Paws of War

Luke Reinhold was standing in Bass Pro, but his mind was an ocean away. The burly 48-year-old Army veteran had been browsing the aisles at the St. Charles store when he’d bumped into a fellow soldier who’d served with him in Kuwait in 1991, during Operation Desert Storm. They had chatted briefly, then gone their separate ways. That’s when the trouble began.

“Suddenly, I’m looking around. I’m in uniform, no weapons on me, and I’m backing up,” says Reinhold, who was 22 when he served in the Persian Gulf. “I smelled the oil fires. I felt the grit from the sand in my teeth.” Panicked, he inched backward—then bumped into something. He looked down to see a German shepherd peering up at him. “Dog, get out of here,” Reinhold said, confused. Instead, the dog nudged him again and lay down at his feet.

Alerted by the fuss, Reinhold’s daughter approached. Reinhold placed his right hand on her shoulder and gripped the dog’s leash with his other hand. The German shepherd quietly led him out of the store, and the flashback began to subside.

It’s the kind of story that’s familiar to military veterans and first responders with post-traumatic stress disorder, or PTSD. It’s the sort of story that sometimes ends with sirens and flashing lights, handcuffs, or a jail cell. But it was different for Reinhold because of his support dog, Nita, who helps him deal with symptoms of PTSD.

“Because of Nita, I was able to go to a movie by myself for the first time in 25 years,” says Reinhold. “She had my back. She was a buffer between me and the public.”

DOGS, LIKE HUMANS, are intensely social creatures. Maybe that’s why the two species have gotten along for centuries. This bond has allowed humans to train dogs to serve in a variety of support roles, including as service companions for people with  eyesight and mobility problems. Over the past decade, support dog training programs have also sprung up to help veterans, police officers, and other first responders dealing with PTSD.

The St. Louis region now has two programs that train PTSD support dogs: Got Your Six Support Dogs, in Maryville, Illinois; and Dogs That Help, based at the Tom Rose School for professional dog trainers, in High Ridge. Both programs are trying to keep up with soaring demand from veterans and first responders—demand that will continue to skyrocket. Already, more than 350,000 veterans of the wars in Iraq and Afghanistan have applied for benefits from the U.S. Department of Veterans Affairs because of PTSD, and hundreds of thousands more will likely apply in the future.

Keeping up with the demand is made even more difficult by months-long training protocols and high costs. Got Your Six requires the better part of a year for training and graduates six golden and Labrador retrievers per year. Dogs That Help requires seven months of on-and-off training. It has nine dogs—in a wide range of breeds—in various stages of training.

Training typically costs $20,000 before the support dogs can be adopted, and almost all the required money comes from private fundraising. At the moment, the government provides limited support. As the U.S. Department of Veterans Affairs website notes, the “VA does not provide service dogs for physical or mental health conditions, including PTSD.” (It does, however, pay veterinary bills for veterans with physical disabilities who have guide or service dogs.)

Psychologists and animal trainers emphasize the positive impact of a PTSD service dog, even beyond the skills learned during training. “If you pet a dog for 30 seconds, dopamine is released in your brain,” says Nicole Lanahan, founder of Got Your Six. “Dogs are essentially walking, wagging Xanax.”

And that’s just the beginning, she says: Dogs “are a reliable, nonjudgmental, breathing piece of love that is there for these veterans, no matter what.”

LANAHAN KNOWS THE NEED. A professional dog trainer who works out of Cindy’s Critter Camp, a dog-training facility 20 miles northeast of St. Louis, she had received multiple calls from veterans. She’d refer them to other organizations that trained support dogs, then hear back “Well, that didn’t work. This organization wants to charge me $15,000” or “That organization can’t help me” or “Can’t get me a dog—their waiting list is five years long.”

Then one day a desperate veteran called her. He started weeping. “Why can’t you help me?” he pleaded.

After thinking about it, Lanahan thought, “Why can’t I?”

In January 2015, she launched Got Your Six, named for the military equivalent of “Got your back.” She developed the program after seeking the advice of Behesha Doan, founder of This Able Veteran, a PTSD service dog program based in Carbondale, Illinois. Doan helped shape a rigorous training process, as well as the program’s philosophical underpinnings. “The work and presence of the dog is only one wing of the bird,” Doan explains. “The other wing on the bird is the trauma resilience program... The dogs cannot do for [veterans] what they are unwilling to do for themselves.”

Before veterans receive their dogs, they participate in a 10-day program. Besides working with the dogs, they learn about resilience and suicide prevention. “The therapist teaches them, ‘OK, the dogs just alerted to your growing anxiety. Now what? What can we do to bring that growing anxiety down?’” Lanahan explains. “They’re not only getting the dog but also getting that program, which is going to help them.”

As part of a painstaking selection and training process, each dog must learn to identify signs of distress. “If an applicant clenches their fist, we will teach the dog to alert to clenching fists,” Lanahan says. “We can teach the dog to watch for incidences of growing anxiety and alert to that with a nose nudge or a paw.”

Reinhold first met Nita in May 2015, when she was 8 weeks old. He’d traveled to a facility near Sikeston with a friend who trains dogs for a living. The friend gave Nita 12 tests of intelligence. She passed. The brown ball of energy began obedience training two weeks later, followed by specialized service dog training. “She’s my right hand,” Reinhold says today. “I don’t go anywhere without her.”

One debate in the PTSD support dog community concerns whether to teach dogs to “block,” circling their human partners to keep strangers at bay. Neither Got Your Six nor This Able Veteran teaches the practice. “It can fuel the already exaggerated feelings of vulnerability, feelings of not being able to handle what life brings,” Doan says. “If you were afraid to go into crowds, and I gave you a way out of going into crowds, would you ever go into crowds?”

Though some, like Doan, believe that blocking can make the dog a psychological crutch, Reinhold doesn’t mind the practice—or the analogy: “What’s a crutch used for? It helps prop you up. A dog is not a replacement for going to my PTSD doctor, my counseling, my medication.” In his experience, Nita’s given him the confidence to leave his house. “Yeah, she’s a crutch,” he says. “She helps prop me up, keep me going.”

JONATHAN RAMSEY, a 27-year-old Army veteran, says his PTSD developed after a 2010 tour of duty in Afghanistan. When he returned home to Wood River, Illinois, he began experiencing anxiety about going into public. He’d visit Walmart at midnight to avoid crowds. He’d have vivid nightmares. He tried therapy and medication, to no avail. Finally, his wife suggested a PTSD support dog.

Got Your Six eventually matched Ramsey with Hollywood, a black Labrador retriever. He’s since built a small bunk bed for the dog so she can sleep across from him, making it easier for her to spot his physical cues indicating anxiety or nightmares. “She can see if I fidget around, or she can lick me on the face and wake me up out of a nightmare and comfort me,” he says. “She’s been trained to detect all of that.”

Over time, Ramsey’s symptoms have grown more manageable. “I can go to Walmart and places like that,” he says. And though Ramsey still attends counseling classes through the VA, Hollywood provides her owner with a constant source of support. “I am the dog’s life,” he says. “That’s what her purpose is. And all they know is love: It’s a nurturing thing, a comforting thing.”

Rory Diamond has heard countless stories similar to Ramsey’s. “You see a multitude of symptoms that just wear on a warrior over and over again,” says Diamond, CEO of K9s for Warriors, based in Ponte Vedra, Florida. “Being afraid all the time. Inability to sleep and the neuroses that come with that. The inability to have the life you used to have. The depression and dissociation that come with it.”

Support dogs are effective, Diamond says, because they give their human partners a sense of purpose. “They have a reason to get up in the morning: They have to walk their dogs. They have a reason to have a day. And after going through a day, they have a better chance of getting a good night’s sleep.”

The importance of a good night’s sleep can’t be overstated, he adds. Diamond’s clients get twice as much sleep, on average, and have fewer nightmares once a support dog is in the picture. He says those results are part of the reason that K9s for Warriors has been so effective. Of the more than 300 veterans whom the program has matched with support dogs since its inception, in 2010, just one has committed suicide. Nationwide, the VA estimates, at least 22 veterans per day take their own lives, though some believe that the number is far higher.

“It goes down what I call the ‘PTSD loop’: down, down, down until their heart breaks and they give up,” says Diamond.

Nonetheless, some still aren’t convinced that support dogs are the answer. In 2012, the VA said it would not fund service animals for PTSD patients. The department is conducting a years-long $12 million study to determine the efficacy of support dogs against PTSD. Last April, Dr. Michael Fallon, chief veterinary officer for the VA, testified before Congress that so far, no meaningful evidence has shown that support dogs mitigate PTSD symptoms.

Critics question the validity of that research, and advocates for PTSD support dogs counter with other findings. Southern Illinois University–Carbondale’s psychology department, for instance, partnered with This Able Veteran to conduct research, which revealed that after three weeks of working with a support dog, scores on a PTSD checklist dropped dramatically. Significant improvements were recorded in clinical depression, negative cognition, and stress levels.

K9s for Warriors points to similar findings from the National Institutes of Health and Purdue University. “Families are stronger,” Diamond says. “Their relationships statistically last longer, their kids statistically have better grades, their overall health has improved, and they use fewer resources.”

Diamond believes the VA should help cover the costs of PTSD support dogs. “What,” he asks, “is the worth of one of our veterans’ lives?”

A GROUP OF VETERANS gathers around a table at Troy Family Restaurant in Troy, Illinois. Reinhold and Nita sit beside Jesse Morton, a 73-year-old Vietnam veteran who soon hopes to adopt Deacon, an Australian cattle dog trained by Dogs That Help.

For nearly 50 years, Morton says, since fighting in the Army’s 1st Infantry Division in the Tet Offensive, he’s dealt with the effects of PTSD. “There’d be times when my stress would be so bad, I couldn’t go to church,” he says, “and if I did go, I’d have to sit all the way in the back, with my back against the wall. It was like I was in this crowd and I was waiting for something to happen.”

Morton’s been hospitalized several times and taken part in a months-long PTSD management program. Many problems in his life as a civilian, he says, stem from the experiences that he endured as a soldier: “The average person has never had to rise to the level of violence where it’s automatic.”

Jason Countryman can relate. The 39-year-old Army veteran of Iraq sits across the table from Morton, with his dog, Mac, lying at his feet. Countryman says he often feels angry for no reason. “Something will trip me up—my kids will do something, or somebody I don’t even know will do something,” he says. “I will get so flippin’ angry, to the point I am almost violent.”

In such moments of distress, Mac is there. “He’ll nudge me. He’ll paw me. He’ll lick me,” says Countryman. “He takes my attention off what I was pissed off at, and he puts it solely on him. All of a sudden, it’s, like, ‘Jesus Christ, dog. Thanks.’”

It’s a feeling that Morton first conveyed to Reinhold 25 years ago, after the two first met at a VA counseling session. Reinhold was the only Desert Storm veteran in the room. “I had already decided, ‘It ain’t my war,’” Reinhold recalls. “I already had an exit plan—it was sitting in my truck. I figured, the VA broke me; they can deal with the body.” Morton followed Reinhold out of the meeting and persuaded Reinhold to hand over his pistol and come back inside.

A few years later, on a day when Reinhold was feeling particularly down, the two met at a stable outside St. Louis where Morton keeps a horse. “Get in there and hug on that horse,” Morton said. “An animal’s outside is good for a veteran’s inside.”

Reinhold reluctantly began petting the horse. “It started responding to me,” he says, “and took all the anxiety away.”

Seated at the restaurant, Reinhold suddenly smiles, as if he’s found a winning lottery ticket. He glances down at Nita, who lies curled at his feet. “It’s the same thing she does for me,” Reinhold says. “I can’t explain it.”