Connection Therapy Podcast

February 28, 2024

Hello and thank you for joining the Connection Therapy podcast. This is a podcast about the craft of psychotherapy, and we seek to support those who strive to improve their crafty by sharing research about the science and stories about the art of psychology.  Together we will explore these findings, so you can decide how you want to apply them to benefit your practice.

Welcome to the Connection Therapy podcast, this is Dr. Brenda Murrow, and I’m wondering when was your last statistics or research methods class?

In the field of psychology we are always trying to learn new things. This appears to be true throughout the near 150 years the field has been in existence, and it is even more intense now as technology advancements and introspection about our role are combining to bring new insights to practitioners.

Yet…the research on how psychology works can be confusing at best. It is difficult to figure out what it all means when the studies are written in a way that is not regular language and not understandable to many people. Yet, as mental health practitioners we are responsible to our patients to understand how new research affects the way we practice, in fact we are ethically bound to do so, which can leave us in a bind if it has been a while since that last statistics and research methods class.

Would you like a way to decipher some of the psychological research studies and get an explanation of how you can really use them in your sessions? You know, have someone explain the theories and concepts, and translate all the hypotheses, methodology sections, and get to the conclusions, and most importantly, get to the applications. Psychology studies can be interesting, but like what do they mean in a session, if you’re a practicing clinician? Or, more generally, what do they mean in the world, if you’re a curious person?

And, if you are interested in all these things, I’m guessing you might prefer to listen about them, instead of read them, which is great because that’s what we are up to with our specific episodes focused on research about the science of psychology. As both a clinician and faculty member myself, I happen to be deeply interested in both the foundational concepts of psychology and the research about them. And, I’m accustomed to switching the language and terms back and forth. For each theory and clinical practice we discuss in an episode of the podcast, I will likewise provide an episode about associated research on that topic. I’m organizing them in this way, so you can select which podcasts to listen to based on the clinical topics about which you would like to learn more.

That said, here in this first research episode, there is something unique amongst all the research episodes that are planned, so let me explain… I did a study for my doctoral dissertation that covers some of the topics we will discuss later in the podcast. So, a lot of the research we are going to discuss is research I did about some of these phenomena, it was introductory but I still feel it important to provide you this overview, since later podcast episodes are going to refer to this original study. I want explain here it in detail, so that for those interested, you understand the design protocols and methodologies that were used, and it provides you more of a foundation to later concepts.

In this episode, I am going to provide an overview of the research project I did, which looked at how participants responded to a therapy dog entering session. And, it was heavily influenced by one of the foundational assessments in the field of attachment theory. And, there is a secondary assessment that my project also illuminates in a way. I will explain my study in detail along with the designs of those additional assessments, and how my study relates to them. These two assessments, called the Strange Situation and the Adult Attachment Interview, are important to the larger field of psychology, so with this overview it may help you to consider their implications today. I also provide the reasoning behind my study, as well as tie in additional features about animal-assisted therapy and working with children who have been abused, that I incorporated into my study. So, there is a lot of information in this podcast!

This podcast is an overview of my study and it ends up yielding a preview of many of the episodes in this podcast, as I just mentioned. The study I am describing here included the observation of behaviors made by the children who participated in it. For the behaviors I observed, there are both the foundational concepts that drove me to study them as well as the findings of what I learned, and so those are shared in podcasts about those particular behaviors.

In other words, this is an overview podcast about the study itself, and then there will be follow-on episodes that explain the behaviors in more detail. That way, if you want to isolate a particular behavior, and learn about it, say for example projections that were introduced in the podcast’s first episode, you will have a variety of ways to learn about it, including information about the research I did as well as the clinical intervention podcasts, and they will be easy to find because they will all have the term “projections” in the names of the episodes, in this example.

Why might you want to listen to an entire episode about a research study? Well, for me, it is one thing to theorize about a particular psychological phenomenon, it is another to see something happen in a session that you know has importance, but can’t quite explain, and there is a middle-ground in research that helps me gain perspective, to try and understand what I’m seeing in session and how the theory applies. Hopefully, this episode will support you in doing something similar, giving you the confidence to begin finding that line where practice becomes an art.

As part of these research episodes, I’d like to orient you to the typical ways research studies are organized by providing the overviews in a way that shares how they are typically presented in a journal article balanced with some commonsense terms. My belief is that all people can gain information from research studies, it doesn’t have to be restricted to those who are researchers. It just takes a few translations on the language and terminology used.

Commonly, research studies start out with an overview or summary, called an abstract.
A brief version of the abstract, the purpose of the research along with an introduction of the literature I reviewed, is as follows:

Abstract

The study I did was to explore the effects of Animal-Assisted Therapy (AAT), with a therapy dog, on the treatment of children at a community non-profit agency. It is entitled, A Quantitative Exploration Into the Effects of the Human and Animal Connection, and it was completed in 2013.
If you listened to Connection Therapy’s first podcast episode, you may remember that I mentioned my dog, Maddie. And, she was the therapy dog in this study.

Right up front I need to let you know the research I did is small in scale. There needs to be more research done, before significant conclusions can be made. There were nine participants, aged four to twelve, who were in treatment at the non-profit agency for experiences of domestic violence, physical, or sexual abuse.
Original data collection was completed with the design of a four-session protocol that combined content known to be important for children who have experienced severe trauma, integrated AAT practices, and implemented neurobiological and psychoanalytic principles.

The sessions were video-recorded and participant behaviors were studied. A behavioral assessment was created that scored for 15 behaviors. What I also considered is not only that the empathy shared in the relationship with the therapy dog could be therapeutic but also that the behaviors toward the therapy dog could be diagnostic. As I mentioned, I modeled my study after a significant assessment in the field of attachment to test this idea.

My interest in the topic lies at the core of understanding the connection between beings, in this case humans and animals. One of the definitions, from The American Heritage Dictionary, of connect is “to join to or by means of a communications circuit.” The idea of a connection between humans and animals implies some linkage between species, which leads to a way for communication to pass back and forth.
Since it was an exploration into the effects of the human and animal connection, I started by reviewing our overall relationships with animals. Humans receive a lot of benefits by being in relationship with animals, including physiological, behavioral, and psychological which I considered. I specifically focused on the emotional expression common to both humans and animals, how that emotional expression translates to empathy, and how the experience of animal-assisted therapy may result in encouraging healthy brain functioning as described by interpersonal neurobiology. (And I will explain those in more detail in a later section)

For a connection between beings to occur, there is a need for a similarity in experience, at least enough so that when one counterpart in the connection shares an expression, the other counterpart can somehow integrate it enough and arrive at a commonality of experience such that a real communication has transferred. For example, if I say that a human and an animal companion are connected, the perception is that there is a bond and that there are things shared across that bond, presumably love might be one of those things shared. For that to occur, both the animal and the human need to have an internalized experience of love to be able to receive that expression from the counterpart, when it is communicated across the bond. And, for me, the important psychological question is, how and where does that occur in the human counterpart; and furthermore, if that communication channel is somehow impaired for the human counterpart, might the similarities in emotional expression between humans and animals provide an opportunity to heal it?

Literature Review
One of the things we have learned in a few major studies in the field of psychology is that the style of therapy really does not matter to the effectiveness of the treatment, what matters is how the patient experiences the relationship with their therapist.

In 2002, a meta-analysis was published, which means the researchers reviewed a wide variety of previously done studies over five decades, and they were looking at effectiveness of therapy, and it concluded that the “relationship variables that are most often related to effectiveness are the conditions of empathy, genuineness, and unconditional positive regard” (Bozarth, Zimring, & Tausch, 2002, p. 168). This is from authors, Bozarth, Zimring, and Tausch published in the Handbook of Research and Practice for the Humanistic Psychotherapies, you can more information at our website connectiontherapypodcast.com

Since I was interested in understanding more about animal-assisted therapy, it stood to reason that I needed to understand how humans experience empathy, genuineness, and unconditional positive regard from the animals they worked with during animal-assisted therapy.

Often, the frustrating thing about a research project is how each item of interest has to be broken down into parts. For example, since I was interested in understanding animal-assisted therapy, it may seem likely that I then considered all the animals working in animal-assisted therapy at the time and how they connected to humans. I had some experience with animal-assisted therapy at that time, as I had done some equine-assisted therapy during my practicum training. And, I had also had the privilege of observing how dolphin-assisted therapy works in a very unique trip organized by two wonderful biology teachers at my high school. However, that would be too large of study, with many variables, for example, I would have been looking to see how humans felt horses display unconditional positive regard along with how they experienced dolphins display genuineness. So, I had to narrow that down quite a bit, since there was only one person researching, me, and this was my dissertation for my doctoral degree, so there was a time limit for it to be completed.

Looking at a way to scale it back, I considered how we could “know” that animals are displaying any of these qualities, and even then as I described earlier, the important part for the effectiveness of therapy is how the humans experienced the qualities displayed by the animals. Stephen Porges had released his book, the Polyvagal Theory, in 2011, and I was familiar with how he had proposed that mechanisms of empathy have a biological bases, and in some cases a very obvious behavioral counterpart, which is currently not as easily described for genuineness and unconditional positive regard, although the capability to research these phenomena is exploding right now, so that will change in the future.

Empathy is “identification with and understanding of another’s situation, feelings, and motives” as defined in The American Heritage Dictionary. Dr. Lou Cozolino is an American psychologist and professor of psychology, and he explained the patient’s “empathic attunement (that is their ability to track our situation, feelings and motives) with the therapist provides the context of nurturance in which growth and development occur. By activating processes involved in attachment and bonding, as well as moderating stress in therapy, empathic attunement may create an optimal biochemical environment for enhancing neural plasticity” (Cozolino, 2002, p. 62). Neural plasticity is a complex way to describe the ability for our brains to change, as I understand it, it has to do with the pathways the neurons take when they move around being pliable or moveable, and what I take this to mean in a session, or in the world, is that it means we have more of an ability to get out of previous pathways and consider new ones for our lives, in this case, relationship patterns. As a sidenote, the way phrases develop can be a curious thing to explore. As an example, when someone is in a habitual pattern of behavior, we might hear the term, “they are stuck in a rut.” Interestingly, this has some truth to it, so in the terms of the ways their neurons move around their brain, it is considered to be a repetitive neuronal pathway. So, the encouraging news about neural plasticity means that we can get out of these ruts. And what Dr. Cozolino is describing here is that one way to achieve this is to work with a therapist who shows us empathic attunement, in other words, they track and listen to our thoughts and feelings, and most importantly, we are aware and can sense a therapist doing this for us. So then, our brains become more changeable, and those “old ruts” can find find new pathways, in this case, possibilities for new relationship patterns.
In my dissertation, I reviewed the emotional similarities in humans and animals by discussing authors such as Charles Darwin, Marco Iacoboni, Marc Bekoff and more. I’ll summarize their work by stating it is important to understand that the exchange of empathy can occur across species, that is from human to animal and animal to human, because both animals and humans experience emotions. The presence of emotions in both species enables the empathic exchange, and also of interest is the current neuroscience that points to physiological similarities in the experience of emotions across species.
So, I focused on empathy, and selected animal-assisted therapy modality that I could study most easily. For a lot of people, that tends to be with a canine, and that was was true for me too, my dog, Maddie, was the therapy dog in the study. I theorized that maybe the therapy dog could provide empathic attunement, much like a human therapist can do. And, I wanted to know if the empathy displayed by the therapy dog could also encourage positive outcomes for the patient.

Another important facet that I learned about is that trauma can influence the way the brain operates, and this was being explored by Porges and others including Allan Schore and Dan Siegel, and my practicum training experiences included working with children and adults who had experiences of domestic violence, sexual and physical abuse. When people have experienced severe trauma at the hands of other humans, they can feel much safer in interaction with an animal, and even if there is not a history of trauma, the animal doesn’t say all the judging and other harsh shaming responses many of us are sensitive to, especially children.

So I built a protocol that included four sessions by combining content known to be important for children who have experienced severe trauma, integrating AAT practices, and implementing neurobiological and psychoanalytic principles.

The sessions were video-recorded and for this study, I only focused on the participant behaviors. I theorized that the behaviors displayed may reveal data about participants’ inner states, such as emotional responses and internal models of relationship. Thirty-six videos, each approximately 20 minutes in length, were analyzed to calculate individual counts of fifteen specific participant behaviors, selected for their importance in psychoanalytic, attachment, and other psychological theories, and a few of them were added because I sensed something important about them in the data analysis.

Complete findings, including extensive session summaries, are presented in my published dissertation. And, this podcast will be presented in multiple episodes, first I will introduce the foundational theories and background on the reasons for the design. Then, I will share an overview of the findings and add further discussion. Then, the individual behaviors that warrant a clinical discussion about how to work with them in sessions will be individually presented.

This research study revealed the possibility that behavioral trends in interaction with a therapy dog exist that are unique to each participant and may indicate important characteristics of individual personality styles and histories, what I hope to be potentially a way to understand relationship patterns.

The fields of ethology, which is the study of animal behavior, and neuropsychology, the part of psychology focused on learning how things are physically working in the brain, pointed to clear commonality of the emotional expression in both humans and animals. So, to go further with this knowledge, for the human counterpart, I considered the physiology that is directly impacted by emotional experiences and that is the autonomic nervous system, which is explained by the Polyvagal Theory.
The Polyvagal Theory, as proposed by Stephen Porges (2009) suggests that there is a reciprocal relationship such that an individual’s environment influences the psychological state of the individual, and that the individual’s predisposition influences the individual’s perception of their environment. Let me say that again (repeat it). This theory also explains that the individual’s psychological state has a basis in physiological characteristics and that changes in those characteristics reveal changes in psychological state. If it is understood that an individual’s psychological state can be improved by a change in the environment because of the reciprocal nature of the environment’s impact on psychological state and the individual’s appraisal of it, then it is inherently important to study those things which alter the individual’s environment and how they impact the physical and thus psychological state of the individual.
That is, in the example above, does being in relationship to an animal companion ameliorate the stress-related physiological states as discussed as part of the Polyvagal Theory? The introduction of an animal into the human participant’s environment could provide stimulation (i.e. an environmental change) such that differences in the human participant can be studied,, and the next question to address would be how this emotional expression might be displayed and how could it be effectively studied?
So, I had in my mind the ways things may be working, now I needed to design a research protocol to put these theories to test.

I hope you’ll join us again for future explorations in the field of psychology.  If you would like to learn more about the authors and the studies listed in this episode, you’ll find more information about them on our website, connectiontherapypodcast.com .   And, if you’d like to take a step further, we offer additional ways you can collaborate with us.  Maybe you would like to confidentially discuss a case, or do some additional consulting?  We’d be happy to speak with you.  We also have study groups where you have the opportunity to join and gain more knowledge in a supportive environment.  These are small groups where we share and explore the podcast topics and more, in detail.  And, in some states, your time spent in the group may be able to qualify toward your continuing education requirements for many licensure types.  You will find more information on our website, connectiontherapypodcast.com 

Thanks!  

Until Next Time…