This chapter offers some further practical applications of ecotherapy that were not covered earlier, as they did not belong in any of the five categories of obstacles. I believe that it is important to provide therapists who want to practice ecotherapy with a variety of situations where ecotherapy can be used. This is useful as this area needs development (S. Conn, 1995), in addition to offering therapists options so that they can decide what suits them and their practice modality. This chapter provides examples of what practicing ecotherapists are doing in sessions, this includes an ecotherapy assessment; how to develop a sense of connection, awareness, and mindfulness with nature, along with exercises for clients outside of therapy; and how to practice outdoor ecotherapy.
When assessing and meeting a client for the first time, it is helpful to gain information about the relationship between a client’s sense of place and their health, and what ecosystem the client inhabits (Buzzell, 2009a). Specifically asking about the client’s relationships with people, nature, and animals; their concept of “home” such as where they and their ancestors were born and live now; do they have now (or in their past) special environments that they connected with or felt at peace in (Buzzell, 2009a; Cahalan, 1995; Milton, 2009; Rust, 2009; Scull, 2009). Ecotherapists are interested in where and how clients spend their time and what makes up these spaces, such as the lighting (Buzzell, 2009a; Rust, 2009). How often are they are touched and how; do they spend most of their time, with loved ones or strangers, or do they spend a lot of time alone; how active are they and where; how is much sleep do they get; and how much time do they spend watching television or in front of other electronic equipment? (Buzzell, 2009a; Rust, 2009) In addition, it is helpful for therapists to ask whether the client prefers indoor or outdoor spaces, and if they know the reasons behind this preference, such as an event in their past or their associations with spaces (Rust, 2009).
After gathering this information, therapists need to be able to use it to influence their formulation or treatment planning. The ecological is included alongside the psychodynamic (or the chosen modality), by acknowledging the client’s relationships with nature and their environment, and assessing for relationships and behaviours that are contributing to their presenting problems; this is examining and understanding clients within all that influences their life, rather just their human relationships (Cook, 2012). This seems like a challenging endeavour, one requiring creativity, and freedom in how the therapist practices, along with a supportive supervisor or at the very least, supportive colleagues:
psychologists and other mental health professionals may find great support and energy in coming together to discuss this professional journey, especially if we move outside of our usual groups and debate these issues with colleagues from a range of disciplines and experiment with new ways of practice together. (Milton, 2009, p. 12)
A different approach is offered by Cahalan (1995) who wrote about exploring with clients what type of animal they are like, what are the animal’s traits, and how does this animal relate to client. Although this might feel strange at first, it can provide useful information, such as whether there is dissonance between their chosen animal, and how the therapist experiences the client (Cahalan, 1995). Depending on the client, Buzzell (2009a) asks about their relationship with the sacred, and if they have felt close to mysteries in life. This assessment is to determine “the role place and space play in this person’s life, and whether, how, and why, place and space are involved in the person’s conflicts” (Santostefano, 2008, p. 550), in addition to how humans and non-humans have contributed to the clients current struggles. According to Buzzell (2009a) clients are often surprised by these questions as they are more familiar with the impact of genetics, family dynamics, themselves, or neurochemicals; rather than how modern lifestyles can take a massive toll on an individual’s psyche. She also explores how they feel about the state of the world, and if they have children/grandchild, whether they imagine life will be easier or more challenging for them than their lives are (Buzzell, 2009a). According to Psychotherapist Chris Robertson (2012), the client’s struggles have manifested through personal and collective history, and some clients could be considered the designated clients for the earth, as they are particularly sensitive to hearing its message.
Awareness and Practice
There are many ways for a client (or anyone) to practice connecting into the world and developing awareness, many of these ways utilise mindfulness techniques such as: meditation, drawing, looking, listening, writing, keeping a time-diary, simplifying lifestyles, having a weeklong media fast, and changing eating habits (Buzzell, 2009a; S. Conn, 1995; Gomes, 2012). Conn (1998) encourages clients to search for some form of connection with the natural world that feels restorative, and to focus on sources of nourishment. Therapy sessions can be as held walking in nature and allowing the client to feel drawn to places or objects, and voicing any associations or responses that arise. Conn (1998) would also help the client to develop an awareness of emotional states by taking time to discover a mindfulness practice that works for the client, and then having them practice it by describing a physical space, such as their apartment. Once their relationship is established, they spend a few sessions, or more if needed, talking about going outside, and exploring how the client feels it could help them. For instance, a client felt that going outside would help her to be able to hold contrasts or extremes, something she normally struggled with (S. Conn, 1998). In this example, the client appeared to find her emotional vulnerability soothed by nature, perhaps by seeing trees adapt and survive through rain and wind, or by expanding her awareness beyond her personal troubles. Based on this case example, I speculate that (for therapists who prefer to use diagnostic terms) some clients with borderline traits or personalities could also notice a similar soothing effect with exploring outdoor therapy.
For therapists wanting to practice ecotherapy, a useful tip is to oscillate awareness between the personal and the larger areas, such as the political, ecological, and cultural. (S. Conn, 1995). In this manner the tendency of client or therapist to pathologise personal pain is reduced, as the pain is situated (and held) in the larger context, enabling other hurts to be acknowledged (S. Conn, 1995). For example, when treating a client with a sexual abuse history a therapist could explore a range of areas, from the very personal sphere, to the cultural context and gender concerns, and then shifting further out to the environmental abuse (S. Conn, 1995). Santostefano (2008) and Totton (2011) have suggested that these spheres are also the networks of places, people, and animals that form embodied meanings, which in therapy, client and therapist seek to discover and understand.
Psychoanalyst Shierry Weber Nicholson (2009) has presented an example of a client’s beloved pet dying; the client feels silly or unjustified about feeling upset as it was not a person (2009). This is a good opening, according to Nicholson (2009) to provide, “them [clients] space to feel, to go beyond the embarrassment, and the sense of illegitimacy and feel that grief.” (p.110). Another potential scenario is a client raising the topic of environmental degradation or pollution, or their distress about the environment. When practicing ecotherapy, the therapist does not interpret these as displacements or projections from an inner source (Mack, 1995; Watkins, 2009). Instead, the topic is considered within the scope of therapy and worthy of direct exploration.
At times, it may be useful to offer the client exercises to practice outside of therapy. These exercises depend on what the client appears to need to cultivate, support, or release. Some examples are, going outside at dawn, sitting under the night stars, searching for something in nature that reminds them of a particular person, or being open to an object that chooses them (Harris, 2009). This object can be a tree, rock, or a landscape that is convenient for the client to visit daily, spending time in silence. In all of these exercises, the client guides the therapist to discover suitable homework (L. Conn & Conn, 2009; Harris, 2009). These exercises foster an appreciation for just being, allowing the client’s sense of time to slow down as they develop an awareness of their connection with the object, and hopefully, broadening their sense of boundaries (L. Conn & Conn, 2009). Identification with a natural phenomenon, animal, landscape, or plant helps people emotionally engage with nature and re-establish an ancient connection that has been severed (Roszak, 2001; Seed, Macy, Fleming, & Naess, 1988). In this respect, nature therapy joins ecotherapy by offering a practical framework that can be used to broaden people's "ecological selves" (Totton, 2003) and hone the importance of this basic human-nature alliance (Berger, 2009a).
Buzzell (2009a) often begins treatment with a nature journal whereby clients record time spent outside, sometimes with surprising results, as some clients spend less than 30 minutes outside per day, other than walking to and from their cars. Therapists can encourage their clients to slow down, and to spend time in nature (Walsh, 2009), especially whilst exercising, as this is can improve their health and wellbeing, receiving the combined benefits of physical activity and the restorative qualities of nature (Mind, 2007).
There is a range of options for seeing clients outdoors. Some therapists have a private space such as a garden where they can see clients undisturbed by passers-by. Psychotherapist and Ecotherapist Linda Buzzell believes that introducing and respectfully acknowledging the natural world as a third party in the therapy expands the therapy conversation. Buzzell (2009a) practices ecotherapy in her permaculture garden where the client is invited to choose the space to spend time in, and to explore their process behind this choice. In Buzzell’s (2009a) experience, the space tends to reflect an aspect of the client or the session. This approach seems to fit better for therapists in private practice, although an agency could have a shared garden as long as there is due consideration to the privacy needs of the client (and therapist). The benefits of a private outside therapy space include easy access (i.e., in therapist’s backyard), the possibility of setting up a sunroom/shelter to protect against the elements, fewer contracting or frame considerations (see framework section), and being able to design the garden. These benefits make this a good option for therapists living in urban areas with limited or no access to suitable public greenspaces. In contrast, the limitations are that options of how to use the space is limited; a private garden will generally not be large enough for incorporating walking, or varied enough for more contextually-orientated therapy, or other activities (see below) into sessions.
Outdoor spaces that are suitable vary on the type of therapy practiced. Some therapists take clients on walks through forest areas situated nearby, others use a public park to use a combination of walking and sitting, or they can just sit in an area chosen by the client. Sometimes time is spent silently with the client gesturing to indicate areas of interest, or therapist and client separate and meet at an agreed place and time, and reflect on the clients process, and when appropriate, the therapists process (Cahalan, 1995). When working with groups or individuals in a nature walk meditation or activity, Scull (2009) recommends a three step process. The first step is giving mindfulness instructions (preparation), followed by the experience, which is solitary and/or silent, and then debriefing with a particular focus on the individual’s sensory experience and discouraging theorising.
Other outdoor practices involve the client engaging in an activity that the therapist believes might facilitate healing, such as a client named Ran, who was experiencing intestinal symptoms resulting from stress (Berger & McLeod, 2006). Ran described his stomach as revolting and unpleasant, like “wet soil”. Instead of working with the metaphor, the therapist asked and gained the clients permission to go outside and work with actual soil. Through a series of activities where Ran interacted with the earth, he processed and reflected on painful childhood memories, until he realised how much he had missed his childhood and being playful, and how this affected himself, and his relationship with his children. This illustrates a shift from working person to person, to person and nature with therapist acting as mediator. This approach might work well for clients who feel that talk therapy is not the best fit for them, and where a more tactile or body-oriented process in relationship with the natural world in conjunction with talking helps shift blockages (Berger & McLeod, 2006). Watkins (2009) practices near a lake and woods with children who feel safer out under the sky, as it is wider and less personal than at home, which they have experienced as dangerous.
Another option is creating a home in nature. This is a therapeutic/sacred space chosen, created, and maintained by the client, with the assistance of the therapist; this space is very important as it influences the entire therapeutic encounter (Berger, 2007b). Through creating a home in nature, clients create their own space and can tell stories about its meaning, it can also be incorporated into the creation and performance of rituals (see: Berger, 2007a).
Therapists with access to suitable public outdoor spaces and the flexibility to practice in different locations face additional challenges, as there is the need for more contracting with clients, particularly in the initial stages in order to establish the frame, context, and what happens with variable weather, such as who decides and how is this decided. Also discussing with the client how he or she might like different situations that may arise handled, and safety/first aid practicalities if an accident occurs.
In outdoor therapy there is a flattening of power and hierarchy between client and therapist, as the space is not owned and controlled by the therapist (Berger, 2007b). Whereas indoor therapy can create the dynamic of the therapist as expert, which could lead to the client feeling passive; the more passive a client is, the less benefit they will gain from therapy (Duncan, Miller, & Sparks, 2011; Lambert & Barley, 2001; Miller, Mee-Lee, Plum, & Hubble, 2005; Norcross, 2011). Therefore being outside can be a unique advantage for some clients, possibly helping them to feel freer and more empowered than if seen indoors. Gestalt and person-centred therapies come to mind as therapies that also aim for this flattening of hierarchy; “a horizontal dialogue” (Houston, 2003, p. 6), where therapists are not the expert, and instead they trust the client’s own wisdom and ability, as a self-regarding and individual being (Gillon, 2007).
There is a symbolic power to being outside (Jung, 1968), the open sky, exposed to changing forces; this can create a feeling of openness, perhaps dissipating the insulating effect of the indoor therapy room (Roszak, Gomes, & Kanner, 1995). I wonder if, for some clients, being outside might feel dangerous, too large, and uncontained (Counselling and Psychotherapy Outdoors, 2009), perhaps they prefer the comfort of feeling as though the therapist owns the space and holds more power.
In my opinion, working outdoors could reduce the likelihood of the client compartmentalising their life inside and outside of therapy, this is because therapy occurs in a neutral outside space that is more similar to where their life occurs than inside the therapist’s room. The therapist’s office is a private space, compared to the publicly shared space of a park; this division could lead to clients acting differently in the therapist’s private domain compared to when they are in a public domain. If a client has insights that they feel are lost when they leave the therapy room, perhaps working outdoors in a more public space could help them to feel the continuity (and enhanced benefit) of therapy in the rest of their life. In addition, different spaces influence our entire being, therefore changing the therapy space could help the client and therapist access new material, changing the conversation and perhaps moving the therapy along in a positive way.
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