Once a Warrior, Always a Warrior: Navigating the Transition from Combat to Home

by Charles W. Hoge

 

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.

 

 

Genres: Nonfiction, Military Fiction, Psychology, War, School

328 pages, Paperback

First published January 1, 2010

Reviews

[Erin Byers · Rating 5 out of 5]

This book is by far the best book that explains PTSD and combat stress. Do not be apprehensive that it is written by an officer, he knows his stuff. He also coordinates with a 1SGT from Vietnam to relate to the readers. This book is a must for anyone returning from Iraq/Afghanistan or combat, new or old. Please spread the word about this book, as I know Vietnam Vets did not have this type of resource! If you are not sure if you need to read this book, then you probably do, no harm done. PTSD is not a stigma. It is a natural response to an unnatural situation. Combat stress is normal. If it is not dealt with properly, it can definitely manifest into PTSD, adjustment disorders, homicide, or suicide. This is obviously no joke, as the stats have shown an increase in homicide and suicide in the military. $17 will not set you back far from what you will gain from this book. If you cannot afford it, contact me, and I gurantee you will receive a copy.

Regards,
SGT Erin Byers
2BCT, 10 MTN Div.
OIF 06-08
May our lost never be forgotten

[Meredith · Rating 5 out of 5]

On the back cover, one reviewer compares this book to John Denver's lyrics about "coming home to a place you've never been before." I can't say it any better. Colonel Hoge gets it -- he understands PTSD and its related disorders like no other author. Most importantly, he knows how to connect with and get through to those suffering from PTSD. I've read a lot of books while trying to understand my own PTSD and how it affects those around me -- but his is the first that made me say "This is it. I understand! That's me!"

It's ironic that THIS book -- designed to help soldiers and their families during post-deployment reintegration -- resonates with me. Yes, my husband recently returned from a deployment, but I'M the one with PTSD (triggered by life-threatening pregnancy complications, a series of emergency operations, and deployment stress).

Unlike other PTSD books, Col. Hoge's book is completely free of the implication that people suffering from PTSD were or are victims. He avoids medical jargon and abstract explanations. Everything he writes is grounded in concrete examples, personal narratives from a variety of servicemen and their families, and clear plans of action. The book is part self-help, part reference, and part workbook -- chapters are peppered with checklists, questionnaires, and instructions for coping with difficult situations. Like a good soldier, he uses acronyms to help us remember steps for coping.

I keep this book handy at all time and refer to it several times a week. Every time I've had a reaction or an emotion I couldn't quite explain, I've opened it and found the answers I needed. It's helped me communicate with my husband and family in language we can both understand, and helped us all realize how PTSD permeates all aspects of my life. But better than that -- it's given us the tools we need to start coping with it.

There is come military jargon in the book, but not enough to confuse or discourage civilians from reading it. Similarly, some personal narratives are very military-centric (stories from Vietnam vets, for example), but there are plenty of stories that anyone could relate to. They were written by soldiers, so several contain strong language. I didn't have a problem with it, but readers should be aware that the f-bomb gets dropped more than a couple times.

This is a must read for all servicemen, their families, their friends, or ANYONE coping with PTSD, Combat Stress, or mTBI -- or anyone confused about the difference! I think this would an invaluable tool for anyone who has been through any trauma -- medical, car accident, rape, combat, etc. It's absolutely changed my life.

[Catherine · Rating 4 out of 5]

Engaging from beginning to end and chapter after chapter of compassionate and useful knowledge. May not be as helpful for female warriors who have survived sexual assault. I plan to read this again.

[Julie · Rating 2 out of 5]

Bleh. Simplistic and not very enlightening... but then again, it was written by the bane of a soldier's existence- an Army psych doctor. One of these days I pray the military writes about a different type of PTSD, one that affected me and my friends, where combat was not our stressor... our leadership was. We call it the Groundhog Day Effect- same crap, day in and day out. Senior leaders there because they missed the boat for getting a right arm patch and couldn't retire without one. COLs getting DSCs for 6 months of nothingness. LTCs getting MSMs while LTs did all the work. We'd complain when salsa lessons were cancelled. We'd grumbled when the wireless internet was down.

We didn't fight a war. We fought ourselves. It sucked so badly that we were angry, once we redeployed, that we actually missed the Groundhog Day Effect.

You won't find any help in this book if you were at the tail end of OIF.

[Sarah Jensen · Rating 5 out of 5]

Book Review: Once a Warrior, Always a Warrior: Navigating the Transition from Combat to Home by Charles W. Hoge
Rating: 4.8/5

Reactions & Emotional Impact
Reading Once a Warrior, Always a Warrior felt like being handed both a compass and a lifeline. As someone who has studied military psychology but never served, I was struck by Colonel Hoge’s ability to bridge the gap between clinical expertise and lived experience. His writing carries the weight of authority (backed by decades of military psychiatry research) yet radiates empathy—like a trusted platoon leader guiding you through uncharted terrain. The chapters on “LANDNAV for the home front” left me awestruck, reframing combat skills as assets rather than pathologies. I found myself alternating between admiration for Hoge’s dismantling of mental health stigma and quiet fury at how society fails veterans. The section on mTBI (mild traumatic brain injury) and PTSD comorbidity was particularly revelatory, blending hard science with poignant veteran testimonials.

Strengths
-Clinical-Meets-Combat Insight: Hoge’s dual perspective as a soldier and psychiatrist lends unparalleled credibility. His explanation of hypervigilance as an adaptive combat skill—not just a “symptom”—challenges reductive diagnoses.
-Practical Frameworks: The “LANDNAV” system (a military navigation metaphor for reintegration) is genius, offering concrete steps for emotional regulation, sleep hygiene, and relationship repair.
-Family-Centered Approach: Rare for the genre, the book dedicates equal space to partners/spouses, validating their parallel “transition trauma” with actionable advice.
-Stigma-Busting Tone: Hoge’s direct yet compassionate prose (“Warriors aren’t broken—they’re rearranged”) could rewrite public discourse on veteran mental health.

Constructive Criticism
-Cultural Scope: While exhaustive on U.S. military experiences, more cross-cultural comparisons (e.g., UK’s Combat Stress services) could broaden applicability.
-Tech-Era Gaps: A chapter on digital reintegration (social media triggers, virtual therapy access) would modernize the 2010 edition.
-Veteran Diversity: More narratives from female veterans and non-combat roles (e.g., medics, drone operators) could enhance inclusivity.

Final Thoughts
This isn’t just a book—it’s a battlefield manual for peace. Hoge transforms the “warrior mythos” from a burden into a toolkit, proving that survival skills honed in combat can anchor a meaningful civilian life. A must-read for clinicians, veterans, and anyone who loves one.

Gratitude:
Thank you to National Book Network and Edelweiss for the gifted copy—this arrived as I work with veterans, offering language for struggles I’d previously only half-understood.

Why 4.8?
Docked slightly for dated tech/cultural references, but Once a Warrior remains the gold standard for transition literature.

Key Themes for Further Study:

-mTBI/PTSD overlap in veteran vs. civilian populations
-The neurobiology of “moral injury” in reintegration
-Comparative analysis of international veteran support systems
-Family systems therapy for military households
-The role of peer support in reducing suicide risk
A seminal work that deserves shelf space beside On Combat and The Body Keeps the Score.

[Patrick Moore · Rating 5 out of 5]

written in 2010, a good overview of how people get PTSD and mild brain injuries, treatment, what support people can do and what a person can do for themselves. I learned a lot that was helpful to me.

Since the book came out there is more talk of another type of PTSD called Moral Injury, that is interesting. Articles on the internet are as helpful as the books on this, in my opinion.

Treatments for PTSD and brain injury are not yet showing much healing effect. EMDR is shown to have some effect but the studies are not robust enough, some say. Also it can be too much too fast. I have a friend who was a combat veteran with diagnosed PTSD who became a counselor for 30 years. He told me he has effectively treated people with PTSD. He feels three years is a good amount of time to build a relationship, safety, and to provide the things that really make a difference including things like Viktor Frankl's, family dynamic stuff, gestalt, narrative therapy, and qualities of the therapist like spontaniety, compassion, nonjudgment, curiosity. . Not likely the VA will want to spend 3 years of weekly talk therapy on each person.

In the mean time Dr. Hoge's book provides much that can supplement therapy, coping, sleep (valerian), support, relationships, exercise, reducing the amplitude and duration of one's reactions, not judging oneself, etc.

I was never in the military but I found much of this book very helpful.
Highly recommend.

[Kade Worry · Rating 2 out of 5]

I knew going into the book that much of the information was outdated, as psychologists now use the DSM-V in lieu of the DSM-IV used in this book. With that said I thought that maybe many of the tools and coping mechanisms suggested in the book. On that note I was disappointed, Col. Hoge recommends exercise that require you to actively seek out stress triggers. I feel this to be an unnecessary and counterproductive approach. Veterans would be better served to having coping techniques to deal with stressors as they occur instead of actively seeking them.

[Maria · Rating 3 out of 5]

Colonel Charles W. Hoge, MD, discusses and explains various treatment methods for PTSD, combat stress and mild TBI.

Why I started this book: PTSD is a challenge for warriors and their families.

Why I finished it: Strong reassurance that the skills developed downrange for survival, are not reasons to beat yourself up over when the warrior returns home. That there is always an adjustment period and that drugs, various techniques and exercises can help.

[Wes M · Rating 4 out of 5]

If you want bottom up line front praxis about PTSD for combat veterans, or merely soldiers that have deployed into a legitimate combat zone and integrating back into civilian life - then yes, this book is a read for you or your loved one.

[James Wilson · Rating 5 out of 5]

This is the first book I have read that covers every aspect of living with PTSD and how to recover from it. It contains knowledge for both the affected and their families and or friends. THis book shoud be given (or made available) to every person who serves in combat.

[Rosanne Randall · Rating 5 out of 5]

Excellent for Soldiers!
Used for my dissertation.

[Alexander Roth · Rating 4 out of 5]

Brilliant final chapter on “‘The V’s!’ - Vision, Voice, Village, Joie de Vivre, Victory”

[Steve Woods · Rating 4 out of 5]

This is probably one of the most useful books about ptsd I have read.Although the focus is American so that a proportion of the book is specific to that national context and the US system of veteran's care the basic issues and principles are the same for all combat veterans. The book focuses on a system called LANDNAV as a self directed way of handling the difficulties that arsie for sufferers of ptsd and it's directed specifically towards combat induced ptsd.With the dilution of focus now apparent in the Australian system as a result of the definitions applied by the DSM IV, it provides guidance that is generally not available to combat veterans through the standard avenues available in Australia. Combat derived ptsd is different and more intractable than that normally derived from other sources(at least the research indicates so).It needs to be handled in a particular way by people who understand combat. I have not, in 25years in the Australian system, encountered a clinician who has ever displayed that understanding let alone the experience.

There is nothing that I am awars of available in Australia to compare to the LANDNAV system outlined here and I can say that through working out for myself what works for me I have developed routines which approximate many of the techniques presented here and they have been effective for me. The lack of a coherent approach to Combat related ptsd and the scarcity of professionals competent to deal with it has largely resulted from the privatisation of service delivery to profit making hospitals.It seems that the cost of developing effective programs and delivering them is too much ofa strain on the bottom line to bother so veterans coping with combat related ptsd are lumped in with a motley collection of the rest, many of whom have never even seen active service let alone combat. Combat veterans are largely left to fend for themselves. A bit difficult without competent professional guidance and zonked out on drugs,the standard management approach.

There is developing a major problem that is being ignored under the cover of poorly thought out and poorly delivered services. Politicians can then point to all that is being done no matter how useless that may be and wash their hands of the results of their cavalier attitudes to commitment to conflict.

This book or an Australian adaption of it should be handed to all those returning from a conflict zone; that would be a start!

[Emily · Rating 4 out of 5]

While primarily aimed at service members and veterans, this book contains information that is invaluable for anyone dealing with PTSD and anyone whose loved one is struggling with PTSD. Col. Hoge explains the physiological basis for the cognitive, emotional, psychological and behavioral reactions that can result for PTSD and how they are related to the skills and attributes that are vital for the soldier during war. “Every 'symptom' of PTSD stems from things your body normally does in response to severe danger or stress,” he writes. “An adaptive and beneficial response when there is a threat to your personal welfare or that of others, and the persistence of these reactions is the body's effort to ensure that you're immediately ready if the danger occurs again.” In addition, he mentions that PTSD often occurs in conjunction with depression, anxiety and substance abuse, which often makes it more difficult to sort out and diagnose the root issue.

For more book reviews, come visit my blog, Build Enough Bookshelves.

[Jthooghouse · Rating 5 out of 5]

This is a must "listen" book from audible! Easier than reading it! Sooo on target! If you are a warrior, you get this book...if you're not, you probably won't "get it" as much, but, good for all either way....ratings tend to reflect this....and in fact, he talks directly to this point! BLUF...if you picked it up, it's your starting point!

[Julia · Rating 4 out of 5]

I read this book for a class I am doing a library instruction class for. The class is for veterans who are first-time college students. This book is the common reader for the course. This book seemed to provide good tips for veterans after returning home. It will be interesting to see how they liked it.

[Laela · Rating 4 out of 5]

I found the information straight forward and easy to understand. Each Chapter was set up in an easy to follow manner. There is no doctor gibberish going on. Anybody can understand the language in this book.

I would have given it a fifth star if it didn't read so much like a text book including chapter summaries. I would have also like a longer chapter on how family members could help.

[Luis · Rating 5 out of 5]

Hogue has done a masterful job of dissecting the contemporary effects of war on our beleaguered warriors.

[Cari]

skimmed through the book, information wasn't applicable to me. Nothing new