Page 94 - JSOM Spring 2025

preferred SOF in-groups. The segregation demonstrated by performance as it relates to their ability to achieve dynamic
4
this family formation fosters in-group versus out-group be- freedom of maneuver amid the ambiguity of SOF missions.
havior and cultivates relationship obsolescence, causing con- Exposure is a central component of bag sets because in cata-
nections to become stagnant. strophic injury occult findings it can lead to death. Within bag
sets, family formations metaphorically 8–10 carry the weight of
Uniformity creates an affective sense of safety and comfort the exposure component, which assists in assessment and diag-
amid ambiguity. However, social sedentarism in everyday life nosis of injury that contribute to the lethal triad of trauma. Op-
dilutes latent potential in social contrast. Short-term uncon- timized family formations function similarly to the exposure
ventional resilience degrades when ambiguity is eschewed for process, when the casualty is completely undressed, thoroughly
unyielding conformism. Long-term unconventional resilience assessed for life-threatening injuries, and recovered from the
degrades and the medic’s, team’s, and organization’s character iatrogenic risks of hypothermia. In other words, optimized
refinement atrophies when vulnerability to existential uncer- family formations reveal embarrassing aspects of relation-
tainty is rejected instead of embraced. ship-building in order to assess for latent threats to unfolding
new connections. While familial exposure is expected to cause
The second family formation that degrades unconventional temporary disruption in the relationship system’s performance,
resilience is a stratified formation. Within this formation, var- it is also necessary to protect against a cascade of other poten-
ious relationship connections are rank ordered such that the tial downstream interpersonal harms during the character re-
SOF family is placed first, the medical family second, and the finement process. To buffer against total humiliation that could
civilian family last. COG is engaged by withdrawing from a lead to a rigid, blocked, and toxic relationship system, these
diverse social circle amid the character refinement process. The family formations also compose and coordinate the weight of
following quote illustrates this type of formation: exposure by embracing, appreciating, and respecting perfor-
mance vulnerability that emerges when moving with adversity.
SOST comes first over everything else. Our personal ob-
ligations and medical development tend to take a back When assessing and diagnosing threats to connection, degraded
seat to achieving integration into the SOF family. None of family formations avoid calculated risks that expose them to
us want to admit it, but we’ve all essentially chosen SOF relationship embarrassment. While these family formations
over our nuclear families and even professional develop- create an externalized appearance of superlative performance,
ment as clinicians. We sacrifice years of our spouses’ and they do not maintain comprehensive threat awareness. Un-
children’s lives to make the world a better place. Many of willingness to observe, examine, and integrate new unfolding
us struggle through divorce and raising kids in an environ- connections that are established when vulnerability is exposed
ment that asks us to put SOF above all else. We often see limits relationship building to only the most superficial forms of
patriotism as the willingness to make medicine secondary familiarity and hides life-threatening vulnerabilities. Focusing
and family tertiary when considering the political impli- only on the development of predictable and controllable rela-
cation of our missions. We’ve convinced ourselves that tionship connections hinders the ability to compose and coor-
we’re doing the greater good for America by achieving a dinate the weight of exposure because it eschews interpersonal
“cool guy” status in the SOF family. discomfort in relationship-building. Rejecting needs, concerns,
and experiences of relationships outside the SOF community
This family formation misdirects devotion into an emaciated provides a temporary sense of viability. However, the attempt
sense of communal purpose that dismisses the legitimacy of to proliferate boilerplate SOF culture eventually blocks innova-
sacrifice not immediately relevant to the SOF family. It prej- tive performance because individuals who are not initiated into
udices value to SOF social authority and amputates diverse the SOF culture are eliminated as life-threating vulnerabilities.
connections. Monoculture based on allegiance to the most superficial norms
and values of SOF buffers against temporary humiliation but
Elitism creates a sense of communal safety amid ambiguity. also prevents creation of a fluid, fluent, and flourishing rela-
However, erecting quotidian structures of social supremacy tionship system during the character refinement process.
cements momentum on “cool guy” status and reinforces SOF
status quo. Short-term unconventional resilience is degraded Tactical Process of Forming Social Determinant:
when ambiguity is eliminated for a sclerotic sense of right per- Family Formations
formance. Unwillingness to tolerate civic uncertainty atrophies Within our metaphor, the organization optimizes tactical en-
the SOF medic’s, team’s, and organization’s vulnerability to the gagement with the social determinant of family formations by
character refinement process, degrading long-term unconven- allowing the weight of exposure components to be distributed
tional resilience. across individual medics and their team. By advocating for ev-
ery SOF medic to carry trauma shears in their personal bags,
the organization not only empowers individuals to expose
Bag Sets as Meaningful Metaphor: Family Formations
potentially embarrassing performance patterns that threaten
Tactical Function of Social Determinant: relationship building but also inspires teams to capitalize on
Family Formations fortuitous relationship connections discovered during the ex-
The social determinant of family formations carries the weight posure process. Similarly, providing space blankets to every
of the exposure component of bag sets. Since this is our final SOF medic allows individual wisdom—gained across various
paper describing social determinants, we conclude our use of performance spaces—to influence team performance when al-
the bag sets as a metaphor. This metaphor has been used to leviating resistance to potentially crude outcomes. When the
describe how social determinants function at the tactical level organization designs a larger space in a community bag to
of everyday life. Metaphorically, bag sets represent an intimate carry the blood warmer and hypothermia prevention manage-
relationship for SOST medics and help explore their practical ment kit, it promotes the creation of a more comprehensive,

92 | JSOM Volume 25, Edition 1 / Spring 2025