Service Dogs for PTSD Veterans

Army veteran Galmiche, who served his country for 20 years, was diagnosed with post-traumatic stress disorder in 2002. He says he worked with a counselor and took medication for years, but did not find relief from his symptoms until he was matched with a PTSD service dog.

The first time I met a patient with a service dog was when I was doing social security examinations, as a psychiatrist.  The woman was about 60 years old, motherly and white-haired, and she told me that she was nervous about the interview and was being treated for an anxiety disorder.  She did not think she could “make it” unless I saw her with her “service dog.”  Many years before, when my allergy to dog-hair was in flower, I would have declined.  I had since treated it effectively with alternative methods, so I told her we could try it. It was a tiny dog, the kind my husband would call a “barfy” dog.  The dog had the cutest little blue coat with very official looking embroidery — including the wheelchair picture that is usually used to mark places that are reserved for such vehicles.  The little dog wouldn’t stop staring at me. I did a customary and very basic psychiatric interview.  I started with questions that involved little or no stress, like name and diagnosis.  Eventually, I ramped up to questions about the topics that generated anxiety, such as past traumas.  The pooch stood on its hind legs while she rubbed it vigorously, staring at me.  I stared back.

The woman explained to me this pooch had helped her get off Xanax, a highly addictive short half-life benzodiazepine.  I remember distinctly that evening when I came home and told my husband that I was stressed, so he needed to stand still and let me rub him a lot.  He did not object; even told me it was good for him, too. I am not a total stranger to the nature and importance of the human-animal relationship.  When I first accepted a position as an academic psychiatrist, I distinctly remember having located a publication from that institution on the human-bovine relationship.  When I left the university in favor of private practice, the single intervention that did the most to fill my practice was an article I wrote about grieving for the loss of a pet.  Besides this, I have heard a lot from patients about how important their pets are to them. I once had an aquarium full of fish, which I dearly enjoyed.  There was never the emotional depth of the dog and cat relationships my patients describe.  All those patients were convinced they could read emotions from these entities, dogs especially.  Providing food and play were the dominant interactions. Since dogs are nonverbal even on the best of days, we are talking about barking and tail wagging.

In general, patients seemed to “over-interpret” simple movements or vocalizations, ascribing to the dogs a level of understanding of the human condition.  Things the dogs had ever been capable of feeling and most certainly incapable of expressing.  It did not take a lot of psychiatry knowledge to figure out we were looking at “transference.”  In other words, a patient can see in a dog whatever love and acceptance they need, even if they are not articulate enough, social enough, or resourceful enough to build such a relationship with a human.

The single most serious looking website I could find about “service” or “assistance” dogs was the one from Assistance Dogs International, Inc.  Helping the handicapped I can see really clearly.  Psychiatry and associated disabilities are a slightly different matter – and harder to define. First, let me assure you that being classified as a not for profit organization does not mean that nobody makes any money, and may mean quite the opposite.  And although absolutely everyone in this field seems to be classified this way, we shall put this aside.  A more significant problem, at least to my way of thinking, is how much the service helps, how you measure that it helps, and research behind such services.

One such organization is the Psychiatric Service Dog Society.  Their discussion about veterans and PTSD discusses “models,” not “tests”. The problem here is that anybody who has a dog will say it “understands” them, like the veteran interviewed for the article above.  It understands him better than his counselors, he says.  He tells this from looking into the animal’s eyes.

ABC News covered the story and includes the above subjective findings from the veteran Galmiche, but also tells the challenges of the study.  Problems like its suspension when a young girl was bitten by a dog and the fact that nobody pretends this is a “cure.” Subjective and satisfying?  Yes.  Science or psychotherapy?  No.  It’s simply a transference relationship. I can barely tolerate the plethora of stories of cutesy pets saving human lives on local news.  Somebody somewhere has decided these stories appeal to a demographic that not only wants to see news stories about this, but will also keep watching accompanying commercials or the like.  A “transference” relationship for all of America.  I have to wonder, are we all inarticulate in human relationships, getting more satisfaction from pets? Look, I have no problems with the VA cutting funding for service dogs because there is not enough research.  This is an all-too-rare decision for science as having value greater than superficial, non-human emotionality.

People associated with the “serious” website for assistance and service dogs have a series of criteria.  Where there are criteria, there are possibilities for statistics and testing.  The proof here should not be subjective human-pet love, nor should it be the ability to take a pet in public places, with a real or imagined entitlement. Give dogs to vets who want them.  There are actually things in life that are good and helpful, especially relationship things, which are not science at all.  I do better when my husband is close to me than I do if we have to be separated, even for a few hours.  I do not need a double blind placebo controlled study for this one.  I need my husband because I am crazy in love with him.

I certainly do not expect a wildly in-debt government to pay me to be close to my husband.  Humanity and true love can go places science cannot dream of.  I wrote “How to Locate and Marry your Lifetime Love” based on how I found my husband.  For over 21 years I have joyously referred to this process as the best piece of science I ever wrote. We can probably do a lot of good by emptying our dog pounds into the homes of our veterans who would like the companionship of an animal.  But there are other ways to use science, such as observational studies of human behavior, to make people happy. I doubt anybody has the guts to do or to fund the study we really need.  Do veterans do significantly better with a trained PTSD dog than they do with a loveable mutt from the pound?