How the human-animal bond of clients affects veterinary practice (Proceedings)

Veterinarians in the past couple decades have embraced the growing awareness and accommodation for what is often termed "the human-animal bond," a concept that was developed by Leo Bustad. By now, human-animal interactions has become a broad new field of study with an international society, International Society for Anthrozoology (ISAZ), and several journals focusing on related topics. A brief overview of this field will be presented, including scholarly leaders, practitioners, journals, societies, and programs. Searching tools for accessing the relevant research literature are available at the UC Davis Companion Animal Behavior Program website, http://www.vetmed.ucdavis.edu/CCAB/main.htm.

The interest in human-animal interactions stems from the basic phenomena of human attraction and attachment to animals and the comfort we derive from them. Attraction to animals is evident in the appeal of ecotourism and the high attendance at zoos, as well as in the popularity of companion animals. Understanding the depth and importance of this phenomenon has practical implications for veterinarians and their practices.

Human and animal connections in veterinary practice

The connection and relationship with the animal are important, often becoming a bridge with people, including the veterinarian. Reflecting the demographic changes of the past century, we live in homes with smaller families, marrying later if at all, living longer, and spending more of our years living alone. During the same period, the animal has moved indoors, even into our bedroom.

Veterinary practice over the 20th century shifted from a general focus on large animals to a personalized emphasis on companion animals of individual families. Small practices were a norm, in which the client knew the veterinarian over many years. The recent shift toward specialization and corporate practices has reduced the personal connections of practitioners and individual clients. Now we see a counter-trend toward focusing again specifically on families in the community, establishing relationships with them and a veterinary role in the community in helping animals. This trend, termed veterinary family practice, or community practice, often is profiled as better serving the clients' needs. It embraces the many aspects of veterinary practice that involve the human-animal bond, including effective practice with assistance animals, people with special needs, pet loss, shelter animal adoptions, and families with young children. In addition, many practitioners find that a family practice model offers them more satisfaction as well and provides the contact with clients and animals that drew them into veterinary medicine.

Attachment to animals

Animals can provide meaningful comfort and relaxation to people and help them to feel whole and learn who they are. The psychoanalytic perspective of self psychology, based on work by Kohut, when applied to the special roles of animals, helps to explain in a theoretical framework the mechanisms of animals' healing power. Developing a healthy sense of self, with self esteem, a sense of well-being, and general cohesion, can be maintained and supported by responses from others that are calming, soothing, and affirming. Companion animals are well-suited to serve as these supportive others, termed selfobjects, as reviewed by Brown (2004). In Kohut's words, responsiveness from selfobjects is the "oxygen" for the psychological life and required throughout the lifespan. They can: mirror and reflect the affirmation and recognition of our goodness and wholeness; serve as an ideal admired selfobject that is stable, wise, powerful, and calm; act as a twin of essential likeness to oneself. At a time when isolation and loneliness are becoming more common, the potential role of animals to serve as selfobjects becomes more important.

Databased evidence of the potential healthfulness of attachment to animals reveals animals' capacity to normalize deficits that humans are facing. Persons likely to be lonely due to living alone, loss of a spouse, having a disability, or facing increasing isolation due to AIDS or Alzheimer's disease show less adverse indicators when they have a companion animal (Hart, 2006). The significance of companion animals is most easily documented among the most vulnerable people, for whom the animals can assume life-sustaining importance.

An important aspect of attachment to animals is that it can be jeopardized if the relationship comes to involve too much conflict, as caused by behavior problems, such as aggravation of neighbors, household damage, toileting problems. The conflict can ultimately reach a tipping point at which at least one family member is no longer willing to cope. It can become a source of further dissension within the family if the problems are ongoing and unresolved, with disagreement among family members about the course of action.

Some outcomes of attachment

Behavior problems are widespread among companion animals—few people describe their animals as perfect. Behavior problems can be extremely compelling to people, who often view a problem as something that requires immediate attention. Preventing or reducing behavior problems is a shortcut toward enjoying and enhancing the rewards of attachment to animals. Thus, veterinary leadership and foresight are well-invested when advising clients on pet selection and the early management of living with a new pet.

With several species available as pets, and with a wide array of breeds of dogs and cats, people can thoughtfully fine-tune their choice of pet and select an animal of the size, interactivity, behavior, and care requirements they desire. This selection can optimize the likelihood for a compatible relationship, one that is not stressed with behavior or management problems that were unanticipated prior to the adoption. The opportunity to select either a male of female affords additional latitude for avoiding undesirable problems, or at least reducing their likelihood, including aggression and housesoiling.

A consequence of animals mattering so much is that clients can be extremely stressed when accessing veterinary care for their animals, just as with a human family member. The AVMA Committee on the Human-Animal Bond (1995) has provided a cautionary document for veterinarians that highlights areas where special preparation for dealing with particular types of vulnerable clients, patients, and situations is merited. Veterinary practices, in their regular meetings, can discuss these types of cases to develop a plan and outline protocols for how they as a group will cope with them in the future.

With more animals living longer lives, a philosophy of care that emphasizes the animal's quality of life becomes more important. As arthritis and other aging conditions develop, curing the animal may not be feasible, but assuring a high quality of life is a worthwhile objective. The tradition of human hospice care is well-developed, and is informing the development of hospice for companion animals.

Animals contributing to the human quality of life

As people develop a relationship with an animal over time, especially lacking serious behavior or management challenges, they notice the enhancement of their quality of life. The animal adds vitality, beauty, and humor to the home, in ways that are experienced from moment to moment. This improved quality of life cuts across social class, age, and gender differences. The animal can buffer stressful moments of daily living in any family.

The potential contribution of animals to people can be seen in cases where the person is coping with an incurable disease or condition. Someone who is in hospice or who has a disability can still benefit from an enriched quality of life. This is a special niche where animals can offer something significant. When a person has special needs, the animal can offer therapeutic benefits that are tuned to the person's needs. The general psychosocial benefits of providing comfort, stimulating socializing, motivating, or cardiovascular enhancement can be exploited to enrich a person's life. The human hospice movement provides models for caregiving, whether of humans or animals, that focus on providing care (in this case, rather than cure), and offers patients' bill of rights and goals of caregiving (Hospice Foundation of America, 2009; Lattanzi-Licht, 2001). Advocacy for this healing perspective has also been spearheaded by physician Rachel Remen (1996, 2001) in books and teaching.

Conclusions

Attachment to animals is a pervasive phenomenon that has led to developing a new scholarly discipline based on "the human-animal bond." By now, the study of human-animal interactions is emphasized in veterinary and other professional organizations and journals. The knowledge gained from the study of human-animal interactions continues to inform the effective and successful practice of veterinary medicine.

References

AVMA Committee on the Human-Animal Bond. 1995. AVMA guidelines for responding to clients with special needs. Journal of the American Veterinary Medical Association 206, 961-976.

Brown, S.-E. 2004. The human-animal bond and self psychology: Toward a new understanding. Society & Animals, 12:67-86.

Hart, L. A. 2006. Community context and psychosocial benefits of animal companionship. In: Handbook on Animal-Assisted Therapy: Theoretical Foundations and Guidelines for Practice, 2nd ed. (A. Fine, ed.), pp. 73-94. Amsterdam: Elsevier.

Hospice Association of America. 2009. Hospice patients' bill of rights. Website accessed February 5, 2009, http://www.nahc.org/haa/attachments/BillOfRights.pdf

Lattanzi-Licht, M. 2001. Hospice as a model for caregiving. Hospice Foundation of America. Website accessed February 5, 2009, http://www.hospicefoundation.org/teleconference/2001/model.asp

Remen, R.N. 1996. Kitchen Table Wisdom: Stories That Heal. New York: Riverhead Books.

Remen, R.N. 2000. My Grandfather's Blessings: Stories of Strength, Refuge, and Belonging. New York: Riverhead Books.