The Department of Veterans Affairs (VA) is conducting a $12 million study to determine whether service dogs can be an effective treatment for PTSD. The VA currently does not fund or support the use of service dogs for veterans with PTSD, claiming no evidence exists whether service dogs “help PTSD sufferers get better or just feel better.” I have to say, as a person with PTSD, either of those options sounds good to me. I don’t really care if I “get better” or just “feel better,” especially considering many of the standard treatment options for PTSD at the VA do neither, and in fact, can make things worse.
Did the VA forget the 10 empirical studies done in the last 10 years on the usefulness of service dogs in child abuse survivors and military veterans? The most prevalent outcomes were reduced depression, PTSD, and anxiety when the patient was involved in training the dog themselves, connected with the dog by telling it about their trauma, used their interaction with the dog as a metaphor for interacting with their usual social partners, and brought the dog to therapy sessions. That worked. But the VA study is doing something very different:
“Dogs in the study are being trained to sweep a room for threats before the veteran enters. They’re also required to block—keeping people away from the vet.”
That is not a service dog. That is a guard dog. One of the most devastating symptoms of PTSD is emotional numbness and feeling disconnected from other people—something that a service dog can help remedy, but not if they’re trained to keep everyone away.
“Training a dog to watch your back, and sweep, and block, is supporting those symptoms and those thoughts,” warns animal-assisted therapist Rick Yount.
In a congressional hearing last week, “The VA contends that there is insufficient evidence that service dogs help those with PTS[D].” To give the VA the benefit of the doubt, they are extending their study to go through 2019 based on “ample scientific findings and ongoing research suggest that the VA is wrong.” But whatever the outcome of this flawed study, nothing should discourage the use of animal-assisted therapy, as animals can and are helping people right now cope with PTSD, depression, anxiety, OCD, Alzehiemer’s disease, and schizophrenia—and those benefits don’t even necessarily have to come from trained service dogs.
So what’s the difference between a service dog, a therapy dog, and a pet dog? First of all, dogs aren’t the only animals used in animal-assisted therapy, which is the term for any type of therapy that involves the use of an animal—horses, birds, elephants, rabbits, fish, and all sorts of other animals have been successfully used in therapeutic interventions for physical and psychiatric impairments. But we know a lot more about training dogs, and they have some unique abilities that make them ideal therapy animals.
The Americans with Disabilities Act defines service dogs as any guide dog, signal dog, or other animal trained to provide assistance to an individual with a disability. These service animals can be trained to pull wheelchairs, sense changes in blood sugar for people with diabetes, sense the onset of seizure activity in people with epilepsy, bring their owner medication at certain times of the day, provide balance on stairs, and aid people with visual impairments. Obtaining and training service dogs can be quite expensive, as they are specifically trained to accommodate a person’s unique disability needs, but the benefits can be life-saving. Psychiatric service dogs and emotional support animals, trained to help people with life-limiting psychiatric disabilities, fall under the service dog category and must be prescribed by a licensed mental health professional. The good news is that for many psychiatric disorders, a therapy dog is sufficient to provide assistance.
Unlike service dogs, therapy dogs can be considered pets and a person doesn’t have to obtain a specially trained animal. In fact, training the animal yourself has been shown to be part of the bonding in the healing partnership that can develop with a therapy animal. A therapy animal, commonly a dog, is obedience trained and screened to interact favorably with people. Therapy dogs can provide support to their owners, but they can also be brought to hospitals, nursing homes, schools, and disaster relief areas to support people in individual visits. Therapy dog visits to hospitals and other patient care centers have been shown to improve mood and pain in patients with fibromyalgia, promote a more rapid recovery in children after surgery, reduce depression and anxiety in hospitalized mental health patients, reduce anxiety in women with high-risk pregnancies, and improve memory and socialization in Alzheimer’s patients.
Having a dog has been shown to facilitate positive human-human interaction in both people with psychiatric disorders and healthy individuals. Children with autism, who can have difficulties interacting with people, interact more with other people and have greater use of language skills in the presence of a dog. This effect, called the “social catalyst” effect, has been shown in children, adults, and the elderly with other psychiatric diagnoses as well. The presence of a friendly animal has also been shown to increase trust toward other people and decrease aggression. Animal assisted therapy consistently reduces depression and anxiety. Direct evidence shows that interacting with a companion animal positively affects hormonal stress responses including those involving cortisol and adrenaline—the presence of a dog can lower blood pressure and promote a healthier heart rate. These changes are even greater in the presence of a dog than they are in the presence of a friend or spouse!
My area of expertise is in the effects of trauma on the brain—particularly post-traumatic stress disorder—so this is where most of my knowledge about animal-assisted therapy lies. Despite what the VA says, animal assisted-therapy has been shown to reduce PTSD symptoms. One of the big problems with PTSD is reconciling the past with the present and knowing that the past trauma is no longer happening. Having an animal present can act as a reminder that danger is no longer present (by bringing one out of intrusive memories) and can act as focal point for mindfulness experiences in the present. Emotional numbing is one of the key symptoms of PTSD and animals have been shown to increase emotional capacity in humans. Another key aspect of PTSD is hyperarousal, which is promoted by increases in cortisol and adrenaline, both of which animal interactions can decrease. When living with service dogs, veterans with PTSD reported having better sleep and fewer nightmares. Children who have been sexually abused show decreases in anxiety, depression, anger, PTSD, and dissociation when participating in animal-assisted therapy. I have experienced all of these things with my PTSD after getting my own dog.
After getting my dog, Lady, I was able to go for walks/runs outside without feeling scared for the first time in 10 years! I felt safer in my home and slept better. I found that caring for Lady made me more willing to care for myself. The sense of purpose and responsibility in caring for Lady has helped me stay sober (3 years and counting) after a decade of alcohol dependency and has helped me process through fears of abandonment. If I’m anxious or scared, she comes to my side and I feel an immediate surge of relief that everything will be okay.
How do dogs do all this? One early hypothesis suggests that humans used to be partially dependent on signals from animals for signs of threats, so being with an animal that is in a peaceful state may make us feel more safe. Several recent studies have documented increases in oxytocin in people after petting a friendly dog or gazing into its eyes—oxytocin is a chemical produced in the brain that is released directly into the bloodstream to decrease stress hormones and aggression and promote social interaction, empathy, and trust (lots of oxytocin is released during romantic attraction or “pair bonding”). This oxytocin release is greater when the interaction is with one’s own dog compared to an unfamiliar dog, so the quality of the human-animal relationship is important.
I’m not suggesting that a service dog or therapy dog can cure PTSD or any other mental illness, but I think they can help create the environment of stability and safety that is required for other therapeutic interventions to work in healing or coping. Plus, animals don’t judge you for what you’re wearing, they don’t abandon you or say mean things, and they don’t kick you out of a restroom because you don’t look like a “real woman” (although they may sit next to you while you pee). Animals can show you what unconditional love looks like, and that is something everybody deserves.
Apryl Pooley is a scientist by training, a writer by practice, and an artist by nature who strives to make sense of the world around her and help others do the same. She is a neuroscientist at Michigan State University where she researches the effects of traumatic stress on the brain and is author of Fortitude: A PTSD Memoir. Apryl lives in Michigan with her beautiful wife and two rambunctious dogs, Lady and Bean. Read more about her at http://www.aprylpooley.com. You can also find Apryl on Twitter, Facebook, and LinkedIn.