A Journey Inside Noah’s Ark: A Group Analytic Theory of Child Psychotherapy in a Therapy Zoo
So is written in Genesis, Chapter 6:
(6)18 But with thee will I establish my covenant; and thou shalt come into the ark, thou, and thy sons, and thy wife, and thy sons’ wives with thee.19 And of every living thing of all flesh, two of every sort shalt thou bring into the ark, to keep them alive with thee; they shall be male and female.20 Of fowls after their kind, and of cattle after their kind, of every creeping thing of the earth after his kind, two of every sort shall come unto thee, to keep them alive.21 And take thou unto thee of all food that is eaten, and thou shalt gather it to thee; and it shall be for food for thee, and for them.22 Thus did Noah; according to all that God commanded him, so did he.
The notion of Noah’s Ark came to me as I was thinking of a title for this chapter. It struck me that no word is said in the scriptures about what happened inside the ark during the deluge and the flood, which lasted a year and eleven days.1 The biblical myth depicts the great flood as a punishment visited upon humankind for their sins vis-à-vis God and their fellow humans. The sins are moral in nature. It is thus a text which deals with moral purge and reconstitution. Into the ark went Noah, chosen by his God, and with him his family and a selection of animals. I like the idea that the Ark can also represent the analytic space. Firmly defined and secluded from the outer world, it is a space to which a person can withdraw from life’s marathon, from the demands and stressors of earthly mundane business and engage in self-development, in a search for inner resources and in the appeasement of moral conflicts. Contemporary approaches focus on the patient’s experience of emotional isolation and psychic stagnation, and on the task of finding one’s place in the world within the interpersonal fabric of one’s community2. Therefore, the patient is not alone in his journey. The analyst is there with him as an Other, a subject who makes herself available for emotional involvement. The relational school, unifying under its wings a variety of psychoanalytic approaches, sees the meeting of subjects, or minds, in therapy as both the spark that ignites and the engine that pushes the therapeutic process forward.
Clearly, the biblical narrator locates Noah as the protagonist, in relation to which all other characters, human and non-human, remain in the background. The tension in the story revolves around Noah’s relationship with God. The only hint as to Noah’s state of mind is given in Chapter 6 verse 22: ‘Thus did Noah; according to all that God commanded him, so did he’. This narrow behavioural description is so tight that we can virtually feel Noah’s awful terror and trepidation in the presence of the Almighty, the supreme authority who has chosen and who commands him. At the same time, the scriptures leave no doubt that this journey is about family, community and the survival and prosperity of all those ‘wherein is the breath of life’ (Chapter 7, Verse 15). God makes a point of populating the ark with couples, from Noah and his wife, his sons and their wives, to the rest of the animals, always male with female, priming the reader to think of them as couples, fathers and mothers, procreative units, all selected and personally separated from the rest of their kind. And there is another being present in this journey, although in a more subtle, decentred way. It is God himself, always watching but rarely intervening, in a voice that probably only Noah can hear. In a wider context, God’s presence is strongly felt by all, of course. He is the one who architected the ark, broke up ‘all the fountains of the great deep’ (Chapter 7, Verse 11) and is the initiator and orchestrator of the whole journey.
The intimate relationship between God and Noah, which includes a deep scrutiny into the latter’s soul, is backboned by an alliance which God drafted and brought to Noah to sign. In my interpretation, Noah is in the role of the patient, ready to act first and understand later, for the sake of saving his soul and his community. God, then, is in the role of the animal-assisted therapist, aware of the vital importance of the presence of animals in the healing and survival of the human race. Being a group analyst as well, he can appreciate the intra-psychic, inter-personal and social impact of group processes, and knows how to marginalise himself and minimise his authoritative presence, once the ark has been set on its course, to allow for a maximum degree of freedom in the contact and communication among the other participants. According to this interpretation, God intended the ark to be a floating therapy zoo, meant to treat the sick human race through Noah, its chosen representative, via group-analytic animal-assisted therapy. A method more commonly referred to as Animal-Assisted Psychotherapy (AAP) in a therapy zoo.
In this chapter I will try to fill in the gap in the scriptures and describe some of what may have taken place inside the ark during its journey. The present chapter aims to offer a group-analytic perspective on the practice of AAP in a therapy zoo. It is also a part of a theoretical project, which tries to draw some preliminary outlines around a three-axis theoretical framework for AAP. The group-analytic axis adds to the neuro-psychoanalytic and the relational axes, presented in Chapter 4. The main body of the present chapter will be divided into a theoretical and a clinical part. First I will discuss the setting of the therapy zoo through the group-analytic perspective, and try to contextualise the psychotherapy of children, within this setting, by using group-analytic concepts and by comparing it to the model of the ‘small group’ in group-analysis. In the second part, using a case study, I will illustrate and discuss the implications of looking at child-psychotherapy in a therapy zoo through the group-analytic lens.
Part I: child psychotherapy in the therapy zoo: a group analytic exploration
My main line of thought will be as follows: since habitats, or ‘niches’, in the therapy zoo, are social systems, it is therefore possible to analyse the dynamics therein in terms of the tripartite matrix (Nitzgen and Hopper, 2018; Hopper, 2018), emphasising the primordial socio-biological inheritance, which is an aspect of the foundation matrix (Foulkes, 1973; Bacha, 2019). The communication among individuals in the tripartite matrix is initially understood as operating implicitly, conveying mostly emotional states. Emotions are the basic currency in the transpersonal network of communication and are the embodiment of the social nature of all mammals, avians and arguably, all vertebrates. Within this multifaceted matrix the therapeutic dyad is conceived, born and developed. Embedded in the community of animals, it becomes a part of the matrix and a new phenomenon is created, which can be compared to the small analytic group.
S. H. Foulkes founded the group analytic method of group therapy and research out of a deep belief that humans are social beings through and through. He wrote:
What is inside is outside, the ‘social’ is not external but very much internal too and penetrates the innermost being of the individual personality. The ‘objective’ external ‘reality’ is inseparable from the being, animal or human, and indeed the individual whose world it is and therefore is part of the ‘psychological’ reality as well (Foulkes, 1973, p. 227).
Stacey (2001) explores this idea by comparing two approaches. In the first, drawing on Brown (1994) and building on object-relations theories, he formulates a view of the individual psyche that emerges in a social context through processes of projection and internalisation, as an ‘internal world’ consisting of representations of objects (including the self) and relationships between them. This representation system is an action system that lies ‘behind’ social interactions, motivating and affecting them, while being affected and constantly created by them. The social is also present ‘outside’
A journey inside Noah’s ark 81 these social interactions, in the norms, values, customs and so on, that impregnate the internalised objects and relationships. This, he says, is how the social is transmitted from one generation to the next. Stacey compares this view to a second approach, which he bases on Mead (1934), who saw the social as an interactive process of meaningful gesturing and signalling between bodies in continuous cycles of cooperation and competition. According to Mead, Mind and Self emerge in social relationships. They are interpersonal processes made up of communicative actions and interactions, rather than entities that can be located within individuals. The individual psyche is then inherently social, being a communicative interaction of a body (the ‘I’) with itself (the ‘me’).
Current theories of attachment and regulation, as well as a growing body of neuroscientific findings, provide ample evidence for the natural induction that animals too are social by nature. In the previous chapter, I wrote about the animal self and its relational aspect, drawing on several fields of neurological research. Once we have broken the mental barrier and overcome our resistance to speaking about the relational self in animals, the road is open for us to consider the deep implications of animal sociality. While reading the previous paragraph, the reader may have noticed that in discussing the place of the social in the individual’s life, there was no need for the word ‘human’ or for any of its derivatives. It seems that this discussion is as relevant to animals as it is to humans. The object relations perspective can easily be applied to animals, as discussed in Chapter 4, in connection to what we know about implicit knowledge and about the operation of internal working models in animals. The second perspective echoes the theories, outlined in Chapter 4, about the basic emotional systems, implicit communication and emotional regulation, and about the role of mirror neurons in development and social adjustment.
Lavie (2005), in his paper on the roots of the theory of Group Analysis, elaborates on Foulkes’ ideas about socialisation and individuation as two parts of a simultaneous-interdependent process, through which individuals (and social systems such as groups and institutions) develop, within a specific social context. He thereby adheres to Foulkes’ conviction, drawing on the work of Norbert Elias, that the individual is not a closed but an ‘open system’ (Fuchs, 1938). I think that the notion of inter-related individuals, of open systems or social beings, captures the essence not only of how relational psychoanalysis and group analysis see human individuals but also constitutes the cornerstone of the theory of AAP proposed here. Namely, that human and non-human individuals are inherently social and that any grouping of these inter-related open systems will create a potentially transformational context for the individuals within it. Community life in the animal habitat in the therapy zoo, providing that it offers minimal conditions for a safe environment suitable for the animals to live prosperously and interact freely, is an example of such a context.
The matrix in the therapy zoo
Therapy zoos are specified adaptations of menageries and petting zoos. Roitman and Kassirer-Izraeli (2013) have pointed out four elements composing the physical experience in the therapy zoo. These are: (1) A hands-on contact with natural elements and with the rhythm of natural cycles and nature’s permanent changing. (2) A variety of possibilities for moving around, between niches and through gates, doors and passageways. (3) An explosion of multi-sensual stimulation. (4) Rich opportunities for interactions with a variety of animals. It is the latter that interests us here. Animals in the therapy zoo are bred and lodged in niches, each designed as a specific habitat to suit a community of individuals of one or more species. These communities qualify as social systems because we can discern the set of variables ‘in which a change in any one of them can be explained by changes in one or more of the other variables in the set’ (Hopper, 2018, p. 199). If we introduce a new male rabbit into an existing community of rabbits, we will notice changes in the behaviours of other rabbits, as well as a change in the general behaviour of the pack. For instance, a veteran adult male (a buck) may exhibit unusual hostility while a female (a doe) may show signs of excited curiosity. In fact, the whole community will react to the newcomer, mobilizing various subsystems to reach a new systemic equilibrium. One can assess these animal communities through the same dimensions that Hopper (2018) mentions as featuring in all social systems. These are complexity and simplicity (in terms of role differentiation and specialization), cohesion-incohesion, closureopenness, dynamism-static and stability-instability.
Foulkes used the term ‘Matrix’ to draw attention to the transpersonal network of communication within and among the participants in a group (Foulkes, 1973). Working with groups inspired Foulkes to theorize about a ‘supra-personal mental matrix’, which is a mental field of operation that includes the individual but also transcends him, and in which all the transpersonal processes occur. ‘These processes pass through the individual, though each individual elaborates them and contributes to them and modifies them in his own way. Nevertheless, they go through all the individuals - similar to X-rays in the physical sphere’ (p. 229). He realised that thinking just in terms of individual interacting minds wasn’t enough to make sense of the enormous complexity of processes, actions and interactions between even two or three parties, let alone explain how they can understand each other and ‘to some extent refer to a shared and common sense of what is going on’. He says,
Instead, I have accepted from the beginning that even this group of total strangers, being of the same species and more narrowly of the same culture, share a fundamental, mental matrix (foundation matrix). To this their closer acquaintance and their intimate exchanges add consistently, so that they also form a current, ever-moving, ever-developing dynamic matrix (p. 228).
Nitzgen and Hopper (2018) suggest a tripartite formulation of the matrix, in which the personal-matrix is added to the foundation-matrix and the dynamic-matrix, the personal matrix being the mental field of interacting processes composing the individual mind. In short, Foulkes conceptualized ‘the mind of an individual person in terms of a personal matrix in the context of the collective mind of a grouping, characterised by a dynamic matrix in the context of a society, characterised by a foundation matrix’ (ibid, p. 15). In the group situation, which Foulkes investigated through his invention of the T-situation (the group-analytic group), the three levels of the matrix can be seen as operating upon each other in recursive loops. Personal matrices feed into the dynamic matrix, which also feeds from the foundation matrix, and vice-versa. We will come back to the operational principles of the tripartite matrix in the context of the therapy zoo, later.
Let us first delve a little deeper into the foundation matrix. Here, Foulkes saw the pre-existing, relatively static, biological and cultural background of the individual, resonating ‘down the generations’ (ibid, p. 12) and transmitting the socio-cultural inheritance of the past into the here-and-now of the dynamic group matrix. The reference to both species elements and societal elements is somewhat blurred and confusing, and Foulkes has not given us much to work with. Understandably, most literature on the subject has focused on the socio-cultural aspect in humans, and neglected the species related biological and social aspects. Bacha (2019) makes an interesting connection between Foulkes’s notions of the foundation matrix (Foulkes, 1973), his notion of the primordial level of communication (Power, 2017) and Panskepp’s notion of the MindBrain (Panskepp, 2011). These concepts all refer to a socially and biologically inherited set of processes, involving emotional communication and patterns of interactions between embodied selves within a living community. ‘Human and mammal emotions’, she says, ‘originate in distinguishable [neurological] pathways which are the same across individuals and across enormous swathes of time’ (p. 6). This primordial level of both mental and neurological activity (hence: MindBrain, or BrainMind), which is essentially emotional and social, also cuts across species, with many resemblances, as well as differences, between individuals, communities and genomes. So, better informed than Foulkes was in his time, we can now therefore accept that any group of animals, merely being of the same class (e.g. Mammalia) or phylum (e.g. Chordata), share some basic fundamental mental matrix (foundational matrix).
What does this foundation matrix look like in a community of rabbits? Take a rabbit pen for example, with hutches, logs and straw bedding scattered around on the ground. In this wide, well protected and equipped pen lives a community of say 5-10 domesticated (pet) rabbits, bucks and does more or less evenly balanced. Much in common with their wild relatives, the Wild European Rabbits, they have a pecking order and a dominance hierarchy. The more dominant adults get to eat first, and the dominant male has mating rights with the females. The adult females show territorial behaviour around their hutches, especially during spring and summer, when they are busy lining their nests with hair pulled from their tummies. At such times, competitive and aggressive behaviours may erupt to establish dominance and mounting will appear as part of sexual or hierarchical transactions. In the presence of a perceived threat, rabbits thump the ground with their hind feet to communicate danger and scatter into their shelters. Play, care and grooming behaviours are also observable among rabbits in the community. In a cohesive pack with good living conditions, young rabbits race up and down and jump in the air, and older rabbits dig at the same hole, or rip up some old newspapers together. Rabbits groom each other as a sign of affection and generally spend a lot of time together, sleeping snuggled up against each other. This is the culture of the rabbit community, culture being here the biologically inherited social patterns and habits. All this is part of the foundation matrix in the rabbit pen and can be described in terms of a mental field, within which many interpersonal processes take place between individual minds grouped together, forming a dynamic network of ongoing communication.
How does the interplay between the three levels of the matrix occur in the rabbit community? Each rabbit has its own unique personality, influenced by its gender, age, breed, personal history and living conditions. On the mental level or the personal matrix, each rabbit perceives the social sphere via its internalised working models and reacts to social events by the activation of mental processes informed by implicit knowledge drawn from its own life experiences. Through its behaviour, the individual rabbit affects the dynamic matrix of the community at any given moment. If a human steps into the pen, for instance, the rabbits’ reactions will vary between expressions of fear and curiosity, within the range dictated by their foundation matrix, depending on the norms and history of the specific community. Individual rabbits who feel safe around humans and anticipate positive feelings (potentially resulting from receiving physical or emotional nurturance) will bend the community norms towards approaching and gathering around the visitor, sniffing his hands, and seeking food and touch. Home-grown free-ranging rabbits are known for their tendency to include humans in their social hierarchy and to show positive attachment to humans, while rabbits who are raised alone in cages are known to show schizoid interpersonal styles and be more suspicious of both other rabbits and humans. Such individuals will affect the dynamic matrix of the pack in the direction of their personal perspectives, while at the same time driven to change their personal matrices according to the patterns of the group. Foulkes’ basic law of group dynamics describes this interplay nicely: ‘The deepest reason why [these] patients... can reinforce each other’s normal reactions and wear down and correct each other’s neurotic reactions, is that collectively they constitute the very norm, from which, individually, they deviate' (Foulkes, 1948, p. 29, my italics).
Communication in (e)motion
As shown in Chapter 4, the basic operating system of social organisms lies in the activation of emotional states in response to events in the external environment. Emotions are more ancient and are situated deeper in the brain than thoughts and cognitions. ‘Emotions let us know that something is happening in our environments, in much the same way as pain or fever alert us to something happening in our bodies’ (Bacha, 2019, p. 5). Emotions have a value tag attached to them, which tells us if what is happening is good or bad: whether to approach or to avoid. The foundational emotional systems are action-systems, activating ‘intentions in action’ (Panskepp, 2012). The basic emotions are thus expressed through the behaviour of the animal, transmitting its intention and appreciation of the situation. Those emotional behaviours become communicative actions as they are received by other organisms and take part in interpersonal/social interactions. The Latin origin of the word ‘emotion’ combines the prefix ‘e’, which means ‘outwards’, and the word ‘movere’ which is ‘to move’. In French, the word is close to ‘emouvir’ which means to excite, or to stir-up. It underscores both the action and the interpersonal aspects of emotions. Emotions are therefore the fundamental currency in interpersonal communication among animals. They link the embodied nature of animal sociality, as described by Panskepp (ibid), with the mental field of communication (the matrix), described by Foulkes as operating in all groupings of minds (1973).
If the matrix is conceptualized as a transpersonal network of communication, then what flows through its channels, transmitted between and through its individual stations and intersections (or as Foulkes called it - the nodal points), is first and foremost the emotional states that arise in the social system at each specific point in place and time. Emotional states evoke thought patterns and mental activity that correspond to the emotional content and to the environmental circumstances in which it arose, within the limitations and inclinations of each individual from each species, and to the best of what its neurological apparatus can produce. While the working models and interpersonal patterns vary between any meeting of individuals, they all are part of the dynamic matrix and reflect the foundation matrix of the social system. In this context we speak of the emotional and mental state of a sub-group or the group-as-a-whole in any given moment. We see this clearly when we enter the rabbit pen with a bucket full of vegetables. The excitement that spreads throughout the pack is contagious, driving even the most timid of the rabbits to emerge from their hutches, stand up on their hind paws and sniff the air in curiosity. In this situation, we also will hardly remain indifferent and will most likely come to share the excitement that bubbles all around us. At times, only a part of the group will share a specific emotional state, while others will react differently or indifferently, such as when mating behaviours occur.
The therapy zoo is a grouping of a number of such communities. Some of them are confined to exclusive areas and some share a corral or an open space with other species. Open and shared areas serve as a ‘market-place’, with busy traffic and a variety of animals. This is the bedding in which the therapeutic dyad is conceived. The therapy sessions can be limited to specific niches or, as usually is the case, the child chooses the route and the rhythm of the session. And so the therapist accompanies the child in the early sessions, in his exploration of this new world into which he has landed. Many patients will spend their sessions hopping from one niche to another, visiting each habitat briefly and moving on, roaming the central scene, absorbing the culture and adjusting to the social atmosphere of the place. As they merge into the matrix, they develop their habits and create rituals. Their weekly visits become a routine. They get more and more involved and invested in interactions, adding to the matrix while being created by it, as does the therapist. The patient follows the therapist’s lead in his first attempts to connect with animals, as the therapist follows the patient around. They are a pack of two. A pack with a dynamic matrix of its own. Gradually, the dyad finds itself spending more time in specific niches, to which they return at each session. The child now feels more at home in the therapy zoo, less like a newcomer and more like one of the locals. The relationship with the therapist deepens and her presence gives the child a sense of security that establishes his capacity to be alone (Winnicott, 1958), in the sense that he is freer to engage in emotional social interactions with the animals around him. His ability to explore his social surrounding in a playful, relatively anxiety-free state of mind depends on the mental maintenance of a transitional space, where he can begin working through the challenges that are re-enacted for him in his interactions with the animals he meets. In these interactions the patient experiences emotions and relives self-states of various kinds. His communicative gestures transmit those emotional states outwards. A flinch, a hesitating hand or a frozen posture while clinging to the therapist, as well as a carefree running around, chasing animals, distributing food or shoving hands inside a rabbit hatch, are all indicators that animals respond to with communicative gestures of their own. Emotions flow in the matrix, creating an emotional atmosphere that can be assessed by the therapist and discussed with the patient, improving her awareness of her own feelings and of the relational processes that take place around her. A myriad of relational events and emotional transactions present themselves to the child, with the assistance of the therapist, from which the child can choose the ones that carry the most relevance to the therapeutic goals.
At this point, focusing on sequences of sessions in a certain community within the therapy zoo, we can speak of the nascence of a new clinical phenomenon, in which the therapeutic dyad becomes one with the animal community. Connections between humans and animals are now moulded into social patterns, enriching the dynamic matrix and affecting the personal
A journey inside Noah's ark 87 matrices of individuals. Some animals may begin to show enthusiasm and greet the patient and/or therapist when they come on their weekly visit as if they were waiting for them, while others will learn to run and hide at the mere sight or sound of the child and/or adult approaching their niche. Sometimes the whole pack will experience a positive or negative transference towards the human dyad, and sometimes they will disregard them, treating them as inconsequential fellow animals that incidentally share the same space. The animals in the therapy zoo are accustomed to people engaging them to interact and may not at first distinguish one visitor from another. But as the session proceeds, this new social system, the dyad-in-the-matrix, will begin to exhibit its unique characteristics, some of which can be compared to the group-analytic model of the small analytic-group (the ‘T-situation’, Foulkes, 1986).
With regard to the treatment (T) situation, Foulkes devised a method in which a small group of strangers meets regularly and is encouraged to free-associate. He referred to the group therapist as a conductor, alluding to the conductor of an orchestra, once he realized that one of the therapist’s missions is to intervene in ways that enhance the group’s synchronicity, harmony and coherence (Foulkes, 1984; Pines, 1994). He says:
With this orientation in the mind of the conductor, the group-analytic situation becomes the natural meeting ground of the biologist, anthropologist, sociologist and psycho-analyst. In fact, it displays the living process as what it really is - a co-ordinated and concerted whole (1984, p. 64).
One of the peculiar features of the group-analytic situation is its orientation towards a discussion which is ‘completely loose and undisciplined, a free association of ideas, which can be best described as a “free-floating discussion’” (Foulkes, 1984, pp. 45-55). In the dyad-in-the-matrix group the dynamic field of interactions can be described in the same manner, although we are inclined to change the word ‘ideas’ to something less cognitive and more biologically oriented, like emotions or mental-states. In both situations the group is seen as a ‘concerted whole’ where each individual, human or animal, is looking to find its own way to fit in, thereby adding its ‘colour’, to the total picture. In the process of fitting in, the individual experiences a growing sense of coherence and a better understanding of what is going on (Pines, 1994). She becomes an active member, takes part in establishing the norms of the group and is corrected by the group when she deviates from these very norms (Foulkes, 1948). It is not just the conductor/therapist but the whole group, including the conductor/therapist, which is doing the therapeutic work. Each response by any participant to another constitutes an interpretation, mirroring or resonating with some aspect in the recipient (Foulkes, 1977), an aspect that the latter may not have been aware of, but which was communicated by his earlier gestures and processed and responded to by others.
The dyad-in-the-matrix within the animal community is very different from the analytic-group. While the group members in the analytic group are discouraged from, and even forbidden to communicate in any way other than through words and body language, in the new matrix that incorporates both human and animal, communication is not restricted to words, but encompasses all manners of interactions, including movement, touch and nonverbal voice-making. Interactions are hands-on, remain relatively simple most of the time and are based on emotional communication, given the paucity of wider foundational common grounds like language, culture and symbolic thinking. The dynamic matrix of the dyad-in-the-matrix is impregnated by forces belonging to the relational bio-social nature of all creatures in the matrix. It is nevertheless quite poor in the realm of words, symbols and ideas. This remains a private matrix of the therapeutic dyad, which holds the alpha function (Bion, 1967) in the transitional space, the place of birth and processing of ideas, the playground of the mind. Another difference is that the animals are not concerned with exploring their relations with each other and with the humans. They are action oriented and focus on the here and now only, monitoring a much narrower field. They usually don’t care about and don’t intentionally think of what they do or why they do it, whether in relation to humans or to other animals. The dyad, under the orchestration of the therapist, doesn’t share with the animals the mental activity dedicated to the explorations of the social and psychological processes that touch the patient. It is not because they don’t talk to the animals about it, but because the animals can’t understand most of it.
Consequently, patients map the social climates of different niches and navigate the therapeutic dyad between them according to an inner campus. The patient chooses to visit specific individuals and/or groups who have captured their interest and who may be willing to engage with them socially, maintaining an ongoing relationship. It is important to remember that the clinical focus is still distinctly and unmistakably centred on the patient. In this model, the child patient is the one who experiences the maximal transformative effect of the group processes. Nevertheless, the animals and of course the therapist are also affected, and it is not uncommon that some animals, individuals and groups, benefit from the therapy with observable change.
Part II: Sara’s journey: clinical illustration and discussion
The clinical material that will be presented below is based on extracts from the treatment of Sara in a therapy zoo. The details have been altered and personal features changed for confidentiality reasons. Following is a discussion of the material, using the theoretical perspective and terminology presented above.
Case study - Sara learns to play
Sara, 9 years old, is an only child with a mild developmental disorder. She was born with hypotonia and was late to reach all her developmental milestones. The challenges and hardships that her parents have gone through with Sara are the reason why they have decided not to bear more children. Sara has undergone all kinds of treatments and is reported to be cooperative because ‘she understands that it’s all for her own good’. At home, although quite able to do everything on her own, Sara is still assisted by her parents down to the minutiae of her daily chores (e.g., bathing, dressing and brushing her teeth). In school, she is struggling academically and participates in a special education program. Sara gets along socially but tends to be easily offended and seems meek and compliant with her peers. Generally, notwithstanding occasional bouts of distress, Sara is a happy girl without any signs of a major emotional disorder.
At the beginning of therapy, the therapist noticed that Sara loved feeding animals and showed no fear when they fought amongst themselves over the food. In fact, she found interesting ways to trigger these fights. She brought apples to the donkeys or collected carobs and hay for the goats and then went to the most crowded areas, where she distributed the food as evenly as she could. She then reprimanded the rude donkeys who took more for themselves at the expense of others and scolded the butting goats for their aggressiveness, ordering them to stop fighting. Sara was fascinated by the birds and it was as if an invisible force was drawing her again and again to the aviary. She liked standing in the middle of a flock of cockatiels holding a mixture of grains in her hand, choosing individual birds whom she had learned to identify by their colours and trying to feed them. This got the flock into a frantic dance of wing-flaps and screeches, creating around her a chaos of competition and pursuit. With a very serious face Sara talked to the cockatiel she was determined to feed and reached out to it with her palm full of grains. The frightened bird escaped, leaping from one branch to another, sometimes trying to bite her hand. Other cockatiels took shots at picking up grains from Sara’s hand, which swung forth and back. The whole flock became aggressively ecstatic, while Sara remained cold and resolute and used her second hand to fend off the snatchers. She kept talking, addressed specific cockatiels or the group-as-a-whole, or talked partly to the therapist and partly to herself, as if narrating the choreography of the matrix in front of her.
Please honey, you need to eat. Don’t run away. Stop grabbing, you. It’s not for you! You already got some, leave for the others. Look, they are fighting. This one is biting, be careful. Ah, you moved over here, now you want some? Here, come eat.
Similar scenes repeated themselves with the geese and ducks by the pond. The therapist intentionally stayed back most of the time, observing silently.
When a group of angry geese approached her once with menacing screeches and beak-strikes, Sara didn’t pick-up on the threatening vibe and the therapist had to intervene. She pointed out to Sara that they are not asking for food but are actually communicating that they want her and the therapist to back off. But Sara wasn’t available to notice that. She had to be gently removed to avoid herself being hurt.
Within a few weeks, it seemed that Sara was becoming aware of the emotional states in the animals around her and responded to them. Noticing their fear brought to the surface issues of competition and power. ‘Who is the strongest?’, ‘who do you think?’. Sara named two donkeys, ‘because they make the others scared.’ ‘Why are the others scared of them?’ Sara couldn’t say. On some occasions, when the goats broke into a fight, she asked to leave the scene, showing first signs of fear. She felt pity for Toby, a white male pygmy goat who was kept in seclusion and was thirsty for attention and she gave him weekly encouragements. In the chicken coop, there was a social structure that resembled a family, which led to a discussion on sibling rivalry and to Sara sharing that at home she has the TV all to herself with no one to fight her for it, ‘except for when daddy wants it, and then I go to my parents’ room, they also have a TV. It’s more cosy there’. In the nursery, there were four chicks, two of them significantly bigger than the other two, who were newborns. She said the big ones are ‘daddy and daddy’ and was preoccupied by their size. Then she asked, ‘why are they looking at me?’. She said they should have a slide so they can play. She then took the therapist to a slide in a corner of the therapy zoo, went up and sat down at the top. But she didn’t slide down. She changed her mind and came down by the ladder. Then she headed to the pen to feed the goats. Passing by Toby, Sara said it must be that he is kept apart because he was being bullied, and now he is safe. Suddenly a group of peacocks came right through them. She had bread in her hand and began throwing pieces at them, saying ‘take, take, just don’t fight’. The blue ones, she explained, are the dads. ‘My best friend A has no father. My father and I play ball together. Do you have a ball?’ They then went to the playroom and got a ball and played passes until it was time to say goodbye. Sara’s father then came in and she seemed to react with panic and embarrassment. Something that was released earlier was now restrained. She returned the ball to its place and went silently to join him.
One day she brought carobs to Toby, ‘to make him happy’. The therapist asked, ‘what else will make him happy?’. ‘Company. If we play with him’, Sara answered. After Toby had eaten, the therapist suggested they open the gate for him to walk around. Sara didn’t resist. They followed Toby who took off in the direction of the pen where all the other goats were. Sara said he misses them, and that he is lonely. The therapist showed Sara how to caress and play with Toby by rubbing his forehead. They played together for a while and then resumed their stroll. Toby was now much calmer and more playful, exploring around himself but keeping a short distance away from Sara. After a while, Sara became anxious about him being out so long. She
A journey inside Noah’s ark 91 became bossy and started taking him back to his solitary enclosure. The therapist tried to appease her by saying that Toby could use the time-out after being closed in all day. Sara stopped and suddenly said that she also is alone a lot, when daddy is at work and mommy is cooking. She then relaxed and set Toby free, leaving him to visit other niches. In the next meeting, she went straight to Toby, who responded to the sight of Sara and the therapist approaching with loud excitation. She fed him and played with him. Watching them, the therapist thought that she had not seen Sara so playful and uninhibited previously. She let Toby nibble her shoelaces and stand up, laying his front paws on her chest. She answered in sweet words and caresses and rubbed his forehead. His affectionate attention filled her with joy. Then she let him out again and they strolled in the open area. It made her proud when she noticed that he was following her this time, and not the other way around, like last week.
By choosing to bring such rich material my aim is to demonstrate the multilayered therapeutic experience that the work in the therapy zoo can offer. I will not attempt to touch upon all that transpired in the vignettes that I have described. The following discussion will present the way that I think, as a clinician, while trying to make sense of what is going on, and to connect the personal and the interpersonal, and the matrix and the transitional space. My discussion also reflects a movement between languages and theoretical perspectives, integrating as it were the three axes of the theory of Animal-Assisted Therapy outlined in the previous and the present chapters.
The therapy zoo plays a leading role in Sara’s therapy. It has a strong presence as an interactive environment (Roitman and Kassirer-Izraeli, 2013). It is characterized by responsivity and initiative, thus enhancing the relational aspect of the therapeutic process. As an analytic space, it is very much ‘alive’ and enlivens Sara’s internal dramas, by facilitating the production of enactments with the participation of the animals. As a patient, Sara quickly let herself dive into a transitional space within the matrix and engaged in what relational analysts call ‘play’ (Frankel, 1998) with the animals. Disregarding social constraints, which demand some time and effort to remove in most children her age, Sara immediately went for contact with the animals in a way that conveyed the assertion that they are her equals. At first, she initiated interactions trying to control the situation by taking on the role of the giver. By possessing the goods, she made sure the others will be drawn to her. Still, she only managed to feel effective when she got the dynamic matrix intensely agitated. Her version of the giver role was a brilliant recapitulation of her mother, who hovered over her continuously to offer assistance. It also had some clear features of her father’s authoritative manner. She didn’t tolerate aggressiveness but kept inducing it, as part of the enactment that she created with the animals. The communitiesshe frequented became enthusiastic in her presence. She could magically invoke a contagious SEEKING state (Panksepp, 2012) around her, spreading to all the participants but somehow not affecting her. Nor did she seem to be touched by the uneasiness that accompanied the aggressive side of the dynamic matrix that was being enacted. I believe this is a good example of a massive scale projective identification, or in the group-analytic nomenclature, a case of strong resonance in a group (Foulkes, 1977). We can ask how this kind of interaction affects the animal community’s dynamic matrix over time, and how the personal matrices of the cockatiels, the geese, the donkeys, are changed by it. These questions are important as part of the ethical and zoological aspects of the therapist’s work, but this is not the place to address them.
A few weeks into therapy Sara seemed to have descended one level deeper into the matrix. As a result, her awareness of others’ feelings has opened, and her authoritative style has softened. She has mapped the therapeutic space and was now choosing a niche or specific animal to visit to match an internal state or need she experienced. She took the therapist with her in a journey through her internal zoo (Maayan, 2005), reflected on the encounters she had with animals in the real (external) zoo. It is clear that the therapist was now much more present as a subject for Sara, as were the animals. We can say that the dyad-in-the-matrix was now born. With the donkeys and the goats, a re-enactment of power struggles and anxieties related to oral-aggressive drives were featuring in the themes that resonated in the dynamic matrix. In Toby, Sara found mirroring for her socially rejected part, and in the chickens, a reflection of her longing for siblings, her fear of competition and her wish for father’s attention. These projections, accompanied by behavioural gestures, were responded to by the animals, thereby co-creating relational moments in which Sara could explore and express her feelings and self-states, and work through some of her emotional and developmental challenges.
For example, when she talked about giving the chicks a slide to play, she was probably referring to her own wish and difficulty in playing, which was connected in her mind to the longing for siblings and to her ambivalence towards her father, who represented for her alternatively a daunting authority and a play partner. In my mind, this is the context of her change of heart on the top of the slide. Sara is a girl who can’t play as freely as other children do. We know that the emotional state of PLAY (Panskepp, 2012) requires a specific relational context in which to evolve into the socially expected capacity to play. The context of the therapy zoo can encourage children to develop this capacity, by giving them both the incentive and the relational context they require. Note the interplay between the effects of the animals on Sara and her ability to make use of the therapist as a developmental agent. I am addressing here the observable fact that Sara’s invitation to the therapist to play ball, maybe the first time she had done this since the
A journey inside Noah's ark 93 beginning of therapy, was preceded by the feelings that were aroused in her while watching and interacting with the ‘family’ of chickens. Here, Sara’s personal matrix fed into the dynamic matrix, also fed by the foundation matrix of the chickens, and a re-enactment of a scene from Sara’s relationship with her father emerged. It also demonstrates a sequence beginning in the interpersonal, touching the personal and resounding back to the interpersonal. This back and forth resonance of emotional interplay of self-states, or object-relational patterns, occurs in the transitional space inside Sara’s mind and in the context of a set of communicational processes occurring in the matrix. What was exchanged here were emotional states, which regulated the emotional state of the group, or sub-groups, by activating PLAY states and soothing FEAR states. Sara’s reaction to her father stepping in shows a reverse effect.
Pulling just one more of many possible threads, I want to focus on another sequence, involving Sara, Toby and the therapist. In the first session of the two reported, Sara decides to go and make Toby happy by feeding him. The therapist, holding in mind her social difficulties and her sensitivity to Toby’s need for company and attention, interprets in the form of a leading question, ‘what else will make him happy?’. Sara immediately understands, and by that acknowledges the containment of her own similar need by the therapist. She goes on feeding Toby, still treating his loneliness, but unable to connect to her own vulnerability. The therapist then intervenes again, opening a concrete as well as a metaphoric gate. And then, another intervention is needed on her part, in order to show Sara a way to engage Toby in play. Her interventions affect both Toby and Sara, building a bridge connecting both their needs to interact more intimately with each other. She models for Sara how to play with Toby, thereby impacting the dynamic matrix towards increased degrees of freedom, playfulness and intimacy. Sara is finally able to relinquish the safe position of ‘giver’ and meet Toby from a more equal and vulnerable position. Toby also gives up his plan to join the other goats, turning instead to Sara whom he now sees as a playmate. Their play is therapeutic for both, but Sara still can’t hold it for long. While Toby seems to have relaxed and is joyfully prancing around, Sara resumes her adult-like manner and soon becomes anxious, as if she did something wrong and is about to get castigated. A surge of guilt and anxiety drives Sara to take Toby back and lock him up. I believe that this was a transformative moment, beginning with a possibly malignant form of projective identification between Sara and Toby, but which was then resolved by the therapist, in her statement that Toby would actually prefer staying out than being locked up again. By giving words to Toby’s subjectivity, she helped Sara regain empathic connection with herself and an implicit memory surfaced, that of Sara’s feelings of loneliness in her own home. In the next session, Sara and Toby are anxious to meet again and repeat the pleasurable experience of playing together. Their personalmatrices have incorporated something from the dynamics of the last session and are feeding into the dynamic matrix of the here-and-now. For Sara, it was a revelation to realise that she is wanted and loved by her peers and that she can be a leader, not just a follower, in her relationships with them.
Part III Summary
Thinking within the framework of the dyad-in-the-matrix enables us to encompass and analyse various processes, both intra-psychic and interpersonal, that take place simultaneously in a child-therapy in a therapy zoo. I have found that although such processes as those depicted in the above case study are common in AAP, we have so far been short of an appropriate theoretical framework and terminology to address them. Especially with regard to the relational and social processes in which the animals are taking an important part. It is my impression that today, still, every AAP therapist and supervisor must invent his or her own nomenclature to think about and discuss analytically what is going on in therapy, beyond the merely behavioural concepts of causality and conditioning.
The suggested approach can be applied to group therapy in a therapy zoo, as well as to individual therapy involving a single animal, say when a dog takes part in the psychotherapy of a child in a playroom, or outdoors. In any case, it may be useful to begin by assessing and mapping the various matrices that are present, and the interplay between them. As far as the technical implications that this has on the work of the clinician, these may affect mostly the way we think and to what we attend to. 1 believe that most experienced AAP therapists working in therapy zoos have developed strong intuitions as to how to intervene in ways that facilitate and enhance the therapeutic process. This has to do with the fact that they have themselves become part of the matrix of their working environment, affecting and being affected by it. This has inevitably impacted their personal matrices in ways that help them ‘read’ in richer and more sophisticated ways the human-animal multifaceted matrix in which each dyad-in-the-matrix is conceived, born and developed throughout the therapy. What we need most urgently now is a comprehensive theory to explain how it all works and provide us with the words to communicate it.
The therapeutic journey of Noah’s Ark concludes with the arc-in-the-sky covenant, where God says: (9)12 ... This is the token of the covenant which I make between me and you and every living creature that is with you, for perpetual generations:13 I do set my bow in the cloud, and it shall be for a token of a covenant between me and the earth.
Here, we are reminded of the larger context, uniting all living things under God’s eyes. The story of Noah’s Ark therefore marks an awakening of the awareness of the foundation matrix connecting the whole animal kingdom, to which mankind also belongs.
- 1 Parallel myths from other cultures, such as the Mesopotamian, the Greek and the Persian, are slightly different but preserve most basic motives of the story. Interestingly, all avoid going into the details of what the passengers of the ark went through during the deluge and the great flood.
- 2 In awareness of the on-going debate about gender issues, references to the patient and the therapist, when a gender isn’t specified, will be either in male or female terms. They should be read as referring to both genders.
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