Equine-Assisted Therapy: Info & Heretical Thoughts

[If you read no further, please note that equine-assisted psychotherapy is undertaken by a licensed mental health professional who has undergone additional training and supervision in how to adapt their therapeutic orientation to include equines in their clinical work. And ideally, such clinicians are dually competent in both the practice of psychotherapy and their understanding of equines and equine behavior.]

 

Okay, y’all…

It’s been a year and a day since my last blog post (and what a year it’s been. If y’all only knew.), but I’m back in the saddle again.

Some readers may be aware that I enjoy including equine-assisted psychotherapy (EAP) in my clinical work when I can. Recently, I was contacted by a colleague wanting more information on EAP as she was working on a referral.

In the course of that conversation, it became evident to me that many clinicians do not necessarily have accurate information regarding EAP. As a result, I decided to draft this blog post. I’ll outline some clear information I hope will be helpful, and I’ll opine in the process.  If need be, please remember these wise words from Jeffrey Lebowski regarding statements made herein, “Yeah, well, you know…that’s just like…your opinion, man” (Coen & Coen, 1998). Standby, heresy follows.

So…what is equine-assisted therapy?

Equine-assisted therapy” is a really good umbrella term under which any therapy incorporating equines falls. This term can also be a bit misleading, however, in that anyone, in the absence of any formal and/or professional training in a type of therapy (psycho-, OT, PT, etc…), can claim to operate an equine-assisted therapy program. Many persons that fall into this category might argue, “but wait a minute, I have X number of certifications through the _____ training model.” Yes, it is true. There exist training models in equine-assisted [this-training-or-that] for which there are no prerequisites for certification. And, some of the folks developing these models have no formal training in any therapy discipline, themselves.

While I’m potentially ruffling feathers, though, I would like to note that many such individuals are very well meaning people whose net outcome is largely positive. The ethical exception I take here is that such persons have no training, and give no training, in what I’ll simply refer to as “do no harm.” I will forego further discussion on this topic for another blog post, however, as it deserves its own treatise.

With all of that out of the way…

There are many ­equine-assisted therapy programs that are more aptly referred to as therapeutic horsemanship (or therapeutic riding) programs. These programs simply suggest that there is something therapeutic about learning horsemanship, and they’re right! That said, what takes place within these programs is not therapy in any traditional sense of the word. The therapeutic value inherent in recreating through horsemanship could be likened to the therapeutic value realized in recreating via routine hiking, taking up jogging, or acquiring a new and enjoyable skill. Ideally, persons involved in running such programs have participated in training in best safety practices for operating horsemanship programs.

There are many types of equine-assisted therapy that are, in fact, legitimate forms of therapy that also incorporate equines. These are not psychotherapies, however. In these programs, work is undertaken by a licensed professional from any number of disciplines. Examples include, but are not necessarily limited to: equine-assisted occupational therapy, equine-assisted physical therapy, and/or equine-assisted speech therapy. Equine-assisted work being undertaken to address physical needs generally falls under the term hippotherapy.

Finally, we move into a discussion of EAP. As mentioned at the top of this post, I argue in the strongest of terms that EAP is undertaken by a licensed mental health professional who has undergone additional training and supervision in how to adapt their therapeutic orientation to include equines in their clinical work.

Many licensed mental health professionals who offer EAP received additional training through the same aforementioned [this-training-or-that] models that train people foremost in their model and do not necessarily train clinicians in how they can adapt the therapeutic work they’re already doing to include equines. While I’d posit that the latter approach is more ideal (and I’m biased, admittedly), there is value in some of the models in existence. At minimum, some of the practitioners are at least licensed mental health professionals! The drawback is that some such programs end-up being shortsightedly rigid. Bear in mind, such programs have a vested interest in continuing to legitimize the commerce of their respective model, and so there is often posturing to substantiate* a given model over others.

As a final point of interest, some of these current leading models adhere strictly to an approach to EAP wherein there is 1) a licensed mental health professional and 2) an equine-specialist who, while having no mental health training, possesses an understanding of equines. In these models, the therapist and the equine-specialist work in concert, always, and without exception. My fear is that this, too, is done in an attempt to make these models more accessible by not making dual competency requisite. In any other specialty, dual competency would be the expectation.

Regarding my bias, and in the interest of transparency, after receiving training in some of the [this-training-or-that] models, I was very pleased to see training in EAP move into academia. While EAP has taken a foothold, to varying degrees, in a few academic institutions throughout the United States, as a graduate of the post-masters Equine-Assisted Mental Health Practitioner certificate program at the University of Denver, I am admittedly a proponent of that program.

So, if you’re looking to make a referral to equine-assisted therapy, you may do best to ensure the program you’re referring to has a licensed mental health professional on staff (who will be doing the therapeutic work). The same is true if you’re a consumer looking for equine-assisted therapy. In either case, it would also be appropriate to inquire about the training practitioners have received, and I would encourage you to lean towards referring to clinicians who are dually competent and practice autonomously**.

In summary, there is:

  1. Therapeutic Horsemanship (Therapeutic Riding)
    – therapeutic value is inherent in recreating through horsemanship
  2. Hippotherapy
    – a term used to refer to therapies, undertaken by licensed professionals from a range of disciplines (PT, OT, ST), incorporating equines in the treatment of physical needs
  3. Equine-Assisted Psychotherapy
    – psychotherapy undertaken by a licensed mental health professional trained in incorporating equines in their clinical work


*  –  Seldom does this substantiation come in the form of empirical scientific evidence. But, many in the field, even many within some of the [this-training-or-that] models, are working to change this.
** – I believe it is perfectly acceptable for a clinician running EAP in a group setting to have extra hands (equine knowledgeable assistants) to help  facilitate the logistics of managing many people and equines.

RESOURCES:

Coen, E. & Coen, J. (Producers), and Coen, E. & Coen, J. (Directors). (1998). The Big Lebowski [Motion Picture]. USA: Polygram Filmed Entertainment and Working Title Films.

More about the author: www.ElementsWellnessAustin.com/jason.html

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Cray Button: A 1st Person Account Of The Limbic Brain?

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Salutations, Dear Readers:

Before we get started, let me first express that I understand that the use of the word “crazy,” or any of its diminutives, is taboo in regard to mental health. My aim herein is not to cause offense. Just hang with me and try to follow the spirit of this here blog post.

In the 21st Century, it can often be a challenge to find music the whole family might enjoy. This is not a treatise on what one’s standards should be for music appropriateness or the censorship thereof. Often, music meant for children is unbearably cheesy (less polite descriptors come to mind) and hard for parents to listen to for extended periods. Conversely, some may find that much of modern pop, hip-hop, rock, and [name it] music, while fun and catchy to listen to, might not always be the most appropriate for younger listeners. Enter Family Force 5, a band whose music is both fun, catchy, on par with contemporaries, and safe for the whole family. This seems to be their niche.

While recently listening to one of their songs, “Cray Button, (Olds, Olds, Olds, Currin, Mount, & Friresen, 2012)” with my own children, it occurred to me that Family Force 5 had unwittingly written a song that in many ways parallels the Limbic Brain’s trauma response. For your viewing and listening enjoyment, I’ve included the original music video, as well as a lyrics video, for “Cray Button.”

   
Dan Siegel, M.D. uses the illustration of the Upperstairs Brain and Downstairs Brain to talk about and differentiate the Upper Cortex and the Lower Brain (ref: video). Now, a discussion of all of the complexities, functions, and nuances of the neurobiology involved is beyond the scope of this discussion. “This is a very complicated case, Maude. You know, a lotta ins, a lotta outs, and a lotta what-have-yous” (Coen & Coen, 1998). Suffice it to say, for children who have endured complex trauma, the brain’s survival center (i.e., Limbic/Downstairs Brain) can often be the driving force behind profound dysregulation.

upstairs-downstairs-blog-graphicbrain

In reference to the song, “Cray Button,” I do not see the song as describing a child, but rather I like to think of the song as having been written in the 1st Person by the survival center within a child’s brain. In keeping with Siegel’s metaphor, imagine a person who dwells within the Downstairs Brain and hits a cray button whenever a threat is perceived. Now imagine, as is so often the case, that a child has no control over this.

Of course, the behaviors made manifest by the cray button being hit can be quite problematic, and they can be especially difficult for parents and caregivers to respond to in constructive ways. We’re now hitting on a topic that will be reserved for another blog post some other time.

My hope here is 1) that this might give readers, especially layreaders, a bit of a new framework with which to understand trauma related dysregulation and 2) that this might also serve as a fun, non-shaming, tool to accompany discussions of trauma-and-neurobiology for children having endured trauma and who are working to resolve challenges created therefrom.

In summary: remember, part of the Limbic Brain’s responsibility is the organism’s survival. The problematic behaviors that can arise from an organism’s experience of trauma are rooted in, and aimed at, continued survival. While it might seem counterintuitive in many instances, when an organism gets “cray,” it is really working to ensure that it is not subjected to the same threats it has encountered in the past. When this happens, it is the brain’s survival center that is at the helm. The organism is, essentially, held captive by its own survival mechanisms.

 

Just As Some Example Parallels (make your own!)
and remember to read this as 1st-Person-Limbic-Brain

I will show you crazy,                                                         (Get ready. I am going to get defensive)
I’m a maniac                                                                         (I’m wild and dangerous)
No more final warning, I’m not holding back                (Time’s up. No more messing around)
I ain’t going nowhere,                                                         (I can’t run. I’ll fight)
let the roof cave in                                                                (I’ll tear the whole place down if I must)
‘Bout to blow up something,                                              (About to blow, and I’ll take you with me)
here goes nothing                                                                 (I’ve got nothing to lose)
Watch me hit the cray button                                            (DYSREGULATE)

Cray (x3)

Let’s get cray                                                                           (Survival Mode: ON)
Turn it all the way up                                                            (DEFCOM 5)
Got a double dose of bass                                                     (Going to shake this up)
You love it so much                                                               (I know you love it when we dysregulate)
Get out of your head                                                             (No room for reason any more)
Get out of your skull                                                             (Move your body. Flail)
If you ain’t gettin’ cray                                                         (Gotta do this, or..)
Then you ain’t got a pulse                                                    (We might die)
A lunatic time bomb just got dropped                               (Time to explode)
I get cray all day, it’s my full time job                               (This is my job as your survival center)
Wild like a wolfpack, howlin’ at the moon                       (Let’s let this animal out to announce itself)
Attack, attack, you’ve bitten by the boom                        (Time to Fight!)

I ain’t going nowhere,                                                           (I can’t run. I’ll fight)
let the roof cave in                                                                 (I’ll tear the whole place down if I must)
‘Bout to blow up something, here goes nothing              (I’ve got nothing to lose)
Watch me hit the cray button                                              (DYSREGULATE)

Cray (x3)

Put your fives in the sky if you’re feelin’ alive                  (Fists Up)
Throw ten in the air ’cause you don’t care                        (Make yourself big)
CrayBans on, rock your cranium                                        (Blinded to what’s happening. Brain on Fire)
3-2-1, detonation                                                                    (Count down. EXPLODE)

I wonder what happens when I hit the cray button?      (How can we survive?)
I guarantee the whole place starts jumpin’                       (This will get everyone stirred up)
I wonder what happens if I hit the cray button                (How can we survive?)
I guarantee the whole place starts jumpin                       (This will get everyone stirred up)
I wonder what happens if I hit the cray button               (How can we survive?)
I guarantee the whole place starts jumpin                       (This will get everyone stirred up)
I wonder what happens if I hit the cray button               (How can we survive?)
Im’ma do it! (do it)                                                                 (I must)
Watch me hit the cray button                                              (DYSREGULATE)

I pledge allegiance to the U.S.Cray (cray)                     (I’m committed to my organism’s survival)
U.S Cray U.S U.S Cray
I pledge allegiance to the U.S Cray (cray)                     (I’m committed to my organism’s survival)
U.S Cray U.S U.S Cray

 

RESOURCES:

Coen, E. & Coen, J. (Producers), and Coen, E. & Coen, J. (Directors). (1998). The Big Lebowski [Motion Picture]. USA: Polygram Filmed Entertainment and Working Title Films.

Olds, S., Olds, J.,Olds, J., Currin, N., Mount, D., & Friresen, R. (2012). Cray Button [Recorded by Family Force 5]. On III.V [EP]. Atlanta, Georgia: Tooth & Nail.

 

I know. I know. But,…

“PUT YOUR LAUNDRY AWAY, OR I’LL PUNCH YOU IN THE FACE” ~ LOVE, MOM

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Before saying anything else, I’ll begin by saying “I get it.” I GET IT!

I’ve been wanting to start a blog for sometime. I would have never pegged this as my likely Blog Post #1 topic, though.

In recent weeks, I started seeing folks post pictures here and there of a sign reading “Put your laundry away, or I’ll punch you in the face. Love, Mom.” I must be late to the game, because it seems these signs are quite popular, and I’ve only now realized their existence.

Please allow me to reiterate: I get it.

Living in a household of 7 (and often 8), laundry is an unyielding juggernaut; a literal or metaphorical force regarded as mercilessly destructive and unstoppable (“Juggernaut,” 2016). No sooner is all the laundry clean, folded, and put away before a mountain of dirty clothes is made manifest again. It is, without exception, a never ending process. As a side note: the good Shanoans of the famed Star Ranch experience this challenge to a much lesser degree. Maybe they’ve uncovered1 something?

I understand that the spirit of the language in this sign is aimed at the soul-sucking reality of life that is laundry, and that it is not, in fact, meant to imply any ill will towards one’s child/ren, nor to promote the actual physical abuse of one’s child/ren. All the same…

Working in the field of complex developmental trauma, it has become hard for my stomach not to turn when I see things like this. I’ve worked with kids who have been punched in the face, and it isn’t something to joke about.

To offer an anecdote:

I recently returned from a trip to Eastern Europe where I worked with several children, all of whom had endured considerable abuse and/or neglect. One child comes to mind when I see this sign. We’ll call him John.

John is 7-years-old. John’s mother and step-father were both IV drug users. Before using, presumably because dealing with a 7-year-old can be bad for one’s high, John’s parents would first shoot him up so as to not have to deal with him (i.e., they’d knock him out). John’s parents would also physically abuse him, including hitting him in the face.

The latter injustice, while well documented, also became apparent one morning when I was trying to engage John in a silly game of patty-cake. You might ask, “Patty-cake?” Yes, patty-cake. Activities that involve using one’s limbs and crossing the center of one’s body happen to be not only very good for the brain, but also crucial for proper development. I won’t delve into the neurobiology behind this, but readers interested in knowing more can Google bilateral integration and/or crossing the midline.

In John’s case, patty-cake proved very difficult. This wasn’t because he didn’t possess the motor skills required to play patty-cake. But, when we’d attempt patty-cake at a tempo thought customary, John would flinch in such manner that we couldn’t play the game. It was disheartening to see the toll being hit in the face had taken on John the 7-year-old.

My best knowledgeable guess is that social services in John’s country will terminate the parental rights of his mother. What remains to be seen is whether John will spend the next 9-10 years of his life in an institution or will eventually find a home within another family. Could you imagine John entering a new home for the first time only to find this sign hanging in the laundry room? Yes, that question is asked rhetorically. Most of us get the point.

And for readers raising children in a loving, healthy, nurturing, and abuse-free home, can you imagine for a moment your children even mentally entertaining the sort of abuse John has endured? Would you ever want them to think that someone might literally hit them in the face? And while we have good reason to believe they enjoy every bit of confidence that you would never do such a thing, do we even want to joke about it?

I am not preaching (or at least not meaning to). I understand the laundry sign is squarely a joke. I am not calling anyone that finds humor in it a bad person. And I am not calling anyone that hangs it in their home a bad parent. For those up in arms about this post, the words of  Jeffrey Dude Lebowski may serve you well: “just take it easy, man.” My only aim in this blog post is to use this sign as an opportunity to visit a bigger issue.

ABOUT THE AUTHOR:
Jason is a LPC-Intern working towards full licensure under the supervision of Suzette Lamb, LPC-S. His work is undertaken at Elements Wellness, an affiliate of the Central Texas Attachment & Trauma Center.


RESOURCES:

Juggernaut. (August, 2016). Retrieved from https://en.wikipedia.org/wiki/Juggernaut

Van der Kolk, B.A. (2016). Developmental trauma disorder: towards a rational diagnosis for children with complex trauma histories. Manuscript in preparation.

FOOTNOTES:

1. Yes. That is intended as a pun. I hope you chuckled.