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Once a Warrior--Always a Warrior: Navigating The Transition From Combat To Home--Including Combat Stress, Ptsd, And Mtbi Paperback – Unabridged, February 23, 2010

4.7 out of 5 stars 103 customer reviews

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Editorial Reviews


“Returning veterans who are affected by PTSD, traumatic brain injury (TBI), combat stress, and other war-related reactions will find both compassion and the resources needed to understand and get needed help for these troubling, and often disabling, conditions.” ―ForeWord Magazine

“There's combat. Then, there's the rest of your life. We need survival skills for each battle zone. This is the guide to surviving the war back here. We all need it. A hell of a book. The lucky get it.”

―Max Cleland, former United States Senator from Georgia, former Administrator of the Veterans Administration, decorated wounded combat veteran of the Vietnam War

"I've never met a mental health professional who 'gets it' as well as Colonel Charles Hoge. He's done the research, he's been shoulder-to-shoulder with warriors, and he's woven it together in language that is real and resonant. Once a Warrior―Always a Warrior is a vital handbook for every leader, and it is a survival book for warriors-come-home." ―Nate Self, former Army Ranger Captain, author of Two Wars: One Hero's Fight on Two Fronts―Abroad and Within

“John Denver's lyrics about coming home to a place you've never been before sums up this book. A brilliant guide, and very much needed now.” ―Gordon R. Roberts, Medal of Honor recipient

“Of all the victimizing crap out there regarding what real warriors experience in battle, Dr. Hoge's deeply researched work stands a breed apart from anything in this genre. He has simply written the best, most comprehensive study of not only what those at the tip of spear have endured, but what they can expect to go through as they confront the realities of combat. Just as every warrior should drink water and clean their rifle in battle, every returning veteran should pack this book as they continue their journey home.” ―Staff Sergeant David Bellavia, author of “House to House: An Epic Memoir of War”

"Once a Warrior―Always a Warrior provides a uniquely valuable addition to the subject of Post Traumatic Stress in the military population because it comes from a Soldier and a mental health professional who has years of real world, hands-on experience helping our warriors deal with these issues. Dr. Hoge possesses the rare gift of being able to translate the science from published research into the language of the warrior. As valuable as this book is for warriors coping with experiences that in many instances are normal responses to abnormal circumstances, it should also be required reading for mental health professionals to whom our warriors turn for assistance. It will help them strike the right chord with those they serve, even if they have not walked in their boots. Finally, it's a book for the warrior's family. It will help them to understand, participate in, and facilitate the warrior's journey, and realize that it can be a journey of growth."
―James B. Peake, M.D., Former Secretary of Veteran Affairs (2007-2009), 40th Surgeon General of the U.S. Army, decorated combat veteran
“Dr Hoge has served his nation well by compiling a user friendly guide to issues this generation faces in the long wars of Iraq and Afghanistan. Written in a language warriors can understand he takes complex issues and delivers practical advice, tips and strategies that are the antidote to suffering. Ultimately no matter the experience, the warrior must decide which path they will choose. They can go down a negative path that leads to dysfunction and suffering or they can chose to own their experience, rather than being owned by it. This book and the skills within it can serve as a first step in a journey toward resilience and positive growth.” ―Steve Robinson, SFC (Retired), Army Ranger, Veteran Advocate

“Dr. Hoge explains cutting edge medical discoveries in plain English, and describes the psychological and physiological mechanisms underlying post-deployment transition challenges. In essence, he tells us two things: there are good reasons why it is hard to adjust to “normal” life after combat, and understanding those reasons empowers us and makes us more likely to succeed at adjusting and integrating combat experiences into a healthy psychological and emotional life. This understanding is essential for our growing ranks of combat veterans and their loved ones, mental health professionals, policy makers, and concerned citizens, and this book is the way to get it.” ―Gabriel Ledeen, Former Captain, U.S. Marine Corps, 2-tour Iraq Combat Veteran, Senior Fellow, Vets For Freedom

“Dr. Charles Hoge has provided those who defend us a road map for treatment and support of their unseen wounds. The burden is heavy among those returning from deployment and the system they must navigate is complex. Barriers jump up at many points along the way. Our warriors are provided with the very best guidance on the battlefield so they may find their way to safety and victory; Dr. Hoge has provided our returning warriors guidance for gaining victory over the pain within.” ―Dan G. Blazer, MD, PhD, JP Gibbons Professor of Psychiatry and Behavioral Sciences, Duke University Medical Center

“Once a Warrior – Always a Warrior is the answer to the question “Where can I get great advice to help me adjust to returning home?” Charles Hoge shares his experience as a soldier and his wealth of knowledge as a physician and mental health expert with the aim of easing the transition from the battleground to civilian life. The book is fact-filled, authoritative, and immensely practical. It is a must read for returning military personnel, their families and friends, and anyone who provides care to active duty personnel and veterans.” ― Murray B. Stein MD, MPH, Professor of Psychiatry and Family & Preventive Medicine, University of California San Diego; Staff Psychiatrist, VA San Diego Healthcare System; Volunteer Staff Psychiatrist, Naval Medical Center San Diego

“Finally, a respected military leader and mental health professional brings a no-bullshit, common-sense approach to the discussions on combat stress, resilience and warrior adaptations. Colonel Hoge's integrity and deep commitment to supporting America's service members are clearly expressed in this book. It is an excellent starting point for anyone who wants to understand and navigate their own adaptations to operational stress and adversity, or those of the people they care about. This is a great resource for warriors of all backgrounds and generations.” ―Dan Taslitz, former Reconnaissance Marine, Iraq combat veteran.

About the Author

Col. Charles W. Hoge, M.D., Colonel U.S. Army (Retired), served as Director, Division of Psychiatry and Neuroscience at Walter Reed Army Institute of Research from November 2004 until his retirement in summer 2009. Since 2000, Colonel Hoge has directed a comprehensive research program at the Walter Reed Army Institute of Research (WRAIR) focused on mitigating the mental health impact of the current wars in Iraq and Afghanistan. His program has been responsible for the Mental Health Advisory Team (MHAT) assessments in Iraq and Afghanistan, research that led to the DoD Post-Deployment Health Reassessment Program, and the development of novel educational efforts to reduce stigma and promote psychological health after deployment, including Battlemind Training. In addition, he maintains a clinical practice caring for soldiers and family members with war-related mental health conditions.

Col. Hoge is also a national spokesperson for the Department of Defense (DoD) on war-related mental health issues and traumatic brain injury. He has been interviewed on hundreds of occasions by major news organizations on camera, radio, or in print, including NBC, CBS, ABC, CNN, C-SPAN, NPR, Reuters, AP News, New York Times, Washington Post, USA Today, Newsweek, and numerous others, including the Diane Rehm Show, the Paula Zahn Show, and the Dr. Oz Show.

He has published over 90 peer-reviewed articles, letters, and chapters. His most widely cited articles pertain to the mental health impact of the wars in Iraq and Afghanistan and to mild traumatic brain injury among U.S. troops returning from Iraq.

He is the recipient of numerous awards in his field, including the U.S. Army Achievement Medal for Psychiatric Research; the U.S. Army Commendation Medal for selection as finalist for Bailey K. Ashford Research Award, Walter Reed Medical Center; the Iraq Campaign Medal, OIF-2, Mental Health Advisory Team Member; the U.S. Army Meritorious Service Medal for General Officer Mental Health Summit, and, in 2006, the U.S. Army Medical Research and Materiel Command Combat Casualty Care Program Award for Excellence in research to support the mental health of deployed forces.

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Product Details

  • Paperback: 328 pages
  • Publisher: Lyons Press; 1 edition (February 23, 2010)
  • Language: English
  • ISBN-10: 0762754427
  • ISBN-13: 978-0762754427
  • Product Dimensions: 1 x 6 x 8.8 inches
  • Shipping Weight: 15.2 ounces (View shipping rates and policies)
  • Average Customer Review: 4.7 out of 5 stars  See all reviews (103 customer reviews)
  • Amazon Best Sellers Rank: #41,505 in Books (See Top 100 in Books)

Customer Reviews

Top Customer Reviews

Format: Paperback
I attended "Return form the War Zone: Reintegrating Soldiers, Sharing Experiences", a panel which included Col. Hoge at the International Festival of Arts and Ideas in New Haven where I was very moved by the veterans personal descriptions of their struggles as they resumed civilian life and bought "Once a Warrior...". The introduction gives a useful summary of the culture shock warriors can expect when they return to civilian life. Warriors have trained to react appropriately to the stress of war, but often not had the luxury of reprogramming themselves to return home. I was particularly struck by the suggestions in the table of contents that read like the table of contents in a mindfulness text. I teach yoga in a Veteran's Community Care facility to help my students breathe, relax, focus, and observe their emotions and experiences without judgment, all therapeutic activities listed by Col Hoge. Many of my students are older, having taken years to realize that they could benefit from help. I hope more families read "Once a Warrior..." and begin to process their experiences through telling their stories and practicing mindfulness before problems arise or become more serious.
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Format: Paperback
Why is this book great

1. Page 146. There is a specific scale which clearly defines control issues or extended use of controls in a person's life to help stabilize PTSD. These control factors can bring a sense of stability to a person but turn off other people. Because of these control issues, I have people turn against me. That hurts me and probably them-which is why they turned against me.

2. Page 175. Brings home FULLY why people do not get help. Anyone who wants to work with those of us who have these PTSD conditions needs to understand this. Not just read the page-have this page burned in our memory. Xerox this page and carry it in your pocket.

3. Page 275. The V's at the end of the book are the solution to get us somewhat stable from the PTSD mess left in our heads. These V's can build good action plans. These V's should be the foundation of everyone's encounter notes!

This book also teaches all the therapies and treatments out there. The book doesn't really make judgements. This book just lays out the options. The same could be said for navigating the system. Most people do not understand how navigate the system. Most people do not know-they are about to enter a system. They just want help. They are about to get that help by entering a system. Navigating the system is almost never taught or recognized.

If I had enough money I would buy this book and drop it by air drop all across America.

The down side
The author doesn't seem to recognize the importance of the amount of veteran's returning with characteristics of Axis II. Axis II symptoms are in large numbers of current returning veterans. Repeated deployments? I do not know.

There is:
I want you-I hate you.
I am here-I am gone.
Read more ›
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Format: Paperback
While browsing the book store for help with my own ptsd and trauma recovery, this book popped out at me and I instantly grabbed it. All I will say is that I am so grateful to this compassionate Colonel for spelling out what he does here. As a warrior I was looking for something particular without even realizing it; this book is a life-changer.

Thank you so much, Colonel Hoge!
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Format: Paperback Verified Purchase
As a volunteer therapist for The Soldiers Project, I have recently begun working with warriors returning from Iraq and Afghanistan. This book was invaluable in helping me to understand military culture, combat related PTSD and mTBI, and the struggles faced by these brave men and women as they navigate their journey home. It is also an excellent "handbook" for the soldiers themselves and can be used to assist them in this process whether they are in therapy or not. The section devoted to family members and their role in the healing process as well as information on how to cope with their own changing roles in the family and the life of the soldier is insightful and informative. This book pulls no punches. The approach is honest and straightforward; one that can be understood and appreciated by therapists, soldiers, families and all those whose lives have been touched by a warrior.
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Format: Paperback
This is a soldier's book. Written by a military psychiatrist whose published articles in scientific and medical journals has been on the cutting edge of military traumatic disability research, Once a Warrior dispenses with doctor-talk and is directed to the grunt at the front who is trying to come home - in every sense of the word.
Using a format that consists of both didactic, plain-talk instruction and a set of self-help exercises, this book addresses what have been called the "signature injuries" of the Iraq and Afghanistan theater wars, posttraumaric stress disorder (PTSD) and traumatic brain injury (TBI), specifically focusing on so-called mild traumatic brain injury (mTBI), which usually does not result in dramatic symptoms and impairments like loss of vision, impaired speech, or immobility, but which can produce a wide range of more subtle, yet significantly disabling physical, cognitive, emotional, and behavioral symptoms. These include dizziness, sleep loss, fatigue, sensory hypersensitivity, impaired concentration and memory, irritability, impulsivity, and depression. In fact, many of the symptoms of mTBI overlap with those of PTSD, often confounding accurate differential diagnosis and appropriate treatment planning.
Early chapters describe the challenges of transitioning from a red-alert war-zone mentality to the vagaries of civilian work and family life. Subsequent chapters provide practical strategies for dealing with tension and stress, improving sleep, avoiding overuse of alcohol and drugs, modulating anxiety levels, managing anger, dealing with irrational guilt and justifiable grief, and using meditation, mindfulness, and narrative approaches to lower stress.
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