THESIS: Creating A Dog Centered Care Approach

(Or Why We Must Stop Always Trying To ‘Fix’ Things)

Introduction

I intend my thesis to be making the argument that often we are spending too much time trying to ‘fix’ behaviour rather than recognise the limitations and sensitivities of the dog. I hope it will help give confidence to look again at how we approach behaviour cases, knowing that we are doing the best for the dog and are able to present this to the clients in such a way they can embrace it. For example, control and management has often been seen as the poor relative to the more glamorous rehab plans, but, in my opinion, this can be at the expense of best outcomes for the dog. Giving the owner the tools to manage the dog, to control environment and be the best caregiver they can to the dog they have is, I hope to argue, in some cases the best approach and outcome.

Supportive definition of behavior

I think before looking at approaches to dealing with behaviour that I spend some time outlining my views on what behaviour is and what it is designed to do. This is based on years of study both in human behaviour (Bsc Psychology and 15 years in human practice) and now with animals. I do recognise that some of my projections regarding animals might not be deemed the norm by some, but I do believe the science is pointing more and more towards an over-arching relation of behaviour regardless of species.

So, let us start with looking at what behaviour actually is. The Oxford Dictionary describes behaviour as: ‘the way in which an animal or person behaves in response to a particular situation or stimulus.’ The reason it is ‘in response to a certain situation’ is because behaviour is driven by how we ‘feel’ about that situation or stimulus. It is really important we look closely at what this really means as this is crucial to our understanding of behaviour.

Behaviour has two primary roles;

Firstly, behaviour communicates, and it communicates emotional responses. That emotional response is triggered by a stressor (this can be internal (e.g. pain) or external (e.g. environment). This communication is either active or passive. Active communication is when we deliberately use behaviour to express our feelings; passive communication is where we ‘give away’ our emotions through our behaviour without consciously meaning too. For example: if a dog growls at us they are ACTIVELY communicating they are stressed by our presence, where as if a dog runs under the table and starts shivering they are PASSIVELY communicating that stress. If I met someone for the first time it is unlikely they would punch me or alternatively hug me- why would they do either!? If they were scared I might hurt them then they might punch me. If I gave them a £100k cheque from the lottery, then they might hug me. Behaviour is totally directed by how we feel on an emotional level.

Secondly behaviour has to provide relief. The word relief is hugely important and will underpin my main arguments for this thesis so I will spend a few moments looking at what relief means. The Oxford dictionary defines relief as: ‘a feeling of reassurance and relaxation following release from anxiety or distress’. There are two types of relief – temporary and absolute. Absolute relief comes when the stressor that caused the emotional response has completely been removed and the emotional response has changed. Temporary relief comes from behaviour designed to mitigate the initial feeling of the initial emotional response but the original stressor is still evident. I will use the act of losing a mobile phone to show the effect of stress and the difference between the two types of relief.

As soon as you realise it is missing you will have an emotional response that will build very quickly. This will cause a neurological and physiological response – your heart beat will increase as will your body temperature, your breathing will quicken and your blood pressure will rise, your body will be flooded with adrenalin and cortisol. This is the sympathetic system kicking in, which is the pumping up bit of the autonomic system. Your brain will slip into panic mode as the limbic system fully takes over, which will make rational thought very hard. All this will happen in an instant and will only build as your panic continues. This will have a direct effect on your behaviour: you will become agitated, grumpy and highly animated as you look for it. Now let us look at the two possible outcomes. If you find the phone, then you will experience absolute relief. The parasympathetic system will immediately kick in and that sudden euphoric release is such an amazing feeling! Although physiologically your body will take time to get back to a relaxed state, you will no longer be plagued by the emotional response of losing the phone, but instead have it replaced with positive emotions of finding it. However, if you do not find your phone although the initial stress response will subside over time, the emotional response will still be very raw. We will now actively seek out something to make us ‘feel’ better – we might go and have a drink, go to the gym, go and buy another phone etc – behaviours all designed to take our mind off the loss but ultimately these activities can only provide temporary relief. The point here is that whether the relief is absolute or temporary it is an important aspect of behaviour that it offers us relief – in other words we REALLY want to find some relief! If we keep getting temporary relief from stress this, over time, will create real problems as the stress ‘bucket’ never has chance to drain properly. We should always strive to get absolute relief, and in turn this means doing the same for the dogs in our care!

Note: Often the given behaviour provides some relief, even if absolute relief isn’t found. For example: if we get some really upsetting news the act of crying will offer us some temporary relief, even though the sad news hasn’t changed.

I would like to make a distinction between what I will call High and Low level behaviours. High Level behaviours are reflexive in nature meaning there is little or no thought process involved. Low Level Behaviours are usually, but not exclusively, anticipatory in nature and there is a usually a thought process involved. It is important we recognise the difference between these different motivations of behaviour. For example: If a dog is giving behaviour in response to fearful triggers (high level behaviour), we have to work to remove that stress straight away and if appropriate work with the dog, overtime, to create a more positive emotional response. (In my opinion ANY direct aversive punishment of a high-level behaviour is abusive). If the dog is giving a low-level behaviour we need to find what the dog is trying to ‘get’ from offering that behaviour and get a different behaviour instead.

These differences in motivations of behaviour are so important when we think about working with a dog, and I feel are overlooked by some professionals. There is a world of difference between a dog that is getting the relief because it now has the ball, the cookie, social contact etc, and a dog that is looking to get relief by feeling safe and away from danger! EVERYTHING we do HAS to be based on understanding what the dog is communicating from its behaviour, and most importantly what the nature of the relief is they are trying to achieve. Gaining relief is a primary purpose of behaviour so it is imperative it sits at the centre of what we are doing to help the dog. We have to make sure the dog is getting relief and not just giving us a behaviour we find more acceptable.

Challenging some approaches to changing behavior

I have spent time detailing what behaviour is as I want to be clear of my definition before I challenge some very popular approaches to changing behaviour. I am NOT dismissing these approaches out of hand and I use them myself all the time. What I do want to do is point out the considerations we must give to using them when we think about the important of getting absolute relief for the dog.

DRI (Differential reinforcement of an incompatible behaviour).

DRI is basically a method of mega reinforcing a different behaviour instead of the one the dog currently gives. It has a heavy operant aspect to it. This is usually because the behaviour previously given is not deemed appropriate to the owner/handler/trainer, so a different behaviour is reinforced instead. This is a really popular way of changing behaviour but in my opinion is often used inappropriately. Let’s look at an appropriate use and inappropriate use of DRI.

Appropriate: Rover jumps up the owner when they return home, almost knocking them over. The emotional driver here is excitement and the dog will get relief when they get social contact. By mega reinforcing a different behaviour, sitting, the dog is still able to get the relief it wants but just gives a different behaviour instead. Absolute relief is given.

Inappropriate: Rover is really scared when it sees another dog. He used to show this by lunging and barking. The barking demonstrates the dogs stress, it is communication after all, and does probably offer some temporary relief to the dog. Rover is then taught a mega solid ‘watch’ to the owner instead. This would be ok AS LONG AS THE DOG WAS NOW GETTING RELIEF! Many dogs are STILL just as anxious around the dog, they have just been conditioned to give a different behaviour that we find more acceptable. I have worked with many dogs that have been trained to do this and the owners have been led to believe that dog is now ‘ok’, and then when a dog gets too close the dog has a complete melt down. In reality the dog was not ‘ok’ it had just been conditioned to give a different behaviour. No absolute relief had been given and the dog’s behaviour was just modified and communication suppressed. We have to recognise that Rover was probably getting some relief from the original behaviour of barking, but maybe be getting little or no relief with the new conditioned behaviour.

So, for low level behaviours DRI is a great tool, but for high level behaviour we have to be really careful to make sure the dog is getting relief from what we are conditioning in.

Counter conditioning

This is very much based on Pavlov’s early experiments where he paired a previous neutral stimulus to something positive, eventually creating a positive conditioned response to previously neutral stimulus. The big challenge when working with reactive dogs for example is that the initial stimulus is not neutral, the dog already has a negative emotional response. Depending upon the depth and motivation of that emotional response, will depend upon how effective counter conditioning will be and how long it will take to see really positive results. For complex and damaged dogs it can take more skill to do CC than, if we are honest, many of us have. Many dogs find themselves really struggling to cope, even if the process is done slowly and they appear under threshold. There can be, in my opinion, an element of force and suppression of behaviour during this process unless real care is taken. It is not as simple as pairing the trigger with something great when for many dogs the old trigger represents something deeply scary and overwhelming. We run the risk, at best, of just having a dog come to tolerate a trigger rather than to necessarily come to feel truly comfortable with it. This is ok, and better than an outright scared dog like before, but we have to be clear (especially with owners) that this is what has happened, and not that the dog is now ‘ok’.

An important point to remember with the science of learning theory and behaviour is that much of it comes from controlled experimentation and ‘laboratory conditions’. On paper things look great, but the reality is often more complex and so many setting events and motivations can come in to the mix when dealing with behaviour. Regardless of whether we are following a scientific principal, the end goal must always be doing what is best to provide relief to the dog, and not in just changing behaviour.

I must add at this point that I have seen hugely positive results from using a good desensitisation and counter conditioning programme, but again we have to be mindful about what we are trying to do with it, what relief we are trying to achieve for the dog and most importantly what we are trying to MAKE the dog do. If the dog has been communicating through its behaviour that it is really struggling to feel safe with the trigger, why do we have to feel the need to change this dogs perception? If we are focussing on behaviour but cannot guarantee we are truly changing the underlying emotional response, then we are just suppressing and changing behaviour and not offering the relief originally sought out by the dog. This is where we really need to think about whether control and management would actually be a better option!

Changing our focus towards behaviour change – creating a DOG CENTRED CARE approach.

In my opinion the industry has sometimes been too focussed on changing behaviours – the focus should be about understanding the motivations for those behaviours, what they are communicating and making sure we getting relief for the dog. We tend to think of dominance model/punishment led trainers focussing purely on behaviour, but trainers on both sides of the force/ force free divide do this, especially when adopting various behaviour change models. Behaviour is communication- that is all. We cannot ‘fix’ behaviour, if we focus on it all we can ultimately do is try and change or suppress it.

In my opinion for high level behaviours changing or suppressing should never be our aim – identifying and addressing the underlying emotional drivers the behaviour communicate should be (which in turn should provide different behaviour).

When we think about the bad old days of treating people with mental health and behavioural issues, especially children with learning challenges, they were often judged, defined and treated based on behaviours alone. This led to the things like the borstal system, mental asylums etc. Sadly, so much emphasis was placed upon the suppression and changing of behaviour with no thought of the motivating factors that drove that behaviour. I feel much of dog training still fits this model.

In recent times there has been a huge move to an approach defined as ‘Person Centred Care’. This is defined by the Institute of Medicine as ‘Providing care that is respectful of, and responsive to, individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions’. No longer do we try and ‘fix’ behaviours, but start by trying to understand the emotional drivers causing the behaviours and most importantly what is being communicated by them. Instead of trying to project our ideals and communication styles to the patient, we allow them to communicate in their own way to us. This is especially the case when supporting children with special needs for example, and I will use this as an example later. The emphasis is on support and management and educating guardians to be the very best care givers.

I believe we all need to make sure we are working with a Dog Centred Care approach, placing the dog and their needs and emotions central to the work we do. We have to see the DOG as our client, and the owner as that dog’s carer. This is a huge statement to make, as the owner are the ones paying the bills and there can be huge pressure on the professional to be seen to get ‘results’ – but we have to ask ourselves who we are trying to get results for! Unless we can be sure we are working on getting relief for the dog, then we are not getting results for the dog. Is the fact the behaviour has changed or we feel the dog is ‘coping a bit better’ enough? If managing environment and stress can provide better relief than dealing with the behaviour is this not something we should embrace?

Let’s use a child with learning difficulties as an example. This child is prone to feel overwhelmed by the environment around them, stressed by social pressure and struggle to feel they are communicating successfully as others seem to communicate differently to them. This is because of how they internally process sensory and environmental information. If they start to feel overwhelmed by the world around them, or get frustrated because those around them are not ‘listening’ then they may have a meltdown which is in turn observed by their behaviour. This behaviour might be quite ‘aggressive’ and physical.

If we dealt with this child with many of methods we use in dog training, we will just be focusing on the behaviour. All effort will be made to change or suppress this behaviour, and indeed this is the approach that used to be taken in the past. I remember visiting a group of adults with learning difficulties and behavioural issues, where their behaviours we ‘redirected’ into activities designed to keep them quiet. Many looked really miserable and shut down. No relief was coming for how they really ‘felt’ and many were engaging in activities in a very robotic and ‘forced’ way.

The person centred care approach turns all this on its head. The child mentioned earlier is telling us they feel overwhelmed in these situations so we need to start by listening to this communication and accepting they are really struggling. Through control and management the parents would do everything they can to manage environment and social interactions to try and remove as many of the stressors as possible. Then, by trying to understand the communication of the child (as opposed to expecting the child to accept theirs) they can start to give the child a voice and allow communicating more confidently.

This in turn reduces frustration and builds resilience and confidence in the child, allowing them to cope better in the same situations in future. In my mind this is no different to working with a dog that is giving high level behaviours to communicate real fear and distress and sensory overload from an environment that is moving too fast for them to process and to feel safe in.

Having a dog centred care approach means starting squarely with the dog, understanding what they are trying to communicate and then creating a plan that will provide both immediate and long term relief for that dog. This brings us back to control and management and its importance in a behaviour protocol. It should be the MOST important aspect of the plan, not some add on or temporary element to support the rehab. Here are a couple of examples of when control and management was either the solution or an important early aspect of the plan.

I recently worked with a little terrier. The dog was very reactive to dogs and cars and had terrible generalised anxiety just by being out in the environment. They had enlisted a great local trainer who had done lots of work with the little dog, and some improvements were created in the dog’s behaviour. However these improvements were short lived and the dog would go back to having melt downs, they stepped up training again and things got better, but then the meltdowns would happen again. This is a good example of where the emphasis was too much on trying to change or ‘fix’ behaviours and not on ‘listening’ to the dog. The reality is this dog really struggled to cope when out on the walk. The training only provided at best temporary relief for the dog, but the deep underlying emotional issues were not being addressed, despite good attempts to condition a new emotional response. Part of this maybe that sometimes there are stressors we can never fully understand for that dog – it is not just ‘dogs’ and ‘people’ but more about over arousal and sensory overload from the environment.

The owners had a lovely home with a large corner plot garden so my plan was a simple one – stop taking the dog out. This dog could clearly not cope with the world at large regardless of the attempts to help him. It was overwhelmed, over aroused and over threshold all the time. However, it is really happy at home, loved by the owners and enjoys cuddles on the sofa and lazing in the sun in the garden. It feels safe in this environment; its needs are wholly being met. Why should we try to impose training on this dog to MAKE it have to accept a world it clearly finds overwhelming?

Another example is a GSD I am working with that has similar issues – very reactive to most people and dogs when out, constant general vocalisations and a real struggle for owners to even get a lead on to go out etc. This dog could not communicate more that the outside world was too much for her. The first thing I did was to stop the walks and focussed on enrichment at home. It would have been easy to try and get this dog doing some rehab work straight away, but in my opinion this dog desperately needed a break from the environment which was causing so much stress. The idea is to make this dogs world very small and then, when the time is right, gradually start the process of building her confidence in the environment. The owners were initially reluctant as they felt the dog needed the usual three walks a day. However I was able argue the point that she was not getting anything but stress and anxiety from them. After just two weeks of structured routine and enrichment at home the owners started to see huge positive changes in her. She was eating more, playing more, and most noticeable resting more. She no longer had the daily stressed of walk she found so scary. This case show taking time to get the control and management right first is so important before jumping straight in with rehab- if I had of done that she might have been like the terrier in the first example.

Note: Practical control and management, such a muzzle, is important but we still need to remain mindful of the emotional needs of the dog. In the case of a muzzle for example, not only do we need to ensure the dog is happy to wear the tool, but we also have to remember that just because the dog can no longer do damage via a bite, the muzzle doesn’t stop the dog feeling scared or anxious around the trigger. Too often I hear people (sometimes trainers) say -‘it’s ok the he’s muzzled’ –about a dog that is obviously stressed and surrounded by triggers he find stressful.

Working with reactive dogs for many years has taught me that we have to focus on the emotional needs and limitations of the dog, just as much as in trying to help them feel better around the triggers. Some dogs just desperately want to get away from the trigger, and unless we ultimately provide this then it will never get absolute relief. Even if we get the dog performing a more appropriate behaviour, or more able to tolerate being in the presence of the trigger we are still at risk of just providing temporary relief for this dog and asking it to fit an agenda that suits the human rather than accepting the reality of the dog. Long term temporary relief often leads to depression and more generalised anxiety and I feel a lot of dogs end up going down this route despite the best intentions of good trainers.

I am not saying we should not try and work on long term plans to change how dogs feel about the triggers they currently find difficult, far from it. What I am arguing is that we MUST make sure we have a dog centred care approach – this means fully understanding the motivations of the behaviours the dog is offering, its personal abilities to deal with stress, the depth of the emotional condition the dog has and most importantly we have to give the dog a voice in the plans we make. An important part of the job is then to communicate this to the owners by making a sound diagnosis of the issue and making the dog’s sensitivities and limitations clear to the owner. We have to always be the dogs advocate – especially in communicating their emotional needs to an owner who cannot make that deduction themselves.

Conclusion

In my mind all dogs are vulnerable. Dogs with issues even more so. I believe our main job as a practitioner is to not only properly diagnose the issue the dog is experiencing, but to also communicate this clearly to the owners. We have to start the intervention process by getting the owners to fully understand AND accept the dogs they have right now and much of our early work should be based around allowing them to become the very best caregivers they can be to this dog. Using a dog centred care approach means starting by addressing the current and pressing needs of the dog in our care, issues and all. I believe for some dogs a well structure control and management plan can be much better placed to provide best outcomes for that dog than embarking on modification plans, and even if modification plans are appropriate we have to get relief for the dog straight away before starting it. We need to be brave enough to sell all this to the owners and educate them so they can be amazing and supportive caregivers that not only understand their dog’s limitations, but can also recognise times that will cause them stress and are then able to provide that all important relief the dog so desperately craves.