News Service dogs: do they really do any good?

[Gs172003]

I posted a thread a while back about service dogs and their purpose and then I posted another thread about what psychiatrists really think ( it was a forum I found of them talking amongst themselves)

This is a thread they created about the topic of service dogs. Not only do they think it's a sham but they get quite nasty about it. Thoughts?

Service animals for psychiatric illness

I am not trying to stir the pot I am just not sure what their real argument is.

 

[desiderata310]

I see what their issue is and - to some extent - Believe that they have a valid point. (and I am a service dog handler)

The idea is that the dog becomes a paralyzing crutch that inhibits health and growth and winds up being a way that isolates the patient more.
I GET THAT. That's what happened to me with Charlie at my old job. I was not dealing well with being out in the world and isolating but Charlie created a barrier between me and the rest of the world because no one wanted to interact with me because of the dog. It was frustrating.

The point about feeling 'safer' at the grocery store because the dog has your back or blocks someone? I KNOW that the dog doesn't do anything magical. He's not going to know S from a hole in a wall but I also KNOW if someone is behind me without collapsing into a panic attack, dropping my groceries and running out the door (which is what usually happened) Large crowds create an impossible scenario for me. KNOWING something doesn't mean I will be able to force my way through a flashback or panic attack. The level at which I experience panic is greater than the average Joe. Telling me that I should just experience it and force my way through it is a bullshit answer. It's a bit like telling an epileptic to just DEAL with the seizure without offering a solution to keep them from happening. No, not quite the same but you get the idea.

Then there's the question about taking care of the animal and having to be out in the world with it. Yes, Charlie means I wind up interacting with the public a great deal more than I would otherwise and has forced me to have interactions that ordinarily I would have not had or would have shied away from. It's made it easier to deal with just ... day to day stuff because it's practice for unpleasant interactions on high symptom days.
At some point the dog is like a cane. It really is. You don't WANT it there but those moments you need to lean on it, it's great that it's there.

All that said, my therapist and I had a long conversation not long ago where I pretty much got angry with his solution to how to deal with the stressors I was facing. His solution was avoidance. I had come to realize that this had left me more isolated than ever before. That I was beginning to isolated and stop doing even things I loved to do and that his avoidance plan was hurting more than it was helping. What I needed was a plan to deal with the issues in real time. Since then we have run with that idea and have worked to brainstorm ways to deal with symptoms in ways that don't leave me a hermit. (which to be fair I would happily become) Charlie has be central to dealing with that and also has NOT been central to certain things because I knew he created that barrier. When I felt he created more of a hurdle, we would have to work harder to sort out a better way of dealing with that scenario. It's been hard. It's been a bit like physical therapy where you are forced to let go of the cane (because you want to get stronger) and work on strength exercises.

With my new job, I decided that I would not use Charlie at work. OMG, that has been a choice. A hard one. It means that I have to deal with the shit I would usually have to deal with WITH Charlie- on my own and those have, on many days, taken a herculean effort, but it's allowed me to establish WORK as a semi-safe space SANS Charlie. Which, I didn't realize how useful that would be. But more importantly, it took away the physical manifestation of the PTSD standing beside me and allowed me to 'hide' it. I have reserved the right to decide that this is not going to work for me. That I will need Charlie at some later point at work. And have told my boss that I DO have a service animal that I am not using at work. (boy did that raise an eyebrow. He thinks it's for something else though since he is fully aware that I take an anti-epileptic)

When I go out into the world for non-work things, Charlie is there. I am still as symptomatic but it takes the edge off just enough to allow me to do the things I do with out leaning on other, less healthy options: self medicating (which I would be doing) and depending on things like delivery services for all of my shopping needs which would encourage more isolation. Being in the city, we have to go to the dog park as well, which means interacting with and MEETING new people- something I have always had a hard time with but as we have been going to the same park for a few months now, I am beginning to recognize a few people: the funny woman who works at night and has a herding dog she's trying to train, the couple who work for Wag in their off time, the musician who works with the symphony, etc and they are beginning to recognize me at that lady from CA who works up at that broken down theater up the street with the giant dog (we go to the park sans vest).

Whew, this has become more of an answer than I meant for it to be.

First I would say, stop reading that shit. The main people who answer seem to be assholes (almost trollish) whom I wouldn't wish my worst enemy on if they needed therapy.

Second, at some point, I think anyone who needs a service dog, makes decisions about when they can leave their 'cane' behind and when they will definitely need it- just the same as someone who has a balance or physical need. In doing that, they make their own strides towards healing and normalcy.

If wearing a hoodie in summer makes you feel safe, f*cking wear it till you don't need it. If a service animal is what you need during this season of life to get to the goddamn grocery store (and it's TRAINED correctly) use it.
In other words, f*ck the haters, you don't know me.

And stop reading what these ass hats have to say. If you want to know what therapists think, ask yours. That's the only one you REALLY need to worry about. I know what mine thinks. The rest can f*ck off. Healing and therapy is a very individual process. There is no one way of doing things that works for everyone.

 

[Gs172003]

I see what their issue is and - to some extent - Believe that they have a valid point. (and I am...

That is probably a good idea. I do need to stop reading this stuff. I already don't trust psychiatrists enough this ain't helping.

 

[Justmehere]

A lot of this depends on how you use a service dog, where you live and the culture around you, what your life and symptoms are like, and a few of the posters on that thread pointed to that.

With daily life tasks and work, using my service dog doesn’t isolate me at all. In fact, so many people come up to interact with me because of her, I leave her behind at one of my jobs because it’s actually too much of a distraction to have to deal with that. (And I gain the benefit of pushing myself to be without her.) She ironically helped me not be triggered to engage total strangers anymore, by putting me in a position where I had to do it over and over.

There are quite a few circumstances where using her can become its own stressor or something that does isolate me. I fight against that and don’t always bring her.

Can a service dog isolate reinforce learned helplessness like some of the commenters said? Yeah, any tool for ptsd can. The problem isn’t the tool, it’s the person and the symptom of learned helplessness.

Take a grounding stone. Someone can become so stuck on having a grounding stone in their pocket wherever they go, it can pull them away from using other skills. They can develop a belief set that they can’t be ok without it. They can get obsessed wirh polishing that grounding stone. But does that mean the tool of a grounding stone is a bad idea generally for everyone with PTSD? That’s rather black and white thinking to think so.

Reading these (alleged) doctors is like reading a bunch of orthopedists commenting about how crutches are a bad idea for all people wirh broken legs just because some people use them too long or get sore spots from them. Sometimes it’s better to have the crutch than to not be able to walk at all.

Psychiatrists are well trained in how to administer medications, diagnosis, and testing. Very few have any significant training or experience in therapeutic treatment techniques outside of medications. I’ve never discussed my service dog with a psychiatrist outside of one doc who was working closely with a trauma therapist, and they thought it was a great idea. Every trauma therapist I’ve seen has encouraged use of the dog to engage life and cope.

Does using my service dog have huge drawbacks? You bet. I had to be on crutches recently and those had huge drawbacks too. I do hope that someday, I won’t need the dog at all for service work but until then, I’ll use the dog as needed, like I use all other tools for recovery.

I don’t much care what a commenters on another forum who don’t know me at all have to say about it. One can find someone saying just about anything on the interwebs.

@Zoogal, if you already struggle to trust doctors, why do you keep returning over and over to a thread of a bunch of strangers that reinforces your distrust? What’s the draw to focus on service dogs and disagreement over them? Are you considering getting one yourself? Or is this more about your distrust of doctors and trying to work that through on some level? Is returning to that forum over and over going to help you in your own recovery? Or will it reinforce negative beliefs that will only fuel keeping you stuck?

The internet, like all other tools, can be helpful or harmful for recovery. It depends how we use it.

 

[Gs172003]

A lot of this depends on how you use a service dog, where you live and the culture around you, what...

I'll stay off those sites and try to stick with what I'm learning from others on this site instead. Im not sure what I'm trying to gain from what they are saying, maybe reinforcing my belief that im dumb?

 

[Justmehere]

It is good to consider other perspectives, but just take into account if some websites, sources, and subjects are helping your own recovery or not. It strikes me as a little counter-phobic - moving towards what you fear (what doctors really think about patients) in order to try to master it somehow. (I’m rather compulsively counter-phobic with some things myself, so no judgement here.) If reading that stuff only leads you to believe you are dumb, then stay away because that is not true! Or helpful.

 

[desiderata310]

maybe reinforcing my belief that im dumb?

Perhaps? Seriously, one of the most important things that I have learned from my therapist (and have taken with me to other places in life) is that they are human, fallible and don't have all the answers. The same is true of medical professionals. There's a tendency to set them up as gods. They aren't. They just spent time in school taking tests and (hopefully) gaining some practical knowledge while they were there. That doesn't make them good at what they do. That doesn't mean that they are gods, hell, these ass hats may well be the doc that scraped by in school by the skin of their teeth. They too have a degree hanging on their wall that says they are qualified to do something.

There is a reason they call it a 'practice'

You and your therapist (if s/he's worth their salt) will be willing to try and fail and try again with different modalities and tools to help you. Not insist you use (for instance) CBT only or EMDR only if it doesn't work for you. Take what works and leave the rest.

 

[joeylittle]

@desiderata310 and @Justmehere have both given great ways to think about the intersection between learned helplessness and service animals for psych disorders.

Not only do they think it's a sham but they get quite nasty about it. Thoughts?

No, they don't think it's a sham. They are having the same kind of free-range thread that we have here, often. The nastiness comes in when two members go at each other about access issues in public businesses.

I am just not sure what their real argument is.

The questions are:

• Are service dogs for anxiety and stressor-related disorders medical necessities, or are they helpful tools?
• Does using a SD for these disorders help or hinder treatment?

We know that the evidence-based treatments are some combination of exposure therapy and cognitive therapy. This is well-put:

There's a difference between 'feeling safe' at the local grocery store and 'being safe.' And while the patient may 'need' the dog to 'feel safe' at the local grocery store, the fact is that the dog is not needed to actually 'be safe.' This difference between 'feeling' and 'being' safe is THE VERY DEFINITION AND DEFINING CHARACTERISTIC OF AN ANXIETY DISORDER and this distance must be closed via treatment if the condition is to improve.

I think this is a very valid point. It's also very conceptual. Remember, when a clinician evokes the concept of 'closing the distance via treatment' - they are assuming that it may take years to close that distance. I know the sentence makes it read like there's no transition, but thats not what is being said.

No-one on that thread is arguing against the usefulness of animals in a psychiatric treatment plan. They are saying it's a slippery slope, to simply say a SD is 'medically necessary' w/o the clinician really integrating the use of the dog into the treatment plan. In other words, what Justmehere said:

Can a service dog isolate reinforce learned helplessness like some of the commenters said? Yeah, any tool for ptsd can. The problem isn’t the tool, it’s the person and the symptom of learned helplessness.

I also liked this observation:

I actually think that 'emotional support animals' may have the ability to positively impact some symptoms of PTSD for some people (particularly if they are socially isolated and depressed/withdrawn)...it may have something to do with Stephen Porges' polyvagal theory where the dog is a 'stand in' for other humans who is able to provide 'this is a safe environment' feedback (in terms of what Porges would call 'neuroception') that engages the portions of the parasympathetic nervous system to dampen down sympathetic arousal. But this is purely speculation on my part.

Bottom line is: a service or support animal can be very helpful to someone with an anxiety/arousal disorder, like PTSD. But, there's a serious lack of research into the medical necessity of service animals as applied to psych disorders - and clinicians should remain aware of both the pros and the cons of incorporating a service animal into treatment, especially in regards to learned helplessness and avoidance of cognitive restructuring.

You and your therapist (if s/he's worth their salt) will be willing to try and fail and try again with different modalities and tools to help you. Not insist you use (for instance) CBT only or EMDR only if it doesn't work for you. Take what works and leave the rest.

Yep.

And you get to decide what you want your life to feel like - what your goal is. We're always going to depend on certain things. I depend on certain things to help my PTSD, and some of those things I am comfortable retaining long term. Some of them, I would like to not need anymore someday.

It's so easy to become overwhelmed by just coping, that it can be hard to maintain a more long-term goal. Try and stay in touch with both, is my advice.

 

[Gs172003]

@desiderata310 and @Justmehere have both given great ways to t...

Thank you all. You all are awesome.

 

[Deleted member 541]

I’m not here to argue with any of you... I just want to voice my opinion on the subject of Service dogs.

While I know that they are a valid serve to people that need them and I know why people have them... What I absolutely detest is people that brig their f*cking dogs into grocery store and put them in the grocery carts!!!!! MY FOOD has to go in them and dogs are walking around outside, probably stepping in mud, dirt, piss and shit, and then people put them in the grocery cart.

I think its wrong, people are ignorant to do this, and don’t tell me it doesn’t happen because I’ve complained more than once to a store manager for this. I even saw a person with a f*cking ferret in his shirt in BJ’s a few months ago.

Animals shouldn’t be allowed in stores with food. JMO!!!!!

 

[Justmehere]

I even saw a person with a f*cking ferret in his shirt in BJ’s a few months ago.

People do stupid things all the time. Service ferrets are not allowed under the ADA. I’m not really sure what this has to do with what doctors think about the validity of the helpfulness of service dogs for PTSD symptom mitigation. That being said, it is true that people doing stupid things with animals and abusing service dog access allowances does make life harder for many, including legit service dog users.

 

[Gs172003]

People do stupid things all the time. Service ferrets are not allowed under the ADA. I’m not reall...

I see people with fake service dogs at work all the time. It bothers the heck out of me

I’m not here to argue with any of you... I just want to voice my opinion on the subject of Service do...

That wasn't a service animal that was for "emotional support" and didn't have to be allowed at all.