाज़े और लोगों को देख सकें
06:17
And he wanted to leave, but he didn't.
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यह उनके लिए कठिन था
06:20
He remembered his training
in the Marine Corps,
in the Marine Corps,
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सैनिक प्रशिक्षण का अनुभव होने के कारण
06:23
and he pushed through his discomfort.
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उन्होंने खुद को प्रोत्साहन दिया
06:25
And every time he did this,
his anxiety ratcheted down a little bit,
his anxiety ratcheted down a little bit,
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धीरे धीरे करके
06:28
and then a little bit more
and then a little bit more,
and then a little bit more,
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वह ऐसी स्तिथि
06:31
until in the end,
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तक पोहोंच गए जहाँ वे
06:32
he had effectively relearned
how to sit in a public space
how to sit in a public space
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सार्वजनिक जगहों पर आराम
06:38
and just enjoy himself.
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और इत्मीनान से बैठ पाएं
06:41
He also listened to recordings
of his combat experiences,
of his combat experiences,
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कई बार उन्होंने अपने युद्ध
06:45
over and over and over.
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अनुभव के रिकॉर्डिंग भी सुने
06:47
He listened until those memories
no longer generated any anxiety.
no longer generated any anxiety.
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जब तक उन्हें सुनके
कोई उत्तेजना ना महसूस हो
कोई उत्तेजना ना महसूस हो
06:52
He processed his memories so much
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उन्होंने अपनी मानसिकता हो इतना बदला
06:55
that his brain no longer needed
to return to those experiences
to return to those experiences
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की नींद में उन्हें युद्ध के सपने
06:58
in his sleep.
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आना बंद हो गए
07:00
And when I spoke with him
a year after treatment had finished,
a year after treatment had finished,
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जब मैं उनसे एक साल बाद मिला
07:03
he told me,
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उन्होंने कहा "डॉक्टर, ४३ सालों
07:05
"Doc, this is the first time in 43 years
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में पहली बार मुझे अब
07:10
that I haven't had nightmares."
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डरावने सपने नहीं आते"
07:13
Now, this is different
than erasing a memory.
than erasing a memory.
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यह यादाश्त मिटाने से अलग है
07:18
Veterans will always remember
their traumatic experiences,
their traumatic experiences,
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सैनिक युद्ध के अनुभव भुला तोह नहीं सकते,
07:21
but with enough practice,
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लेकिन उनसे पोहोंचने वाले दुःख को
07:22
those memories are no longer as raw
or as painful as they once were.
or as painful as they once were.
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कम ज़रूर कर सकते हैं
07:28
They don't feel emotionally
like they just happened yesterday,
like they just happened yesterday,
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अब वे उन अनुभवों से
07:31
and that is an immensely
better place to be.
better place to be.
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मानसिक तनाव में नहीं आते
07:37
But it's often difficult.
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यह हमेशा आसान नहीं होता
07:39
And, like any training,
it may not work for everybody.
it may not work for everybody.
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सब पे कारगर भी नहीं होता
07:44
And there are trust issues.
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इसमें विश्वास बोहोत ज़रूरी है
07:45
Sometimes I'm asked,
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मुझसे पुछा जाता है कि
07:47
"If you haven't been there, Doc,
how can you help me?"
how can you help me?"
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"बिना युद्ध अनुभव के
07:49
Which is understandable.
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आप यह कैसे कर लेते हैं"
07:52
But at the point of returning
to civilian life,
to civilian life,
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लेकिन असैनिक जीवन पर शिक्षा
07:56
you do not require
somebody who's been there.
somebody who's been there.
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देने के लिए युद्ध अनुभव की ज़रुरत नहीं है
07:59
You don't require training
for operations on the battlefield;
for operations on the battlefield;
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आप को बस यह पता होना चाहिए की
08:03
you require training on how to come home.
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असैनिक जीवन कैसे जीना है
08:10
For the past 10 years of my work,
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पिछले दस साल से हर रोज़
08:13
I have been exposed to detailed accounts
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मैं युद्ध के कई
08:16
of the worst experiences
that you can imagine,
that you can imagine,
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दर्दनाक किस्से सुन
08:18
daily.
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चुका हूँ
08:19
And it hasn't always been easy.
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यह आसान नहीं है
08:22
There have been times
where I have just felt my heart break
where I have just felt my heart break
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कभी कभी यह मेरी क्षमता
08:25
or that I've absorbed too much.
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से बाहर हो जाता था
08:28
But these training-based
treatments work so well,
treatments work so well,
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लेकिन इस प्रकार का प्रशिक्षण
08:31
that whatever this work takes out of me,
it puts back even more,
it puts back even more,
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और सैनिकों की बहाली बड़ा
08:34
because I see people get better.
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संतोष प्रदान करता हैं
08:38
I see people's lives transform.
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इससे लोगों का उद्धार हो जाता है
08:42
Carlos can now enjoy outings
with his grandchildren,
with his grandchildren,
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कार्लोस अब अपने बाल बच्चों के साथ
08:46
which is something he couldn't even do
with his own children.
with his own children.
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हंस खेल के घूम फिर सकते हैं
08:49
And what's amazing to me
is that after 43 years of suffering,
is that after 43 years of suffering,
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ताज्जुब की बात है की ४३ सालों की पीड़ा
08:53
it only took him 10 weeks
of intense training to get his life back.
of intense training to get his life back.
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१० हफ़्तों के प्रशिक्षण से ठीक हो गयी
08:58
And when I spoke with him, he told me,
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मैं जब उनसे मिला, तो उन्होंने कहा
09:00
"I know that I can't get those years back.
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"मैं अपने ४३ साल तो
09:05
But at least now, whatever days
that I have left on this Earth,
that I have left on this Earth,
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वापस नहीं ला सकता,
लेकिन अपने बचे हुए दिन
लेकिन अपने बचे हुए दिन
09:10
I can live them in peace."
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शान्ति से बिता सकता हूँ
09:13
He also said, "I hope that these
younger veterans don't wait
younger veterans don't wait
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आशा करता हूँ की युवा सैनिकों को
09:16
to get the help they need."
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ऐसी सहायता
09:18
And that's my hope, too.
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समय पर मिल पायेगी
09:21
Because ...
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क्योंकि जीवन छोटा है,
09:23
this life is short,
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और अगर आप युद्ध की
09:25
and if you are fortunate enough
to have survived war
to have survived war
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आपदाओं से गुज़र चुके हैं,
09:28
or any kind of traumatic experience,
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तोह बाकी जीवन सुख और शान्ति से
09:30
you owe it to yourself
to live your life well.
to live your life well.
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बिताना आपका अधिकार है"
09:34
And you shouldn't wait
to get the training you need
to get the training you need
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लेकिन किसी को इस प्रशिक्षण के इंतज़ार में
09:37
to make that happen.
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नहीं बैठना चाहिए
09:40
Now, the best way of ending
human suffering caused by war
human suffering caused by war
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सबसे बेहतर तोह यही होगा
09:46
is to never go to war.
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की युद्ध न हो
09:49
But we are just not there
yet as a species.
yet as a species.
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लेकिन वो मंज़िल अभी दूर है
09:52
Until we are,
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तब तक,
09:53
the mental suffering that we create
in our sons and in our daughters
in our sons and in our daughters
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हम युद्ध से होने वाली
09:58
when we send them off to fight
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पीड़ा से अपने भाइयों और बहनो को निजाद
10:00
can be alleviated.
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दिला सकते हैं
10:03
But we must ensure that the science,
the energy level, the value
the energy level, the value
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और अच्छा होगा अगर जितना विज्ञान और धन
10:09
that we place on sending them off to war
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हम युद्ध में लगाते हैं, उतना
10:13
is at the very least mirrored
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लौटने वाले सैनिकों की खुशहाली में लगाएं
10:15
in how well we prepare them
to come back home to us.
to come back home to us.
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उनको घर वापसी में कम से कम परेशानी हो,
10:19
This much, we owe them.
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इस बात के हम ऋणी हैं
10:22
Thank you.
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धन्यवाद.
10:23
(Applause)
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(तालियां)
ABOUT THE SPEAKER
Hector Garcia - PsychologistHector A. Garcia has spent his career as a frontline psychologist delivering evidence-based psychotherapies to veterans with posttraumatic stress disorder (PTSD).
Why you should listen
Hector A. Garcia is a psychologist with the Valley Coastal Bend Veterans Health Care System and a clinical assistant professor in the Department of Psychiatry at UT Health Science Center at San Antonio.
In his work as a researcher, Garcia examines barriers to PTSD care, masculine identity and its impact on PTSD treatment-seeking, and how occupational burnout impacts PTSD care providers, who daily hear detailed accounts of trauma. As a teacher and scientist, he explores how evolutionary psychology and biology have influenced human tendencies toward violence in religion.
Garcia's groundbreaking book, Alpha God: The Psychology of Religious Violence and Oppression, reveals how human evolutionary history has left us prone to religiously inspired bloodshed. In particular, he explains how men's competition over evolutionary resources -- especially sexual primacy and territorial control -- has too often been projected onto notions of God, resulting in religious warfare, the oppression of women and ecological devastation. His regular blog on Psychology Today examines the evolutionary psychology of violence, politics, religion and our everyday lives.
Hector Garcia | Speaker | TED.com