Petting
a dog or cat feels great after a hard day at work, doesn't it? Helps you bounce
back. Am I right? There's a good reason for that. The human-animal bond may be
one of the best prescriptions for what ails many animal health workers.
Veterinary
professionals need a lot of resilience. The American Psychological Association
website says resilience is exemplified by adapting well in the face of
adversity, trauma, tragedy, threats, or significant sources of stress. In a
typical day of practice we may get exposed to each and every one of those more
than once.
Remember
Tubthumping by Chumbawamba? "I get knocked down, but I get up again.
You're never gonna keep me down!" That's the spirit! What if that's not
quite enough? The lyrics go on, "He drinks a whisky drink, he drinks a
vodka drink, he drinks a lager drink..."
Sounds
like the veterinary school lesson I was taught about how to deal with hard
times. Buck up and soldier on!
That
method has been taught since around 400 BC when Hippocrates established objectivity
and stoicism, AKA clinical distance, as a central tenet of professional
medicine. Not a new idea! The problem is that method is ineffective for many
veterinarians and may exacerbate fear, shame, and isolation, making things
worse.
Personally,
I need a lot of resilience and recovery. The word "resilience" has
Latin origins meaning to spring back or rebound. I also need
"recovery" or restoration to health from sickness. I've had to bounce
back and recover from substance use disorder (SUD), compassion fatigue (CF),
and burnout (BO), among other things. In an effort to decrease the stigma
associated with these conditions I'm going to tell you a little about my path.
When I
was a boy I injured my dog when trying to train her not to dash out the gate.
In my unskillful impatience I slammed the gate into her side. She yelped and
limped. I felt awful. But her body language told me right away that she forgave
me. By the next day she seemed fine.
Months
later, when she developed a leiomyosarcoma in her spine, I asked the
veterinarian why it happened.
"We
really don't know, but sometimes trauma can trigger cancer," he said.
I told
nobody, but I knew I had caused my dog's disease. The decision to become a
veterinarian followed soon thereafter, as did my experimentation with
marijuana, LSD, and alcohol. Guilt drove my bus to veterinary school and
private practice, but I did not deal with that guilt, much less acknowledge it,
until my first few years of recovery from SUD.
The
human animal bond is a powerful healing force, but it's not all unicorns and
bubbles. As with love of any kind, there will be negative emotions associated
with the inevitable loss of the object of that love, especially if one makes a mistake
and hastens that loss. We are human, so that means that we will all make
mistakes no matter how hard we strive for perfection.
My
childhood experience set me up for striving for perfection followed by
suffering from shame. This dynamic duo, perfectionism and shame, sets the stage
for CF and BO. I held myself to a high standard, was ashamed when I didn't
achieve goals, held others to high standards as well, and worked hard to get
them to perform better. I was sometimes difficult to get along with as a
practice manager and owner.
My
recovery from SUD while a solo practitioner was not easy. I had a lot of help.
After a few years of SUD recovery I found I needed to sell my practice. In my
case, CF manifested most prominently when I euthanized pets with children
present. I suffered memory lapses.
I had
an odd feeling when I saw the client at the grocery.
"How's
Fluffy doing?"
"You
euthanized Fluffy last week, Doc."
I
learned not to ask such questions when I had that odd feeling upon seeing a
client. I often recalled the euthanasia as I walked away from the client.
Apparently my brain protected me from the pain of remembering the event when in
front of the client.
I had
dreams about pets and clients. I took cases home with me, sometimes in my head,
other times literally. I was anxious, on edge, and jumped at unexpected noise.
In addition to having CF, which is acute and associated with a particular
client or pet, I also had BO from too much to do and not enough time. I
neglected my family. When I was with family and friends I often did not pay
attention to those in front of me, instead I worried. I was in a nearly
constant sympathetic, fight-or-flight, state. I did not recover from CF while
still a practice owner. Instead I sold the practice.
I
wonder if I knew then what I know now about CF and BO if I would have been able
to stay in practice full time. Since selling I've done relief work, technical
service veterinary work for industry, worked as a medical writer, and most
recently I've been consulting and coaching about SUD, CF, and BO.
I don't
think that owning a dog or cat, petting it, caring for it, and receiving its
love in return is the whole answer to developing resilience or recovery, but it
sure helps. There is so much work involved in recovery. I had to establish a
multitude of new routines to improve my physical and mental hygiene. But
matching up the signs and symptoms of SUD, CF, and BO with the psychosocial and
psychophysiological effects of the human-animal interaction (HAI) (which is
easier to quantify and validate compared to human-animal bond) reveals some
interesting observations, as described in a review paper by Beetz, et al.
Isolation
is a feature of SUD, CF, and BO. We've all noted that HAI has a social catalyst
effect. Best way to meet people? Take your dog for a walk in the park. According
to studies cited by Beetz, et al. human smiles, sociability, helpfulness,
responsiveness, and conversations occur more often when animals are present.
And patients with SUD get along better with their therapist when an animal is
present.
Have
you had a friend or relative in the midst of the disease of SUD? If so you'll
know that one of the characteristics of folks with raging SUD is that they lie
and do not trust others. Building trust is imperative. Students rate a
psychotherapist who has a dog as more trustworthy. In fact, people in general
are more trusting of others in the presence of a dog. Children in a classroom
with a dog have more empathy.
Folks
with SUD, CF, or BO are often depressed. Having a dog present reduces
depression and improves people's mood. Elderly caring for a canary have reduced
depression and improved quality of life.
Increased
stress is a hallmark of BO and CF. Hence the rubber meets the road when we
consider the anti-stress effects of HAI. There are decreases in cortisol, epinephrine,
and norepinephrine when a pet is present. HAI is associated with decreased
blood pressure, heart rate, and reactivity to stressors. With HAI there is
increased heart rate variability, which is characteristic of being in a more
relaxed, parasympathetic-tone state. With HAI there is reduced fear and
anxiety, and in stressful situations, calmness is increased.
I
believe that contact with pets, my own and those of friends and clients, made
my recovery easier than it would have been without and will strengthen my
resilience as I move forward. My belief is as much experiential as it is
intellectual.
All I have to do is feel fur in my fingers, look into those eyes, and see them squint when I hit just the right spot to confirm the importance of the human-animal bond to my mental and physical health.
Beetz,
Andrea, Kerstin Uvnäs-Moberg, Henri Julius, and Kurt Kotrschal. 2012.
"Psychosocial and Psychophysiological Effects of Human-Animal Interactions:
The Possible Role of Oxytocin." Frontiers in Psychology 3: 234.
doi:10.3389/fpsyg.2012.00234.
