© Rik Jesse / Florida Today
Curtis Arnett participates in equine-assisted psychotherapy at Forever Florida near St. Cloud. He was able to build trust and establish boundaries with one particular horse. The West Melbourne man was rendered a paraplegic in 2005 after a motorcycle accident.
Mental health professionals incorporate equine therapy into approach

Chris Hamrick still is haunted by the memories.

It was Feb. 27, 1991, during the first Gulf War. His platoon leader stepped on a land mine, injuring the sergeant, killing his best friend and blowing off part of Hamrick's left leg.

"It don't ever go away," said the 44-year-old Palm Bay resident, who sees a therapist once, sometimes twice a week, for post-traumatic stress disorder. "You learn how to cope better. It helps just to be able to vent."

Recently, instead of sitting in an office and talking about his feelings, he tried something different -- a therapy involving a three-legged horse named La Nina , who lost one of her hind legs when it got wrapped in a wire fence several years ago. The session was at the Equine Education Center at Forever Florida near St. Cloud.

"The three-legged horse intrigued me," Hamrick said. "That's a pretty heavy animal to try to get around on three legs and develop a gallop. It takes a will to survive. I went through quite a bit myself, complications off and on, being an amputee. You got to decide that you are willing to accept the struggle and keep on going. It's interesting to see how an animal deals with it."

A growing number of mental health counselors are incorporating horses into their sessions, using the animals to treat a host of mental health issues ranging from eating disorders to substance abuse to post-traumatic stress disorder. NARHA, formerly known as the North American Riding for the Handicapped Association, has been offering equine-facilitated psychotherapy and learning since 1995 and calls them fast-growing disciplines in the equine industry.

The Equine Assisted Growth & Learning Association, which was founded in 1999 and sets standards for equine-assisted psychotherapy and equine-assisted learning, has more than 3,500 members in 38 countries and growing. Half are mental health counselors and half are equine specialists.

Close to home, Sandra Wise, a Melbourne clinical psychologist, recently began offering equine-facilitated psychotherapy and learning at Eye of a Horse at the Equine Education Center at Forever Florida in St. Cloud.

And while not a psychotherapist, Holly Pollock is the owner of Epona Rivers, an equine-facilitated learning and yoga center at Kingswood Stables in Malabar. Pollock was inspired by Linda Kohanov, author of The Tao of Equus: A Woman's Journey of Healing and Transformation Through the Way of the Horse.

"The idea of using horses to help people heal has been around for hundreds of years," said Lynn Thomas, co-founder and executive director of EAGALA. "To use it in a focused way for mental health treatments is a little newer. We're providing psychotherapy. The horse is just an additional tool."

Or as Wise put it: "You take a traditional model of psychotherapy and embed a horse."

Horse history

Psychotherapists Adele von Rust McCormick and Marlena Deborah McCormick of Texas are considered the pioneers of equine therapy, developing their method decades ago. Their approach grew out of their clinical experience and expertise in the equestrian arts. The McCormicks have been breeding Peruvian horses, the 15th century steed of Spanish conquistadors, for more than 30 years and also train and show them.

Years ago, the McCormicks witnessed how healing horses could be and added the dimension to their successful practice with adult and adolescent psychiatric patients, the McCormicks said in an e-mail interview. Their books Horse Sense and the Human Heart: What Horses Can Teach Us About Trust, Bonding, Creativity and Spirituality and Horses and the Mystical Path: The Celtic Way of Expanding the Human Soul explore that journey.

"We believed that exposure to nature, via the 'real' world of horses could help restore inner balance and a sense of aliveness," they said. "It worked. Entering into a relationship with a horse is not only a joyful and empowering experience but it is challenging. In time, we discovered that horses could benefit all human beings who desire psychological and spiritual advancement."

As equine therapy gained public recognition, many mental health therapists began using it, they said, adding that unfortunately, many of them are not equestrians and horses can become depressed and demoralized with the burden of having to fix people's problems. The McCormicks have their own model and train their own apprentices to be students of human nature and of the horse.

The horse is captivating because it is an animal with powerful instincts, which can elevate people's own instincts.

"Unlike dogs and cats, horses are herd animals and so are human beings," they said. "We love dogs and cats, but they cannot school the human mind and heart in the way a horse can."

The animals work well for therapy because they are great at reading nonverbal communication, said Thomas of EAGALA. The horse picks up on every nonverbal message a person sends. So a counselor can observe how a horse responds to a patient and ask questions and devise exercises based on that.

"Horses are an amazing mirror," Pollock said. "When people are out with them, they build an awareness of themselves that they would have never had. The horses either mirror someone in their life or they're mirroring an emotion or a pattern of behavior that has kept this person stuck or paralyzed from moving forward in their life towards something they really want."

How it works

Equine-assisted psychotherapy and learning are not about mounting and riding into the sunset though, NAHRA sometimes includes riding as part of treatment.

Rather, the horse serves as a metaphor, in addition to being a catalyst to bring up issues, Wise said. She said many times, talking about something in a sterile therapy room makes it hard to get to the real issue.

"The magic word here is experiential learning, so experiencing something," Wise said. "If you are a person who has some social problems, relationship problems, if you were to approach the horse and he was to turn around and walk away, that's very impacting. The person would feel something at that moment that could relate to what happens in their relationships."

In that situation, Wise and an equine specialist would encourage the person to approach the horse in a different way. Could the person change something so the horse behaves in a different manner?

"So we might coach that person, on his own, to discover changes he can make in himself that will help him get to where he wants to in life in terms of having more satisfying relationships."

Wise said equine-assisted psychotherapy can be used for most issues that psychologists address in traditional psychotherapy in an office, whether it's depression, bereavement or anxiety. She said with more severe mental illness, psychotherapists need to use sound clinical judgment when choosing treatment options.

Some counselors use EAP as a supplement to talk therapy; others use it in place of it. Insurance coverage varies; the cost is similar to a therapy session.

No two EAP sessions are the same. Sometimes patients direct what happens.

Curtis Arnett, 40, of West Melbourne, who was left a paraplegic in 2005 after a motorcycle accident, wheeled his chair into a pen of horses, selected one that he liked and then led him into a separate area. There, he worked on a relationship with the horse -- making requests, building trust and establishing boundaries by asking Mud Dog to repeatedly retrieve a soda bottle.

He tried to lead Mud Dog back into the pen when the session was over, but all the horses came into the area and surrounded him, making him feel stuck. A military veteran, it brought up issues of what it was like to have to leave his family to go into combat. When his wife would drop him off, she wouldn't want to leave.

Arnett, a psychology student at Florida Tech, was at Forever Florida to get a feel for what it would be like to go through an actual EAP session.

In the arena, you have real-time experience and nonjudgmental interaction between a patient and the horse, said StarrLee Heady of PX Equine Enterprises Inc. in Green Cove Springs. "You don't worry so much about what the horse thinks," she said.

That is useful for an eating disorder patient, said Sari Shepphird, a clinical psychologist and eating disorders specialist in West Los Angeles, who sometimes refers patients to EAP.

She said the therapy eases patients into trusting relationships. A substantial percentage comes from tumultuous backgrounds.

"Equine therapy is again a nice way to show, 'you can be good enough. You can be good enough to have a relationship with another being, who is not going to comment on what you weigh, who is going to respond to your unique gifts of talent and personality.' "

Learning about yourself

The work does not always deal with mental health issues. For example, Eye Of A Horse provides equine-assisted learning to sports teams that want to learn how to communicate better and use nonverbal cues with teammates. Some people want to learn more about themselves; how assertive are they, how much influence do they have, how good are they at setting boundaries?

Horses can help.

Pollock of Epona Rivers describes the learning process as a method of distinguishing the feelings you create by the thoughts in your head from authentic emotion.

"This whole program, this whole methodology is about processing your life, and your experiences in your life, and your relationships in your life to create a positive frame of mind and to activate the positive mind," she said.

Eight teens from the Bright Star Center for Grieving Children and Families, part of Hospice of Health First, came away from a weeklong day program at Epona Rivers last summer knowing how to set boundaries. Horses, like people, will invade your space.

They also learned to pay attention to their environment, quiet their minds and cope with some hard emotions.

"You could just see them relax," said Cynthia Koppler, who runs the program. "The boundary work was so important. Being able to set boundaries and say, 'This is what I do and don't want for myself, and it's OK. I have the right to set that boundary.' You have a right to say no to people."

As for EAP, the future looks bright. Researchers have been studying the effects of equine-assisted psychotherapy for more than 10 years. Although some studies are more scientific than others, there is credible research on EAP in peer-reviewed publications, Wise said. With even more supportive research conducted in 2009 and 2010, she is inviting graduate students from Florida Tech and University of Central Florida to get involved at The Equine Education Center at Forever Florida.

Hamrick said he would love to continue with EAP.

"I was really impressed with the horse. I think I fell in love with it," he said. "You got a horse, a big animal I'm amazed by. I think I'd like to interact with the horse more. Kind of like we understood each other a little bit -- instinctive wise. I think maybe some positive things can come for maybe the horse and me both."