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How To Prepare For A High Stress Tour Of Duty At Landstuhl

28 Jul


Dear Belleruth,
I am leaving soon for Landstuhl Regional Medical Center, to provide mental health services to our military and their families. I have been in private practice for the last 6 years, and have used your book Invisible Heroes and CD's nearly daily. My question is this:
Do you have any advice for me as I begin this two year assignment?

Warm Regards,



Dear Paul,

My best advice is to pay careful attention to your first impressions - of the people you'll be serving and the hospital culture that will be the context for your work - beginner's mind could be your best teacher here. In some ways, you'll never have such clear eyes!

If at all possible, try to jot down your impressions and thoughts, because in about 2 months, you'll be part of the system and won't notice this stuff - and it's important to let it inform the care you are giving.

Also, if you can,

  • Keep a journal
  • See to your own self-care, including exercise, meditation and/or guided imagery, to deal with the vicarious suffering that will be entering your very pores
  • Hand-pick a sympatico work buddy (perhaps with a different skill set or approach) with whom to debrief on a regular, semi-structured basis
  • Meet with colleagues, if possible, once a week, for solution-oriented discussions (as opposed to gripe sessions, which are ultimately demoralizing)
  • Keep your heart open, but with good, behavioral boundaries. Contrary to popular belief, it's a closed heart that leads to burnout, not an open one.

Thank you for doing this work. I salute your adventurous spirit!

All best,

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Belleruth Naparstek

Psychotherapist, author and guided imagery pioneer Belleruth Naparstek is the creator of the popular Health Journeys guided imagery audio series. Her latest book on imagery and posttraumatic stress, Invisible Heroes: Survivors of Trauma and How They Heal (Bantam Dell), won the Spirituality & Health Top 50 Books Award.