Doggy Behavioural Therapy

31 January, 2019

Mellow Mushroom

SO, I go for months without writing, then two blog posts on the same day! I published them on separate days just to make it look like I had it timed or something :)

I mentioned in my last post that I began my internship. This is the practical experience part of counselor training. I have to put in so many hours under supervision before I can take a licensure exam and start practicing on my own. I won’t bore you with the details, they’re not relevant to being blind or having a. Service dog. I’ll just tell you that I am working with a nonprofit organization that places trained therapists in public schools to give free counseling services to students, staff, and faculty. I love my supervisor, co-therapists, and the work environment. I have become far more passionate about working with students than I anticipated, and I have had a truly wonderful, life-changing experience working with these lovely brothers and sisters in Christ.

The organization I work with places their interns in elementary, middle, and high school throughout the internship so we get to experience all three levels of counseling. I started out at an elementary school, then switched to a high school when my time at the elementary school was up. I should start at a middle school here in a few weeks.

When I switched to a high school, I started remembering what TSE trainers told us about service dogs and high school. They said that they don’t give Seeing Eye dogs to high schoolers because the high school environment is too stressful for the dogs. Now, in my infinite wisdom and understanding, I assumed that this meant that the combination of young people of incomplete maturity and the chaotic environment were the problem, not just the environment. But somewhere in the back of my mind I knew otherwise.

I started thinking about that a lot. I started waking up tired, I stopped sleeping Sunday nights before work almost entirely. My back seized up, I had headaches like I haven’t had in years. Then the problems began. Greta started barking at students.

We’d be in the halls between classes or at lunch time and, without any provocation I could identify, Greta would just haul off and yell at a student in Canine. The students hardly reacted. The staff all assumed the kids had done something to provoke her. Apparently high schoolers are hooligans until proven otherwise. But it strongly affected me. I woke up with a racing heart and couldn’t calm down until I got to school. Several times I almost called out sick.

This lasted for almost a full week before I figured out what to do. I’m a therapist, after all. I correctly diagnosed myself with acute anxiety. And I correctly diagnosed Greta with Adjustment Disorder. I called The Seeing Eye for support and a trainer got back to me within an hour of my message. Thank God for the continual, thorough, and timely support of the trainers and staff at The Seeing Eye!

When I told the trainer that I worked at a high school his first words were “oh God.”

Then he told me not to let the difficulty of the situation scare me off. Difficulty isn’t a barrier, just a challenge. He gave me some techniques to use to help manage Greta’s anxiety, a method which I am dubbing DBT — Doggy behavioural Therapy. This is not to be confused with DBT — Dialectical Behavioural Therapy, a popular treatment for Borderline Personality Disorder.

DBT

Every good therapeutic approach begins with a “theory of person,” an idea of what a person’s thoughts and feelings have to do with their experiences and development. My new therapeutic approach proposes that dogs have a reciprocal relationship between their emotions and behaviour. Emotions affect behaviour, behaviour affects emotions. They do not develop long-term memory, but rather sensory-associated emotional responses. For example, a dog does not remember “I get a treat when I sit on command.” What he does remember is “Something good happens when I sit on command.” He remembers the satisfaction of the treat, not the treat itself.

The next aspect of a good therapeutic approach is a theory of problem. What is a problem, how does it occur, and how is it maintained? A problem occurs for dogs when they are unable to adapt to a social structure or physical environment, or both. This causes them to have negative experiences which become linked with certain activities and places, creating the sensory-emotional memory described above. Problems are maintained by repeated reinforcement of negative sensory-emotional experiences.

The final piece of a good therapeutic approach is therapeutic technique. How do we solve problems? Well, if the problem is instability, create stability. If the problem is negative emotional-sensory experience, create positive sensory-emotional experience. Reverse the bad.

Greta wears her gentle leader at work to help calm her down and to reinforce that she is low-man on the totem pole. She is lower than the students and does not get to scold them, regardless of the shenanigans she catches them at. The gentle leader also releases endorphins to calm her down.

I am also using my clicker to reinforce positive sensory-emotional experience. Per the trainer’s directions, whenever we leave the office or bathroom to enter the hallways, whether there are students out there or not, I perform a “click — treat” routine with Great. I press the clicker and immediately give her a treat. I repeat these two or three times to build her focus on me and relax her with the treat rewards. I’m using little tiny “pupperony” bits and removing pieces of kibble from her dinner to account for the higher food value. No fat shepherds on my watch!

We haven’t had a single incident since I began this training, about a week ago. I’ll keep up the click-treat routine for about two or three weeks, maybe longer. I’ll probably keep the gentle leader on another month after that. This is, of course, pending my consult with my trainer again next week to see what he thinks.

In the meantime, I get to tell my students suffering from severe anxiety that they’re not the only ones having panic attacks in the crowded halls.

So how did I deal with my own anxiety? Did it just evaporate when I got the techniques for Greta? 

This isn’t so much a blindness or dog issue as it is a...well, human issue, but I thought I would share my experience anyway in case someone learns something helpful from it. I did make such a big deal about describing my symptoms up there, after all. Best not to leave the reader hanging. I do hate cliffhangers...

I have the privilege and problem of having a high level of internal awareness. I can monitor my own thoughts and identify themes and causal relationships and motivations very easily. This, unfortunately, means that I spend an awful lot of time in my head analyzing my own thoughts. It probably doesn’t sound like a bad thing, but when the analysis becomes obsessive or guilt-driven or fear-driven, that’s a problem. I’ve experienced all three of those drives and obsessional episodes before. Many times.

On the other hand, it gives me very high insight into causes of problems. It took me a month to identify the sleep disruption pattern, but it took me ten minutes to figure out what the greater whole was. I just didn’t want to admit it.

I buried the problem for months before I finally acknowledged it to myself. But service dog problems can feel extremely isolating. If your dog barks in public people will assume the dog is aggressive, right? All of a sudden everyone within earshot of your hefty-chested German shepherd’s lusty voice knows that you don’t’ control that beast and it could break loose at any moment! Service dogs aren’t safe for society and you’re going to get kicked out and give service dog handlers a bad reputation and have to give up your dog because she’s out of control and you’re not qualified to handle her and...

Whoa, slow down!

Yeah, that’s what I was trying to avoid thinking about. That’s what I buried, that I didn’t tell people. Greta’s stress began bleeding out into other areas of work outside the high school and I started concealing those events from my family because I was so ashamed and afraid. I didn’t want to answer the probing questions of “well, have you done this?” As they tried to help me solve the problem. Those questions always feel like accusations to me. “Why haven’t you done this yet? Have you thought of this? Why not? Are you being lazy or can you not solve a simple problem without someone pointing out the obvious?” That, of course, is a whole different issue.

So, I set to work worrying. Now that I couldn’t bury the problem, I began to try to solve it. I was trained to solve problems very thoroughly. Prepare for difficult conversations so your emotions are under control. Evaluate and assess resources, reach out for help. I came up with the plan to call TSE and to share my worries with those around me, as much as I could, to make sure that they saw the problem from my perspective as well as theirs. This was a good plan. It should have eased my worry, but it didn’t because I couldn’t STOP solving the problem.

I reworked and resolved and reviewed the problem over and over and over again. I couldn’t stop trying to fix things even though I already had a plan and just had to wait for it to work. This is when I found out that “worry” doesn’t simply mean “obsessing over what-if.” The definition is much broader than that. I worry by obsessively solving and resolving the same problem over and over again until it goes away. And for the first time the stakes were high enough that this worry triggered a physiological response. I couldn’t sleep or eat enough, and my heart raced and my back seized. 

It was the appearance of these classic anxiety symptoms that alerted me to the fact that my problem-solving had become pathological. When the symptoms arrived, I asked myself “if I were my own therapist and I saw these physical symptoms and knew about the stressors, what would my diagnosis be?” If not for that question I might never have realised how much of a worrier I truly am. Or was. I grew up hearing that worry was synonymous with unsolved problems and uncertainty, not emotionally charged recurring thoughts of the future. But once I knew it was worry, I knew how to treat it. I did go to grad school for something, right?

Obsessive problem-solving falls under the category of intrusive thoughts and rumination. Intrusive thoughts are unwanted thoughts and concerns that disrupt focus and functionality. Rumination occurs when the mind cannot be easily prompted to dismiss these thoughts, but returns to them repeatedly to the detriment of the person. Intrusive thoughts can take many forms; there is the classic “what if…?” along with obsessive problem-solving, negative self-talk, negative predictions about the future, and other disruptive and unpleasant material. Intrusive thoughts are one of the hallmarks of anxiety, however, and there are a variety of techniques available to disrupt and dismiss them.

The method I chose to use is a somewhat abstract mindfulness practice. Now, for those of you who have not studied mindfulness, don’t get hung up on the idea that mindfulness is abstract already. It’s only abstract in popular verbiage, but that topic is outside the scope of this post. What I did to resolve my intrusive thoughts and ruminations was to intentionally choose a set of thoughts to forcibly overwrite my current thinking. I set up a mental trigger, a channel switch, and a focus.

Ok, lots of pseudo-technical terms in there…

A trigger, in this case, is a familiar phrase or thought-pattern that lets me know when I have fallen into ruminating on my intrusive thoughts. In this case, my trigger was rehearsing conversations. If I caught myself planning and rehearsing conversations with school staff, my co-therapist, supervisor, or TSE trainers on this subject I knew I was ruminating. The next part is changing the channel in my brain. It works sort of like a basic logic equation. “If ruminating, then think this thought.” So, whenever I encountered the word or concept of rumination in my thoughts I immediately recited Ephesians 3:20.

That verse isn’t arbitrary. It came from a review of my trust fast from this summer. When I was searching for an internship and my husband was temporarily unemployed, I noticed that my concerns for the future had begun to impact how I treated people. I tried to exert control over my uncertain world by ensuring that no one around me irritated me by “not pulling their weight,” or some other justification. When I realised this, I took time to fast from comfort foods and a few leisure activities that I had used as escapes from my worries. I devoted the time and effort normally used in pursuing these comforts to studying God’s characteristic of trustworthiness. God provided me with an internship more suitable and beneficial than I could have imagined, and provided my husband with an amazing job. And one of the verses that God used to give me peace while waiting for these results was Ephesians 3:20. “Now all glory to God, who is able through His mighty power at work within us to accomplish infinitely more than we could ever ask or imagine.” God’s solutions do not necessarily, or even often, resemble what we think the ideal solutions ought to be, but they always surpass our anticipated best outcomes, whether we understand this initially or not.

So, “when ruminating, recite Ephesians 3:20.” I did this out loud as often as I could, but thought it out in full when I couldn’t. Then I picked a new focus, such as reading a book, doing a chore around the house, or talking to someone. I engaged my body and brain in the act of moving away from rumination.

Sometimes I had to repeat Ephesians 3:20 several times in the space of ten minutes. It was a grueling process, and I know that my brief bout with clinical-level anxiety was fairly mild and short-lived in terms of the potential severity of the condition. But I won’t minimize how hard it was at first, either. It took a lot of willpower. I had to surrender my very productive-feeling, responsible-feeling, important-feeling worrying and acknowledge that the problem was not under my control — and that was a good thing. I had to stop trying to envision the solution to the problem to make myself ready to receive however He wanted to solve it. But whenever I repeated my verse, I would be reminded of how His accomplishments are always more than I ask and imagine.

If you’re suffering from an anxiety disorder, or simply find yourself worrying throughout the day, be it on uncertainty or plans not yet enacted, first let me encourage you to seek counseling. There is nothing like having someone totally dedicated to helping you when you’ve got a heavy load on your shoulders. Find someone to share the burden. If you’re not ready for counseling, seek a mentor, or someone you deeply trust and who will actively support you through contact and accountability.

Then find yourself a verbal “remote” so you can change the channel. Pick a word or phrase that disrupts the rumination and pair it with a physical action, or two or three actions since you can’t always do the dishes when you’re worrying — you might be in a car, et cetera. Share your plan with your counselor, mentor, or accountability partner so they can help you remember to use it and help you monitor its effectiveness.

And if your counselor suggests medication, take the idea seriously. Medication isn’t right for everyone; it is a change to your body chemistry that could be temporary or permanent, depending on the nature of your anxiety. But, as I tell my clients, there is no reason you should have to fight your mind and your body at the same time. If they’re ganging up on you, medication might keep one opponent at bay until you claim victory over that first opponent. Then you can take on the second one, when you’re ready, when you have the resources to do so.

I did not use medication during my one-week bout with anxiety but I considered it an option if the physical symptoms did not recede within a reasonable amount of time. Fortunately, my DBT and Cognitive Spiritual Behavioural Therapy worked and I didn’t have to revisit that consideration. Greta is doing well at school and I sleep like a rock every night and my mind is filled with stories and therapeutic techniques and plans for my trip out west in a month or so and my to-do list and the last novel I read and the next one I want to read and how to bless my family members that day and whether or not that black furry object on the back of the couch is a cat or my missing scarf. This is a success story, but it started out as a panic-inducing feeling of failure. I hope you found something useful in all of this, even if it’s the knowledge that your own experience is normal and understandable by others. You’ll never know that if you don’t share what your experience is, though. I’m sharing this so others might see some reflection of themselves in this, but I only had the courage to do this because, when I shared my anxiety with my family and coworkers and the TSE trainer, they nodded, mm hm’d, and said ‘yeah, I’ve been there” or “I get that, I soooo get that.”

“If we knew each other’s secrets, what comfort we should find.” – John Churton Collins.