Though combat stress dogs like Boe are few, canine therapy is a growing trend, one that continues to gain legitimacy in the world of psychotherapy. And dogs have long been regarded as a therapeutic tool for psychologically wounded patients.
Sigmund Freud supposedly brought his dog Jofi, a Chinese chow, into his therapy sessions. The father of psychoanalysis not only felt the dog provided a soothing presence, but also used Jofi to gauge his patient’s inner mood. If the dog was relaxed, it meant the patient was at ease. If the dog tried to leave the room during the session or showed any signs of discomfort, it revealed the patient was particularly anxious. Freud loved his dog, but he also believed that the emotions of dogs were exhibited more purely, writing, “Dogs love their friends and bite their enemies, quite unlike people, who are incapable of pure love and always have to mix love and hate in their object relations.”14 Perhaps that is why he relied on Jofi’s “judgment” of his patients.
While the idea of using dogs for therapy—actually selecting for breed and temperament and then training them—would take years to take root, it was around Freud’s time that militaries started employing dogs to help wounded soldiers, physically and emotionally.
During World War I, military dogs deployed by the French Legion who, for one reason or another, were no longer able to fulfill their combat duties, were retrained to be the companions of blind soldiers. They were taught to anticipate approaching cars, to alert their charge to drops and inclines in the road, and even find the soldier’s favorite haunts and guide him safely to the homes of his friends and family.15 The process for acquiring such a dog was fairly uncomplicated: men who needed a guide dog simply sent letters to the War Dog Service. But as Harold Baynes reported from France, despite the accessibility of the dogs, it wasn’t a very popular service. This, he wrote, was largely “because of the feeling that a blind man led by a dog must necessarily appear to be an object of charity.” The stigma of helplessness and desperation attached to this kind of handicap must have been so potent that even Baynes (not so sensitively) believed that a soldier making his way through the city with a guide dog would have been indistinguishable from a common beggar.16
It seems an obtuse, thoughtless assessment, but it was, disappointingly, representative of the time.
The November 5, 1927 edition of the Saturday Evening Post featured a stirring article by a woman named Dorothy Harrison Eustis. Though a native of Philadelphia, Eustis had been living in Switzerland and had just traveled to the city of Potsdam, Germany, where she saw firsthand how the country was rehabilitating its “war blind.” What she witnessed had a profound effect on her and would forever change her thinking about the future of any blind person.
In darkness and uncertainty he must start again, wholly dependent on outside help for every move. His other senses may rally to his aid, but they cannot replace his eyesight. To man’s never failing friend has been accorded this special privilege. Gentlemen, I give you the German shepherd dog. . . .
No longer dependent on a member of the family, a friend or a paid attendant, the blind can once more take up their normal lives as nearly as possible where they left them off.17
In a small Tennessee town a man by the name of Frank read Eustis’s article out loud to his blind son, Morris. The young man had lost his right eye in a riding accident when he was six years old. The left eye was damaged beyond repair ten years later during a high school boxing match. Morris was so inspired by Eustis’s experience he sent her a letter four days later, asking her for the address of the school and any other details she would share. She responded and they negotiated a trade—she would bring Morris abroad, where he would receive his education and even be given one of the school’s dogs—if, in return, he promised to show off his success and promote the cause once he returned to the States.
Morris agreed and traveled overseas to meet with Eustis. He was paired with a dog named Kiss (whom he quickly renamed Buddy).18 By the time their training was done, Morris Frank was moving through the sleepy town of Vevey, Switzerland with Buddy with total comfort and ease. When the pair made the trip back home and docked in New York, a crowd of spectators had gathered, including reporters who had come armed with photographers. It was a skeptical if not altogether unkind crowd, and one reporter shouted out, daring Frank to cross West Street to prove to them all what a dog could do for a blind man.
Compared to the roads of Vevey, West Street was a high-speed interstate of danger. Buddy had never ventured anything like this—cabbies jeered out the window, trucks barreled by them, horns honked from all sides. As Frank lifted his foot off the curb he relinquished all control over entirely to his dog, and for three long minutes Frank was completely directionless. To the shock of all watching, they made it across without a hitch. He dropped his arms around Buddy, jubilant and relieved, his heart still thudding. “Good girl, good girl,” he commended her.
Eight years later he and Buddy had packed away 50,000 miles behind them preaching the good word of guide dogs. They helped to establish the Seeing Eye School in 1929 for training dogs to lead the blind in Morristown, New Jersey, and by 1936 the school had paired dogs with 250 blind men and women.19
When Japan bombed Pearl Harbor, Eustis and Frank, still friends and colleagues, made an immediate decision to rejoin forces. By then Morris Frank was no longer a young man and had another dog, Buddy II. Eustis too had long since retired from their cause, but they reunited to organize and fund this project—veterans of World War II would have guide dogs if they needed them.
The ability of dogs to boost not only a wounded soldier’s confidence but also his morale did not go unnoticed. As early as 1919, the US military brought dogs in as a therapy tool for their psychiatric patients at St. Elizabeth’s Hospital in Washington, DC.20 But it was during World War II that dogs made their mark helping veterans recover from war.
The Associated Press filed over the newswire direct from the Anzio beachhead in Italy one such story of a dog named Lulabelle. Lieutenant Colonel William E. King, a chaplain, was making his rounds of a hospital tent visiting the beds of the wounded. On this particular day he’d brought along his dog, who was so small she often made these visits in the chaplain’s pocket. One of the nurses stopped the chaplain and pointed out a soldier lying on his back, his gaze fixed on the ceiling. He had lost both hands and was, the nurse said, lucky to be alive. He’d been virtually nonresponsive since they brought him to the hospital. But when he saw Lulabelle he tried to speak and the chaplain went over to his bed to see what he wanted. The request was a simple one—he asked the chaplain to put the dog on his bed. Lulabelle obligingly scrambled across the man’s chest to lick his face.
“I used to have a dog, sir,” he explained. “That’s the first time a dog has licked my face since I left home.” And then he smiled. When the chaplain left the hospital that day he did so without Lulabelle. Instead she stayed on that bed, curled up with the young man, her head resting over his shoulder.21
A similar encounter and act of benevolence would bring canines into the halls of the American Air Forces Convalescent Hospital in Pawling, New York. In the summer of 1944, a Red Cross volunteer got the idea that a dog might break the melancholy of one recuperating airman, Lieutenant Colin, who’d shattered his leg. Dogs for Defense, the very same organization responsible for providing the military with its canine fighting force, arranged for Colin to get a dog, a German shepherd puppy named Fritz. The change in Colin was extraordinary: he improved so much that his recovery time exceeded doctors’ expectations by six months.22
Fritz’s presence at Pawling and Colin’s undeniable progress kicked off a small movement at the hospital. Soon, other patients were asking for their own dogs.
And, just as they had during World War I, war dogs who had been wounded or for other reasons had finished their tour of service were paired with wounded soldiers to become healing companions. Soon hospitals in Massachusetts and others a
round New York State were requesting and receiving dogs for their patients. Nearly two years after Lieutenant Colin was paired with Fritz, the hospital in Pawling installed an 80-foot kennel fully outfitted to house the 50 dogs living at the hospital.
As one former pilot, and a Convalescent Hospital patient who benefited from this movement, wrote, “the Red Cross got me Patty, the swellest Irish Setter you ever saw. We’re never apart. . . . And I’ve been feeling better since the day I got her.”23
Over the next few decades, animal-assisted therapy slowly began attracting attention in the civilian world. Therapist Boris Levinson, owner of a dog named Jingles, once forgot to remove the dog from the room during a therapy session, only to notice that a young patient, a withdrawn boy, became noticeably more relaxed with Jingles in the room. Levinson took note of this canine-inspired improvement and Jingles became a regular fixture in his therapy sessions. In 1962, Levinson published an article on the phenomenon, “The Dog as Co-Therapist.”24
But while animal-assisted therapy became popular during the 1960s and 1970s, it really wasn’t until the 1990s that scientific evidence started to accumulate that suggested more conclusively that dogs have a tremendously positive effect on lowering stress and anxiety. A 1998 study showed that, after a half hour spent with a dog, psychiatric patients exhibited a reduction in their anxiety that was two times the effect of other, more standard stress-alleviating therapeutic activities. In 2003, the woman who conducted this study, Sandra Barker of Virginia Commonwealth University, reported that patients awaiting electroconvulsive therapy were less fearful after spending 15 minutes with a dog.25 The American Heart Association released a study in 2005 that showed that 12 minutes of time spent with therapy dogs improved “heart and liver function, reduced blood pressure, diminished harmful hormones, and decreased anxiety in heart patients.”26 And finally, in March 2010 Barker published a third study on the “buffering effect” dogs have on human emotions by measuring the cortisol level of their human companions to determine their stress level.27
So convincing was this data that in 2009 Senator Al Franken, Democrat from Minnesota, and Senator Johnny Isakson, Republican from Georgia, drafted and passed the Service Dogs for Veterans Act. The bill mandated that no fewer than 200 service dogs would be paired with US veterans, and that these dogs should be divided evenly between those suffering from physical injuries and those suffering “primarily from mental health difficulties.” In tandem with this pilot program were plans for a scientific study of the initiative within the Department of Veterans Affairs that would last for no less than three years in order to determine the therapeutic benefits to veterans, from quality of life to savings on health-care costs.28 And the following year, in 2010, the federal government committed to spending several million dollars to gather scientific evidence on the impact that dogs have on PTSD.29
But it wasn’t the research that inspired the arrival of the first therapy dog at Walter Reed National Military Medical Center in 2007. It was an accidental observation very much like the one made at Pawling during World War II. At the height of the Iraq War, occupational therapist Harvey Naranjo, a former combat medic, was watching his patients while they were at the stables for equine therapy: riding the horses to help work their core muscles. A few dogs were also ambling around the barn. Naranjo saw his most reticent and withdrawn patient playing with one of the dogs, looking so much happier and more relaxed that his entire demeanor altered. Naranjo commented, offhandedly, to a man standing nearby, that having a dog at Walter Reed would make his job a lot easier. The man turned out to be a retired Army veterinary officer who took Naranjo’s idea seriously. Within a short time, they had their first trained service dog on staff—a chocolate Lab named Deuce.30
The positive impact that Deuce had on everyone he encountered at Walter Reed was what inspired the Warrior Transition Brigade’s Wounded Warrior Service Dog Training Program in 2009. The program was designed to use dogs to prepare recovering patients for the life transition they would make once they left the hospital, whether it was to return to their military service, go back to school, or find employment in the civilian world.
The idea for the program was actually twofold: in addition to spending time with the dogs, the recovering soldiers would be training them to be service dogs for veterans. It worked miraculously well. Patients previously unable to perform everyday tasks were suddenly empowered and able to accomplish them once they were next to a young puppy.
While the program wasn’t limited to soldiers struggling with PTSD, they were often the best candidates. The dogs not only provided soldiers who had been withdrawn or depressed with calming and unconditionally loving company, but their presence also gave them the motivation to get out of bed and provided them with a prideful purpose. Despite the fact that these soldiers knew their dog wasn’t going to belong to them forever, the effect was profound.
Even the patients’ families reported seeing a change. Training a young puppy takes a steady, careful hand and a willingness to emote happiness and praise. The necessary exercise of offering the dog a reward for good work requires a particular tone that combines inhibition with enthusiasm, high pitched and joyful. By interacting with the dogs in this manner, over time, patients relearn a more gentle way to interact with their spouses and children—even if only subconsciously. Their voices were transformed, from the flat, dejected affect so typical of PTSD, into something more upbeat and engaged.
Sara Hook was the chief of the Warrior Transition Brigade’s Occupational Therapy Department when the dog program started at Walter Reed. She remembers one soldier in particular who came into the military hospital with a combination of psychological and physical wounds, confined to a wheelchair. Like many newly admitted patients, he was closed off, always with his head down and his eyes low. But when therapy dogs approached him, Hook observed an instant transformation. By the time this patient completed the program some six months later, he was able to stand at a podium and speak from a microphone in front of a crowded room and lead an official military ceremony. Of course he had other traditional rehabilitative therapy while at Walter Reed, but Hook believes this soldier will say that it was the dogs—their unconditional love, that they were always happy to see him no matter how he looked or felt, regardless of his being in a wheelchair—that made the difference.
Hook and her staff at Walter Reed not only saw changes in their patients after the dog program began, but also had case managers report that there was a decrease in prescriptions for medications for pain, anxiety, and depression. Yet, so far the evidence supporting the success of this kind of stepping-stone therapy program at Walter Reed is largely anecdotal. Scientific studies have not yet been conducted to analyze the efficacy of the dog program.
Captain Najera faced a similar problem. Even though Boe’s positive impact was clear to the observant eye, Najera had difficulty building a clear case among the military’s top brass for continuing the use of therapy dogs.
During her deployment Najera started collecting data for a research paper, one that would examine what evidence, if any, would show that the therapy dogs were making a difference. She compared the dogs with three other therapeutic techniques: guided imagery (envisioning a safe, happy place), deep breathing exercises, and basic education on coping with stress taught in the clinics. But conducting the surveys proved difficult. It was hard to assess the range of the dogs’ impact: while Najera and Boe had regular visits with patients, not everyone who might have found relief in Boe’s presence could be accounted for. And then, just as they were collecting this data, things for the US military in Iraq began to change. The drawdown of troops started, and servicemen and women were transferred from their bases in Iraq. Najera and the other occupational therapist–dog handlers lost track of the soldiers in their survey pool. One day they were there with Boe and the other dogs then, suddenly, those same people were gone.
Boe was in Iraq for a total of 18 months, s
erving two deployments back to back. Toward the end of their tour, Najera started to see a change in Boe. She had never been the kind of dog who relished being the center of a large crowd, but she’d always accepted the affection offered to her and indulged the excited fuss the soldiers made with a friendly patience.
But after nearly 15 months of being Boe’s handler, Najera noticed that when soldiers approached Boe, she turned away from them. The only time she ever seemed happy was when she was free to just be a dog. She didn’t want to engage anymore. It was as if, Najera says, she had absorbed too much sadness.
It would be counterintuitive, even foolhardy, to assume that dogs can experience war but are somehow immune to its hardships, that they do not shoulder its burdens. Dogs experience the same heat, the same chaos, the same injuries, the same violence, and the same trauma. War and combat affect all dogs, just the way they do soldiers. And like people, each dog responds differently. But because working dogs are in such high demand, and their numbers relatively few compared to their handlers, they do not take breaks between deployments as their handlers do. Dogs with good working records who are in good health are, potentially, deployed more times and more often than their handlers, even serving back-to-back tours. This takes a toll. Military working dogs, like soldiers, return from war changed.
War Dogs Page 21