My Cat Abby and the Clinical Relationship

         (Abby next to her pillow)

          The relationship I have with my pet Abby, has been multi-dimensional, mutually beneficial, and in many ways curative.  My love for her is represented by a reciprocal process.  I yearn for her affection, acceptance, security, respect, trust, and care for my wellbeing.  She yearns for my affection, attention, security, and trust that I will attend to her emotional and biological needs. Our dependence on each other parallels the relationship between mother and child, and we exchange roles based on intuition and communication with each other.  We promote each other’s survival and our dependence on each other has birthed feelings of comfort and security.  

          Even before we discovered that we could depend on each other, there was a connection that was felt and unexplained by science. I experienced primary love with Abby within days of adopting her which preceded the mutual benefits that developed in the months and years that followed.  It was analogous to the relationship of therapist and client, where an intuitive and trust-based bond is formed within a few sessions, and sets the tone for the rest of the relationship.

            The harmonious and soothing interactions which are the thread work for our bond have changed me as a person.  Since adopting Abby, I have educated myself about the unique behaviors and needs of felines.  I am motivated to understand her language, assess her needs and attend to them.  My love for Abby led me to spread awareness through activism about cats and their living conditions in the human world, prevention of over breeding, and the ethical treatment of cats.  I have joined PETA and the SPCA and am a longstanding member of Sierra Club.  Abby has not only impacted me by igniting a passion for animal activism, but also inspired my desire to find a solution to the millions of animals that die meaninglessly each year from euthanasia.  I began to research the use of Animal Assisted Therapy in prisons, hospitals, and libraries, finally to ask myself the question, “Have animals been incorporated into the healing of people with mental and emotional challenges?”  As a psychotherapist, I went on a quest to discover that Animal Assisted Psychotherapy (different than AAT) is a burgeoning field.

          I decided to join the movement to promote AAP’s credibility through certification and research with Animal Assisted Therapy Programs of Colorado. My mission is to plant the seeds of a paradigm shift.  One that animals are not just mere tools, or good for kids, but that they serve a critical role as members of our living world.  Our respect for their precious needs and freedoms provides pathways to human healing as we reconnect with fragmented parts of ourselves and our own nature. It is needless to say that Abby has changed me as a person and a clinician in a big way.

            The human-animal bond (HAB) has impacted me as a clinician by providing a sense of relief after long days at work.  I remember nights eager to get through traffic just so I could see my cats. The nature of work as a therapist is unpredictable, often requiring high levels of emotional output and input and mental alertness.  My relationship with Abby represents an ideal primary love of mutual benefit. It is one where I am both caretaker and being taken care of and one where I am uninhibited (i.e. I can be in pajamas). It is one with no injury or pain, in a world of complex human relationships, sometimes wrought with conflict.  They are a gift of comfort, stability, unconditional love, and joy I have often wished for my clients that experienced little to no relief or joy in their daily lives.

(Abby and my other feline Baby Yoda)

            The research shows that animals provide motivation for me the clinician, as much as for the clients to attend therapy. During my 5 years working for the Department of Mental Health (Medi-Cal/Medicaid), I experienced burn out which compounded with the paperwork, driving in traffic, working in unsanitary conditions, and confronted with client resistance and trauma cases.  The impact of burn out was so much that it took a physical toll resulting in often being sick and developing an autoimmune disease.  Abby’s presence has been shown to provide a buffer to the release of stress hormones which is directly correlated with immunity and health.  I project that my health will improve by her presence as evidenced by the research on reduced arousal of the nervous system, reduced heart rate, and blood pressure.  These same physiological benefits will impact my clients. In a future blog, I will expand on the 20 plus years of research in the area of health as  related to the HAB.

       Abby's presence will also assist by helping to melt away the barriers of client resistance.  I understand that individuals and families may be in the beginning stages of change.  They may seek help but not yet be ready to engage in action due to unconscious fear of change, previous experiences in psychotherapy, lack of motivation, or transference with the therapist.  To some degree, resistance triggers countertransference for the therapist. An animal present helps to reduce client anxiety and tension by creating a more welcoming and friendly environment.  This encourages the therapist’s motivation as well as the clients to engage in therapy.

            On a clinical level, Abby may also supplement my client’s treatment by creating a third point in the therapeutic triad with myself and client.  Within the triangle, I can witness the client play out thoughts, feelings, and behaviors with the animal which are access points into the client’s inner world.  By being present, as a witness, I am no longer the only medium for transference and projection by the client.  This will allow for a more clear and objective lens to understand my client. It also provides an opportunity for in vivo and experiential interventions to enact with the animal. Newly learned behaviors can then be applied to the client’s outside relationships. Abby’s presence may also lend to helpful anxiety-reducing triangulation during middle stages of treatment. When a client feels uncomfortable or challenged in session, they may indicate avoidance by directing attention to the animal.  These moments are opportunities to explore the client’s discomfort, stay sensitive to the client’s pace, and maintain the therapeutic alliance.

            Abby’s presence in therapy with me may also present unique challenges.  The therapeutic process may be inhibited if either I or my client is overly engaged with, or overly focused on the animal instead of the therapy. For instance, a child runs to the animal and avoids directives of their parents or the therapist by using the animal to ignore others. Triangulation can be helpful when intentionally used, but can also be misused and over-used. This is not helpful to the client in outside relationships where there is no animal present to rely on.

To some degree, the way I relate with my animal is revealing about my relational style which makes me more warm, 'human' and approachable. Abby, by her animal nature is wild, and I can anticipate that she will act on her own free will during sessions. She will ask for affection from myself or the client, use the litter box to defecate and urinate, need to feed and hydrate, or sleep and be active.  The sessions may play out in a more unpredictable manner with her present which can be exciting and stimulating, helping the client feel more free to express themselves. Or, it may be impeding if it interrupts the client’s thought process and expressive flow.

            My specialty is with adolescents and young adults with behavioral, emotional, and relational issues. I believe having an animal present will help this population while they are going through critical developmental stages and life adjustments (finishing high school, going to college, working, and launching). An animal in therapy can facilitate more engaging tactile and experiential interventions, which would be age appropriate and motivational.  Abby would bring the natural world to a formerly sterile and medical environment.  I anticipate my client population will develop a bond with Abby and may even miss her in between sessions. This will reduce client drop-out, increase consistent attendance, and improve overall treatment outcomes through these factors alone. 

          Secure attachment with Abby and myself in the therapy may be a catalyst for healing.  However, the client-animal bond may add another layer of grief and loss during discharge from treatment.  A client that is lacking a safe haven or secure attachment in their natural world may feel the impact of the loss more, since they had an alliance with not only myself but with Abby.  What I would do to reduce the impact of this loss is engage the client in a longer step-down process and more thorough and extensive aftercare planning.  I would make more effort to ensure a support system is in place for my client, and perhaps promote the adopting of an animal if that is something that the client is prepared for and considering.   

            It may happen that a client does not like animals, cats, or my cat, Abby.  The client’s attitude toward animals plays a large role in their perception of treatment, motivation to engage in treatment, and as some of the research shows, may have adverse effects on arousal and other physiological responses.  This would counter-indicate the goal of therapy and perceived benefits of Abby’s presence in treatment.  In some cases, it might be worth working with the client to adjust their perceptions on animals if it aligns with their treatment goals. Thorough assessment of the client’s history, experiences with animals and felines, as well as attitudes towards animals must be done prior to the introduction of my animal, both for the benefit of the client and the animal.  It is okay not to incorporate an animal if it is not in the best interest of the client and animal.

The feeling of therapeutic love with the inclusion of an animal may prohibit the appearance of other more uncomfortable feelings if the feelings of love take the forefront. For example, a client may have a belief that animals are more reliable and safe than humans, and positive feelings associated with Abby’s presence would override the display of emotions like anger or hate, that would otherwise be shown when alone with the therapist.

Feelings of therapeutic love may also lead to the client misinterpreting the purpose of therapy which includes dealing with their personal challenges at home, school, work, and in the community.  With youth and young adults, the display of feelings of love may be ever more present than with adults. It is best to provide and obtain a very thorough consent, both verbally and in writing. It should effectively communicate the purpose of treatment and the focus being on the client's needs, their goals, and importance of accessing both positive and negative emotions.  Furthermore, informed consent should define the ways in which the animal assists in the client’s healing and growth though interventions in the beginning, middle and end stages of therapy. 


            Lastly, working with youth may present unique challenges associated with maturity and development.  Children can be unpredictable in their behavior which can be a source of anxiety for Abby.  For the younger clients, there may be limited comprehension during the informed consent process and later rules and session guidelines will need to be drawn out to prevent any mistreatment or undue stress for Abby. Ethical treatment of both the client and the animal are paramount. Young adults are still maturing and their brains developing until 25 years old.  There is a still a risk factor for impulsivity among this population. 

         However, a client’s perceptions of animals, prior experiences with animals, personality, diagnosis, and attachment style are still overarching predictors of their handling and treatment of Abby. Impulsivity problems or lack of empathy are present among adults as they are with children, and may a risk for causing stress to my animal. Conversely, there are children with nurturing qualities and positive attitudes toward cats.

       There are a broad range of issues which can focal point of therapy, including promoting impulse control, empathy, and pro-social behaviors.  There is still an opportunity for the carefully supervised application of interventions with the animal.  Many number of factors must be assessed prior to the inclusion of my animal to ensure the benefits are mutual among the therapist, client and animal. Lots of preparation and detailed assessment will determine if Abby and the client are a good fit. 

           

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