Beasts of emotional burden

All veteran cowboy crew gathering cattle at dawn. (Photo courtesy of Nancy De Santis.)Former Green Beret and U.S. Marshal Rick Iannucci is a lifesaver-at least that's what he's been told by several military veterans who've been through his nonprofit program Horses for Heroes' Cowboy Up!

Cowboy Up! is a free program for all post-9/11 veterans and active military personnel that teaches horsemanship, personal wellness and neurological retraining. Iannucci and his wife, Nancy De Santis, started the program in response to what they saw as a growing need to help veterans adjust to life after combat.

According to the National Center for Posttraumatic Stress Disorder, between 11 and 20 out of every 100 veterans who served in either Operation Iraqi Freedom or Operation Enduring Freedom have PTSD.

"Because of my background, I understand how the warrior relates to the world,” says Iannucci, executive director of Cowboy Up! “Once you're a warrior, it's very hard to dilute that warrior memory and those feelings. The warrior mentality can be especially difficult to disengage for men and women coming back from serving multiple deployments in Iraq and Afghanistan.” This is especially true for veterans who've experienced combat trauma, sustained physical injuries or are suffering from posttraumatic stress disorder (PTSD), Iannucci says.

From warrior to civilian

Founded in 2007, Cowboy Up! uses American quarter horses to help bridge the gap between warrior and civilian. “Horses gently command us to be present in the here and now while also encouraging us to be meditative and peaceful,” says Iannucci.

Cowboy Up! participants live in a bunkhouse on Crossed Arrows ranch near Santa Fe, New Mexico, and start working with the horses from day one, beginning with groundwork and progressing to riding. They also participate in other aspects of ranch life, including working cattle and experiencing camaraderie with other participants. This is all part of a process that Iannucci and De Santis have developed and trademarked called Skill-set Restructuring.

“It's the first nonclinical program specifically designed for posttraumatic growth in the nation,” Iannucci says. “It's self-paced, objective and outcome-based. We've made everything analogous to the veteran's military occupational specialty and have incorporated operational procedures that veterans are familiar with by rote so they can immediately relate ranch tasks to something they've done in the military.”

As a result, Cowboy Up! is far more than Horsemanship 101. It also incorporates Wisdom Way for Warriors, an equine coaching program developed by De Santis, who is certified as a horse instructor and equine gestalt coach, to specifically address challenges faced by veterans.

“Our Native American veterans tell us that the horses are the bridge between the physical world and the spiritual world,” Iannucci says. “They carry us both physically and spiritually. For many warriors, emotional feelings can get out of alignment when they try to transition to civilian life. Horses provide a ground, a center, that helps many veterans deal with the spiritual dissonance they're experiencing.”

Participants find a sense of inner peace and calmness by working with the horses, Ianucci says. “Veterans tell us that once they come through our ranch gateway, their blood pressure decreases,” he says. “As they start listening to the breathing of the horse, they begin to connect with these magnificent, majestic creatures. They feel a certain softness.” De Santis says that veterans with combat trauma often experience tension and anxiety. “But regardless of the tension level, horses can help recalibrate their souls,” she says.

Staff Sergeant Joel Tavera and Nancy De Santis getting horses ready to ride. (Photo courtesy of Shawn Murphy.)PTSD: Posttraumatic spiritual dissonance?

According to De Santis, there's no one-size-fits-all PTSD.

Oxytocin and PTSD

Oxytocin is a powerful hormone that plays a role in regulating social interactions. “It promotes trust and bonding,” says Dr. Valentine. But many veterans' oxytocin systems are damaged, making them feel withdrawn.

“Veterans with PTSD can experience decreased oxytocin release as a consequence of traumatic experience or moral injury,” says psychiatrist Dr. Gerald Valentine. So activities that promote oxytocin release, like building relationships with horses, could be therapeutic. “As the veteran positively works with the horse, their nervous system reflexively responds, thereby releasing oxytocin and diminishing arousal symptoms. Just being in the presence of horses activates the oxytocin system.”

And because Cowboy Up! takes place in a more realistic setting (as opposed to a clinical research facility), it may have a better chance of helping veterans' oxytocin systems long-term, Dr. Valentine says.

“Here lies the eternal struggle for the warrior,” she notes. “For some, the first casualty of war is often a wound to the spirit. For others it may be that their active combat survival skills aren't serving them as well at home as they did in the field. Perhaps the veteran feels disconnected, dishonored or depleted. That is why we refer to PTSD as ‘posttraumatic spiritual dissonance.' It's better described as disconnect, distress or injury, not a disorder. It's part of the human condition, a human response to stress or trauma.”

“PTSD is not a mental illness, per se,” explains Gerald Valentine, MD, of the Yale School of Medicine, who serves as the Cowboy Up! program psychiatrist. “Rather, it's a reaction to extraordinary circumstances. Individuals with PTSD are suffering. It's serious and causes severe distress. And while the diagnosis may be repeatable and valid, no one treatment fits every veteran's needs or best matches the nature of their suffering.”

However, Dr. Valentine thinks the program Iannucci and De Santis have created offers the ideal setting and method for treating PTSD. “Horses For Heroes' Cowboy Up! program has so many things going for it because it is working on different aspects of PTSD, including reactions to traumas or moral injuries. For many veterans, not being able to reconcile behavior-either witnessed or perpetrated by themselves-that was in complete conflict with their deeply-seated beliefs about what's appropriate or right causes deep suffering,” he says.   

Army Sergeants Joe Riggs, Chris Chaisson and Eric Yorty with Rick Iannucci in the arena at the Crossed Arrows Ranch. (Photo courtesy of Rick Iannucci.)Memory modification

The Cowboy Up! program is designed to modify these traumatic memories.

Dear Cowboy Up! A letter from a thankful veteran

Upon my return to the “salt mines,” I pondered all the good I gained from participating in the Cowboy Up! program. My main feeling upon returning home was one of being more settled, more in tune with my current reality (rather than with memories), more comfortable with myself. You gave me a great gift: a combination of perceptions that allowed me to stop my mental flailing that led only to wasted thought, frustration and, yes, sadness.

I think that we combat vets have a special focus on our downrange memories because of the intensity and dynamic nature of what we've experienced. Most of us serve in the military to avoid “normal things,” and combat definitely grants that wish. It might have been only one event, or an entire tour's worth, that created the combination of adrenalin and attention that causes deep imprints on our brains. Regardless, the resulting memories stand in stark contrast to the mundane daily activities we experience upon our return home, such as working on a computer, doing dishes or watching TV.

It is thus inevitable that the majority of us tend to focus on those more “colorful” memories and less on the duller ones we live each day. This is not a good thing, because it leads us to not live in the here and now, especially if those memories are bad, which is like living in a nightmare. There's no doubt that living solely in one's head negatively impacts relationships and overall mental health. But what can we do to change this?

You [De Santis] and Rick know! Horses For Heroes offers a positive solution that allows us to create new, dynamic and positive memories to replace (or certainly push away) memories of combat, and in so doing, it allows us to reengage with the present, with reality. This eases feelings of frustration and sadness and replaces them with feelings of accomplishment and contentment (and, for me, joy!).

I consider your program a key enabler of healing, especially self-healing, which is a major achievement and one that is priceless, because it permits us vets to feel in control again. Such a program cannot be replicated through talking sessions with a mental health professional or by working with a group of other vets, which often become another dull memory with no end. And it is definitely more healing to the damaged soul that you and Rick talk about in your definition of PTSD (posttraumatic spiritual dissonance). God bless you for coming up with this methodology and especially allowing me to participate!

Personally, I know that my heart and soul will ever carry scars and signs of my combat tours, but I now know that there's no need to pick at the scab any longer to feel alive. I feel less fragmented (like a Rubik's cube that has been solved, where all the pieces fit together again), and I can recall my combat memories without the same intensity as before, because my New Mexico memories are still fresh and tangible.

-Sgt. Major S. S., U.S. Army (retired), Afghanistan veteran (2003-2010)

“PTSD treatment, from a neurobiological perspective-and a lot of current research on PTSD is using this model-is that memories of any type are modifiable,” says Dr. Valentine. “They aren't just static entities that you file away in your brain, then take out, access the information or experience the emotions attached to them, and put back into the filing cabinet of the mind without alteration.”

Memories, says Dr. Valentine, are much more fluid and multidimensional. They can be continuously modified and updated by new experiences. To modify a traumatic memory, for example, you can try reexposing the veteran to that memory in the context of a new experience. The new experience “can't be very distant from the traumatic memory, otherwise there is no activation of that trace, but only the encoding of a new memory that has no relation to the targeted one,” Dr. Valentine says.

According to Dr. Valentine, the beauty of Cowboy Up! lies in that memory modification “sweet spot.” Skill-set Restructuring activates many combat warrior associations: situational awareness, teamwork, improvisation, preparation, decorum, rules of engagement and aesthetics (for example, cowboys, like military personnel, wear uniforms).

“All of these things can activate processes that were engaged during combat or during the trauma,” Dr. Valentine explains. “It's not direct reexperiencing, but reexperiencing aspects to sufficiently and specifically activate those memory traces that are combined with new experiences. It's such a sweet spot that they don't even know they're receiving therapy for the trauma. It's not in a clinical intervention setting and it isn't framed as reconditioning, but it's working on the fear response. And because the environment is so warm, inviting and supportive, the participants are likely to stay.”

Sergeant Robyn Hopkins is all smiles as she and Knight saddle up. (Photo courtesy of Nancy De Santis.)Healing horses

The horses themselves play a vital role in the healing process. “There's benefit from even short-term interactions with horses,” says Dr. Valentine. “But developing a relationship with horses over time reinforces the benefit from a neurological and social engagement standpoint. Safe, meaningful interactions with another living being can be a social catalyst for veterans who feel threatened by human relationships. At the neurobiological level, the same type of mechanisms are engaged that make you feel close to your own children, to a spouse, to a good friend or to your parents.”

Horses can also help veterans be present in the moment, which can be a struggle for many veterans with PTSD. “Dissociative experiences are a subtle hallmark of the PTSD experience,” says Dr. Valentine. “Veterans may not feel present-either physically, like they're not quite in their body, or temporally, like they have a distorted sense of time. But when working with a horse, veterans have to be present and focused on these powerful, sensitive creatures.”

Around horses, veterans who've been withdrawn around family and friends are able to gradually reengage the mechanisms of social engagement without threat, Dr. Valentine continues. This then affects their human interactions. “A lot of the magic happens when veterans are sitting around together after being with the horses all day," he says.

Horses can have a powerful physiological effect on veterans as well by reducing arousal and their fight-or-flight response. As a result, blood pressure, cortisol and muscle tension decrease.

The view from the bunkhouse on a snowy Santa Fe morning. (Photo courtesy of Rick Iannucci.)Immersive learning

“Horses provide vast opportunities for growth and learning about our world and the world around us,” says De Santis. “Working with them creates an environment where we can recognize and acknowledge our actions, how we learn, how we communicate and how we interact with others. Working with horses brings a deeper understanding and helps to provide a person with tools that can be taken into everyday life.”

According to Dr. Valentine, all of this learning and understanding takes time and best occurs in an immersive setting. “When there is total immersion, veterans are less aware of their suffering because they're so focused and absorbed by this new experience, which is why Cowboy Up! is so powerful,” he says. “It's saving lives-and that's not an overstatement.”

Ed Kane, PhD, is a researcher and consultant in animal nutrition. He is an author and editor on nutrition, physiology and veterinary medicine with a background in horses, pets and livestock.