On Therapy Dog Examinations, Fear, and Systematic Desensitization

Last Sunday was the big day--it was finally time to take my examination to become a therapy dog. Once my paperwork is processed, I'll officially be a registered pet partner with the Delta Society. The human was excessively worried about the test. There were a few key things that he thought I'd have difficulty with--things that might actually cause me to fail.

His biggest concern was that as a rule, I hate being brushed. The brush comes out and I immediately start mouthing the brush. Part of the exam is being brushed by the examiner and in order to pass said exam I can't be eating the brush. He practiced and practiced brushing me. The general principle was that every time the brush came out he'd bring out food. As he brushed my fur there was a steady stream of little rewards entering into my drooling mouth. He thought for sure this would work. That is, he though for sure it would work until one day he left the brush on a table and I snuck off with it and chewed it.

What did I do during the exam? The brush came out and I rolled over to get my belly brushed.

The next worry of the human was the neutral dog. On a lead, I walk on the outside of the human as he passes another human with a dog on a lead. The humans stop for a few moments, shake hands, and exchange pleasantries. I'm not supposed to lunge, bark, snarl, or otherwise be inappropriate toward the human or the other dog. I'm not an aggressive dog by nature: that wasn't the human's concern. Rather, I'm a playful dog. Each and every dog that I pass is considered a potential best friend. I like to way my tail, do a play bow, and otherwise try to entice the other dog to say hello to me. This is somewhat problematic for the test.

What did I do? Exactly what the human anticipated. He stopped and shook hands with the other human. I went up on my rear feet hoping that I could shake hands with the human too. I passed this portion--while I didn't pass it with flying colors it was okay because the human was in control of me. He made sure I didn't get onto the other human.

The problem I faced--and what almost caused me to fail my exam--was totally unexpected. During the exam I was examined by the examiner. He was supposed to touch my paws, look in my ears, look in my mouth. He then went on to pet me in an exuberant and clumsy way and give me a restraining hug.

These are all things that happen to me on a regular basis. Those of you who meet me in the office know that I love this. We have one particular patient who comes running into the office, sits on the floor, and proceeds to roll me over, pat me vigorousness, squeeze me, and otherwise show me exuberant affection.

What did I do during this portion of the exam? The examiner was wearing a puffy winter vest. He took it off prior to getting down on the floor. I took that as my cue to hide behind my human to do anything I could do to avoid the situation. I displayed just about every sign I could that I was scared and exhibited every one of Turrid Rugaas' calming signals. We repeated that portion of the exam with a female examiner and I did marginally better.

The human first thought that it was the removal of the puffy winter vest. The human doesn't wear puffy winter vests and I've never seen one. In light of me become scared when I saw it being removed, he assumed at first that it was the stimulus that put me into a fear response. I wish I could speak: if I could I would have told the human that he had it all wrong. Thankfully he figured it out on the way home.

To understand why I got so scared the human needed to think about four other pieces of information.

1. The examiner was male
2. The examiner had a scruffy beard
3. Several months ago, for no apparent reason, I became fearful of a patient who has a scruffy beard. Previously I would sit in his arms and nuzzle the side of his neck.
4. Several months ago I became afraid of a homeless man with a scruffy beard that I used to run to greet.

So how does this all fit together? Why did I get scared? The human has been curious about the last two pieces of information for some time now. My behavior change was sudden, unexpected, and very localized. Other than those two situations I am outgoing, friendly, and confident.

Driving home from the examination I could see the light bulb appear over the human's head as he thought of one more piece of information. I was eager and excited to go to the vet as a puppy. I thought it was big fun to be examined, played with, and given attention. I would actually scamper into the vets office with my tail wagging! In a large part, this happened because my human went to the vet with me multiple times as a puppy and just walked in the door. No exams, no shots. He asked everyone to pet me and I learned that this was a good place to be.

As regular readers know, I had some bladder issues in the late summer and fall. No one could figure out what was going on and I needed all sorts of tests. Naturally, I started to become afraid of the vet--and guess what--the vets who did those procedures were men--some of which had scruffy beards.

The worst experience was when they tried to take a sterile urine sample from me. The vet and vet techs took me into the procedure room, strapped me down on my back, and inserted a tube into my bladder. The first time they did this I had just peed so there was nothing for them to take. A week later they did it again and I hadn't peed. I learned here that the vet was a scary place. Now rather than walking into the vet's office I started pulling away from the human at the door, displayed many signs of fear, and generally had an unpleasant time at the vet's office.

For a variety of reasons, the human fired that vet. He felt like he wasn't being treated like an equal partner in my health care and questioned the vet's knowledge. We tried a new vet. This office wanted to do more procedures--this time an x-ray and ultrasound. They needed the human to leave me at the vet's office. He asked if I could be given a tranquilizer--which they refused. Begrudgingly, he left me there as I was trembling. There again I was strapped down to a board and given procedures without any sort of tranquilizer. The human again questioned if this was a good idea and fired that vet because he felt like he wasn't being treated like an equal partner in my health care and questioned the vet's knowledge.

The third time was charm. The new vet had a holistic remedy for my issues and they have completely cleared up. I'm still afraid of the vet but have learned that I can walk into the office without trembling (we are back to random visits for playtime with the office staff).

Anyway, this is all to say that I was not afraid of the puffy winter vest. I was afraid of a man with a scruffy beard attempting to examine me. I learned that when men with scruffy beards examine me they usually restrain me and do very uncomfortable things. I've learned that it's best to avoid these sorts of men because if they restrain me, there isn't anything I can do but to wait it out.

The human feels he has enough data suggesting that I have a trauma response going on. Since I can't talk, I can't tell him if he's right. In the absence of other compelling data, he's going to move forward with a treatment plan that would be appropriate for a traumatized dog.

What's the treatment plan? Systematic desensitization. What's that? It's a procedure that one can do to reduce a trauma response to stimuli. It goes something like this. First off, the human prepared a list of stimuli that are triggering a fear response. He arranged the list in order of least triggering to most triggering. He then is exposing me to these stimuli in order, and pairing them with a pleasurable stimulus.

For example, the patient who I'm now afraid off gets to give me a piece of food every time he comes into the office. The human makes sure that it is successful every time. He keeps me on a lead so I'm in his control, close to him, and feeling safe. The other human will approach me in a positive way and offer me the food. If I take it, great. If I don't, that's great too. My human will praise me and continue to support me in feeling safe and secure. We take things at my own speed and I eventually learn that men with scruffy beards in the office are okay.

The human also makes sure that he encourages my curiosity when we are walking in Cambridge and we come across all sorts of different people. He lets me meet people at my own pace. If I show any signs of fear we slow down and he gives the other person a small bit of food to offer me. Every time this happens, I'm learning two things (a) it's okay to go slow and (b) when my human is interacting with someone they are usually friendly people who offer me food.

That's how systematic desensitization works. It's a slow process that builds successful experiences upon other successful experiences. It's been tested an replicated in scientific literature over and over again. It's effective, safe, and a powerful agent of change.

An alternative is flooding that has been popularized on television by dog trainers such as Caesar Millian. When flooding is used in dogs, humans, and other creatures the individual is held within the context of a fearful stimuli and not released, no matter what the creature does, until the creature gives up. In this case if I was strapped down onto a table by a human and wasn't released from the situation, no matter what I did, until I gave up--that would be flooding.

Keep in mind that most people confusing negative reinforcement with flooding. In negative reinforcement, a creature can exhibit a certain behavior that will cause the stimulus to stop. For example if I was strapped to the table and released only when I was calm, that would be negative reinforcement. If I remained tied to a board after I gave up that would flooding. Remember that with flooding, there is nothing a creature can do to escape a stimulus other than to give up and wait.

In some cases, flooding works. The human does not use it for treating humans, dogs, or any creature. Flooding doesn't provide a creature with useful coping skills to approach novel situations with confidence. It teaches a creature to give up and not respond.

With systematic desensitization a creature is provided with tools (humans can be taught coping skills to reduce levels of anxiety, dogs and other creatures can have their natural coping skills reinforced and enhanced) to meet a fearful situation with success.

Try it out--and be sure to ask your dog trainer or friendly psychologist for help. Any behavioral intervention needs a qualified expert to help you design a program that works.