HOW HORSES HELP VETERANS HEAL
Blending Research and Anecdotal Accounts
By: Shellie Kwitkowski, USA
Take a moment and think about the last time you spent with horses. What did your senses feel? Were you outside with the horses and enjoyed the sun on your face? Did you feel the breeze on your skin, the smell of horses and grass? Take a deep breath and appreciate the peacefulness of the moment. Now, contrast that with the stress and horrors of combat faced by active-duty soldiers and the memories of veterans returning home. Imagine the chaos, the stress and the physical and mental tension felt on a daily basis.
It is hard to have a conversation about military veterans without the conversation evolving to the challenges faced by veterans returning home. PTSD (Post-Traumatic Stress Disorder), depression, and anxiety are common mental health challenges faced by veterans (1). The Department of Defense (DOD) reports that as soldiers complete the discharge process, over half are referred for mental health evaluation (2). But less than half complete the evaluation process and even less complete recommended treatments. The “warrior culture” tells soldiers that any mental or emotional problem is a sign of weakness, and they are trained to push it aside or bury it and face the task at hand (3).
Connections
One Vietnam era veteran did exactly that. He returned home and became a successful corporate employee, business owner, husband, and father - working hard and living the American dream. When he entered retirement, he began to have downtime and emotions crept in. He found himself facing demons from years past and spiraling downhill. His local VA hospital provided medical care and therapy including visits to a local therapeutic riding center. There a new passion and purpose was born. He began attending sessions with a group from the VA and eventually began volunteering as well. Years later, he still attends a weekly session, often taking new veterans under his wing to mentor them on their journey. Research tells us that veterans often resist help because they feel that a civilian cannot possibly understand what they went through in the military (3). While this veteran has gained peace and focus from time spent with horses, the horses still serve as a reminder to live in the moment. One Haflinger, Jake, will refuse to walk on until our veteran takes a breath, relaxes his shoulders and leads peacefully on. If the energy is too high, the tension too strong, Jake will plant his feet and wait.
On the other hand, Jake recently highlighted his intuitive nature and how he can mirror emotions. During a weekly session, another veteran shared that she found out that her dog has cancer and when asked how she was feeling, she replied that she was numb. Her group headed out on a trail walk leading their horses and Jake kept nudging her arm, lightly bumping into her, crowding her space. She commented that she wasn’t sure how she felt about Jake’s behavior, but upon reflection the discussion evolved to the fact that Jake was making sure she felt something, even if it was annoyance. Jake was not allowing her to stay numb but crowding her space to push emotions to the surface.
Many veterans are used to being the helper not the one who needs help. While many will resist the idea of therapy, horses change the dynamic from traditional therapy such as CPT (Cognitive Processing Therapy) or PE (Prolonged Exposure) which are the traditional gold standard currently recommended by the VA. Despite their large size, horses are prey animals and reluctant to trust easily or quickly. However, their size prevents them from being bullied or pushed around, so they demand respect and will give respect in return (4). Horses live in herds (or units) similar to a military unit, making it easier for veterans to relate to their needs and desires. The herd requires communication and a relationship with all herd members to survive, again, similar to a military unit. A horse depends on subtle communication with body language, energy (positive and negative), emotion and reading the intentions of others (5). A typical equine assisted services program utilizes a horse’s willingness and responsiveness to interact with humans, and mirror the emotions presented by the human to show the therapist what the individual is feeling, even if they cannot verbalize it. Horses live and react in the moment providing quicker and more direct feedback to the veterans’ energy and mental state.
The literature shows that forming connections is helpful to veterans, so working together in a small group setting can provide the bonding and interaction that veterans crave (6). Interestingly, veterans connect with each other based on their service, regardless of which branch they served in. The horse provides the common interest and can prompt conversation on shared experiences. This is readily apparent when visiting a veterans transitional housing facility with a miniature horse. Just having a horse show up prompt’s connections. As the group gathers on the front porch of the facility, the social visit turns more introspective, as veterans talk about their history both prior to and during their military service. The veterans here also share a history of homelessness, and many have faced substance abuse issues as well. This facility happens to be in the flight path of a regional airport and as the miniature horse spooks slightly at a jet taking off, the conversation turns to the fears of the horse. The intent is often for the veteran to draw parallels between the horse’s actions and reactions and their own thoughts, actions, and reactions in their life (7).
One Vietnam era veteran did exactly that. He returned home and became a successful corporate employee, business owner, husband, and father - working hard and living the American dream. When he entered retirement, he began to have downtime and emotions crept in. He found himself facing demons from years past and spiraling downhill. His local VA hospital provided medical care and therapy including visits to a local therapeutic riding center. There a new passion and purpose was born. He began attending sessions with a group from the VA and eventually began volunteering as well. Years later, he still attends a weekly session, often taking new veterans under his wing to mentor them on their journey. Research tells us that veterans often resist help because they feel that a civilian cannot possibly understand what they went through in the military (3). While this veteran has gained peace and focus from time spent with horses, the horses still serve as a reminder to live in the moment. One Haflinger, Jake, will refuse to walk on until our veteran takes a breath, relaxes his shoulders and leads peacefully on. If the energy is too high, the tension too strong, Jake will plant his feet and wait.
On the other hand, Jake recently highlighted his intuitive nature and how he can mirror emotions. During a weekly session, another veteran shared that she found out that her dog has cancer and when asked how she was feeling, she replied that she was numb. Her group headed out on a trail walk leading their horses and Jake kept nudging her arm, lightly bumping into her, crowding her space. She commented that she wasn’t sure how she felt about Jake’s behavior, but upon reflection the discussion evolved to the fact that Jake was making sure she felt something, even if it was annoyance. Jake was not allowing her to stay numb but crowding her space to push emotions to the surface.
Many veterans are used to being the helper not the one who needs help. While many will resist the idea of therapy, horses change the dynamic from traditional therapy such as CPT (Cognitive Processing Therapy) or PE (Prolonged Exposure) which are the traditional gold standard currently recommended by the VA. Despite their large size, horses are prey animals and reluctant to trust easily or quickly. However, their size prevents them from being bullied or pushed around, so they demand respect and will give respect in return (4). Horses live in herds (or units) similar to a military unit, making it easier for veterans to relate to their needs and desires. The herd requires communication and a relationship with all herd members to survive, again, similar to a military unit. A horse depends on subtle communication with body language, energy (positive and negative), emotion and reading the intentions of others (5). A typical equine assisted services program utilizes a horse’s willingness and responsiveness to interact with humans, and mirror the emotions presented by the human to show the therapist what the individual is feeling, even if they cannot verbalize it. Horses live and react in the moment providing quicker and more direct feedback to the veterans’ energy and mental state.
The literature shows that forming connections is helpful to veterans, so working together in a small group setting can provide the bonding and interaction that veterans crave (6). Interestingly, veterans connect with each other based on their service, regardless of which branch they served in. The horse provides the common interest and can prompt conversation on shared experiences. This is readily apparent when visiting a veterans transitional housing facility with a miniature horse. Just having a horse show up prompt’s connections. As the group gathers on the front porch of the facility, the social visit turns more introspective, as veterans talk about their history both prior to and during their military service. The veterans here also share a history of homelessness, and many have faced substance abuse issues as well. This facility happens to be in the flight path of a regional airport and as the miniature horse spooks slightly at a jet taking off, the conversation turns to the fears of the horse. The intent is often for the veteran to draw parallels between the horse’s actions and reactions and their own thoughts, actions, and reactions in their life (7).
Moving Through Obstacles
In a typical session at the farm, the veteran(s) will be given a task such as moving a horse from one area to another without touching the horse. When faced with an unfamiliar task many veterans use a coping mechanism (e.g bullying) to manipulate the horse, which is rarely effective. Veterans learn to pause and recalculate their approach to a problem and gain instant feedback from the horse as they experiment with different methods, feelings, and emotions. Another common activity is to guide the horse through obstacles, perhaps stepping over poles on the ground or going around cones. Mental health professionals may provide the suggestion that the poles represent something the veteran is “getting over” and the cones represent something that the veteran is “avoiding” by going around the issue. This might be later addressed in the debriefing afterwards if the veteran chooses to share or just bring an idea to the forefront that the veteran may not have isolated until that moment. The experiential interacting with horses helps the veteran to gain insight into their thoughts, feelings, emotions, and actions.
Historically, the literature offers a theory that PTSD symptoms originate in the Autonomic Nervous System and develop due to chronic hyper-stimulation, which promotes a flight or fight response and ultimately the symptoms of PTSD (4). As prey animals, horses remain in hyper-stimulation as they depend on it for survival, just as a soldier in a war zone might do. As herd animals, horses must manage to control the hyper-stimulation while functioning in their community (herd) and maintaining appropriate communication with other members of their herd. A horse that is isolated faces a greater threat to their survival. This possible link between a horse’s behavior and a combat veteran’s behavior allows for more metaphors to develop. Horses show veterans how to reduce their hyper-stimulation while providing appropriate responses to activities and obstacles. Information on the horse’s ear movements, body language and posture are relayed from the equine specialist to the mental health professional, who will use it at the end of the session to debrief, with the veteran, on how the equine interacted with them. Debriefing also gives the veteran a chance to express how they felt during the session and the mental health professional can ask questions that might lead the veteran to process the experience in a new way.
In a typical session at the farm, the veteran(s) will be given a task such as moving a horse from one area to another without touching the horse. When faced with an unfamiliar task many veterans use a coping mechanism (e.g bullying) to manipulate the horse, which is rarely effective. Veterans learn to pause and recalculate their approach to a problem and gain instant feedback from the horse as they experiment with different methods, feelings, and emotions. Another common activity is to guide the horse through obstacles, perhaps stepping over poles on the ground or going around cones. Mental health professionals may provide the suggestion that the poles represent something the veteran is “getting over” and the cones represent something that the veteran is “avoiding” by going around the issue. This might be later addressed in the debriefing afterwards if the veteran chooses to share or just bring an idea to the forefront that the veteran may not have isolated until that moment. The experiential interacting with horses helps the veteran to gain insight into their thoughts, feelings, emotions, and actions.
Historically, the literature offers a theory that PTSD symptoms originate in the Autonomic Nervous System and develop due to chronic hyper-stimulation, which promotes a flight or fight response and ultimately the symptoms of PTSD (4). As prey animals, horses remain in hyper-stimulation as they depend on it for survival, just as a soldier in a war zone might do. As herd animals, horses must manage to control the hyper-stimulation while functioning in their community (herd) and maintaining appropriate communication with other members of their herd. A horse that is isolated faces a greater threat to their survival. This possible link between a horse’s behavior and a combat veteran’s behavior allows for more metaphors to develop. Horses show veterans how to reduce their hyper-stimulation while providing appropriate responses to activities and obstacles. Information on the horse’s ear movements, body language and posture are relayed from the equine specialist to the mental health professional, who will use it at the end of the session to debrief, with the veteran, on how the equine interacted with them. Debriefing also gives the veteran a chance to express how they felt during the session and the mental health professional can ask questions that might lead the veteran to process the experience in a new way.
Integration
As society begins to acknowledge the needs of our veterans, the next step is to use any and all resources to help veterans successfully return to civilian life. The COVID-19 pandemic caused most in-person services to pause, so mental health professionals and equine specialists came together and offered a new idea. Many began adding equines to their telehealth sessions, perhaps sitting in a horse’s stall or videoing horses interacting with each other. In many cases, as the conversation became deep and perhaps hitting a lot of nerves, somehow even through the Zoom call, the horse’s seemed to know exactly when to blow out a calming breath, or sneeze, or even fart, and just change the tempo of a call for a veteran who may be getting locked into the memories of the horrors they experienced. Even virtually, horses offered the reminder to live in the moment.
Multiple organizations and individuals provide Equine Assisted Services for veterans. However, as the literature frequently shows, there has not been a standard curriculum offered, so sessions are highly dependent on the training, education, and opinions of the professionals offering the sessions. Another drawback is that Equine Assisted Services are seen as an activity and not a therapy, so participants cannot be reimbursed by insurance for the cost of the sessions. While the cost can be high for equine specialists to maintain horses and a facility, funding can be found from sources such as the Wounded Warrior Project for activities.
The VA is growing increasingly more receptive towards alternative treatments. In 2006 there was a lack of knowledge prevalent in the VA system to any kind of “horse therapy” as noted. But just 4 years later, another researcher shared that while the VA still required more education on Equine Assisted Services, leaders were quickly embracing the concept and referring veterans for sessions (8). As more research is completed and results are documented, Equine Assisted Services can be more widely accepted and recognized as a valid treatment option for veterans.~*~
As society begins to acknowledge the needs of our veterans, the next step is to use any and all resources to help veterans successfully return to civilian life. The COVID-19 pandemic caused most in-person services to pause, so mental health professionals and equine specialists came together and offered a new idea. Many began adding equines to their telehealth sessions, perhaps sitting in a horse’s stall or videoing horses interacting with each other. In many cases, as the conversation became deep and perhaps hitting a lot of nerves, somehow even through the Zoom call, the horse’s seemed to know exactly when to blow out a calming breath, or sneeze, or even fart, and just change the tempo of a call for a veteran who may be getting locked into the memories of the horrors they experienced. Even virtually, horses offered the reminder to live in the moment.
Multiple organizations and individuals provide Equine Assisted Services for veterans. However, as the literature frequently shows, there has not been a standard curriculum offered, so sessions are highly dependent on the training, education, and opinions of the professionals offering the sessions. Another drawback is that Equine Assisted Services are seen as an activity and not a therapy, so participants cannot be reimbursed by insurance for the cost of the sessions. While the cost can be high for equine specialists to maintain horses and a facility, funding can be found from sources such as the Wounded Warrior Project for activities.
The VA is growing increasingly more receptive towards alternative treatments. In 2006 there was a lack of knowledge prevalent in the VA system to any kind of “horse therapy” as noted. But just 4 years later, another researcher shared that while the VA still required more education on Equine Assisted Services, leaders were quickly embracing the concept and referring veterans for sessions (8). As more research is completed and results are documented, Equine Assisted Services can be more widely accepted and recognized as a valid treatment option for veterans.~*~
Footnotes:
- Veterans Administration. (2018, July 24). VA.gov: Veterans Affairs. How Common is PTSD in Veterans? https://www.ptsd.va.gov/understand/common/common_veterans.asp.
- Currier, J. M., Holland, J. M., & Allen, D. (2012). Attachment and mental health symptoms among US Afghanistan and Iraq veterans seeking health care services. Journal of traumatic stress, 25(6), 633-640.
- Malmin, M. (2013). Warrior culture, spirituality, and prayer. Journal of religion and health, 52(3), 740-758.
- Baugh, B. (2009). Therapists using horses in treating PTSD. Retrieved April 2, 2010, from http://www.aikenstandard.com/local/0202maze
- Hallberg, L. (2017). The clinical practice of equine-assisted therapy: Including horses in human healthcare. Routledge.
- Ferruolo, D. M. (2018). Veteran Focused Equine Facilitated Mental Health (Order No. 13426630). Available from ProQuest Dissertations & Theses Global. (2173203191). https://links.franklin.edu/login?url=https://www-proquest-com.links.franklin.edu/docview/2173203191?accountid=38107
- Klop, K; & Davis, B. (2006). Have you ever played checkers with a horse? What about billiards? Paradigm. 4-5.
- Dieperink, M. (2005). Comparison of treatment for post-traumatic stress disorder among three department of Veterans’ Affairs medical centers. Military Medication, 305-308.
