Once a Warrior--Always a Warrior: Navigating the Transition from Combat to Home--Including Combat Stress, PTSD, and mTBI [Unabridged] [Paperback]

Charles W. Hoge M.D. (Author)

Book Description

Publication Date: February 23, 2010

 

The essential handbook for anyone who has ever returned from a war zone, and their spouse, partner, or family members.

 

Being back home can be as difficult, if not more so, than the time spent serving in a combat zone. It’s with this truth that Colonel Charles W. Hoge, MD, a leading advocate for eliminating the stigma of mental health care, presents Once a Warrior—Always a Warrior, a groundbreaking resource with essential new insights for anyone who has ever returned home from a war zone.

 

In clear practical language, Dr. Hoge explores the latest knowledge in combat stress, PTSD (post-traumatic stress disorder), mTBI (mild traumatic brain injury), other physiological reactions to war, and their treatment options. Recognizing that warriors and family members both change during deployment, he helps them better understand each other’s experience, especially living with enduring survival skills from the combat environment that are often viewed as “symptoms” back home. The heart of this book focuses on what’s necessary to successfully navigate the transition—“LANDNAV” for the home front.

 

Once a Warrior—Always a Warrior shows how a warrior’s knowledge and skills are vital for living at peace in an insane world.

 

 

Editorial Reviews

Review

“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.

 

 

“This superb book should be required reading for all mental health clinicians working with new veterans, particularly those in Veterans Administration medical centers.  Dr. Hoge's combination of crystal clear prose, deep understanding of the warrior experience, and thoughtful, practical advice, makes Once a Warrior indispensible to any veteran (or anyone helping him) ease the transition to civilian life or recover from more serious illness.  Dr. Hoge's message is essential - everyone is changed by war, but even those with the most lasting effects can recover by embracing their warrior spirit.”   —Sally Satel, American Enterprise Institute, Washington DC

 

 

“True to his word, Charles Hoge "cuts to the chase", gets rid of as much jargon as possible, and provides warriors with a comprehensive, accessible and sophisticated no-nonsense survival manual regarding post-deployment transition and readjustment.  He provides a unique perspective that is rarely equaled through both his personal experiences as a soldier and his scientific mastery of the latest developments on the causes and treatment PTSD, TBI and related problems.”     —Matthew J. Friedman MD, PhD; Executive Director, National Center for PTSD, US Department of Veterans Affairs; Professor of Psychiatry and Pharmacology & Toxicology, Dartmouth Medical School 

 

 

“Colonel Hoge, MD, a well-known and respected psychiatric researcher and clinician, has written a smart, insightful, jargon-free book on reactions to trauma and the syndrome of Post Traumatic Stress Disorder. This book is a gift to anyone in the military or anyone who has relatives or loved-ones in the military. What was obvious to me is that Col. Hoge genuinely cares about the health and well-being of people serving in the military and of their relatives. His direct, clear language and thinking help clear up many misconceptions about reactions to combat, and provide useful tools to aid in recovery/readjustment.”  —Greer Richardson, MD, Assistant Clinical Professor of Psychiatry, Yale University; Veterans Affairs Staff Psychiatrist, West Haven, Connecticut

About the Author

Charles W. Hoge, MD, Colonel (Ret.), U.S. Army,  directed the premiere U.S. research program on the mental health and neurological effects of the wars in Afghanistan and Iraq from 2002 to 2009 at Walter Reed Army Institute of Research. He deployed to Iraq (2004) to improve combat stress care. He continues to work as a staff psychiatrist treating service members, veterans, and family members. As a national expert on war-related mental health issues and traumatic brain injury, Dr. Hoge has testified to Congress and is interviewed frequently by national news organizations. 

Product Details

• Paperback: 328 pages
• Publisher: GPP Life; First edition (February 23, 2010)
• Language: English
• ISBN-10: 0762754427
• ISBN-13: 978-0762754427
• Product Dimensions: 9 x 6 x 0.9 inches
• Shipping Weight: 7.2 ounces (View shipping rates and policies)
• Average Customer Review: 4.8 out of 5 stars  See all reviews (31 customer reviews)
• Amazon Best Sellers Rank: #27,131 in Books (See Top 100 in Books)
  • #23 in Books > Health, Fitness & Dieting > Mental Health > Post-traumatic Stress Disorder
  • #72 in Books > Health, Fitness & Dieting > Psychology & Counseling > Neuropsychology
  • #86 in Books > Medical Books > Psychology > Pathologies

More About the Author

Charles W. Hoge, MD, Colonel, U.S. Army (Retired) directed the U.S. military's premiere research program on the mental health and neurological effects of the wars in Afghanistan and Iraq from 2002 to 2009 at Walter Reed Army Institute of Research. He deployed to Iraq in 2004 to improve combat stress care. A national expert on war-related mental health issues and traumatic brain injury, Dr. Hoge has testified to Congress and is interviewed frequently by national news organizations. His articles on PTSD, mild traumatic brain injury (mTBI), and stigma are the most frequently cited medical publications from the wars in Iraq and Afghanistan. He continues to work as a staff psychiatrist treating service members, veterans, and family members. He lives in the Washington, D.C. area.

Most Helpful Customer Reviews

22 of 22 people found the following review helpful

4.0 out of 5 stars Warriors and Yoga July 8, 2010

By Yoga Reflections

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.

20 of 21 people found the following review helpful

5.0 out of 5 stars The missing piece March 10, 2010

By TR

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!

17 of 18 people found the following review helpful

5.0 out of 5 stars Great book July 5, 2010

By moe armstrong

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.
Lack of impulse control can lead to some possible violent reactions.

Still, the book is the most complete and comprehensive book that I have seen on what will be the greatest mental health plague, ever.

Also, Prazosin is discussed. Which I found encouraging. An often overlooked and under utilized medicine.

The book is comfortable to hold. This book is the right size to carry around and keep referencing. I only hope that people see the distinct value of this book as comprehensive book in a small package. This book will go a long way to bring stability to those of us who have PTSD. People who want to work with us can keep one book and get to work.

I only hope that Colonel Hoge gets wider recognition than he has gotten so far. Through this book, Colonel Hoge might have a hand held reference to the after effects of these current wars which will begin to come home in the next five to ten years.

BUY THIS BOOK. I bought two. Kept one and gave one away. Consider doing the same.

Moe Armstrong
Founder of Vet to Vet