In times of stress nature has always soothed me. Since isolation restrictions due to coronavirus were put in place it has been one of my biggest daily resources, helping me to negotiate my way through these challenging times. From what I can glean from conversations with friends, observations while out and about and social media, nature is proving a resource for many others too. I submitted a thesis the week after social distancing measures began looking at nature's impact on mental health and the potential of taking therapy outdoors (something I already offer clients). I got my results last week, and thought now might be a good time to share it with you. Today I will share a slightly edited version of the first chapter of "Counselling al fresco: is there a case for taking therapy outdoors", which offers an explanation for why nature is sustaining many of us right now and shows how it can help even those who are cocooning.
Nature and mental health
Getting out of the house and seeing the blackthorns and lime tree opposite our cottage induces a response in me that I can only describe as a neuronal sigh of relief: an unseen, silent reaction in the brain that is simultaneously soothing and curative. (Mitchell, 2019, p. 5) Anecdotal evidence has long suggested that nature is a resource for improving and
maintaining mental health. A stroll on the beach seldom gets bad reviews. Walking the dog is for the person attached to the other end of the leash too. Weeding, pruning, planting and harvesting is good for more than just the garden.
Research looking at exactly how nature benefits mental health is becoming more common, and the picture is becoming clearer: the anecdotal evidence is slowly being more and more comprehensively backed up by empirical evidence that points towards nature being much more than just an aesthetically pleasing backdrop to busy lives.
Roger Ulrich is something of a pioneer in the area, with many studies looking at nature as a stress-reducer. He found that views of nature with predominantly green vegetation “significantly improved the emotional states of stressed individuals” (Ulrich, 1981, p. 524) compared with exposure to urban scenes with no nature elements, which tended to have the opposite effect.
Psychologist Stephen Kaplan has also authored pioneering work researching the connection between nature and mental health. Together with Rachel Kaplan he came up with the idea of attention restoration theory (ART). Attention restoration is the antidote to directed attention fatigue, a state arrived at after mental effort has been put into concentrating intensely on one thing and ignoring distractions. Kaplan (1995) suggests that nature is an ideal restorative environment, where one’s attention is held involuntarily and with little effort. He argues that a reaction to beauty in nature is far from trivial, and that behind the reaction is an assessment of the environment culminating in a judgement that the area is compatible with human needs and where we are likely to function best (Kaplan & Kaplan, 1989).
A 90-minute walk in nature has been shown to lower levels of rumination and result in less neural activity in the part of the brain linked to risk for mental illness, when compared with a similar walk in an urban setting (Bratman et al., 2015). A meta-analysis by Robertson et al. (2012) found walking to be an effective intervention for depression, and noted a statistically significant, large effect on its symptoms in some populations. A study by Harvey et al. (2018) concluded that even small amounts of exercise could protect against future depressive episodes. O’Mara (2019) describes walking as a “simple, doable, personal fix” (p. 4) that allows him to “walk it off, whatever it is” (p. 12).
Mind, a charity working in England and Wales that promotes ecotherapy as a mental health treatment, found that people’s mental health significantly improved after activities in nature (Bragg et al., 2013; MIND, 2007, 2013). Being outdoors has been linked to positive effects on feelings of vitality (Ryan et al., 2010), while even small, short engagements with nature have been found to make for better cognitive control (Berman et al., 2008).
Students in Canada who completed a 17-minute walk between two campus locations along a riverbank reported improvements in mood to the order of about one-third compared to those who made the journey via underground tunnels (Nisbet & Zelenski, 2011), though interestingly substantially underestimated how the outdoors walk would make them feel compared to the indoor alternative. Pretty et al. (2005) found that green exercise (exercise in the presence of nature) is more effective than exercise alone in improving mental health, while Barton and Pretty (2010) concluded that while exercise in nature improved self-esteem and mood, exercise in the presence of nature including water made for more improvements. As Mitchell (2019) eloquently describes: “walking in a garden, field or wood is like reaching into an invisible natural medicine cabinet” (p. 10).
Being in nature makes for a better ability to reflect (Mayer et al., 2009). O’Mara (2019) makes a connected observation regarding the inclusion of cloisters in building designs of the past, allowing people to walk and think outdoors while simultaneously being protected from inclement weather. A report for Mind charity also makes mention of nature’s role in mental health in the past, in particular how mental health institutions were “often situated in pleasant gardens and natural landscapes” (Mind, 2007, p. 4).
Nature has an impact even when viewed from indoors. A study of hospital patients discovered that those in rooms with windows looking out at a tree had shorter post-operative stays, had fewer negative evaluative comments from nurses, took fewer moderate and strong analgesic medicine doses and had slightly lower scores for minor postsurgical complications than their fellow patients in rooms looking out at a brick wall (Ulrich, 1984). Meanwhile workers in an office setting have been found to be more hostile, anxious and depressed than those working in rooms with windows, while those working near windows are reportedly more content than their colleagues seated further away (Selhub & Logan, 2012).
Nature does not have to remain outside to positively influence a person’s mental health. Adding plants to an indoor room makes for a better mood (Selhub & Logan, 2012), while McGeeney (2016, p. 74) argues that adding “a bowl of fresh flowers or a potted plant can make a difference” in the therapy room. Fearful patients waiting to see the dentist have been found to be less stressed when a large nature mural was added to a previously blank wall (Heerwagen, 1990, as cited in McGeeney, 2016, p. 77). A study recording intentional damage to artwork at a Swedish psychiatric hospital over two decades found that no pictures of nature were touched over the duration of the study (Ulrich, 1986, as cited in McGeeney, 2016, p. 74).
Raynor Winn and her husband set off on a 630-mile walk in 2013 when they became homeless in their 50s. A tough existence with few comforts, Winn (2019, p. 370) nonetheless describes nature as her safe place and acknowledges how the couple changed with their path, becoming “stronger, calmer, our passage quieter”.
The ancient intuitive understanding that nature plays a very important role in mental health has more recently been augmented with theories and supported in a wide range of research studies.
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