Exposure Therapy for Fearful Dogs
Can exposure therapy be used for dogs? How is exposure therapy different from systematic desensitization? Let's take a closer look first of how fear affects dogs. Fears in dogs may get in the way of their everyday life. Fearful dogs tend to be prone to using avoidance to keep themselves safe. For instance, if your dog is fearful of thunder, he'll likely panic, move away and hide in the closet. Dogs don't do this rationally; rather, it's an immediate response triggered by their brain. For a good part, this is a good thing; after all, fear is helpful when a dog faces danger as it allows him to react quickly, and ultimately, it's what helps with self-preservation, but when fear affects the dog's every day life, leading to chronic stress, it can become quite harmful and disabling.
What happens when fear takes place? When a dog is stressed, his fight or flight response is activated by the amygdala, an almond-shaped part of the brain that acts as an interpreter of information that comes from the senses and is responsible for a variety of chemical responses that cause the dog to react quickly and escape. The amygdala also forms associations from past experiences, so next time the dog is presented with the scary stimulus, he will automatically develop a fear response. This happens to humans as well. You may be walking on the road one day and an off-leash black dog comes towards you, sniffs you and then bites you in the leg. Next time you see a black dog, you'll be likely to feel a strong fear response. Most likely, you would leave the area in hopes of not encountering the dog. On top of that, your fear may become so paralyzing and maladaptive, that you avoid any dogs, even the friendly ones and take different routes to avoid walking near parks. This avoidance behavior may then put roots and persist for the rest of your life simply because the amygdala stores memories and emotions so you'll be able to recognize similar events in the future so you can avoid them and stay safe.
Fact is, avoidance behaviors are very reinforcing. Because escaping from the trigger reduces the level of stress and anxiety, this behavior is reinforced through negative reinforcement. You can almost hear a sigh of relief when the dog scared of the vacuum runs to the basement or when the person who fears flying misses his flight! Ahhhh... it feels so good to not face the trigger and feel safe! However, people and dogs do not learn anything about their fears when they practice avoidance behaviors. Because they always avoid exposure to the trigger that causes them fear, they never have a chance to realize that that trigger ultimately won't pose any danger. This explains why people or dogs left to their own devices will ever see any progress. Weeks, months or years may go by and they are both stuck in avoidance.
So what can be done to help people and dogs face their fears and learn that there's really no harm? Simple; all they have to do is re-train their amygdala. Because the amygdala learns from experience, it can be trained to form new memories and associations. Only through facing the fear will the amydala learn that it doesn't need to be so worked up and reactive. And how is this accomplished? Through exposure therapy, which we will see more in detail below.
Exposure Therapy for Dogs
As the name implies, exposure therapy consists of confronting one's fears repeatedly until the fear subsides. As we have seen, avoidance is often what fuels fears and phobias. By taking flight and escaping, dogs are strengthening and maintaining the associations between the trigger and the fear since avoidance behaviors are ultimately rewarded by the reduction of anxiety. To see progress, these past associations, that is, the Stimulus-Response conditioning needs to be undone. This is doable! After all, Pavlov's dogs could be un-conditioned to salivate at the sound of the bell, by simply no longer providing food! With a fearful dog though, the process may take longer as we aren't simply dealing with a neutral stimulus (the bell) that has been given a positive meaning (associations with food), but one that has had negative connotations that are quite established. This is where exposure therapy comes into place.
According to Anxiety Coach, exposure therapy activates the amygdala and with repetition, it will develop new memories so that life won't any longer be disrupted by phobias and anxiety attacks, or at least, is much more manageable. When working on exposure therapy with dogs, the aim is to gradually accustom the dog to the trigger and help him habituate to it. Habituation takes place when the trigger produces a decreased response. Basically, dog's behavioral and sensory responses diminish over time. It's as if the dog's nervous system starts to get bored by the whole situation. According to Psychiatric Times, the process is similar to getting used to cold water in the ocean. When you first dip your leg, it may feel cold, but as you immerse yourself more, you eventually acclimate to it.
With established fears though, the path may be long since the amygdala has long-term memory and years of avoidance behaviors only have contributed to increasing the fear, but it is worth it. Exposure therapy would involve exposing the dog to the trigger gradually and systematically through steadily escalating steps. To get started, you would initially compile a list of your dog's triggers from the least fearful to the worst (fear hierarchy). The first step would be exposing your dog to the least fearful trigger or situation. This is the complete opposite of flooding, where exposure towards the most extreme item in a fear hierarchy takes place. After some time, the stimulus-response association weakens until it's almost "cancelled out" and soon the trigger is associated with a lowered state of stress. The fearful response at some point may totally extinguish.
Counter-conditioning in addition to exposure therapy significantly increases the chances for success. So if your dog is fearful of gunshots, through exposure therapy, he would be exposed to gunshots from a distance where they are barely audible, gradually decreasing the distance. When adding counterconditioning, positive associations are being built, so the dog's meal would immediately follow the noise of the gunshot. Soon, after several repetitions, the gunshot becomes a cue that the meal is arriving and a positive, emotional response takes place. With the combination of exposure therapy and counterconditioning, not only nothing terrible happened as a result of being exposed to the trigger, but actually exposure makes wonderful things happen! To put yourself in your dog's shoes, imagine being terrified of spiders and having $10 bills raining from the ceiling every time you touch a spider. Not only the spider didn't bite you, but money is falling on the ground!
In order to be effective, exposure therapy sessions shouldn't be too far apart and should always end on a positive note. Never should the dog be forced or coerced into facing a fear he is not ready to deal with, doing so may affect trust between dog and handler and increase the anxiety. In the case of a setback, the situation should be evaluated and a few steps back may need to be taken to make exposure more tolerable and increase motivation for treatment (ie if the dog is food motivated, use more high-value treats).
What' the difference between desensitization and exposure therapy? The two may appear quite similar and some websites use the terms interchangeably. I wanted to go more in depth on this though. This is what I found by lurking on message boards, websites and books for human exposure therapy. According to the book "Handbook of Exposure Therapies," exposure therapy in humans is as effective as desensitization, but the main difference is that before going through desensitization, relaxation techniques are taught so to better cope with the exposure. Since dogs cannot be rationally taught relaxation techniques as in humans (you can't tell a dog count and breath slowly!) to reduce anxiety derived from exposure, a graduated exposure is an ideal approach and you can also invest in calming aids. As mentioned, small steps are taken by exposing to the least fearful form of the trigger. Flooding, another exposure therapy method, where the subject is exposed to the most scary trigger or situation, is certainly out of question for obvious ethical reasons and its potential for unneeded trauma.
In humans, exposure therapy is highly effective and new methods are now expanding. In vivo- exposure involves live exposure to the feared trigger, graduated exposure entails successive approximations of steps, and virtual reality is now being used too with success. There are as well many other variations of exposure therapy based on the rate, intensity and duration of exposure. For correct behavior modification implementation, seek the assistance of a force-free behavior professional to help you out.
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