October 2, 2017 
They have come seeking help in an unfamiliar place. Six young men and women who, at least on the surface, reflect a picture of courage and strength. But like so many of our country’s veterans, they are suffering inside. Tortured by an invisible force that lingers in the crevices of their souls where conventional psychiatry often cannot reach. So instead of ‘talking it through’ in a generic office somewhere, they are here, at the equestrian center, seeking counsel in the company of horses.
It’s a statistic you have undoubtedly heard before and one that is impossible to shake: 20 veterans commit suicide each day in the United States. Further, it is estimated that 20% of all veterans of the wars in Iraq and Afghanistan suffer from Post Traumatic Stress Disorder, PTSD. Treatment programs are springing up all across the country to combat this crisis and help our veterans heal their physical and psychological war wounds; to deal with the past and manage the present. These programs have undoubtedly saved a number of lives, yet the statistic endures, and so too does the hope for a better solution.
One emerging alternative treatment for PTSD is Equine Assisted Therapy (EAT). The healing power of horses is no secret to anyone who has spent time around them, and we’ve all read about or watched various success stories, from children with autism, to adults with MS. But equine therapy is still a relatively new option for PTSD, void of basic clinical guidelines and assessment protocols.
The aptly named Man O ‘War Project is working to change that. The brainchild of noted businessman, horseman and US Army veteran Earle Mack, the purpose of the Man O’ War project is to study the effectiveness of Equine Assisted Therapy for treating PTSD. A longtime advocate for racehorse aftercare, Mack saw an opportunity to help veterans rediscover their purpose in life while creating a new one for potentially ‘unwanted’ horses. Led by researchers from Columbia University, the project is aiming to establish a set of guidelines for the broad application of EAT-PTSD.
For Dr. Yuval Neria, no stone should be left unturned when it comes to addressing the veteran crisis. The Director of the Trauma and PTSD Program at Columbia University Medical Center and Co-Director of the Man O’ War Project, Neria believes standard treatments are limited in their effectiveness, and thus, the imperative to look for innovation in unconventional avenues. Like horses.
“There is really something special about horses that distinguish them from other animals,” said Neria. “The main reason why horses are relevant to [PTSD therapy] is that PTSD is primarily a fear disorder. People with PTSD are distressed and anxious. They tend to be remote as far as possible from things they feel can endanger them. As prey animals, horses are very sensitive to stress and threats. So we have two players that are kind of similarly disturbed and concerned about the same things.”
While the study’s sessions are rooted in human and horse interaction, you will not see riding tack. Instead, the sessions focus on ground basics like grooming and leading horses around the ring, a concerted effort to build mindfulness of subtle behavioral cues.
“Our program isn’t a riding program,” explained Dr. Prudence Fisher, Associate Professor of Clinical Psychiatric Social Work at Columbia and the project’s Co-Director. “There’s a difference in riding and being level and doing groundwork with them. It’s a totally different experience that gives both parties an even role.”
The majority of the patients have limited to no equine experience, which can be a barrier in itself, but as Fisher explains, this unfamiliarity is also a catalyst for breakthrough.
“Veterans with PTSD are hyper-vigilant,” said Fisher. “Some feel uncomfortable walking into the ring with these large animals. But the idea that by the end they can lead the horse around, pick their feet, and even guide them at liberty simply by their interaction is really amazing. At the end of treatment they’ll often say something like ‘This horse seemed so big at first, but now they seem so small to me.'”
Someone who is no stranger to horses is Man O’ War Project President Anne Poulson, a long-renowned thoroughbred breeder, owner and advocate.
“From a horseman’s perspective, it’s really interesting to see how the veterans react to the size of the horse,” Poulson explained. “But when they do something like get to a spot where they can finally pick up a horse’s hoof, there’s sort of an ownership; all of a sudden there’s this wonderful connection that they got so far to get this close to this creature, and they can then transfer that to other aspects of their lives, at home and at work. That task is really empowering.”
The study is being conducted at the Bergen Equestrian Center in Leonia, NJ. All participating veterans have been clinically diagnosed with PTSD. The majority come from area VA centers, ranging in age from 30-68 (37% are women). After some initial test runs and tweaks, organizers settled on a format for the study:
- Groups of 3-6 veterans and 2-3 horses per session.
- Veterans attend eight 90 minute sessions per week.
- The veterans are guided through a series of non-riding exercises.
- A team of mental health professionals and equine specialists lead the sessions, and experienced “wranglers” are on hand to ensure safety.
The study is expected to be completed by July of 2018, and while the results will not be published until then, Dr. Neria said the impact is evident and quite promising thus far.
“When humans develop PTSD, through war or other truama, the capacity for basic emotions like love and trust is negatively altered towards a new baseline that is primarily of fear, anger and distrust,” Neria explained. “In order to reset the original baseline, they need to go through a process. Horses, by being prey animals who can mirror this elevation of stress and fear but can also bond nicely with humans when they feel relaxed and safe, provide the patient an option to reboot more to the original baseline. This is very important in reduction of stress hormones and the ability to love and feel happy again. And that’s what we see in the treatment. After an hour or so in the pen they are laughing, joking and hugging each other. Really, a complete change compared to how they entered the pen initially.”
Drs. Yuval Neria (left) and Prudence Fisher.
If the results of the study are deemed a success, Poulson said they will work with Veteran Affairs, the National Institutes of Health and the Department of Defense, among others, to have the program implemented nationwide.
“There’s not a lot of research on equine therapy,” said Poulson. “Yeah, we know horses make people feel good, but everyone has their own system. You have to come up with a standard. We had to identify ‘what is this therapy going to look like?’ So we came up with a therapy that looks reasonable, that was laid out like other [psychotherapy treatments].”
“With horses, you have to find that level of trust,” she continued. “Learning how to get there is what helps these veterans learn and assimilate that into a more normal daily life. Most of them create such a bond that when they leave we’ll give them a picture of the horse, or a horseshoe, and they can use that when they get anxious.”
For centuries, horses played a vital role in human combat. Although long rendered obsolete in modern militaries, horses remain relevant to the soldiers of today. As any horse person can attest, the connection between humans and horses is profound and powerful, and as we are learning more and more, potentially life-saving.
To learn more, visit www.mowproject.org.
