the Most Read series EVER published by BarkMagazine.com continues by Mark Carlson ~ a MUST READ:

Part 2:
Dr. Joan Esnayra began to search the then-new Internet for information on dogs trained to help persons with mental illness. “I found nothing. No websites or information at all. She joined online forums of Service dog users and wanted to expound on her discovery. “But, I found there was a great deal of hostility towards people with mental illnesses wanting to use a Service dog. The people in the forum felt like it was wrong and that people like me shouldn’t have a dog at all. In the summer of 1997 I coined the term ‘Psychiatric Service Dog.’”

She was told by the forum host that if she talked about mental illness and dogs one more time, she would be unsubscribed. “So being the rebel that I am,” Esnayra said, chuckling, “I started an Internet forum of my own and began actively seeking out others who had discovered the disability-related benefits their dog was providing to them. It started small,” she said, “but soon the forum took on a life of its own.  I wasn’t going to shut up about this. I knew it was real, and I knew it was BIG.”

The forum grew at first by word of mouth. She found more and more people who’d been afraid to talk in other forums, and who said their dogs did much the same thing as Wasabe.

She compiled the comments and observations of the members, using them to strengthen her theories about how much dogs could be trained to assist persons living with mental illnesses.

“I first allowed people to join if they had a mental illness and were genuinely interested. But in time I had to screen members by phone.”

When asked about this, she explained that she had also attracted what to the Internet forum community are known as Trolls. “Trolls are people who go out of their way to create chaos in online forums and communities. I had my share of them.”  With regard to her detractors, Esnayra said,

“They really did their best to discredit me and the work I was doing,” she said sadly. “Their criticisms were infused with stigma and fear of persons living with mental illness.”

In some cases, through careful and reasoned communications, Esnayra was able to help people who were initially opposed to service dogs for people with mental illnesses to better understand what she was doing and work with, rather than against her.

She founded the Psychiatric Service Dog Society in 2001 after receiving a community service award from her then-employer, the National Academies in Washington DC. The $1,000 prize, given to her for her pioneering work with Psychiatric Service dogs allowed her to incorporate PSDS and to subsequently apply for nonprofit status.

Then, through a chance encounter on an airplane while accompanied by Wasabe, she earned the interest of a wealthy benefactor. “He was big in the television and movie industry, and he donated generously to practitioners and institutions in the field of human-animal bond research. He built the Rainbow Room at U.C. Davis, so that dogs could be euthanized with compassion and dignity. He donated approximately $20,000 a year to PSDS over the course of seven years until his death in 2008.

PSDS is a non-profit information and referral resource for persons interested in learning about Psychiatric Service Dogs, what they do, how to get one and, through the forum, share their needs and experiences.

Her diligence has made her terrbly busy. “I get about 1,000 calls per year and I answer every one of them,” she says with pride. As of 2009 the call volume became so unmanageable that she was literally overwhelmed with people who needed information about training Psychiatric Service Dogs. That, in itself, is a tribute to her work and the increasing need for such dogs for people living with mental illnesses.

Esnayra, though she has never in any way claimed to be a psychiatrist or psychologist, has sufficient training in neurobiology to be competant in developing the cohesive framework that she terms ‘the Psychiatric Service Dog Therapeutic Model.’

With her PhD in Biology, she has read and researched hundreds of papers and reports about mental illnesses and their effects. She understood the basic brain chemistry of persons with PTSD or Bipolar Disorder and how medications do their work.

“Medications are not the only answer to symptom management,” she says confidently. It can take months or even years to find the right  combination of medications that work in a given individual’s body.”
 
The issues raised in the earlier forum continued to play out and shape the debate between the physical disability community and the mental health community.
“It mainly centered on the issue of tasks,” Esnayra explained. “The opponents state that since a PSD doesn’t do any physical tasks, such as guiding a blind person, picking up dropped objects or alerting them to a seizure, they’re not really Assistance dogs.”

Esnayra said she and her forum members compiled a list of thirty ways a dog can assist its mentally ill owner. “They break down into two major categories, tasks and work.  The latter term ‘work’ incorporates cognitive behavioral skills, mind/body approaches, and clever ways to leverage your dog’s natural responses to its immediate environment in order to better manage mental health symptoms.”

When asked to explain the concept of work, Esnayra used the example of veterans suffering from PTSD. “We teach veterans to read their dog as their dog is reading them in order to obtain new information about subtle changes within their own body that he/she is otherwise unaware of. This is a Mind-Body approach.  We show them how to perform a ‘body scan’ of their dog in order to mitigate the symptom of hypervigilance, which may be described as an erroneous but ominous feeling that something terrible is about to happen. This is a cognitive behavioral approach. Work notwithstanding, psychiatric service dogs may also be trained to perform physical tasks that assist their handler. When a veteran returns to his/her darkened home at night. The veteran may not feel safe entering the house, because who knows what is lying in wait behind those doors. So the dog is trained to enter the house and search from room to room, then signal to the handler that all is well. Psychiatric Service Dogs can also be trained to signal their handler that it is time to take their medications. Dogs have a keen sense of time that is reliable and accurate.

Esnayra provided examples of biofeedback these dogs can provide. “When someone is with their service dog for months on end, the dog learns to read the handler’s ‘baseline’ behaviors, attitudes, and dispositions. When these change as a result of encountering a trigger stimulus or because one is entering an episode of mental illness, the dog registers the change even before the handler is aware of it. Cognizance on the part of the dog will be reflected in the dog’s facial expressions, body langsuage, or behaviors. Therefore the handler learns to read their dog as the dog is reading its handler.  This is a form of biofeedback that empowers the handler to make smarter choices about how to manage the episode.

This is a cognitive behavioral paradigm and what Wasabe was doing for Esnayra when she was experiencing episodes of Hypomania. “I learned to leverage Wasabe’s alerting behaviors and use them to my advantage.”

Another example. “Let’s say a veteran with PTSD is walking on a busy city street with his service dog. Suddenly he senses danger for some unexplained reason.  He looks around and only sees unarmed civilians.  He wonders if there are any insurgents in the crowd.  He reaches for the place where his weapon used to be, but it isn’t there.  He shakes his head for a moment thinking, “Wait, I’m home.  I’m not in Baghdad.”  He remembers the word, ‘hypervigelance’and knows that it characterizes his combat PTSD.  If there is danger in the environment, his dog will sense it before he does. “Does my dog sense danger in this environment?” he wonders. He performs a ‘body scan’ of his dog.  There are no hackles raised, no ears folded back, no tail between the dog’s legs, no predatory creeping,and no low decibel growl. In fact, his dog’s body is completely relaxed and its tail is swinging blithely from side to side as he casually takes in his environment.  The veteran concludes that since his dog does not perceive danger in its immediate environment, this sensation of danger that he feels is probably his PTSD hypervigelance, and has learned to trust his dog. This is a cognitive behavioral intervention that allows the veteran to continue on with his day rather than running home and bolting all the doors and windows.
 
All of these are tasks or work a Service dog can do for their owners. But it is a splendid example of the precious human-canine bond. Trust, mutual need, love and loyalty are indisputable elements of the bond. All dog owners, and particularly those of Assistance dogs learn to trust and depend on this bond.

~ end Part 2 ~

Part 3 continues February 15th... don't miss it. 

but if you did miss Part 1

read below...

In the chaotic and fast-paced modern world, there are few things we can find true solace and joy in. The warm sun after a long winter, the fragrance of blooming flowers, the laughter of a child.  And of course the unconditional love and devotion of our dogs.  For most of us the dogs in our lives are pets who give more than they take, making us laugh, smile and feel loved.  There is a rapidly growing community of dogs who are in their own special way, making life better for a lot of Americans.  They help people with mental illnesses.

Never an easy subject to discuss, mental illnesses such as Bipolar Disorder, Major Depression, Schizophrenia and Post-Traumatic Stress Disorder are affecting the lives of millions of people of all ages.  Post-Traumatic Stress Disorder, or PTSD, is fast becoming one of the most diagnosed mental illnesses in the modern world. Victims of childhood abuse, assault, disasters, accidents, and combat live their lives with a bewildering and terrifying constellation of symptoms that limit their ability to function and sustain healthy relationships. Some with PTSD will even resort to suicide.

According to an often-cited RAND report, more than 18% of returning soldiers from Iraq and Afghanistan manifest symptoms of PTSD. The military mental health provider community is ill-prepared to deal with such large numbers of cases. Veterans with PTSD are experiencing an upspike in domestic violence and divorces. PTSD is making it very difficult for these veterans.  Many are so withdrawn and emotionally numb that they are unable to properly engage with their children or spouse.  Some manifest explosive tempers and this accounts for the increased rates of domestic violence that we are seeing in the veteran community. Where is the light at the end of this dark tunnel?

There is one. It is a very bright and warm light, in the form of our loving canine companions.  They are part of the growing ranks of Assistance animals, which include Guide, Service, Seizure Alert and Mobility dogs. Psychiatric Service Dogs (PSD) are becoming recognized in the professional  mental health community for the remarkable and long-term benefits they provide to their owners with PTSD and other mental illnesses.

Guide Dogs are well known. PSDs, however are new in the Assistance animal community. A groundbreaking researcher, Dr. Joan Esnayra, PhD, of Arlington Virginia is the founder of the pioneering Psychiatric Service Dog Society (PSDS). Esnayra, 45, is Native American and was raised in Washington State. She earned her B.A. in Philosophy from the University of Washington in 1991. Her career goal was to become a biomedical researcher so she attended Grad school at U.C. San Diego for her doctorate in Biology.

She is also a Psychiatric Service Dog handler. Esnayra lives with Bipolar Disorder and suffers from episodes of severe depression or hypomania. Esnayra endured undiagnosed Bipolar symptoms for most of her life with little understanding of what was happening to her. “I became suicidally depressed after some serious emotional crises, and in 1994 I was diagnosed with Major Depression and PTSD.”

Esnayra decided to write a doctoral dissertation focused on behavioral genetics, aggression, and drug development.  She chose her subject matter, in part, because of the insights she garnered through the experience of her own mental illness.  “Much of human behavior is genetically controlled, more so than people realize.” She began to seek holistic treatment alternatives and by accident, she found one in the form of a Rhodesian Ridgeback puppy named ‘Wasabe.’

“I love Ridgebacks,” Esnayra said. “I grew up with one, and I wanted a puppy so badly. So, in the spring of 1997 I found a Ridgeback show breeder in San Diego. Sitting on the floor with the new litter, some puppies were jumping up and kissing me, others played and scampered around me. But one puppy just climbed into my lap, curled up and went to sleep.”  And that was Wasabe. Asked about the name, Esnayra said it was symbolic. Wasabe, a hot Japanese horseradish is definitely an acquired taste. “It’s about  trying something you’re not sure of but you end up loving.”.

Esnayra did not acquire her puppy with the intention that the dog would become her Assistance dog, and certainly not for her mental disorders, since at that time “I didn’t know there was such a thing. I was getting a pet dog.”

She managed to scrape together $400 to hire a respected Del Mar, CA, dog trainer named John Rubin, who gave her twelve individual lessons in basic obedience.

Within a few months of bringing Wasabe home something strange happened. “I was determined to understand and master my bipolar disorder, and I was reading and studying a lot. I have episodes of hypomania,” she explained. “I worked at my computer, hyper-focused. I wouldn’t eat, or pay attention to anything around me, or even go to the bathroom for eight or ten hours straight. Then I began noticing that Wasabe bumped my elbow repeatedly during these sessions, trying to get my attention. His alerting behavior helped me become aware of the subtle changes happening in my own body that I otherwise did not perceive.

And thus was  born the genesis of her life’s work. Esnayra, with her background in research, began to make careful notes of her perceptions and reactions, along with that of her dog. “And soon I realized he was doing something that really helped me better manage my disability.”

- This is the first of a four-part series which will be presented in monthly editions. -

written by Mark Carlson

Edited and approved by:
Dr. Joan Esnayra, PhD  - Dr. Carmen Davis, PhD - William O’Hara