Service dogs have a long and distinguished history helping physically impaired people live more productive lives, including assisting military veterans. More recently, dogs have been found to be important players in veterans’ recovery from mental and emotional wounds.
Dr. Elspeth Cameron Ritchie is a retired Army colonel and a psychiatrist with expertise in military and veterans' issues. She retired from the Army in 2010, after holding numerous leadership positions within Army Medicine, including as a psychiatry consultant. She has personally studied using dogs as therapy animals in alignment with therapists, also called animal-assisted therapy, to help bridge the gap between therapist and soldier. “Dogs have been used in war before, but for other functions, not in this [therapeutic] way, except perhaps using dogs for blind soldiers,” she says.
Ritchie was working within the U.S. Army Surgeon General’s office when personal stories surfaced about dogs and veterans with post-traumatic stress disorder, or PTSD. “So many people said how wonderful a dog is for them, and it quickly moved from anecdote to a lot of information,” she says. So Ritchie started researching the matter. “The question came up whether we should accept two dogs as therapy dogs,” she says. “What happened is, once you start down this hole you get more and more interested.”
Service Dogs Allay Fear
Soldiers with PTSD can experience a variety of symptoms, including anxiety, paranoia, sleep disruption and fear of public spaces. “They suffer from hypervigilance, startle easily, have nightmares and intrusive thoughts and live in isolation and detachment. If you match those symptoms with the right dog, it helps them feel safe and calm,” Ritchie says. A trained dog, for instance, can sense when its owner is having a nightmare and nuzzle him or her awake. It can be trained to remind its owner to take medication or turn a light on when its owner is sitting in the dark.
The dog also forces the owner out into the world. “Isolation is one of the most important parts to this,” she says. “You can’t sit at home. The dog has to walk, has to poop, and that forces interaction. Other people talk about how cute the dog is, they ask what it does, and that helps bridge the gap between other people.”
Many veterans with PTSD also feel numb to their surroundings. “They feel more comfortable connecting with the dog than with a family member,” Ritchie says. “In a family situation, the dog can help bring family members together.” Veterans who feel fearful and paranoid are likely to get weapons to protect themselves. A dog can help the veteran feel safer on its own. “I am a big believer in having a dog instead of firearms,” she says.
Pet Dogs Help, Too
A study presented at the 2016 American Psychiatric Association Annual Meeting suggests that adopting a dog as a pet, rather than waiting for a specially trained service dog, can also be useful for veterans with PTSD. A pilot trial led by Dr. Stephen Stern, an adjunct professor in the department of psychiatry at the University of Texas Health Science Center at San Antonio and research investigator at the South Texas Veterans Health Care System in San Antonio, compared a control group with a group of veterans with PTSD who adopted a dog as a supplement to typical care such as talk therapy and medication.
Over the three-month period the dog group showed significantly more improvement in PTSD symptoms than the control group. In addition, average scores on scales of both depression and loneliness improved for the dog group and declined for the control group. In interviews, most veterans in the dog group said they developed close bonds with their pets and became more physically and socially active. They also described improvements in their overall happiness, ability to cope with stress and relationships with others. “There was a reduction in fear, anxiety, irritability, they were less likely to avoid going places,” Stern says. “Also, though depression is not an official criterion for PTSD, there was significant improvement in depression symptoms, and quality of life was reported to be a lot better.”
Stern says he has been looking into dogs and PTSD since 2005, when he worked in a PTSD clinic during his 35-year career with the Department of Veterans Affairs (he has retired from the VA but still conducts research with the department). “We noticed veterans would talk about their dogs, and it was striking,” he says. “My colleagues noticed the same thing.”
In his study of pets – Stern prefers to call them companion dogs – the veteran could pick from one of five candidate dogs, and the pair would take obedience classes to enhance the dog-patient bond. That training in itself is beneficial, as the veteran needs to control his or her own anxiety around the animal. “Training an animal is therapy for the veteran,” Ritchie says. “It helps you modulate your own symptoms. You can think of it as biofeedback. We do it with horses, too.”
Not everyone benefited from the veteran-dog pairings, Stern says. “Some returned the dog in a few weeks because it wasn’t a good fit for various reasons – they didn't like the smell or the match wasn't right,” he says. More research needs to be done comparing service and companion dogs, he says, “but many things a service dog can do a companion dog can also do. It can provide love, warmth and interaction with others. And there are some drawbacks to service dogs.” They require a year or more of training and can be very expensive, whereas companion dogs are readily available – “we got ours from a shelter,” Stern adds.
Stern also says a service dog can in fact interfere with psychological recovery from PTSD. A veteran who goes to, say, Walmart on his own can learn that nothing bad will happen and slowly master his or her fears. “But with a dog, if nothing bad happens it’s because the dog was there,” he says. “It’s like having a bodyguard. So they don’t learn it is safer here than in a war zone, and that is a concern.” Ritchie agrees that this is a potential issue. “If I get a Rottweiler to feel less paranoid, is that helpful or is it reinforcing my anxiety and paranoia?” she asks.
Nevertheless, dogs can be a big benefit to many suffering soldiers. “It’s a bit cliché but it’s hard not to be – dogs and humans, when the temperament is right, have good connections," Ritchie says. She and other researchers believe that oxytocin, the “love transmitter” hormone that new mothers get from nursing their babies, rises in both the dog and the human when there is a good match. “Dogs have been with us for, like, 10,000 years,” Stern adds. “Their love is unconditional.”