Historical perspectives of the human-animal bond within the Department of Defense.
Animals and the Military
Ever since mankind went to war, animals have played significant roles. Such roles have been either in official capacities such as cavalry horses, sentry dogs, carrier pigeons, and unit mascots, or unofficially as a Soldier's battle companion. Prior to a battle, the Roman army performed a ritual that involved offering food to sacred chickens: if the chickens ate the food, it was an omen that the gods would join them; if the chickens refused to eat, defeat was imminent. (1)
During World War II, highly trained carrier pigeons provided a means of communication. Today, most utilitarian uses of animals in the military are not well known, except for the military working dogs that are trained to attack the enemy and detect explosives or narcotics. However, our military inventory of animals expands to US Navy dolphins, Special Operations horses, Marine Corps mules, and even peacocks that act as security alarms at key government installations.
Lieutenant Colonel George A. Custer of Battle of the Little Big Horn infamy, was known to have his dogs around him during campaigns. He affectionately mentions being surrounded by his dogs in several letters to his wife, such as the one written on June 12, 1876:
Tuck regularly comes when I am writing, and lays her head on the desk, rooting up my hand with her long nose until I consent to stop and notice her. She and Swift, Lady, and Kaiser sleep in my tent. (2)
During World War II, General Eisenhower once remarked that his Scottish terrier mascots were especially appreciated, "because they are the only 'people' I can turn to without the conversation returning to the subject of war." (3)
Animal mascots have long been associated with unit esprit de corps. Interservice rivalries have boasted the Air Force Falcon versus the Army Mule or the Navy Goat versus the Marine Corps Bulldog. Animal mascots have been placed on official unit orders and even given rank by the adoring units that proudly parade them around the military posts. Stories abound of animal mascots being integral parts of combat units, offering pride, stress relief, and a sense of humility during challenging periods.
Pets are bona fide members of the military family, even perhaps assisting with military family transfers or service member deployments as the pet is seen as a stabilizing factor for children of military families. (4) It has also been shown that for a married couple without children, the attachment level to the pet can be very high, implicating a "surrogate" child relationship with animals (P.R.C., unpublished data, 1992).
Animals and Military Healthcare
In the healthcare field, there exists an increasing popularity of the bond that is enjoyed between humans and animals. Multiple healthcare professions have recognized potential health benefits of the interactions that humans experience with animals. For example, it is well documented that the act of stroking a pet can significantly lower a person's blood pressure. The presence of dogs has been associated with reductions in blood pressure, mean arterial pressure, heart rate, and distress. Friedmann et al demonstrated a decreased mortality rate in pet owners one year after discharge from a coronary care unit. (5) These examples illustrate the beginning of many potential treatment benefits offered by companion animals in a clinical treatment setting.
Animals have found such a place in assisting the human healthcare professionals, the practice now known as animal-assisted therapy. In fact, there is an early history of animal-assisted therapy in US military treatment facilities. The US military promoted the use of dogs as a therapeutic intervention with psychiatric patients in 1919 at St Elizabeth's Hospital in Washington, DC. (6) Another early documented human-animal bond program involved the Department of Defense (DoD) at Pawling Army Air Force Convalescent Center, Pawling, NY, in the 1940s. (7) The Center's farm animals were integrated into the treatment milieu for emotionally traumatized veterans and provided a purposeful interaction during their convalescence.
Following World War II, Dr Boris Levinson, a psychologist, used his own dog as a co-therapist during counseling sessions and published his findings in the 1960s. Interest in this field grew rapidly with the formation of the Delta Society in 1981, along with international membership and influence, leading to recognized benefits of human-animal bond interactions being accepted by the healthcare professions.
In 1983, LTC Thomas Catanzaro, US Army Veterinary Corps, wrote of the interdependent relationships of animals, humans, and the health professions, and also described many considerations for establishing an animal-assisted therapy program in his An Administrator's Guide for Animal Facilitated Therapy Programs in Federal Healthcare Facilities. (8)
In 1985, the US Army Veterinary Corps, the DoD Executive Agent for Veterinary Services, took the lead in developing a better understanding of human-animal relationships and actively pursued ways for this knowledge to contribute to the military community. To that end, a Veterinary Corps officer, MAJ Lynn Anderson, was designated as the Human-Animal Bond Advisor to The Surgeon General of the Army in 1986.
The Veterinary Corps established a 2-year Masters of Public Health program with an emphasis in the human-animal bond and community health specialties at the University of Tennessee in Knoxville. Upon graduating from this program in 1992, the author became the Veterinary Corps' subject matter expert and established and directed the US Army Service Dog Training Center (SDTC) at Fort Knox, Kentucky from 1995 to 2004.
The SDTC was a pilot program initiated to assist physically disabled Veterans and/or exceptional family members. The SDTC trained select stray dogs to become the indispensible helpers for physically disabled Veterans or family members. The SDTC staff consisted of 2 civil service animal trainers who trained not only the animals, but also select inmates from the Law Enforcement Command's local prison. By assisting with training the dogs, the inmates received a rehabilitative experience as they transformed the unwanted stray dogs into invaluable helpers for those in need. The STDC program graduated its first trained human recipient and animal teams on Veterans Day, 1997. Throughout its 7-year history, the SDTC successfully graduated over 60 human-animal teams represented by all of the DoD Services. Unfortunately, this program closed in October 2004 due to funding constraints within the Army Medical Department.
Various animal-assisted activity programs, including animal visitation, operate at a number of Army medical centers (AMC), most notably at Tripler AMC (Honolulu) and Brooke AMC (Fort Sam Houston, TX), as well as the Munson Army Health Center, Fort Leavenworth, KS, and the Walter Reed National Military Medical Center (Bethesda, MD). Such programs are supported by the local Army medical commands and operate with a core of Red Cross volunteers. The main purpose of these programs involves bringing smiles to the patients, family members, and hospital staff. In doing so, patients focus on the animals which may help alleviate their fear, anxiety, or pain. Often, the hospital staff reports an increase in interaction with the patients associated with animal visitation programs. An example of continued animal-assisted activity program success is the recognition of the Tripler AMC program, which has existed for over 20 years, by the Annual Hawaii State Chapter Heroes Award. Also, before it was deactivated, the Army Veterinary Command recognized the values of such involvement with a competition each year for the best human-animal bond program among its subordinate branches. Another type of approach is represented by a unique human-animal bond program at Fort Myer, VA, the Equine-Assisted Program, which uses the caisson horses to help improve balance for certain traumatic brain injury patients.
Army military veterinarians of the Public Health Command perform the behavioral temperament evaluations and health examinations for the animals involved with the animal-assisted therapy and animal-assisted activity programs throughout the contiguous United States, Hawaii, and Germany. This involvement helps to ensure that the appropriate animals are employed to assist patients, clinicians, and families during the healing processes.
As an adjunct to more traditional treatment modalities, the Walter Reed National Military Medical Center (WRNMMC) is currently involved with several human-animal bond programs that allow rehabilitating Soldiers to skillfully train potential mobility service dogs for Veterans with mobility impairments. This program is in collaboration with the therapeutic service dog training program operated by Warrior Canine Connection, a nonprofit organization located near WRNMMC. At the Eisenhower Army Medical Center, Fort Gordon, GA, certain Soldiers who are recovering from posttraumatic stress disorder are recommended by behavioral healthcare providers to work with dogs to facilitate their goal-oriented therapeutic regimens.
In the military operational environment, pairs of certified therapy dogs have been specially trained and deployed to Iraq and Afghanistan with several combat and operational stress control units. The 212th Medical Detachment and the 254th Medical Detachment both employed therapy dogs for approved studies related to how the animals' involvement may affect certain attitudes such as mood state, job satisfaction, stress levels, and resilience levels. To date, results of that study are pending. The dogs are viewed as a means of breaking down the perceived barriers and facilitating social interaction between Soldiers and occupational health medical professionals.
Interest in the human-animal bond field expanded enough that an Animal-Assisted Therapy Summit was organized in December 2009 by the Behavioral Health Division, Office of The Army Surgeon General. The 3-day meeting at Fort Myer was initiated to help describe and define existing animal-assisted activity and animal-assisted therapy programs and terminologies, as well as uses of animals in combat stress control units, Warrior transition units, and several military treatment facility programs. A consensus was developed to enhance standards, polices, objectives, and research metrics for various existing and potential programs.
The Future of the Human-Animal Bond and Healthcare
Although it is widely held that there are both physical and psychological health benefits of pet ownership, there have been few well-controlled studies. However, the more subtle benefits that may be objectively measured via lower drug dosages or blood cortisol levels, and may be investigated as possible adjuncts to conventional therapies in pain management. Recently, Olmert (9) summarized findings that show blood oxytocin levels rising in both animals and people as they interact with each other. Oxytocin is thought to be associated with pair bonding and a reduction in fear or anxiety.
Another area of investigation with possible far-reaching implications is the human-animal bond effect as a broad alternative to conventional direct pain relief. Using a multidisciplinary approach, the human-animal bond programs associated with animal-assisted therapy may offer a significant role for select patients to minimize pain. For example, the activity of caring for animals, both small and large, assists people with arthritis by providing activities that requires them go outside and walk a dog or feed a horse. Select patients who possess the inherent "nurturing" attribute may have a more apparent pain tolerance while in the company of animals. This nurturing attribute of animals may be the key difference that separates the effect that animals may render to patients versus an inanimate or animate "distracter" that may temporarily alleviate pain.
There is a definite role for companion animals in the treatment of our military personnel in multiple treatment venues. Involving the animals as an adjunct to traditional treatment modalities has been shown to have positive psychological and physical benefits for some patients during the healing process. Although much of the evidence that supports the use of animals is anecdotal, the empirical data is increasing with promising results.
For clinical staff interested in learning more about animal-assisted therapy programs, the Department of Defense Technical Bulletin TB MED 4 (3) is an excellent initial source for information and guidance.
(1.) Roth JP. Roman Warfare. New York, NY: Cambridge University Press; 2009:61.
(2.) Custer EB. Boots and Saddles. Norman, OK: University of Oklahoma Press; 1961:272.
(3.) Department of Defense Technical Bulletin TB MED 4: DoD Human-Animal Bond Principles and Guidelines. Washington, DC: US Dept of the Army; June 16, 2003:2-2. Available at: http://armypubs.army.mil/med/dr_pubs/dr_a/pdf/tbmed4.pdf. Accessed January 10, 2012.
(4.) Anderson LJ. The pet in the military family at transfer time: it is no small matter. In: Sussman MD, ed. Pets and the Family. New York, NY: The Haworth Press; 1985:205-222.
(5.) Friedmann E, Katcher AH, Lynch JJ, Thomas SA. Animal companions and one year survival of patients after discharge from a coronary care unit. Public Health Rep. 1980;95(4):307-312.
(6.) Velde BP, Cipriani J, Fisher G. Resident and therapist views of animal-assisted therapy: implications for occupational therapy practice. Aust Occup Ther J. 2005;52:43-50.
(7.) Bekoff M. Animal assistance to humans: animal-assisted interventions. In: Bekoff M, ed. Encyclopedia of Human-Animal Relationships. Vol 1. Westport, CT: Greenwood Press; 2007:1-2.
(8.) Catanzaro TE. An Administrator's Guide for Animal Facilitated Therapy Programs in Federal Health Care Facilities. Fort Sam Houston, TX: US Army-Baylor University Graduate Program in Health Care Administration; 1983. Available at: http://www.dtic.mil/cgi-bin/GetTRDoc7Location=U2&doc=GetTRDoc. pdf&AD=ADA222034. Accessed January 18, 2012.
(9.) Olmert MD. Made for Each Other: The Biology of the Human-Animal Bond. Cambridge, MA: Da Capo Press; 2009.
COL Chumley is Chief, Human-Animal Bond Programs, DoD Veterinary Service Activity, Office of The Army Surgeon General, Falls Church, Virginia.
COL Perry R. Chumley, VC, USA