on July 8, 2010
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.
on July 5, 2010
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.
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.
Founder of Vet to Vet
on November 13, 2010
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.
on September 10, 2011
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. A separate chapter helps the veteran develop a sense of resiliency to deal with the range of annoying jerks who can often make the service member feel like he or she is about to blow up or implode.
An important chapter guides the military service veteran through the mental health care system. Recognizing the stigma that is often associated with seeking help for anything "psychological," this chapter describes the types of mental health professionals who provide care, the different settings where treatment may be offered, and the variety of medications and psychotherapeutic modalities that may be utilized. A separate section of this chapter is directed at mental health practitioners themselves in terms of advising them how to provide the kind of services best suited to military personnel.
A subsequent chapter focuses on accepting, living, and coping with major losses that occur as the result of military service, including grief, survivor guilt, and many of the unanswerable questions of war. The final chapter offers advice for military families in working with their service member to strengthen family bonds and aid in readjustment to civilian life.
Although specifically intended for military service members themselves, and despite a clear, crisp, and user-friendly writing style, this book may still be just a little too long and complex to hold the attention of many ordinary troops. But every counselor and therapist who works with military personnel should definitely have this in their library. In fact, one productive use of this manual might be for the clinician to access the information about PTSD and mTBI in order to explain it to his/her patient, then adapt some of the book's exercises to that particular patient in that particular treatment setting. Overall, Once a Warrior, Always a Warrior is a book that will help clinician and patient work together productively.
- Laurence Miller, International Journal of Emergency Mental Health
on March 27, 2011
First, to anyone who is starting treatment or someone who has been in treatment for a while now, there are no shortcuts, meds help (they aren't a cure), stay strong. I have been in a PTSD group on base for months and although it's helpful to be around others, and our Docs are very down to Earth this book really opened up a lot more insight into where I am at in my life. I have served in Iraq and Afghanistan as a medic. My wife just returned from a tour herself, and I will be "loaning" my copy to her Kindle. We've both seen our share of combat and both being medical we've seen the aftermath of the fighting, be it troops or civilians. It took me many years to begin to address the things that were going on.
on August 25, 2010
I am a nurse and have never witnessed a war. The closest that I ever came to 'witnessing' a war was through movies like "Saving Private Ryan", "Platoon", and reading the late Daniel Perlman's first-hand reports from the war-zone.
Dr. Charles Hoge has poignantly portrayed travails of the soldiers and has very succinctly depicted their trials and tribulations in the war-front and at home as well.
Treating soldiers from wars as recent as in Afghanistan and Iraq to the soldiers from Korean war, I can relate to and validate their sentiments based on their daily narrations.
Ret. Col Charles Hoge has afforded us all a vivid insight into the grim reality of the strife with a psychological perspective.
Dr. Hoge should be up for a Pulitzer award at the least.