Recently I had the honor of writing the forward for an important and timely book: The Role of Companion Animals in the Treatment of Mental Disorders. Published by the American Psychiatric Association, this book is a testament to the hard work of mental health researchers and practitioners who are doing their best to find when, and how, companion animals can provide significant help to those struggling with mental challenges, including developmental disorders like ASD, and trauma-related ones like PTSD.
I hope I summed up my feelings about the importance of this work described in the book, with its excellent range of knowledge and perspectives, collected by editors Gee, Townsend, and Findling. I’ve included the Foreward below, emphasizing how important it is to know what works, know what doesn’t, and how to ask the help of companion animals without compromising their welfare. Here it is:
Timmy was never in the well.
And yet, the phrase “Lassie! Timmy’s in the well,” inspired by a 60-year old television show, lives on. It’s become a meme, passed on through generations, signifying the ability of non-human animals to rescue us from danger, or perhaps more accurately, our desire that they do so.
Many of us have felt rescued by a dog. We don’t need to be trapped in a well to wonder if we’d have made it through something–the pandemic, sexual abuse, profound grief—without a dog on our couch. However, enjoying the companionship of a strokable, sentient, emotionally-receptive mammal does not tell us if dogs, or other animals, can be constructively involved in the therapeutic treatment of mental disorders.
There are many reasons that this could be true, perhaps best suggested, at its deepest level, by the words of John Muir: “I only went for a walk, and finally, concluded to stay out till sundown, for going out, I found, was really going in.” The fact is, as special as we humans might be—with our busy brains and our elaborate communication—we do not “just happen to inhabit” the world, as David Abram reminds us in Becoming Animal. Other animals (and the land around them), are “as much within us as they are around us.”
Perhaps this is another way of saying that we all need to feel connected. Humans are highly-social animals, but the need to be with others is not necessarily confined to members of the same species. Biologist E.O. Wilson popularized the concept of biophilia, “the urge to affiliate with other forms of life,” while Richard Louv, in the Last Child in the Woods, coined the phrase “Nature-Deficit Disorder,” to emphasize that to be truly healthy, people need to feel close to the natural world around them, including animals, plants, and the land. This is not news to the peoples of many cultures, including members of many Native American tribes, but has, until recently, been counter to the perspective of classic Western philosophy.
At a more proximal level, we know that non-human animals are often seen as givers of unconditional love and affection. In part, no doubt this is because they can’t use human language. I have joked in many a speech that it’s a good thing that dogs can’t talk, because we wouldn’t always like what they have to say. Every animal behaviorist and dog trainer can tell you a story in which they’d bet the farm that an animal’s facial expression would translate into something unprintable. However, our perception of unconditional love is based on far more than a lack of language. As is described in detail in the Introduction and many of the chapters within, many adults and children have emotional attachments to companion animals on par with those of their siblings. Dogs, for one, can “get us coming and going,” as I write in “For the Love of a Dog.” They can provide a sense of the unconditional love we all desire from our parents, while, because of their relative helplessness, elicit feelings in us of parental love and nurturance.
These attachments are not one-directional. Social and highly-emotional animals like dogs, horses, and yes, cats, clearly form strong attachments to their humans that are often equally powerful, driven by a shared mammalian physiology that shows, for example, an increase in oxytocin during relaxed gazes between dogs and their owners. Although oxytocin is a far more complicated hormone than is sometimes portrayed in the popular press, its deficits appear to be a potentially important player in many psychiatric challenges, including autism and anxiety disorders.
But is this enough to support the idea that animals can, or should, be involved in the treatment of mental illness or developmental disorders? Or to tell us what animals? For whom? In what way? Not at all, which is why the science presented in this book is so important. Decades ago, when I was starting out as an applied animal behaviorist, the head pharmacist at the University of Wisconsin School of Veterinary Medicine told me that if a drug had the power to do good, it had the power to do harm. That is also true of Animal Assisted Therapy and Animal Assisted Interventions.
I remember a client I had years ago, a middle-aged devoted mother with a twelve-year old son on the autism spectrum, ASD level 3. She had adopted a dog for him, based on the recommendation of a professional, in the belief that the dog would provide companionship, and, she was promised, an increase in the child’s ability to communicate. By the time I came into the picture, the dog and the child were terrified of each other.
She wanted me to fix it. I couldn’t begin to, unless you define fixing as explaining that the situation was untenable. The dog was a highly reactive and sensitive herding breed, who barked when he became aroused at fast, erratic movements. The child was overwhelmed by the dog’s movements and barking, and flapped his arms and screamed when it happened, which set off the dog, which set off the child. It was a heartbreaking cycle of dysfunction and suffering, and an illustration of why it is vital that each case is carefully evaluated. After doing my best to explain that the situation was unfair to both her child and the dog, I was summarily dismissed. I never knew how it sorted out.
This is why the information contained in, for example, Chapter Six, “Companion Animals in the Treatment of Autism Spectrum Disorder,” is so valuable. As in other chapters, the authors emphasize what factors lead to successful outcomes (or failures). They summarize the results of 85 studies, which suggest that AAI can lead to increased social interactions, along with improved communication abilities, in some cases, in some environments. However, as is often the case in this field, the authors also note concerns with methodology, small sample sizes, and a lack of randomized controlled trial designs.
The Center for Disease Control estimates that one in twenty-five Americans lives with a serious mental condition, while the National Institute of Mental Health stated that in 2020, one in five adults in the United States suffered from “any mental illness.” We are in desperate need of information about how to more effectively prevent and treat these debilitating illnesses. Editors Gee, Townsend, and Findling have done prodigious work collecting state-of-the-art knowledge about when and how companion animals can be involved effectively in the treatment of mental illness, developmental disorders, and the promotion of mental health.
The information in this book is a critical antidote to two of the biggest challenges facing the AAT and AAI fields: First, the feel-good assumption that dogs, in any context and with any patient, make everything better; and second, that you can’t take HAI seriously, because, it’s “just about pets” and what is scientific about that? The answer to the latter is: A lot, thanks to the work and expertise of the authors of the book’s chapters. Their chapters are rich with case examples, practical applications, and insights about what we know, as well as what we still need to know, to make progress in the field. This book will do much to advance the fields of AAT and AAI, to remind practitioners that the welfare of the animals involved must be protected, and that companion animals, in the right context, can play a vital role in treating mental health illness and developmental disorders.
We are all “trapped in the well” to some degree, including mental health professionals who struggle to balance heavy client loads with staying current about the best ways to help them. Some people are down deeper than others, and in some cases, as we learn in the pages that follow, there are indeed Lassies out there, just waiting to assist in the rescue.
I’d love readers to join in here, and add any of their experiences related to the use of companion animals to alleviate suffering related to mental challenges, no matter what kind.
MEANWHILE, back on the farm: I am rejoicing in the bird life around the farm. Robert and Roberta Robin have returned and are building a nest in the nest box Jim built. (How do I know it’s the same pair from last year? Well, I don’t, but the male came a month ago and staked out the territory around the box right away, wasted no time showing it to the female when she arrived, and she settled right in. It seems most likely it’s them, so I’m going with that.) Last night I watched Robert chase off an inquisitive House Finch, a Starling, and a Dove. Good housing is hard to find.
The back yard is a riot of color–a necklace of bright orange orioles, hyper gold goldfinches, carmine-colored cardinals, rose-breasted grosbeaks, blue jays, and the resident modern art exhibit of chickadees, nuthatches, and woodpeckers. A raft of yellow-rumped warblers decorate the suet feeder, while even the sparrows are a delight–white-throated, white-crowned, and chipping sparrows are doing clean up duty under the seed feeders.
The photos below are from last year, I’m on “conserving energy mode,”today, so no new photos, but this gives you an idea of how colorful it can be out here. I’ve included the female cardinal because she might not be as colorful as the male, but I think she is gorgeous.
Last weekend we had a brief visit to one of my favorite trials, Nippersink or Swim, outside of Lake Geneva. I didn’t enter, but it was wonderful to see some good friends after the long winter. Best was getting a chance to let Skip set out sheep a few times. I love that he got to work, and I love doing the functional sheepdog work that trials demand. Wish I could’ve worked Maggie too, but she loves to travel and had a good time, especially with Skip as her wingman.
Here’s Mr. Wonderful waiting to get started. Please don’t tell him that he didn’t need to hold the sheep in the pen, since the gates were all closed.
One of Skip’s finer points is that he’ll “honor” another dog working. (Granted, sometimes I have to quietly remind him, with a whispered “stay there, stay there.”) In the photo below he has moved the sheep away from the pens to an area with a small amount of grain scattered on the ground. Once the sheep are set, the handler at the other side of the course sends their dog. Here’s one competitor “lifting” the sheep off the corn and beginning their run, while Skip watches patiently.
We didn’t do too many runs, but it was great fun. Mostly it’s pretty easy work, once you get the sheep pointed in the right direction, they run to the corn. However, we had one group who didn’t read the memo and tried for the woods. Wish I had a video; Skip was at his best at that moment, quiet and purposeful and totally in charge. Good boy.
These lovely creatures were in a nearby field. (You can see part of the course in the background.) Not the animals I want my dogs trying to work, thank you.
That’s it for this week. Tell us what jewel-like birds or flowers are brightening your day, and if you’ve had experience with either providing or receiving either Animal Assisted Therapy or Interventions.
Charlotte Kasner says
I think that we always have to bear in mind that rewards and punishments are in the eye of the beholder. I alway think that with animal-assisted interventions we need to bear in mind how the animal may feel about it.
How many times do people with fearful dogs ask other humans not to approach to be confronted by “It’s OK, I like dogs”. Similarly, my sister hates the countryside and feels insecure when not surrounded by urban development whereas I crave open spaces and greenery.
Dogs, and to a lesser extent horses, seem to have been seen as something of a panacea for human woes recently. I too have clients who blithely inform me that their puppy is a “therapy dog”, bought for offspring to use as a living cuddle/carry toy and angry that they are meeting resistance. Mark too the range of animals that have been taken on aircraft in the USA as “assistance” animals, often to the distress of the animals as well as other passengers.
My last dog was a Pets As Therapy visitor and he loved it. I got a lot out of it too but I know that was due to his personality (and my training!) not an inherent quality of canis lupus familiaris.
MinnesotaMary says
As a long term Hospice pet therapy team with two different huskies, I can tell you that, while it’s an amazing thing for most people, it’s not at all helpful for others. Some patients whose family signed them up for pet therapy were not “dog people” and did not appreciate me and my dog poking our heads in to their room asking if they’d like a visit. I was told a few times to “get that animal out of here if you want to come in my room.” Similarly, family of my patients are often comforted by my dog, as are staff in the facilities we visit. But there were definitely a few people working at the nursing homes or assisted living facilities that were terrified of dogs. I’ve watched a few grown men run screaming down the hall to hide in a closet, stairwell or bathroom. They were almost all here from a country where feral dogs were the norm and you did not interact with dogs without planning an elaborate defense. My experiences have mostly been positive though, and we’ve helped dozens (maybe hundreds) of people spend their final days more comfortable and peaceful.
Tricia says
Unfortunately, we fail to take the animal’s well being in this scenario.
Trisha says
Actually, it is the opposite. This book is full of cautions about not compromising an animal’s welfare. It’s part of why I wrote the foreward.
Trisha says
Charlotte: That is exactly why this book is so good. It’s the best volume I’ve seen that takes the welfare and comfort of both giver (animal) and recveeir (client/patient) at the forefront.
Trisha says
Exactly, Minnesota Mary, that’s why I love this book. It is full of cautions about the negative effects on both client/patients and animals. These concerns are critical, and are highlighted over and over again in this book.
Elizabeth P. says
We got Pippin puppy a week before we lost our older dog (we did not plan it that way, I assure you!). I realized a few days later that it was the first time I had heard my husband laugh with delight since our son had died 4 months earlier. We did not get her to help with our mental health (although my husband had been looking for another dog since we suddenly lost our younger dog a year previously- talk about a horrible year) but she has definitely been a huge help to us in dealing with life after losing our boy. I can imagine it must depend on the temperament of the person as well as that of the dog, though!
Bitsey Patton says
Thank you so much. I have seen Therapy Dogs that hated what they were doing, and the handlers seemed not to notice. Sometimes our ego gets in the way of the welfare of our dogs. We are having fun and assume the dog is. We like feeling like a superstar, but perhaps the dog does not. Hoping the book is accessible, readable, and not too expensive.
Maureen says
Thank you for the info (and foreward!) on what sounds like a great book. I too am always concerned about the animal’s welfare in all of this, and glad that the book is addressing that aspect of this topic. In my rescue work (again – I seem to always fall back on this in my comments!) we get a lot of folks applying for Rottweilers (the breed I rescue) so they can train them as their “therapy dog” and it sets off red flags for me every time. For all the reasons we all know, but primarily because these dogs are all usually traumatized to some degree (or will be when they are rehomed, due to the stress rehoming causes by its very nature) – some dogs not so much, others very, very much – and to expect them to then provide support to a human in need is just more than I will subject them to. We are rescuing THEM, often because of what other humans have done, and I am very protective.
That being said, I am a subscriber to the saying “All dogs are therapy dogs, but most are just freelancing” – as I know that the dog snoring on my sofa right now lifts me up in ways I cannot even articulate, even as I care for him (and his epilepsy needs). (I LOVE your line about how dogs “get us coming and going” – exactly!) The dogs I love and care for may seem to have it easy, indulged as they are, yet in my view they do all the heavy lifting around here. I am sane, stable, content, and able to function in the world normally because I have them – to love, to care for, to bring immeasurable joy into my life just by being their brilliant, amazing and very canine selves.
Kat says
I’ll confine myself to just three stories of the dozens and dozens I could tell.
I’ve adopted a grandchild. Her mother had another appointment that she had to get to just after the daughter got braces so my granddaughter came here directly after the orthodontist. She was miserable and her mouth hurt. Not a mental illness per se but definitely a person in distress. Falkor Bash adores her and every time she was working herself up to being very upset about her braces Falkor was there shoving his head into her hands demanding her attention. It was so clear that he was trying to make her feel better that even the distressed 11 year old noticed. When her mother came to pick her up the girl was laughing even though she’d arrived leaking a few tears.
I share my home with someone with a diagnosed anxiety disorder. One of the most effective things I’ve found to help them is having them massage D’Artagnan. This means spreading their fingers wide and moving the skin with pressure no more than the weight of a nickle. As they do this I see their breathing even out and slow down and I watch their muscles relax. Five or ten minutes of this and the person is back in balance. And as a bonus it’s good for D’Artagnan’s health as well.
D’Artagnan is a Therapy Dog. He’s my second Therapy Dog. Working with these amazing animals I get to see again and again how much difference they can make. I’ve lost track of how many times I’ve been asked if we can visit a resident who is unresponsive or severely depressed. We enter the room and my dog goes to work. Sometimes that means he stands close, focused and waiting. Sometimes it means he’s shoving his nose under a hand demanding attention. I know my dog picks up more clues from the person than I do (I can’t smell how they are doing for example) so the dog is in charge of how to engage the person. Whatever method the dog chooses I’ve never seen it fail. The resident has always chosen to engage with the dog. I’ve seen it enough that I don’t think it is unusual (although it’s always wonderful). The activities directors that accompany us usually describe it as magic.
D’Artagnan loves his job and is always eager to go to work but he also has the option at any time to stop. He is never forced to interact with someone if he doesn’t want to. And I work with him to set everyone up for success. I know he doesn’t like to face the wall when someone is petting him so we walk up next to a bed with him on the outside then turn so he is next to the bed facing the room. When I’m mentoring new Therapy Dog teams I emphasize to the human that care of their canine partner is their number one priority. Therapy Dogs have to be willing participants choosing to do the work not a dog that is being coerced into a role they don’t want. But when the dog chooses the work amazing things can happen.
Cristina Meyer says
I am autistic and live with four dogs. They keep me functioning. They are my family and my companions. After the accident, I scraped myself together and found away to take them out again, so they would be happy, which advanced my motoric abilities incredibly.
And, as a fun note, the pictures of dogs and humans comparing their facial expressions – these helped me read human faces better.
Karen Lasker says
Sounds like an excellent resource for anyone running an AAI/AAT program. I wish this information was available when I was working in the field, but I feel we maximized whatever in formation was available — including your valuable expertise!
Barb Stanek says
For some reason, I needed comfort today, and your mentioning that you were dismissed by the woman with the autistic child and herding dog is giving me comfort!
I too have been dismissed after giving my honest, valuable albeit unwanted assessment to a client. I tend to hang on to the dismissal, focusing on the help that I could have been.
Finding another in the dismissal room with me is comforting. Thanks for sharing that.
Leslie Haller says
I’m a special education teacher at a residential school for a range of students with behavioral and emotional challenges. My young APBT is a therapy dog in training, she comes to my class two days a week. My class of delightfully bright and funny 9th and 10th graders love Lucid, and understand (and relate to) her tendency to push limits. She starts each morning crated, today one of my students asked me if he could “…let out the little oxytocin generator ?”
Felicia Jacobson says
My “pet/therapy” dog was a cocker spaniel and though not trained as a therapy dog she went everywhere with me and provided comfort and sanity when I needed it. I deal with bipolar disorder and anxiety and I had her for 13 years. I have 2 other girls now who were not properly socialized due to my physical disability so unfortunately they have no contact with anyone outside the apartment. I know this is a great disservice to them, but they are loved and taken care of. They do help with my anxiety a great deal and Miss Ellie is never far from my side.
This book sounds like an absolute must read. Thank you for sharing this.
Gayla says
Thank you for the book recommendation and the lovely photos!
In looking for holistic ways to help with depression, I stumbled onto a TED talk that said ‘human connectivity’ was a critical component for mental well-being. The theory was backed by data from a decades long clinical trial and involved thousands of participants. Just the sort of science-based opinion that gets my attention. The irony is; I’m pretty sure it’s my connections with the people in my life that’s bumming me out!
For me, the surest way to re-balance my perspective and lift my own spirits is for my dog and I to spend time, alone together, on the mountain.
Karie says
After I experienced an extremely traumatic situation in 2017 my doctor wrote me a prescription for an ESA. My Shih Tzu Dixie, age 8 at the time, stepped into that role. When I lost her last year I wanted to properly grieve her before I got another dog and that month alone was one of the most difficult of my life! I have my beautiful Misty now and she provides me with such great companionship and comfort. She is very calm and we’ll behaved and goes with me EVERYWHERE! Stores, church, restaurants, tai chi, etc
Lainy says
I have a retired therapy dog. We spent 8 1/2 years visiting special needs children in 4 schools in our area. I was continually amazed at my little border collie McGee and how intuitive he was. McGee had a favorite bean bag chair in one classroom that he would curl up in and the kids would sit with him. One day, a little girl was laying on a mat in a corner quietly crying as she didn’t feel good and was waiting for her mom to come pick her up. When we got to the class I dropped his leash so he could settle in his chair, but he quietly by passed his chair and the the other children and went directly to the corner where the little girl lay. He then curled up beside her and stayed til her mom came. The teachers were amazed and asked how I trained him to do that. I told them’ that wasn’t any training that I did, that was all McGee’.
He touched so many lives over the years and I have made many wonderful friends because of him. When Covid hit so did arthritis and I retired him, but I do so miss working with him and watching his magic.
Anne says
I get really emotional about this because we just had to put down our 13 year old Aussie Pepper when her health failed suddenly. I have a picture of her with my kid the weekend we picked her up from the breeder. Child was 5, puppy was 8 weeks, so they basically grew up together. As a dog breeder myself, I know that some dogs and some kids are a terrible combination, and the parent has to be responsible to make the decisions. However, when it all works it is the BEST thing ever. I know because I was a kid with social difficulties and my parents letting me have a dog literally changed my life (there were years of begging for a dog first).
As a young teen my kid suffered from anxiety and depression which preceded coming out to the world and us as transgender. There were days when she’d hide under a blanket on the floor and nothing I tried to do would help. But Pepper wouldn’t leave her alone. Only Pepper could get through. She’d burrow her nose under the blanket persistantly until she finally got some reaction, and a few minutes later there would come a kid giggle.
I will always have dogs, and I hope one of our other dogs can step into the role of emotional support, but until they do, they are still entertaining in their own way, being young and silly. It’s not something you can just decide “this is emotional support dog”, it’s something they do or they don’t do depending on their temperament and the bond.
Donna says
I’ve been blessed to have several of my no- longer- at- my- side dogs have the interest & ability to become certified therapy dogs. One of the most important things I always mention to people considering this path with their pup is this- if it’s not fun/enjoyable for the dog, it will should not happen. My last 2, Shasta & Spencer, loved visiting, though not with the same types of people. Spencer did not care for children, tolerated them, but didn’t want to go to library or school visits; his jam was with significantly limited adults with various developmental needs- he figured out his own way to position himself against their wheelchairs to be within their visual field, so they could see him. Shasta instead preferred people of any age that could pet or stroke or scratch him- the same folks that Spencer adored Shasta would often quickly move on from. It’s important to pay attention to what the dog/animal wants, or the potential for usefulness is diminished. Another thing- some dogs can make the work of being a therapy dog look incredibly easy, until you see another animal that is struggling, as Tricia described. I could go on & on (I’ve been blessed to be doing therapy visits for 20 years now!) about the good, and less than good experiences canine/human interactions can create, but am VERY interested in reading this book. Anything Tricia recommends has been fantastic!
Trisha says
Argh! Someone wrote a wonderful comment that included a link to the “spoon” explanation for energy vampire diseases like CFS and Lupus. When I went to approve it, it disappeared. I can’t find it anywhere, and I am SO SORRY. It was a great comment, the link was fantastic and I hope hope hope whoever wrote it reads this and resends it. So sorry!