by David Sack, M.D.

Winston Churchill said, “There is something about the outside of a horse that is good for the inside of a man,” he may have been more right than he realized. A growing body of research is beginning to confirm what has long been observed anecdotally — that animals can help us heal in ways both physical and psychological.
More and more in therapists’ offices and mental health and addiction treatment facilities, animals are being used as a bridge to those who are struggling, with encouraging results. A 2007 clinical trial of an equine-assisted therapy program, for example, found that “reductions in psychological distress and enhancements in psychological well-being were significant immediately following treatment and were stable at 6-month follow-up.” Those involved in the program described themselves as better able to live more fully in the here and now, less burdened by regrets, guilt and resentments, less focused on fears related to the future, more independent, and more self-supportive.
A more recent 2012 study of psychiatric uses for animal-assisted therapy concluded that animals are especially helpful in improving social and communication skills, easing anxiety, lifting mood, and boosting empathy. All ages can benefit from the therapy, the report noted, which is most commonly used for those struggling with issues of addiction, depression, sexual abuse, anxiety, schizophrenia and autism spectrum disorders.

Another study that looked at an equine-assisted psychotherapy program for at-risk youths noted that all the participants ultimately reported better self-image, self-control, trust and general life satisfaction.

The Animal as Therapist

The idea of the animal as therapist is far from a new one. As long ago as 1792, the York Retreat in England, one of the few facilities of the time to offer humane treatment of the mentally ill, allowed its residents to interact with and care for farm animals as a way to improve their emotional state.
The concept was picked up by others as the years went by, and used to help those suffering from war fatigue, epilepsy and a variety of psychiatric illnesses. In the late 1800s, companion animals were increasingly common at European mental institutions. As scientific methods advanced in the early 1900s, animals were largely pushed out of the treatment picture. That changed in the 1960s, however, when child psychiatrist Boris M. Levinson discovered by chance that his dog helped his youngest patients open up during sessions. This “pet therapy,” as he termed it, became widely accepted as a helpful complement to traditional treatment.
Today, the therapy goes by a variety of names — animal-assisted therapy, pet psychotherapy, pet-mediated therapy, co-therapy with an animal, and more. Programs range from simple interaction with an animal to structured psychotherapy sessions in which animals are used to help participants understand and express their feelings, overcome fears and develop healthy emotional responses.
For example, in an equine-assisted psychotherapy session, participants might be asked to choose a horse — and, in turn, be chosen by a horse — and then interact with it. Someone who has boundary issues, for example, might be instructed to back a horse out of his personal space. Another person who has struggled with abuse and rejection might find empowerment in having such a large and majestic animal respect her attempts to guide it. In all interactions, the participants take initiatives, face fears and get immediate feedback from the animal.

And it’s not just horses and dogs. Llamas, cats, birds, dolphins, rabbits, donkeys, even wolves, to name a few, are used to form a connection with those who need help, whether dealing with addictions, depression, schizophrenia, phobias, PTSD, or a host of other issues.

What Animals Offer

What is it about animals that can help us get back on track?

Animals share a deep, genetic bond with us. We are wired to react to animals.Our evolutionary survival has depended on our noticing them and responding to them. Animal-assisted therapy puts that ancient bond to work in new ways.

Animals give us immediate, honest feedback. Animals mirror our physical and emotional states but without our need for filters. Instead, we get nonjudgmental feedback and new insights into our own moods and emotions. Perhaps most important, animals don’t care what you look like, how successful your love life is, how many friends you have, what you do for a living or how much money you make. They respond without criticism only to your mood and your actions.

Animals lower barriers to communication. An animal’s mere presence and its unscripted behavior is, in essence, a neutral conversation piece that can spur and improve interaction. People also appear friendlier, less threatening and more relaxed when in the presence of animals, according to several studies. In the case of therapist and client, this can act as a shortcut to developing rapport, a key component in successful treatment. In one study, 56 percent of those in a substance abuse program appeared to interact spontaneously when a therapy dog was present and subsequently reveal significant portions of their histories relating to violence, loss, self-esteem, family dynamics, and consequences of drug and alcohol use.

Animals are physically and psychologically comforting. Anyone who has held a puppy or leaned their head against the neck of a horse after a bad day can attest that animals ease stress. Studies confirm that animals can boost levels of oxytocin, a hormone that reduces anxiety and blood pressure, and can even help extend the life of those recovering from coronary problems.

Animals allow us to practice relationships. For those who find it hard to connect with or deal appropriately with others, animals offer a nonthreatening way to test out relationships before taking bigger risks in building human interactions. The animal doesn’t substitute for failed or inadequate human relationships; rather, it acts as a bridge to a higher level of emotional functioning.

Animals take us outside ourselves. Caring for and interacting with an animal allows us to focus on something other than our own problems. Stepping away, even momentarily, from our sometimes all-consuming issues can be an important first step in seeing avenues to change. Animals also serve as metaphors. A dog rescued from a lifetime of abuse but now happily dispensing face licks at a shelter or a horse seeking to escape when frightened can serve as powerful symbols of our own struggles. Interpreting and understanding their reactions can lead us to better understanding of our own.

Animals teach us responsibility and self-control. We can’t rush an animal. We have to learn to move at its pace and break down tasks into manageable steps. This cause-and-effect relationship can help us build the control needed in our own lives. In addition, taking responsibility for the care of an animal not only shows us how to meet the needs of others, it illustrates the joy of being of service. Some programs even prefer to refer to animal-assisted therapy as “animal assisting therapy,” emphasizing that caring for another living creature is in itself part of the treatment.

Animals bring touch back to therapy. For obvious reasons, physical contact between therapist and client is just not a treatment option. Animals return the important component of touch back to the therapeutic realm.

Animals improve our self-esteem. It’s hard not to respond to creatures that respond to us so deeply. Even if we have a trail of bad choices behind us in our lives, seeing ourselves in the eyes of a dog allows us to think, Maybe I’m not so hopeless after all.

An Important Complement to Traditional Treatment

Despite success stories and a growing body of research, the use of animals in mental health and addiction treatment can sometimes be looked upon dubiously. Sure, it might be fun to ride horses, scratch a dog behind the ears or interact with dolphins, but is it therapy?
While it is true that larger and more controlled studies are needed to quantify the effectiveness of animal-assisted therapy and the field will benefit from the growing move toward more standardized methods and terminology, we shouldn’t dismiss it in the meantime. There is very little to lose in letting animals be part of a well-rounded course of treatment, and a lot to gain.

David Sack, M.D. is board certified in Addiction Medicine and Addiction Psychiatry. As CEO of Elements Behavioral Health he oversees a number of treatment programs that have integrated animals into the therapeutic programs, such as wolf therapy at Promises in California, equine-assisted therapy at The Ranch in Tennessee, and dolphin therapy at Lucida Treatment Center in Florida. For more about Elements and the services they provide visit  www.elementsbehavioral.com