Anxiety In the Saddle
Post Traumatic Stress Disorder in Riding Accidents
By Gabriel Denison
John von Haas could not figure out why he was still in the saddle as he flew away from the back of the crowhopping colt. He hit the rocky ground with his feet in the stirrups, and as pain exploded in his lower body, he began to scream.
John had just experienced the preliminary requirements for a comorbid, or companion, condition in many accidents: Post Traumatic Stress Disorder. Post Traumatic Stress Disorder, or PSTD, is defined by the DSM-IV Diagnostic and Criteria Manual as “exposure to extreme trauma that involves…threatened death or serious injury…resulting in persistent reexperiencing of the traumatic event.” Victims also feel free floating fear, powerlessness, and horror.
In addition to the rupture of major veins in the pelvic girdle, internal bleeding and nerve damage, John experienced helplessness, pain, confusion and immediate disability. As weeks passed, all the symptoms of accelerating PSTD affected him. He had difficulty concentrating, outbursts of irritability, difficulty sleeping and preoccupation over the accident. Nightmares plagued what little sleep he had.
The actual occurrence of a broken billet strap (the strap opposite the ladigo holding the cinch to the saddle) did not exist for John. As his broken body healed, his mind continued to race, and his anxiety mounted. He began to attach this anxiety to mounting a horse, a very unproductive conclusion for a successful rehab trainer.
“ I felt anxiety at the thought of myself, or anyone else getting on a horse,” John reported. “I had trouble going to the stable, seeing a horse come out of a stall, with the knowledge someone would mount it eventually.”
Doctor Adam Starr, an orthopedic surgeon at the University of Texas Southwestern Medical Center in Dallas, Texas reports that the development of PTSD is at least 50% higher in physical accidents – cycling, horseback riding, automobile and gunshot wounds – that involve a “crush” orthopedic incident.
“The more severe the orthopedic injury, the more likely a patient is to suffer from PSTD,” Dr, Starr writes in his recent study. “Breaking a bone can trigger strong, negative emotions. Treating the PSTD has enormous implications for treating the orthopedic trauma.” Dr. Starr went on to say, “These injuries turn healthy, active people into instant invalids, and that is bound to affect their mental state, as well.”
Many riders have experienced some level of this psychological phenomenon, and the common advice, consisting of “getting back on the horse as soon as possible,” is easier said than done. There are both mental and physical steps for PSTD recovery. The victim must “desensitize” the event, and in some cases, “re-frame” the memory. In PSTD, the memory will overwhelm the victim, disabling him or her from perceiving what is actually occurring around them.
Diana Freeman recalls such an experience in her recovery from a dragging incident. “I agreed to ride a strange horse,” she said.
Diana entered therapy with her own horse, and through reframing, realized the terror was a past memory overriding current events. By bringing herself “into the now” through talk and body work, she experiences no problems today.
John sought the advice of local psychiatrist, Dr Geoffrey Hyde, who recommended that John reintroduce himself to his beloved horses in stages, under safe conditions. He advised John that if his anxiety symptoms continued, medication might be prescribed.
A new technique used in recovery for returning soldiers,as well as crush accident victims suffering from PSTD is EMDR, or Eye Movement Desensitization and Reprocessing Therapy. With a trained therapist, patients concentrate and talk over the trauma while following a rapid movement of a light or moving object before their eyes. This allows the patient to release disturbing emotions through stimulated eye movements available in REM sleep. Although skeptics abound regarding this method, patients report relief from anxiety that is lasting and quickly achieved.