Sorrows unsaddled

Not many people would ask that question. But Concord resident Jane Karol did.

And then she answered it. At her Bear Spot Farm, Karol not only trains equestrians in the art of dressage, she also counsels young people with depression, anxiety, and other mental health issues with the help of her co-therapist, Jake - a 12-year-old pinto with a black and white coat and gentle demeanor.

“Both horses and psychology have always felt like a calling, something pulling me toward them,’’ Karol said. “I feel incredibly fortunate to be able to marry those two.’’

On a perfect sunny day at her farm, which is crisscrossed with fences and dotted with horses, Karol’s spurs jangle as she walks. The 46-year-old is petite, almost pixieish, with dark cropped hair and delicate features.

A tractor is busy leveling a field for the Children of the Americas Dressage Invitational, an event that Karol is hosting tomorrow and Saturday. Seventeen equestrians, ages 12 to 14, will come from all over the Western Hemisphere to compete.

Karol spends part of her days training students in dressage, which is sometimes referred to as “horse ballet’’ because of the dance-like maneuvers accomplished by rider and mount. The two must learn to communicate, with subtle movements from the rider telling the horse which fancy footwork to perform.

The rapport that Karol developed with Jake in training him for dressage segued perfectly into using him as a therapy horse, she said. Turns out, the same sensitivity a horse needs for dressage is also useful in emotional therapy sessions.

Karol has 18 students that she trains in riding and 10 therapy patients.

She recalled one patient in particular who may have had a breakthrough thanks to Jake.

The 9-year-old girl came to her about four years ago. She had stopped eating to the point where her growth had halted, said Karol. The girl’s symptoms seemed to point to obsessive-compulsive disorder, said Karol, and perhaps stemmed from a fear of germs.

So Karol, Jake, and the girl started working together. Karol describes her approach as very much like traditional psychotherapy, except that everything happens outside with Jake.

Horses are powerful creatures, said Karol, and her patients “borrow’’ that power.

“The kids come with these emotional difficulties, and . . . it’s interesting the horse can bear some of that emotional complexity and pain,’’ said Karol.

However it works, her 9-year-old patient seemed to respond. After a few months of treatment, she announced to Karol that she needed to tell her a secret. She wrote something down on a piece of paper, folded it up several times, and asked Karol to read it after she left.

When Karol opened the note, it had just one word on it: “peanuts.’’ It turned out that the patient was obsessed - not with germs, but with peanuts. She was terrified she might have a peanut allergy and was afraid to eat anything out of a fear that she might have a severe reaction.

Karol attributes the breakthrough to her four-legged colleague.

“She didn’t want to lose Jake,’’ she said. “If I had a normal office, she would have ended up in the hospital.’’

The patient started eating and is still doing well, said Karol.

Therapy involving horses is a growing field, according to Lynn Thomas, founder and executive director of the Equine Assisted Growth and Learning Association, a nonprofit organization based in Utah.

The group has 3,500 members in 33 countries, said Thomas. (Karol is not affiliated with the organization.)

Thomas said it is unusual for someone to have skill with horses and in psychology because both disciplines require a large investment of time to master. The association certifies people in teams, she said.

Thomas articulated several theories on why therapy with horses seems to work.

For one, horses are large and strong, which “creates a dynamic of people facing their fears and developing confidence,’’ she said. These lessons can then transfer to other parts of a patient’s life, giving them the ability to better deal with their insecurities, said Thomas.

One impediment to this type of therapy is the expense. Horses need food and shoes and veterinary care, among other things. It would cost upward of $400 per hour if all expenses were transferred to patients, said Karol. She said she charges $125 per hour and uses the Bear Spot Foundation for Equine Assisted Psychotherapy, a nonprofit she established, to subsidize the rest.

The mother of another of Karol’s patients said she was desperate for help when she heard about the horse therapy sessions. The woman, who asked that her name not be used to protect her daughter’s privacy, thought it would be a good fit because her daughter had always loved horses.

She adopted her daughter, who is now 14, at age 7. The girl had a history of neglect in her early childhood, according to her mother, and she has multiple problems, including attention deficit hyperactivity disorder as well as trouble controlling her anger, which have landed her in the hospital several times.

The teenager started seeing Karol in March of last year and hasn’t been hospitalized since.

“This has been just extraordinarily helpful,’’ said the girl’s mother. “The behavioral problems are not as frequent or intense, and I think it’s because she can talk about all her really overwhelming feelings and difficult issues with Jane in the presence of her horse, which provides her with unconditional acceptance.’’

The mother continued: “Sometimes I’ll say, ‘Will you talk to Jane about that?’ and she’ll say, ‘I don’t know if I’ll talk to Jane about it, but I’ll talk to Jake about it.’ ’’

Karol’s interest in psychology came later in life, but she can’t remember a time when she wasn’t infatuated with horses. She recalled the first day of school in perhaps the second grade, when she marched up to the teacher to deliver some important news: “I need to tell you something,’’ she recalled saying. “I love horses.’’

Karol grew up in Newton but her family moved to Texas when she was a teenager. After relocating, her parents told her she could get a horse or car. Of course, she picked the horse.

Karol received her doctorate in psychology from Antioch University New England. She wrote her dissertation on using horses in psychotherapy.

One of her colleagues, Anthony Rao, a child psychologist who is director of Behavioral Solutions in Lexington, said he was “curious but skeptical” when he first heard about Karol’s work with horses. Now they work together on some cases.

“She’s just extraordinary,” said Rao. “So many therapeutic issues come up in that barn or field that would never in a million years come up in a therapist’s office. The therapist’s office is a contained environment. It’s very safe and people aren’t pushed either physically or emotionally as they are when they are doing something physical or in nature. . . Only a really great psychologist who knows horses could pull this off.’’

Karol still competes in dressage, at the Grand Prix level, the highest category. She said she enjoys hosting the annual Children of the Americas Dressage Invitational, which she sees as a valuable cultural exchange. Her 13-year-old daughter will be among the competitors.

“They connect around the horses,’’ said Karol, which leads to “crossing boundaries in a good way.’’

So, what would the younger version of herself - the one who thought only of horses - make of this unusual career combination?

“I think that she would probably think, ‘Wow, that’s a pretty cool way to have developed your life,’ ’’ said Karol.

“I think she’d approve.’’

Lisa Kocian can be reached at 508-820-4231 or lkocian@globe.com.