For many involved in both allopathic and complementary practices, owners serve four primary functions:
- Supply transportation for the animal
- Implement any requests made by the veterinarian
- Pay the bill
- Assume blame for “noncompliance” when treatment fails
As with the animal’s behavior, its relationship to the owners hardly warrants mention in a most veterinary texts. Although a trip to a few animal shelters or even discussions with clients in the waiting room would prove otherwise, the writers of these texts (and the treatment processes they recommend) assume that all owners and animals experience optimal relationships that would lead all owners to a) want to pursue any treatments recommended by the veterinarian and b) successfully implement these.
Of course, anyone who has been in practice a matter of weeks realizes that, rather than hardly warranting mentioning, the relationship stands smack in the middle of the healing process: a solid owner-animal relationship can make veterinary practice a joy under the worst of circumstances and a poor relationship can yield a nightmare under conditions those owner-deleting textbooks would describe as the best.
Unfortunately, when we experience the negative effects of a less-than-optimal relationship first-hand, a tendency exists to dismiss the owner as a nut-case and give little thought to what these relationships might actually mean in terms of animal health. Instead we muddle through, perhaps even secretly hoping that the client will move away or the animal will die so we needn’t put up with them any more. This strikes those who experience such thoughts as sufficiently callous that they often also experience guilt, another negative emotion that further increases the toll these problematic owner-animal relationships take on the practitioner as well as the practice of quality medicine. Nonetheless, the fact that veterinary education fails to provide veterinarians with the knowledge and skill to properly address the many effects of the relationship may make this appear like our only option.
Nonetheless, any definition of a holistic veterinary practice must include the owner-animal bond simply because that relationship affects the animal’s physiology in and of itself. Just as animals affect human heart rate, pulse, triglycerides, cholesterol, and other parameters, studies going all the way back to Pavlov suggest humans exert the same effect on animals. The more intimate the relationship, the greater the physiological effect. And although the majority of the bond data presents such effects as overwhelmingly positive, some relationships may also create pathology for animal and/or human. Consequently, even though a lack of time and/or skill may preclude practitioners addressing relationship problems in the course of any medical treatment, the effects of the relationship do warrant notice.
A Sampler of Problematic Human-Animal Relationships
Many problematic human-animal relationships result from dependencies experienced by one or both participants. Admittedly, the idea of pathological human-animal dependencies may initially seem bizarre, but it flows logically from the process of domestication. The goal of domestication is to make animals dependent on us so that we can then use them to fulfill our needs. Concurrently, we humans rank as the most domesticated species, so it comes as no surprise what we’re programmed for a certain amount of dependency ourselves. However, whereas we traditionally view domestication as a process whereby we gained physical benefits from animals (milk, eggs, help with hunting or herding), we know that the human species gains great mental benefits from interactions with animals, too. Moreover, we also know that the more complex life with other humans becomes and the less we can intimately interact with the natural world, the more people may depend on any companion animals to meet certain emotional needs. The net result of all this are human and animal species which may become highly dependent on each other to fulfill both physical and emotional needs; the more intimate the relationship, the more energy devoted to the fulfillment of those needs.
Further complicating matters, our society and sometimes even our profession has a way of elevating some of the worst relationships. No one claiming the label of “animal lover” would ever speak kindly of someone who kicks their dog. At the same time, though, at least some of those people see nothing wrong with describing a dog whose relationship with the owner leads to such stress when separated that the dog attacks the environment or itself as “loving the owner too much.” Why in the world would we describe an animal so beside itself with fear that she tears out a window or chews herself raw as expressing love? We could make a valid case for this based on the parental relationship these dogs often have with their owners; when separated from those people, many of them do act like inexperienced, unconfident bitches separated from their pups. However, linking this fear-based behavior to owner love can backfire if owners lack sufficient confidence in the relationship that they need concrete proof of the animal’s affection. In that case and thanks to that definition of the behavior as love-based, the more the animal destroys the more proof of its great love for the owner.
One medical corollary of this takes the form of those owners who equate food with love: the more the animal eats, the more it loves them. On the most fundamental level, these people lack the confidence to believe that their pet loves them simply for themselves. They don’t see a pat, some kind words, or the pleasure of their company as a sufficient reason for the dog to want to be with them. If this belief exists, badgering about all the negative health effects of obesity won’t work any more than the most carefully designed program of dietary control and exercise. Instead, the underlying belief must be addressed to ensure lasting change. And while some owners can transfer their love symbolism to another object or activity that enhances rather than undermines the animal’s health, other times the food-equals-love symbolism is so firmly entrenched in the owner’s belief structure that acceptable food symbols must be factored into the weight-reduction program.
In another group of problematic owner-animal relationships the owners suffer from what the author refers to as the Saint Francis Syndrome. The basic tenet of the St. Francis Syndrome is that anyone can love a healthy well-behaved animal, but it takes a real saint to tolerate one with problems. Here again, veterinarians may unwittingly support this view with their comments. This most commonly occurs when we focus more on the owner’s willingness to accept any inconveniences associated with the animal’s problems rather than on their and the animal’s ability to successfully resolve these. As the veterinarian concludes yet another annual rodeo with the snappy dog, he smiles and says to the owner, “Ms. Smith, you are a real saint for putting up with Alfie.” Although the veterinarian may consider this a genuine complement or preferable to what he’s really thinking—”Ms Smith, only an idiot would put up with such a monster.”—the fact remains that his words reinforce both the owner’s and the dog’s behavior. Granted our training in normal and abnormal animal behavior and human-animal relationships lags our training in animal physical health so drastically that few feel comfortable tackling such problems. On the other hand, clinicians can point out how the animal’s negative behavior directly and indirectly may affect its health (undermining its immune response, setting the animal up for stress-related medical problems, requiring tranquilization or anesthesia for even the simplest procedures, etc.) and referring these clients to someone with this expertise. While these owners may refuse to follow this advice, as least the veterinarian doesn’t reinforce the negative relationship.
The St. Francis Syndrome also exists in the medical arena. We all want to encourage owners of animals with chronic problems not to give up, but here again we must be sure our attention doesn’t actually perpetuate the problem. For example, when the veterinarian effusively congratulates his client with, “Ms Smith, you’re one in a million for coping with Alfie’s ear infections for all these years,” he assumes his words cause her to follow his recommendation even more religiously. However, if much of Ms Smith’s rapport with her veterinarian and her interactions with her friends and co-workers centers around her pet’s medical problems, curing them might not be her top priority.
In fact, informal surveys of owners conducted by the author indicate that those whose animals with chronic problems respond the best are those whose owners accept these problems as a normal part of their relationship. They daily medicate the animal with no more emotion than they assign to taking a shower or brushing their teeth. They don’t see the animal as lesser because of its problems or themselves as greater for treating them. When others congratulate them on their willingness to juggle all the variables inherent in treating a diabetic animal, they can’t understand why this is such a big deal. What they appreciate most is the veterinarian congratulating their animal for its strength, stamina, good humor, and other positive characteristics that will help the animal heal itself.
At its worst, the human need to perpetuate animal problems for self-gratification crosses the line between the St Francis Syndrome and the human psychiatric syndrome, Munchausen-by-Proxy (MBP). This rare, difficult to prove syndrome merits mention because it shows how harmful certain relationships can be to clinicians as well as their patients. Although no concrete data exists regarding its prevalence in veterinary medicine, anecdotal evidence suggests it can occur. Named after an 18th century German soldier, Baron von Munchausen, known for his notorious exaggerations and lies, MBP in the human medical arena refers to those parents who feign or create illness in their children to maintain the attention of physicians and the medical staff. Motivations for the behavior include a desire to be the center of attention, to master illness, or to gratify ambivalent dependency needs. Unfortunately, all the exciting technology coupled with the attention of a compassionate medical staff often serves as an ideal source of gratification for these people.
In addition to the harm done to the child, these cases are extremely traumatic for clinicians and staff because these parents fit the common stereotype of the ideal parent. They appear exceptionally caring, attentive, and supportive, so much so that clinicians who agonize over why the child never gets or stays healthy may give them their home phone numbers. Within the veterinary setting, these clients may keep journals, extensively research the animal’s condition, look up any treatments in the Physician’s Desk Reference or other tomes, ask intelligent questions, speak knowledgeably about the animal’s condition and treatment, and refuse referral to others because “I have complete faith in you, Dr. Smith!”
As mentioned, such relationships are very rare and extremely difficult to prove, but they bear mention because they demonstrate how easily we could be seduced. These people speak to us in our own language; they think everything we do is wonderful and exciting; no matter how discouraged we get, they never lose faith in us. Although they appear attached to their animals, they display what has been described as a”belle indifference” which physicians perceive as denial or heroic coping, but which veterinarians may attribute to “realism”: We want our clients to be attached, but not so attached that they would put the animal through unnecessary suffering if its condition becomes hopeless. Needless to say, when clinicians discover how their relationship with these clients inadvertently contributed to the deliberate harm of the patient, they feel devastated.
And so we come full-circle in our discussion of human-animal relationships as they affect the treatment process. At the “ends” of this linear spectrum, which are more correctly opposite sides of the same coin, we see owners who use their animal’s ailments to fill their own emotional needs. At best, the animals must go through life plagued by treatable problems; at worst, the owners consciously or subconsciously create those problems to elicit attention from us and others. What all of these relationships remind us is the role balance plays in a quality client-animal as well as client-patient-clinician relationship. For owners this means gaining the knowledge and confidence to respect each animal’s unique physical and mental needs and placing these at least equal to if not above their own. For clinicians, it means recognizing the role the human-animal relationship plays in the diagnosis and treatment of all medical problems, and becoming close enough to communicate genuine caring to our clients, but not so close that we lose our objectivity.
References:
Beck, Alan and Katcher, Aaron. Between Pets and People: The Importance of Animal Companionship ( West Lafayette, Indiana: Purdue University Press) 1996.
Milani, Myrna. The Art of Veterinary Practice: A Guide to Client Communication, “Problematic Owner-Animal Relationships” (Philadelphia: The University of Pennsylvania Press. 1995.