Introduction

Take a look at the wide array of behavior problems that are problematic for pets and their families and you will notice that fear and anxiety play major roles or contribute in some way to a majority of canine and feline behavior disorders (see definitions of anxiety, fear, and phobia in Box 12.1). Storm phobias, noise phobias, social avoidance, fear-related aggression, compulsive disorders, and submissive urination have obvious anxiety components, but even problems such as urine marking, territorial aggression, and resource guarding can be fueled by fear or anxiety. Understanding the behavioral and physiologic aspects of anxiety and the fear response, as well as how to choose and coach the owner patiently through conditioning exercises become important aspects of working with a wide variety of behavior problems.

The fear response

When an animal experiences anxiety, fear, or stress, both the sympathetic system and hypothalamic–pituitary–adrenal (HPA) axis are stimulated so that the body can respond to the threat.¹ The sympathetic system releases norepinephrine (noradrenaline) and epinephrine (adrenaline) from the subcortical areas of the brain and adrenal gland, leading to the behavioral responses of fight, flight, or freeze. The physiologic response is an almost instantaneous immediate increase in heart rate, blood pressure, respiratory rate, and vasoconstriction to internal organs. Epinephrine also stimulates breakdown of glycogen and fat (lipolysis) and increases glucose production (gluconeogenesis) to provide immediate energy to fuel fight or flight. Stimulation of the HPA axis provides cortisol release which aids in the immediate response; however, chronic stimulation may lead to the medical and behavioral consequences associated with chronic stress (see Chapter 6). Studies have shown that psychological factors may stimulate the HPA axis more than physical factors; therefore, addressing mental well-being is essential to both health and welfare.^2,3

The amygdala is an almond-shaped structure located deep within the temporal cortex; it is considered part of the limbic system. The amygdala is considered to be the primary site responsible for processing external and internal triggers that are fear-evoking or potentially threatening to the animal (i.e., visual, auditory, odor, hypoxia, pain). Inputs run from the sensory organs through the thalamus.⁴ When an animal perceives the stimulus, the amygdala triggers an immediate physiologic fear or startle response, priming the body for immediate action. A second slower pathway travels through the cortex to analyze the signal to determine if the threat is real but once the emotional stage is triggered it may be difficult to inhibit. The amygdala signals the cells of the paraventricular nuclei of the hypothalamus to release corticotropin-releasing factor, thus stimulating the hypothalamic–pituitary axis and the release of norepinephrine from the locus ceruleus.⁵ The amygdala is also the central site for fear conditioning; it integrates prior learning and memory to stimulate other brain centers to initiate the autonomic threat response.⁶ In humans, fear conditioning is thought to play a role in the development of anxiety disorders such as posttraumatic stress disorder, phobias, and panic disorder.

The locus ceruleus is a brainstem nucleus located in the gray matter of the pons.⁷ The locus ceruleus contains the highest concentration of norepinephrine neurons in the brain and sends projections to many brain regions, including the cortex, hypothalamus, hippocampus, and the median and dorsal raphe nuclei.⁸ Stimulation of the locus ceruleus triggers the release of norepinephrine. Inputs to the locus ceruleus arrive via sensory and visceral stimuli and from afferent projections from the central nucleus of the amygdala. Corticocotropin-releasing factor resulting from amygdalar stimulation has an excitatory effect on the locus ceruleus.⁹ Dysregulation of the locus ceruleus may be associated with a variety of psychiatric disorders, including panic attacks, attention deficit hyperactivity disorder, sleep and arousal disorders, and affective disorders.

The hippocampus is another major nucleus of the limbic system and is involved in memory storage.¹⁰ It has anatomical connections with the amygdala and hypothalamus. It is also considered to be responsible for processing contextual information, and differentiating between safe and dangerous; dysfunction may lead to an anxiety response to benign stimulation with an overestimation of potentially threatening context, as in posttraumatic stress disorder in humans.¹¹ The hippocampus can normally suppress the HPA axis. However, chronic stress and cortisol can damage the hippocampus which can then no longer regulate the HPA axis, resulting in excessively high levels of cortisol.⁵ A reduction in hippocampal volume has been identified in posttraumatic stress disorders and in animals exposed to chronic stress.¹² The individual is thought to be less able to draw on memory to evaluate the nature of the stressor when hippocampal function is compromised.

The dorsal and medial raphe nuclei are two functional neuron clusters located in the centromedial portion of the brainstem and considered part of the reticular formation.¹³ Together these nuclei provide virtually all serotonin input to the forebrain.¹⁴ It is hypothesized that the limbic projections of the medial raphe nucleus help modulate fear and anxiety, including autonomic responses, while the dorsal raphe nucleus modulates cognitive and motor components that inhibit flight or fight responses.¹⁴

The forebrain is also involved in the fear response in that it has some influence in modulating the limbic system and hypothalamus, and a functioning forebrain is necessary to unlearn fear responses.

Dysregulation of fear pathways appears to be important in manifestation of the clinical signs associated with phobias and anxiety disorders. This dysregulation involves alterations in the activity of a number of neurotransmitters, including serotonin, norepinephrine, and gamma-aminobutyric acid (GABA). Of these neurotransmitters, serotonin and GABA are inhibitory and typically quiet the stress response.

Excessive fear responses may be due to genetic factors, inadequate early environmental experiences, inadequate early socialization, a conditioned fear due to one or more unpleasant experiences, medical or behavioral pathology, or a combination of these factors (Box 12.2). Many fearful behaviors can be linked to experiences in the first year of development. Handling, nutritional and maternal care during the first few weeks of life in the breeder’s environment, as well as exposure during the socialization period with its own and other species and to its environment can set the pet up for success or can contribute to fearful behaviors that might be difficult, if not impossible, to resolve. However, even with adequate exposure, fear may arise unless exposure to social and environmental experiences is maintained.¹⁵ There may be a second phase of heightened sensitivity arising around sexual maturity.^16,17 Unpleasant and stressful experiences during early adolescence, including punishment-based training, may also contribute to fear conditioning and increased avoidance.^18–24 Attendance at puppy classes and use of pheromones may to some degree be preventive.^25–27

When dogs and cats are exposed to new stimuli, their response will depend in part on their sociability (genetics, stage of development), previous experience with similar stimuli, and the emotional and medical health of the pet at the time of exposure.² If the outcome is positive then the fear may reduce with further exposure. If the stimulus has no consequence, the pet may ignore the stimulus with further exposure. However, pets that have an unpleasant experience, or perceive that the stimulus might be harmful, will avoid or become increasingly fearful of the stimulus. Increasing the frequency of exposure to fear-evoking stimuli has been shown to increase the risk of inducing further fear and phobias.²⁸ An intensely unpleasant or aversive event can lead to an intensely fearful and lasting memory of the stimulus (one-event learning). Although the pet may only become fearful of specific stimuli (discrimination) such as a noise (e.g., gunfire), place (e.g., veterinary clinic), or person (e.g., neighbor’s child), some pets may generalize to many similar stimuli (e.g., all children). In addition, the pet may become fearful of events that precede the unpleasant situation (e.g., the car ride that precedes the veterinary visit). High states of arousal or anxiety place the dog in a state of hypervigilance, where fear responses are automatic, and preclude the possibility of conscious decisions as to how to respond (Box 12.3). Therefore, only if the pet’s level of arousal is sufficiently reduced can it review options and make conscious decisions as to whether a stimulus is positive, aversive, or of no consequence. Arousal can be reduced by ensuring that the pet is calm through training by using products for control such as head halters, by selecting an appropriate environment for exposure, and through selection and control of appropriate stimuli for retraining. Drug therapy may also be useful.

Regardless of the cause, each fear-eliciting event that does not end with a positive outcome is likely to aggravate the problem further.²⁸ Since the goal of counterconditioning is to change the association with the stimulus to one that is positive, any response from the owner or the stimulus that might lead to a negative or unpleasant consequence will further increase the fear and anxiety. Therefore punishment and other aversive correction techniques must be entirely avoided, and the stimuli should be muted, minimized, or avoided until controlled and successful exposure training can be implemented. In addition, if the owner displays any emotions of anger or anxiety, this is likely to increase the pet’s anxiety. Also, if the pet escapes from the situation or aggression results in retreat of the stimulus, then the behavior has been negatively reinforced because the threatening stimulus has been removed. In treating a fear-related problem, it is often just as important to tell the family what not to do, as it is to tell them what to do.

Basic behavioral modification and the fearful pet

All management approaches for treating fear are based on two important principles: (1) avoidance of any stimuli or situations that evoke a fear response; and (2) controlled exposure to stimuli in such a way that the pet becomes relaxed in their presence and they no longer elicit a fear response.

Techniques for managing fears and phobias include controlled exposure, habituation, systematic desensitization, counterconditioning, shaping, response substitution, and positive reinforcement^29–33 (see Chapter 7). They can be used individually or together in behavioral modification therapy (Table 12.1). If a situation arises during training or counterconditioning that might trigger an aggressive response, safety is the overriding concern. The use of confinement, tie-down, muzzle, and the physical control provided by a leash and head halter (dogs) or leash and harness (cats) can prevent aggression and retreat.

Table 12.1 Behavioral modification techniques used for fearful behaviors

Desensitization, counterconditioning, and controlled exposure

Before exposure exercises, the pet should be taught calm and reliable responses such as sit–stay or down–stay using high-value rewards. The owner should also consistently require that the pet display these behaviors before any attention is given. By being predictable in all interactions, the pet’s anxiety is reduced by giving it control over social interactions, while at the same time learning the behaviors the owners want to train and reward. Over time, the owner can gradually shape longer and more relaxed behaviors prior to each reward, further calming the pet and training the desired behaviors (see client handout #13 on structured interactive training, C.14). Similarly, whenever the owner has a reward of high value, the focus should be on training behaviors that calm and relax the pet, with the further intent of using these during stimulus exposure. Training should focus on specific behaviors that might be most practical for stimulus exposure such as relaxed loose-leash walks or sit and focus for outdoor stimuli and sit and focus, down and stay, or mat exercises for indoor stimulus exposure.

For desensitization and counterconditioning, a highly valued reward should be paired with each exposure to the fear-evoking stimulus. If the pet is also taught to respond reliably and consistently to cues to settle and calm, these can be used to keep the pet’s focus. The stronger the reward, the more likely the pet will maintain focus and make positive associations during low-level stimulus exposure. The pet should then be gradually exposed to progressively stronger levels of stimuli while making a positive association with each exposure to the stimulus. Should the threshold for fear be surpassed at any point in the desensitization program, the owner should return to an earlier level of training and proceed in smaller increments. By withholding rewards except for each pairing with the stimulus, a new positive association with the stimulus should be conditioned.

If the fear is mild and the owner has good control over the pet, stimulus, and situation, controlled flooding techniques (continuous exposure to stimuli at levels that are minimally above the threshold that elicits fear) may be successful as long as the pet will quickly habituate to the stimulus so that a reward can be given. Ideally, this would be a valued positive reinforcer. However, removing the pet from the situation or removing the stimulus before the pet begins to calm may negatively reinforce the behavior. If the stimulus is too intense for the pet to calm quickly, the stimulus intensity should be reduced (by increasing the distance between the pet and the stimulus) to minimize the fear to a level at which the pet can habituate. A leash and head halter can be helpful in providing increased control and ensuring compliance. Once all signs of fear subside and the pet responds to the owner’s commands, rewards (food, play, social attention) should be given. The strength of the stimulus can gradually be increased during each succeeding training session as long as the endpoint of each exposure is positive (Box 12.4).

Fear of people

Some pets show fear toward a particular person, all unfamiliar people, or a type of person (child, baby, man in uniform – Box 12.5). Depending on how a pet was socialized when it was young and the experiences it has had with people, it may be fearful of individuals with whom it is unfamiliar or with those it associates with an aversive experience.

Management and treatment

Successful treatment requires that the family identify all fear-evoking people so they can be reintroduced to the pet under controlled situations while making positive associations. It is important for owners to be aware that any fear, anxiety, or threats from the stimulus, or any anxiety, threats, or punishment by the owner will worsen the problem.

For each type of person, the owner should develop a gradient or hierarchy of intensity from weakest to strongest. Controlling the appearance or presentation of the fear-eliciting person and the distance between the person and the pet are two means of developing this gradient (Boxes 12.4–12.6). The conditioning should take place in a calm, nonthreatening environment where the pet can easily be controlled. For some pets, it might be helpful to hold the first session on neutral territory such as at the neighborhood park. The goal is to associate the person with something that is highly valued such as a favored treat, toy, or social attention (counterconditioning). The key to success is to determine the threshold for eliciting fear of the stimulus (e.g., the distance where the pet exhibits the slightest fear) and then begin conditioning below the threshold. Eventually, the appearance of the person becomes a cue that something good will happen. A leash and head halter for dogs or a crate for cats might be used for exposure if there is the potential for aggression and to prevent escape.

Box 12.6

Example of a gradient of stimuli for a dog that is fearful of unfamiliar men

For fear of people, training should begin with a person with only slightly similar characteristics to the type of person that elicits the fear response. For example, if the pet is afraid of children under 5 years of age, it should first be desensitized to teenagers. The pet can also be desensitized to the sounds of children by exposing it to recordings before beginning conditioning sessions with children. Pets that are afraid of men with beards should first be conditioned to approach from men without beards, or even a member of the family wearing a beard. Carrying a doll wrapped in a blanket and playing a recording of a baby can be a first step in accustoming the pet to babies.

At first, the strangers should ignore the pet while the owner gives treats for relaxed behavior at a safe distance. Initially, eye contact should be avoided. The owner and the pet can slowly approach the person as long as no fear is evoked and the pet is given a tasty treat every few steps. Next, the treats can be tossed by the stranger. Fearful dogs may cower and retreat but some may attack. Therefore the owner should proceed cautiously and slowly to ensure safe and successful retraining. A head halter can provide safe and effective control for dogs while a carrying cage or a body harness and leash can help to ensure control and safety for cats. Perhaps most important is to have reasonable goals. If the pet is intensely fearful or has the potential for aggression, interactions, especially with children or the elderly, may need to be limited (Box 12.7) or entirely avoided.

Box 12.7

Example of a hierarchy or gradient for desensitization of a dog fearful of men in uniforms

1. Female owner wears uniform while counterconditioning by second family member

2. Female owner in uniform asks the pet to sit and rewards with treat or toy

3. Male owner in uniform

4. Familiar woman in uniform

5. Unfamiliar women in uniform

6. Familiar men in uniform

7. Unfamiliar men with no uniform

8. Unfamiliar men in uniform at gradually decreasing distance

Before bringing strangers into the home for conditioning exercises, the owner should first plan on providing a safe haven where the pet can go to settle away from strangers until the situation is set up for successful exposure. Using reward training, teach the pet to go to a mat, crate, or room with a gate so that access to visitors can be prevented until the pet and owner are prepared for exposure. Begin by desensitizing the pet to the door bell by having family members ring the bell and enter. The bell should be rung repeatedly in close succession until the pet habituates and all undesirable or fearful responses cease. Each time the bell rings and the pet shows no undesirable response a very tasty food reward should be tossed to it. Next, set up practice visits with people the pet knows and feels comfortable around. Have the pet on a leash at a safe distance away from the door. One family member should focus on greeting the visitor and one should focus on the training. As the visitor enters he should ignore the dog and avoid making eye contact. The dog should be asked to sit and focus (with a head halter if necessary). If the dog sits and calms the owner should immediately reinforce with a favored treat. If necessary, repeat the process with the visitor leaving and returning until the dog immediately sits and calms (response substitution). Another alternative is for the owner to keep the dog at sufficient distance and give favored treats or toss treats on the floor as long as the dog shows no anxiety. Entries can be repeated while giving treats until a positive association is made (counterconditioning). The owner should then ensure that the dog will sit with each entry before giving the reward. Once indoors, the visitors should continue to ignore the pet, while the owner gradually determines how close the pet can approach, remain calm, and take treats. If the pet appears ready to approach in a friendly, nonfearful manner, the visitor can casually flip small pieces of meat or cheese toward it. Extending a hand with food instead of flipping it is more likely to inhibit approach behavior and should initially be avoided. Determine an end point where the pet feels comfortable. Next, proceed to strangers. If the pet is most afraid of adult men, then the next set of exercises should first involve unfamiliar women followed by exercises with unfamiliar young men, and finally adult men. The owner should save high-value rewards for training sessions, so that the pet learns to really look forward to the presence of visitors or strangers. Each training session should end at a distance (limit) that can be successfully and positively achieved.

Some pets do better if they are confined when company arrives such as in a room, crate, gated area, or tie-down or restrained in another room on a leash by a family member. Upon arrival, the visitor is asked to sit at the far end of the largest room in the home. The owner gives the visitor a bowl containing small pieces of meat and instructs the person to remain quiet, avoid eye contact, and completely ignore the dog when it is brought into the room. When the pet will calm and settle for a reward it can be brought out of its room on a leash, and a head halter if needed. The owner gradually moves the dog toward the visitor, giving food rewards every few feet if the dog remains calm. If the pet does not sit or take the treat the owner should move the pet back a few steps and proceed more slowly. As long as the dog is calm and takes the reward the owner can proceed (as in the paragraph above). Some pets are more motivated by a favored play toy, in which case this can be used to lure and reward the pet for approaching and interacting with the visitor. Finally, the pet can be given a toy stuffed with food to work on while the family and friends visit. In some cases keeping the dog entirely away from visitors is best for the dog, the family and the visitors.

When the dog appears entirely relaxed with the visitors and there is no history or potential for aggression, the question then becomes how much interaction with the stranger the pet would enjoy.

It is important to note that some pets will find interactions with unfamiliar people undesirable or potentially threatening. In fact some dogs will show limits in how much affection they will tolerate even from familiar people and family members. Therefore it is essential for owners to know their dog and read its facial expressions, body language, and posturing to determine how far to proceed with each stranger.

If the dog enjoys physical contact from known individuals and the owner can evaluate the situation and determine that the dog is relaxed and willing to engage in further interaction, the owners should proceed to structured interactions with the visitors (see Appendix C, form C.14, client handout #13, printable version available online). Visitors are told that they may not touch the pet unless it first sits and takes a treat. This does several things to help make the situation safe. If, for some reason, the pet shows signs of fear and is too anxious to eat, the interaction should not yet progress to physical interaction. By giving a command that the dog has learned will consistently receive rewards, the dog controls the outcome; therefore if it does not sit and settle, it is indicating that it is not comfortable with taking the reward from the stranger. When the dog does take the treat from the visitor, it is building a positive relationship with the stranger (Boxes 12.8 and 12.9).

Box 12.8

Behavior modification for dogs that are afraid of people or pets (client handout #9, printable version available online)

There are many different stimuli that can frighten your dog or lead to an aggressive response. Although fear can lead to avoidance and escape attempts, the dog that is defensive or aggressive when it is frightened can pose a serious danger. This handout is designed to help improve or resolve fear of people and other animals. Fear can be generalized to all people or all animals of a certain type (e.g., children, strange dogs) but can also be quite specific so that fear may only be exhibited with specific people (e.g., delivery men with beards, small white dogs).

Treatment of fear

The plan involves repeatedly exposing the pet in a controlled manner to the type of person or animal that causes fear, and pairing that exposure with something the pet really likes. In time, the pet should actually look forward to and enjoy being with the person, although there may be some limits on how much you can expect your dog to tolerate. For example, not all dogs will be comfortable with physical contact (petting by people) or playing with other animals.

Desensitization is used in combination with counterconditioning to change the pet’s attitude or “feeling” about people or animals from one that is negative to one that is positive. Desensitization involves controlled exposure to situations or stimuli that are weaker or milder than will cause fear. This can be done by beginning the sessions with the stimulus (person, other animal) sitting or staying far enough away so that the pet is not anxious. Counterconditioning is then used to change the dog’s response to the stimulus by associating the dog’s favored rewards (food, toys, play) with the stimulus. The dog is then gradually introduced to similar but progressively more intense stimuli paired together with the presentation of a favored reward. If an inappropriate response (fear, aggression, attempts at retreat) is exhibited, then the dog should be moved slightly farther away so it can calm, take the reward, and end the session with a positive outcome.

Response substitution is used to train the dog to display a new acceptable response (e.g., sit or lie down calmly) each time it is exposed to the stimulus. Again, rather than attempting to overcome an intense response, the training should be set up to expose the dog to stimuli at a low enough intensity that fear is not evoked. Before training with fearful stimuli, begin a program of structured interactions where every time your dog seeks attention, you only give the attention for behaviors you want your dog to learn. Be consistent and predictable and your dog will quickly learn. For example, asking your dog to sit, lie down, or go to its bed (or waiting until it does one of these behaviors) before giving attention will teach your dog that these are the behaviors that get rewards. This is a win–win situation. Not only do you train the behaviors you want, but you give the dog control over its rewards, since it now can learn what behaviors are rewarded. Rule structure reduces a dog’s anxiety and teaches desirable behaviors. Also use food, play, and treats in the same way to train the same behaviors in other situations. Once your dog is responsive to these commands when there is no fearful event, then training to overcome its fears can begin. A head halter and leash can be used to ensure success and high-value rewards used to mark and reinforce an acceptable relaxed response. You may also consider clicker training.

You will heighten the pet’s fear or anxiety if you respond with a raised voice, agitation, or punishment. How the stimulus reacts also affects your dog’s response; therefore, ensure exposures begin with stimuli that are well controlled, mild, and non-threatening. Avoid all further fear-evoking stimuli until you are ready for successful exposure. The goal is to reward only desirable responses. Therefore, it is critical that rewards are not given until your dog is calm, settled, and displaying the behavior you want it to learn.

Steps for treating a pet that is afraid of animate stimuli (people, other animals)

1. Know the signs of fear; identify all stimuli and situations that cause fear (e.g., children playing, tall men).

2. Prevent your dog from experiencing the stimuli except during conditioning sessions.

3. If there is aggression associated with the fear, then your dog should be trained to wear a head halter or basket muzzle so that safety during exposure exercises can be ensured.

4. Train the dog to relax on cue in the absence of any fear-evoking stimuli. Work on the cues you plan to use when you begin exposure. Outdoors, you might focus on walking with a short amount of slack leash (“heel”), sit and focus and turn and walk in the other direction (“walk away”). Indoors, “sit” and “focus,” “down” and “settle” or crate and mat exercises might be most useful. A head halter can be used to ensure success.

5. Once the dog will reliably focus, settle, and accept rewards in a variety of environments, then training can progress to include exposure to controlled levels of the stimulus.

6. Set the pet up to succeed. A familiar dog or person can be used as the initial training stimulus to ensure that your dog will relax and take rewards as soon as it sees the stimulus (e.g., dogs on the street, visitors at the door).

7. For both counterconditioning and response substitution, the dog’s favored rewards should be used. Save the rewards of highest value for training sessions and exposure to the stimuli.

8. You will need to develop a gradient for introduction to the fear-evoking stimulus so that initial exposures are mild. Setting up sessions with good stimulus control can be difficult and take some forethought but is essential for successful counterconditioning and response substitution.

(a) First, list all stimuli that might incite fear or anxiety. Stimuli may be sights, sounds, smell, or touch. There may be multiple stimuli that need to be improved. For example, a dog that is fearful of children on bicycles may need to be desensitized to bicycles, children, and bicycle motion separately.

(b) Once each stimulus is identified, a means of controlling the stimuli along a gradient of increasingly greater intensity must be developed. A gradient can be designed using distance from the stimulus (far to near), similarity (e.g., beginning with least similar to what causes fear and moving to more similar), activity level (low to high), noise level, location (from calmest to most problematic), and familiarity (train to family members before strangers). If the dog is calmer or more responsive to a trainer or particular family member, that person should work with the dog first.

(c) Advance along the gradients very slowly. If you proceed through a step too quickly and the pet responds fearfully, relax, and allow the pet to settle. Using a leash and head halter, it is often possible to calm the dog with a gentle pull to get eye contact and release when calm. Otherwise move back to a distance where the pet calms. Once the fear response has ceased, give the valued reward. At first the animal or person should avoid eye contact and walk back and forth at a distance that does not cause fear.

(d) The favored reward is paired with success and calmness at each new step. Ideally give the reward as soon as the dog looks at the target (LAT). If the dog shows no aggression and looks away, or looks at you, removing the dog can also serve as a valuable reward (in addition to the food reward). Always end each session on a positive note.

Example

A dog might be most fearful of young boys at a distance of 15 meters (50 feet) or less while playing in front of the house. Four gradients could be used: distance, appearance, location, and actions. For distance, exposures would start at 20 meters (65 feet) (i.e., beyond that which would evoke the fear response) and move progressively forward a few meters at each session as long as the dog takes the rewards and shows no fear. The appearance gradient might start with exposure to adults or teenagers before younger boys. The activity gradient might begin with two people standing quietly and progress gradually to more intense play, and a location gradient might begin with off-property training such as boys playing at a distance in a park. If the fear was toward boys on bicycles or roller blades, then desensitization and counterconditioning with the bicycle or roller blades would also be necessary. One method might be to use a family member for training the dog to make positive association with bike riding, before counterconditioning to children standing with the bike and then riding the bike.

Fear/anxiety toward other animals

The approach is similar to that outlined above.

For aggression toward other animals, stimuli that might cause anxiety are visual: physical characteristics (e.g., species, breed, color, size, age), postures, facial expressions and actions, odors, and sounds (e.g., growl). As the other animal begins to interact with your dog, tactile cues may also be a factor to consider, so progress slowly with each new stimulus. Always know and accept your dog’s limits.

Be confident, calm, and make sure your dog is responsive to commands and motivated for the rewards to ensure successful outcomes. A leash and head halter will provide more control if safety is an issue.

Box 12.9

Desensitization and counterconditioning for cats that are afraid of people or other cats (client handout #10, printable version available online)

The plan involves repeatedly exposing the pet in a controlled manner to the type of person or animal that causes fear, with the exposure minimized so that the cat will take a favored reward each time it sees the stimulus until a positive association is made.

Desensitization is used in combination with counterconditioning to change the pet’s attitude or “feeling” about the stimulus from one that is negative to one that is positive. Desensitization involves exposure to people, animals, or situations that might cause fear but at levels that are minimal enough that your cat will adapt. Counterconditioning is used to change the cat’s response to the person or animal by associating the cat’s favored rewards with each exposure. The cat is then gradually introduced to gradually more intense stimuli (e.g., closer) paired each time with the presentation of the favored reward.

Response substitution is where the cat is trained to display an acceptable behavior (toy chase, come, fetch) for favored rewards each time it is exposed to the stimulus. This training can only be used if the cat can be successfully reward-trained to respond eagerly to one or more commands. As with counterconditioning, the training should begin with a stimulus of low enough intensity to ensure the cat responds to the command and reward.

Favored rewards (treats, play) must be saved for reward training and exposure training so that the pet can make the positive association between the stimulus and the reward. Avoid all fear-evoking situations until you are ready for exposure training as each fearful event may increase the cat’s fear. If you become agitated, raise your voice, or punish the pet, you will only serve to heighten your cat’s fear or anxiety.

Finally, be certain to train only with calm, controlled stimuli. The goal is to make each association with the stimulus positive and nonfearful. If you begin to expose your cat and it becomes fearful, remove the cat from the situation and begin subsequent training at a less threatening level.

Fear of people and pets – desensitization and counterconditioning – common first steps

• Begin with safe and effective control of both your cat as well as the stimulus that causes fear. Initially the cat and the stimulus (other cat, people) can be separated by confinement behind a common solid door (until the cat adapts to the odor and sounds of the stimulus) or across a glass or screen door, which would allow for safe visual exposure. A positive association can be achieved (countercondition) by giving the pet favored rewards with each exposure.

• The next step is gradually to increase the intensity of exposure while ensuring the cat continues to take rewards. If barriers have been used, the goal is gradually to get the cat into the same room with the stimulus (person, pet) at sufficient distance that the cat will take the food or treat.

• If the cat exhibits fear at any step in the desensitization program, go back to the step that was successful and repeat until the pet will readily take rewards before progressing again. Always end on a positive note. It is critical that the owner and the stimulus at all times remain calm and show no fear and that the owner uses no punishment as these will increase fear and anxiety.

Fear of people and other animals

1. Know the signs of fear and identify the fear-eliciting triggers. For some cats, fear may be generalized so that all strangers or other animals cause fear. Other cats may be afraid of specific people or pets. Until prepared to move forward with conditioning exercises, avoid all fear-evoking stimuli.

2. Setting up safe exposure: because a fearful cat can quickly become aggressive, precautions must be taken before beginning treatment. Some method of safe exposure will need to be devised. Initial exposure to stimuli should be sufficiently mild and gradual that no fear is exhibited. A good starting point is to have the cat adapt to the sounds and smell of a visitor by giving the cat rewards while housed in an adjacent room. Videos or audio tapes might be useful for introducing the sound of a stimulus at low intensity. If the cat becomes anxious and cannot be called away with a command and reward, a large blanket or towel can be wrapped around the cat to move it into another room until it calms.

3. Each stimulus will need to be presented along a gradient beginning with exposures to the stimulus that do not cause fear, and moving slowly to higher intensities with each positive outcome. To develop a gradient you will need to determine how to control the stimuli that cause fear (situations, people, places, or animals) so that they can be gradually intensified for counterconditioning. If the cat is fearful of a particular person or type of person (e.g., child), the training can begin with milder stimuli, such as a calm adult or teen. The stimulus intensity is then gradually increased. The person may move slightly closer during training sessions, but should not move closer until the cat takes the reward and is calm. Next, the goal will be for the person to give or offer the reward to the cat, or to throw it near the cat so that it approaches to take the reward. Each step should end on a positive note, with the cat receiving a reward before proceeding to the next level. Withhold rewards except when the stimulus is present.

4. Control can be provided with a leash and harness, keeping the cat in a crate or carrier, or by closing doors to block escape (provided the cat does not become aggressive or more fearful). The cat should be positively conditioned to accept any new control device prior to exposure.

5. Food or treats that have the highest appeal should be identified and saved exclusively for desensitization, counterconditioning, and reward training. Favored toys, catnip, and even short periods of affection may also be effective for counterconditioning if these are important to the cat and reserved for the exposure sessions.

6. Training the cat to respond to verbal cues such as “sit,” “come,” or “go to a place” before every reward is given may provide a useful, predictable pattern of interaction. Cats may also be taught tricks.

7. If the cat is too reactive or anxious to learn new behaviors then medication or pheromones may reduce anxiety and promote positive learning.

Treatment – fear of other cats: desensitization and counterconditioning

1. Introduction of a new cat into the household or reintroducing a cat in the home to one that it fears must be done slowly and cautiously so that each association has a positive outcome.

2. Once the cats have been adapted to each other across a common doorway, there must be a safe means of control so that the cats can be put in a common area. It may be helpful initially to place a towel with the cat’s scent in the other cat’s confinement area for a week before beginning visual exposure. Another approach is to allow one cat out into the common area while the other remains housed in its own room and to alternate for a few days so that they are each familiar with the common area. Also add as much space for perching, climbing, and hiding as is practical, and maintain separate litter stations to reduce conflict. It may also be helpful to offer a collar-activated cat door so that each cat can learn to go back into its own room without the other cat following.

3. When placing the cats together maintain sufficient distance that they show no fear and will take treats, catnip, or play toys when together. A body harness on one or both cats or crates for one or both cats may be useful when first introducing them to a common area together.

4. At this point, if both cats have been in crates, the more fearful cat may be allowed out, and the food, treats, toys, or catnip should be given progressively closer to the other cat’s crate. When both cats can be placed out of the crates in the same room together while eating at a sufficient distance to avoid fear, a leash and harness on one or both cats may be necessary for safe control. If one or both cats do not eat, move the food bowls farther apart. If things go well, the dishes can be moved slightly closer together during subsequent conditioning sessions.

5. Progress slowly! Allowing either cat to become fearful or aggressive sets the program back. The cats must remain separated except during counterconditioning sessions.

6. When the cats appear ready for some freedom to roam the home, it might help to place a bell on the assertive cat to help the family supervise and so the other cat knows when it is near.

7. Drugs and pheromones (e.g., Feliway) may be useful during a behavior modification program to reduce apprehension and allow the cat to learn pleasant associations.

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