Staff Perspective: Becoming an Active Duty Behavioral Health Provider – An Unpreparable Journey

Staff Perspective: Becoming an Active Duty Behavioral Health Provider – An Unpreparable Journey

There is a big difference between looking in a window and living in the house.”

This truth is something I rapidly discovered as I wore my purple suede suit for the last time on a Friday, the final day of my civilian internship, and showed up on Monday, dressed in an Army uniform, hoping I had put it on correctly.  I had, but barely.

I have been, and am, a Military Psychologist.  I spent my first five years wearing the uniform, and the next ten assisting others as they began their first year on this journey.  It truly is a journey.  Up until I walked in to Brooke Army Medical Center the first time, I had never been around the military.  But during graduate school I found myself becoming interested in what it takes to create a military.  How do you take a person and shape them to go against their basic instinct of survival?  So, when that scary time for psychology students came around, known as “match”, I found myself applying to the one civilian Army internship that was available, not quite sure I wanted to go active duty since I knew I had no idea what I would be signing up for.  Through the first months of my time on internship, I found I loved working with soldiers.  Right around then, 9-11 happened.  Somehow I still found myself deciding “why not!”  Before I knew it, my civilian life ended and my military life began. 

I frequently reflect back on my first year on active duty.  Life challenges ultimately made me leave active duty, but ever since I’ve been working with the internship back at Brooke Army Medical Center where I first started.  My primary duty is working with the Army interns and residents, as well as other students in our department.  I love working with students – every year I get to see the beginning all over again.  Each year I watch in awe as young adults not only begin their behavioral health careers, but start their first days being part of the military family.  It is an exciting and scary time for most.  Prior to their arrival, we often receive questions about how they can be best prepared to enter the service and start working with Service members.  Predictably, I was asked this question a couple weeks ago during our interviews for next year.  Thinking out loud, I said “You can’t.”  You can’t be truly and completely ready.  Admittedly, that is not what should have slipped out to the apprehensive applicant in front of me.  I continued and discussed some reading that could be done, people to talk to, etc., but to be completely honest, you can’t be “prepared” for the cultural change that entering active duty service entails.  I don’t think this is a bad thing, though.  Those first months on active duty are amazingly odd – the language seems foreign, everything is a three letter acronym, you rapidly discover the subtle nuances of communication, the difference between a suggestion and an order, how there are different rules of polite decorum and discussion, and a whole lot of other things that are just not apparent when you are simply observing and studying the military world.  You are learning how to be in a group-based culture, where technically your time and physical being are not totally your own.  But the trade-off is you are part of an incredibly tight family where someone is going to be looking out for you.  Within a few months, you are amazed when you are visiting “civilian” family members and having to back-translate what you are saying to them.  The transition happens relatively quickly, and during this journey you learn how truly flexible and adaptive you are.  Flexible and adaptive – two things necessary for ANYONE working with the government (probably a blog for another time).  These are also two things that will make you an even better provider and person.

So every year for the past ten, I have been honored, and to be honest amused, to watch new interns as they learn to salute for the first time.  Being here to support the next generation is probably the best job there is.  I think the best advice I have for those considering or beginning the journey to becoming not just a psychologist, but a military psychologist, is to relax.  Read all you want, it can’t hurt; but also take a deep breath and realize you are about to enter a culture that you simply don’t know and can’t really know until you are in it.  There will be surprises.  There are many things you simply can’t prepare for.  Just like that person looking through the window, you may know what the furniture looks like, but you have no idea where the thermostat is set at and you won’t until you walk through the door.  Inside there is a family waiting.  Every one of them had to walk in the door for the first time themselves.  They get it.  They understand where you are at, with all of your nervousness.  They are there to guide you along the journey.  So just take a deep breath and open yourself to the experience, the guidance, the mentorship, and the opportunities.

The opinions in CDP Staff Perspective blogs are solely those of the author and do not necessarily reflect the opinion of the Uniformed Services University of the Health Science or the Department of Defense.

Deb Nofziger, Psy.D., is a Senior Military Internship Behavioral Health Psychologist with the Center for Deployment Psychology at the Uniformed Services University of the Health Sciences. She is currently located at the Brooke Army Medical Center in San Antonio, TX.