November 2009

Leave it at the gate

As a heath care provider it is most important to be fully present with our patients. From the moment we walk into the exam room, throughout the patient visit, and until we say good-bye. This is critical in patient care and diagnosis. There is so much we miss both verbally and non-verbally when we are not present in the moment.

I have always attempted to be totally present but to be honest my mind is a busy one and it often wonders. The chatter in my head does stop when I am listening or talking with with a patient, it really can do more than one thing at a time. I must also say calm and centered is not my usual modus operandi.

The practice of "leaving it at the gate" is a consious quieting of the mind so that one can be available and present with the beings and job in front of you. This type of practice has always been a challange for me. You see, I am a multi-tasker and my mind is very chatty.

For these very special patients we would be working with, I decided I would "leave it at the gate" and do my best to be totally present for them. Well, to be honest these imposing beings demand it. The patients of the Medicine and Horsemanship class weigh at least 1,0000 pounds. These horses, like humans, can be very unpredictable and I knew I better be totally present for them and for myself. Their every move, sound and smell captured my full attention.

The practice of "leaving it at the gate" being present and calm created a strong feeling of connection with the horse. For me it was a feeling of oneness, it felt wonderful. This new practice and skill I now take with me to the children and families I care for.

Thank you, Dr. Kane, Liz, Lucia and M&H classmates

ADDY

An entry on how I chose that horse, or how we chose each other.

This was the second class of the day. There were 3 horses. And we were each asked to say hi to each horse and choose one that you wanted to work with.

There was this broad male horse that was young, active, dominant, healthy and energetic.
There was this other horse, a submissive tender female horse that seemed really nice and gentle.

Then there was this smaller horse, off by itself, really restless, seemingly bored and anxious at the same time, hooving at the gate as if waiting to get out of the ring.
He immediately reminded me of myself. I too was hyperactive, comfortable to be doing my own thing away from the pack, and at times anxious about the situations. I nicknamed him ADDY, because he seemed quite ADD (attention-deficit disorder), and I chose to work with him.

In retrospect, I think what drew me to him was the fact that he seemed complex. I wanted to figure him out, help him out by easing his anxieties. Perhaps its no surprise that the other two medical students also chose him.

Turns out he was an older Ararbian horse, a breed of horse that gets bored easily, is very intelligent, and he was also past his prime so he didn't care much about trying to mate with the female horse who was in heat. Can't say the same about the broad young male horse.

We are drawn to other people who are similar to us. We also tend to see qualities in other people in terms of ourselves- how are they similar and how are they different? As a budding psychiatrist, I think its important to keep these in minds. The one person we know best is ourselves, and understanding ourselves, our personality and traits can help us understand the human mind and how other people are. But at the same time, this can blind us as we think from a subjective perspective, an egocentric one perhaps, that is framed by who we are and who we are not. Something to keep in mind.

How playing with horses for 2 months left a strong impression on me

I would like to echo the special thank you to all the course facilitators.

I joined the course as a way to get off campus and have a relaxing Wednesday afternoon off from medical school, but the course has been much more than that. It has opened my eyes to the possibilities of different treatment modalities, especially in relation to mental health. Equine-assisted therapy is truly a fascinating subject I hope to learn more about and engage in later in my career as a child/adolescent psychiatrist.

Horses have also taught me a lot of social dynamics, the importance of strong leadership, nonverbal communication such as body language, intention and emotional tone of our words. Experts have often said communication is 90% non-verbal, and I believe it. I think the class has made me a much more aware and effective communicator, and even a more strong leader.

Thank you!

Response - Is love enough??

In this subject I tend to be idealistic so I had to give this some thought. I certainly think it is the foundation of most of what is good in this world. In working with the horses is it enough to get them to do something they are uncomfortable with? Very much like humans this will in part depend on whether trust accompanies that love. The horses must at this point in the course sense we mean them no harm but is this the same as having nothing but good intentions? Afterall, they rely heavily on instinct. Being domesticated doesn’t squash this survival mechanism. If both trust and love are there is THIS enough? I trust and love my husband but he could not talk me into skydiving! Equally important we must consider what are that particular horses’ life experiences, temperament, external influence in that moment and perception of the task.

As with our human patients we must always weigh the benefit of persuasion with the ultimate outcome keeping in mind our methods will need constant adjustment depending on the goal and patient.

In gratitude

I would like to take a moment to extend my deep and heartfelt gratitude to Dr. Kane, the teaching assistants, and my fellow classmates for the wonderful and transformational experiences I have gained while in the Medicine and Horsemanship course. When I entered the course, I was already in a place of transition regarding my academic career and the direction my dissertation and eventual career as a psychotherapist was taking. However, I never expected that as the course continued those transformations would continue to evolve in ways I would have never dreamed of. Now as the course is coming to a close I am amazed at what doors have appeared before me. I am now re-considering doing my dissertation on equine-assisted therapy or somewhere in that direction, I still have some time to decide and there are so many interesting options to consider. :) I am also very excited to attend, hopefully with Dr. Kane, a weekend course regarding equine-assisted psychotherapy in April. I feel very grateful to have bonded with a handsome horse by the alias of “Orion,” and to top if off I was lucky enough to have all of you there to experience this with me. Thank you all for sharing this course experience with me; it has been an exciting ride. Thank you to the teaching assistants for bringing your knowledge, skills, and compassion to the course. A special thank you to Dr. Kane for offering this amazing course and for caring enough about this topic to step forward as a medical professional and teacher to pass down your wisdom to us with passion, presence, and peace.

NCEFT

I must admit that I was more than a little bit skeptical of the benefits of equine assisted rehabilitation prior to visiting NCEFT. I couldn't imagine how the movement of a horse could be a better course of therapy than work with a licensed physical therapist. Even after watching the DVDs provided by the facility, I still was unconvinced.

It was the moment that I saw one of the children atop the horse, overcome with enthusiasm and working hard to ride by herself that my opinion changed. The horses awakened in her an unrestrained excitement, which led to strong motivation to perform the activities requested by the physical therapist. I feel that this motivation is especially important for children, who may not understand why they need to undergo grueling physical therapy that none of their friends have to undertake. I agree with Tamara that it was magical seeing the children interact with the horses.

I was also struck by the total cost of running such a facility (they estimated $2,000 for a half hour session), and I was amazed that such a facility could exist, despite its astronomical cost. I think it really exemplifies the things that are possible when you get together a group of horse-lovers with a passion for helping others.

-Shawn