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Traumatic Pet Loss and the Integration of Attachment-Based

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 Journal of Psychotherapy Integration
© 2019 American Psychological Association 2019, Vol. 29, No. 2, 119 –131
1053-0479/19/$12.00 http://dx.doi.org/10.1037/int0000143

Traumatic Pet Loss and the Integration of Attachment-Based Animal

Assisted Therapy

Katherine Compitus
New York University
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

The sudden death of my Labrador Retriever was traumatic and extremely difficult
This document is copyrighted by the American Psychological Association or one of its allied publishers.

to process. Despite previous experience in grief counseling, I was intellectually but

not emotionally prepared for my own pet loss. In order to process my grief, I began
to explore my own childhood and the nature of the attachment between my dog and
me. Reflecting on different schools of psychology, including self-psychology and
attachment theory, I discovered that selfobject needs contribute significantly to the
development of an attachment bond and attachment anxiety. Animals are extremely
helpful in repairing disrupted or damaged attachments. The traumatic loss of my
dog made me aware of my own reliance on my pets as therapeutic objects, a
realization that greatly transformed my interests and goals. I moved from working
as a generalist practitioner to a clinician specializing in using animal-assisted
therapy (AAT) as an adjunctive modality when working with trauma survivors. The
brief history and current applications of AAT as an effective adjunct treatment
option will be discussed. AAT has been found to work well with a variety of
modalities such as dialectical behavior therapy (DBT) and Psychodynamic Psy-
chotherapy, and should be considered by clinicians working with any clients with
a disrupted or disorganized attachment.

Keywords: animal, attachment, loss, AAT, Animal-Assisted Therapy

Morgan was diagnosed with cancer just 10
days before she passed away. She died with a
scream, suddenly, in front of me, when I was
visiting her in the hospital. It was without a
doubt the most traumatic moment in my life.
Morgan was my black Labrador Retriever, and
as a result of Morgan’s death, I became clini-
cally depressed. Her death not only greatly in-
fluenced the way that I saw the world, but also
directly influenced the focus of my therapeutic
work and the treatment modality that I subse-
quently used with my clients. The American
Veterinary Medical Association defines the Hu-
man-Animal Bond as
Katherine Compitus, Silver School of Social Work, New
York University.
Special thanks to Carol Tosone, Aminda Heckman-
Chomanczuk, and Rise VanFleet for their help in the prep-
aration of this article.
Correspondence concerning this article should be ad-
dressed to Katherine Compitus, 8 Peter Cooper Road, New
York, NY 10010. E-mail: kog206@nyu.edu
119
a mutually beneficial and dynamic relationship be-
tween people and animals that is influenced by behav-
iors that are essential to the health and well-being of
both. This includes, but is not limited to, emotional,
psychological, and physical interactions of people, an-
imals, and the environment. (American Veterinary
Medical Association, n.d.)
This is a dynamic relationship and one that
can be used to accelerate the healing of people
who are in a state of disequilibrium (McNicho-
las & Collis, 1995; Serpell, 1996; Siegel, 1990).
The human–animal bond is a powerful treat-
ment modality that can be easily integrated with
a variety of other treatments but is often over-
looked. I began this journey as a clinician who
worked with a variety of populations and mo-
dalities. The death of my beloved Morgan pro-
vided me with a deeper insight into the nature of
trauma and loss. I realized that trauma, whether
chronic or single-episode, often involved a dis-
ruption in attachment, as well as a loss of a
sense of safety and security. I discovered that
animal-assisted therapy (AAT) as an adjunctive
modality is an effective method of quickly re-
 120 COMPITUS
pairing that disruption while working toward
long-term healing.
Personal Narrative
Something about the symbiotic nature of the
dog– human relationship has always deeply ap-
pealed to me. I adopted Morgan when she was
just 8 weeks old from a local shelter. I had been
severely allergic to dogs as a child and recently
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
discovered that I had outgrown my allergy. I
This document is copyrighted by the American Psychological Association or one of its allied publishers.
had other pets while growing up, but had always
wanted a dog.
It was a time of emotional vulnerability and
adjustment for me, and the presence of a dog
was particularly helpful. I had recently com-
pleted graduate school, I was moving out of my
parents’ apartment, and I had recently ended a
5-year relationship with my fiancé. I was begin-
ning to explore and learn who I was as an adult,
consistent with Mahler’s description of the sep-
aration-individuation phase of toddlers (Colar-
usso, 1990; Mahler, 1972). Establishing oneself
as an independent adult felt overwhelming and
scary. Somehow, I knew that with this little,
loving, dependent puppy by my side I would
always have someone to whom I could come
home. Morgan was the secure base that I relied
upon when I faced challenges and the safe ha-
ven that I turned to when in distress (Ainsworth,
1991). Although I had friends and family who
provided a strong support network, they did not
provide the same sense of calm that I felt when
I spent time with Morgan.
Morgan was never taught how to work as a
service dog, but she always intuitively behaved
in a way that assisted me in self-regulation,
adaptation, and coping. When I cried she would
become frantic; she would run over and lick the
tears from my face until I calmed down. If I felt
sad and did not want to get out of bed, she
would paw at me, whine and nudge until I got
out of bed and took her and Angie (my newly
adopted puppy) for a walk. Morgan made me
aware of my behavior and helped me monitor
and regulate my affect; she helped me emotion-
ally grow and mature. My dogs transformed me
from a young, dependent adult to a responsible,
nurturing parent. They transformed not only me
but the relationships that I had with friends and
with family. In parenting these young dogs, I
learned how to become an adult.
Eventually, I became a clinical social worker,
and we moved upstate and adopted more ani-
mals. It was Christmas Day, a few years later,
when Morgan had what I thought was an asthma
attack. I rushed her into the emergency veteri-
nary hospital, and a few hours later received a
phone call telling us that her lungs were filled
with cancer. But despite the diagnosis, Morgan
was still a very active and playful 11.5-year-old
dog who had boundless energy and showed no
signs of slowing down; she was even playing
with my younger dog, Boston, every day. Based
on her exuberance, I was hoping that the hos-
pital had misdiagnosed her, so I consulted a
veterinary oncologist to run more tests. Ten
days after the initial diagnosis of cancer, Mor-
gan was back in the hospital to have a lung
biopsy. There had been a complication and,
although she was supposed to come home, they
wanted to keep her overnight on oxygen. I had
seen her hours before and thought I would be
picking her up the next morning, but I felt
compelled to visit her in the hospital anyway.
They opened the special oxygen cage and I
could see she was having trouble breathing. I
stroked her, pet her, rubbed her belly and her
ears. Believing that Morgan could potentially
recover, I told her I loved her very much and
that she would be back home soon. And that is
when she let out a painful howl and collapsed.
Morgan died and I would never be the same.
Morgan’s death was deeply traumatic for me.
I suddenly burst into tears and could not stop
crying. I couldn’t breathe; I felt my heart pound-
ing in my chest. I was crying while having my first
panic attack, and it felt like I did not stop crying
for two months. I became clinically depressed. I
could not get off the sofa, eat, sleep, or attend to
my daily basic needs. I felt helpless, hopeless, and
worthless. Although I had known it intuitively
since I was a child, here I was experiencing the
powerful bond that can be created between hu-
mans and other species. I had become dependent
on Morgan to provide me with a sense of safety
and security, and without her presence, I became
lost.
Sadly, 6 months after Morgan’s death, Angie,
my other dog, was also diagnosed with cancer.
She had surgery, chemotherapy, and holistic
supplementary care. It was the need to take care
of Angie that helped me to quickly recover from
Morgan’s death. Fortunately, she lived an addi-
tional year and a half, during which time we
 PET LOSS AND ANIMAL THERAPY
created a “bucket list” for her that included
spending a week at Cape Cod. The special care
that we provided to Angie helped me, as well.
Spending a week on the beach (for Angie’s
sake) strengthened the bond between me and
my husband and gave me an excuse to tempo-
rarily escape the home that held so many mem-
ories of Morgan. We helped Angie peacefully
pass away via euthanasia administered by a
veterinarian at our home. Angie’s passing was
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very different than Morgan’s because we had
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the time to appreciate our last moments with her
and we were able to help her gently die. The
traumatic nature of Morgan’s death reaffirmed
for me that the human–animal bond, while often
underestimated, is extremely powerful.
Pet Loss
The loss of a companion animal can be severe
in both intensity and duration and can cause
intense psychological distress (Carmack, 2003).
Animals are often viewed as family members by
their human guardians and may provide uncon-
ditional positive regard and reciprocal attach-
ment security (Field, Orsini, Gavish, & Pack-
man, 2009). When a pet dies, people may be
thrown into a state of disequilibrium because they
had depended on the animal as an adaptive
coping mechanism that was no longer available
to them. Kurdek (2008, 2009) explains that dur-
ing times of distress it is often more common
for people to turn to their pets than to relatives
or friends. However, when the pet has passed,
the person may have lost a primary coping
mechanism and, therefore, may have significant
difficulty recovering from the loss.
The death of a pet may be especially difficult
because other humans may not be as under-
standing; often the loss of a pet is a disenfran-
chised loss (Carmack, 2003; Packman, Field,
Carmack, & Ronen, 2011). Packman et al.
(2011) explain that “the grief associated with
the loss of a pet is still relatively unrecognized
and underappreciated. This may be due in part
to lack of awareness of and appreciation for the
depth of the attachment that humans can form
with companion animals” (p. 342). Although it
would be bizarre to suggest that someone
should replace a recently deceased child with a
new one, it is still common for people to suggest
that the loss of a pet is trivial and the pet should
be quickly replaced. It is this lack of societal
121
awareness that often deprives the bereaved of
social support.
Sable (2013) explains that companion ani-
mals often “offer a predictable, uncomplicated
and consistent relationship which substitutes for
the lack of close relationships in our challenging
and unsettling times” (p. 93). The support of
human companions often cannot compare to that
of companion animals; research findings sug-
gest that even adults who have a strong support
network may feel especially relieved when
thinking about their companion animal during
times of stress (Allen, Blascovich, & Mendes,
2002; Tarling, 2017). Companion animals, such
as dogs, can be a stabilizing presence in times of
transition, stress, or life adjustments. Dogs are
especially adept at reading nonverbal cues, and
this mutual understanding often leads to a
deeper bond than with other companion animals
(Fine, 2010). It is important for clinicians to
discuss a person’s attachment to their pet be-
cause “examining feelings about the close bond
they share with a pet may lead to further aware-
ness of their attachment experiences with oth-
ers” (Sable, 2013, p. 96).
Loss is often cumulative, and therefore the
loss of an attachment figure, such as a pet, may
bring up past trauma, anxiety, and even the
deaths of human relatives. Levinson (1978)
writes that “association with animal compan-
ions has a therapeutic value and contributes to
self-understanding” (p. 1031). He explains that
when becoming the guardian of an animal (as
their “parent”), we may gain a deeper under-
standing of our relationship with our own par-
ents and parental functioning including when
and how to nurture and discipline (Levinson,
1978, p. 1033). It is, therefore, important to
make meaningful sense of the loss of a pet,
integrate it, and use the loss to transform into a
stronger person.
Personal Transformation
The death of Morgan provided me insight
into my own psyche. I knew that I was an
insecure person before adopting her and more
confident after, yet I had not been aware that she
so completely filled some of my psychological
needs. Through the lens of self-psychology,
Morgan was a selfobject for me. Blazina, Boy-
raz, and Shen-Miller (2011) explain that “a sel-
fobject need is provided by an animal . . . which
 122 COMPITUS
gives a sense of cohesion, support, or suste-
nance to a person’s sense of self. If the selfob-
ject is taken away, the person will feel a sense
of fragmentation or falling apart” (p. 138). This
is due to the validation and connection that the
selfobject provides to the self (Kohut, 2009).
Although already a trained clinician, I had pre-
viously only an intellectual understanding of the
importance of validation and connectedness. In
order to adjust to the death of a loved one,
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people must redefine themselves and the situa-
This document is copyrighted by the American Psychological Association or one of its allied publishers.
tion, and reorganize their attachment configura-
tion and the way they view the world (Bowlby,
1969/1982). Never before had I experienced a
loss so severe that it deeply impacted my sense
of self.
The loss of Morgan made me aware of at-
tachment issues and childhood trauma that I had
not realized existed. Immediately after her
death, I sought to learn everything I could about
death studies, loss, and trauma. I became a certi-
fied family trauma specialist and received train-
ing in EMDR. I slowly moved from becoming a
generalist practitioner to a trauma specialist. As
I was learning about grief, trauma, and dis-
rupted attachments, I was surprised to learn that
there were just a handful of practitioners re-
searching and implementing AAT in their work
with trauma survivors. I started working in the
psychiatric emergency room of a local hospital,
and again was surprised that during clinical
assessments they did not ask about pets as a
source of support. I began asking all my clients
about their pets and very often found that it
would engage them quickly and help to form an
immediate rapport. It also gave me a sense of
the support system they had at home; often
people lived alone but had a dog or cat (or other
animal) that they loved dearly. It was the bond
with this animal that kept them hopeful and
alive. In fact, research indicates that people with
pets are less likely to commit suicide (Stanley,
Conwell, Bowen, & Van Orden, 2014).
At the hospital I also saw clients who needed
help taking care of their pets—some had schizo-
phrenia and had stopped taking medications. I
was able to help these clients connect with
people or agencies that could help them while
recovering in the hospital. I also saw a few
clients who became suicidal after the death of
their pets. In particular I remember one man
who attempted to hang himself after he found
his cockatiel dead. I recognized that the bird
was his best friend and primary source of sup-
port. Without his bird he did not know who he
was or what to do with his day; he became
deeply lost. Some other staff members mocked
his pain but I understood that a secure attach-
ment did not need to come from another human,
it just needed to come from a being who pro-
vides support. The patient had a trauma back-
ground and reported that he found other humans
unreliable and untrustworthy. But his bird had
never betrayed his trust. For that man, his bird
was his family and he did not want to live
without his best friend. Countertransferentially,
it was very difficult for me to work with this
patient, given my identification with him as a
pet parent in recent mourning.
The extent to which I missed Morgan directly
influenced my interactions with this patient, as
well as with staff. I was frustrated with staff that
mocked the patient, and I had to carefully reg-
ulate my own emotional response before ex-
plaining to the staff why his grief was so valid.
I felt more allied with this patient than with
some of my other patients since I understood the
cumulative effect of loss and that the loss of a
beloved pet, a stable object, can be so devastat-
ing. Yet I had to be careful, as a therapist, to not
make assumptions about his feelings or to proj-
ect onto him my own feelings of loss. My
psychological history was not his own, and my
feelings of vulnerability were not the same. We
had both lost an important figure in our lives,
but I had to allow the client to tell his own
narrative, instead of imposing mine upon him. It
was difficult, but important, for me to work with
this patient. I had to maintain strict boundaries,
in order to not make the counseling about my
own needs. There was also a concern that I
would feel overwhelmed and perhaps suffer
from compassion fatigue if I spent too much
time with this patient. However, it was the in-
timacy established by working with this client
that allowed me to be helped by my client. I
never self-revealed, but hearing a story so sim-
ilar to mine gave me a different perspective on
attachment, grief, and loss that I had been lack-
ing. In helping to heal, I was able to heal my-
self. I continued working at the hospital, with
people of all demographics and all ages (pedi-
atric through geriatric), but I never forgot the
lessons that I learned from that patient.
I had learned about trauma, grief, and loss,
but my transformation was about to come full
 PET LOSS AND ANIMAL THERAPY
circle. The patient who had grieved the loss of
his bird reminded me of the powerful bond that
we form with animals, and research findings
suggest that AAT can be reparative for people
in a state of disequilibrium (Blazina et al.,
2011). My work with that patient, and my own
personal experience with loss, encouraged me
to search out new ways to integrate animals into
direct psychotherapy with clients, and espe-
cially to connect them to the modalities that I
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
was trained in such as EMDR, dialectical be-
This document is copyrighted by the American Psychological Association or one of its allied publishers.
havior therapy (DBT) and psychodynamic psy-
chotherapy. I therefore left my job at the hos-
pital and sought out a clinical position doing
direct psychotherapy with a psychologist who
specializes in attachment issues (primarily with
children and adults who had developed disorga-
nized attachment styles due to severe and
chronic trauma), where I could begin to work at
trauma therapy with AAT.
What Is Animal-Assisted Therapy?
Definitions
There are a variety of ways in which animals
may be integrated into the therapeutic process.
Animal-assisted therapy “is a goal directed in-
tervention in which an animal meeting specific
criteria is an integral part of the treatment pro-
cess” (American Veterinary Medical Associa-
tion, n.d.). A therapy animal is not trained to do
specific tasks (other than basic manners), is
often evaluated and certified by a national ther-
apy animal organization, and may be integrated
in the treatment of one person at a time, multi-
ple people, or with groups (Waite, Hamilton, &
O’Brien, 2018). An emotional support animal
(ESA) is a companion animal that is not spe-
cially trained but provides emotional support to
one person who has been diagnosed with a
mental illness (Pet Partners, n.d.). A service
animal (SA) is a dog or miniature horse that is
a working (not companion) animal and is indi-
vidually trained to do specific tasks to aid a
person with a physical or psychological disabil-
ity complete their activities of daily living (Pet
Partners, n.d.). Unlike ESAs or therapy animals
(TAs), SAs, by federal law, are allowed to go
anywhere a person can go (Lee, 2017). Exam-
ples of SAs are psychiatric service dogs for
veterans suffering from posttraumatic stress dis-
order (PTSD) or guide dogs for the blind. Al-
123
though ESAs and TAs can be a variety of spe-
cies, including llamas, pigs, cats, and rabbits,
service animals are most often dogs. A dog’s
dependence on and protection of humans, and
the species’ developed sensitivity to human
emotional states, makes dogs particularly atten-
tive to the psychological needs of vulnerable
people. Thielke and Udell (2017) state that “pet
domestic dogs (Canis lupus familiaris) have
demonstrated an acute sensitivity to human be-
havior such as gestures and attentional and emo-
tional states, which may be a product of both
evolutionary and lifetime factors” (p. 379).
Despite the differences in training, access,
and integration, all of the above categories uti-
lize the human–animal bond to facilitate psy-
chological health and well-being. Animal inter-
ventions have been used to encourage the
development of adaptive coping skills in those
experiencing loss, anxiety, or depression (Fine,
2010; Waite et al., 2018). As a clinician, the
profound loss of my dog was deeply insightful
and transformative; it was only after her death
that I began to utilize AAT as a primary treat-
ment modality with my clients.
A Brief History of Animal-Assisted
Therapy
Scholars have known about the therapeutic
benefits of animals for a long time. AAT is a
burgeoning field that uses the human–animal
bond to facilitate therapeutic treatment. Most
AAT has been done in hospitals, schools, as-
sisted-living facilities or in independent prac-
tice. In the 1600s, John Locke discussed the use
of small animals to help children develop a
sense of empathy (Chandler, 2012; Fine, 2010).
In 1792 a Quaker retreat in England began
integrating farm animals in the treatment of
their patients; they reported that it decreased the
need for extreme management of the patients
such as isolation and restraints (Baun & Mc-
Cabe, 2000). Other mental hospitals in England,
such as Bethel, also began to include animals to
help patients with a variety of illnesses from
mental health to epilepsy (Baun & McCabe,
2000). Even the famed nurse Florence Nightin-
gale noted the healing influence of small ani-
mals on patients (Braun, Stangler, Narveson, &
Pettingell, 2009). In fact, Freud was one of the
first doctors to include animals in direct psycho-
therapy with patients. Freud started bringing his
 124 COMPITUS
dog, Jofi, to work to aid him with his own
anxiety but he also found that his dog would
move closer to a person who was calm and
would move farther away as a person became
more anxious (Shubert, 2012). Although Freud
wrote in his private notes about the therapeutic
value of having animals involved in direct prac-
tice, those notes were not made public until
recently and, therefore his involvement in AAT
continues to remain largely unknown.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
Boris Levinson (Levinson & Mallon, 1997) is
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credited as the father of the modern animal-
assisted therapy movement. Levinson acciden-
tally discovered the therapeutic benefits of ani-
mals when, like Freud, he brought his dog to
work. He previously had difficulty connecting
with a particular pediatric patient, but when the
child began to play with the dog the child was
able to more quickly establish a rapport with the
doctor (Levinson & Mallon, 1997). After that,
Levinson regularly included his dog in sessions
(Shubert, 2012). Thanks to Levinson’s experi-
ences with the therapeutic effects of AAT, his
work encouraged more research into its mental
and physical benefits, as well as the benefits of
pet guardianship (Shubert, 2012). Recently, Dr.
Aubrey Fine has been a pioneer in developing
AAT as a formal treatment modality. In his
book Handbook on Animal-Assisted Therapy
(Fine, 2010), he outlines practical steps to im-
plement AAT in a variety of settings and with a
variety of populations. To date it is the most
comprehensive database of animal-assisted in-
terventions available to clinicians. VanFleet and
Faa-Thompson (2014) have also written exten-
sively on AAT and recently developed a certi-
fication program integrating animals into play
therapy; it is the first of its kind and quickly
growing in popularity. Although the therapeutic
effects of animals have been recognized for
hundreds of years, they remained largely unrec-
ognized until the last 15 years. However, AAT
appears to be expanding rapidly as more and
more clinicians are noticing the benefits of an-
imals in therapy.
Current Applications of AAT
Hartwig and Smelser (2018) recently sur-
veyed 300 clinicians in New York State to as-
sess their perceptions of AAT. The majority of
surveyed practitioners (97.1%) stated that they
view AAT as a legitimate treatment modality,
and approximately 30% of the clinicians sur-
veyed had already used animals in their practice
(Hartwig & Smelser, 2018). Although only 12%
of the practitioners reported past training in
AAT, 57% reported an interest in receiving
AAT training. Fortunately, there are different
ways that animals can be incorporated into ther-
apeutic activities and the benefits of AAT are
numerous. The purpose of AAT is to increase
the well-being of the human participant by en-
hancing their ability to function physically, cog-
nitively, behaviorally, and socially (Polking,
Cornelius-White, & Stout, 2017). In fact, oxy-
tocin, the hormone that bonds mothers to their
children or causes romantic partners to fall in
love, has been found to increase significantly
when humans are allowed to spend time with
their own animals (Olmert, 2009). Oxytocin is
so powerful that it is currently being explored as
a treatment option for various psychological
disorders, such as PTSD, schizophrenia, and
social anxiety disorder (Thielke & Udell, 2017).
This is due to its powerful effect on not only the
behavior, but also the cognition and health of
both humans and animals. If higher levels of
oxytocin cause people to feel a reduction in
social anxiety and traumatic stress, and the pres-
ence of an animal causes raised levels of oxy-
tocin in humans, then it stands to reason that the
presence of animals would result in a calming
effect on the human psyche (Olmert, 2009).
AAT With Various Populations
There are a number of different ways that
animals can be incorporated into therapeutic
activities particularly by enhancing the partici-
pant’s ability to function physically, cogni-
tively, behaviorally, and socially (Polking et al.,
2017). One of the first documented instances of
therapy animals being integrated into treatment
(outside of independent practice) was during
World War II in a hospital for war veterans
suffering from what we would now call PTSD
(Shubert, 2012). Often veterans have difficulty
readjusting to life as a civilian after experienc-
ing the horrors of war. Service animals are
animals specifically trained to do tasks to help a
disabled person complete their activities of
daily living. PTSD dogs help veterans adjust to
life at home (Blank, 2015). Tarling (2017) ex-
plains that companion animals do not detract
from the relationships with other humans, but
 PET LOSS AND ANIMAL THERAPY
only add to them. They are an extra and stable
source of support that the client can rely on
when all else fails. Unlike service dogs, therapy
dogs are not trained to do special tasks, and help
many people with a variety of medical and
psychological needs. In addition to implement-
ing service dog programs, many veterans hos-
pitals also use AAT as a regular intervention for
their patients. In one program, the veterans
“have the responsibility to teach the dogs that
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the world is a safe place. In doing so, they must
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convince themselves of the same” (Blank, 2015,
p.14). An unintended benefit of this program is
that the veterans have reported an increase in
social functioning and improved family dynam-
ics as a result of the increased positive emotions
that result from working with the dogs (Blank,
2015).
Veterans are not the only ones benefiting
from the use of AAT. There has been a sharp
rise in the number of requests on college cam-
puses for emotional support animals or therapy
dog programs (Polking et al., 2017). Research
conducted on depressed college students
showed a significant improvement on the Beck
Depression Inventory when AAT was used as a
treatment modality (Polking et al., 2017). As a
result of exposure to a therapy dog, the students
experienced reduced symptoms of anxiety, as
well as increased relaxation. Interestingly, the
benefits apply to younger students as well, and
extend to academic and social achievement. Re-
cent research indicates that elementary school
students are also able to focus more on a lesson,
remain more on task, and exhibit more prosocial
behaviors when a dog is present in the room
(Polking et al., 2017).
Not only do we feel a connection to our
animals, but our animals help us to connect to
each other, as well. Thompson et al. (2014)
observe that current research explains how an-
imals in the community provide social capital,
which in turn plays a role in the connectedness
of the community. The animals facilitate inter-
action between community members and allow
them to build social networks and feel as if they
are active members of their neighborhood.
There is a significant amount of research on
animals as “social lubricants” that provide
meaningful contact between people, especially
in an urban environment (Levinson, 1978). The
social connection facilitated by animals is not
isolated to vulnerable populations but can be
125
found in members of all demographic popula-
tions.
Waite et al. (2018) examined the use of ani-
mal-assisted interventions in a medical setting.
They conducted a meta-analysis and examined
22 studies that included the use of dogs in a
therapeutic capacity in the treatment of medical
populations. They found that animal-assisted
interventions significantly reduced physical
pain, anxiety, and distress in patients (Waite et
al., 2018). This is consistent with current re-
search that the human–animal bond goes be-
yond psychological benefits but includes phys-
ical benefits, as well, such as lowered blood
pressure, lowered cholesterol, and lowered cor-
tisol levels (Centers for Disease Control and
Prevention, 2018). Waite et al. (2018) explain
that “pain, anxiety and distress are some of the
most frequently reported and most distressing
symptoms associated with medical treatment
and procedures” (p. 5) and suggest that integrat-
ing animals into the treatment process may al-
leviate not only the pain itself but also other
pain-related symptoms such as loss of appetite.
They concluded that animal-assisted therapy
not only benefits those suffering from mental
illness but also those suffering from physical
illnesses such as fibromyalgia and cancer.
Clinical Work With AAT
I trained Chompy, one of my own dogs, as a
therapy dog to work with me and my patients.
Chompy was certified by Pet Partners to work
as a therapy animal in a variety of settings,
including schools and hospitals. He is gregari-
ous, outgoing, charming, and silly. People enjoy
being around him because he is calm but char-
ismatic. He is also a trauma survivor; he was
found starved and neglected on the streets of the
South Bronx. My husband and I nursed him
back to health, and his trauma background is
especially helpful when working with clients
who are trauma survivors. Chompy is a model
of hope and resilience for my clients. I work
with Chompy to facilitate the therapeutic alli-
ance, create a deeper and faster rapport, and for
psychoeducation (Fine, 2010; VanFleet & Faa-
Thompson, 2014). AAT can be difficult because
the therapist must attend to the animal’s welfare
and needs as well as that of the human client
(Hoy-Gerlach & Wehman, 2017). The therapist
must be knowledgeable of animal behavior, and
 126 COMPITUS
if the therapy animal shows signs of distress or
stress, the session should be paused (Interna-
tional Association of Human–Animal Interac-
tion Organizations, 2014). Morgan intuitively
knew how to help me, which (with additional
training) would have made her an ideal service
dog. She was focused on helping one person
with their daily activities. Chompy is very dif-
ferent; he enjoys attention from many different
people and is not in tune to the needs of just
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
one. He is an ideal therapy dog, perhaps due to
This document is copyrighted by the American Psychological Association or one of its allied publishers.
his trauma background; he does not get stressed
easily, and he is comfortable in a variety of
environments. He illustrates to my clients that,
despite the hardships that he suffered, he has not
lost faith in humanity and still thoroughly en-
joys his life.
In my practice I primarily integrate AAT with
psychodynamic psychotherapy and/or DBT. I
have found that the presence of a therapy animal
provides clients with another source of strength
when speaking about traumatic events. Chompy
provides my clients with unconditional positive
regard, genuineness, and acceptance, no matter
what difficult experience they may need to dis-
cuss. A therapy animal such as Chompy also
makes teaching DBT skills more relatable and
fun for clients. I explain to my clients that
mindfulness is so important to our well-being
and that animals, like Chompy, always live in
the moment. I integrate him into each lesson,
explaining how he illustrates core ideals such as
radical acceptance, mindfulness, distress toler-
ance, and even interpersonal skills. He also
helps clients practice emotional regulation
skills, since he intuitively adjusts his position in
the room based on the client’s affect.
AAT is useful not only with adult trauma
survivors, but is particularly effective to engage
pediatric and adolescent clients (Bryant, 1990).
In my work, I now primarily focus on pediatric,
adolescent, and young adult trauma survivors.
Some of my clients (especially the teenage
boys) may be reluctant to start therapy but will
come to my office to play with Chompy, the
therapy dog (Chandler, 2012; Fine, 2010; Mills
& Hall, 2014; VanFleet & Faa-Thompson,
2014). Although they come to see Chompy,
while there they genuinely engage in direct psy-
chotherapy and do difficult psychological work.
This is not a new concept in AAT. As men-
tioned previously, Sigmund Freud was one of
the first to notice behavioral changes in his
patients when incorporating animals in direct
psychotherapy practice. He reported that chil-
dren and adolescents were more willing to
speak openly about difficult issues when one of
his dogs was in the room (Fine, 2010). My own
clients often engage with Chompy to learn how
to self-soothe or self-regulate; if they feel over-
whelmed they will stop and play with the dog,
pet him, or ask him to do tricks. They are then
ready to resume working. One of my own ado-
lescent clients has a disorganized attachment
style and is working on emotional regulation
issues. She explained the benefit of animal as-
sisted therapy as “when I am angry and I yell
(not at my dog, but at other people or at the
universe, out of frustration), the dog will move
away from me. But as soon as I calm down he
returns and he loved me just the same, uncon-
ditionally, with no judgements. He doesn’t care
that I yelled a minute ago, he’s just happy to be
with me now. I know not to yell because I don’t
want to scare him away. Dogs may not be
human, but they make me want to become a
better person.”
Recommendations for Clinicians
So, what is it about an animal that allows peo-
ple to be a better version of themselves? Perhaps
it’s because animals are mindful of everything
they do. They appear to live in the moment, a
skill that many humans work so hard to learn.
Animals are also more accepting of our flaws
than other humans, and in turn they stimulate in
us feelings of genuineness and empathy (Field
et al., 2009). Research suggests that the thera-
peutic rapport may be one of the most important
predictors of success in therapy, and when a
therapy animal is integrated into the treatment it
may help to not only create but also to maintain
the connection (Chandler, 2012). In addition,
clients may use the animal as an excuse to
attend therapy when they may otherwise feel
unsure or embarrassed about the idea of seeking
help. Finally, the client may play with the ani-
mal, be comforted by the animal, and feel the
healing tactile sensation of petting the animal,
all of which are conducive to creating a healing
environment for clients (Grossberg, Alf, &
Vormbrock, 1988).
AAT is a treatment modality that can be
adapted and used with a wide variety of clients,
from children to geriatric patients, from those
 PET LOSS AND ANIMAL THERAPY
with persistent mental illness to trauma survi-
vors, to helping teach children prosocial behav-
iors and helping them achieve academic suc-
cess. It can be used in combination with other
modalities, which makes it adaptable to treat a
multitude of conditions. AAT “can be beneficial
with patients suffering from acute symptoms of
disorders such as schizophrenia, personality dis-
orders, and anxiety; in hospices to improve the
quality of end-of-life care for patients; and in
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
work with children with disabilities. It can al-
This document is copyrighted by the American Psychological Association or one of its allied publishers.
leviate pain in youngsters and decrease loneli-
ness in older adult patients” (Blank, 2015, p.13).
Sable (2013) states that “companion animals
have positive effects on psychological and
physical well-being, helping shape how people
regulate their emotions, deal with stress or
trauma, and relate to others.” Research findings
suggest that the presence of a family pet can
help humans calm themselves in times of stress,
and children at a doctor’s office will feel less
scared and behave more calmly when the family
pet is present (Nagengast, Baun, Megel, & Lei-
bowitz, 1997; Walsh, 2009).
Animal-assisted interventions also can be a
useful tool for mental health clinicians to teach
“socialization skills, combat bullying, and en-
hance physical health, among other therapeutic
goals” (Blank, 2015, p.13). AAT is a flexible
modality; it can be implemented with a variety
of populations, in a variety of settings, with a
variety of types of animals. There are even
programs that have veterans with PTSD diving
with sharks or interacting with parrots (Phillips,
2016). There are residential homes for children
with behavioral problems where caring for farm
animals is an integral part of their therapy; there
are also programs in correctional facilities
where inmates care for animals as part of their
rehabilitation (Fine, 2010). Although animals
can be easily implemented into any program,
research findings suggest that clients suffering
from anxiety, depression, trauma, grief, loss (of
any kind), and abuse may be best suited to have
AAT integrated into their regular treatment mo-
dality (Blazina et al., 2011; Levinson, 1972).
Currently, there are several large agencies
that fund research into the efficacy of AAT. The
National Institutes of Health (NIH) and The
Human–Animal Bond Research Institute
(HABRI) both provide funding for research into
the psychological benefits of human–animal in-
teractions. The NIH, since 1989, has also spon-
127
sored an AAT program in one of its hospitals, in
the palliative care clinic. They even allow dying
patients visits from their own pets, which illus-
trates a recognition of the identification of a pet
as an important family member (Blank, 2015).
Animal attachment can be used not only dur-
ing formal therapy, but also during disaster re-
lief efforts to increase resilience (Thompson et
al., 2014). Although the requirements are more
extensive, Chompy and I are currently working
toward certification as a Crisis Response Ani-
mal Team. Animal-Assisted Crisis Response
teams are on-scene first responders who provide
comfort, support, and a sense of safety to trauma,
crisis, and disaster survivors (HOPE Animal-
Assisted Crisis Response, n.d.). There are a
number of ways that therapy animals can be
beneficial to a mental health crisis intervention
worker. The animals provide a therapeutic
bridge and help psychotherapists engage and
establish a rapport with the survivors and other
first responders (Fawcett & Gullone, 2001).
Perhaps one of the reasons that animals are so
efficient in helping people in crisis return to a
state of equilibrium is that they often serve as a
transitional object that orients with a reality-
based relationship that provides comfort and
alleviates both physiological and psychological
stress (Winnicott, 1986).
The animals may provide a grounding expe-
rience and a way to encourage reality testing.
Survivors and first responders acknowledge
that, although it is life-changing, they will re-
turn to a state of normalcy and begin to heal.
Mental health crisis intervention workers at the
bombing of the World Trade Center on Septem-
ber 11, 2001, later wrote in detail about the
benefit of having therapy animals on site, stat-
ing, “the presence of the dogs had allowed them
to connect with the recovery workers in ways
that would have been very difficult if they had
been alone” (Shubert, 2012, p.75). The animals
facilitate a relationship between the mental
health professional and the client, and expedite
the therapeutic response. People in crisis may
be in shock and forget how to interact with other
people; the animal will serve as a bridge back to
interpersonal connections (Mims & Waddell,
2016). Kelly and Cozzolino (2015) explains that
people in crisis benefit from observing the pos-
itive and trusting relationship between the ther-
apist and therapy animal in order for the person
to internalize the feeling and overcome a lack of
 128 COMPITUS
control that they may feel at the time. Due to
their mindful and forgiving nature, for many the
dogs may also symbolize a hope for the future
(Thompson et al., 2014).
The human–animal bond is a powerful tool
that is not used often enough with clients who
would greatly benefit from this type of interven-
tion. Many clinicians are confused on how to
implement AAT in their practice. In the last few
years, several books by Chandler (2012), Fine
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
(2010), and VanFleet and Faa-Thompson
This document is copyrighted by the American Psychological Association or one of its allied publishers.
(2014) have been published that outline direct
applications of AAT with a variety of popula-
tions. Graduate schools of social work and psy-
chology are now offering more courses in the
human–animal bond and AAT internships.
There are full-day informational seminars, lec-
tures, and continuing education courses offered
throughout the country. In 2016, the American
Counseling Association published a paper out-
lining the professional competencies that are
essential to the implementation of AAT (Stew-
art, Chang, Parker, & Grubbs, 2016). However,
more research and publication are necessary to
help clinicians become more comfortable with
animal-assisted therapy as a treatment option.
Conclusion
Morgan, my Labrador Retriever, provided me
with a secure attachment for many years. When
she passed I was thrown into a state of disequi-
librium from which I had difficulty recovering.
The factors that helped me to heal were the
presence of my other pets and the need to care
for Angie as she received treatment for cancer.
Emotional bonds serve a basic and primary pur-
pose whether it is to provide a secure attach-
ment or a protective and nurturing selfobject.
The loss of a loved one, whether human or
nonhuman, may cause a serious disruption in
attachment and cause the person to feel incom-
plete. The trauma that I personally suffered
helped me explore my feelings of attachment
and emotional development. Although I previ-
ously knew that companion animals are often a
strong source of emotional support, the loss of
Morgan drove me to find new ways to integrate
AAT into my direct practice with clients. The
trauma survivors that I work with report a high
level of satisfaction with AAT as an adjunctive
treatment modality. I continue to miss Morgan
daily, but through her death I was able to help
others heal, grow, and form more secure attach-
ments, just as Morgan taught that to me.
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.0001

Pérdida traumática de mascotas e integración de terapia basada en apego asistido por animales

La repentina muerte de mi Labrador fue traumática y extremadamente difícil de procesar. A pesar de mi experencia previa
con terapia de duelo, estaba preparado intelectualmente, pero no emocionalmente para la pérdida de mi propia mascota. Para
procesar mi dolor, comencé a explorar mi propia infancia y la naturaleza del apego entre mi perro y yo. Contemplando las
diferentes escuelas de psicología, incluyendo la auto-psicología y la teoría del apego, descubrí que las necesidades del objeto
contribuyen significativamente al desarrollo del vínculo de unión y apego de ansiedad. Los animales son extremadamente
útiles en la reparación de los accesorios. La pérdida traumática de mi perro me hizo consciente de mi propia confianza en
mis mascotas como objetos terapéuticos, una realización que transformó enormemente mis intereses y objetivos. Pasé de
trabajar como terapeuta generalista a terapeuta especializado en el uso de terapia asistida por animales (AAT) como
modalidad complementaria cuando en el trabajo con sobrevivientes de trauma. En este artículo se discutirá la breve historia
y aplicaciones actuales de AAT. Se ha encontrado que la AAT funciona bien con una variedad de modalidades terapéuticas
como la terapia conductual dialéctica (DBT, por su sigla en inglés) y la psicoterapia psicodinámica, y puede ser considerada
cuando se trabaja con clientes con apego disruptivo o desorganizado.

animal, apego, pérdida, AAT, terapia asistida por animales

创伤性宠物失丧以及整合依恋为基础的动物协助治疗
我的拉布拉多寻回犬的突然去世是一段创伤性的、非常艰难的历程。虽然以前在哀悼咨询中有过经历，但是我在
智性上，而非情感做好迎接我自己的宠物的失丧的准备。为了能够理顺我的哀悼，我开始回溯我自己的童年和我
同我的狗之间的依恋关系的本质。在不同心理学派别中反思，包括个人心理学和依恋关系理论，我发现自我-物体
需求对依恋关系的简历发展和依恋焦虑有着很大的影响。动物对于修复被破坏的或者是受损的依恋关系有着很大
帮助，我的狗的创伤离去让我意识到我自己对于宠物类似于心理治疗物体的依赖，一个使得我对于兴趣和目标都产
生了重大转变的认识。我从一个宽泛的从业者变成了在使用动物-协助性心理治疗方面有专业能力的临床工作者，这
也成为我同创伤幸存者工作的附加形态。了在使用动物-协助性心理治疗的短暂历史和当前应用作为有效的附加治疗
选项在这里也会被讨论。动物-协助性心理治疗被发现可以很好地与许多其他的治疗形态一起使用，例如：辩证行为
 PET LOSS AND ANIMAL THERAPY 131

疗法以及心理动力学疗法，并且在同与有着被破坏的或者是无序的依恋关系的来访者工作的时候，应该被临床工作
者列入考虑范围。

动物, 依恋关系, 失丧, AAT, 动物-辅助性治疗

Received June 28, 2018

Revision received September 14, 2018
Accepted September 17, 2018 䡲
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