Once a Warrior, Always a Warrior : Navigating the Transition from Combat to Home--Including Combat Stress, PTSD, and MTBI

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, presentsOnce a WarriorAlways 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 successfullynavigatethe transition"LANDNAV" for the home front. Once a WarriorAlways a Warriorshows how a warrior's knowledge and skills are vital for living at peace in an insane world. *** "There's combat. Then, there's the rest of your life. . . . This is the guide to surviving the war back here. We all need it. A hell of a book." Max Cleland, former U.S. Senator and VA Administrator, wounded Vietnam combat veteran "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 WarriorAlways a Warrioris a vital handbook for every leader, and it is a survival book for warriors-come-home." Nate Self, former Army Ranger Captain, author ofTwo Wars: One Hero's Fight on Two FrontsAbroad and Within "

Author Biography

Col. Charles W. Hoge, M.D, served as Director of the Division of Psychiatry and Neuroscience at Walter Reed Army Institute of Research (WRAIR) from November 2004 until his retirement in summer 2009. The recipient of numerous awards in his field, he maintains a clinical practice caring for soldiers and family members with war-related mental health conditions. As a national spokesperson for the Department of Defense on war-related mental health issues and traumatic brain injury, Col. Hoge has been interviewed hundreds of times by major national news organizations. He lives in Silver Spring, Maryland.

Table of Contents

Acknowledgments	p. viii
Introduction: Postwar "Transition-Readjustment"	p. x
How to Use This Book	p. xx
Combat Stress and Post-Traumatic Stress Disorder	p. 1
Combat Mild Traumatic Brain Injury (mTBI/Concussion)	p. 37
Navigating the Home-zone Area of Operations: Introduction to "LANDNAV"	p. 48
Life Survival Skills-Warrior Reflexes and Sleep	p. 51
Become more aware of your reactions by writing about them
Learn to accept your reactions without judgment or anger
Improve physical conditioning and relax muscle tension
Improve sleep
Learn how alcohol or drugs affect your reactions
Attend to and Modulate Your Reactions	p. 87
Learn to pay attention to your physiological reactions and anxiety level
Learn to pay attention to your feelings and emotions
Create space between your reactions to stressful events and behaviors
Learn to monitor and eliminate "should" and related words or phrases
Notice your breathing
Improve your focus and attention through meditation and mindfulness
Narrate Your Story	p. 116
Deal with Stressful Situations	p. 134
Resiliency inoculation training (facing your fears)
Dealing with the "stupid stuff" people do
Dealing with more-serious situations involving people
Dealing with anger, rage, and related emotions
Navigate the Mental Health Care System	p. 170
Stigma and other barriers to care
Road map for getting help
Types of treatment offered: the cold, hard facts
Disability and treatment
Acceptance: Living and Coping with Major Losses	p. 213
Understanding the emotions of loss
Exploring the connections between complex and primary emotions
Letting go of unanswerable questions
Coping with grief and survivor's guilt
Accepting other difficult events that happened in combat
Navigation Strategies for Spouses, Partners, and Family Members	p. 253
Deployment affects everyone
Your strength and independence
Tapping into your resources
Strengthening your relationship and considerations for coping with postwar reactions of your warrior
Considerations for coping with infidelity
Helping your children cope with the stresses of deployment and transition
V = The "V"s!-Vision, Voice, Village, Joie de Vivre, Victory	p. 273
References 278
Index	p. 294
About the Author	p. 304
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