A History of Taking Therapy Outside
Early psychotherapy was not as exclusively held indoors as it is today; according to Martin Jordan and Hayley Marshall (2010), Freud held his earlier sessions walking the streets of Vienna. Additionally, Freud is thought to have enjoyed spending his free time hiking in nature, and he even held some sessions, with a few of his patients, walking along wilderness trails (Gay, 1998). Unfortunately, any literature that may offer insight to Freud’s behaviour or thinking about these outdoor sessions is either difficult to find or absent. In general, Freud (1961) viewed nature as disconnected from the human psyche, and seemed to view it as dangerous, despite apparently enjoying the outdoors, “[t]he principle task of civilisation, its actual raison d’être, is to defend us against nature” (p. 15).
Jung also held therapy sessions in the woods, and in particular he enjoyed being near running water; apparently Jung felt more at ease in the woods than in urban environments (Roszak, 1998). Illustrating his love of the woods, Jung’s (1968, 1989) theories embraced nature and had similarities to ecopsychology, such as his belief that a source of human psychological disturbance is due to our isolation with nature. Jung (1968) theorised that as nature has no boundaries it cannot be located outside of the body; as Sabini (2002) put it: “my self is not confined to my body. It extends into all the things I have made and all the things around me” (p. 155). Jung (1989) also described personal experiences of profound vastness, as if he were living in a tree and the ocean, and, did not link them back to womb or mother/infant experiences, which might occur in more Freudian influenced psychotherapy.
Robert Greenway became interested in psychoecology in the 1950s, and he went on to teach the subject at Sonoma State University in 1968. Twenty years later, one of Greenway’s students, Elan Shapiro, began an extracurricular psychoecology discussion group (Scull, 2008). The reputation of these meetings, which included prominent ecopsychology figures such as Mary Gomes and Alan Kannar, attracted Social Historian Theodore Roszak’s attention, and from this beginning he authored The Voice of the Earth (1992), wherein he developed the theory of ecopsychology (Schroll, 2004). Roszak’s work drew on his earlier writings (see: 1972, 1978) and work by Ecologist Paul Shepard (1982) (Scull, 2008). Roszak (1998) had the view that psychology needed to understand the human psyche in conjunction with the natural environment, a split that he traced back to the founder of psychotherapy, Sigmund Freud.
Before Roszak’s time, some theorists radically critiqued and modified Freud’s theories by gradually expanding the scope of therapy beyond the strictly intrapsychic. “Alfred Adler, Otto Rank, Carl Jung, neo-Freudians such as Erich Fromm, Karen Horney, the ego analysts and object relations therapists” (Clinebell, 1996, p. 129) as well as Harold Searles (1960). This expansion outwards, beyond the intrapsychic, brought interpersonal dynamics into therapy, which helped to pave the way for ecopsychology. This brief history offers an entry place for therapists to think about nature, especially for those who prefer to follow in the footsteps of historical figures of therapy (Santostefano, 2008).
What is Ecotherapy?
Ecotherapy (or applied ecopsychology) is based on ecopsychology theory. Broadly speaking it is a psychology that incorporates ecology, which aims to be holistic in theory and practice. Ecopsychologist Mary-Jayne Rust (2009) described it as “listening with the earth in mind” (p. 39). The perceived needs of the earth and the individual human are respected equally in ecotherapy, as it is grounded in the belief that both are (or, in essence, everything is) interdependent and interconnected (S. Conn, 1998). This means that from an ecotherapy perspective, the health of human beings is viewed in the context of the health of the planet; as Swimme and Berry (1994) put it: “[w]e cannot have well humans on a sick planet” (p. 257). Howard Clinebell (1996), one of the original writers on ecotherapy, talks about the interdependence of body alienation and nature alienation; if we are struggling to take care of our own human body, then we are likely to find it difficult to care for the larger body of our earth.
As humans, we are struggling to maintain our own physical, emotional, and spiritual wellbeing. Currently the human race is more obese, anxious, depressed, and isolated than ever before (Flegal, Carroll, Kuczmarski, & Johnson, 1998; Leahy, 2010; Ludwig & Nestle, 2008; Nestle & Jacobson, 2000; Twenge & Campbell, 2010). It is hard to take care of ourselves individually and our families in the face of the modern challenges and expectations that we encounter in our everyday lives. Without some degree of stability and health, it is difficult to consider and work on the needs of others, such as the need to take care of our planet, and all beings upon it. This need is hard to address if we have not gained equilibrium with our more base human needs, such as safety and stability. However, at times it seems as though fulfilling our needs are endless. Rather than solely focusing on meeting our own needs, interdependence tells us that through taking care of those around us, we help to take care of ourselves (Loori, 2002).
All modalities of ecotherapy aim to heal this human-nature relationship, for the individual and the collective, through facilitating people to reconnect with nature and their own bodies (Buzzell & Chalquist, 2009b; Buzzell, 2009b). Rust (2012) has refined this idea of reconnecting, preferring to conceptualise it as realising (or deepening) our intimate relationship with nature, maintaining that as we are never outside of, or unconnected to nature, we cannot “reconnect” with it. Although I agree with this point, for many of us, realising our interconnectedness with nature, or anything, can be difficult to experience. In my experience, there are many ways to access the experience of connection or oneness; it may be through developing the belief of interconnectedness and then beginning to feel this slowly or suddenly, or through having the experience without understanding the meaning. As I have only experienced this feeling in the wilderness or through spiritual practices, I wonder how easy this is to develop during indoor therapy.
This idea of reconnection points to a key ecopsychology theory that seeks to remind humans that we are animals who are part of the natural world, rather than separate from it (Jones, 2010; Totton, 2011). This concept is applied in ecotherapy, by expanding therapy beyond the conventional focus on the intrapsychic and the interpersonal, and it steps (literally at times) out into the world, incorporating and recognising the environment as a third partner in the therapy (Nicholsen, 2009). This notion diverges from some modalities of therapy (and in my experience, the majority) that do not recognise nature or our environment as a part of the therapy, thereby promoting the treatment of the client in a vacuum (Berger & McLeod, 2006) rather than addressing (what is inadequately described as) both the internal and external worlds (Hillman & Ventura, 1993). For example, in ecotherapy, space is created for the client to express despair over climate change through the therapist acknowledging and responding to this as a valid topic. In other modalities of therapy, this issue might instead be linked back into the intrapsychic or interpersonal, perhaps by the therapist wondering (and possibly offering an interpretation) if the client is projecting their destructive impulses out onto the other; a response that pathologises personal pain (S. Conn, 1995).
Often, ecotherapy takes place outside as this is a palpable way to bring nature into therapy; however, it is also possible to practice ecotherapy inside. Therapists such as William Cahalan (1995) and Sara Harris (2009) bring nature indoors through incorporating sounds, smells, and sights of nature into the therapy room. Ecopsychologist and Body Psychotherapist Nick Totton (2011) states that “wild therapy”, which is similar to ecotherapy, does not need to occur in any particular environment: “it is an attitude of mind, rather than a bag of tricks, and this attitude may express itself in a great variety of ways, including sitting in a room and talking” (p. 183).
Ecotherapy manifests in a diverse range of modalities and due to this, I had to exclude some modalities for the purposes of this literature review. In this section, I have provided a general overview of many of the current practices in order to illustrate the diversity of this field. These modalities are: green exercise, green views, horticultural therapy, wilderness therapy, shamanic influenced ecotherapy, body therapy, expressive art ecotherapy, eco-dreamwork, animal-assisted therapy, outdoor ecotherapy, and group work for developing a sustainable lifestyle. As the field of ecotherapy develops, it is likely that some of these modalities will evolve or disappear.
One modality of ecotherapy is green exercise, this is any intensity of physical activity that includes direct exposure to nature (Pretty, Peacock, Sellens, & Griffin, 2005). It could be walking outside in a park, working out in a gym with a view or images of nature, participating in an active conservation or restoration project, or any form of outdoor recreation such as mountain biking or skiing (Pretty et al., 2007). Another modality utilises green views, which is an indoor healing or therapeutic space with a view of nature such as a lake, trees, or a garden, and there is evidence that people heal faster with a green view (Ulrich, 1984; Vries et al., 2003). Personally, I have experienced the benefits of green views whilst working on this dissertation. My workspace has large windows that overlook native trees and birds, the sky, and the sea is near with its refreshing ions and breeze. This has had a moderately calming and restorative effect on me; being able to see the trees so close, and able to walk in nature (albeit briefly) when I need a break from the computer. This also helps me to feel connected into the world and less isolated as much of my day is away from other humans.
Horticultural therapy (or outdoor restoration) is the process of caring for, and tending to the outdoors, such as gardening, rubbish removal, and replanting activities. For instance, the Natural Growth Project in the United Kingdom works with torture survivors by providing allotment or communal gardens (depending on the degree of trauma) and weekly visits from a gardener and a psychotherapist (Linden & Grut, 2002).
Wilderness therapy is another modality of ecotherapy; this term covers a wide range of philosophies and activities, which makes it hard to define (Russell, 2001). In general it is being in the wilderness (defined as being away from centres of high population and artificial structures) for the purpose of therapeutic interventions (Russell, 2001). Activities can be primarily experiential, such as adventure-based therapy or outdoor rehabilitation programmes, where challenges within the participants or nature are overcome, thereby developing self-confidence; or primarily therapeutic, where nature is not treated as a resource to be conquered, and is considered to be inherently therapeutic. The particular definition I am drawn to (as it aligns with my experience and philosophy of wilderness or wildness) is that the wilderness needs to be encountered with therapeutic intentions, rather than mastery (Russell, 2001). For instance, the Natural Change Foundation (naturalchange.org.uk) was developed to inspire community leaders to live sustainably through solo experiences in nature. This project included overnight stays in the wilderness and a day spent alone in one spot, participants then had group processing time to share their experiences, which for many, where thought-provoking (Natural Change Foundation, 2014). The School of Lost Borders (schooloflostborders.org) offers a variety of programmes, which can include vision quests, fasting, and solo excursions utilising indigenous traditions. This links with another ecotherapy modality that uses shamanic ritual practices, states of consciousness, and re-wilding the soul, such as connecting with your power animal (Buzzell & Chalquist, 2009a).
Another modality of ecotherapy focuses primarily on movement (body therapy) such as dance, yoga, role-playing, and sensory awareness to deepen or develop a connection with their human body and the larger body of planet (Clinebell, 1996). There is also expressive art ecotherapy – using the creative process to connect with nature. The range of mediums used are extensive, some examples are poetry, craft work, drawing, or creating sounds or music (Degges-White & Davis, 2010). Eco-dreamwork is another ecotherapy modality, based on Jungian ideas, it utilises the unconscious by working with dreams to reveal and process our unconscious feelings and the meaning of dreams in relationship to the earth. Sometimes these dreams are viewed as the channelling of the collective unconscious via an individual’s dreams and symptoms, and some people are considered to be the mediums of these voices (Buzzell & Chalquist, 2009a; Prentice, 2003).
An ecotherapy modality called animal-assisted therapy brings humans into contact with other animals in an attempt to promote healing of a human being, and in some modalities, to be of benefit to the non-human as well (DeMayo, 2009). For healing of both human and animal to occur, it is important that all participants can choose whether they enter into a therapeutic encounter, and the intention is for all participants to benefit from the alliance (DeMayo, 2009). The animals involved are generally marine animals and mammals (such as dolphins), domestic animals and pets, and farm animals (King, 2007).
There is also an ecotherapy practice of taking talk therapy outdoors; this could be in the therapist’s private garden, a community garden, or a public space such as a park. This practice often incorporates elements of mindfulness practices. In the outdoor therapy space, both nature and the human being(s) are the therapists who are assisting the client towards healing; the primary therapist role can oscillate between nature or human depending on the needs of the client. Another modality of ecotherapy is helping people to align their lifestyle to their values. For example, Eco-Philosopher Joanna Macy’s and Therapist Molly Brown’s (1998) Work that Reconnects (influenced by deep ecology, systems theory, and spiritual traditions), aims to assist participants in the transition towards a sustainable human culture.
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