Psychological health and resilience are indispensable requirements for military personnel serving in combat zones. Their importance is even greater because of their close relationship to the experience of pain. An example shows a German NCO with chronic dental pain for three years after deployment whose pain ceased after psychotrauma therapy.

Differentiated prevention programs are becoming more and more important to protect troops not only from Posttraumatic Stress Disorder, but also from depression, anxiety disorders, and pain syndromes.

Prevention programs in the German Armed Forces follow a “Framework Regulation for Coping with Psychological Stress of Servicemen.” The concept defines measures on a three phase and three level basis. The three phases include pre-deployment preparation, deployment itself, and post-deployment measures. Right now the Framework Regulation is being further developed. The focus has shifted from psychological stress to psychological fitness (PF). PF needs to be defined and operationalized by its components. The practical implementation includes a computer-based training program during pre-deployment training. Regular screening measures will monitor the PF of troops and regulate an individualized combination of post-deployment modules to strengthen personal resources. These components of primary and secondary prevention also include elements to reduce the basis for mental and physical pain.

The concepts and their relation to pain will be presented and discussed.