Horse assisted systemic interventions in stroke sequela: case report

CASE REPORT

ANDRADE, Maria Ruth Martinelli Villela de ^[1], COSTA, Alessandra Maria Lima Lisboa ^[2], CAMPOS, Lilia Teixeira de ^[3], SCHMIDT, Ana Karina Arima ^[4], FREDIANI, Daniela Franco Lopes ^[5]

ANDRADE, Maria Ruth Martinelli Villela de et al. Horse assisted systemic interventions in stroke sequela: case report. Revista Científica Multidisciplinar Núcleo do Conhecimento. Year. 10, Ed. 04, Vol. 02, pp. 120-131. April 2025. ISSN: 2448-0959, Acess link: https://www.nucleodoconhecimento.com.br/psychology/stroke-sequela, DOI: 10.32749/nucleodoconhecimento.com.br/psychology/stroke-sequela

ABSTRACT

Introduction: Horse-assisted systemic interventions refer to a series of approaches and dynamics based on biophysical sciences, quantum physics, neuroscience, equine ethology, epigenetics and systemic movements, which utilize horses. Its effectiveness as a practice based on scientific evidence is still limited and inconclusive despite its use in neurological disorders, post-stress disorders, dysautonomia and psychological imbalances. The aim was to investigate the effects of a systemic intervention on a patient with ischaemic stroke sequelae using the methodology Systemic Movements Assisted with Horses (MSAC®). Methodology: the patient motivated to MSAC® goes through three distinct phases: Phase 1: interview with the facilitator; Phase 2: the facilitator and patient enter the field of the enclosure and Phase 3: the dynamics that precede the movements with the horses and the dynamics of the movements with the horses are carried out. Results: on the same day after MSAC®, the patient, still wearing the naso-oesophageal tube, swallowed liquid without choking and gradually started eating again the following day. Conclusion: through observations of the hidden metaphysical content (unconscious) and the interaction of the assistant with the horses, the effects were revealed, revealing the reason that prevented the patient from changing and raising the frequency to a level of psychic understanding that promotes the harmonization of cells and, consequently, of health.

Keywords: Systemic interventions, Horses, Morphic field, Stroke.

1. INTRODUCTION

Anthropological studies report that the first human-horse interactions took place around 1500 b.C¹. However, it wasn’t until 1952 at the Olympic Games in Finland, after a physically disabled rider with paralysis won the silver medal, that there was a shift that sparked the potential for horses to act in the healing of physical disabilities¹. From the 1940s onwards, for the first time in an Air Force hospital in New York (USA) the use of animals was described for therapeutic use, where patients were encouraged to care for, observe and touch the animals to promote the patient’s general personal well-being². At the end of the 1990´s, American horse trainer and instructor Linda Kohanov founded Epona Equestrian Services, starting educational programmers that use horses to teach leadership, assertiveness, personal empowerment, relationship, intuition and emotional fitness skills³.

Linda Kohanov is internationally recognized in the field of equine experiential learning and a respected writer on the subject of equine-facilitated psychotherapy, bringing her horse-inspired insights into the non-verbal elements of exceptional communication and leadership to our workplaces and relationships⁴. In Brazil since 2008, Ruth Villela, a psychotherapist and systemic coach with horses, has shown through her experience that living with these beings positively influences everyone involved, since horses have no ego, which in a way makes it easier to show our attitudes and perceptions of the movements displayed by the herd for any therapeutic purpose (Equine Therapy, Eagala Method, Assisted Coaching, Psychotherapeutic Dynamics and Family Constellations). Horse assisted coaching isn’t exactly therapy, its training, but when the person being coached is open to the influence and willing to understand the journey of personal transformation, these are facts that corroborated the development of the methodology Systemic Movements Assisted with Horses (MSAC®)⁵.

Many emotional and physical conflicts are caused by imbalances in systemic laws. Recognizing this excluded being and inserting them back into the family and the heart results in the discovery of the hidden (entanglements) that are unconscious, following primitive rules and loyalties to the family field that are responsible for the conflicts, but through intervention the pain of many beings is relieved ⁶. Morphogenetic Fields are probability structures in which the influences of the most common past types combine to increase the probability of repetition of those same types ⁷, they carry information (without using energy) that crosses space and time without any loss of intensity after being created. Fields contain an inbuilt (intrinsic) memory given through self-resonance with a morphic unit’s own past and through morphic resonance with all previous similar systems, where memory is cumulative ⁸.

Genes are transferred materially by their ancestors and enable certain types of protein molecules to be produced; morphic fields are inherited in a non-material way, by morphic resonance, not only from direct ancestors but also from other members of the species. The organism tunes into the morphic fields of its species and thus has at its disposal a collective or group memory where it gathers information for its development₉.

Epigenetics demonstrates how environmental influences induce genes to express themselves according to beliefs, emotional experiences, nutrition and lifestyle. This flexibility is reflected in the different mutations that can occur in DNA base pairs all the time and are consequently easily influenced by the environment in which the organism lives and therapeutic stimuli that are guided by¹⁰. Therapeutic Interventions with Horses (ITC) take place in a similar way to systemic constellations, with the animals taking on the role of ‘representatives’ of the client’s family system, representing feelings, entanglements and solutions¹¹, understood here as the impetus for a harmonizing action, in order to respect and restore the ‘systemic principles’ pointed out by Hellinger⁶.

The ITC´s can be individual or group and during the intervention it resembles a socio-psychodramatic act, and the explanatory hypothesis of the process is that the horses enter the morphic field⁸ of the client in a genuine, free, spontaneous way. During therapeutic experiences with horses, the facilitator perceives information through behaviors, through movements or the absence of movements, and interprets it¹¹.

By decoding the information, a conflict or entanglement in the system is revealed, then systemic phrases of solution are pronounced, which represent the impulse (frequency) for harmonizing action, respecting and rescuing the systemic principles⁶ Through knowledge of the three universal systemic laws: belonging, hierarchy and balance, guided by clinical methods of individual or group psychology, allowing us to migrate from the ‘’Mindset‘’ to the ‘’Heartset‘’, through the 40,000 cardiac neurons SNIC (Cardiac Intrinsic Nervous System)¹² recovering cardiac intelligence through which it is possible to find emotional, existential and conflict solutions in the areas of health, professional, legal and business^13,14.

Dyk et al.¹⁵ state that research into Horse-Assisted Interventions (HAI´s) focuses on therapeutic studies, but academic research into the effectiveness of horse assisted leadership development programmes is little known. Villela et al. ¹⁶ verified in their practice of more than 20 years, the effects of MSAC® in several pilot studies through blood morphology in dark field microscopy “in vivo´´ and the frequency pattern of organs and tissues, before and after the intervention, suggesting that all participants showed rheological changes in the blood and changes in frequency patterns in organs and tissues. The MSAC® methodology was co-created and based on at least 20 types of science, including Neuroscience¹⁷, Quantum Physics^18,19, Equine Ethology^4,5,20,21, Epigenetics¹⁰ and Systemic Movements^11,16,22.

Cerebral Vascular Accident (CVA) is a serious and disabling disease, with a high morbidity and mortality rate, which affects more and more young people). This disease is related to comorbidities such as hypertension and diabetes mellitus as risk factors in the Brazilian population²³, other causes such as atherosclerosis, but other factors such as high blood pressure, smoking and obesity. Initial care for patients with ischaemic stroke is of an emergency nature, requiring intervention within a maximum of 4-5 hours after it occurs for patients with ischaemic stroke, requiring a high level of coordination between services²⁴. In the acute phase, thrombolytic therapy or mechanical thrombectomy is used to clear the artery before irreversible technical damage occurs.

2. METHODOLOGY

This research is descriptive and qualitative in nature, as it is suited to the flexibility and mobility of everyday life, as it is hypothesized that they will be able to immediately use their experience to solve the problems they face. It proposes looking at the subjectivity and complexity of the human being, with the notions of systemic interventions and the therapeutic approach as an epistemological backdrop. The research subject signed the Informed Consent Form (ICF) attached to the article. The case report for this research was carried out at Fairy Valley Farm, Campista, in the city of Campos do Jordão-SP (Brazil), so that all the participants – humans and animals – can move freely in the enclosure, and there are no mounts. The intervention takes place in three phases described below.

3. OBJECTIVE

To report on the multidisciplinary therapeutic action of MSAC® in a patient with the symptom of haemiplegia after an ischaemic stroke.

3.1 CASE REPORT

In 21/02/22, female, 32 years old, woke up feeling unwell with dizziness, headache, profound nausea and loss of swallowing control and asphyxia. She was taken to hospital, given anxiolytic medication and medication for labyrinthitis and a computerized tomography scan (CT) was carried out and no alterations were detected. She returned home with no improvement; her tongue was swollen, and she had difficulty swallowing. When she swallowed water, bronchial aspiration occurred, she choked, became cyanotic, had shortness of breath and fainted.

She was seen by another doctor and when she was given a serum intravenous, she felt no pain in her arms. After 24 hours (22/02/22) and with worsening symptoms, she was referred for a consultation with a neurologist who referred her for immediate hospitalization in the Intensive Care Unit (ICU) for seven days, where she underwent Angio tomography (Figure 1) and nuclear Magnetic Resonance Imaging (MRI) (Figure 2) showing that an ischaemic stroke had occurred with dissection of the right vertebral vein.

Figure 1: Angio tomography image on 22/02/22

Figure 2: Brain MRI scan showing sign of acute ischaemia and arterial dissection

After seven days, the patient was transferred to her room and stayed there for another 18 days (Photo 1A). With the nasogastric tube, she acquired Pseudomonas bacteria, causing infection of the digestive and respiratory tracts and a lot of pain in the stomach. She was discharged from hospital and received physiotherapy, neuro-motor rehabilitation and speech therapy at home for six months, as she was unable to feed herself without a nasogastric tube, could not swallow saliva without choking due to the sequelae of oesophageal haemiplegia, as well as losing weight, having probes changed four times, many sores on her nose and mouth with a lot of trauma. No-one could explain why the patient couldn’t swallow.

X-rays with contrast were taken and the food did not pass through the oesophagus due to hemiplegia. This illness caused a lot of trauma, sadness, loneliness and insomnia. An attempt to remove the tube was made several times without success, and she was inappetent. When she learnt about Ruth Villela’s work on the internet, her veterinary sister suggested that they go for a systemic integrative treatment, which led her to look for a place that performed MSAC® (Photo 1B).

Photo 1: (A) patient in hospital after stroke (28/02/22); (B) during MSAC®; (C) patient removing the probe after 15 days and (D) patient discharged from hospital. Source: personal archive provided by the patient

4. RESULTS

The results are shown in Photo 1 (B) on 01/07/22 during the systemic consultation with his family at Fairy Valley Farm, whose consultations are conducted by transpersonal psychotherapist Ruth Villela, creator of MSAC® for over 20 years. The theme of the therapy was: What is hidden in your illness that prevents you from eating? After 3 hours of systemic therapy with the horses, the patient returned home. In the account below, described by the patient, on the same day she had the desire to drink soda, she did so without choking and then asked for water and drank it. In photo 1 (C), on 15/07/22, after 15 days of MSAC® and eating various foods, the doctor successfully removed the nasogastric tube, accompanied by the patient’s account in a photo on the social network (photo 1D).

My name is Mayara Marques and I live in the interior of São Paulo (Brazil).

“As Ruth herself says: everything is felt and it’s very difficult to describe in words what happened to me, and I’ll use extracts from my testimony at the time to tell you about it. After days in intensive care, more hospitalizations, many setbacks and some treatments that didn’t work, I ended up there, at Fairy Valley Farm in Campos do Jordão, and I can see that this was a calling for me. It wasn’t coincidence or chance, it was my time, my hour to be there. And what happened? One of the most serious consequences was that I couldn’t swallow, I couldn’t put anything in my mouth, I couldn’t chew, I couldn’t even swallow saliva, I was hydrated and fed by tube. Was it a blockage? Fear? Trauma? Anguish? Weakness? Discouragement? Perhaps all together, but the systemic movements made with the horses showed me what was hidden, and I was transformed! ´´

5. DISCUSSION

Hemiplegia is one of the sequelae of patients who have suffered ischaemic strokes and can be irreversible^23,24. The patient had this symptom for 6 months, which prevented her from swallowing without choking, despite conventional physiotherapy interventions. Through the interaction between man and horse, it is possible to perceive reality in the present time, allowing us to feel more integrated, to reflect on our thoughts and actions and to modulate our emotions, leading to a welcoming relationship^23,24,25. “Horse movements also make it possible to bring awareness to our attitudes by clarifying our non-verbal communication”, since unconscious emotions are not easily accessed or accepted and transformations can be measured not only by emotional sensations, but also through physiological parameters and electrocardiographic and electro encephalic variability ²².

Ferreira et al. (2023)²² carried out an evaluation of the psychic effects on children of a horse-assisted intervention, given that Animal-Assisted Interventions (AAIs) that use the equine species as a mediator, acting as social facilitators and potential catalysts for contact between humans. The observation of ‘mirror neuron’ behavior, the reading of our unconscious and subconscious are demonstrated by the bodily movements of the herd, because horses have social habits very similar to ours, offering rich information analogous to our lives⁵.

Knaapen²⁶ described three different levels of action in his work with horses: behavioral, intrapsychic and systemic, especially the latter two requiring a phenomenological attitude from the therapist; considering only the event, the phenomenon of the horses’ intervention in the process. On an intrapsychic level, the horse mirrors the inner state of the individual participant, informing the therapist of their incongruities, whether conscious or unconscious. On a Systemic level, when the horse mirrors the internal image, it reflects how belonging is felt by the individual and this influences their choices. In line with the studies presented, we can observe in the patient’s report that, from the ground dynamics with her assisted family members, the horses act in resonance with the Morphogenetic field of the patients in imbalance ^8,9,25. When we recognize an excluded being and insert them back into the family and heart, unconscious personal sufferings are revealed that are linked to family conflicts of a hidden, sometimes unconscious entanglement, and can follow rules of loyalty to the family field, resulting in relief from the pains of many beings^5,6,10,11. According to the patient’s account, she felt encouraged to try food again.

6. CONCLUSION

This is a potentially expanding multidisciplinary field that needs more research, not only based on qualitative and quantitative evidence, but also on measuring the energetic, morphological and biochemical levels of both man and horse at work. It is concluded that the therapy carried out through Systemic Movements Assisted by horses in a patient with haemiplegia after ischaemic stroke, decoded by the professional facilitator, led to the resolution of the conflict through the horses that revealed the unconscious personal suffering linked to family conflicts that prevented the full recovery of the sequelae presented by the patient, totaling a period of 15 days after the intervention with the horses. More academic research should be carried out on this subject so that activities assisted by horses allow us to acquire credibility as legitimate methods of learning and developing leaders.

REFERENCES

1. HALLBERG, L. Walking the way of the horse: Exploring the power of the horse human relationship. 1^a. ed. New York: iUniverse, Inc. 2008. 664p.
2. BAUN, M.M.; MCCABE, B.W. The role animals play in enhancing quality of life for the elderly. Handbook on Animal-Assisted Therapy: Theoretical Foundations and Guidelines for Practice. Academic Press, chapter 11. 2006. p. 237-251. DOI:10.1016/B978-012369484-3/50014-1.
3. EPONA EQUESTRIAN SERVICES (EPONAQUEST®). Linda Kohanov. Available in: https://eponaquest.com/. Access in: 10/05/24.
4. KOHANOV, L. The Power of the Heart: A Nonpredatory Approach to Social Intelligence, Leadership, and Innovation. Editorial New World Library: Novato, California, 2013. 451p.
5. ANDRADE, R.V. Minha Vida com os Mestres Cavalos. 1ª ed. Lisboa: Chiado Editora. 2016. 250p.
6. HELLINGER, B. Ordens do Amor: um guia para o trabalho com constelações familiares. 1ª ed. São Paulo: Editora Cultrix. 2007. 424p.
7. SHELDRAKE, R. A sensação de ser observado: experimentos em escolas. 1ª ed. São Paulo: Editora Cultrix, 2004. 384p.
8. SHELDRAKE, R. A presença do passado. 1ª ed. São Paulo: Ed. Instituto Piaget. 1996. 500p.
9. SHELDRAKE, R. O renascimento da natureza: o reflorescimento da Ciência e de Deus. 2ª. ed. São Paulo: Editora Cultrix. 1993. 240p.
10. SOUZA, M.E.; OLIVEIRA, J.V.; FABIANO, Q.R.S.A. We are not hostages of our genetics: epigenetics in the control of gene expression mechanisms involved in some disease. Brazilian Journal of Health Review, p. 11938, 2023. DOI:10.34119/bjhrv6n3-277.
11. EVANGELISTA, E.K.C. Therapeutic interventions with horses, Revista Brasileira de Educação Médica, v.47, n.3, p.e110, 2023. DOI: 10.1590/1981-5271v47.3-2023-0002.
12. GRAY, A.L. et al. JOHNSON, T.A.; ARDELL, J.L.; MASSARI, V.J. Parasympathetic control of the heart. II. A novel interganglionic intrinsic cardiac circuit mediates neural control of heart rate. Journal of Applications Physiology, v.96, n.6, p.2273-2278, 2006. DOI:10.1152/japplphysiol.00616.2003.
13. ANDRADE, L.A.A. A família e suas heranças ocultas. 1ª ed. Fortaleza: Edição da autora Fortaleza. 2016. p.122.
14. HESSE, U. Homem–Cavalo: Uma relação sensível. Revista Brasileira de Equoterapia, n.19, p.8-9, 2009.
15. DYK, P. et al. The effectiveness of equine guided leadership education to develop emotional intelligence in expert nurses: A pilot research study. University of Kentucky Center for Leadership Development, Lexington, Kentucky, 2012.
16. VILLELA, R.; SAMICO, A.P.; BARTOLINI, F.B. Une étude pilote analyse les effets de l’apprentissage assisté avec les chevaux sur les mesures biochimiques du sang et biophysique en hertz du champ d’énergie des participants à un atelier d’intervention systémique avec les chevaux. Comité National Français de Géographie (UGI-IGU), Paris, 2022.
17. SILVEIRA, L.L. et al. Os efeitos do mindfulness na percepção dos estudantes de Medicina de uma universidade brasileira. Revista Brasileira de Educação Médica, v.45, n.2, p.e053, 2021. DOI:10.1590/1981- 5271v45.2-20200149.
18. SCHRÖDINGER, E. The Present Status of Quantum Mechanics, By, E. Schrödinger, Oxford, Die Naturwissenschaften, v.23, n.48, 1935.
19. ARANTES, J.T. Experimento obtém emaranhamento de seis ondas luminosas com um único laser, 2018. Available in: https://www.ifsc.usp.br/~fotonica/pt-br/news/pesquisa-sobreemaranhamento-quantico-em-destaque. Access in: 12/02/24.
20. MILLER, R.M.; LAMB, R. The revolution in horsemanship: And what it means to mankind. Guilford, Connecticut: The Lyons Press Series. 2005. p.354.
21. CINTRA, A.G.C. O cavalo: características, manejo e alimentação. 1ª ed. Rio de Janeiro: Editora Roca. 2010, p. 3-12.
22. FERREIRA, P.D.M.; CUNHA, M.C. Efeitos psíquicos em criança a partir de uma intervenção assistida com equino: estudo de caso. Revista Científica Multidisciplinar Núcleo do Conhecimento, v.2, n.2, p.134- 159, 2023. DOI: 10.3279/nucleodoconhecimento.com.br/psicologia/intervencao-assistida
23. MACHADO, V.S. et al. Conhecimento da população sobre acidente vascular cerebral em Torres RS. Revista Brasileira de Neurologia, v.56, n.3, p.11-14, 2020. DOI:10.46979/rbn.v56i3.38210.
24. LEIBINGER, F. et al. Which patients require physician-led inter-hospital transport in view of endovascular therapy? Cerebrovascular Diseases, v.48, n.3-6, p.171-178, 2019. DOI:10.1159/000504314
25. A Teoria dos Campos Mórficos e a emergência da visão sistêmica sobre o equilíbrio no meio ambiente, Pesquisa em Educação Ambiental, v.13, n.2, p. 69-81, 2018. DOI:10.18675/2177-580X.vol13. n2. p69-81.
26. KNAAPEN, R. Coaching com cavalos: uma abordagem sistêmica. 1ª ed. Curitiba: Arte Editora; 2016. 160 p.

^[1] Postgraduate degree in Systemic Law (Hellinger Schule). Degree in Journalism from UNAERP. ORCID: https://orcid.or/0009-0003-3194-8216. Currículo Lattes: http://lattes.cnpq.br/2819260259373643.

^[2] Master’s degree in Systemic Psychology CUDEC – Mexico; Postgraduate degree in Psychopedagogy Pontifical Catholic University of Minas Gerais (PUC-MG); Postgraduate degree in Systemic Pedagogy Faculdade Innovare. Bachelor’s degree in Pedagogy (PUC-MG). ORCID: https://orcid.or/0009-0002-6014-2564.

^[3] Independent integrative physician. Postgraduate degree in Biophysical Technologies applied to health, Instituto Fernanda Ben. Graduated in medicine from UFMG (CRM: 27379). ORCID: https://orcid.org/0009-0001-1355-7700.

^[4] Independent Veterinarian, Postgraduate in Biophysical Technologies applied to health, Instituto Fernanda Ben; Postgraduate in holistic therapist (IBRTI); graduated in Veterinary Medicine from the University of Alfenas. ORCID: https://orcid.org/0009-0000-7869-6333. Currículo Lattes: https://lattes.cnpq.br/8169923497574541.

^[5] Advisor. Veterinarian, PhD. Biomedical Engineering (UAM), Spec. Health and Quantum Therapies Fisioschool, Msc. Biomedical Engineering (UNIVAP), Vice-president ABMVI, Researcher MSAC®. ORCID: https://orcid.org/0000-0001-6968-9510.

Material received: July 19, 2024.

Material approved by peers: September 9, 2024.

Edited material approved by authors: April 16, 2025.