Equine Therapy for (PTSD) Post Traumatic Stress Disorder

For thousands of years horses have been mystical, magical creatures playing the role of transportation, gladiator, companion, entertainer and more. Now they are also playing the role of psychotherapy assistant through a discipline known as Equine Assisted Psychotherapy (EAP) which is increasingly being used to treat war veterans suffering from Post Traumatic Stress Disorder (PTSD).

The U.S. Department of Veteran’s Affairs estimates that Post Traumatic Stress afflicts as many as one-quarter of the troops returning from the Middle East, or about 300,000 men and women.  The growing field of Equine Assisted Psychotherapy is showing great promise in treating veterans and their families who suffer from the nightmares, anxiety, depression, anger, irritability and other debilitating effects of this invisible, yet very real disability.

Preliminary Studies Validate EAP for PTSD
Equine Assisted Psychotherapy for PTSD has gathered the attention of the U.S. Department of Veterans Affairs, who has provided grants for practitioners to run equine assisted therapy groups with returning troops from Afghanistan and Iraq.   Preliminary results are favorable, suggesting statistically significant rates of change.

The Equine Assisted Growth and Learning Association (EAGALA) also evaluated treatment of members of the Georgia National Guard where deployments averaged two years or more.  The study revealed that 100 percent of soldiers who completed therapy had dramatically reduced stress levels.

Animal-assisted therapy has shown evidenced-based efficacy in patients including war veterans with PTSD, depression, anxiety, attention-deficit/hyperactivity disorder, conduct disorders, dissociative disorders, and other chronic mental illnesses.

Why Horses?
According to Dr. Laurie Sullivan-Sakeada, a Utah based Clinical Psychologist and leading practitioner of EAP, horses are prey animals, and, like those who have been to war, rely on their heightened senses for survival.  They react to and mirror the emotions of visitors directly, without words.  Horses respond negatively to negative emotions.  They respond positively to positive emotions, and they have no ulterior motives.

“They are just there,” says Sakeada, “providing non-verbal feedback.”  The horses are therapeutic and interactive tools that speed up the therapy process substantially.  Dr. Sakeada notes that one session of EAP in the barn is equal to five sessions “on the couch.”

 Equine Therapy for Emotional Healing
In Equine Assisted Psychotherapy, horses are used as tools for military veterans to gain self-understanding and emotional growth.  It recognizes the bond between animals and humans and the potential for emotional healing that can occur when a relationship is formed between the two species.  In most cases, the horses are not ridden, and usually are not tethered in the arena, but allowed to roam free.  Exercises can be as simple as giving the client a halter, and letting them figure out how to approach the horse and put it on.

Confidence:
The learning and mastery of a new (horsemanship) skill–enhances patients’ confidence in their ability to tackle new projects, such as recovery, and leads to improved self-esteem.

Self-Efficacy:
Learning to communicate and achieve harmony with a large animal promotes renewed feelings of efficacy. A motivated “I can do it!” replaces feelings of helplessness, de-motivation, by empowering the person to take on new challenges in other areas of recovery.

Self-Awareness:
Riding helps participants to develop a more realistic view of themselves through awareness of their size in relation to the horse. This is especially important in treating patients with eating disorders as well as those with interpersonal aggression problems.

Communication:
Horses’ sensitivity to non-verbal communication assists patients in developing greater awareness of their emotions, the non-verbal cues that they may be communicating, and the important role of non-verbal communication in relationships.

Trust:
Learning to trust an animal such as a horse also aides in the development, or restoration, of trust for those whose ability to trust has been violated by difficult life experiences such as physical or sexual abuse, abandonment, neglect, or marital infidelity.

Perspective:
Through grooming activities and other types of care for a specific horse, patients are able to put aside the absorbing focus of their mental illness, such as depressive ruminations, and instead to direct their attention and interests outwardly toward safe and caring interactions.

Anxiety Reduction:
Many studies of human-animal interaction indicate that contact with animals significantly reduces physiological anxiety levels. Some patients are initially afraid of horses. But horses’ genuineness and affection allay these fears, helping patients to embrace exposure therapy for their anxiety issues.

Decreasing Isolation:
For many individuals with mental illness, there is a long-term or recent history of feeling rejected by, and different from, other people. Mental illnesses are intrinsically isolating experiences. The horse’s unconditional acceptance invites patients back into the fellowship of life.

Self-Acceptance:
Many patients are initially concerned that they will do something embarrassing while learning about or riding the horses. Yet patients quickly learn that the other participants are engaged in their own equine experiences, and they observe the comfort of the horses in their own skin. Fears of embarrassment in public are thereby often reduced and self-acceptance increased.

Impulse Modulation:
Particularly for those whose mental illness involves the experience of lost control over impulses, the need to communicate with a horse calmly and non-reactively promotes the skills of emotional awareness, emotion regulation, self-control, and impulse modulation. Research clearly indicates that animal-assisted therapy reduces patient agitation and aggressiveness and increases cooperativeness and behavioral control.

Social Skills:
Many individuals with mental illness are socially isolated or withdrawn. A positive relationship with a horse is often a first, safe step toward practicing the social skills needed to initiate closer relationships with people.

Assertiveness:
Communicating effectively with a horse requires the rider to demonstrate assertiveness, direction, and initiative; important skills that enable the patient to express their needs and rights more effectively in other relationships.

Boundaries:
Many patients have experienced prior relationships as controlling or abusive. Healing takes place as patients discover that riding occurs within the context of a respectful relationship between a rider and a horse, and that, although physically powerful, each horse typically operates within the boundaries of this mutually respectful relationship.

Creative Freedom:
Many persons with mental illness have been emotionally inhibited or over-controlled, and have lost some measure of spontaneity. The playful aspects of riding and team equine activities can help restore spontaneity and ability for healthy recreation and play.

1,200 Pounds of Lie Detector
Jennie Hegeman, an equine rehabilitation specialist as well as a professional horse trainer is another proponent of EAP for PTSD.  She is creator of The Hegeman Method, a patented, cross-discipline equine bio-kinetic training and rehabilitation method based on the muscle structure and bio- mechanics of the horse.  She has worked with Dr. Sakeada in treating children with physical, emotional and mental disabilities at the National Ability Center in Park City, Utah.

Ms. Hegeman refers to horses as “1,200 pounds of lie detector.”   Her role is to interpret the horse’s body language, such as flicking ears, wide eyes, or a dropped shoulder that will provide feedback for the therapist and the veteran.

So Why Horses?
Horses also possess a variety of “herd dynamics” such as pushing, kicking, biting, squealing, grooming one another and grazing together.  In the process of describing the interactions between horses, clients can learn about themselves and their own family dynamics

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