29th Jun 2020
Article by Graduate Stephanie Putsch
All views expressed in the following article are those of Stephanie Putsch and do not represent the opinions of any entity whatsoever which have been, now or will be affiliated with The Irish National Stud.
Equine-Assisted Psychotherapy and the Thoroughbred: a novel mental health treatment using an animal fit for purpose
The strong bond we share with horses has been shaped over many centuries. The earliest evidence of equine domestication comes from the Eurasian Steppes, around Ukraine, Kazakhstan and South-West Russia, some 6,000 years ago (BBC News: 2020). Beyond our earliest dependency on these animals for their physical capabilities, they often figure prominently in myth and lore. In no arena is this more evident than the Thoroughbred Racing industry. Champions and breed-shaping individuals – think Northern Dancer, Secretariat, Urban Sea – are universally revered, with anecdotal stories and stud book statistics passed from racing generation to generation. We have successfully put Thoroughbreds on a pedestal, but why not foster intimacy with the breed?
Equine-Assisted Psychotherapy (EAP) offers the perfect opportunity for just that. A form of mental health treatment with equine interaction at its core, it has shown positive outcomes in children with Autism Spectrum Disorder (Lanning et al.: 2014), at-youth risk (Burgon: 2011) and Dementia sufferers (Dabelko-Schoeny et al.: 2014). This article explores EAP’s ins-and-outs; specifically, its role in treating patients who suffer from trauma related conditions. How do equine behavioural patterns influence this treatment, and how does it relate to our own behavioural psychology? Can the ‘Sport of Kings’ really be of benefit to some of our most vulnerable? And what can the industry, in turn, learn from racehorses migrating from the track to the mental health arena?
What is Equine-Assisted Psychotherapy?
Psychotherapy is a broad term, but in essence it refers to methods of targeted mental health treatment. These are numerous – cognitive behavioural therapy, interpersonal therapy, etc. – and their associated methods are manifold (Smith: 2010). Equine-Assisted Psychotherapy, a young branch of the discipline, focuses on patients interacting with horses to help alleviate negative psychological patterns and symptoms (Frewin, Gardiner: 2005). It can be enacted in a number of ways, such as grooming, riding, and training, to help foster a space of connection with the animal. As highly sensitive creatures, horses become attuned to human body language and emotions, forming the basis of therapeutic attachment. EAP is most effective when complemented with more established forms of psychotherapy to assess and discuss treatment outcomes.
EAP falls under the umbrella of Equine-Assisted Therapy. There is a long-standing tradition of using horses in other forms therapeutic treatments, such as Hippotherapy, therapeutic horseback riding and Equine-Assisted Learning, to name a few. However, the focus on explicit mental health remediation using horses is a novel approach. Despite being in its infancy, Equine-Assisted Psychotherapy has the potential to be an effective and versatile treatment option. Horses are a unique therapeutic object, as they fulfill our need for tactile reinforcement and instinctual understanding, without the need for explicit verbal communication. They also demand mutuality and respect, a legacy of socialization and bonding in the herd, which promotes trust. Consequently, strong herd attachments can be replicated in human-equine relationships to form deep connections.
Equine Behavioural Patterns and History
Over the course of tens of thousands of years, humans have refined new methods for domesticating horses, building a strong bond with the species as work, sport and pleasure companions. Observation and knowledge of equine behavioural patterns has been key in this process, and is important when evaluating the horse’s role in equine-assisted psychotherapy.
Horses are prey animals in the wild, and dependent on group membership to a herd for protection and survival. The herd is hierarchical, consisting of a dominant stallion, his harem of mares and their offspring. While he is responsible for protection and mating, a dominant female, usually an older mare, rises up the ranks to lead the herd. Those lower down in the social hierarchy submit to her, as she will educate the younger horses if they step out of line. Horses are highly social animals, with specific group dynamics – mare/foal bonding, pair bonding and loyal herd attachments. Group socialization is imperative for foal development, and is communicated through tactile behaviours (such as grooming), ‘mirroring’ body language and punishment for deviating from group norms (Aaep: 2020).
However, horses can also suffer from negative behavioural abnormalities. Stereotypes – i.e. box walking, weaving, crib biting, etc. – are the result of a domesticated environment which deviates significantly from their natural habitat and norms. The primary environmental stressors for this behaviour are thought to be excessive confinement, such as box rest, and the prevention of proper socialization through isolation from the herd (Camargo: 2014). The animal responds by channeling its heightened anxiety into stereotypes as a coping mechanism, not unlike a human response to disruptive or traumatic events.
Interaction between horses and humans in Equine-Assisted Psychotherapy is dependent on shared social structures and physiological responses. For instance, the ability to create strong attachment relationships is imperative to build a shared emotional foundation and trust in a therapeutic setting (Scopa et al.: 2019). Research into mammalian psychological responses has highlighted the inter-species parallels in behavioural and biological development.
Studies conducted by Meaney et al. (2001) in rodent-pup relationships found that maternal stressors can impact long-term synaptic and hippocampal development. This compromises key brain functions – such as memory, spatial awareness and cognitive processing – in the rodent’s adult life. Therefore, neural pathway interruptions caused by trauma are not species-specific, but rather biologically patterned.
Moreover, research conducted around Bowlby’s Attachment Theory suggest that animal-human interactions share many of the same markers as human-human relationships. Attachment Theory states that the attachment style people display in their adult relationships is a latent effect of their first bonding experiences with primary caregivers (Bretherton: 1992). These styles are organised into three categories: secure, anxious and avoidant. Studies conducted on dogs found that, when exposed to Ainsworth’s ‘Strange Situation Test’ – a test designed to gage which attachment style a child possesses – canines responded with definitive attachment styles dependent on the relational dynamic with their owners (White et al.: 2010).
Given the similarities in psychological development in certain animals and humans, it’s not a big leap to posit that equine-human interaction is compatible, to the degree of creating measurably positive results in a controlled therapeutic setting.
Childhood Abuse and Neglect
Childhood abuse and neglect can have severe impacts on the infants’ brain development and psychological stressors. Trauma, in particular disruptive maternal care, experienced at critical stages in the child’s development prohibit healthy attachment strategies. This causes impaired emotional self-regulation and even effects cognitive development in extreme cases. Disruptions in this primary relationship have been found to promote a phenomenon called ‘Kindling’, an enhanced sensitivity to stimuli and stress. The long-term effects of Kindling have extensive neurological effects, such as a reduction in neuroplasticity – the brain’s ability to form new neural pathways throughout life. New research has even shown disrupted attachment may have implications for epigenetics – which genes are expressed or suppressed in a living organism.
Yorke et al. (2013) conducted a study on the success of Equine-Assisted Psychotherapy in young children with abusive or traumatic histories. They found that equine interaction can have an impact in two key areas; attachment and resilience. As communication between human-equine pairs is primarily non-verbal, patients involved in ETP must learn a new ‘language’ to interact with the animal. This language includes sensory input, touch, shared/symbiotic movement and, most notably, kinetic empathy; skills which contribute to the formation of attunement with the animal. These bonds can partially substitute the deficient attachment relationships with primary caregivers, reducing negative neurological effects.
The researchers in this study found that ETP participation lowers cortisol levels in children – the neurochemical linked to stress. Horse stables and yards are examples of Enriched Environments; complex and socially stimulating environments which can facilitate learning and problem solving. Enriched Environments foster resilience, which acts to counter Kindling and helps modify the child’s automatic stress response to unfavourable stimuli.
PTSD in Combat Veterans
Post Traumatic Stress Disorder is a mental condition caused by a severe traumatic experiences. Symptoms include flashbacks, nightmares, anxiety and constant thoughts surrounding the event in question. While there are numerous treatment options, it is a notoriously difficult condition to treat and often requires a variety of interventions (Blanchard et al.: 1996).
A novel approach in treating this disorder, Equine-Assisted Psychotherapy has shown to have beneficial outcomes in Veterans with PTSD (Masters: 2012). Much like in children, this therapy is effective in trauma recovery in adults. This is because trauma, at its core, is a breakdown in social relations, and trauma recovery requires a system of rebuilding these connections. The tactile foundation of equine interaction means veterans revert to the earliest form of connection – touch. This can be built upon to re-establish more complex forms of connection and social integration.
Another key strategy for trauma recovery is mindfulness. Horses are highly instinctual, a consequence of being ‘flight’ animals in the wild. As such, they have developed to be highly attuned to environmental stimuli and potential. In a domesticated setting, this translates to horses being able to both interpret and ‘mirror’ human body language. Their evolutionary traits parallel PTSD symptomology, as sufferers experience chronic over-stimulation of the nervous system. The added layer of experiential similarity allows the veteran to literally and metaphorically reflect on their own emotions, promoting behavioural awareness and better self-regulation.
Equine-Assisted Psychotherapy and Ex-Thoroughbreds
In recent decades, the Thoroughbred industry has made concerted efforts to support numerous re-homing and re-training schemes for ex-racehorses. Thousands of racehorses are retired each year, and with programs such as the Godolphin ‘Lifetime Care’ program, the supply of new ‘jobs’ is slowly catching up to demand (Independent: 2020).
The marriage of Thoroughbreds and Equine-Assisted Psychotherapy is one which suits the sensitive and intelligent breed. Although racehorses enjoy the stereotype of being highly-strung and difficult to handle, this is often overstated, as temperament varies wildly amongst the demographic. These horses adapt to intense training regimes and bustling environments from a very young age, becoming accustomed to race-day pressure and working in partnership with their handlers and jockeys. Highly versatile, they adapt easily to their delicate interpersonal work as psycho therapeutic animals.
Bred to be athletes, the Thoroughbred’s racetrack career only spans a short period of their productive life. By channeling their talents into other avenues, we can encourage fulfillment and longevity for the animal into old age. ETP places a great deal of responsibility on the horse, designating it as the central practitioner in sessions (Ferwin, Gardiner: 2005). This role not only stimulates the horse, but reinforces its membership in the interaction. Consequently, treatment dynamics support social bonds with the patient, mimicking the animal’s instinctual need for herd membership and socialization.
The compatibility of the breed with treatment, evidenced through a wide variety of equine interaction, has already spurred programs in the UK. Charities such as Greatwood and HorseBackUK are at the forefront of integrating Thoroughbreds into therapeutic work. Greatwood, based in Wiltshire, specialises in Special Needs Education in children and young adults through Animal Assisted intervention – their stable roster even includes retired great Deanos Beeno. HorseBackUK, based not far from Aberdeen in Scotland, focuses on supporting servicemen and women in mental and physical recovery through Equine-Assisted activities. They also work closely with local schoolchildren and Racing Welfare. Currently in their yard reside ex-racehorses Peopleton Brooke, Can Can Dream and Intiwin – the latter came as a package deal with dedicated yard manager Duggie Loy!
While this is an extremely promising start, targeted Thoroughbred Equine-Assisted Psychotherapy has yet to become a reality. Projects of this nature require both funding and a wider awareness from the industry. Racehorses are expensive assets, and few established channels exist for retirement. However, beyond the clear positive outcomes of ETP for all involved, it can also be educational for the industry at large.
Training horses is an art, with knowledge and skill being refined over generations of talented horsemen. Yet, what can we learn from horses training people? Studies have elucidated the human component of this exchange: fostering resilience, the healthier formation of attachment relationships, bridging social interaction through tactile connection. The outcome for the equine portion of these treatments requires more empirical research. We can make an educated guess, and suppose that equine welfare, mental or otherwise, is predicated on empathy and trust. Whether or not this is entirely accurate, models of Thoroughbred rearing and training can only benefit from mutuality and partnership. Though talent is key, collaboration is paramount.
If you would like further information about the charities mentioned in this article, please visit:
Greatwood – https://www.greatwoodcharity.org/
HorseBackUK – https://horseback.org.uk/
Aaep.org. 2020. Equine Behavior Through Time | AAEP. [online] Available at: <https://aaep.org/horsehealth/equine-behavior-through-time>
BBC News. 2020. Horse Origins Mystery ‘Solved’. [online] Available at: <https://www.bbc.com/news/science-environment-17943974>
Blanchard, E.B., Jones-Alexander, J., Buckley, T.C. and Forneris, C.A., 1996. Psychometric properties of the PTSD Checklist (PCL). Behaviour research and therapy, 34(8), pp.669-673.
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Burgon, H.L., 2011. ‘Queen of the world’: Experiences of ‘at-risk’young people participating in equine-assisted learning/therapy. Journal of Social Work Practice, 25(02), pp.165-183.
Camargo, F., 2014. Stereotypic Behaviour in Horses. [online] Available at: <www2.ca.uky.edu/agcomm/pubs/ASC/ASC212/ASC212.pdf />
Dabelko-Schoeny, H., Phillips, G., Darrough, E., DeAnna, S., Jarden, M., Johnson, D. and Lorch, G., 2014. Equine-assisted intervention for people with dementia. Anthrozoös, 27(1), pp.141-155.
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Independent. 2020. Gone But Not Forgotten – National Hunt Racehorses Enjoy Retirement. [online] Available at: <https://www.independent.ie/business/farming/gone-but-not-forgotten-national-hunt-racehorses-enjoy-retirement-34699483.html>
Lanning, B.A., Baier, M.E.M., Ivey-Hatz, J., Krenek, N. and Tubbs, J.D., 2014. Effects of equine assisted activities on autism spectrum disorder. Journal of autism and developmental disorders, 44(8), pp.1897-1907.
Masters, N., 2012. Equine assisted psychotherapy for combat veterans with PTSD.
Meaney, M.J. (2001). Maternal care, gene expression, and the transmission of individual differences in stress reactivity across generations. Annual Review of Neuroscience, 24, 1161–1192.
Scopa C, Contalbrigo L, Greco A, Lanatà A, Scilingo EP, Baragli P., 2019. Emotional Transfer in Human–Horse Interaction: New Perspectives on Equine Assisted Interventions. Animals. 9(12), pp.1030.
Smith, GC 2010, Psychotherapy. in Encyclopedia of Stress. Elsevier, pp. 302-307.
White, J., McBride, A. and Redhead, E., 2010. Relationship between dog owner behavior and dog attachment security in the strange situation. Journal of Veterinary Behavior, 5(1), p.47.
Yorke, J., Nugent, W., Strand, E., Bolen, R., New, J. and Davis, C., 2013. Equine-assisted therapy and its impact on cortisol levels of children and horses: A pilot study and meta-analysis. Early child development and care, 183(7), pp.874-894.