Saying 'neigh' to traditional therapy

Moving beyond the "tell me about your mother" approach, some psychotherapists are using horses to facilitate the therapeutic process...

It is an innovative mental health approach that is gaining traction across North America.

Jay decided regular psychotherapy wasn’t working when eight years of sitting on a therapist’s couch left him with only one insight: He was tired of sitting on a therapist’s couch.

Jay, a resident of Nanaimo, British Columbia, who asked that his full name not be used, is a survivor of childhood sexual abuse who sought help in 1996 after realizing that he had “buried all this stuff that happened to me.” But after years of traditional psychotherapy, he felt he had made little progress in overcoming his severe post-traumatic stress disorder.

“I was desperate,” said Jay, 54. So he decided to give horses a try.

Working with Deborah Marshall, a trauma specialist and proprietor of Generation Farms in Nanaimo, Jay began equine-facilitated psychotherapy (EFP) three years ago. By interacting with the horse to calm himself down or calling the horse close to work on asserting control over boundaries, he finally started seeing results.

An innovative technique that considers horses “co-therapists,” EFP helps patients work on issues like self-esteem and anger by doing more than just talking about them. By completing tasks with a horse and getting feedback from both the horse and the trained therapist, patients learn to assert themselves and be honest with their feelings, often without ever mounting a saddle.

EFP is one of numerous therapies that use animals to facilitate the therapeutic process. Leading a horse without a rope, teaching it to approach without using words or just watching herd dynamics have proved successful in combating depression, eating disorders and substance abuse, EFP therapists say. The method is gaining traction. Membership in the Equine Facilitated Mental Health Association grew 78 percent last year and now includes 730 North American farms and clinicians.

Patients can often bluff their way through regular therapy sessions, talking about daily events to avoid serious discussion until months into treatment. Horses--even untrained ones--are so intuitive, EFP specialists say, that they encourage patients to come clean about their feelings almost immediately.

“That ‘let’s pretend I’m not afraid’ approach really doesn’t work,” Marshall said. Comparing a horse to a biofeedback machine, she said it was possible to see how the horse acknowledges when the patient starts being honest.

The horse will encourage the patient to speak and act sincerely by obeying selective commands, Marshall said. When a patient says one thing but his body implies another--such as when a person gives a strong verbal order while his body is cowering--the horse will ignore the directions.

Robin, who did not want her real name used for fear of being recognized in her small town on British Columbia’s Guelph Islands, found that out when she began working with Marshall in 2004.

“What I’ve really learned to do is go inside myself and be clear with my intentions," said Robin, 56, who sought therapy after her partner had an affair. "I have to be totally honest and present. You communicate on an intuitive level. I have to be very clear about where I am and where my emotions are.” As a result, “I think I speak more honestly with my partner now.”

Patients overcoming eating disorders also perform activities that look deceptively simple. At Horse Sense of the Carolinas, in Marshall, N.C., tasks include getting the horse to stand still while you circle it or encouraging the horse to go over an obstacle without a lead rope.

“Even if through the horse activity they’re not directly dealing with eating, you get right down to the source by dealing with control and safety and self-esteem,” said Liza Sabir, a clinical intern at Horse Sense. She said patients gained confidence through the activities because they were not only talking about accomplishing something relevant to their recovery, but they were also actually doing it.

And in Omaha, Neb., a six-week program at Take Flight Farms, which works with a residential treatment center for teenagers with substance abuse problems, culminates in an obstacle course for horses that represents the hurdles patients are overcoming.

The course, called “Temptation Alley,” is strewn with grain buckets, which represent methadone; haystacks, which signify peer pressure; and other obstacles that represent impediments to sobriety. By verbalizing what the horse, led by a pair of patients, is avoiding, the teenagers recognize their coming battles and recognize the support network they have within the group.

But not all farms use the same activities. Because equine mental health activities are relatively new--the equine mental health association just celebrated its 10th anniversary and the other professional organization, the Equine Assisted Growing and Learning Association, is even newer--there is no oversight board for practitioners.

As a result, some farms offer only equine-facilitated learning, which does not involve therapy and is used for leadership workshops or for treating childhood social problems like Asperger’s syndrome or behavioral disorders.

While equine-facilitated learning is useful for certain emotional issues, it is not intended to treat people with severe psychological problems, practitioners say.

“If you bring up a lot of stuff and haven’t got the psychological, mental health background, are you helping out or are you just stirring things up?” asked Krista Meinersmann, a professor at Georgia State University who recently studied the successful use of the therapy with women who had been sexually abused.

The Equine Assisted Growing and Learning Association offers three certification levels. The association, along with the mental health association, is working to create certification standards, said Sheila Dietrich, chief executive of EFMHA and its parent group, the North American Riding for the Handicapped Association.

In the meantime, Dietrich suggests that people considering equine therapy make sure both the practitioners and entire facility are credentialed. Also, check how long the farm has been open, she said.

“There are a lot of overnight shops that start up,” she warned. “You want to be in a place that’s stable, since you’re probably pretty vulnerable.”

When a patient does find a facility that feels right, and there are hundreds with certified therapists across North America, it can be a life-altering experience.

“Equine therapy is the first thing that ever made any kind of indentation on that severe post-traumatic stress disorder,” Jay said of his treatment. “This was a lifesaver for me.”