Psychiatric Service Dogs for PTSD
Dogs: Man’s best friend. These furry critters have been finding us food, protecting us, and chewing our moccasins for at least 15,000 years. Some breeds of dogs are born with a nearly insatiable craving for human affection and approval. Many people cannot imagine life without their dog. Our relationship with these mammals is primal, enduring, and downright touching at times. Research is proving what people have known for a long time: Dogs can be very good for our mental health. For those experiencing Post Traumatic Stress Disorder, dogs have proven to be not just friends, but effective emotional healers.
Understanding Post Traumatic Stress Disorder
To understand the impact a service animal has on a disorder, we first must understand the disorder itself. Posttraumatic stress disorder (PTSD) is an anxiety disorder that is only able to be formally diagnosed by a medical professional. According to NAMI Studies, PTSD affects 3.6% of the U.S. adult population, which is about 9 million individuals. About 37% of those diagnosed with PTSD are classified as having severe symptoms.1
PTSD can develop after a traumatic event is witnessed or experienced. This traumatic event commonly involves actual or threatened death, serious injury, or threat to a person’s physical integrity.2 Traumatic events can take many forms: from active combat or a sexual assault to a car accident. PTSD is not only triggered by dangerous events, it can also be caused by other types of life experiences such as the sudden, unexpected death of a loved one. The event or the felt experience causes the individual to have intense fear, an overwhelming sense of helplessness, or stark horror. 3
Symptoms of PTSD usually show up within 3 months of the traumatic incident, but sometimes they begin years afterwards. For PTSD to be diagnosable by a medical professional, symptoms must last more than a month and be severe enough to interfere in important aspects of life, such as work or relationships.3
Symptoms of Post Traumatic Stress Disorder are generally categorized into 4 parts: intrusive reexperiencing of trauma, avoidance, negative changes in mood/thoughts, and reactivity. Fortunately, service dogs can be trained in tasks to alleviate some of these symptoms.2
Psychiatric Service Dog Tasks for PTSD
1. Touch owner with nose or paw when sensing heightened anxiety.
2. Turn lights on/off.
3. Wake owner from nightmare.
4. Check house for intruders.
5. Take owner to predetermined destination or exit.
6. Hug on cue.
7. Provide body pressure to calm owner.
8. Provide companionship to decrease isolation.
Specific Service Dog Assistance for PTSD Symptoms
#1: Intrusive Re-experiencing of the Trauma Event:
One of the capstones of post-traumatic stress disorder is the mind’s difficulty in moving past the traumatic event. Re-experiencing events can lead individuals to not only remember the details of the trauma, but also feel as though they are actively going through it in the present moment. This can be very disruptive to everyday routines. Enter service dogs which have the presence and skills to help push back against some of these troubling symptoms.
Intrusive Flash Backs: Certain physical or emotional triggers such a smell, location, or person can trigger an intrusive flashback. During a flashback the individual is transported emotionally and mentally in time to the moment when the trauma occurred. This is problematic both in the emotional distress it causes and the loss of awareness of current surroundings. This in itself can be a safety hazard.
Service Dog Response: Service dogs are trained to be vigilant and aware of their owners’ emotional state. These pups can be taught to recognize signs that their owner is moving into an anxiety or intrusive flashback mindset and use their nose or paw to assist their human in coming back to the present moment. The physical sensation of a paw or wet nose can have a profound effect on reengaging in the current safer reality. 4
Nightmares: Sleep is another time PTSD’ sufferers may be forced to experience their trauma in their dreams. When individuals re-experience traumatic events during sleep, these nightmares can be accompanied by real physical reactions, such as a pounding heart and sweating. Nightmares can occur at random or like flashbacks can be triggered by sights, sounds, or smells that remind the person of the trauma.5 Sleep is one of our most basic physical needs. Having the bedroom be transformed into a place of recurring horrors instead of a place of peace and rest has distressing long term negative effects.
Service Dog Response: Service dogs can be trained to notice when their master is experiencing a nightmare and intervene. Some have even been trained to turn on the lights to rouse their distressed master. These furry friends can excel at interrupting at the right time in the right way. Whether it is interrupting a nightmare, anxiety attack, or an intrusive flashback, these dogs get the job done. 4
With all the distress we just explored about reexperiencing trauma, it is understandable for individuals with PTSD to avoid trauma reminders. This often looks like an individual staying away from certain places or objects that are reminders of the traumatic event. 3
Unavoidable Trauma Reminders: Although it is natural for a trauma survivor to avoid reminders of the incident, it is not always possible. In some cases, the trauma occurred in everyday surroundings, and therefore trauma reminders are things that are all around us. Someone who experienced a violent home invasion, for example, can hardly avoid living in a home. That person needs strategies to make the home feel less threatening.
Service Dog Response: In the example of a person who experienced a home invasion, the service dog can be trained to check the house for intruders at regular intervals and reassure his/her owner of safety. Dog’s keen sense of hearing, smell, sight and intuition has served humans in the home protection business for millennia. When a person realizes these abilities and puts his or her trust in that trustworthy friend, the home can regain its sense of security.
Service animal tasks for trauma reminders may be somewhat unique to each situation. Talk to your service dog trainer to identify the tasks your service dog can do for your particular trauma reminders.
#3: Negative Changes in Mood and Thoughts:
Post-traumatic stress disorder not only affects the ways we act, but also the ways we feel and think. A person with PTSD may experience guilt, worry, isolation, or depression. Thought and cognitive changes can also affect an individual’s sense of place and time and create an out of body effect referred to as derealization.3 These symptoms can impact not only the way we see the outside world, but also how we view ourselves. This is a place where service and emotional support animals can make a difference.
Derealization: Having the sensation that the outer world feels unreal or fabricated is not only distressing but can also pose potential dangers. If someone is in a state where they are feeling disconnected from reality, the person may be less aware of threats in the environment, such as a busy street.
Service Dog Response: If the individual is experiencing a derealization, service dogs can be trained to take their master to the exit or other predetermined location if needed.4
Emotional Changes: Surviving a traumatic event can take its toll emotionally. PTSD’ sufferers can report increased anxiety and depression. It is also not uncommon for individuals struggling with PTSD to self-isolate, which often worsens emotional issues.1
Service Dog Response: Service dogs and emotional support dogs make for trusty and reliable companions. Having one can assist in decreasing one’s sense of isolation. Service dogs can also be taught to hug on cue and use their weight as pressure for anxiety.
Hyperarousal: A common symptom that arises from traumatic experiences is hyperarousal, which causes heightened physical and emotional reactivity. Being reactive is the body’s way of remaining prepared for a threat. When an individual has experienced trauma, it may be difficult to perceive safety in any situation. Heightened reactivity can interfere with an individual’s ability to make sound judgements about what is threatening versus neutral input, such as a loud noise and sudden movement.
Service Dog Response: One reason many service animals are dogs is because canines have the propensity for remaining calm. Individuals who may be having difficulty assessing the safety of a situation due to increased reactivity can look to their service dog for cues. Additionally, the very presence of a canine increases oxytocin and dopamine, and decreases cortisol, the stress hormone.
Although Posttraumatic Stress Disorder cannot be cured in the traditional sense, it can be effectively treated and managed. The National Alliance on Mental Illness states that effective treatment often involves psychotherapy, medication, self-management strategies, and service animals, particularly dogs.1
Whether you or a loved one is grappling with PTSD, there is hope for a normal life. You can make it with the right assistance. Professional help for PTSD is available through licensed counselors. Many places have community mental health centers. Having practiced at such a center myself, I can assure you that the professionals there are almost always competent, dedicated and compassionate. And if you meet a dog in the hall, don’t be surprised if he’s on staff.
Obviously, one must consider the costs, time, and space required to own a dog. Owning a pet is a serious commitment. But also consider the benefits: A dog might play a crucial role in PTSD recovery, either as a pet or an actual service dog. Dogs can truly be the ideal friend and helper in the healing process: Non-judgmental, always glad to see us, intuitive of our moods, and totally unaffected by our bad breath, bad hair, or bad credit. A furry companion with a wagging tail and silly accepting grin might make all the difference in reclaiming one’s life from PTSD.
- NAMI. (n.d.). https://www.nami.org/Learn-More/Mental-Health-Conditions/Posttraumatic-Stress-Disorder/Overview
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC:
- Post-traumatic Stress Disorder https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml
- Selecting Tasks For Ptsd Service Dogs: Veronica M.Ed- Cabc – https://cooperativepaws.com/selecting-tasks-for-ptsd-service-dogs/
- PTSD & Sleep: Nightmares & Treatment https://www.sleepfoundation.org/articles/ptsd-and-sleep
Amy Book, LMHC has been practicing mental health counseling for over a decade. Her clinical specialties include trauma informed modalities, cognitive behavioral therapy (CBT), and body/mind integration. Amy has experience in counseling adults who have a history of anxiety, depression, trauma, ADHD, bipolar, and substance abuse/addiction. Amy lives and works in Boston with her loving cat, Bradly.
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Apr 11, 2020