*The following article was copied from the Summer 2023 edition of Strides Magazine, published by PATH Intl. and can also be read here .
"As more centers are working with participants with mental health and clients from community
organizations, it is important for PATH Intl. members to understand how these individuals have been affected by trauma. This understanding can help create an optimal, cohesive environment while addressing any limitations and expectations for programing. While it may not be possible to know the full diagnoses or backgrounds of individuals seeking services, recognizing common behavioral reactions can help members respond empathetically with additional resources as necessary. By understanding their own need for safety as prey animals, equines are especially beneficial in helping individuals learn emotional regulation and awareness.
Understanding Trauma
By now, most people are now familiar with the diagnosis Post-Traumatic Stress Disorder (PTSD), most commonly associated with extensive or life-threatening trauma, but many would be surprised to learn that all people experience trauma to varying extents. A traumatic experience is any distressing event that has negatively shaped the way a person views themselves or the world around them. This can include the death of a family member/friend, car accidents, natural disasters, long-term illness, divorce, job loss, living in poverty, or facing discrimination/oppression.
Children and adolescents who have experienced trauma will express this in their emotional state through changes in their temperament, school performance and peer interactions. Children that have yet to develop the language for identifying anxiety will describe the sensation as having an upset stomach or a headache. In younger children, regression to earlier behavioral patterns, such as thumb-sucking or wetting the bed indicate high emotional distress. In older children, this distress can be seen in forgetfulness, social withdrawal, hyperactivity, fearfulness or rage attacks. When a person’s body is highly anxious, it shunts blood away from the prefrontal cortex, which is responsible for rational thought and decision making. For this reason, changes to a child’s emotional state are often first identified in school or extracurricular settings through lapses in concentration, memory or performance.
Subconsciously, adults are typically responding to those same negative beliefs, but have
developed differing coping mechanisms to mask their symptoms, such as numbing or avoidance. While identifying trauma responses in adults can be more difficult, the two differing responses most applicable for PATH Intl. members and centers would be hypervigilance or dissociation. An individual who is hypervigilant can present with an anxious or tense demeanor, scanning their surroundings or interactions for perceived threats. Conversely, someone who dissociates would have a more subdued or frozen appearance and may appear disengaged from the activity or discussion.
In any event, if trauma is suspected, only a licensed mental health practitioner is approved to diagnose and treat the child or adult. However, PATH Intl. Certified Professionals often work with individuals with a history of trauma teaching them horsemanship or life skills. It is important to understand how this trauma can affect their learning and create ways to help ground and engage them in the present moment, so they can calm their nervous system and focus on the lesson. Best practice would be for a CTRI to be in ongoing communication/consultation with the treating therapist or have a therapist involved with the program if working with participants with trauma in a non-psychotherapy/counseling service.
Polyvagal Theory and Stress
Polyvagal theory helps explain how the entire nervous system responds through bodily reactions and mental narratives to real or imagined threats and also how it calms down once it
has perceived the threat has passed. These narratives and reactions in turn shape how people view ourselves, relate to others and create habits in their lives. For instance, someone who was bullied as a child may tell themselves, “I am not good enough” or “I don’t belong,” and anything that emotionally feels like rejection can trigger feelings of worthlessness associated with the bullying. Often, these reactions and beliefs are subconscious and physically immediate, but it can take the logical brain time to recognize that the perceived threat being responded to is not actually threatening. For example, a person who has been bullied may immediately cringe and feel intimidated if they see a people pointing in their direction until they realize the group is actually pointing at house for sale sign behind them.
The vagus nerve is the longest-running nerve throughout the body with three main branches. The first extends into the face for social cues. The second reaches the heart and lungs to regulate heartrate and breathing. The third even extends into the gastro-intestinal system to regulate digestion. Together these three branches of the vagus nerve help the brain and body react to stress and information in the environment through three main settings. Imagine these three settings rotating between the three colors of a stoplight:
Ventral Vagal (green light)--the social engagement level, when a person is feeling relaxed
and able to engage effectively with others.
Sympathetic Activation (yellow light)—This occurs when a person’s nervous system begins
to respond to anxiety and stress, and they may experience an increased heart rate, shallow breathing, digestive issues and muscle tension. At this time, the body is releasing the stress hormone cortisol, which is detrimental to health if experienced long-term, so as a protective mechanism our body will send us to dorsal vagal shutdown.
Dorsal Vagal Shutdown (red light)—This occurs when a person experiences lethargy, depression, feelings of hopelessness or dissociation. While the physical body appears shut down, internally someone can feel agitated or restless. An analogy would be like driving a car while pressing on the gas and the brake at the same time.
While most people rotate between the three different levels throughout their day, those who have experienced significant trauma are likely to be fluctuating between or be stuck in either sympathetic activation or dorsal vagal shutdown. It is important that PATH Intl. Certified Professional to recognize when a participant is operating from a heightened activation state including an understand how sensory and physical triggers contribute to a participant’s mood, social skills or environmental needs.
Understanding Horse Feedback In Lessons
Horses provide direct and honest feedback about their environment and whoever is interacting with them and as a result, they will often, but not always, reflect the participant’s mood and stress level. An instructor can use the horse’s body language to cue the participant about where they are holding onto tension and help identify behaviors they are exhibiting beyond their awareness, e.g., clenching their fists around the reins or squeezing their legs. Catching that response, the instructor can ask the participant to check in with their bodily sensations to register the level of nervousness or relaxation they feel.
Equines can also serve as an example for alternative reactions in response to a perceived threat. As prey animals, horses have to be selective about which dangers they choose to flee from in order to conserve energy. They would not be able to survive or function if they were constantly anxiously responding to fear in their environment, which is how those suffering from severe anxiety or trauma are responding in their daily lives. Horses let out a big release of tension by snorting or sighing once they have determined a threat has passed. This can be a playful reminder in a lesson for participants to practice sighing and shaking off their fear like a horse and seeing if that helps them stay more present.
Also, horses offer a safe way for participants to begin connecting through safe touch, such as hugging, or forming a trusting relationship as they interact with their assigned horse each week. Additionally, setting boundaries can be difficult for many participants. In this way, horses are great role models for enforcing boundaries as it relates to safety and mutual respect from others. For example, a horse pinning their ears communicates a “no thank-you” response that participants can recognize as healthy boundary setting and not a personal rejection nor a reflection of an unreasonable request. However, while an instructor can point out when the horse’s behavior (tossing their head) is signaling that a participant’s actions are causing discomfort and intervene (i.e. asking a participant to length reins that are too short), it would not be appropriate for them to try to process their emotions. Any processing of a participant’s trauma or experience of trauma should be done by a mental health professional.
Considerations for Instructors and Centers
PATH Intl. centers and Certified Professionals can be mindful of limiting overarousal or stimulation by:
Communicating driving directions, parking and meeting location for the first interaction
Limiting sensory stimulation such as loud, unexpected noises
Creating a safe, calm place by separating waiting areas or posting signage to be mindful of noise, phone conversations, etc.
Scheduling participants with a traumatic background at times the center is less busy or crowded
Walking alongside the participant or have them halt in the middle of the arena for instruction as opposed to shouting instruction across the arena
Creating opportunities for freedom and choice during lessons
Dictating simple and clear instruction to avoid overarousal
Communicating with volunteers to be mindful of privacy and confidentiality
If, for safety reasons, you have to physically reprimand a horse’s behavior in front of participants, do so, as unobtrusively as possible, and if you can, explain in language the participants can understand why you are correcting the horse, being careful not to us pejorative words like punish or reprimand.
Grounding Techniques and De-escalation
One great practice that instructors can start each lesson is with asking participants on a scale of
1 to 10, with 10 being feeling very good, “How are you feeling today?” Alternatively, you could create a color system of feelings and have the participant point to the color that describes their feelings. This can be a good way to access how stressed a participant feels and what degree of tension they might bring to a lesson. With this information, the instructor can adjust the lesson plan as necessary. For instance, if a participant has had a very stressful week, the instructor might postpone introducing a new skill and instead practice what was learned in the last lesson.
Never underestimate the power of taking deep breaths, as repetitive movement and deepening the breathing are the quickest and most effective technique at regulating the nervous system back into a calm state. Grooming, leading the horse or going for a trail ride are all great ways to help ground and regulate a participant’s nervous system. Ask the participant to softly focus on the following areas of their body by either imagining a white light or by breathing into that area. Start with the top of their head, forehead and throat and move down to the heart, stomach, hips and soles of feet, with pauses for several breaths at each area. A body scan can be adjusted to meet each participant’s needs or attention level and can be conducted either as a mounted or unmounted activity. It can be fun to notice if their horse sneezes, yawns, or licks and chews at certain areas as they progress through the body scan.
Of course, there will always be situations where a participant becomes activated or over-aroused despite the instructor’s best efforts. If a participant becomes agitated or upset, redirect them away from other participants and horses. Going for a walk around the property or having them assist in a chore can help redirect their emotions until they are calm enough to discuss or join the lesson again. A breathing activity for younger children or those with limited attention can be using Mini-Bubbles, or the small tubes of bubbles used as party favors at weddings. Blowing bubbles requires focus, breathing and eye-tracking, and the small tubes are easy to fit in a pocket and less of a messy spill risk.
Mental Health Resources and Boundaries
It is critical that each therapeutic riding center is familiar with local mental health agencies or
professionals for referrals when a participant’s needs indicate support beyond the center’s scope of practice. Most mental health professionals list themselves on the Psychology Today website with filters based on insurance coverage, availability, ages served and areas of specialty.
While PATH Intl. Certified Professionals cannot underestimate the power as their role as a mentor or compassionate adult in some of their participant’s lives, it is important to be mindful of a teacher’s professional boundaries, as too often overly generous support could have unintended consequences. For some individuals, who have endured emotional trauma, this could make them too dependent on the instructor to make decisions or solve problems. Or they may seek the kind of emotional support from their instructor that should be the role of a psychotherapist. That is why it is very important to stay within one’s scope of practice and understand when to refer the person to an appropriate mental health resource.
PATH Intl. members and centers are full of examples of the aspects of a healthy community that rely on open communication and support. Each day that centers create an intentional space for those to have their physical, emotional or cognitive needs met with compassion serves as a hopeful reminder to those who may have endured emotional pain or have experienced a tumultuous background. When in doubt, a center’s equine partners provide great examples of maintaining well-being, whether through seeking the support of their herd mates, their ability to remain grounded in the present moment or openly expressing their emotions without fear of judgement or guilt.
Emily Swisher is a licensed psychotherapist with a private practice in Denver, CO, specializing
in Eye Movement Desensitization and Reprocessing (EMDR) and psychotherapy incorporating
equines. She is a PATH Intl. CTRI and ESMHL and has worked in conjunction with several
PATH Intl. centers in Colorado, Arkansas, and Montana. Previously, she worked as a program
director for an organization that provided therapeutic horsemanship and psychotherapy to
adolescents with a trauma, abuse or neglect background. She can be reached at
emilyeswisher@gmail.com or www.emilyswishercounseling.com.