58 MONITOR ON PSYCHOLOGY • SEPTEMBER 2013
along the Potomac River as part of her practice in McLean,
Va. Trauma survivors, for instance, often carry a lot of shame
and may have created rigid walls to protect themselves.
Directly facing the therapist with no outlets for their physical
arousal may prove too intense for them at times. Meanwhile,
adolescents and people with attention-deficit disorders may
have trouble sitting still.
“There’s something about getting them out and moving that
helps them relax,” she says.
Being outside can also build rapport and humanize the
therapist, Lager adds. She recalls one teenage client who was
scared of bees. As they walked, “a bee came by and kind of
flew in our faces,” she says. “We both reacted with a little bit
of shock, and it was funny. I think those shared moments
help very much with the interpersonal connection that’s
shown to be such a crucial element in what makes therapy
work.”
Research also is starting to show that creativity, self-awareness, emotional awareness and other positive therapy
outcomes can heighten during movement. That may have
to do with greater blood flow to the brain, the activation or
deactivation of specific brain centers, “and probably with
some kind of distraction element that allows the mind to
become clearer,” Hays surmises. Psychologist Arne Dietrich,
PhD, of the American University in Beirut, for instance,
proposes a “transient hypofrontality” model suggesting that
when we exercise, the brain focuses on what it needs to do for
those activities. In the process, it decreases activity in the left
hemisphere and opens the way for creative insights in
the right.
For many people, nature can be grounding as well, says Katie
Asmus, a licensed psychotherapist and wilderness guide in
Boulder, Colo.
“There is something about the environment that helps
our nervous systems unwind,” says Asmus, whose office
overlooks the Flatirons, large rock formations bordering
Boulder that are a haven for rock climbers. People who
walk or run in natural environments report less anger
and sadness directly after exercise than those who walk or
run in “built” environments, finds a 2010 meta-analysis
in BMC Public Health by Diana E. Bowler, PhD, of Bangor
University in North Wales, and colleagues. In another series
of studies reported in the June 2010 Journal of Environmental
Psychology, participants said that being in nature made them
feel more alive, beyond the effects of physical activity and
social interaction in the outdoors, according to University of
Rochester psychologist Richard Ryan, PhD, and colleagues.
And studies beginning in the 1990s by psychologists Terry
A. Hartig, PhD, Roger S. Ulrich, PhD, and others show that
nature helps to quell anxiety and even heal the body.
“When we’re more open and more relaxed, it helps us
access deeper parts of ourselves and our emotions — layers of
ourselves that we often don’t have the opportunity to experience
otherwise,” Asmus says.
How to do it
It isn’t difficult to include walking and the outdoors in your
practice, but some tips can help you head off potential
problems. Experts advise you to:
• Keep it confidential. Going outdoors means you may
run into people who know you or your client. Address this
possibility up front and figure out a strategy beforehand, Lager
advises. She and her clients agree that if they see someone they
know, they’ll indicate that to one another and simply stop
talking until the person is out of earshot, for example. Similarly,
Hays recommends role-playing possible scenarios, or just saying
hi and moving on. “My own experience is it’s never been an
issue,” she says.
• Maintain boundaries. When the body is involved in
therapy as well as the mind, “questions about power and
The “transient hypofrontality” model posits that when
we exercise, the brain focuses on what it needs to do
for those activities. In the process, it decreases activity
in the left hemisphere and opens the way for creative
insights in the right.
