What is horse assisted psychotherapy?

Horse assisted psychotherapy (or Equine Assisted Psychotherapy; EAP) is a kind of psychotherapeutic tool which asks/'uses' the help of a therapeutic horse to cure mental illnesses and pathologies in the psyche of the human beings. 

Equine assisted psychotherapy differs from 'normal', traditional, psychotherapy in many ways. Firstly, it takes place in the wild nature and is not locked  among the four walls. Therefore the therapeutic frames are more different. In horse assisted psychotherapy a therapist and a horse have to create continuously the frames, because there are no walls and a door to keep a patient in the therapeutic setting. In traditional psychotherapy usually there is a therapist-patient diad. In EAP we use the dynamics which is created by the horse-patient-therapist triad. Usually this therapy has the same dynamics as the traditional one has, but it gets more information by the help of this 'oedipal' triad-dynamic. 

EAP differs from a horse riding session. The aim of the latter is to teach a rider to ride a horse better and better. In order to achieve this aim, a riding instructor  uses pedagogic tools which speed up the process and help a rider to reach performance better. Thus she/he gives instructions and makes a rider to repeat tasks. Differently, the aim in EAP is to help a patient to reach a better functioning-level: to feel himself/herself better. Therefore, using this analytical therapeutic method we let the patient choose what she/he wants, and she/he can do, try and repeat whatever is allowed with horses in a safe therapeutic setting.

Whom we suggest taking this therapeutic form?

In the equine assisted child psychotherapy we invoke the infants' elemental love of nature and the relationship with both the therapist and the therapeutic horse to strengthen the effect of treatment. This psychotherapeutic method can cure effectively symptoms of mental illnesses in childhood. A mental illness can be regarded as a problem in the child's normal development or a disturbance in his/her everyday functioning. So, usually these are connected to the requirements of his/her age. 

  • under age 3 usually we treat disturbances in eating, sleeping or communication (speech, language)
  • From the age 3 to age 6 the child usually goes to kindergarten where he/she has to cope with an unknown social world  in separation of his/her parents. In this age we often encounter such symptoms as dysfunction in aggression-controlling, communication problems (stuttering, mutism), problems with keeping attention (in background of psychological agitation), and secretion (enuresis, defecation).
  • From the age 7 the child has to go to school where he must perform, behave and adapt well to a formal institution. In this age we usually see dysfunctions in efficiency, in fitting to institutional standards which are expressed in such symptoms as stomach-ache, headache, anxiety connected to performance, and conformity-problems. 

The equine assisted therapy - similarly to movement therapies - has a stimulating effect on the nervous system. Because of this and enforced by the relationship with the therapist and the horse it can be efficient in treating many symptoms related to the dysfunction of the nervous system (e.g. controlling aggression, hyperactivity, attention deficit disorder, autistic disorder, and so on). 

Working with adults in equine assisted therapy is also possible. In traditional adult psychotherapy therapists give more interpretation and ask more details about the patient's feelings, emotions than in child therapy, because usually adults have a better verbal performance. However most of the psychological problems are connected to the dysfunction in reading out feelings and addressing (verbalizing) them (in psychology we call these processes mentalizing) or to express them properly. Equine assisted psychotherapy can be very useful for patients who has problems in the previously mentioned functions. Horses' mirroring nature, and the everyday situations given by the setting helps the therapist to detect the patient's inner world and help him/her to mentalize it. Riding on horses and working with them demands and teaches expressing feelings and wishes in a socially adaptive way. Equine assisted psychotherapy as a psychotherapeutic tool is good for treating psychological problems which haven't reached the severe psychiatric level, or as a secondary therapy, parallel with medicalization and psychiatric control. E.g. in emotional disorders (depression, maniaco-depressive disorder, systhimia), anxiety disorders (panic, obsessive-compulsive disorders, ), somatoform problems, eating - and sleeping problems, not severe personality disorders. 

Why horses?

 

Horses are prey animals, therefore their basic instinct is to be always keen on the actions in their environment. (1) This instinct and the domestication determine that they give responses to human behavior as well (2). Language of horses is the body-language. Thus they do not care about the disguise given by words – they react only to human non-verbal communication: to the expression of feelings, to gestures, to behavior (1). Living in herd naturally, they are accustomed to social experiences very well. For these reasons horses pay attention and respond to details – to things which can be unnoticed by humans. (3) Like a good therapist does, they mirror our inner content, they show to us how much consistent our unintended expressions and intended verbal communication are. By the help of this mirror (and as well by the help of the interpretation by the therapist) the chance is given for us to realize our real feelings and to learn to express them in a congruent way (4).

There are different forms of relationship between a human and a horse depending on the horse's and person's potential and emotional development (5). A person can learn to groom the horse, or to make it run or, on the contrary, to stop in a round pen, or just observe it galloping on the meadow wildly and untamed. Of course, because of horse has a great and heavy body, a  patient can ride on it. Sitting on a horse's back and letting a horse walk  gives us vestibular (coordination, re-balancing, flowing with the rhythm) and tactile (warm, silky hair) stimulation. These sensory-motor experiences are very similar to human walking thus it has a good stimulating and corrective effect on the nervous system which is used by hyppotherapy. (6). Equine assisted therapy (EAP) enables a patient to build or rebuild his/her sense of body. A rider can experience as safe, 'good enough' and holding body contact environment, as it was (or wasn't) when she/he was a baby. Just as Katcher states: 'The ratio between body weight of a horse and a person is not unlike the ratio between body weight of mother and infant' (Katcher, 2001, quotes (4) p. 291). This cuddling-motion relaxes us, regress us to our preverbal existence (4) and thus helps us to correct our early childhood experiences. 

Their uninhibited, instinct-based behavior is also very useful in EAP. As Vidrine et al (2002) say: 'horses are, by and large, naked and unashamed. They get dirty and eat off the ground; they are hairy and, at times, sweaty and breathing hard. They relieve themselves when they need to, their genitals are visible,yet clients can safely physically interact with them on a fairly intimate basis (wrap their legs around them, brush them, hug and kiss them) at a pace they control.' ((4) p. 595). This free behavior is able to break the inhibitions and defenses (anxiety, repression, so on) built up by the society (or superego) in the patient. 

Horses don't judge us. They don't care or know whether we stutter, or we are too small for our age,  fat or skinny, whether we are black or white, our face is full of spots, wrinkles or freckle, we have no friends, or failed  a test in school (4). This unconditional acceptance is one of the most important factors in psychotherapy. 

Our everyday relationships with humans are too complex, unpredictable and sometimes painful. Being attached to an animal can be less frightening, easier to understand, more harmonic and relaxed. The animal's need to be groomed and loved can meet with the natural human need to take care of and to love someone (7). Working with horses often requires new perspectives, other ways of communication (e.g. assertively) or behavior, it gives a possibility to change old patterns. 

Last and not least in EAP horses can be metaphors. They elicit a range of feelings, emotions and behaviors in humans, thus horses are good 'objects' for projection and transference. The patient's interpretation of the horse's behaviors, reactions can reveal the meaning of the metaphor, which can be helpful for the therapist (and of course for the patient) in recognizing and addressing these reactions in therapy (8).

References:

  1. IRWIN, C. (1998) Horses Don’t Lie. What Horses Teach Us About Our Natural Capacity for Awaraeness, Confidence, Courage, and Trust. Marlowe & Company, 2001, New York.
  2. ROBERTS F., BRADBERRY, J., WILLIAMS, C. (2004) Equine-faciliataed psychotherapy benefits students and children. Holistic Nursing Practice; 18(1)
  3. LENTINI, J.A., KNOX, M.(2009) A Qualitative and Quantitative Review of Equine Facilitated Psychotherapy (EFP) with Children and Adolescents. The Open Complementary Medicine Journal; 1, 51-57
  4. VIDRINE, M., OWEN-SMITH, P., FAULKNER, P. (2002) Equine-facilitated group psychotherapy: applications for therapeutic vaulting. Issues in Mental  Health Nursing; 23: 587-603.
  5. MEHLEM, M. (2009) Dare to be afraid – Ways of Overcoming and Integrating Anxieties with the Help of Horses In. Equine facilitated psychotherapy: case studies and international reports (2009). FN Verlag, Warendorf. p. 20-39. 
  6. KLÜVER, B. (2009) Self-experience on horses. In.  Equine facilitated psychotherapy: case studies and international reports (2009). FN Verlag, Warendorf. p. 10-19. 
  7. HIRSCHMAN, E., C., (1994). Consumers and their animal companions. Journal of Consumer Research, 20,616-632. quotes TROTTER, K. S. (2006) The Efficacy of Equine Assisted Group Counseling with At-Risk Children and Adolescents. Doctor of Philosophy Thesis (Counseling), December.
  8. Klontz, B. T., Bivens, A., Leinart, D., Klontz, T. (2007) The Effectiveness of Equine-Assisted Experiential Therapy: Results of an Open Clinical Trial. Society and Animals 15 (2007) p. 257-267