Thursday, March 27, 2008

New Unquestioned Rule

I have a patient on my caseload who owns a cat, of which he is fond. Mental Health clients have pets less frequently than the general population, but not dramatically so, and they are often quite attached. People generally agree that the pets are good for them, as they are for elderly people, children, and heck, most of us.

When a person with a mental illness decompensates, getting care or rescue for the pet is sometimes a first order of business. It can help you form an alliance with the patient or can solidify an alliance they have with an outside support person; it is good practice for the patient to try and get past troubling thoughts and feelings to deal with the reality of day-to-day care for the pet; it helps the patient be less anxious; it is an act of kindness to the animal.

When the pet-rescue has all gone terribly wrong – when the patient is too paranoid or too angry to contact or allow contact with folks outside who might help – sometimes the pet is taken away from the patient permanently. Sometimes the pet dies.

When either of these unfortunate situations occur, everyone automatically assumes that the patient should no longer have a pet, because they cannot care for it. I think there is a parallel situation with elderly people – if they cannot care for the animal, the animal is taken.

Well, why? Of course it is cruel to the animal to let it suffer, and that is what we are responding to. But it’s also cruel to the mentally ill person – or elderly person – to be alone. Why is the cruelty to the human okay, the cruelty to the animal not? As a practical matter, this stark choice can sometimes be avoided. We can help the patient make advance plans for what to do with the animal in an emergency. Yet sometimes real life can’t be juggled that well, and the stark choice – definitely cruel to the human being vs. potentially cruel to the animal is the operative question.

What did we tend to do a hundred years ago? I don’t think we valued animals as highly then; did we accept the death of animals because of poor human keepers more readily then?


terri said...

I have lots of thoughts about this.

1. We are measuring objective suffering against subjective suffering. While a mentally ill person may suffer from lonliness at the loss of a pet, that suffering is hard to quantify and would hardly be the same in any two people. A poorly cared for animal will physically suffer no matter what the mental state of its owner.

2.Poorly cared for animals can contribute to more mental suffering for an individual. Almost every month, the local news here finds another home overflowing with sick, malnourished, almost dead(sometimes a few that already are) animals. Very often there are dozens of them living in homes covered with feces along with their usually elderly, usually single, usually women owners who very much want to have the animals and miss them terribly when they are gone. They cry and beg for their animals to be returned. However, it's a health hazard for the animals and the owners....and any nearby neighbors. That's an extreme case, but it happens frequently here in Florida.

3. I just love dogs...and can tolerate cats. Don't let them hurt Fido....or Garfield!

Anonymous said...