Introduction
The book “Once a Warrior Always a Warrior” is a classical guide authored by Charles Hoge. The book begins with an inclusive introduction, “Postwar Transition Readjustment,” which provides an intensive description of transitioning home from a combat deployment warzone to normalcy (Hoge, 2010). One of the integral points highlighted in the first chapter is that transitioning home from combat does not mean becoming a civilian (Hoge, 2010). Rather it entails relaxing the responsibilities and focusing on assimilation into the mainstream environment. The book addresses the mental health issues associated with life after combat such as Post-Traumatic Stress Disorder (PTSD), mild Traumatic Brain Injury(mTBI), and depression as well as interventions for the condition such as therapy and self-care routine.
Veterans are prone to suffer from post-traumatic stress disorder (PTSD). The reason is that officers retiring from war battle stress, or any other myriad reactions to war, having missed out on important family events, having trouble making ends meet after being out of work for a while or coping with a physical or mental injury sustained in battle (Hoge, 2010). Therefore, army officers retiring from war must discover the resources and tools available to assist them in dealing with their psychological needs upon their return.
Many exercises and infographics are included to help the reader understand their experience. In section one, the author emphasizes what PTSD is, and how the body reacts to stress, including chest pains, fatigue, chronic stress, and lethargy (Hoge, 2010). Each person experiences different symptoms of PTSD, such as flashbacks about the memories that a warrior wants to forget, insomnia, and overstimulation or reaction to perceived danger (Hoge, 2010). Therefore, the classical guide provides a description of ways to identify the symptoms and the possible treatment for combat stress, PTSD, and Mild Traumatic Brain Injury (mTBI).
Chapter two introduces the many strategies that can help combat mTBI. The guide provides the causes, symptoms, and relevance of early treatment of TBI. One of the revelations made here is that mTBI, such as concussions experienced during the war, can cause PTSD considering that brain trauma causes irritability, dizziness, fatigue, insomnia, and cognitive issues such as hallucinations (Hoge, 2010). Head injuries caused by blunt force can significantly alter how the brain functions, leading to excessive stress, which causes PTSD (Hoge, 2010). In a recount of the war in Iraq and Afghanistan, the author describes how many warriors survived with serious injuries that led to mTBI. The primary cause of mTBI is being knocked out or experiencing a loud blast (Hoge, 2010). Diagnosis of mTBI is through brain scans which help indicate the area of damage and the treatment includes a combination of education and therapy.
Phase three focuses on the successful navigation of the post-war environment. The author introduces one idea of “LANDNAV,” a framework created to help veterans objectively transition home from combat. Hoge (2010) defines “LANDNAV” as a set of abilities necessary for veterans to adjust to civilian society. The author introduces the first acronym, “L,” which stands for Life survival skills considered essential for readjustment (Hoge, 2010). The reason is that veterans need to be able to do things like learn about their compensation, become retrained, develop connections, and seek employment after leaving the military (Hoge, 2010). All these activities are integral in enhancing life outside the war environment.
Chapters Four to Seven
Section four of the book delves into life survival skills, warrior reflexes, and sleep, which guide effective practices that drive a better life. Hoge argues that for veterans to develop their survival skills, they must first recognize the interdependence between their physical and emotional well-being (Hoge, 2010). The author mentions that the brain reacts to threats by activating reflexes such as fight or flight (Hoge, 2010). Warrior reflexes are a set of instincts and actions honed on the battlefield, which should help evaluate a situation swiftly and confidently and make choices.
Hoge says that sleep is another crucial factor that veterans should consider. He explains how getting enough shut-eye is good for your body and mind and can help you relax. According to his recommendations, service members and veterans should obtain seven to nine hours of sleep per night (Hoge, 2010). In addition, he suggests that they try deep breathing and other relaxing methods to help them sleep. Other recommended habits include accepting reactions without judgment or anger, releasing the tension, eating a healthy diet, and medicinal interventions for chronic cases such as using antihistamines for insomnia (Hoge, 2010). All these practices help initiate a better life for individuals retiring from combat lifestyles.
Phase five examines the strategies to regulate reactions effectively. This segment addresses the second initial “A,” which represents “Attend” to the psychological needs such as anxiety, fear, and guilt as they arise. One strategy is identifying the stressors that lead to negative thoughts (Hoge, 2010). One strategy emphasized is creating space between reactions to stressful situations and behavior. The author gives an example of a veteran in a bar drinking, and someone bumps into them, causing the drink to spill (Hoge, 2010). Instead of confrontation, the writer urges that one takes a break before initiating any response considering that the first reaction will be triggered by emotion and not rational thinking (Hoge, 2010). Eliminating phrases such as “should” reduces the reaction pressure, promoting better practices. Other activities, such as mindfulness and awareness, promote better engagement and response.
Episode six reinforces the ideas presented in segment five by addressing how to cope with emotional reactions through suppressive strategies. “Narrative of your story” represents the symbol “N” in the LANDNAV acronym (Hoge, 2010). This strategy follows exposure therapy whereby veterans are encouraged to describe the most horrific combat experience considering that this decreases the symptoms since they become less intrusive and a nightmare when narrated (Hoge, 2010). The subsequent paragraphs recount a story of a veteran on the frontline who experienced the horrors of battle and was forced to learn the harsh effects of war (Hoge, 2010). The next sections provide strategies to help officials retiring from war deal with their trauma.
Phase seven, titled “Deal with stressful situations,” focuses on the symbol “D,” meaning dealing with issues. The author examines some triggers that can affect a veteran, including attending crowded malls and discrimination (Hoge, 2010). These experiences can influence negative thoughts and ideas, resulting in defiant behaviors (Hoge, 2010). Therefore, arguments presented in this stage include building resilience. The story describes how strength, courage, and desire for change can help veterans adjust to post-war environments and deal with people, anger, and trauma.
Summary of Chapters Eight to Eleven
The Eighth segment titled “Navigate the mental health system” represents the symbol “N” in the abbreviation LANDNAV which introduces the strategies that can help veterans deal with PTSD. The author begins by addressing the barriers to care, including stigma and fear of losing control, reducing access to mental healthcare. Other issues addressed include a lack of trust in health professionals, embarrassment, high mental health costs, and the efficacy of interventions (Hoge, 2010). Some strategies recommended include getting advice from veterans, visiting mental health clinics, and engaging with primary care physicians when veterans experience mental illnesses (Hoge, 2010). The treatments for PTSP include psychotherapy, medication, eye movement desensitization, reprocessing stress inoculation, and group therapy (Hoge, 2010). All these interventions are integral when dealing with clients with stress and trauma-related stressors.
Episode nine reinforces the interventions used in self-care routines to help overcome trauma. In this chapter titled “Acceptance, living and Coping with Major Losses,” the author reveals that when people admit to defeat or lack of control it is not a show of weakness but power (Hoge, 2010). The writer argues that it’s essential to keep moving forward and finding strategies to cope with life after a significant loss, despite how challenging it may be to accept the loss (Hoge, 2010). Some strategies to promote acceptance include getting a support system such as family, maintaining a routine involving activities of interest, and a self-care routine.
Chapter ten, “Navigation strategies for spouses, partners and family members” offers a holistic approach to treating mental stressors such as trauma. One of the significant descriptions provided in this episode is that deployment affects everyone and has lasting effects on an individual. Another intervention is communication which involves sharing concerns with people with whom one has a relationship (Hoge, 2010). Other strategies include building rapport with family and friends and focusing on meaningful intimacy. However, the author cautions the reader about codependence which occurs when people get excessively aligned to specific practices or people (Hoge, 2010). For veterans, becoming overdependent on other people can happen inevitably, considering that this stage is a new phase of life where people make new memories and friends.
The last phase focuses on the symbol “V,” which provides a further guideline on how to lead a healthy lifestyle as a veteran. The acronym letter represents vision entails accepting the present issues and working on the goals one needs to achieve. Various concepts enhance vision, including voice, village, and victory (Hoge, 2010). The author explains that speaking about issues that affect an individual is another integral step for recovery. The reason is that the voice helps pass a message to the world, leaving a lasting impact on society (Hoge, 2010). The community, also called “village,” provides a platform for individuals to evolve, develop and transcend worldwide. Victory is another consideration that is achieved in a loss. According to Hoge (2010), people must experience loss to understand the benefits of gain. Therefore, when individuals become victorious in their endeavors, it helps establish their vision to maintain the focus.
Conclusion
The book “Once a Warrior Always a Warrior” is a guide that highlights common mental health issues affecting army officers returning from war. Some of the medical conditions addressed include PTSD, mTBI, and stress-related disorders. The author provides some of the barriers to access to mental healthcare including stigma and lack of finances. The interventions for PTSD, mTBI, and depression including therapy such as cognitive behavioral intervention and self-care routines including better sleep are addressed. The author provides information for readers to reflect on how post-combat lifestyle can influence mental health for army officials and ways to achieve balance as they settle back into the mainstream system.
Reference
Hoge, C. (2010). Once a warrior- Always a Warrior: Navigating the transition from combat to home, including combat stress, PTSD, and mTBI. Rowman & Littlefield.