Could Equine Assisted Therapy Benefit Those With Personality Disorders

Introduction

Since I started researching and promoting the use of horses in therapeutic treatment for both physical and mental health, I’ve heard so much about how it could benefit conditions such as PTSD, depression, and learning difficulties. Unfortunately, these disorders are common.

I’d like to clarify the confusion that seems to be commonly held between PTSD and personality disorders.

PTSD or post traumatic stress disorder is classed as an anxiety disorder triggered by very stressful, frightening events. A personality disorder is classed as a way of thinking, feeling, or relating to others that is different from the average person. They are two completely different conditions and should never be confused with one another.

Not one study or article I’ve read has mentioned Personality Disorders. I find this interesting, and also I’m wondering why. As a sufferer of two personality disorders—borderline and avoidant, I'd like to know if equine assisted therapy could have a positive result.

I am aware there are similarities between Autism and Borderline Personality Disorder, which I plan to research further. I will discuss this at a later date.

Breaking The Barriers of Disability

The Specific Traits of Personality Disorders

What I wanted to learn is whether there were specific traits that were common or typical to all personality disorders that could benefit from equine assisted therapy.

The DSM-5 (APA, 2013) reports that the key traits of personality disorders are:

1. Rigid, extreme, and distorted thinking patterns (thoughts)
2. Problematic emotional response patterns (feelings)
3. Impulse control problems (behaviour)
4. Significant interpersonal problems (behaviour)

There are plenty of good studies indicating equine assisted therapy can be an effective treatment for anxiety-based disorders such as PTSD. Could there be some benefit to those who suffer from personality disorders, too?

Let’s break it down.

Rigid, extreme, and distorted thinking patterns (thoughts)

Rigid implies it cannot be changed. I can totally relate to that. Many of my thoughts seem to be set in stone, and no amount of treatment, whether it be CBT or DBT can change that. It’s not a refusal to try treatment, but a belief that this thought process is unlikely to shift.

Personality disorders are often triggered in childhood, and as with all or most childhood experiences, the thought processes are ingrained early on. They are compounded further by family relationships and other childhood experiences. If the way you behave or react is not corrected, explored, or explained sufficiently this reaction of yours becomes the norm.

One of the distorted thinking patterns often seen in personality disorders is described as ‘black and white’ thinking. This means everything is all or nothing. Take me, for example. Horses are a passion of mine. I do not feel I can live without them. If horses could be not be in my life, I would feel my only other option would be suicide. I couldn’t think or imagine my life without them. This would be identified as an ‘extreme’ thought pattern.

Also, I could not be content with one horse riding lesson every fortnight. If I couldn’t have at least one lesson a week (which I would feel would be sufficient for a healthy mental outlook), it wouldn’t be worth it. My mental health would suffer and it wouldn’t be something I could just ‘get over’.

There are, of course, other examples of distorted thinking that can be found on the MentalHelp.net website.

The question to be asked is: Could distorted thinking be improved by the use of equine assisted therapy?

Deanie Humphrys-Dunne, an award winning children’s author, believes that, ‘If it opens the mind to a new way of thinking, why couldn’t it help?’

also

Nikki from horsesensetv.com says, ‘Horses are super reactive and can be fine with one thing one day then freak out the other. This encourages self reflection in the client: have I changed today? Is this the cause of the reaction? What have I done different?’

and

Joe Slattery from JS Equine Assisted Therapies says, ‘The process of equine assisted therapy can provide the client with a visual experience that allows for a change of perspective.’

So, yes, it seems possible.

Beyond Words

Problematic emotional response patterns (feelings)

In those people with Borderline Personality Disorder, for example, problematic emotional responses can be explained by moving from a highly emotional state triggered by conflicts one day, to feelings of numbness and detachment the next. The intensity of these emotions are key, but so is the extremeness in the range of emotions exhibited.

These ranges of emotions are not easily controlled, and can take several hours to dissipate to normal levels. To benefit from equine assisted therapy the client must not be in the grip of these intense emotions for safety reasons. But in principle, horses can help with the emotions certain situations provoke at a lower level. Equine therapy at these times can show the client how their behaviour can impact the horse, and this learning can be reapplied the next time these extreme feelings occur.

With regards to anger, horses respond negatively to this emotion in humans. It is not an emotion that will encourage respect, willingness to comply, or cooperation. It will cause the horse to display fear and anger. In order to encourage feelings of calmness, the client must exhibit this same emotion.

Impulse control problems

We can all be impulsive, but for people with personality disorders, impulsivity can be uncontrollable, and potentially dangerous to the patient. There does not appear to be a clear on and off switch. Some common impulsive behaviours include sex and aggression.

However, these are not the only impulsive behaviours that can cause potential problems.

As stated by mentalhelp.net, ‘On the over-controlled side of the continuum is the Avoidant Personality Disorder. People with this disorder are afraid to try new things for fear of embarrassment, and fear of ridicule. They hold back when they are with other people, and can come across as stiff and constricted. They lack spontaneity, as every action must be considered for its potential to result in embarrassment or ridicule. Subsequently, people with this disorder end up missing out on some of life's unplanned but enriching adventures.’

Can equine assisted therapy help address this problem? With respect to impulsive problems associated with being afraid of trying out new things, this type of therapy can be helpful. In a protected and confidential environment with qualified equine assisted therapists and horses, there will be no judgments of behaviour of the client. They will be treated with respect, and will be actively encouraged to participate in the given activities. With fear taken out of the equation, the client can only benefit through the use of the equine in a therapeutic setting.

Significant interpersonal problems

Interpersonal problems can be further explained as relating to relationships or communication between people. Yep, we’re quite poor at it. I know from experience, this can be a workable problem. On the surface, I’m okay with one to one relationships providing things do not get too intimate. With regards to long term, intimate relationships I have to work on them. It’s not an easy task, and I’ve made some pretty serious mistakes. Not all of my relationships have worked out well, including those with family, friends, and lovers. I am essentially a loner through my own design, and through the problems I have dealing with people and relationships.

By deciding to keeping my distance, I have made life for myself both hard and easy. It’s hard when I require some help and support for a problem, or advice. In this case, I have no one to turn to. I do not have a friend, whom I can call upon for help with physical activity.

It’s easy, when I do not have to worry about what people are thinking of me, how they perceive me, any problems that may occur, or the work that’s required to keep that relationship ticking over. Friends need interaction and support, and I find this very difficult to maintain and give (but not in a selfish way).

Equine assisted therapy can provide needed support, unconditional love, and companionship that is often missing in the lives of those living with personality disorders. There is no pressure to keep up the contact as it can be sought as and when it is required by the client. Horses can provide an impartial ear to listen, and a huge supportive shoulder to lean on when times are tough. They do not judge and they do not move away.

In summary

I believe there is plenty of good evidence to support the fact that equine assisted therapy could benefit those living with personality disorders.