A few years ago on a flight from Florida to New York, a small, extremely excited dog confused, entranced and disconcerted my fellow passengers and me. It was the first time that most of us had seen an emotional support animal, which his owner said she needed to help her cope with anxiety.

Since then, as a recent article in The New York Times reports, “The number of people claiming they have a right to live with animals for their mental health — as well as to take them onto planes and into restaurants and stores — has been growing rapidly.” Furthermore, the range of animals that provide emotional support has expanded to include geese, pigs, peacocks and even iguanas and snakes.

There seem to be three basic reasons for this uptick in support animals.

Service peacock at Newark Airport. Courtesy Ramon Colon

One is that, according to statistics from the World Health Organization, the level of both anxiety and depression in the world has increased drastically in the past decade. Animals are often soothing and comforting, which is why they are used for therapy in nursing homes, hospitals and schools.

John Howland, a friend who is a psychiatrist in Massachusetts, told me that his patients often request that he “certify some kind of emotional dependence on animals to live with them, usually in supportive housing, or to allow their animals to accompany them on planes or other public transit.” He said: “Most people who request such letters are in various stages of anxiety and sometimes depression. They can rely on animals when people are less trustworthy, available and tolerant.” (I do not write such letters for clients.)

Early in my training, a supervisor told me that his own pets sometimes came into his office, and that patients felt calmed by them. And, at one point I needed to take a pet to an emergency veterinary appointment and, out of necessity, brought her to work with me. One client, a socially isolated woman, asked me to let her out of her carrier. To my amazement, the cat rested quietly beside her for the entire session. In the next session, my client told me, “I’ve never felt so peaceful as I did with your cat sitting with me.”

Eventually, she adopted a cat from the local animal shelter. Caring for and feeling loved by her pet made her feel like she mattered.

A second reason that support animals are more popular today may be related to a change in attitude toward mental illness. At the time that my client adopted her cat, she could not tell anyone that she was being treated for a serious mental disorder because it could have jeopardized her job. Today, by contrast, mental health and emotional issues are seen as part of normal life.

Although much of the evidence is anecdotal, it seems clear that trained service and therapy animals, as well as untrained emotional support animals, can provide important functions for those with psychological and emotional issues. Preliminary studies show that service animals help relieve distress in veterans with post-traumatic stress disorder and other studies have also shown that equine-assisted therapy, which seldom involves traditional horseback riding, can help with addiction, trauma and other emotional and physical disabilities.

Yet, there are also a host of downsides. There can be significant fallout for other people when you bring your pet onto a plane or into a public area. One woman, for instance, has told me that she is afraid of dogs. “I’ve been on a plane where the owner took the dog out of its carrier and let it climb around on the seats. I was so anxious I spent the whole trip shaking and crying,” she said. There is also the problem of allergies. One sufferer told me, “No airline cleans all of the animal dander off the seats after a cat has been allowed out to sit on the seat with its owner.”

Beyond that, there are concerns for the animals themselves. A pet-owner who does not travel with her animals told me that she worried that no one was taking into account their health and well-being. “The animals are not trained,” she said. “Well, how can you train a pig? But even dogs that are supposed to be emotional support animals don’t have to be trained, so they get anxious, frightened, or overexcited when they’re taken into a place with lots of people.”

Professionals who work with these animals echo her concerns. There are significant differences between trained service and therapy animals and certified emotional support animals. A clinical social worker who tried and failed to have her own dog trained as a therapy animal told me, “My dog didn’t pass the course because he gets too excited around people and can’t do the job he’s supposed to do."

She added: "It’s not just the dog that has to know how to handle himself, though — it’s the owner, as well, and people who get their animals certified as emotional support animals don’t go through any training. So they don’t know how to keep their animal, themselves or the people around them safe if an animal gets overly excited, say, or starts to feel protective and maybe gets aggressive in a grocery store or other public place.”

And that suggests a third, and perhaps most disturbing, factor behind the increase in the number of emotional support animals: A heightened “me first” attitude in what author Christopher Lasch has described as “the culture of narcissism.” Friends in Europe, for instance, were taken aback when I asked them about the concept of traveling with a support animal in their countries. As one put it, “I’m afraid it sounds like stereotypical Americans having rather too much sense of entitlement!"

No one that I spoke to denied the role of selfishness; many were honest that it was a way of traveling with pets without paying airline charges. One family told me that they had their pet certified as an official support animal because they had heard too many stories about animals that had been lost or had died while traveling in the traditional way. They were aware that some of their fellow travelers could be uncomfortable with their pet, but they said that he was a hypoallergenic breed and that they gave him a mild tranquilizer before any flight. “Are we gaming the system?" they asked. "A bit, to be sure. But haven’t the airlines been gaming all of us for years? I don’t feel bad about it.”

In the end, the real question is, what purpose is served by emotional support animals that cannot be served by legitimate service and therapy trained animals. While they may well soothe and comfort their owners, they can also increase anxiety and tension among others in the public places where they are now allowed access. Is this a step forward in mental health care? Or does it just reinforce the growing acceptance of narcissism and selfishness in our culture? My British friend asked, “Wouldn’t a stuffed animal do just as well?”

It would certainly be less selfish.