WITHDRAWN: Animal-Assisted Therapy (AAT) As an Adjunctive Treatment for Eating Disorders: Exploration of AAT through the Lens of Attachment and Affect Regulation

Background and Purpose:  There is a growing body of research supporting the attachment and affect regulation functions of Animal-Assisted Therapies (AAT).  While research has explored AAT with certain mental health conditions (autistic spectrum disorders, PTSD, and dementia), there has been no research exploring AAT and the mental health condition with the highest mortality rates and diagnostic vulnerabilities of affect dysregulation and insecure attachment – eating disorders.    

The current research aimed to test the hypothesis of whether AAT relates to important aspects of attachment experience and affect regulation abilities – areas associated with the diagnosis of eating disorders. Because AAT can activate the attachment system and provide new opportunities for experiencing affect, the current study hypothesized that AAT may offer helpful additions to eating disorder treatment. 

Methods: Forty in-depth semi-structured interviews were conducted with self-identified female adults (ages 21 – 40) who were diagnosed with an eating disorder in the last ten years, anorexia nervosa (AN), bulimia nervosa (BN), or a combination of the two (55% AN; 5% BN; 25% AN & BN) and used AAT in their ED treatment (75% Canine-Assisted Therapy; 25% Canine & Equine-Assisted Therapy).  Participants were recruited via posted and emailed flyers, social media posts, posts on NEDA research page, and posts on eating-disorder-facility alumni pages through respective site research directors.  Interviews elicited participants’ experience of AAT, including how they thought the AAT impacted with their ED treatment and their ED.  Interviews were transcribed verbatim and coded thematically using NVivo qualitative software, guided by the principles of grounded theory.

Results:  Data analysis reveals that women with ED who used AAT in their treatment found attachment and affect regulation-benefits specifically in emotional and relational comfort, identity reformation, experience of ED, and thought management.  Participants attributed qualitative differences between the type of comfort provided by the animals (offering protection and safety) compared to humans (prompting anxiety, fear, and judgment).  Participants indicated that the animals had an ability to recognize their needs, provide unconditional and nonjudgmental support, and offer protection. 

The results suggest that symptoms of eating disorders may have a relational/attachment functionality for the individual.  Some participants even describe the eating disorder as protection and shield from interpersonal pain.  Through the lens of attachment affect theory, the findings suggest AAT may be a substitute for qualities previously provided by the eating disorder (i.e. protection and safety).    

Conclusion and Implications: Findings highlight that the relational comfort afforded through experiencing the animal as unconditional, nonjudgmental, intuitive, and safe may have led to an impact on emotions, treatment experience, relational learning, and affective regulation.  Although exploratory in nature, my findings support the hypothesis that interaction with the animal is a mechanism by which the attachment system can be activated and, yet, it may be experienced as a more tolerable opportunity for individuals with eating disorders to develop the capacity to modulate, process and manage overwhelming affects (Petrucelli, 2014).