During the Connected Horse workshop, we hope to affect the relationship between the person living with the dementia diagnosis and their care partner. Because the Connected Horse curriculum and dyad model utilizes some of the basic assumptions behind Systems theory research, facilitators need a basic background understanding of this theory.
At its most basic, Systems theory tells us that people act oddly when something is out of balance and they are anxious. Relationships evolve to manage anxiety by adopting fixed patterns of distance that may or may not be functional for the situation. Systems are rarely helped by a facilitator interfering in this delicate dance, while horses seem to recalibrate it without effort. The facilitator’s job is to hold a shape for this to happen, and then to stay out of the way so it can. A facilitator who gets tied into an outcome or tries to fix something enters the system and becomes part of the system’s anxiety.
In a nutshell, Bowen Family Systems Theory holds that each family is a system where one’s position in that system is what determines which aspects of an individual’s personality (or disease) will find expression and how those aspects will be interpreted by others. In a functional system—that is, one not overwhelmed by anxiety—this is fluid and flexible. When the system is inundated by more anxiety than it can handle, roles become fixed. Roles and relationships are not allowed to flex with changes in chronological age or situation. The systems enter a sort of survival-mode mentality.
When a family member gets a dementia diagnosis, anxiety skyrockets.
Anxiety is not the same as fear. Fear is a real response to a real and immediate danger (like an intruder in the house). Anxiety is a real response to an imagined danger either because of what happened in the past or what might happen in the future. (That creak on the stair could be another intruder!) Fear leads to action, whether that action is to flee, fight or join. Fear ends when the threat is met by action. Anxiety lingers.
When a family is in the grip of anxiety due to a dementia diagnosis, the relationship between the care partner and the person living with dementia may be jolted into fixed roles based on anxiety, as the jagged line below shows. For example, the person in the care partner role can become insensitive to present needs, doing too much or too little. They aren’t aware of what is really needed. The story in their head doesn’t align with reality. The person living with dementia may conform to care partner expectations of diminished ability, ceding more territory to their disease than may be actually needed because the system is set up to support a greater dependency.
During the Connected Horse workshops, care partners often become calmer and more present. We then see changes for the better, including the person living with dementia becoming more independent, confident and engaged.
In bringing care partner-person living with dementia dyads to the horses and asking them to observe and respond to horse behavior, we’ve seen the care partner-person living with dementia dyad shift from an anxious focus on dementia to a renewed connection between them:
For example, a husband and wife dyad came to the first day of the workshop. Sally was the care partner and David was the person living with dementia. David walked with a cane, was quiet and deferred to Sally to answer questions for both of them. Sally was attentive, almost hovering, and somewhat nervous about being at the barn.
After the initial orientation, Sally and David stayed close together. Sally would tell David what horse to approach and how to “brush the horse correctly”, apologizing to the horse when he brushed the horse in a way she didn’t like.
During the next activity, the facilitator asked each participant to approach a horse in a stall and stay with that horse until she called everyone back to the circle. The facilitator approached David and Sally and said, “David do you want to come with me to look for a horse that you are interested in meeting? Sally, I’ll let you find your horse.” The facilitator stayed with David and provided some cues to support his curiosity with the horses. David’s horse was engaged with him, accepting head and neck rubs. Sally was able to stop watching the facilitator and David and have her own experience.
By the end of the workshop, Sally was grooming horses with a group of care partners. David had left his cane at the chair and was leading a horse with minimal support. And as David and Sally came back together, they walked back to the car holding hands. Not to support a feeble body, but because they had reconnected.