New Unquestioned Rule

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

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

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

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

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

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