Can a Stroll in the Park Replace the Psychiatrist’s Couch?

A new generation of psychologists and therapists focus on the relationship between nature and mental health

Can a Stroll in the Park Replace the Psychiatrist’s Couch?
[Image: bobopuffs, Flickr.com.]
By | Posted August 12, 2010
Posted in: Health
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Standing alone atop a modest mountain in rural Maine, Eric Adams looked out into the darkness all around him. Between the silhouettes of boulders and trees, slivers of yellow light wandered and winked — the eyes of wild animals. Fears began to crowd his mind, but he did not push them away. This was part of his therapy.

To help confront a marriage in crisis, Adams (a pseudonym) sought counseling. But the 34-year-old lawyer from Syracuse, New York, didn’t opt for the psychiatrist’s couch. Instead, he chose the mountain. Adams turned to an emerging practice called ecotherapy, which applies the principles of ecopsychology — the study of how the natural world influences mental health.

“I don’t have an office — all my meetings are outside regardless of the weather,” said Dennis Grannis-Phoenix, an ecotherapist in Bangor, Maine who began counseling Adams in 2004. Hiking, camping, kayaking — each therapeutic session centered on an outdoor activity. Grannis-Phoenix asked Adams to climb the mountain alone as an exercise in learning to face his fears and anxieties. Instead of rationalizing his fears, Grannis-Phoenix wanted Adams to embrace them — something both therapist and patient feel is easier to learn in nature than in an office.

“Nature forces you to confront your immediate circumstances,” said Adams. “Ecotherapy speaks to you not just through your analytical and verbal capabilities — your body interacts with nature.” In a way, Adams said, interacting with nature is a kind of therapy for both body and mind.

He isn’t alone in thinking so. In the early 1990s, when historian Theodore Roszak criticized mainstream psychology for failing to consider the relationship between mental health and natural environments, a movement called ecopsychology emerged to address exactly that. Loyal to Roszack at first, the movement developed ideas that budded in the 1960s and framed itself as a critique of Western psychology’s focus on the experiment — but things are beginning to change. Some researchers are mounting a new campaign to bring the scientific method to ecopsychology and its applied practice, ecotherapy. These researchers have already founded the field’s first peer-reviewed journal, Ecopsychology, and they are about to publish a book outlining their mission. The book, published by MIT Press, advocates serious study of how green spaces color psychological well-being.

“We are hoping to revitalize the field of ecopsychology,” said Jolina Ruckert, a PhD candidate in developmental psychology at the University of Washington and one of the authors of the forthcoming book. “We want to bring in the more rigorous approach of the modern social sciences.”

Science and Skepticism
In the past few years, some ecopsychologists have made significant strides in adding scientific rigor to their field. What their research suggests so far is that even subtle interactions with nature provide a range of cognitive benefits, including elevated mood, enhanced memory, and decreased stress. Staring out a window at pretty scenery can significantly lower one’s heart rate, for example, and some studies even indicate that hospital windows with views of nature can facilitate healing. What’s more, nature provides measurably greater benefits than both manmade environments and simulations of nature. Research demonstrates that walking through the city can tax our attention, whereas a park restores our concentration and can even improve our performance on tests of memory.

These findings come from controlled studies that follow the tenets of mainstream psychology. Despite the new enthusiasm for serious empirical work, many researchers in mainstream psychology remain cautious about drawing any conclusions that ecopsychological studies cannot properly support. “My impression as an outsider is that ecopsychology is a promising but preliminary field,” said Scott O. Lilienfeld, a psychologist at Emory University. “I wouldn’t say it’s conclusive, but there are certainly many suggestions that nature may be helpful for short-term mental health. There’s no question it can have positive effects on mood. I think claims that nature may be helpful are reasonable, but claims that our technological society or distance from nature are massively detrimental to mental health go beyond the current data.”

The fact is that empirical work is a new trend in ecopsychology, which began as a field that wasn’t interested in the experiment so much as the experience — an individual’s personal experience with a natural environment.

“In the beginning, we didn’t need to measure anything,” said Lisa Lynch, an ecopsychology pioneer who now coordinates a masters program in the field at Antioch University in Seattle, Washington. The University of Wisconsin, Oberlin College, and Lewis & Clark College also offer graduate programs in ecopsychology.

Lynch’s graduate work at Antioch is emblematic of ecopsychology’s subjective origins. Like many of her emerging colleagues, Lynch drew inspiration from Roszak’s 1992 The Voice of the Earth to examine how natural spaces — as distinct from urban or manmade environments — affect mental health. But her PhD thesis included no scientific research.

Instead, Lynch designed a creative thesis on the ecology and natural history of a river in Oregon where she grew up — a river in which her 11-year-old sister drowned.

“The ecopsychological element for me was to take my own story of loss and grief and look at its relationship to all these other stories — the salmon, the natives that lived on the river,” Lynch said. “It was 1994 and it this was one of the earliest ecotherapy projects.” She wrote a novel; she choreographed a ceremonial dance; she told her stories. But there were no controlled experiments — just experiences and anecdotes.

“My experiences are not empirical science, but for me they are extremely valid,” Lynch said. A new generation of ecopsychologists disagrees.  Experience, they argue, is not enough.

“Ecopsychology just didn’t have the rigor needed to really understand the relationship between the natural world and mental health,” said the University of Washington’s Ruckert. She belongs to a new generation of ecopsychologists who are trying to establish that rigor by growing a body of empirical work.

Parks and Relaxation
According to Thomas Doherty, a clinical psychologist in Portland, Oregon and the editor of Ecopsychology, research by these second generation ecopsychologists evidences the measurable benefits of nature for both body and mind. In green spaces, for example, people’s heart rates decrease, their muscles relax, and they become calmer. It’s the difference you feel when you leave behind a busy city street for a peaceful park.

A recent study by Ruckert’s advisor Peter Kahn confirmed these findings. First, Kahn stressed out his participants by giving them a series of math tests. Then he placed some people in front of a window overlooking a grassy lawn with trees, others in front of a large plasma television screen displaying the lawn in real time, and still others in front of a blank wall. As expected, those in front of the window experienced the quickest drop in stress levels, as measured by their decreasing heart rate. Participants also spent far more time looking out the window and at the plasma screen than at the blank wall. But the researchers found an unexpected result.

“Surprisingly, the blank wall and the plasma screen were no different in terms of stress reduction,” said Ruckert. Their study indicates that gazing at an authentic natural space reduces stress, whereas a digital replica of nature soothes only as well as a boring blank wall.

Kahn, whose study appeared in the May 2008 issue of the Journal of Environmental Psychology, isn’t sure why the plasma screen failed to relieve stress any better than a blank wall — but he suspects it’s because people recognize even a realistic display of nature as a substitute for the real thing.

Emory’s Lilienfeld thinks Kahn’s study is a good example of how to design empirical ecopsychological studies, but says he won’t be convinced until future studies confirm the findings. “There’s a lot of interesting and provocative work, but studies need to have proper controls and some of them are starting to, I think,” Lilienfeld said. “The plasma screen study is a good example, but it’s still only one study. I think it’s a good design, but I want to see the results replicated. I want to see there is that isn’t just a general effect of relaxation, but really is specific to nature.”

Focus Among the Flowers
In addition to helping us relax, authentic interactions with nature help maintain concentration, according to attention restoration theory. “Our energy to focus gets fatigued,” Doherty explained. “Natural spaces restore our ability to pay attention.”

In a 2008 study at the University of Michigan, Marc Berman asked some participants to memorize digits and recite them in reverse order. Then he had one group of participants walk through an arboretum, while others traveled crowded city streets. Afterwards, the subjects completed the digit task again. Those who’d strolled through the arboretum performed with higher attention and memory than those who had walked in the city. The arboretum-walkers recited an average of 1.5 digits more on their second test than on their first, compared with an average of 0.5 digits improvement for participants who had been exposed to the urban environment.

“Our study was one of the first to make it into a mainstream psychology journal,” said Berman, whose study was published in Psychological Science. “We had a lot of experimental control.” For example, Berman made sure his participants followed consistent paths through the arboretum and streets by monitoring their progress with GPS-enabled wristwatches. And he used standardized surveys to assess people’s mood before and after their walks.

“It was one of the first times that we grounded the human relationship with nature in empirical research,” said Ruckert of Berman’s study. “As ecopsychology increasingly incorporates a more systematic approach, I see it emerging more in the dialogue of mainstream psychology.”

Even Lisa Lynch — the ecopsychology pioneer who believes in the experience over the experiment — is excited by her field’s new empirical directions. “Sometimes it was a little like Peter Kahn and I were fighting with light sabers,” Lynch said. “But I think Kahn and his students are doing some excellent work looking at how can we validate these experiences through science. I think that’s an important move for the field.

Ecopsychology had no peer-reviewed journal of its own until April 2009, when Mary Anne Liebert, Inc. published the first issue of Ecopsychology. Additionally, Ruckert, Peter Kahn and Patricia Habash are the co-editors of an upcoming book with MIT Press entitled Ecopsychology: Science, Totems and the Technological Species, in which around a dozen psychologists, anthropologists and biologists discuss their work and the importance of applying rigorous scientific methods to ecopsychology.

But some ecopsychologists and ecotherapists aren’t so enthusiastic about the new empirical work. “For me the science is not a critical piece,” said Dennis Grannis-Phoenix, the Maine ecotherapist who asked Eric Adams to hike a mountain alone at night. “I’ve seen the changes Eric and my patients go through and they are real.”

Adams, on the other hand — who is now divorced, but lives in Bolivia to be near his children — welcomes science. “People who gravitate towards ecopsychology don’t tend to have that kind of a background,” Adams said. “But it’s not like the scientific perspective and the ecotherapeutic perspective are at odds with each other.”

For Adams, divorce was the right decision — one he reached through ecotherapy. “Rather than conform to my environment, I learned to change my conditions,” Adams said. “Because nature is so much a part of who I am, something about interacting with it helps me to make these big life choices.”

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  1. Using nature as therapist is actually big business. There is risky, unproven “wilderness therapy”– in which kids are often actually literally kidnapped from their beds at 3am, taken in handcuffs to the wilderness and then made to subsist on lizards and other forage, already used for tens of thousands of teens, mostly for drug problems.

    No controlled trials support it. In many states, it’s completely unregulated; in others, it’s under-regulated with one regulator overseeing hundreds of programs containing thousands of kids. Dozens have died– but no federal agency tracks the deaths or regulates the tactics that are allowed.

    It’s one thing if you have no data and you as an adult voluntarily choose to go to the mountains and face your fears as therapy– it’s quite another if you have no data to support doing this forcibly to teens. My book, Help at Any Cost (Riverhead, 2006)examines the complete lack of science behind this coercive use of nature.

    Maia Szalavitz, August 12, 2010 at 12:33 pm
  2. This is what so many of us need. Nature therapy along with a caring healthcare professional. keep up the good work.
    try the smokies in Tenn and North Carolina and North Ga mountains
    as well as the lakes and rivers in all three.

    virginia Adams, August 13, 2010 at 10:14 am
  3. This piece is well-done, in my opinion. There is a growing body of research supporting the mental health benefits of nature experiences, much of it coming from the field of environmental psychology (with which ecopsychology shares important overlaps) – as this piece indicates.

    I hope in time to see more research on the implications of ecopsychology, ecological identity, and so on for environmentally-responsible behavior. When we feel deeply bonded to a place or to the Earth, how do we treat it differently. This, after all, was a focus of Roszak’s early arguments for ecopsychology and remains a core part of ecopsychology. While this is an critical question, there is less research on it. A field sometimes called green psychology, as well as environmental psychology, can contribute to this research, too.

    John Davis, August 13, 2010 at 2:51 pm
  4. Regarding COMMENT 1 from Szalavitz on “wilderness therapy”:

    This portrayal of the field of wilderness therapy is highly inaccurate. Most wilderness therapy programs have a therapeutic orientation, not the “boot-camp” style described here. See, for example, the Outdoor Behavioral Healthcare Research Cooperative and National Association of Therapeutic Schools and Programs.

    There is research on the benefits of wilderness therapy, and it indicates that, by and large, wilderness therapy is effective. Meta-analyses indicate effect sizes of approximately .35 for a broad cross-section of wilderness therapy programs. While this is “only” a moderate effect size, it is definitely positive. And considering that the types of programs and clients researched vary a lot, one would expect that many of those programs have stronger benefits.

    Since this is clinical research, it suffers from the same caveats as other clinical research (frequent use of self-report measures, difficulties in assigning clients to treatments, a multitude of variables at work in the therapeutic setting), but there are some high quality studies, and more research is being done. There have been some notorious violations within the larger field of wilderness therapy, but these are exceptions, not the norm.

    For a more personal account of a therapeutic wilderness therapy program, see Gary Ferguson’s book SHOUTING AT THE SKY. It is a more accurate portrayal of the majority of wilderness therapy programs.

    John Davis, August 13, 2010 at 3:23 pm
  5. I completely agree with the comments above – ‘boot camp’ style programs are a very poor representation of wilderness therapy. Many practitioners of wilderness therapy are critical of boot camp programs, as they often fail to adhere to basic principles of good therapy.

    Regarding the original article, it’s great to hear of others pushing back the empirical boundaries of therapeutic work in nature. While ecotherapy may be a new and evolving practice, the field of adventure therapy (which also goes by names such as wilderness therapy, adventure based counseling, therapeutic adventure, outdoor behavioral healthcare, and more) has a well established global community. A number of books describe common practice elements, including Adventure therapy – Therapeutic applications of adventure programming (Gass, 1993), Islands of healing – A guide to adventure based counseling (Schoel, Prouty & Radcliffe, 1988), and The Promise of Wilderness Therapy (Davis-Berman & Berman, 2008). Considerable empirical work has been undertaken in this area, demonstrating benefits for a range of program types, clients and outcomes. There are still a lot of unanswered questions though. Who benefits the most? How long do benefits last? What types of experiences are most therapeutic? And the big question…Why are experiences in nature often therapeutic? What is needed is high quality research that stands up to close scrutiny. Hopefully some of the new work emerging from the ecotherapy and ecopsychology fields can help fill these gaps.

    Ian Williams, August 17, 2010 at 1:27 am
  6. Ah, I see we have touts for the wilderness industry here. I dare you to provide references to recent (within the last two decades) *controlled* trials of wilderness therapy that have been published in legitimate *peer reviewed* journals (and no, not the one journal put out by the wilderness industry association where the “peers” are all wilderness supporters rather than people who study treatment outcomes).

    Moreover, even the non-controlled research that does exist uses self-report data which has self-selection issues (response bias being the biggie), not to mention the problem of kids who were once kidnapped into the wilderness being afraid to admit they have any problems to people linked with the program who might report back to their parents and do it again! None of these studies even use objective measures like urine tests– and a federal investigation by the GAO found deceptive advertising practices in which programs basically admit any child whose parents can afford the program, so baseline is problematic, too.

    While proponents of these programs claim that they are not “boot camp” style or harsh, there have been deaths related to boot-camp-like tactics at the programs with the best reputations, for example, Eckerd and Catherine Freer. This is an unregulated, billion dollar business which has killed dozens of kids and cannot prove safety let alone efficacy.

    If you have a troubled child and you want them to benefit from the wilderness, take a family camping trip or send them to a voluntary program that is not aimed at troubled teens. At least the voluntary programs have not had deaths caused by staff failing to believe legitimate medical complaints like needing water or being unable to control bowels. In contrast, virtually every death in the for-profit programs has resulted from untrained staff not knowing things like the fact that psychiatric medications reduce heat tolerance or simply dismissing any complaint as “faking” without seeking medical care to check.

    Maia Szalavitz, August 18, 2010 at 9:28 pm
  7. P.S. Two of the children who died whose parents testified at the Congressional hearings on the issue of abuse in “troubled teen” and wilderness programs died at programs belonging to the National Association of Therapeutic Schools and Programs, cited above as having only programs with a “therapeutic” orientation.

    If you want to see someone get completely obliterated for being unable to support her claims and her industry, check out the grilling of Jan Moss of NATSAP here http://edlabor.house.gov/hearings/full-committee/ (Scroll down to the Oct. 2007 hearing and the archived webcast).

    Maia Szalavitz, August 18, 2010 at 9:37 pm
  8. I also disagree with comments 5 and 6 above. ‘Boot camps’ have become a bit of a red herring in the wilderness therapy industry. While it’s true that not all wilderness therapy programs make participants forage for food or eat lizards, the industry does support the use of escort services which transport youth–often against their will–to participate in therapeutic intervention. Youth consent is subjugated by concepts such as ‘natural consequences’ and the healing power of exposure to nature. Allegations of abuse and neglect are directed at wilderness therapy programs, the same type of programs that belong to the OBHIC and NATSAP.

    Poorly run programs and shock incarceration programs do exist, and are a cause for great concern, but to claim that they aren’t representative of the industry avoids critical ethical issues in the wilderness therapy field. As Ms. Szalavitz correctly points out, independent academic research in the field raises questions about efficacy. References to the several meta-analyses which have been published frequently fail to mention the findings of the Cason and Gillis (1994) meta-analysis in which the authors demonstrate that the more stringent the methodology, the lower the effect size. Research on the industry is far from conclusive and yet as the two previous posters have demonstrated, claims that wilderness therapy is effective are tacitly accepted by industry members.

    The wilderness therapy industry violates the rights of young people by ignoring their consent to participate and imposing highly-structured therapeutic regiments. Adopting nature-based models assumes that nature is an environment separate from human society. In fact, nature is a social construct, a subjective way of interpreting the human social environment (Raymond Williams, Ideas of Nature 1980) and imposing those beliefs on others. If consenting adults get benefits from spending time in nature, that’s great. But I think we should be extremely cautious about over-generalizing these findings and using them to support the use of wilderness therapy for young people.

    Andrew Fitzgerald, August 19, 2010 at 2:12 pm
  9. All nature is now managed. Parks are manmade just as much as city streets. While I think there is some very promising research to be had in ecopsychology, the term “nature” has to be deconstructed a bit to even begin to make sense.

    Is it seeing trees that lead to stress relief? Or is it a reduction in decibels of sound? Or number of people on the street? There are so many variables and so few that can be controlled that I wonder if ecopsychology was better off being a vague feeling that something is missing from our modern world, and that something has something to do with the destruction of natural places.

    Duff, August 19, 2010 at 3:29 pm
  10. I fail to see how “Boot Camp” programs count as Eco-therapy or any other type of therapy, regardless of how they are presented to the public. While any sort of intervention might be necessary for troubled individuals as a last resort, they can hardly be considered to be a form of therapy. At best they can lead to therapy IF the intervention subject receives the wake up call from friends and loved ones and voluntary seeks therapeutic help of some sort. My guess is that “Boot Camp” interventions are promoted by charlatans preying on parents’ fears and sense of helplessness.

    Regarding ethical Eco-therapy, it’s a good thing that practitioners and others are searching for empirical evidence to either prove or disprove the therapy’s efficacy. But even absent empirical proof, it’s hard to see how the eco component to eco therapy is doing any harm (assuming the therapy component is being done correctly). Couldn’t hurt, might help.

    The usual argument against untested methods is opportunity costs. I don’t see how the eco-component adds any substantial opportunity cost to conventional therapy.

    Marcos El Malo, September 19, 2010 at 5:00 pm
  11. Hey ho! There are always cynics hiding behind the techno-rational screen of ‘science’ who always ask for more proof instead of using their own experience and observations. The benefits of contact with nature are well studied and there are an increasing number of ‘controlled’ trials.
    Some of these criticism are actually fuelled in my view by the established writers in the Ecotherapy field because they use such sweeping generalisations and strident language that it is enough to alienate people and incite criticism even among supporters (and I’m one of them).
    Leaving aside such tedious debates, and looking outside the literature on Ecopsychology, we are surrounded by evidence of the commonplace benefits of contact with the natural environment for human wellbeing.
    And if that isn’t enough, for a little light and illuminating reading, try The Secret Life of Trees, by Colin Tudge, and Landscape and Memory, by the eminent (academic) historian Simon Schama.
    Both books are replete with examples of our relationship with our natural environment, our dependence on it, and the befits we derive. Neither of these authors has any ‘Eco’ or ‘Psycho’ axe to grind, which makes them all the more convincing.

    Barry Winbolt, August 12, 2012 at 6:19 am
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