Vets with PTSD train dogs to help comrades
Monday, November 8, 2010; 1:51 PM
Rick Yount and his golden retriever puppy, Gabe, had separation issues every morning. "The dog kept looking at me at the door with those sad eyes, and finally it was just impossible to resist," Yount recalled. So one morning, "I decided to take him with me."
Yount was then working as a social worker, and on that particular morning he had to take a young boy from his mother's house and drive him to new foster parents. The boy cried and cried. But halfway through the trip, the car suddenly grew quiet. "I looked in the back seat," said Yount, "and the puppy's head was lying on the boy's lap."
That demonstration of canine comforting in 1995 sparked the idea for a program that is getting underway at a Veterans Affairs hospital in California and at Walter Reed Army Medical Center. It's called Paws for Purple Hearts, and it is helping injured veterans and active-duty troops in two very different ways.
The program trains Labradors and golden retrievers - including many offspring of Yount's dog Gabe - as lifelong service dogs and companions for veterans who use wheelchairs. But for their first two years of life, these dogs spread their love around in another way. They are trained by veterans suffering from post-traumatic stress disorder. For many of these psychologically damaged warriors, this human-canine connection provides them with emotional sustenance, a mission and important lessons in patience that help them get on with their lives.
"It was challenging, and it tested my patience, but it taught me to have patience again, and that was something I had really lost because of PTSD," said former Army reconnaisance officer Amanda Heidenreiter, 26, of Columbia, of her experience training Owen, a golden retriever. She had returned from Iraq terrified of crowds and children, and "Owen helped me relax, calm my anger."
Therapy and more
Service dogs have been provided to disabled veterans in the United States since World War I, and programs that train "therapy dogs" for people with psychiatric disorders have grown steadily in recent decades. The Paws for Purple Hearts program, which began two years ago, has drawn the interest of a cluster of scientists who think that the human-dog relationship may have measurable clinical impact on the health and well-being of patients, including veterans with PTSD.
Sue Carter, a psychiatrist at the University of Illinois, says her interest in the human-animal bond developed out of her research on oxytocin, a mood-influencing peptide that flows through the bloodstreams of mothers and newborns after birth, aiding in breast-feeding and mother-child bonding. Carter and others believe it probably plays a role in human-pet interactions as well.
Other scientists, such as Jozsef Topal at Loran Eotvos University in Hungary, are studying dog behavior to understand how human brains work, particularly when it comes to social intelligence.
Through thousands of years of dog domestication, humans have created animals that are particularly attuned to human emotions and cues, Topal has written. Although human DNA is closer to that of chimpanzees, dogs are closer to us in their ability to fathom the intentions of others, especially humans. In other words, through our breeding of dogs, humans have selected for dog genes that might provide insights into the genetic components of our own behavior.
For this reason, according to Topal, dogs could be useful for studying disorders such as autism and schizophrenia. Dogs such as Gabe, which seem to have a genetic disposition to extreme empathy, might provide information to help us understand people better. If we could discover the molecular basis for Gabe's behavior, it might point to factors in our own genetic background that enhance characteristics such as empathy.
Genomes aside, "you don't have to be a brain scientist to know that these dogs help vets," said William Smith, 55, a wheelchair-using veteran who lives in Modesto, Calif. His dog Venuto is Gabe's grandson. "It's so obvious, it's simple."
A change of attitude
Smith, who was injured while on active duty in 1983, credits Venuto with helping him sleep better without the help of two drugs, and with becoming more laid-back. "When you get out of the service, you treat your family and your friends like it was in the military: You're rigid, and everything is 'boom, boom, boom.' It's not a good way to be. [Venuto] has helped me develop more of an attitude of "que sera, sera."
Retired Staff Sgt. Christopher Hill, a 20-year Marine veteran, returned from Iraq in 2004 an angry, hurting man. A rocket attack had slammed him into a concrete barrier and killed three of his comrades, including one who was on the phone with his father when the round hit. One minute he was discussing plans for his arrival home, the next minute his body lay in pieces.
Six men with whom Hill served have committed suicide since coming home, an emotional catastrophe that Hill attributes to the veterans' inability to reengage with a society that doesn't share their experiences of violence, loss, terror and numbness.
"You're there so long, then you get on a plane and come home, and you don't care about yourself or anyone," says Hill, who is 42. "You're introduced to people, shaking hands, welcoming you home. You don't care. You're deep within your own stuff. It's like camouflage."
By the time Hill was admitted to the VA hospital in Menlo Park, Calif., for treatment of spinal cord and brain injuries and PTSD in 2009, he was going 72 hours without sleep, followed by 24-hour crashes.
At the first group therapy session Hill attended at the hospital, he saw that "most of the guys were staring straight ahead. But the ones with the dogs looked peppy. I said, 'I gotta get one of them.' "
Only a few months earlier, Yount, who has not served in the military, had started bringing dogs to the hospital to have inpatient vets train them for comrades who relied on wheelchairs. Paws for Purple Hearts was just beginning, and Hill was one of the first to get a dog.
"It was hard at first to learn how to talk to him, but he has revamped my lifestyle," said Hill as he stroked Verde while walking around the grounds of the hospital during a recent visit.
Hill, who was a music producer before joining the Marines, is a quick-talking, funny man, but he says the violence and stress had clammed him up. "All the drugs . . . made me into a zombie. But now, I have to be up at 7 to feed him. Verde doesn't want anything from me except to be there with him. He's just like the guy in the foxhole. So for that, I'm willing to talk and act like [bouncy TV aerobics instructor] Richard Simmons."
After training Verde, Hill said an emotional goodbye when the dog was sent to a wheelchair-using vet. But Verde proved too skittish to be a guide dog, and a year later he was reunited with Hill for good.
Now that Paws for Purple Hearts has been underway for a while, Yount says he can clearly see how training dogs helps vets open up to communicating with their peers and therapists. The dogs just have a way of getting through to people who shun human touch. "If you went up to someone and offered your hand and they rejected you, would you do it again? No," he said. "But these retrievers are bred to be as engaging as possible. They are the perfect beings for this kind of job."
The mission continues
The vets who train the dogs spend several months with them, sometimes longer, and letting go can be difficult. Yount said that some experience sleep problems after their dogs go, but "processing that sense of loss in saying goodbye to their dog has been a valuable gateway to processing other loss issues that have been hampering their recovery. "
And it's terribly important for veterans to feel they are continuing a mission that held them together through the violence and stress of war. "PTSD carries a stigma, that you're broken and wounded," said Yount, "And many guys have guilt for not still being in the fight. The idea of Paws for Purple Hearts is you can be part of the war effort while you're getting treatment."
Officials at Walter Reed did not allow me to visit the installation or speak with active-duty soldiers in the Paws program there, but at the Menlo Park hospital, I watched Yount - a hulking, crew-cut western Pennsylvanian transplanted to California - show a veteran how to control his chocolate Labrador with gentle commands and rewards of doggie treats.
This is where the dual benefits of the program are apparent. The vets are working on behalf of a wheelchair-using vet, but are learning - or relearning - the emotional skills needed to manage a dog that will help them function in a world of normal human feelings and interactions.
"The training of a dog requires you to emote," Yount says. "That's hard for a guy with PTSD who's emotionally numb. But if you tell them it's necessary to train this dog to help a fellow vet, there's motivation. First, they have to sound happy. It's fake. But there's a concept that says, 'Fake it until you make it.' Within a few days, it sounds more and more sincere. Pretending to sound happy actually impacts your feeling of happiness."
Heidenreiter, the former reconnaisance officer, said training a golden retriever named Owen forced her to go into malls, restaurants and stores so that the dog would be a good companion for a physically disabled veteran. Doing so terrified her at first, but eventually she learned to relax.
'A natural remedy'
As many as a dozen service members may be involved in training dogs as they move through their own rehab. So far nearly 200 vets and active-duty service members have participated. Only three Paws for Purple Hearts dogs have been placed with disabled vets. But Yount says more are in the pipeline, and even the "failures" provide important companionship to vets such as Hill.
Yount is hoping to expand the program, which is run out of the Bergen University of Canine Studies of Santa Rosa, Calif., but it has faced some obstacles. Thus far it has operated with charitable donations, including a major one from Finmeccanica North America, a defense contractor.
Federal money has been held up by bureaucratic problems as well as the Catch-22 of evidence-based medicine: There are few data yet to show that Yount's program has positive effects; but to get the data, you need to expand the program.
Still, the effort seems to be gaining momentum. Legislation that would create a $7 million, five-year pilot program at up to five Veterans Affairs facilities is currently before the Senate. In October, Paws was cleared to set up shop at the new National Intrepid Center of Excellence, a research, diagnosis and treatment center in Bethesda for service members and vets with traumatic brain injuries and psychological problems.
Carter, the University of Illinois psychiatrist, says dog therapy for wounded warriors makes sense. "The pet is an evolved, natural remedy," she said. "The dog became an extra pair of ears and legs to protect us. The boy warrior with his spear may have had a dog with him for an awful long time in history. Thousands, tens of thousands of years."
Allen is a freelance science writer in Washington and author of "Vaccine: The Controversial Story of Medicine's Greatest Lifesaver."