Motivation and emotion/Book/2013/Animals and anxiety

Overview
In reviewing current research relating to my topic ‘How does interaction with animals affect human anxiety levels?’ I found the area of ‘well-being’ to be an extremely large field to research. In particular, with a keen interest to the topic of study, a lot of the time i found myself feeling extremely overwhelmed. Therefore, in an attempt to reduce the amount of racing thoughts to which way my self help chapter could take flight i decided to narrow my topic down to the utmost helpful proposition possible. With much internal searching, drudging through my passions i decided to look at in particular

"What can DOGS offer in terms of therapeutical resources to young people who suffer from anxiety"

In pursuing such a direct research proposal, there were numerous positive outcomes such as clearing a straight forward path of research and in particular, a light at the end of the ‘project tunnel’. However it also brought some difficult tasks such as actually finding relevant research to such an age group, as well as minimal theoretical relevance to the topic. All in all i was able to come up with three specific topics including:
 * 1) Dog ownership with relevance to Animal Assisted Therapy and Animal Assisted Activity.
 * 2) Anxiety and its relationship amongst children.
 * 3) Emotional development theories expanding across the ages.

Dog ownership
The aspects of dog ownership have been reviewed time and time again, taking in aspects including companionship, hoarding, working capacity and therapeutical abilities and from the general direction of studies one is to confirm

"Dog is a man’s best friend"



Canines are extremely interesting animals and having the chance to work and study their behaviour for over a year now has driven me to researching this particular topic. In acknowledging Caesar Milan (dog behaviourist), whom has recently reviewed the ways in which children view dogs (Scholastic Inc. 2008), according to Caesar's recent study, he has found that children reported dogs as emotional supports. They were highly favoured as listeners and protectors, as well as having the ability to reassure and show appreciation. To bring more light on the topic of what canines can offer human beings, Schwab, & Huber (2006) discuss the communication between dogs and human's is critically reliant on non visual cues. Similarly Prothmann, Albrecht, Dietrich, Hornfeck, Steiber & Ettrich (2005) reports that when communicating with animals we do so using mainly verbal types of communication such as facial expressions, gestures, postures and physical contact.

Due to simple yet specific communication bridges between humans and canines Lubbe & Scholtz (2013) refer to Chandler's finding that canines have a natural tendency to foster quick rapport and levels of empathy between children. Lubbe & Scholtz also discuss the basic human needs all people young and old require in order to function emotionally and psychologically on a healthy level. These needs include; being loved, respected, useful, needed, accepted and trusted which an animal has the ability to fulfil by meeting important roles. These roles include (from a dog) a companion, friend, servant, dependant, an admirer, confident, a scapegoat, mirror, trustee and a defender.

Pets do provide meaningful social support adequately enough to alleviate social isolation and ultimately improving psychological well-being and physiological health. By having regular contact with a dog, this connection can provide a sense of belonging which is also essential for humans and is directly linked with self esteem (McConnell, Brown, Shoda, Stayton, & Martin, 2011). Barker, Knisely, McCain, Schubert, & Pandurangi (2010) were able to find a direct link between pet ownership and reduced stress level which also imposes a heightened level of self esteem. Kurdek (2009) reviewed the emotional and mood affect pet owners had towards their pet. They found that owners of dogs rely on their pet to regulate negative effect on their moods and emotions. They were able to conclude that owners viewed their dogs as reliable sources of emotional comfort.

Delving deeper into what can a dog offer in terms of therapeutical abilities, i was able to look further into the research done around Animal Assisted Therapy and Animal Assisted Activities.

Animal Assisted Therapy
According to Lubbe & Scholtz (2013) Animal Assisted Therapy can be defined as a goal-directed intervention in which an animal is part of the treatment process delivered by a health service professional. AAT is the deliberate inclusion of an animal in a treatment plan where the appearance of the animal in designed to accomplish predefined outcomes believed to be difficult to achieve otherwise or outcomes best dealt with through the direct exposure to an animal.

There are numerous species of animal used for different types of therapy for humans including horses, dolphins, birds and the list continues. However, keeping in mind my research is based on dogs being the animal to offer therapeutical resources.

Lubbe & Scholtz discuss the bond that is created between client and animal can help gain trust for the professional therapeutical relationship, which is an extremely valid outcome since the client will trust the animal well before they are able to trust the therapist. This three-way relationship, simply by using the dog as a therapeutical object most commonly manifest numerous bridges of trust helping to create not only a relationship but a willing and comfortable one at that. One of the main objectives of a therapy dog may be to serve as a transitional object into which clients can project their feelings and experiences onto whilst feeling safe and confided with trusting surroundings.

AAT has proven to have positive changes within neurophysiologic stress makers acting as stress buffers (Marcus, Bernstein, Constantin, Kunkel,  Breuer, & Hanlon, 2012). Bizub, Joy, & Davidson (2003) study on AAT and its outcomes have revealed that isolation experiences have dropped dramatically, also with an increase in built social skills with a developed sense of self efficacy. Clients that were studied on numerous occasions reported sensations of feeling relief and relaxation as well as care and acceptance around the therapy dog which is directly associated to a ‘normalising effect’. Another similar outcome from the study of those who have worked with a therapy dog suggests the feeling of being brought back to the ‘here and now’ (Selby & Smith-Osborne, 2013).

Prothmann, et al. (2005) asses a dogs extensive ability to understand at such an in depth level of human gestures and facial expressions, concluding that with the social intelligence apparent through human and canine interaction dogs are extremely useful as social catalysts with clients reporting improvements in social interaction and a decrease in isolating behaviours.

Animal Assisted Activity
Animal Assisted Activity is somewhat similar to AAT, in which there is a therapy animal present, however it is less formal in relation to formal human-animal interactions (Lubbe & Scholtz. 2013). AAA is mostly used for social visits to places such as hospitals and retirement homes more often than not with dogs. This however doesn't make it any less important nor less impacting than AAT. A review of patients at a psychiatric ward revealed that those in the rehabilitation centre felt as though their spirits had been lifted as well as patients whom were normally quiet and withdrawn begun to smile and spoke with others.

There are inquisitively high results from both AAA and AAT in relation to social functioning. Villalta, Roca, Gonzalez, Domenec, Escanilla, Asensio, Esteban, Ochoa, Haro, & Schi-Can Group (2009) reveal areas in which have had direct positive improvement as an outcome of exposure to AAA and AAT. These positive improvements include social contact, the quality of social and daily life skills as well as a connection to relaxation and self evaluated competence.

One of the biggest findings was by Villalta, et al. (2009). They found that a main advantage of dogs in offering therapeutical abilities is that not only do the dogs interact with people, but through their presence they are also able to help modify social behaviour between two or more people. This key prospect leads me directly to the point of defining anxiety.

Anxiety
What is anxiety?

According to the nationally recognised mental health organisation Beyond Blue, anxiety is a ‘life impacting’ disorder in which those experience sever forms of stress and worry. Acknowledging that we all experience anxious feelings, to be diagnosed as having anxiety one may have feelings of extreme debilitating stress and worry which can occur for no apparent reason and or continue after a stressful event has passed. These feelings cannot be brought under control easily and make daily life difficult for a person. What causes anxiety? Different types of anxiety include: Treatments for anxiety include: Depending on the severity of symptoms there are three main treatments for anxiety. The basic principles of anxiety have been covered here, if you'd like to know more follow the link to the Beyond Blue website. Beyond Blue Throughout my research i found minimal studies and articles related directly to children with anxiety and the use of AAT or AAA. What i did find was that still to this day, stigma is commonly attached to mental health issues which directly causes isolation amongst those suffering to the outside world (Jacobs, 2008). Communication processes and disorders directly related to this play an important role in everyday life Prothmann, et al. (2005). Therefore, addressing any possible issues or concerns is in the best interests of any human being.
 * Family history of mental illness can increase the likelihood of developing anxiety.
 * Stressful life events
 * Physical health issues
 * Substance use
 * Personality factors
 * Social phobia – intense fear of criticism, being embarrassed or humiliated.
 * Generalised anxiety disorder (GAD) – feeling anxious on most days over a period of six months or more.
 * Specific Phobias – fearful about a particular object or situation goes to great length to avoid the object or situation.
 * Obsessive Compulsive Disorder – ongoing unwanted/intrusive thoughts and fears that cause anxiety.
 * Post Traumatic Stress Disorder – Occurs after experiencing a traumatic event, symptoms include difficulty relaxing, flashbacks and avoidance of particular places.
 * Panic Disorder – Panic attacks.
 * 1) 	Self help- Things such as exercise, healthy eating, minimal substance use, meditation, yoga.
 * 2) 	Psychological treatments – Most commonly used is the Cognitive Behaviour Therapy which focuses on the process of thoughts influencing emotions and behaviours. However, there are other psychological therapies that may be used as well.
 * 3) 	Medical – Medication may be used to treat severe symptoms of anxiety.

Children and anxiety
According to Field & Field (2013) anxiety in children is one of the most common forms of psychological disturbances which can be linked to long term negative effects including depression and substance misuse. Anxiety in children is associated with cognitive issues effecting attention, interpretation, socialisation, memory and reasoning. One major implication is when interpreting something there is a bias for young people with anxiety to provide more threatening responses and interpretations of ambiguous problems and stimuli. Anxious children are more likely to overestimate dangers and underestimate their own coping skills, providing more avoidant situations and make threatening conclusions based on less information.

This information backs the following study taking into consideration that Prothmann, et al. (2005) stresses the importance of non verbal communication in pointing out that non verbal signals are sufficiently as important cues of communicating when regulating emotional states. Prothmann, et al. study showed those aged six to nineteen years of age who had anxiety disorders showed the least distancing behaviours from an assistance dog as well as the least fear of the animal. These individuals also exercised extensive stoking of the dog as a self-relaxing strategy to overcome shyness of the person present with the dog. After time, the client engaged verbally communicating with the other person present in the room.

Another study by Lubbe & Scholtz (2013) discussed that clients involved in AAT appeared more lively and positive. They also reported having the ability to temporarily forget about present problems, that the interaction with the dog lightened mood and increased smiling and laughter. The conclusion from this study was the development of the dog becoming a social support for the human, enhanced social interactions for the people. Therefore, in understanding that children often turn to animals for social support on account of the fact that animals offer unconditional acceptance and are non judgemental; which means that the dog could act as a safe medium through which other therapeutical support could take place.

Again Jacobs (2008) reported client's recollection of, when patting the animals soft fur it allowed them to feel less anxious and sad as well as more joyful. The dog's presence provided an ‘anchoring effect’ which enabled the clients to stay in the present, alleviated stress and worries enabling relaxation.

One of the main attributes dogs can offer humans is an unconditional companionship which is proven to address several components that humans need in order to maintain a healthy well-being (Siegel, 1990). This companionship offers love, acceptance, can aid relaxation and offers protection which in hindsight is exactly what a child would need when interpreting any anxiety effected situation according to Field & Field, (2013).

Children
The early years in development are crucial in paving and shaping behaviours which balance an understanding of the world for ones hindsight when getting older. Piaget reports that during the ages of six to twelve years, roles of cognitive maturation occur which is when young people discover the logic behind moral rules of conduct and learns to play with peers motivating a child to behave in ways that earn social acceptance and approval (TB). Children develop skills which enable them to understand their own and others emotions, express ones emotions, develop the ability to self regulate inner feelings to create a balanced mood, as well as conforming to social pressures and expectations regarding emotional display rules. This point in a child's life is extremely stressful and can at times be extremely confusing. With many opportunities for dysfunctional situations there is more than enough risk to cause and effect the development of anxiety in children.

This is where i would like to look at the review by Boyd & Mandler (1955) interpreting Sigmund Freud’s idea that children do not stress the gulf between the human and animal world. Children actively indentify more readily with animals than humans and that animal characters facilitate freedom of personal expression as well as stimulating more emotional material rather than human characters. This may be due to the ‘cute response’ discussed by Sherman, Haidt, & Coan (2009) which may lead to an evoked behavioural component that facilitates care giving itself such as nurturing and affectionate impulses. This makes a solid point when looking at children experiencing anxious behaviours lacking control and exposure to an Assistance Animal. Control may pose as one of the most effective aids in addressing child anxiety.

Stekee, G., Gibson, A., Frost, R. O., Alabiso, J., &Arluke, A. (2011) presents one of the reasons people hoard animals is due to the reliance on the ability to control the scenario. Hence, the child is therefore able to let go of worries, due to the calming qualities of the animal, focus on the present moment and care for the dog in congruence with the ‘cute response’ discussed by Sherman, Haidt, & Coan (2009). Giving the young person hands on experience and an object to attach emotional expression may be enough to alleviate the overwhelming worrisome emotions experienced and enable the child to reach a certain level of relaxation aiding their willingness and cognitive ability to decipher and discuss deeper problems relating specifically to their anxious behaviours. Similarly, the dog acts as the key to the lock which protects the chest of problematic contents of the child's psychological and cognitive domain. All in all, the dog may not ‘fix’ the anxious disorder however act as an extremely useful and important role in allowing the child the comfort and control in accessing the issues that do cause the disorder.

According to Lubbe & Scholtz, AAT provides a unique support for children's learning, physical health and emotional well-being which may not have been possible for just a therapist/client type relationship. Another way in which AAT could help therapeutically with young people experiencing anxiety may be in diagnosing and monitoring progress and symptoms of the disorder itself. Again, Prothmann, et al. (2005) discussed non verbal signals are difficult to fake or hide therefore making it possible to observe genuine interactions between people and child as well as people and dog.

Applicable theories
Trauma Theory: This theory explains how a traumatic experience can disrupt the development of a child by projecting overwhelming a persons ability to cope and deal with everyday situations. There are three different types of trauma which include acute, chronic and complex traumas. This theory can be applied when looking at the development of anxiety within a young person.

Attachment Theory: Attachment theory can be applies when looking at a young persons and their relationship with a therapist in using an assistance dog. The four attachment behaviours disscussed by Bowlby (1969) can be applied by the following:

Proximity seeking: Young person maintains close proximity with the dog due to the comfort promoted by the animal.

Secure base: Client uses dog as 'home base' where they feel comfortable and trusted enabling them to reach out to the human therapist.

Safe haven: Client may stroke dog or sit nearer the dog to create self soothing relaxation. DOg resembles comfort zone when in a therapeutical environment.

Separation point: Child feels withdrawn when away from the dog in a therapeutical environment however this problem would be addressed with other break throughs with the client and therapist.

Conclusion
To conclude, although I was unable to find much empirical evidence and more recent research reviewing young people, anxiety and dogs, the literature and research that I did find all point in a very similar direction. For people suffering from some type of psychological problem and have had access to an assistance dog have concluded that after the contact with the dog they felt more lively, positive, smiled and laughed more, felt joyful, accepted and relief; as well as having increased feelings of competence and belonging. The assistant dog's presence was also able to promote social interaction, emotional comfort and self efficacy. Also aiding client relaxation whilst acting as a stress buffer, emotional support, protector and acting as a trust bridge and object for the client to project intense emotions and thoughts onto whilst remaining calm. This may be due to the ‘cute’ response as well as being engaged by the anchoring effect the human encounters from the presence of the animal.

Emotional balance and mood regulation from the dog helps promote a sense of comfort for the clients as well as giving the client authority over the dog and their behaviour enabling the client to gain an overall sense of power igniting a light within oneself creating access to acknowledge, understand and gain control of any anxious behaviours. The therapeutical resources a dog can offer a young person whom suffers from an anxious disorder may include the following: But the most important therapeutical resource a dog can offer a young person is simply friendship. An unconditional, non judgemental friendship which offers support, an open listener, a protector and the utmost important thing of all, someone to cuddle and love when all else feels like it's tumbling down!
 * Aid in diagnosing disorder
 * Form trusting relationship between child and health professional
 * Foster social interactions
 * Decrease isolating behaviours
 * Change the neurophysiologic stress makers