Dogs as Healers, Dogs as Co-Therapists for PTSD
I have worked with canine healers in my clinical practice for nearly 30 years. One of the ways I introduce touch and affection into the therapeutic setting, whether I am working in my capacity as a psychotherapist or as a body psychotherapy practitioner, is to integrate an animal co-practitioner. My animal companion, a Golden Retriever named Bodhi Sattva, accompanied me to work for 11 years. Bodhi (pronounced with a long “o”) is a Sanskrit word that means compassion and love. The Bo tree was a wild fig tree that the Buddha was sitting under when he attained enlightenment. The Bodhi Sattva is the Buddhist appellation given to any being who though s/he attains enlightenment, stays behind to help those in the earthly realm achieve it. A rather lofty assignment for a dog, yet one which others throughout history and across cultures have considered suitable for a dog.
Many of my clients have experienced little appropriate touch or attachment to others in their lives. Bodhi’s contribution to their lives has proved integral and immeasurable. They regard him as an essential assistant, worthy of massages, confidences, tears, and bones. With the exception of a few clients who were oblivious to his presence, most actively engage in a relationship with him and to differing degrees become attached, receiving and giving love through him.
Much of what is known about human development has come from the study of dogs. There are two periods in their growth as puppies during which they are especially vulnerable to traumatic experiences: during the 12th and 16th weeks. In spite of my careful watch, several potentially traumatic events happened to Bodhi during these two periods of growth, a tumble down a flight of stairs and a ferocious dog-bully, neither of which seemed to leave a lasting impression, whether due to his innate hardiness or to my care and massages. In fact, his great charm for my clients is his trusting, goofy nature.
Socializing a Dog Healer
As Bodhi grew, I socialized him extensively in order to prepare him for a “public” life. In addition to private practice, he joined me in meetings with the police and district attorneys during testimony by crime victims. Early in his life, I gave him daily massages, rubbed his gums and belly to promote bonding and to help him grow into a relaxed dog who was comfortable with being touched, not fearful of anyone. I also included methods of exposure to abrupt experiences, including grabbing him from behind, as an unknowing toddler might, exposing him to sudden, loud sounds, being bumped by a wheelchair, and keeping a hand in the food bowl while he munched, so he wouldn’t become aggressive around his food. As an adolescent, he trained and passed tests including registration as a Canine Good Citizen and as a Therapy Dog International.
There is much that has been said about the loyalty, affection, intelligence, optimism, and unconditional love shown by dogs, especially Golden Retrievers. He nurtures the oft-submerged, latent, or distressed capacities for attachment common to victims of chronic childhood violence. This is how Bodhi became a healer. However, I also discovered that the interpersonal affinities between human and dog took on an important rhythm. Bodhi had his own bed on which he invariably stayed when not actively engaged with a client; yet whenever a client would climb on the treatment table, he would move to lie underneath it. I soon noticed that the rhythm of clients’ respiration often became entrained to his (or his to theirs), leading to a relaxation in both their rates and depth of respiration. This was first apparent to me when during the course of the hour, several sighs would occur with both dog and client simultaneously.
Dogs generally breathe ten to thirty times a minute, while humans breathe normally breath 12-16 times, depending on gender, age, and health. People with chronic anxiety state often have a pattern of sighing up to once a minute, holding the breath for eight to fifteen seconds at a time and breathing eighteen times a minute.
Sometimes a client would notice the respiratory entrainment and remark on it. Intimate interaction, such as talking and touching with companion animals reduces levels of arousal, such as blood pressure, relaxed facial characteristics and speech patterns are characteristic of the dialogue between parents and young infants. There is a reciprocal role of facial expression on emotional experience, for example d various patterns of contraction and relaxation of muscles that are linked to specific emotional experiences. The physical act of smiling can activate positive feelings. For survivors who are often in great pain and find no reason to smile, the smile or laughter elicited by an animal can begin to reactivate the pattern of neuromuscular capacity for pleasure.
Case: Susan’s experience
As a result of severe abuse by several family members during childhood Susan, aged 30, had made several suicide attempts by wrist cutting and had been in and out of hospitals. She came for treatment while she was still in the hospital. She reported, “I have no touch in life, not even hugs. I’m afraid of it.” After discussing the parameters of the touch I proposed, I asked if she would like to first pat my therapy dog, Bodhi. I then demonstrated on his paws him how I would touch her hands. After she touched Bodhi, we discussed her preference for seating position and I began by holding one hand in both of mine, contacting He Gu, an acupuncture point in the web of the thumb. Susan’s first responses included an almost overwhelming mixture of pleasure and disgust and we titrated the amount of time we worked according to her tolerance. After the second session, I suggested she might want to massage her hands and I showed her how by demonstrating on myself, suggesting she purchase some skin oil. She came in the following week excited about having massaged her hands and was now doing it for a few minutes every night before bed. Her suicidal ideation diminished and she was released from the hospital. In the early sessions, we did touch therapy for five minutes. Other days Susan preferred only to talk about how she felt and to discuss plans for the next session. Each time Susan came in, we began our ritual with touching Bodhi. This provided a reliable structure and the chance for Susan to take new approaches with her own “technique” of touch. She was experiencing her own sensations but also becoming cognizant of the effect of her touch on the dog. Bodhi’s joy and receptivity, apparent when he rolled over and dog-cooed, reinforced her own deepening sense of connection and capacity to soothe. This work also opened the opportunity for Susan to reminisce fondly about her family dog. Until this time, she had been unable to recall any fond memories of her early life.
One week Susan came in and said that she had allowed a friend to give her a hug, although she struggled with allowing herself that pleasure. The next week she came in exclaiming, “I can feel my hands, I can feel my hands, now I want to feel my arms!”
Our work progressed steadily. Her tolerance for pleasure increased. Hugs with friends became routine and she exchanged shoulder massages with friends. Six months later, she was no longer harming herself and there were no further hospitalizations.
During one of Susan’s final visits, she asked if she could lie down on her stomach, on the treatment table and asked me to work on her upper back. As she did, she began to get scared and dissociate and we “talked her back into her body.” She called Bodhi close to her, and he sat near her head. At the close of the session, she said, “I could come back in my body because Bodhi is here and I trust him.” Several weeks later Susan decided to terminate, saying that she had accomplished what she had set out to do. Two years later, her psychologist reported that she remained free of self-harming behaviors and was working part-time.
What Dogs Might Mean to Clients
Bodhi meant many things to my clients. My relationship with him presented a model for caring interaction that was external to the client-practitioner relationship. As “my child,” or a dependent, he may serve as an object of identification for my client. How I talk to him and treat him gives important clues to traumatized clients who live with the dread that I will eventually betray them. When clients want to bring him a biscuit, they can give freely. When they want to question me about my approaches to dog-rearing, we can discuss some themes that are a subtext for a future exchange about how I feel about them and they me. We often talk about Bodhi’s vulnerability and dependence, for he reflects the open, generous and eager state of the (inner) child my client and I try to reach and reassure, whose memories are often subsumed with pain and fear.
Case: Lucy’s experience
Lucy was a survivor of childhood rape, who was crying deeply and shaking over the losses she had endured. Bodhi got up out of a sound sleep and grabbed her coat off the couch between his teeth and brought her coat, to her. She was stunned by the care. She talked about this for months afterward for it signified to her the level to which Bodhi (and I, in ways I could not otherwise sufficiently convey) was attuned to her pain and suffering.
When a particular memory or story engenders too much shame to share with me, with gentle encouragement my client can tell him first, and make it safe to tell me. Conversely, I can catch the wrath of the abandoned. For, if Bodhi has rolled in something (that is perfume only to him) during his morning run and he has to stay at home until he has a bath, I’ll be advised by everyone that day that both practitioners better be there next time. However, this unexpected and temporary loss often proves fruitful as well, for old memories, of loss and death, of childhood animals and people, create an opportunity to explore grief and loss and trust, often for the first time.
The History of Healer Dogs
There is a long cross-cultural history of the use of dogs as agents of healing. Contemporary renewal of interest in clinical application and research started after World War II. For the Sumerian goddess, Gula, the “Great Physician,” and of the Babylonian and Chaldean god of healing, Marduk, the dog was the sacred emblem of healing. In ancient Greece, dogs were considered “emissaries of the gods” and along with the sacred snakes of the temples, licked the people while they slept as part of the healing ritual. Hermes’ son Pan was a woodland deity associated with animals. Aesculapius, the Greek god of healing, was guarded by a dog as a child and is often shown pictured with a dog by his side. In Greek cosmology, the serpents ruled in the valley and the dog ruled in the mountains, they were considered two sides of the same essence. The dog also represents transition in many cultures; Quetzelcoatl, the Nahua deity, was accompanied by a dog (who was his twin) on descent to the underworld and the dog also travels with Hekate, midwife and goddess of the gates in the underworld. Thus, the dog passes between light and dark, death and life, representing guide of the underworld. In the late 18th century in England, animals were used at a country retreat for the mentally ill and the first recorded use of animals for therapy in the U.S. was during World War II with veterans recovering from traumatic stress. In the 1950s, Levinson introduced his dog into the treatment of children and elders. During the 1970s, the first research was published on pet-facilitated therapy in which dogs worked in psychiatricwards with nonverbal patients.
In their role as modern day healers, dogs continue to serve: to lick the wounds and to guide the traumatized individual back from the underworld of despair and detachment. Animal assisted therapy works with almost every type of animal. Dogs, cats, horses, rabbits, birds, fish, and even dolphins are increasingly integrated into treatment of PTSDin private and public settings.
This blog post is adapted from my book Rhythms of Recovery: Trauma Nature and the Body. Routledge, NY., 2013
Rhythms of Recovery: Trauma, Nature and the Body. (2013) Routledge, NY