WRITTEN BY Kathleen Choe
I watched her make her way to the therapy office for her intake session, struck by the way she made her approach: crouching down, she almost seemed to be crawling towards the door; constantly looking over her shoulder before ducking her head again. Her trajectory weaved in zig zagging diagonals across the open space between her weather beaten pick up truck and where I was now standing on the front porch. “Hello, *Dee!” I called out, hoping not to startle her. She stopped and stared at me for a full minute, eyes wide, statue-like among the wildflowers blooming along the path. I knew their bright colors were lost on her. The only thing Dee could see at this moment was the distance that remained between her and the door, and the dubious likelihood that she would make it there safely. This was my first introduction to one of the most traumatized clients I have ever worked with using Equine Assisted Psychotherapy (EAP).
Dee had been referred for EAP by her social worker because she has been brutally raped by a neighbor whom she let into her home when he promised to help change her air filters. Dee struggled with balance issues and was afraid to stand on a ladder to change them herself, but also suffered from asthma so she overcame her natural reticence of men in hopes that clean filters might help her to breathe better. Dee’s decision to trust this seemingly good Samaritan proved to be catastrophic when he held her captive for hours and subjected her to unspeakable suffering. Dee came to me suffering from panic attacks, insomnia, flashbacks, vertigo, anxiety, and depression. She experienced dissociative spells where she would lose days at a time, lying trance-like on her couch without eating or having any contact with other people. Coming to our therapy appointment was the first time she had left her apartment in the past 3 weeks.
I had to be careful to always walk where Dee could see me, a little ahead of her, never behind, and never too close. I noticed, though, that she could let the horses into her space much more easily. She chose a horse with which to build relationship fairly quickly, a light colored Palomino that she nick-named Sunny. Dee spent hours grooming Sunny, untangling her tail, feeding her slices of apple, talking around and around the assault. I wasn’t allowed to label anything that had happened to her accurately; she flinched and reacted when I used words like assault or rapist, preferring to say “the event” or “that man.” Little details about past abuse drifted out: an abusive, alcoholic father, then a series of similar stepfathers, until she married an abusive alcoholic, whom she left behind in another state to come here, and encountered again in the form of a treacherous neighbor. All the while the brush made rhythmic, circular patterns on Sunny’s side as Dee and I breathed in and out together, inhaling the soothing smell and presence of her horse, exhaling the pain and suffering she had experienced throughout her troubled life.
When we started working on increasing their attachment, Dee stopped bringing apples to sessions because she said: “I want Sunny to be connected to me, not the food, and the apples make her pushy and rude.” Indeed, Sunny spent a great deal of time early in the therapy work pushing into Dee’s space and driving her around the pen instead of following her during attachment work. Dee allowed this to happen for a long time before recognizing she had re-created the bullying patterns of relationships she experienced with the abusive men in her past. Once she realized that her passive (too low) body energy invited aggression from Sunny, Dee began using appropriate amounts of pressure to make requests for connection. As Dee grasped that she was worth being recognized and respected, she and Sunny had more positive interactions.
Detachment felt better to Dee than attachment initially but worse for Sunny. Sunny often simply refused to step away and allow space between herself and Dee. Dee would allow her to stay, stroking her neck and worrying about Sunny feeling rejected if Dee insisted on creating some space between them. We reflected how giving herself space had never been an option for Dee in the past because she allowed other people to set the terms for the relationship. We worked on creating safety for both of them using appropriate levels of body energy to maintain the pressure when Sunny resisted the request to move away from Dee.
On the day Dee felt ready to tell her whole story, she paced around the round pen in jerky, short strides. Sunny fell in step behind her. Dee spit out her pain in ragged, harsh tones. Sunny fell behind, eyes wide, ears upright and forward, body rigid. Eventually, she stopped following Dee and stood stock still in the middle of the pen. Dee didn’t notice at first, continuing to hurtle around the pen in a frenzy of anguish. Her voice trailed off when she saw Sunny’s frozen stance. She burst into the first tears she had shed in a session. “I’ve frightened her . .. it’s too much,” Dee cried, crumpling to the ground. Sunny walked over to where Dee lay in a heap and breathed softly in her ear. The mare’s eyes were half closed and her body was relaxed. She cocked one hind leg as she stood vigil over her sobbing friend. I pointed out that Sunny did not seem to be overwhelmed by Dee’s story, or her pain. Dee finished her account siting cross legged on the ground, Sunny’s head resting against her shoulder, stroking the blaze that ran down her face. Her tone was soft, her words unhurried and thoughtful. She used the language we had created together, naming her rapist and the assault as well as the rage and grief that followed. Sunny and I created a safe space for Dee to experience her pain and be accepted and supported through it.
In subsequent sessions, Dee participated in equine assisted trauma processing (informed by my training in TF-EAP and EMDR) to help her begin to re-process her traumatic memories. This kind of mounted work helps metabolize traumatic memories that have been frozen in their original state so that the intense emotions they trigger can be released and the traumatic memory can be stored in the brain the way that normal memories are stored. I explained how her brain literally needed to be “re-wired” so that she didn’t remain in the survival part or base of her brain, in a constant state of hyper-vigilance and fear, or in the limbic system, or mid brain, in an emotionally escalated state, but could be in the thinking part of her brain, her neocortex, to make more informed decisions about the input coming in from the environment, giving her a wider range of responses available to her than the avoidant and dissociative tendencies she had been relying on to avoid being triggered into a state of panic.
At one point in the therapy, Dee had to go back to her home state to visit her daughter, who had been hospitalized after an accident. Dee had created a Safe Place Protocol as part of her trauma processing work, visualizing a meadow full of flowers where she and Sunny played and dozed. The warm, wonderful feelings accompanying that visualization helped Dee ward off the panic the survival part of her brain produced whenever she thought about going back to the place where her ex-husband and other abusers still lived. Using mindfulness and grounding techniques, Dee practiced remaining fully present in the round pen with Sunny instead of dissociating in a panic while visualizing flying home to visit her daughter. Every time Dee started to dissociate, Sunny disconnected from her, turning or walking way. Sunny taught Dee how to recognize when the dissociation started, and how to catch and change this habitual pathway in her brain with mindfulness techniques before her mind completely drifted away. “I miss her when she leaves,” Dee would say. Staying connected with Sunny became Dee’s motivation to work on her dissociative tendencies. She walked beside Sunny, with a hand on her side, so she could feel the rhythm of Sunny’s heartbeat and breathing and use it to regulate her own. (When calm, a horse’s resting heart rate is 38 – 40 beats per minutes, considerably slower than a human’s, particularly a traumatized human. The large electro-magnetic field of a horse’s heart can help regulate the heart rates of those around him.)
Dee was able to successfully travel home to visit her daughter without incident. By the time we finished therapy, Dee was not only leaving the apartment for her sessions, but also taking her newly acquired rescue dog to a dog park and talking to other dog owners she met there. Whenever she began to feel panicky, she would visualize being connected to Sunny and breathe deeply through the wave of anxiety until it passed. Before leaving therapy, we took some of Sunny’s hair from her mane and tail and braided the strands into a bracelet that Dee could wear as a transitional object. Dee recently texted me that while she misses coming to see Sunny, “I carry her in my mind and heart and can experience her presence whenever I need her.” They built a truly lasting internal connection!
*all names and identifying information have been changed to protect confidentiality
Here is a breakdown of some of our sessions:
There is a powerlessness involved in the aftermath of experiencing trauma that can cause a person to internalize false messages concerning their efficacy at problem-solving, initiating activity, engaging in relationships and succeeding at tasks. They begin to shrink away from trying new things and doubt their ability to be successful in areas they may have previously been comfortable with. Dee presented with a great deal of self-doubt and insecurity in all of these areas. In fact, when I first started working with her, she was only leaving her apartment for therapy sessions and doctor’s appointments. She felt completely defeated by tasks that she used to handle with ease such as driving or shopping. Contemplating a trip to the store would trigger a wave of panic. She developed agoraphobia and her world shrank to the confines of her apartment. In order to be able to participate more fully in her life, Dee was going to have to be able to regulate her emotions when faced with a task she now found daunting.
Rhythmic Riding provides a source for passive “bottom-up regulation” and presents wonderful opportunities for the client to learn to regulate their emotions. By starting with a stress level just slightly outside of their window of tolerance, the client can practice staying calm using skills taught first on the ground, then while mounted. Using breath to self-regulate is an easy way to maintain or return to a calm state. Horses regularly “sigh” or take a deep breath to release stress and regain their equilibrium. I asked Dee to notice when Sunny exhaled in this way, especially when she blew out her lips in what humans would call “a raspberry” or “pursed lip breathing.” Dee observed that when she was particularly upset during a session, Sunny would yawn and exhale to release stress. This helped Dee become more aware of when she was minimizing or dissociating from her anxiety. Dee would take deep breaths, pushing the air all the way down into her stomach before releasing it (belly breathing) while counting each breath so that the inhale matched the exhale (rhythmic breathing).
As Dee became more proficient at belly breathing and rhythmic breathing while mounted on Sunny, we incorporated using the five senses to remain grounded in the present. She would notice the breeze blowing through her hair, the muffled clopping of Sunny’s hooves in the dirt, the feel of the bareback pad underneath her, the coarse texture of Sunny’s mane, and other sounds, smells, sights, and tactile sensations to stay present instead of dissociating. Using an EMDR protocol to visualize a positive template, Dee began imagining successfully leaving her apartment, driving to the grocery store, pushing her cart up and down the aisles and checking out. When she began to panic or dissociate, Sunny would sometimes come to a dead halt, or begin yawning and tensing her muscles. This lets both Dee and myself know that she was getting beyond her window of tolerance and needed to practice her relaxation and mindfulness skills to come back to the present. After several Rhythmic Riding sessions like this, Dee was able to do her own grocery shopping for the first time in a year.
The beauty of the Natural Lifemanship model is that no structured, pre-planned activities are necessary to address specific client issues such as these. They unfold organically when the therapist is willing to step back from being directive with an agenda and allow the client to build her relationship with the horse in her own way. I saw the power of this serendipity the first time Dee and I went out to the pasture to find Sunny. Dee was carrying a halter to lead Sunny to the round pen, and we discussed the difference between inviting someone to spend time with you vs. forcing them or manipulating them to do so, as we walked. It was clear as we discussed this concept of having choices in relationships that Dee had not experienced this freedom and spent a lot of time in coercive, abusive situations just trying to survive.
When she saw Sunny munching hay with other horses in the herd, Dee hesitated, not wanting to interrupt Sunny’s meal or take her away from the other horses. She stood off to one side of the round bale, holding the halter, head drooping, shoulders slumped, with an air of defeat. I asked her what she was experiencing at the moment and then the tears came. “Ignored. Invisible. Disposable. Worthless.” After letting her feel those emotions and where they came up in her body (constricted chest, cramps in her stomach), I asked how she would like to feel about herself. She answered immediately: “Worthwhile. Lovable. Significant.” I asked how that felt different in her body when she thought of those words. Her shoulders straightened up a bit and she lifted her head. “Energizing. My chest is opening up.” Sunny turned and looked at her for a bit before turning back to the hay. “What just happened?” I asked Dee. “Sunny looked at me,” Dee said in wonder. “What made her do that, do you think?” I asked. Dee shook her head. “What changed in you?” I persisted. “My feelings about myself,” she said. “How did changing your feelings about yourself affect your body?” I asked. “My energy changed,” she conceded. She seemed encouraged that Sunny had noticed her more positive body energy and acknowledged her presence, but was still hesitant to “interrupt” Sunny’s meal.
I asked Dee how spending time with Sunny might not just be good for Dee, but also for Sunny. We talked about how horses spend a great deal of time in their brainstem, or the survival part of their brain when they are with their herd. They react, rather than respond, to each other, which often involves biting and kicking to communicate and establish dominance. Giving Sunny opportunities to be in her neocortex, or the thinking part of her brain would help her develop a calmer, more responsive stance towards her herd, allowing her to problem solve rather than react defensively to the other horses. It also helps her have more positive relationships with humans, upon whom she relies for food, water, and care, which ensures a better quality of life for her as people will be more likely to treat her well if she can display cooperative and friendly behavior. When Dee could see that her request for connection from Sunny was actually beneficial for Sunny as well, and not just for Dee, she became more confident about requesting Sunny’s attention and began making clucking sounds and swinging the halter rope slowly from side to side. Sunny swung her head around a few times, but resumed eating every time. Dee turned away.
“What just happened?” I asked her. “She just wants to eat,” Dee responded glumly. “She is ignoring me,” I asked her what she would do when her daughter was little and wouldn’t get up in the morning for school. “Well, at first I would come in and stroke her forehead and let her know it was time to get up. If that didn’t work, I would pull back the covers a bit – she hated to be cold. Then I would turn on the light . . . sometimes I literally had to drag her to her feet to make sure she was fully awake!”
I told her she had just beautifully illustrated the principle of gradually increasing the pressure when her request was being ignored. I asked her what turning away from Sunny had done with the pressure. “Released it,” she acknowledged.
“What did that tell Sunny?”
“That her behavior is what I wanted.”
She turned back to Sunny and began asking for connection again by clucking and clapping her hands. Sunny turned to face her. Dee kept clucking and Sunny turned back around. “What did you do when Sunny turned to look at you?” I asked.
Dee thought a moment. “I kept clucking,” she said. “Oh, I didn’t release the pressure, did I?”
“Sunny didn’t know she had done the right thing because you didn’t release the pressure,” I agreed.
Dee went back to trying to get Sunny’s attention. Sunny flicked one ear back occasionally but otherwise kept eating. “I confused her,” said Dee.
We talked about how it’s o.k. to make mistakes in communication as long as we try to repair them. I asked her how she was going to let Sunny know that this relationship was important enough to Dee that she was willing to put in the work it required to have a good connection instead of giving up because she wasn’t getting immediate results. “Sunny isn’t going to care more about the relationship than you do,” I pointed out.
Dee had to increase her body energy (the pressure) quite a bit (clapping and then rhythmically swinging the halter rope helped to increase her body energy in a calm fashion) before Sunny finally turned around again. This time Dee stopped her movement and took a big step backward. Sunny took a step forward and Dee took another step back. Sunny blew out a big horsey raspberry at the same time as Dee exhaled loudly. We ended the session there. Dee was beginning to see how important it was for her to be consistent and committed to connecting with Sunny for them both to believe the relationship was worth having.