Not your typical therapy session

by Maeve Peoples

“If you go down in the woods today, you’re sure of a big surprise…” (Kennedy, 1932)

We amble up the forestry path. The sun is shining, but there’s a cold sharp breeze, the kind that can be quite cutting. The evergreen trees provide plenty of shelter. I’m thankful for this today.

This walk isn’t about getting steps in or exercising. No, this walk is different.

“What do you mean, you do therapy in the woods?” a prospective client asks. I’m comfortable with this question now, although I wasn’t always. In particular when I first started out.

The pandemic changed everything. This included how I worked as a psychotherapist. No longer was I able to meet clients in the office. We were all too scared of what we didn’t understand. I tried to adapt to online therapy with my clients. While I found that it worked for some, it didn’t work for everyone. I’m still trying to understand why that is. But as we all know, just like therapy itself, there is no one prescriptive formula that works for everyone.

Ask anyone what a psychotherapist’s office might look like, and most people will think about Freud and his infamous couch. A client lying across it with the man himself sitting at the end writing notes. The couch now resides in London, free from the burden of dreams, traumas and phobias. It was recently restored, continuing the cultural legacy of Freud’s work.

So what does a psychotherapy space need? Bookshelves with psychology and psychotherapy texts. A desk, at which to write notes. Objets d’art. Paintings on the wall. Qualifications, framed and hung. A box of tissues. Chairs placed at just the correct distance apart. Personal, but not too personal. A professional tone. What does this space tell a prospective client about the therapist? What is the therapist, consciously or unconsciously, relaying about themselves?

Working therapeutically outside of an office space wasn’t something that my fellow students and I had explored in my psychotherapy training. Indeed, very little time was spent on discussing what a therapeutic space might, or should, look like. I remember there being some discussion around whether the client or the therapist should sit closer to the door. Safer for the therapist, a chance to get out if things turned sour. Or, a feeling of safety for the client, knowing they were closer to the exit. Symbolic of their ability to hold some control over what was happening in the therapy session.

So what to do? I needed an alternative to the office space. So I took a risk. I’d never heard of people doing therapy in the woods. I didn’t know what that might look like. But I knew that I had to think differently and I needed to address the problem in a creative way. I also knew I had to adapt to how the world was changing. Psychotherapy is changing. That’s certainly true for me.

I call it Walk & Talk. It’s not exactly a highly original title, but I’m sure that you get the point. But that’s exactly what it is. We walk. And we talk. Sometimes we stop. We look. Tree stumps provide seating if we feel the need to rest. Up in the hills it’s possible to breathe in the clean fresh air. We can connect with the seasons and with the environment around us. Nature is grounding. No matter what the weather, the time of year, or the day, these woods can teach us and restore us.

Research suggests living near green spaces and spending time in nature can improve mental health (Capaldi, 2014). GP’s in Scotland started prescribing time outdoors in nature before the pandemic (Frumkin et al., 2017). Scientists are still trying to figure out why it works, but the leading theory is that spending time in nature reduces stress.

Barcelona, a city with one of the highest populations and traffic densities in Europe, has implemented a plan to create more green spaces. The thinking behind this is to improve the health of more than 30,000 people, and thus reduce the use of antidepressants. According to research, this will save up to €45m annually in costs associated with mental health issues (Yañez et al., 2022).

Professor Shane O’Mara, author of In praise of walking: The new science of how we walk and why it is good for us, says “Research shows that walking facilitates feeling better even when you expect the opposite” (In praise of walking book steps up, 2020).

Walking has many benefits for both the body and mind. It helps to protect and repair organs that have been subject to stresses and strains. It’s good for the gut, helping the passage of food through the intestines. Walking is also associated with improved creativity, improved mood, and the general sharpening of our thinking (O’Mara, 2018).

So, on our Walk & Talks, we meander. We pause to take a few deep belly breaths. We notice our surroundings. We hear the birds. We feel the sunshine on our skin.

We walk side by side. You and I. At the same time. We walk the path, go on this journey together. If you stop, I stop too. If you walk quickly, I might deliberately slow my pace. Or I might keep up. As part of the therapeutic process, depending on what you as a client need, I can adjust our pace. We bring our entire body to the session. Our movements, our body language. Just like bringing our attention to the landscape that surrounds us, we bring our attention to the inner landscape of our body. We do this as we walk.

Walking in the woods allows us to learn how to stop. To pause for a moment. To be still and to breathe. To begin to understand that we have a choice. Learning not to impulsively do the same thing over again and again. To develop and understand that working this way can be a transformative experience by allowing the client to simply pause and breathe. To pause and not feel that they need to fill the space.

To linger and listen. A background of human existence far off in the distance, a rumbling of an engine. Pigeons cooing. Leaves rustling. The water from the nearby stream. To smell the earth, nature, the outside world. Smell the resin from the trees. To feel the wind pulling past my face. To feel my toes wrapped in my woolly socks. The rough pebbles under my boots. The cuff of my jacket on my wrists. To taste the coffee I had before I started work.

And then to notice that I am breathing. I am alive. I am experiencing. I am connecting to my internal world, I am supported by the external environment.

To be aware of the impact of this pause, this stillness. We can begin to know ourselves more deeply. To connect with our deeper selves. To be allowed to respect ourselves. A space to permit and embrace anything that may emerge from within.

From both peers and clients I hear similar questions. What do you do if you meet someone? What if it rains? Does it work as well as therapy in an office? Is it be dangerous? How do you keep track of time? This last one is definitely a question from a therapist.

If we meet someone, we smile and say hello. Sometimes we will briefly pass the time of day with them, perhaps commenting on the weather or the steepness of the hill. Our lives are full of constant interruptions. How we deal with these interruptions in therapy may resonate with how we deal with them in real life.

As an aside, I do wonder what the regular dog walkers that I meet think of me. They see me two or three times a week, with different people, of different ages. Perhaps they just think that I’m quite sociable!

If it rains, we feel it on our skin. Perhaps we take shelter under the boughs of a nearby tree. I have even been known to jump in the puddles. The sun shone on me yesterday. Five minutes later, I could feel and hear hail stones hitting my jacket. Each offer equal value while we walk. As with life, we note what is happening, and we resume our journey.

We live in Ireland. It rains here, that’s just part of life in this country. For me, outdoor clothing is essential. But it’s not mandatory. What you wear is up to you. As the Scandinavians say “there’s no such thing as bad weather, there’s only bad clothing”.

My father always had an uncanny knack of guessing the time accurately. I’m not sure if I’ve inherited that particular skill or not but I seem to instinctively know when to retrace our steps. How far to walk before we turn back. If we take the loop walk, at a decent pace it takes 40 minutes, so I know I have time to stop and do a grounding piece, or to take a few minutes to pause and sit on the bridge and listen to the water as I listen to you.

This way of being a therapist, in nature, sits well for me. The up side of that for the people I walk with is they are getting a genuine me, a comfortable me, a me not trying to be something which I’m not.

As for danger; engaging in therapy certainly is daunting, and I hope never dangerous! But it’s definitely not and never will be, a teddy bears’ picnic!

Psychotherapy is changing. It was forced to. In all its disciplines, be they online, face to face in a room, or outdoors.

Maeve Peoples is a fully accredited psychotherapist, Maeve brings her compassion and her ability to create a space that is both safe and nurturing for her clients. Part of this journey is adapting to the changing needs of clients, either face to face, or online. Maeve offers Walk & Talk therapy in the woods near her home. She can be contacted at maeve.peoples@icloud.com

References

Capaldi C.A., Dopko R.L., Zelenski J.M. (2014). The relationship between nature connectedness and happiness: a meta-analysis. Front Psychol. 5:976. https://doi.org/10.3389/fpsyg.2014.00976

Frumkin H., Bratman G.N., Breslow S.J., Cochran B., Kahn P.H. Jr, Lawler J.J., Levin P.S., Tandon P.S., Varanasi U., Wolf K.L., Wood S.A. (2017). Nature contact and human health: A research agenda. Environ Health Perspect., 125(7): 075001. https://doi.org/10.1289/EHP1663.

In praise of walking book steps up. (2020, February 14). In praise of walking book steps up. A mindful walker. https://www.amindfulwalker.com/in-praise-of-walking/

Kennedy, J. (1032) Teddy bears picnic [Song]

O’Mara, S. (2108, October 14). In praise of walking – My new book. Shane O’Mara brains, behaviour, organisations. https://www.shaneomara.com/2018/10/14/in-praise-of-walking-my-new- book/

Yañez, D.V., Barboza, E.P., Cirach, M., Daher, C., Nieuwenhuijsen, M., & Mueller, N. (2022). An urban green space intervention with benefits for mental health: A health impact assessment of the Barcelona “Eixos Verds” Plan. Environment International. 174:107880. https://doi. org/10.1016/j.envint.2023.107880

IAHIP 2023 - INSIDE OUT 100 - Summer 2023