Although the desire to remain thin, and all of the concomitant social pressures that accompany body image have been around for some time, and now well documented in books such as “Rethinking Thin,” by Gina Kolata, in the field of psychotherapy, clinically recognized eating disorders are not the old. And what is even more nascent, is just how to treat these often pervasive cases of self induced starvation.

While certainly many therapies have been tried, and the among these, some experiential forms, one of the more popular methodologies has been that of equine therapy. But how is it that hanging around a horse can help someone reconstruct the often very distorted body image, heal the fractured relationships, and rekindle the desire to eat?

To answer this question, we must first consider that one of the most complex challenges that is faced by those with anorexia or bulimia is emotional tolerance and containment. Similar to the way a client with OCD uses a variety of structured compulsions to distract from the overwhelming obsessions, a client with an eating disorder uses restriction of food to avoid intense and unwanted emotions. Certainly, avoiding emotions over the long term makes them less easy to decipher, and further, more detached from the individual. In time, the mind of the anorexic is ruled only by a number on a scale.

But we must also be aware that starvation itself, alters emotional responses. As an anorexic goes without food, the body responds by resorting to alternative fuel sources. The adrenal glands activate, epinephrine and nor-epinephrine are released, and the anorexic experiences what is known as “starvation high.”

In fact, the physiology is not that different from a stimulant medication, or drug. However, as the person is essentially in flight mode, anxiety levels rise, and the desire to restrict food increases to counteract it. Yet, as time goes on, cognitive deterioration is more likely, and the potential to understand what is happening, on a cognitive level, decreases. This also means the anorexic’s chance of recovery declines.

So enter a horse. A horse, communicating primarily on a physiological level, uses emotional responses — which have physiological ramifications — to receive and convey messages, read others, and determine roles, expectations and intentions. By responding to the physiology that the client presents with, the horse opens to window to her repressed emotions. Perhaps the horse begins to display protective behaviors, followed by obvious distancing. This would be an indication of a client that needs care, yet is clearly more comfortable avoiding the closeness/intimacy that caretaking denotes.

By making unconscious conflicts such as this evident to the client and her therapist, the horse — in a very non-threatening way — exposes the client’s dilemma. That is, she wants to be accepted, yet also greatly fears it. And more importantly, the message is coming from an animal, where intimacy is less threatening, and so is the truth.

Photo by dersans, available under a Creative Commons attribution license.

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    Last reviewed: 17 Apr 2011