Emotional support animals offer four-legged therapy

When she was just 17, Melissa Colin decided to join the military as a combat medic.

“When I first went in, I actually really loved it,” Colin recalls. “I had just gotten out of high school; I had to have my parents’ signature and all that.”

Shortly after enlisting, however, she was sexually assaulted, which led to debilitating anxiety, post-traumatic stress disorder and depression. Soon after, Colin’s father committed suicide, and her ex-fiance died from cirrhosis of the liver. These traumatic experiences, and the resulting mental health hurdles, left her feeling despair, unable to face the world around her.

“I was very suicidal,” she remembers. “I was in and out of psychiatric hospitals for numerous suicide attempts. I could not hold down a job to save my life, and I tried really hard. I was self-medicating at the time, and I just wanted to die.”

After working with numerous care providers and a combination of medication, behavioral therapy and other treatments, Colin decided to try a different approach: She adopted an emotional support animal.

Nearly five years later, Colin says Petunia, her charcoal gray cat, has helped her rely less on anti-anxiety medication, and the frequency of panic attacks has decreased dramatically.

“It definitely made a huge difference in my overall emotional well-being,” she reports. “She’s not a lap cat at all: She tends to keep to herself. But whenever I feel stressed or panicked, she will come to me. She will put her paw on my face or just sit with me and purr.”

Proponents say ESAs can offer relief to people experiencing a wide variety of mental health conditions. But as they continue to grow in popularity, these animals are increasingly making their way onto airplanes and into college dorms, restaurants and other public places. That’s led some folks to question both their legitimacy and effectiveness.

Legal distinctions

Kim Brophey, who owns the The Dog Door Behavior Center in downtown Asheville, is an applied ethologist. In that role, she works individually with people and their animals, focusing on their relationship in order to guide behavior. The idea of using animals in therapy isn’t new, notes Brophey, but the increased use of ESAs is due, in part, to a lack of public understanding about their role and legal status.

“Lord knows there’s a lot of confusion, and this is exactly why there’s so many fake service dogs and ESAs: People are exploiting the confusion,” Brophey maintains.

Current federal law recognizes three categories of animal helpers, she explains: ESAs, therapy dogs and service dogs. Each of these designations dictates where those animals can or cannot be.

Therapy dogs, she says, live with a family and are brought into a medical facility such as a hospital or nursing home so patients can experience the general therapeutic benefits of interacting with animals. They receive only limited training, however, and therefore are not allowed on planes or in restaurants that have a no-pet policy.

Service dogs, on the other hand, are specially trained to assist an individual who has a mental, physical or emotional disability that makes it harder for them to lead a normal life. Such people may obtain a service dog for assistance with a wide range of issues, as defined by the Americans With Disabilities Act: everything from visual impairment and mobility limitations to anxiety and post-traumatic stress disorder. Service dogs can also learn how to detect a change in their handler’s body chemistry and alert the person that they may be about to experience a seizure, mental health episode or the onset of vertigo.

“Really, the sky is the limit,” notes Brophey.

Asheville resident Judith Loniak, who has lived with PTSD, depression and bipolar disorder since serving in the Navy more than 30 years ago, decided to adopt her dog, Dixie, after numerous stints in and out of psychiatric care.

“I didn’t get her until last year, because I did not want to believe that that’s what I need. I’ve been hospitalized six times since the ’90s, mostly at the [Asheville Veterans Affairs Hospital] for depression and bipolar disorder and suicidal ideations,” says Loniak, who now works as a professional landscape photographer.

The training process for both human and animal was lengthy — it took nearly a year — and cost about $700 a month, she says. Besides learning how to navigate public places without disruption, Dixie also learned to apply deep pressure therapy by leaning or laying her weight across Loniak’s body to reduce the symptoms of anxiety or the impact of a panic attack. And while Loniak still takes medication for her mental health conditions, having a service dog by her side has provided much-needed support and reassurance during crises, she says.

“I struggled for a number of years, but since I’ve had her, it hasn’t really been an issue.”

Just being there

ESAs, though, fit into a somewhat murky legal category, notes Brophey. According to the U.S. Department of Justice, emotional support animals “provide comfort just by being with a person” rather than being trained to perform specific jobs or tasks.

“‘My dog makes me feel good’ is not a task, even if it is the primary benefit to the person,” she explains. “Some people with service dogs, 90% of what makes that dog beneficial to them is the fact of just having them with the person. It helps enable the person to leave the house and go to the store rather than stay home, because they know the dog can help them if they need it. But if it ends there, technically it’s an ESA.”

Further muddling public understanding is the fact that several federal laws do grant ESAs certain specified rights. The Air Carrier Access Act allows these animals on airplanes, provided there is documentation from a licensed mental health professional. And according to the U.S. Department of Housing and Urban Development, the Fair Housing Act lets people live with their emotional support animal even in places that don’t allow pets. But they can’t bring the animal into restaurants, bars or other establishments that have a no-pet policy. In some cases, state and local laws may grant additional access; North Carolina does not, however.

Because of the legal ambiguity surrounding ESAs and the proliferation of companies selling service animal and ESA vests, growing numbers of people are now using the law as a way to keep their furry (or feathered or scaly) friend with them during flights or in their home even if they don’t actually have a legally recognized medical need, Brophey maintains.

“I’ve been doing this for 20 years, and it’s just getting so much worse,” she says. “People think it’s really harmless when they put a vest on them and fly with them and just call them an ESA. That’s not funny. You’re making life so difficult for the people who really need these service dogs, because your untrained dogs could create problems and distractions for the trained dogs, create a horrible template and precedent for the other people who don’t want a dog on an airplane.”

Loniak adds that when people claim their pet is a service animal or ESA, it may lead others to question even people with a legitimate challenge that isn’t apparent, such as a mental health issue.

“Disabilities can be invisible,” she points out. “I was walking in Ingles one time and this man was looking at me with this terrible look on his face. He said, ‘Get that dog out of here: That dog doesn’t belong here.’ I said, ‘Sir, she’s a service dog.’ He said, ‘I don’t believe it.’ It was very upsetting and humiliating.”

Animal medicine

Brophey recommends that people who feel their mental health condition is severe enough to need an ESA should look into obtaining a trained service animal that could provide more tangible benefits.

At the same time, she continues, “All animals are emotional support, because of the valid physiological, scientifically established benefits of animals in our lives. They’re all emotional support animals.” Having animals — even ordinary pets — in our lives, she says, brings “therapeutic benefit to the human psyche, physiology, emotional states, longevity.” Touching animals and interacting with them, having relationships with them, Brophey explains, is healing because “We’re all living in an overly sterile world where we don’t always have those things, and they’re immediately beneficial to us.”

For her part, Colin says that while her cat has given her valuable support, she also understands ESAs’ limitations in treating mental health conditions. For that reason, she’s in the process of obtaining a service dog from Wags4Tags to help with PTSD. The Raleigh-based nonprofit rescues dogs from shelters, trains them and gives them to veterans free of charge.

“Having a trained service animal makes a huge difference,” she notes.