PTSD and Equine Therapy

The Problem

There currently lies a far-reaching epidemic in our nation’s armed forces.  The return of the soldier is a time of celebration marking the end or a respite from the waging of war.  However, more and more soldiers, sailors, airmen, and Marines are returning to short lived celebrations followed by years of depression, rage, and debilitating psychological issues.  The repercussions of their experiences in the theater of war are staggering—divorce, depression, abuse, fear, and anxiety are occurring in some of the highest rates ever seen.  Even more tragically, far too many of our servicemen and women have returned home to such confusion, depression, and hopelessness that they have taken their own lives.

The Complexity of PTSD

The effects of Post-Traumatic Stress Disorder are deeply-seeded and extremely complex.  They can affect nearly every facet of the mind including emotional, cognitive, and physical responses—nightmares, increased startle reflexes, depression, extreme irritability, and even times of rage.  Although these issues affect separate parts of the brain, they cannot be treated separately.  When the brain is exposed to consistent trauma (as in war and combat), the brain is literally rewired in such a way that it locked into the thoughts, fears, guilt, and emotions of those traumatic experiences long after the fighting is done.

The same hyper-vigilant mental state that raises a soldier’s awareness and abilities during combat is the same mental state that can destroy him after returning home.  These intertwining paths of traumatic experiences and emotional injuries add a level of complexity to the therapeutic process that is not present in many other psychological issues.  When faced with the combination of cognitive, physical, and emotional symptoms (as with PTSD), the opportunity for recovery is at its highest when all three of these modalities can be experienced together during the therapeutic process.  This is why the action-based and experiential approach of equine assisted therapy is proving so effective at treating post-traumatic stress disorders.

A Stronger Approach

While the military has made large strides in the assessment and diagnosis of PTSD, the tools and approaches used to actually treat these behavioral health problems have failed to achieve the desired results.  In fact, 4 out of 5 suicides have occurred while the servicemember was in the U.S. and over 40% had actually received recent mental health treatment.  In 2012, the U.S. Army reported that for the first time in history our country lost more soldiers to suicide than to combat.

What does this say about our ability to address this epidemic?  It says that many are preventable.  It says that most are occurring in an atmosphere where help could easily be available.  Sadly, it also says that our current strategy is not becoming a story of success.

Equine assisted psychotherapy offers a more comprehensive experience for those receiving counseling for PTSD.  Since EAP is a proven experiential/action-based form of therapy, it allows for the immediate integration of concepts in real-time.  While there is time for participants to reflect on what they’re experiencing, EAP is not “talk therapy.”  The concept of experiential therapy is absolutely vital when approaching a sufferer of PTSD.  Much of a traumatic experience simply cannot be verbalized or explained with words—equine assisted therapy allows for the focus to be in-the-moment and led by the patient’s agenda.  While working through different exercises and interacting with the horse, participants gain real-time feedback about what does and does not work.  It can be overwhelming to bring new strategies into your relationship with yourself and others.  Equine therapy gives you the opportunity to try new communication methods with a partner without an agenda.

The Horse: A Partner without an Agenda

Horses are well-suited for the therapy environment because of their natural instincts and communication methods.  While humans can speak, explain, and rationalize thoughts, horses live in an entirely action-based social structure.  This works well in therapy because in action-based exercises you must change your actions to change your results—horses don’t question your motives, they react to the actions you take.

Their hyper-vigilance and heavy reliance on body language is also a large part of the counseling process.  Horses are significantly more aware of body language than humans and more readily recognize and react to levels of anger, anxiety, fear, or sadness that are imperceptible to humans.  This provides real-time feedback for the participant and the therapist.

There is no magic or mystery as to the use of horses in therapy.  They’re therapy partners that simply have the natural perception, response, and inclination to allow participants to try new communication strategies.

How it Works

Sessions are tailored specifically for the person’s needs—we work within their agenda.  The client is given exercises & tasks to make the horse perform.  It may be as simple as having the horse walk over a pole or as challenging as having it follow you through an obstacle course.  The techniques that clients try with these challenges are varied and telling.  The client typically has to try several different approaches (some of them very different from how they usually communicate) before finding one that the horse understands and is comfortable with.  People tend to communicate with the horses in the same manner that they communicate within their relationships. If you can’t get the horse to do something, you have the chance to experiment with your approach to get the desired result.  Observing the client during these challenges and asking open-ended questions such as “do you think the horse understood what you were doing” or “what can you tell me about what just happened” guides the client towards their goals but allows them to do it in their words with their strategies.

One Soldier’s Story: Dan’s Realization

During one exercise, Dan’s task was to have the horse follow him.  After several minutes, it was obvious that Dan was becoming uncomfortable with requesting this of the horse.  Instead he allowed the horse to stand in place and eat grass.  When Dan was asked by the therapist “I noticed you stopped trying to get the horse to follow you, tell me about that,” he responded “if I ask the horse to do something it doesn’t want to do, it won’t like me anymore.”  This exchange occurred within 15 minutes of the very first session.  He went on to say “I just do what everyone else wants me to.” By the end of the first session, Dan was putting into words that he realized that this habit was preventing him from getting closer to people.  Real examples, like Dan, show how quickly and decisively you can identify major issues in someone’s life using real-time feedback and interaction with horses.

Other Benefits

Equine assisted therapy does not require the long process of establishing the connection between therapist and patient or achieving a certain trust level (as traditional “talk therapy” requires) because the real interaction takes place between the client and the horse.  In additional contrast, people do not fear being judged or exposed by the horse, accelerating the time it takes to make progress.

Since EAP is done in an open and non-traditional environment, patients tend to be much more relaxed and less anxious than in a traditional talk-therapy session.  Furthermore, the action and task-based approach removes much of the stigma that many soldiers have about therapy.

Most importantly, people enjoy coming to their sessions—they look forward to it.  Retention rates are much higher than with traditional therapies and the average number of needed sessions is lower.

Changing Lives

PTSD is a very complex affliction that brings together symptoms from many modalities of the mind.  They’re all connected so it’s necessary to treat them all together—cognitive, emotional, and physical/experiential.  Traumatic experiences inundate you through all three of these modalities and by using experiential therapy such as EAP, all three are used in the recovery process.  Many times, traditional talk-therapy struggles to effectively instill the required behavioral changes necessary for a sustainable recovery from PTSD.  Furthermore, talk-therapy can’t offer real-time feedback and the opportunity to quickly try multiple strategies for communicating such as EAP offers.

The horse acts only as a partner and many times as a mirror for how the patient is seeing the world and how the patient is responding to that world.  EAP has been proven across the world as being highly effective in treating patients with PTSD and has a solid track record of enabling dramatic results in fewer sessions.