When thinking about addictions, some things are quite obvious, while others are much more disguised. Clearly, those with substance abuse issues of any kind are still subject to a healthy dose of social stigma. Often this desire to hide what is not considered acceptable by the masses is what fuels the emergence of a multitude of “exclusive” addiction centers. For a sense of what these day spa like treatment centers look like, just Google “Malibu drug treatment.” Yet this avoidance of the problem also disguises a much larger issue. That is, that aside from the war in the Middle East, addiction issues — from prevention efforts to treatment, loss of work time, health claims, and addiction related incarcerations — claim the largest share of national spending. So it seems fitting then that treatment centers scramble for the latest and greatest way to treat this massive social problem. Of late, equine therapy has become one of these nascent methods for getting to the root of what causes a person to turn to the bottle, pill, or powder.

Horses and addictions would seem strange bedfellows, but our four legged friends are actually quite well suited for this population. For one thing, addictions involve a great deal of denial. Denial not just of the problem, but of what one is actually feeling, thinking and doing. And this denial pervades beyond others, but to the self as well, leaving a person that has a very fractured understanding of himself. This detachment from the self can actually be a very prominent reason to drink.

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Today, somatic disorders are readily affecting a significant percentage of the American population. The group of somatoform disorders have been called the most common psychiatric problems seen by general practice medical professionals.[1] A large scale study of over one thousand patients examined by their general practitioners, reported that 16 percent of patients met the criteria for severe somatoform disorders, and 22 percent could be diagnosed with mild impairment.[1] More telling even was that many of these patients also complained of depression and anxiety. In a further study, approximately 36 percent of hospital patients who met the criteria for any somatoform disorder also had other mental health problems, such as depression and anxiety.[2] Looking internationally, a study in Belgium showed that somatization syndrome ranks as the third highest psychiatric disorder, with a prevalence rate of 8.9%.[3]

So what is a somatoform disorder?

Somatoform disorders are a group of disorders characterized by physical symptoms that might point to a medical disorder. Somatoform disorders are none the less psychiatric conditions because the physical symptoms that appear cannot be fully explained by a medical disorder, substance use, or another mental disorder. Therefore, somatoform disorders often mystify medical providers who must look past the physical complaints, in order to correctly diagnose the disorder.

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For those who work in trauma, the concept of repetition compulsion — or the tendency to recreate traumatic experiences that are similar to the original trauma — is nothing new. However, foreigners to the world of trauma can often shake their heads at the seemingly bazaar habit of those around them to “keep doing the same thing, expecting different results.” From the inside, it makes perfect sense. Your brain is simply trying to maintain what is now normal — that is operating in trauma mode, complete with elevated epinephrine, norepinephrine, and lowered serotonin. Yet, it is understandable that this behavior can defy logic, and put those immersed in it at odds with friends. The good news is that trauma specialists are well equipped to manage this reaction to overwhelming and terrifying circumstances. The not so good news is that those who’ve had trauma can unknowingly recreate it in their lives through their many relationships — even those with horses.

Think, for just a moment, of a friend or acquaintance that seems to always find himself/herself in the same dysfunctional, unhealthy, or even abusive, relationships. It seems that no matter what anyone says to this person about the “warning signs” she/he remains in denial, idealizing the new mate, and minimizing any risk. Yet, over and over again, the same thing happens. The rosy love affair ends in a nasty battle with sometimes legal consequences, and in worse cases, hostage children.

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While the presentation of narcissism can often be difficult to tolerate, and certainly challenging for therapists to work with, the elevated sense of self, characteristic grandiosity, and lack of empathy often disguise the underlying feelings of shame and inadequacy. Making treatment of narcissism even more dicey is the narcissist’s persistent denial of any of these feelings, or any flaws whatsoever. However, without becoming aware of what uncomfortable feelings lay under the surface, the prospects for establishing and maintaining healthy relationships remain very fractured for the narcissist. While this may be a sticking place for many therapists, and the narcissist himself, this is also where equine therapy can be helpful.

Horses, being bound by physiological reactions and nonverbal behaviors, can only respond to what the narcissist feels, and not what he consciously presents. Therefore, when the grandiose person acts on his feelings of inadequacy and overcompensates through controlling or self-absorbed behavior, the undetected raising of the heart rate, shallow breathing, and elevations of epinephrine that all go with fear become palpable to the horse.

And in such a situation, the horse will do with the narcissist what they will do with any scared herd member. They will engage in protective behaviors. Circling tightly around the self-involved person, nudging them gently, and displaying concern, their behaviors literally bring the inability to protect oneself in a healthy way to life. The narcissist’s adopted compensatory mechanisms are not viewed by the horse as “safe” by the horse, because they do not cure the inadequacy and restore feelings of confidence, connection to others, and emotional safety to the overly sensitive narcissist. So, to be safe then, the grandiose person must be protected, as he is not capable of really protecting himself emotionally, and therefore, a horse perceives him as not safe alone.

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