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).
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Dr. Mary Andrus DAT, ATR-BC, LCPC