NURSING
FINDING THEIR VOICE: DEVELOPING EMOTIONAL,
COGNITIVE, AND BEHAVIORAL CONGRUENCE IN FEMALE
ABUSE SURVIVORS THROUGH EQUINE FACILITATED
THERAPY
Linda Porter-Wenzlaff, PhD, RN
he female voice may not be
T straight from the horses mouth
but its congruence may be found
through interaction with horses
for girls and women who are victims of
abuse. The experience of personal abuse
comes in many forms, often with serious
and pervasive consequences. In this con-
text, abuse is inclusive of direct physical
violence, verbal threats, and intimidating
or threatening behavior, as well as verbal
and nonverbal emotional abuse and psy-
chological violence. The prevalence of
abuse in the United Stases is well docu-
mented. The U.S. Department of Health
and Human Services1 reports that 872,000
children were abused or neglected in 2004.
Research indicates that exposure to inti-
mate partner violence as children leads to
increased interpersonal violence among
peers and as adults. Boys who witness pa-
ternal violence are significantly more
likely to engage in spouse abuse in later
adulthood than boys from nonviolent
homes.2 Violence to women continues as
they mature. A study in the Journal of the
American Medical Association reports that
one in five public high school students in
Massachusetts were physically or sexually
violated while dating.3 The Centers for
Disease Control report that nearly 5.3 mil-
lion incidents of intimate partner violence
occur each year among US women aged
18 and older.4
The costs of intimate partner violence
against women in 2003 exceed an esti-
mated $5.8 billion dollars. These costs in-
clude nearly $4.1 billion in the direct costs
of medical care and mental health care
and nearly $1.8 billion in the indirect
costs of lost productivity and present
value of lifetime earnings.4 The conse-
Nursing
quence of abuse to women is ongoing and
insidious in nature, striking at the very re-
lational nature of women. The impact is
woven through a womans life, affecting
thoughts, feelings, and behaviors in com-
plex and often unconscious ways.
WOMENS DEVELOPMENTAL
MATURATION REPRESENTED
METAPHORICALLY THROUGH
VOICE AND RELATIONAL STANCE
The relational nature of women increases
their vulnerability to violence. Its under-
standing by the practitioner working to as-
sist her in recovery is essential. It is this
same relational nature that opens the door
to such effective responses to equine facil-
itated therapy. Carol Gilligans sentinel
work, In a Different Voice,5 tells us that the
female approach to morality includes an
innate drive to care for others. She sum-
marizes this by saying that male morality
has a justice-based orientation and that fe-
male morality has a responsibility-based
orientation that is necessarily relational in
nature.5 She outlines three stages in a
womans moral development. The first is a
selfish stage, the second is a belief in con-
ventional morality, and the third is a post-
conventional stage. Gilligan believes there
is a progression from selfish, to social, to
principled morality.5 Understanding these
stages assists practitioners in recognizing
the specific vulnerability of women to
abuse.
Female children start out with a selfish
orientation. They then learn to care for
others, and that selfishness is wrong. In
their second conventional stage during ad-
olescence as reflective thought develops,
women typically feel it is wrong to act in
EXPLORE September/October 2007, Vol. 3, No. 5 529
their own interests, valuing instead the in-
terests of others. They equate concern for
themselves with selfishness.5 In this stage,
women are particularly vulnerable to
abuse, as it is relational in nature and they
developmentally feel an ownership or a
responsibility for the relationship. As
adults in the third, postconventional
stage, they learn that it is just as wrong to
ignore their own interests as it is to ignore
the interests of others. Although males
work through the development of identity
and intimacy, marked by the ethical
stance of justice and rights (equality and
fairness), women are working on develop-
ing an ethical stance of responsibility and
caring (equity and recognition of differ-
ences in need).5 It is in this third stage that
women learn to include self and others in
the act of care, and at the same time, to
accept responsibility for decisions. At this
point, if they reach it, they have developed
their authentic voice; a voice that allows
them to deal with abuse in a constructive
manner. Reaching this stage of develop-
ment is particularly challenging for
women who have been abused and are
protectively closed to their own reflective
process.
In Womens Way of Knowing: The Devel-
opment of Self, Voice, and Mind, Belenky et
al6 describe the five female perspectives on
knowing. Beginning with silence (a passive
and dependent stance)6 through received
knowledge (assumed truths received from
authorities),6 then through subjective
knowledge (when they trust themselves
more than the authorities),6 and then pro-
cedural knowledge (a distrust of all knowl-
edge)6 to finally arrive at a constructed
knowledge (the integration of subjective
and procedural knowledge).6 Here, all
knowledge is constructed and the knower
is part of the known. This is a personal
evolution where authentic voice and a re-
lational stance are integral to knowing and
thus acting.
Equine facilitated therapy demands au-
thenticity in a relational approach be-
tween the client and the most sensitive of
prey animals, the horse. Establishing a hu-
man/animal bond sufficient to build the
trust necessary to partner with a horse is
accomplished in a natural setting, enhanc-
ing both the need for congruence and its
precursor authenticity. It is well suited to
the challenge of facilitating positive out-
comes for girls and women who have been
abused. By drawing them into the present,
calling their senses and feelings to the sur-
face, demanding honest presence, integ-
rity in thought, feeling, and action, a clear
voice and safe leadership, women begin to
establish an authentic relationship with
the horses. The development of self that
occurs in this process and the related skills
learned may then be transferred to human
relationships.
HUMAN HEALTH IN CONNECTION
WITH THE NATURAL
WORLD/MIND BODY
Umberto Eco discusses the state of mod-
ern life in his work Travels in Hyperreality,7
describing a society cut off from the natu-
ral world in an artificially created existence
that disconnects us from a vital part of
ourselves.7 This awareness of a culturally
normed, environmentally constructed dis-
connect is supported as we recognize how
institutionally conditioned we are to ig-
noring or suppressing our natural in-
stincts. Basic functions are programmed.
We work in artificially lit windowless of-
fices, use the restroom on preassigned
breaks, eat at defined times, work late into
the night when our bodies and mind are
beyond tired, control the temperature of
our environments, etc. We are less and less
accustomed to attending to our natural,
authentic, experiences and feelings. For
girls and women who have been abused,
there may already be suppression of emo-
tions and memories. In combination with
a society disconnected from the real world,
it makes the journey to the discovery and
development of a truly authentic self a
long and arduous one; one that necessarily
deconstructs unnatural reality and takes
530 EXPLORE September/October 2007, Vol. 3, No. 5
the person back to the core of their natural
being.
Paul Shepherd, in The Others: The Ani-
mals that Made Us Human,8 reflects a simi-
lar theme. He recognizes mans centuries
of evolution with and close connection to
animals and the natural world as how we
have developed into who we are now. An-
imals and nature are a part of our theology
(the lion and the lamb), mythology
through lessons from childhood (the tor-
toise and the hare), the art, music, and
language that we are acculturated within.8
Connecting with honest integrity to that
natural world is a necessary part of health
in todays constructed world. More than at
any time in our history, man seeks com-
munion with nature and the natural world
as a means of seeking health.
This is reflected often in the recent work
on the mind-body connection and is om-
nipresent in equine facilitated therapy.
Don Hanlon Johnson, in Body: Recovering
Our Sensual Wisdom,9 describes how the
institutionalization of the mind-body dis-
connect moves us to distrust what our in-
nate self tells us is true. He reflects that
women with a history of abuse as little girls
learn to be happy, helpful, brave, and po-
lite when they really feel sad, frightened,
and rebellious and angry.10 This lived in-
congruence precipitates dissociation in an
effort to stay connected relationally to the
abusing individual and to a socially con-
structed reality. Over time, this dissocia-
tive conditioning decreases a womans
ability to protect herself. The natural in-
stincts and feelings one would draw on in
nature to stay alive are deeply suppressed,
along with their associated memories.10
Thus, the presentation of dangerous cir-
cumstances may not be fully appreciated
by an abuse victim, who then may not act
to avoid them or to protect themselves.
This incongruence also precipitates a dis-
connect in the synergistic healing power
of an individual whose life is integrated
and connected.
Mind-body work recognizes the signifi-
cance of the interplay of thoughts, feel-
ings, experiences, and behaviors for creat-
ing an authentic and healthy life. It also
recognizes the healing energy and poten-
tial synergy of a positive connection to the
natural world and of a relational stance to
others. Equine facilitated therapy occurs
in the present, natural world around us,
without the artificial bonds of socially
constructed norms. It demands a partner-
ship between the human and the horse
that extends each beyond itself through a
trust built from authentic interactions of
fully integrated beings.
THE NATURE OF THE BEASTS
Horses are prey in the natural world. Their
existence depends on constant, collabora-
tive vigilance. They have a 340o visual
field with horizontal pupils built for scan-
ning the horizon, ears that move to catch
sounds from varying locations, hooves
connected to the ground that detect vibra-
tions, and a strong sense of smell. Their
brains are divided hemispheres that allow
each side to fully receive what their envi-
ronment presents, so that they may attend
fully to all input. Horses are extremely sen-
sitive to changes in members of their herd
as well, communicating through body lan-
guage, breathing, and vocalizations de-
signed to assure momentary safety or alert
to a potential danger. Their survival histor-
ically has depended on that level of indi-
vidual and collective vigilance. That sensi-
tivity extends to the humans with whom
they interact. They have been called our
mirrors, as their response to us reflects
what our presence tells them. If we are
situationally dissociated or incongruent in
our thoughts, feelings, and behaviors, we
are confusing to them and thus potentially
dangerous. If we are not fully present, we
cannot be counted on to contribute to sur-
vival in their world and thus are danger-
ous. They essentially demand congruence
and presence of us if we are to safely and
fully interact with them. To horses, all
emotion is equal, understanding it is what
is important, for then an appropriate re-
sponse is safely possible. Transferring that
lesson to an abuse survivor is powerful.
Horses are herd animals, with social
rules and positions that help them to sur-
vive, graze, rest, and raise their young. Un-
derstanding their social order, common
communications, and their general rela-
tional norms and behaviors is also neces-
sary to safely and fully interact with them.
To take our lead, they must trust that we
will keep them consistently safe here and
now, and we must understand how to
communicate that to them and to make it
so. This process is incredibly useful in
drawing out repressed, unconscious hu-
man emotions and their associated mem-
Nursing
ories, integrating them into a grounded
present. Our goal with clients is to get
them to recognize the real emotions they
are experiencing and to work with those,
rather than suppressing or displacing
them. Externalizing ones focus, becom-
ing equally attentive to the present mo-
ment and the subtle changes in the arousal
of others in the real 360o world around
usin the presence of a horse that mirrors
our effectivenessis a powerful experi-
ence, especially for women because of
their relational nature.
Prey use chaotic movement and confu-
sion against predators to confound them.
Horses do the same, and you will quickly
find yourself doing what they wantnot
what you want. They respond to you with
fear when you are incongruent or discon-
nected, which is really obvious in a round
pen. The ability to know what youre feel-
ing, grasp the message behind it, and re-
spond to it quickly and efficiently is called Mystic
emotional agility. It is the person with
consistent emotional agility that a horse in
a round pen will follow.10 If a girl/woman
desires a relationship with a horse, she has over time, as well as a gradual exploration horses in their stalls, then tell me what
to work on herself until the horse will will- of what others around the country were they observe. This gives me a chance to
ingly join her and take her lead or partner experiencing and doing in the field, lead watch how they act/interact with each
with her. By doing this, she gains the skills me to their use with my clients, as well as horse and how the horses respond, as well
to transfer her congruence to human rela- with my students in the animal assisted as getting a sense of what they know about
tionships, to stay with her feelings, to set therapy class I have taught since the sum- horses and about themselves. Each horse
limits, and boundaries, and to be healthy mer of 2001 for a local university. Equine offers a unique interaction. Mystic, the
in healthy relationships. facilitated therapy is not the answer for all six-year-old white-socked dappled gray
clients or for all situations, and it is not Andalusian mare is bright, energetic, con-
always practical or appropriate, but it has fident, aggressively curious, and beauti-
become an option for treatment that I fully beguiling with one blue and one
HOW IT HAPPENS have come to firmly respect for the client brown eye peaking out from long flowing
The choice to use equine facilitated ther- open to its healing power and to the work mane. She also knows several crowd-pleas-
apy for many seems to evolve from per- involved in the process. ing tricks and loves being the center of
sonal healing and centering experiences Sometimes it can be just as simple as attention. She is two to three hands (one
with horses, either deliberately or acciden- encouraging people to back off their nor- hand is equal to four inches) smaller than
tally acquired. I have long owned or asso- mal behavior/life, to suspend all goals, the other two, third in the pecking order,
ciated with horses, becoming increasingly and set aside time to do nothing, wander- and headstrong and impatient with inex-
aware of their lessons in my life as I have ing with their horses in the field in the perienced handlers and riders. It requires
aged. As a single parent, caring for an ail- company of the here and now.10 An all- significant patience and frequent bound-
ing mother while working full time and observant prey animal that mirrors your ary setting to have a truly successful ride
attending graduate school, horses were my energy can be surprisingly effective in al- with her.
escape from the constant demands of an leviating long-standing behavioral prob- The 16-year-old traditionally blanketed
overly planned yet chaotic life. I began to lems and some physical challenges as well. snowcap appaloosa gelding, Stay Ready
explore and experiment with their thera- The experience allows one to move from Hope, is large, athletic, muscular, and cau-
peutic use as I completed my graduate the masculine postmodern world of logic, tious. He stays back from the front of the
studies nine years ago. Later, as a woman control, and outcome production to the stall, watching new visitors, occasionally
in my 50s living alone on 10 acres, they feminine stance of intuition, experience, turning his back on some. This changes as
became my confidants and companions. and process. he becomes familiar with a person. The
They connected me at an intimate level to For many, however, it is a deliberate most extensively trained of the three with
the natural world around me, and they and difficult equine-facilitated journey impeccable English and Western gaits and
challenged me to hold my place as head of guided by an experienced therapist. I al- a wall full of show ribbons, he is the most
the herd. Reflecting on my experiences ways let clients observe all three of my challenging to obtain trust from and can

Nursing EXPLORE September/October 2007, Vol. 3, No. 5 531


Stay Ready Hope
be frightened easily, having been abused
as a very young horse. He accepts han-
dling readily and is generally responsive to
groundwork but demands a truly confi-
dent, centered rider to respond to the ex-
ceptional ride he is capable of offering. He
tests his riders often, as if to say, I need to be
sure I can trust you before we continue.
The leader and most senior member of
the herd is a 24-year-old black thorough-
bred, Waggoner Moon. He is a strong, im-
posing 17-hand athlete who still loves a
good race and exudes a sense of mastery and
confidence. He interacts physically with
each new visitor in a calm purposeful man-
ner, always quietly watching their interac-
tions with the other horses. He readily ac-
cepts handling and riders of all levels;
however, he tempers his response to their
level of ability. He is everyones dream horse
with children and will not respond to a re-
quest from a handler or rider that the rider is
not ready or capable of handling. He reacts
calmly to unexpected situations and is a
master of being the one in charge of the ride
before the rider realizes it. He accepts true
direction from only a select few and always
in partnership.
The primary horse the client begins
with is selected based on my initial assess-
ment of the clients observations of them,
their response to the client, my knowledge
of both, and our therapy goals. We then
spend a fair amount of time learning to
safely halter, lead, tie, and groom the
532 EXPLORE September/October 2007, Vol. 3, No. 5
horse. As we do so, I share information
about horses and the particular horse we
are working with, such as his/her story,
things he/she likes, does not like, and how
he/she differs from the other horses, and I
continue to do more observation. The ini-
tial interaction with horse and client each
session is an excellent opportunity for as-
sessment, comfort with touch, proximity,
recognizing the need to control or direct,
actually giving direction, awareness of the
Waggoner Moon
horses response, all of which are indica-
tors of the clients state of grounding and
presence.
For some clients, it takes several sessions
to be able to enter their horses stall, halter
them, lead and tie them, and then success-
fully groom them. The process requires
awareness of the horses responsiveness
through the clients awareness of their be-
havior and emotions.
A nervous client, or one showing either
no emotion or confusing emotions, will
be likely to produce a horse who turns
away from the halter or holds its head up
too high to reach. Likewise, grooming re-
quires significant proximity and physical
presence. It involves touching in a some-
what intimate manner through brushing
and conditioning as well as manipulation
of the horses legs and feet to check, clean,
and condition the hooves. Both the client
and the horse are learning about each
other in this interaction. If the client is
nervous, not truly present, or sending con-
fusing messages, the horse is guarded or
tense. If the client relaxes, the horse does
as well, making it much easier to pick up a
foot. The mirror is in play. There is no
time defined for when each step occurs,
and often we stop during the process to
discuss what is being felt, remembered, or
observed, as well as reflecting at the end of
the horse interaction.
When grooming happens outside un-
der a tree in the real world, there is always
Nursing
something further to be aware of. The be-
ginning winds of a storm blowing in car-
rying smells and sounds only the horse
can sense and respond to opens the door
for a discussion of the importance of at-
tending to subtle changes in our here and
now. An unexpected noise that makes the
horse shy allows for a discussion on natu-
ral responses to perceived dangers or un-
known threats. Even the oppressive heat
and humidity of a San Antonio August
can be the beginnings of a metaphor for
the oppressive nature of an ongoing abu-
sive relationship.
From grooming, we move to the round
pen and begin the process of being with the
horse in an enclosed space. For many, just
being together in a 30-foot-diameter round
pen with a loose horse is very difficult. These
are impressively large animals. The ultimate
goal is to connect with the horse through
body language and verbal commands in
such a manner as to win the horses atten-
tion and gain direction over his/her move-
ments. The horses are trained using John
Lyons11 techniques that build on the natu-
ral instincts of horses. Keeping them mov-
ing on the outside rail of the pen is accom-
plished by being a physical presence in the
middle of the pen that they move away from
(flight). How fast they move (walk, trot,
lope,) depends on how much pressure they
feel from your presence and the ability you
have to lead them with a verbal command.
Changing the direction they are moving in
is accomplished in a similar manner. Mov-
ing or stepping into where the horse is head-
ing causes him/her to turn and move in the
opposite direction (flight again). Relaxing
your presence, perhaps accompanied by a
verbal whoa, relaxes the horse and turns
off the fight/flight response. The horse stops
and turns to watch you, if you have success-
fully gained his/her trust enough, giving at-
tention to you as well as to the environment.
When a horse is moving around the pen and
has his ear turned in your direction, you
know you have begun to connect and estab-
lish the beginning threads of trust and lead-
ership.
When one watches this process between
an experienced congruent person and a
horse with trust in the person, it seems
almost effortless and the communication
seems difficult to discern. When one tries
it for the first time it is often confusing,
chaotic, and frustrating for both the per-
son and the horse, who will often try to
Nursing
take over the process or turn their back
and ignore the person. This is where much
of the most difficult therapeutic work is
accomplished. For some, it takes a long
time, and we take each step as it happens
and look for the lessons in it.
The process of commanding presence
in the round pen requires that the client
stay in the present, moving from the
numb, shutdown state that suppresses
emotions and memories to recognizing
and staying with the emotions evoked,
processing them and integrating them
into consciousness. This may be done by
focusing solely on the emotions,
thoughts, and behaviors in the present, or
it may include time away from the mo-
ment processing painful memories. Gen-
erally, it is a combination of both; eventu-
ally the emotions evoked by memories or
circumstances are able to be felt and pro-
cessed, so that instead of being over-
whelmed and shutting down, the client is
able to recognize the emotions as warning
signs or information to be evaluated. Con-
sequently, the client can make conscious
decisions to promote desired or healthy/
safe outcomes. This is the process that
most directly challenges the client to
move toward cognitive, emotional, and
behavioral congruence.
At the end of each session, we reflect on
the session and why it went as it didwhat
lessons were learned and what insights or
skills were gained. As I see women develop
and solidify skills with the horse work, I
observe that and begin to discuss how it
applies to human relationships as well.
When they begin to change behaviors on
their own (usually without really knowing
it), we discuss what is different and why
they changed behaviors. Sometimes I just
let them change and wait for them to have
their own insight, depending on the client.
Areas of specific focus include increased
skill in recognizing feelings and observing
the behaviors of others, especially subtle
changes that provide warning signs of po-
tential danger as well as increased use of
self to proactively control situations. Set-
ting limits, a clear direct voice, and the
ability to send messages through body lan-
guage are discussed.
Over time, clients begin to look to the
horses behavior to understand their own
and thus begin to recognize their feelings
more readily, eventually recognizing in-
creasing subtle changes in their own emo-
EXPLORE September/October 2007, Vol. 3, No. 5 533
tions. As this process occurs, they enter
into a deeper and more trusting relation-
ship with the horse and themselves. As
their relationship with the horse
progresses, clients begin to assert more
leadership, providing clearer, more cen-
tered direction to the horse who responds
more consistently and willingly. Each
horse tests this process in his/her own way
as part of turning their safety over to the
client. These tests serve to strengthen the
clients voice and ability to set relational
boundaries based on their congruent,
grounded behaviors.
Once a client is able to command the
horses attention and direct their behavior
with significant consistency on the ground
in the round pen, they are ready to move
to the next state of the human/horse rela-
tionship, riding. The horses are trained to
respond primarily through the riders
body language and movement, not reins,
spurs, or crops. So once again, the clients
congruence and presence are paramount
to success. A relaxed rider allows the horse
to feel the subtle, deliberate changes in the
riders muscle tone, which communicates
a desired response, pressure from the rid-
ers legs, for example, to ask for an increase
in their gate speed. If the rider is tense, the
horse is tense and messages are inaccu-
rately sent and received, or may be over
asked. If the rider is not present to the
moment, the horse will lose trust in the
persons ability to protect them and will
move to protect themselves, such as run-
ning back to the herd. If the rider sends
inconsistent or tentative messages, the
horse will respond accordingly with con-
fusion, frustration, increased anxiety, and
fearagain, our best mirrors.
Taking control of a horses life, and
ones own, by climbing onto his/her back
and essentially saying trust me to protect
you and follow my lead is a tremendous
step for many violence survivors. It re-
quires full presence in the here and now
and awareness of subtle changes in the en-
vironment as well as the horse and ones
self. It requires relaxed confidence in ones
self to lead and a centered voice to com-
mand trust in ones decisions. It also hon-
ors the womans moral stance of relational
caring: responsibility for the other while
caring for oneself and accepting responsi-
bility for ones actions. Clients who
achieve this level of healing and develop-
ment frequently continue to ride beyond
their time in therapy or will return on oc-
casion to reinforce the lessons they have
learned or to work through new chal-
lenges.
STANDARDS AND RESOURCES
As with all forms of therapy, equine fa-
cilitated therapy should be practiced ac-
cording to the accepted standards of the
profession. Two significant organiza-
tions in this field are the Equine Assisted
Growth and Learning Association and
the North American Riding for the
Handicapped Association and its sub-
section, the Equine Facilitated Mental
Health Association. Equine facilitated
therapy is a growing and evolving field
that continues to benefit from profes-
sionals organized to support quality in
its advancement. We have much yet to
learn about the magic and power of this
intervention and the unique animals
that make it possible.
SUMMARY
The use of equine therapy for abused
women requires hard work and the conflu-
ence of significant resources. First, there
must be a therapist with the knowledge
and skill necessary to use the gifts horses
offer us and who is comfortable and expe-
rienced working through the aftermath of
abuse. It also requires well-trained and so-
cialized horses able to stay connected in
the company of clients as they process
their abuse and find their voice in a natu-
534 EXPLORE September/October 2007, Vol. 3, No. 5
ral environment conducive to the work.
Finally, it takes clients willing to pursue
nontraditional options for treatment. Fac-
ing ones past abuse and its lingering effects
is always a difficult journey. Having the
courage to take that journey in the com-
pany of horses is particularly challenging
for women without voice. When it all
comes together, the results are synergistic
and profound and the relationships
gained are often long maintained. It is not
uncommon for the women who have
done this work to desire continued con-
nection with the horses that took the jour-
ney with them. The congruence in the on-
going relationship seems to keep them
centered. More than once, I have heard
their voices ring out loud and clear across
the pasture calling Waggoner, Ready, or
Mystic, and the hoofbeats of a nearing
horse in response.
REFERENCES
1. U.S. Department of Health and Human
Services. Chapter 3: Victims. Child Mal-
treatment 2004. Available at: http://www.
acf.hhs.gov/programs/cb/pubs/cm04/
chapterthree.htm. Accessed May 3, 2007.
2. Bancroft L, Silverman JG. The Batterer as
Parent: Addressing the Impact of Domestic Vi-
olence on Family Dynamics. Thousand Oaks,
Calif: Sage Publication Inc; 2002.
3. Silverman JG, Raj A, Mucci LA, Hathaway
JE. Dating violence among adolescent girls
and associated substance use, unhealthy
weight control, sexual risk behavior, preg-
nancy, and suicidality. JAMA. 2001;86:
572-579.
4. Department of Health and Human Ser-
vices. Centers for Disease Control and Pre-
vention. Intimate Partner Violence: Over-
view. Available at: http://www.cdc.gov/
ncipc/factsheets/ipvfacts.htm. Accessed
May 21, 2007.
5. Gilligan C. In a Different Voice. Cambridge,
MA: Harvard University Press; 1982.
6. Belenky MF, Clinchy BM, Goldberger,
NR, Tarule JM. Womens Ways of Knowing:
the Development of Self, Voice, and Mind. New
York, NY: Basic Books Inc; 1986.
7. Eco U. Travels in Hyperreality. New York,
NY: Harcourt, Brace and Company; 1990.
8. Shepard P. The Others: How Animals Made
Us Human. Washington, DC: Island Press;
1996.
9. Johnson DH. Body: Recovering Our Sensual
Wisdom. Boston, Mass: Beacon Press; 1983.
10. Kohanov L. The Tao of Equus. Novato, Calif:
New World Library; 2001.
11. Lyons J. Lyons on Horses. New York, NY:
Doubleday; 1991.
Linda Porter-Wenzlaff, PhD, MA, LPC,
NCC, RN, MSN, CNAA, is an assistant pro-
fessor at The University of Texas Health Science
Center at San Antonio School of Nursing,
where she teaches a graduate and undergradu-
ate multidisciplinary course in animal assisted
therapy as well as independent studies in equine
facilitated therapy. She is also a practicing li-
censed professional counselor specializing in the
treatment of families and children, often incor-
porating her canine and equine cotherapists.
She has given international, regional, and local
presentations on animal assisted therapy and is
a long-standing member and team evaluator
for the Delta Society.
Nursing