ABOUT THE SPEAKER
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).

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.


More profile about the speaker
Hector Garcia | Speaker | TED.com
TED Talks Live

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

Hector Garcia: Adestramos os soldados para a guerra. Adestrémolos tamén para volver á casa

Filmed:
1,099,517 views

Antes de que os soldados sexan enviados ao combate, son adestrados sobre como desenvolverse nun ambiente inmensamente perigoso. Pero tamén precisan de adestramento sobre como volver do campo de batalla á vida civil, di o psicólogo Hector Garcia. Aplicando os mesmos principios usados para preparar os soldados para a guerra, Garcia está a axudar a veteranos que sofren de trastorno por estrés postraumático (TEPT) a recuperar as súas vidas.
- 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

Double-click the English transcript below to play the video.

00:12
Carlos,
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Carlos,
00:14
the Vietnam vet Marine
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un marine veterano do Vietnam,
00:16
who volunteered for three tours
and got shot up in every one.
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foi voluntario en tres destinos
e nos tres recibiu un disparo.
00:20
In 1971, he was medically retired
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En 1971 foi dado de baixa
por razóns médicas
00:22
because he had so much
shrapnel in his body
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debido a que tiña tanta
metralla no seu corpo
00:25
that he was setting off metal detectors.
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que disparaba os detectores de metal.
00:28
For the next 42 years,
he suffered from nightmares,
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Nos 42 anos seguintes sufriu pesadelos,
00:31
extreme anxiety in public,
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ansiedade extrema en público,
00:33
isolation, depression.
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illamento, depresión.
00:35
He self-medicated with alcohol.
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Automedicouse con alcohol.
00:37
He was married and divorced three times.
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Casou e divorciouse tres veces.
00:40
Carlos had post-traumatic stress disorder.
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Carlos tiña trastorno
de estrés postraumático (TEPT).
00:44
Now, I became a psychologist
to help mitigate human suffering,
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Eu fíxenme psicólogo para
axudar a mitigar a dor humana,
00:47
and for the past 10 years, my target
has been the suffering caused by PTSD,
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e nos últimos 10 anos,
centreime no sufrimento causado polo TEPT,
00:52
as experienced by veterans like Carlos.
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que sofren os veteranos coma Carlos.
00:55
Until recently, the science of PTSD
just wasn't there.
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Ata hai pouco, non existían
estudos científicos sobre TEPT.
01:01
And so, we didn't know what to do.
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E polo tanto non sabiamos que facer.
01:03
We put some veterans on heavy drugs.
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Receitamos medicamentos fortes
a algúns veteranos.
01:05
Others we hospitalized
and gave generic group therapy,
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A outros hospitalizámolos e
démoslles terapia de grupo,
01:08
and others still we simply said to them,
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e a outros tan só lles dixemos:
01:10
"Just go home and try to forget
about your experiences."
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«Marcha para a casa e intenta
esquecer o que viviches».
01:15
More recently, we've tried therapy dogs,
wilderness retreats --
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agora probamos a terapia con cans,
escapadas á natureza...
01:18
many things which may
temporarily relieve stress,
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moitas cousas que poderían
reducir temporalmente o estrés,
01:21
but which don't actually eliminate
PTSD symptoms over the long term.
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pero que non eliminan os síntomas
de TEPT a longo prazo.
01:26
But things have changed.
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Pero as cousas cambiaron.
01:28
And I am here to tell you
that we can now eliminate PTSD,
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Estou aquí para dicirvos que agora
podemos terminar co TEPT,
01:33
not just manage the symptoms,
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non só controlar os síntomas,
01:35
and in huge numbers of veterans.
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e nun gran número de veteranos.
01:37
Because new scientific research
has been able to show,
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Porque a investigación
científica puido demostrar,
01:40
objectively, repeatedly,
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obxectiva e repetidamente,
01:42
which treatments actually
get rid of symptoms and which do not.
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qué tratamentos eliminan realmente
os síntomas e cales non.
01:45
Now as it turns out,
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Resulta que
01:47
the best treatments for PTSD use
many of the very same training principles
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os mellores tratamentos para TEPT usan
moitos dos mesmos principios
de formación
01:52
that the military uses
in preparing its trainees for war.
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que o exército usa ao preparar
os seus recrutas para a guerra.
01:58
Now, making war --
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Agora ben, facer a guerra...
02:00
this is something that we are good at.
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iso dásenos ben.
Nós, os humanos, levamos facendo a guerra
02:02
We humans have been making war
since before we were even fully human.
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dende antes de ser completamente humanos.
02:08
And since then, we have gone
from using stone and sinew
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E dende entón, pasamos de usar
pedras e tendóns
02:11
to developing the most sophisticated
and devastating weapon systems imaginable.
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a fabricar os sistemas de armas
máis avanzados e destrutivos imaxinables.
02:16
And to enable our warriors
to use these weapons,
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E para que os nosos guerreiros
usen estas armas,
02:18
we employ the most cutting-edge
training methods.
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utilizamos métodos de adestramento
de vangarda.
02:20
We are good at making war.
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Facer a guerra dásenos ben.
02:22
And we are good at training
our warriors to fight.
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E formar guerreiros para a loita
dásenos ben.
02:26
Yet, when we consider the experience
of the modern-day combat veteran,
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Aínda así, considerando a experiencia
dos veteranos de combate actuais,
02:30
we begin to see that we
have not been as good
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comezamos a ver
que non se nos deu tan ben
02:33
at preparing them to come home.
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preparalos para volver á casa.
02:35
Why is that?
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Por que?
02:37
Well, our ancestors lived
immersed in conflict,
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Os nosos devanceiros viviron
inmersos no conflito,
02:41
and they fought right where they lived.
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e loitaban alí onde vivían.
02:44
So until only very recently
in our evolutionary history,
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Así que ata hai ben pouco
na nosa historia evolutiva,
02:47
there was hardly a need to learn
how to come home from war,
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case non había necesidade de saber
volver á casa da guerra,
02:50
because we never really did.
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porque nunca o fixeramos.
02:53
But thankfully, today,
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Pero afortunadamente, hoxe
02:54
most of humanity lives
in far more peaceful societies,
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a maioría da humanidade
vive en sociedades moito máis pacíficas,
02:57
and when there is conflict,
we, especially in the United States,
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e cando hai un conflito, nós,
especialmente nos Estados Unidos,
03:01
now have the technology to put
our warriors through advanced training,
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temos os medios para darlles
aos nosos guerreiros formación avanzada,
03:05
drop them in to fight
anywhere on the globe
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deixalos na loita
en calquera lugar do mundo
03:08
and when they're done,
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e cando terminan,
03:09
jet them back to peacetime suburbia.
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levalos de volta a un barrio tranquilo.
03:12
But just imagine for a moment
what this must feel like.
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Pero, por un momento imaxinádevos
como debe de ser iso.
03:17
I've spoken with veterans who've told me
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Falei con veteranos que me dixeron
03:19
that one day they're in a brutal
firefight in Afghanistan
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que un día están nunha loita
brutal en Afganistán
03:22
where they saw carnage and death,
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onde ven matanzas e morte,
03:25
and just three days later,
they found themselves
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e tan só tres días máis tarde,
estaban
03:28
toting an ice chest
to their kid's soccer game.
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levando unha neveira portátil
ao partido do seu fillo.
03:32
"Mindfuck" is the most common term.
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"Fodida mental" é o termo máis común.
03:35
(Laughter)
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(Risas)
03:36
It's the most common term
I've heard to describe that experience.
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É o termo máis común
que oín para describir esa experiencia.
03:39
And that's exactly what that is.
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E é exactamente iso.
03:41
Because while our warriors
spend countless hours training for war,
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Porque mentres os nosos guerreiros pasan
horas e horas preparándose para a guerra,
03:45
we've only recently come to understand
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nós aínda acabamos de comprender
03:47
that many require training
on how to return to civilian life.
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que moitos precisan de preparación
para a volta á vida civil.
Como calquera aprendizaxe,
03:51
Now, like any training, the best
PTSD treatments require repetition.
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os mellores tratamentos
de TEPT requiren repeticións.
03:55
In the military,
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No exército,
03:56
we don't simply hand trainees
Mark-19 automatic grenade launchers
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non lles damos sen máis aos recrutas
lanzagranadas Mark-19
04:00
and say, "Here's the trigger,
here's some ammo and good luck."
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e dicímoslles: «Aí está o gatillo e
aquí tes munición, boa sorte».
04:03
No. We train them, on the range
and in specific contexts,
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Non. Preparámolos, en contextos
variados e específicos,
04:08
over and over and over
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unha e outra e outra vez
04:09
until lifting their weapon
and engaging their target
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ata que ergueren a súa arma
e identificaren o inimigo
04:12
is so engrained into muscle memory
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está tan gravado na memoria muscular
04:14
that it can be performed
without even thinking,
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que poden facelo sen pensar sequera,
04:16
even under the most stressful
conditions you can imagine.
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mesmo nas condicións máis
estresantes que poidades imaxinar.
04:20
Now, the same holds
for training base treatments.
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O mesmo aplícase aos tratamentos
baseados na preparación.
04:23
The first of these treatments
is cognitive therapy,
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O primeiro destes tratamentos
é a terapia cognitiva,
04:27
and this is a kind
of mental recalibration.
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e esta é un tipo de recalibración mental.
04:31
When veterans come home from war,
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Cando os veteranos volven,
04:32
their way of mentally framing
the world is calibrated
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o seu marco de percepción
do mundo está calibrado
04:35
to an immensely
more dangerous environment.
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para un contorno
inmensamente máis perigoso.
04:38
So when you try to overlay that mind frame
onto a peacetime environment,
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De modo que se tentas aplicar ese marco
a un contorno pacífico,
04:44
you get problems.
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terás problemas.
04:45
You begin drowning in worries
about dangers that aren't present.
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Comezas a afogarte en preocupacións
sobre perigos que nin sequera están aí.
04:49
You begin not trusting family or friends.
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Comezas a desconfiar de familia e amigos.
04:53
Which is not to say there are no
dangers in civilian life; there are.
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O cal non quere dicir que
non haxa perigos na vida civil; hainos.
04:58
It's just that the probability
of encountering them
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É só que a probabilidade
de enfrontarte a eles
05:01
compared to combat
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comparada cun combate
05:02
is astronomically lower.
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é astronomicamente menor.
05:05
So we never advise veterans
to turn off caution completely.
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Así que non aconsellaremos aos
veteranos que esquezan a cautela.
05:08
We do train them, however,
to adjust caution
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Preparámolos, porén,
para calibrar a cautela
05:11
according to where they are.
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en relación ao lugar onde están.
05:13
If you find yourself
in a bad neighborhood,
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Se te atopas nun mal barrio,
05:16
you turn it up.
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activas a alerta.
05:17
Out to dinner with family?
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Saes cear coa familia?
05:19
You turn it way down.
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Desactívala.
05:21
We train veterans to be fiercely rational,
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Preparamos aos veteranos para ser
extremadamente racionais,
05:25
to systematically gauge
the actual statistical probability
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para avaliar sistemáticamente
a probabilidade estatística real
05:28
of encountering, say, an IED
here in peacetime America.
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de enfrontarse, por dicir algo, a unha
bomba oculta aquí, nos pacíficos EE.UU.
05:33
With enough practice,
those recalibrations stick.
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Coa práctica,
esas recalibracións permanecen.
05:39
The next of these treatments
is exposure therapy,
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O seguinte tratamento
é a terapia de exposición,
05:41
and this is a kind of field training,
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e este é un tipo de adestramento de campo,
05:44
and the fastest of the proven
effective treatments out there.
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e o máis rápido dos tratamentos
dispoñibles de eficacia probada.
05:47
You remember Carlos?
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Lembrádesvos de Carlos?
05:49
This was the treatment that he chose.
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Este foi o tratamento que escolleu.
05:51
And so we started off
by giving him exercises,
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Así que comezamos dándolle exercicios
05:54
for him, challenging ones:
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que foron desafiantes:
05:55
going to a grocery store,
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ir a un supermercado,
05:57
going to a shopping mall,
going to a restaurant,
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ir a un centro comercial,
ir a un restaurante,
06:00
sitting with his back to the door.
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sentar dándolle as costas á porta.
06:03
And, critically --
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E, o máis crucial...
06:05
staying in these environments.
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permanecer nestes contornos.
06:07
Now, at first he was very anxious.
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Ao principio estaba tenso.
06:09
He wanted to sit
where he could scan the room,
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Quería sentar onde puidese
analizar o cuarto,
06:12
where he could plan escape routes,
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onde puidese planear rutas de escape,
06:13
where he could get his hands
on a makeshift weapon.
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onde puidese conseguir
unha arma improvisada.
06:17
And he wanted to leave, but he didn't.
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E quería marchar, pero non o fixo.
06:20
He remembered his training
in the Marine Corps,
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Lembrouse do seu adestramento
na Marine Corps,
06:23
and he pushed through his discomfort.
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e aguantou pese ao seu malestar.
06:25
And every time he did this,
his anxiety ratcheted down a little bit,
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E cada vez que facía isto,
a súa ansiedade reducíase un pouco,
06:28
and then a little bit more
and then a little bit more,
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e outro pouco máis,
e outro pouco máis,
06:31
until in the end,
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ata que ao final,
06:32
he had effectively relearned
how to sit in a public space
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aprendera eficientemente
como sentar nun espazo público
06:38
and just enjoy himself.
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e gozar sen máis.
06:41
He also listened to recordings
of his combat experiences,
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Tamén escoitou gravacións
das súas experiencias en combate,
06:45
over and over and over.
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unha e outra e outra vez.
06:47
He listened until those memories
no longer generated any anxiety.
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Escoitou ata que eses recordos
xa non lle provocaban ansiedade.
06:52
He processed his memories so much
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Procesou os seus recordos ata tal punto
06:55
that his brain no longer needed
to return to those experiences
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que o seu cerebro non necesitaba
regresar a esas experiencias
06:58
in his sleep.
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mentres durmía.
07:00
And when I spoke with him
a year after treatment had finished,
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E cando falei con el un ano
despois de que terminase o tratamento,
07:03
he told me,
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díxome:
07:05
"Doc, this is the first time in 43 years
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«Doutor, é a primeira vez en 43 anos
07:10
that I haven't had nightmares."
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que non tiven pesadelos».
07:13
Now, this is different
than erasing a memory.
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Agora ben, isto non é o mesmo
que borrar un recordo.
07:18
Veterans will always remember
their traumatic experiences,
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Os veteranos recordarán sempre
as experiencias traumáticas,
07:21
but with enough practice,
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pero coa suficiente práctica,
07:22
those memories are no longer as raw
or as painful as they once were.
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eses recordos non son tan fortes
ou tan dolorosos como eran nun principio.
07:28
They don't feel emotionally
like they just happened yesterday,
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Emocionalmente, non parece
que ocorreron onte,
07:31
and that is an immensely
better place to be.
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e iso é unha mellora inmensa.
07:37
But it's often difficult.
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Pero a miúdo é difícil.
07:39
And, like any training,
it may not work for everybody.
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E, coma calquera adestramento,
pode que non lles funcione a todos.
07:44
And there are trust issues.
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E hai desconfianza.
07:45
Sometimes I'm asked,
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Ás veces pregúntanme:
07:47
"If you haven't been there, Doc,
how can you help me?"
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«Se non che ocorreu a ti,
como podes axudarme?»
07:49
Which is understandable.
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O que é comprensible.
07:52
But at the point of returning
to civilian life,
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Pero no momento de volver á vida civil,
07:56
you do not require
somebody who's been there.
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non necesitas alguén
que pasase polo mesmo.
07:59
You don't require training
for operations on the battlefield;
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Non necesitas adestramento
para operacións no campo de batalla,
08:03
you require training on how to come home.
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necesitas adestramento
sobre como volver á casa.
08:10
For the past 10 years of my work,
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Nos meus últimos 10 anos de traballo,
08:13
I have been exposed to detailed accounts
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expúxenme a relatos detallados
08:16
of the worst experiences
that you can imagine,
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das peores experiencias
que vos poidades imaxinar,
08:18
daily.
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diariamente.
08:19
And it hasn't always been easy.
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E non foi sempre fácil.
08:22
There have been times
where I have just felt my heart break
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Houbo veces que sentín
que se me partía o corazón
08:25
or that I've absorbed too much.
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ou que absorbera demasiado.
08:28
But these training-based
treatments work so well,
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Pero estes tratamentos baseados
no adestramento funcionan tan ben
08:31
that whatever this work takes out of me,
it puts back even more,
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que por moito que este traballo me quite,
sempre me achega máis,
08:34
because I see people get better.
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porque vexo a xente recuperarse.
08:38
I see people's lives transform.
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Vexo as vidas da xente transformarse.
08:42
Carlos can now enjoy outings
with his grandchildren,
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Agora Carlos pode gozar
de excursións cos seus netos,
08:46
which is something he couldn't even do
with his own children.
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algo que non puido facer
cos seus propios fillos.
08:49
And what's amazing to me
is that after 43 years of suffering,
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E o que me parece marabilloso é que
tras 43 anos de sufrimento,
08:53
it only took him 10 weeks
of intense training to get his life back.
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só con 10 semanas de tratamento intensivo
recuperou a súa vida.
08:58
And when I spoke with him, he told me,
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E cando falei con el, díxome:
09:00
"I know that I can't get those years back.
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«Sei que non podo recuperar eses anos.
09:05
But at least now, whatever days
that I have left on this Earth,
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Pero polo menos agora,
os días que me quedan neste mundo,
09:10
I can live them in peace."
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podo vivilos en paz».
09:13
He also said, "I hope that these
younger veterans don't wait
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Tamén dixo: «Oxalá os veteranos novos
non esperen para recibir
09:16
to get the help they need."
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a axuda que necesitan».
09:18
And that's my hope, too.
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1286
E eu tamén o espero.
09:21
Because ...
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Porque...
09:23
this life is short,
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esta vida é curta,
09:25
and if you are fortunate enough
to have survived war
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e se es suficientemente afortunado
para sobrevivir á guerra
09:28
or any kind of traumatic experience,
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ou a calquera tipo
de experiencia traumática
09:30
you owe it to yourself
to live your life well.
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é o teu deber contigo mesmo
ter unha boa vida.
09:34
And you shouldn't wait
to get the training you need
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E non deberías esperar
para recibir o tratamento
09:37
to make that happen.
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que o faga posible.
09:40
Now, the best way of ending
human suffering caused by war
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O mellor modo de terminar
co sufrimento humano causado pola guerra
09:46
is to never go to war.
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é non ir á guerra nunca.
09:49
But we are just not there
yet as a species.
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Pero aínda non chegamos aí como especie.
09:52
Until we are,
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E ata que cheguemos,
09:53
the mental suffering that we create
in our sons and in our daughters
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o sufrimento psicolóxico
que creamos nos nosos fillos e fillas
09:58
when we send them off to fight
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1548
cando os enviamos a loitar
10:00
can be alleviated.
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pode aliviarse.
10:03
But we must ensure that the science,
the energy level, the value
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Pero debemos asegurar que a ciencia,
o nivel de enerxía, o valor
10:09
that we place on sending them off to war
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que depositamos en envialos á guerra
10:13
is at the very least mirrored
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estea, como mínimo, igualado
10:15
in how well we prepare them
to come back home to us.
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co ben que os preparamos
para cando volvan á casa con nós.
10:19
This much, we owe them.
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Todo isto, debémosllelo.
10:22
Thank you.
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Grazas.
10:23
(Applause)
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(Aplausos)
Translated by Sara VP
Reviewed by Xosé María Moreno

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ABOUT THE SPEAKER
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).

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.


More profile about the speaker
Hector Garcia | Speaker | TED.com