Art Therapy Studio Chicago, Ltd.
Dogs as adjunctive healers: Benefits of including therapy dogs within clinical and studio art therapy
By Clare McCarthy ATR-BC, LCPC
Central to the trauma healing applications of dogs in the therapeutic context is their ability to create trust in environments and in relationships. When a person sustains interpersonal trauma, it often contributes to lasting feelings of diminished safety in relationships with others and an ongoing sense of hyper-arousal and hyper-vigilance. This makes seeking help and sustaining a helping relationship difficult due to the survivor feeling vulnerable and guarded against further trauma (Barber, Connolly, Crits-Cristoph, Gladis, & Siqueland, 2009). While therapeutic social support and guided trauma reprocessing is critical in psychological trauma recovery, lasting apprehension and heightened sensitivity to perceived interpersonal threats may lead to increases in treatment avoidance and social isolation, with the unintended consequence of isolating the survivor and exacerbating their PTSD symptoms and associated physiological stress (Chandler, 2017). While all clinical therapists may benefit from the inclusion of a therapy dog within their work, art therapists may find this to be a particularly natural fit with their practice due to their training in non-verbal anxiety reducing interventions, and their tendency to work with clients who may be struggling to overcome barriers to verbal communication due to traumatic experiences.
The presence of a non-threatening animal within the therapeutic setting makes use of the biophilia hypothesis, which holds that humans have an innate need for deep and intimate association with animals, and an inclination to affiliate with life to achieve meaning and fulfillment (Kellert & Wilson, 1993). The presence of a dog in the therapy space can help to instill a sense of calmness and reduce the client’s psychological and physiological stress (Shiloh, Sorek, & Terkel, 2003), counteracting the normal tendency to shut down or discontinue therapeutic work when triggered by external stimuli or internal experiences. Research evidence indicates that the amygdala (which plays a primary role in the processing of emotional reactions) prefers pictures of animals to landscapes or people, which may indicate that animals are wired to touch us in deep and basic ways, and can provide access to inner human emotional spaces, even those spaces that are profoundly defended (Mormann et. al, 2011). Likewise, the presence of a supportive animal has been demonstrated to reduce state anxiety as measured by decreases in cortisol levels, blood pressure, and heart rate (Yount, Olmert, & Lee, 2012), and increases in oxytocin (Nagasawa, Kikusui, Onaka, & Ohta, 2008; Odendaal, 2000), a biomarker linked with secure bonding and attachment (Buchheim et al., 2009), social affiliation (Carter, 1998), trust (Theodoridou, Rowe, Penton-Voak, & Rogers, 2009), sharing emotions (Lane et al., 2012), reduction of the fear response (Huber, Veinante, & Stoop, 2005), management of anxiety (Heinrichs, Baumgartner, Kirschbaum, & Ehlert, 2003), and relaxed immobility without fear (Carter, 2017).
In addition, observing an animal interact within the therapeutic setting can help the client to non-verbally assess the safety of the therapeutic environment and the therapist, and can encourage the development of a trusting therapeutic relationship. For example, if the animal appears to be feeling safe and comfortable, and demonstrates that they like and trust the therapist, it can indicate that the therapist is safe and reliable, and a person who can be trusted to keep others safe (Prothmann, Bienert, & Ettrich, 2006).
As the therapeutic relationship becomes established and the therapy progresses, the animal, the therapist, and the client form a living therapeutic triad that expands possibilities for interaction, projection, and expression within the space. Mirror neurons within the human brain respond to the movement and behavior of the animal, and assists the client in projecting their thoughts and emotions onto the animal (Keysers and Gazzola, 2014)—allowing the client to safely experience, express, and process aspects of their own memories and experiences that may have been masked or covered due to the traumatic effects of psychological splitting and dissociation from the real self (Parish-Plass & Pfeiffer, 2019). The warm and supportive energy of the animal can also create a further source of therapeutic unconditional positive regard that can alleviate feelings of overwhelming shame resulting from the unprocessed trauma, and boost client’s ability to see themselves as whole and worthy of love and affection in the present moment (Tedeschi, Jenkins, Parish-Plass, Olmert, & Yount, 2019).
When engaged in art making or discussion surrounding traumatic reprocessing, animals can further serve as a source of security in the here and now, and provide grounding and sensory self-soothing in the case that the trauma memory becomes disorienting or intrusive in the form of flashbacks or overwhelming negative emotions (Greenbaum, 2005; Zilcha-Mano, Mikulincer, & Shauer, 2012). During times of encountering negative emotions associated with traumatic memories, people seek social engagement to reduce anxiety. However, when the social world was or is perceived as the source of the threat, the neural system directs the body to mobilization (fight or flight) or dissociation to reduce anxiety (Porges, 2011). The inclusion of a trusted animal in the space therefore allows the client to engage socially, and receive oxytocin boosting interaction, without being reliant on human interaction. This animal assisted intervention can then serve as a bridge to reconnecting with the human social world in the form of the therapist, without reinforcing unhelpful coping or short circuiting reprocessing.
Animals in the presence of a supportive art therapist offer clients a deep and primal path back into the primary processes that may have become inaccessible due to overwhelming negative experiences and consequent negative coping patterns. The gifts dogs provide as adjunctive trauma therapists can only be fully accessed when the animal itself is psychologically thriving, and in a trusting and secure partnership with the handler which promotes the wellbeing, healthy boundaries, and mutual respect of all parties involved (Howie, 2015).
Barber, J., Connolly, M., Crits-Christoph, P., Gladis, L., & Siqueland, L. (2009). Alliance predicts patients’ outcome beyond in-treatment change in symptoms. Personality Disorders: Theory, Research, and Treatment, S(1), 80-89.
Buchheim, A., Heinrichs, M., George, C., Pokorny, D., Koops, E., Henningsen, P., et al. (2009) Oxytocin enhances the experience of attachment security. Psychoneuroendocrinology, 34, 1417-1422.
Carter, C. (1998). Neuroendocrine perspectives on social attachment and love. Psychoneuroendocrinology, 23, 779-818.
Carter, C.S. (2017). The role of oxytocin and vasopressin in attachment. Psychodynamic Psychiatry, 45, 499-518.
Chandler, C.K. (2017). Animal-assisted therapy in counseling, 3rd edition. New York, NY: Routledge
Greenbaum, S. (2005). Introduction to working with animal assisted crisis response animal handler teams. International Journal of Emergency Mental Health, 8(1), 49-63.
Heinrichs, M., Baumgartner, T., Kirschbaum, C., & Ehlert, U. (2003) Social support and oxytocin interact to suppress cortisol and subjective responses to psychosocial stress. Biological Psychiatry, 54(12), 1389-1398.
Howie, A.R. (2015). Teaming with your therapy dog: New directions in the human-animal bond. West Lafayette, IN: Purdue University Press
Huber, D., Veinante, P., & Stoop, R. (2005). Vasopressin and oxytocin excite distinct neuronal populations in the central amygdala. Science, 308(5719), 245-248.
Kellert, S.R., & Wilson, E.O. (Eds.). (1993). The biophilia hypothesis. Washington, DC: Island Press.
Keysers, C., & Gazzola, V. (2014). Hebbian learning and predictive mirror neurons for actions, sensations, and emotions. Philosophical Transactions of the Royal Society B: Biological Sciences, 369, 20130175.
Lane, A., Luminet, O., Rime, B., Gross, J., de Timary, P., & Mikolajczak, M. (2012). Oxytocin increases willingness to social share one’s emotions. International Journal of Psychology, 48, 676-681.
Mormann, F., Dubois, J., Kornblith, S., Milosavljevic, M., Cerf, M., Ison, M., et al. (2011). A category-specific response to animals in the right human amygdala. Nature Neuroscience, 14(10), 1247-1249.
Nagasawa, M., Kikusui, T., Onaka, T., & Ohta, M. (2008). Dog’s gaze at its owner increases owner’s urinary oxytocin during social interaction. Hormones and Behavior, 55, 434-441.
Odendaal, J. S. J. (2000). Animal-assisted therapy: Magic or medicine? Journal of Psychosomatic Research, 49, 275-280.
Parish-Plass, N., & Peiffer, J. (2019). Implication of animal-asisted psychotherapy for the treatment of developmental trauma through the lens of interpersonal neurobiology. In P. Tedeschi, & M. A. Jenkins (Eds.), Transforming trauma: Resilience and healing through our connections with animals. West Lafayette, IN: Purdue University Press.
Porges, S. (2011). The poloyvagal theory: Neurophysiological foundations of emotions, attachment, communication and self-regulation. New York: WW Norton and Co.
Prothmann, A., Bienert, M., & Ettrich, C. (2006). Dogs in child psychotherapy: Effects on state of mind. Anthrozoos, 19(3), 265-277.
Shiloh, S. Sorek, G., & Terkel, J. (2003). Reduction of state-anxiety by petting animals in a controlled laboratory experiment. Anxiety, Stress and Coping, 16, 387-395.
Tedeschi, Jenkins, Parish-Plass, Olmert, and Yount (2019). Treating human trauma with the help of animals: Trauma-informed intervention for child maltreatment and adult posttraumatic stress. In A. H. Fine (Ed.) Handbook on animal-assisted therapy: Foundations and guidelines for animal-assisted interventions, 5th edition (pp.363-378). San Diego, CA: Elsevier
Theodoridou, A., Rowe, A. C., Penton-Voak, I. S., & Rogers, P. J. (2009). Oxytocin and social perception: Oxytocin increases perceived facial trustworthiness and attractiveness. Hormones and Behavior, 56, 128-132.
Yont, R. A., Olmert, M. D., & Lee, M. R. (2012). Service dog training program for treatment of posttraumatic stress in service members. U.S. Army Medical Department Journal, 63-69.
Zilcha-Mano, S., Mikulincer, M., & Shaver, P. R. (2012) Pets as safe haves and secure bases: The moderating role of pet attachment orientations. Journal of Research in Persoanlity, 46, 571-580.
By Dr. Mary Andrus DAT, ATR-BC, LCPC, LPC
I had the pleasure of talking at length with Jimmy Morris of PsychSessions.com about the complexity of art therapy the profession, specifics of what art therapists do, who they treat, their training and education and how they become licensed. If you are curious about trying out art therapy or considering entering the profession of art therapy this might be a great place to start to learn a bit more about it!
You can download the session from itunes here. Enjoy!
Author: Tricia Morales ATR, LCPC
Many who struggle with an eating disorder, depression or anxiety are distracted by an inner dialogue. We all have an inner critic who sometimes helps us make better choices or to guide us and protect us, although for some the inner critic can be strong and get in the way of daily functioning. Some people daily deal with a critic that is harsh, cruel, self-defeating, blaming, and persistently negative. It is possible to build patience, and over time practice to begin learning new ways to build a different relationship with yourself. Doing so involves learning to acknowledge a thought for a thought, may not always based on reality, and to accept our natural human tendency of thinking towards a negative evaluation. True change comes by way in which you experience your life comes from shifting your perspective of seeing little things you go through day to day from a different lens.
Working with individuals with eating disorders I have come to know the commonality of the inner critic who takes over, leaving little room left for self-compassion. Acknowledging the areas of life that bring you meaning can help you start to know where to find self-compassion in taking the first steps towards connecting with these areas of joy. If you feel unworthy of self-compassion it is time to explore your experience of worthiness historically and start writing a new dialogue for yourself. Here are some things to guide you in your steps toward change:
1. Write a letter to yourself from an imaginary compassionate and validating friend about a specific area you critique yourself. To find more prompts read Kristen Neff’s Self-Compassion: The Proven Power of Being Kind to Yourself, 2015.
2. When your inner critic flares up practice turning the mind towards a more rational stance on the topic.
3. Set an intention to explore self-compassion through art making and allow yourself to approach the art materials with curiosity and openness to spending time on yourself.
4. Practice being kind to those areas of your body you notice yourself continuously judging by getting a massage, putting on lavender lotion, taking a bath, or taking a mindful walk and care for your body in all it does for you.
5. Intentionally share the peaks of your day with those around you when you notice your desire to vent or complain about what is not going well.
6. Find a non-judgmental listener to share your current challenges.
7. Remind yourself our minds are wired towards negative perception of events and challenge yourself to find an alternative more neutral perspective.
8. Sit on a park bench or eat lunch in the sun during your lunch break and enjoy your part of the day.
9. Identify personal goals for meaningful projects and take time once or twice a week to check off objectives towards those goals.
10. Affirm yourself for the work you do in all areas of your life especially on those days when you feel like you are treading water.
Join me, Tricia Morales, LCPC, ATR at Art Therapy Studio Chicago (art-therapist.org) to create art as part of your practice of self-compassion. Try taking one hour a week to begin caring for yourself in a new way and see the difference it makes in the way you feel overall.
Open Studio for Brushes with Cancer Participants
Recently Mary Andrus, founder of ATSC was interviewed for a podcast on creativity with Beth Ann Short in Portland Oregon. We talked about so many topics, from relocating to Portland, Oregon from Chicago...to social action art therapy, state licensure, politics, encaustic painting, working in the field of art therapy and so much more!
Dr. Mary Andrus DAT, ATR-BC, LCPC
Jackie Carmody ATR, LCPC
Clare McCarthy ATR, LCPC
Brittlyn Riley Meade ATR, LCPC