Honoring Life by Kathleen Choe
September is Suicide Prevention Awareness Month—a time to raise awareness, promote hope, and normalize seeking help about this issue. Suicide affects millions of people every year, yet too many struggle alone and in silence. This month is dedicated to recognizing the warning signs for suicide, encouraging open conversations about mental health, and connecting people to proven treatment and resources. When we stand together in strength, dignity, hope, and purpose, we can make a difference—we can help save lives. Suicide claims the life of someone in the United States of America every 11 minutes. Certain populations, such as veterans, and traditionally marginalized groups face an even higher risk than average.
Nature shows us that organisms have an innate “drive to survive.” [i] In their natural state, living beings are neurobiologically wired to move towards pleasant stimuli and away from noxious and painful stimuli, and to make every effort to survive, even in difficult circumstances and environments. While in certain instances, animals have been known to stop eating or inflict self-harm under extreme duress, humans are the only species known to sometimes actively pursue to harm themselves to the point of even ending their own lives. Typically, this occurs in the context of profound psychological, emotional, physical and/or spiritual distress as well as isolation from protective factors such as supportive relationships and other resources. Research has shown that having even one meaningful relational connection can provide a protective buffer against the type of despair that leads someone to contemplate suicide. [ii]
If a person has experienced betrayal and harm in the context of intimate relationships, however, it may be difficult for them to reach out for help and trust that the response will be safe and supportive. This is where partnering hurting humans with horses may become an essential lifeline. Horses can provide opportunities for nurturing, accepting, genuine interactions that serve to rebuild trust and confidence in those who have come to view relationships as sources of pain rather than help.
When 16 volunteers diagnosed with post traumatic stress were partnered with horses for six 2 hour weekly sessions, they reported statistically significant reductions in symptoms of anxiety and depression as well as reduced abuse of alcohol and other substances while reporting increased access to positive coping strategies such as mindfulness and support seeking behaviors.[iii]
Another research study focusing on the effects of partnering a group of veterans with equines as part of their therapy similarly found a significant reduction in the PTSD symptoms that make this population more vulnerable to suicide.[iv]
A client who presents with many of the risk factors for suicide and/or states an intent to end their life can create a great deal of distress and worry for their therapist, and of course for anyone who is connected to and cares about that person. We worry that despair will take that person out of a mindset where they can still access any anticipation that life could change for the better and that they might find reasons to stay alive and into a dark place that is difficult to access with any offers of help and hope. I am grateful that my equine partners do not fall into this distress and worry about any particular client but continue to offer their calm, genuine, non-judgmental presence to even the most depressed and anxious people who come to work with them.
My most compelling example of this is a veteran I worked with several years ago who later told me he had given me six sessions to change his mind about staying alive. He had a plan to end his life that he planned to implement after this period of time, and any attempts to hospitalize him against his will or otherwise intervene in his life outside of our sessions together would cause him to carry out his intent as soon as he was again free to do so. (I am very glad I did not have this information ahead of time!)
Immediately upon beginning our work together I began to understand that he had experienced what is known in the literature as a “moral injury,” where a person witnesses or engages in a transgression that crosses a line with respect to their moral beliefs. This kind of injury results in feelings of disgust, shame, guilt, anger and deep distress and remorse. This particular veteran felt that his decisions had put the soldiers he was responsible for in danger and that he failed to protect them from actions he now saw as morally reprehensible.
Not knowing the deadline I was under, I slowly introduced him to my herd of horses in the pasture, giving him plenty of space and time to orient to his surroundings and their presence and to get to know and learn to trust me as well. He said little but took in much, as hypervigilant, traumatized individuals often do, trying to protect themselves by noticing every detail in the environment around them. He soon picked up on the anxiety of my off the track Thoroughbred, Rigby, who had a particularly unfortunate series of experiences in his previous racing life that left him with trust issues I was working to overcome. He pointed to Rigby, indicating he wanted to get to know him better, and asked if we could approach him together. I explained that I purposefully leave my horses at liberty during sessions so they can choose to participate or not to the degree that they feel comfortable with. He seemed to like that idea, noting that you “can’t force relationship,” which I wholeheartedly agreed with. The closer we came to Rigby, the more noticeably alert and tense the horse became. His neck came up, his eyes grew wide, and he snorted a few times. My client stopped in his tracks. “He feels just like I do,” he almost whispered, dropping to his knees with his head in his hands. Rigby looked curiously at the kneeling figure before slowly making his way over to us and reaching his nose out to snuffle my client’s bowed head. The man froze and I wondered if he felt too crowded or overwhelmed by this large horse standing over him in this way. I was about to ask Rigby to step back when my client lifted his face, which was streaming with tears, and slowly reached out his hand to stroke Rigby’s soft muzzle. Rigby initially jerked back from the touch, but then reached out again and moved his lips gently over the man’s still outstretched hand. Traumatized horse and traumatized human connected cautiously and carefully just a little bit that day in the shared hope that they could find some measure of safety in a relationship once again.
My client returned week after week to work on gaining Rigby’s trust in humanity and rebuild his own. It was only much later that he informed me of the deadline we were initially under to try to change his mind about ending his life. Ironically, it was on his sixth and supposedly final session that he had his breakthrough with Rigby.
I am thankful that both Rigby and this veteran were willing to give their lives another chance to become meaningful and worth living. Horses and humans can be powerful allies in the healing process. HHRF is working to raise funds to support research into this amazing and effective work to increase its reach and people’s access. I hope you will consider supporting the important mission of this organization with your donation and by spreading the word!
“When we stand together in strength, dignity, hope, and purpose, we can make a difference—we can help save lives.”[v]
[i] Cohen IR, Marron A. The evolution of universal adaptations of life is driven by universal properties of matter: energy, entropy, and interaction. F1000Res. 2020 Jun 18;9:626.
[ii] Noelia Lucía Martínez-Rives, María Pilar Martín Chaparro, Yasuhiro Kotera, Bibha Dhungel, Stuart Gilmour, The role of communication and social support in suicidal behaviour in adults aged between 18–40 years: A systematic review, The European Journal of Psychiatry, Volume 39, Issue 1, 2025
[iii] Earles, J., Vernon, L., Yetz, J. Equine Assisted Therapy for Anxiety and Post Traumatic Stress Symptoms, Journal of Traumatic Stress, Volume 28, Issue 2, 2015
[iv] Nagrath, J., Investigating the Efficacy of Equine Assisted Therapy for Military Veterans with Post Traumatic Stress Symptomology, Journal of Veterans Studies, Volume 6, Issue 2, 2020
[v] https://www.samhsa.gov/about/digital-toolkits/suicide-prevention-month