Editor’s Note: In “Hey, Health Coach,” Sarah Hays Coomer answers reader questions about the intersection of health and overall well-being. Have a question? Send her a message (and don’t forget to use a sleuthy pseudonym!).
Hey, Health Coach,
I’ve been reading a lot about “ecotherapy” lately. From what I gather, it just means going outside more, but I have a friend who swears it has changed her life. Is ecotherapy a real thing? Does it actually make a difference to go outside, and if so, how?
— Wondering About Wandering
Dear Wondering About Wandering,
Ecotherapy, also known as nature therapy or the Japanese practice of shinrin-yoku (forest bathing), can sound like something out of a new-age manual, but there’s fascinating research to consider about how going outside can boost your physical and psychological well-being.
It makes sense intuitively, too. If you need to decompress after a tough conversation, you might instinctually step outside for some fresh air. If you’ve got a grumpy kid on your hands, you might send them outside to reboot, and it’s hard to deny the dulcet sensations many of us experience when we witness a simple sunrise or sunset, listen to the sound of the ocean or watch light filter through summer leaves.
In 1853, Henry David Thoreau wrote in his journal, “I have a room all to myself; it is nature.” Many of my clients reported similar feelings in the depths of the COVID-19 pandemic—confined to their homes, crammed in with family or roommates, or isolated entirely. Outside was the only place many of us could go to clear our heads. It allowed for freedom of movement, a precious commodity amid rolling lockdowns.
Scientific research backs this instinctual connection with nature.
Green Space and Health
A 2018 meta-analysis of 143 studies showed an association between increased green space exposure and a decrease in cortisol (a stress hormone) in the saliva. It also noted decreased heart rate, blood pressure, cholesterol, risk of preterm birth, type 2 diabetes and all-cause mortality and increased incidence of good self-reported health. Incidence of stroke, asthma and coronary heart disease also decreased[1].
Meanwhile, research in Frontiers in Public Health suggests ecotherapy-related techniques can help with the medical conditions above, as well as psychosocial conditions like depression, chronic stress, post-traumatic stress disorder (PTSD), attention deficit/hyperactivity disorder (ADHD) and adjustment disorders[2].
The World Health Organization (WHO) looks at the broader implications, reporting that “urban green spaces, such as parks, playgrounds and residential greenery, can promote mental and physical health and reduce morbidity and mortality in urban residents by providing psychological relaxation and stress alleviation, stimulating social cohesion, supporting physical activity and reducing exposure to air pollutants, noise and excessive heat.”
What’s more, a 2019 study of “urban dwellers” in Frontiers in Psychology shows that it doesn’t take long to reap these benefits. Levels of salivary cortisol in participants dropped 21% after spending time in nature, with the most effective duration being 20 to 30 minutes[3].
Another review of studies involving college students found the duration can be even shorter. “As little as 10 min[utes] of sitting or walking in a diverse array of natural settings significantly and positively impacted defined psychological and physiological markers of mental well-being for college-aged individuals,” the authors wrote[4].
On a cellular level, vitamin D plays a big role in our health as well. We need sunlight to generate vitamin D, which is crucial for strong bones and muscles, immune health and mental health.The research is compelling. When people have access to safe, clean outdoor spaces, their health improves. This connection has broad implications for urban planning, poverty reduction and public health, but it’s useful information for all of us as individuals as well.
How to Practice Ecotherapy
Much ado is made about self-care, but a lot of it costs money. Travel, fitness memberships and spa treatments can be prohibitively expensive. Nature, on the other hand, is free and accessible to almost everyone—at least to some degree. Psychotherapy should always happen under the care of a trained counselor or psychologist, of course, but anyone can explore how spending time outside might enrich their lives.
A retreat to the beach or mountains is wonderful, but you don’t need trains, planes or automobiles to reap the benefits of being outdoors.
On the “Humans Outside” podcast, Suzanne Bartlett Hackenmiller, M.D., an OB-GYN and integrative medicine specialist, told host Amy Bushatz that research shows it doesn’t matter if you’re running, sitting on a park bench, birdwatching, surfing or mountain biking. “Do what you like to do,” she said. “That’s where the magic happens…There is something for everyone out in nature. You can’t do it wrong.”
Here are a few ideas on how to get started.
Home
Activities like walking, reading, gardening, grilling, meditating, stretching or journaling can be done in brief increments of 10 or 20 minutes (or more) to achieve the therapeutic doses of time in green space mentioned in the research above.
Work
For the millions of people with the flexibility to take laptops or meetings outside, research in Frontiers in Psychology shows working outdoors is associated with “a sense of well-being, recovery, autonomy, enhanced cognition, better communication and social relations[5].” However, this same study also shows that if managers aren’t explicitly supportive of alternative work locations, employees can feel guilty for working outside. Clarifying expectations can be helpful if you have that option.
Indoor-Outdoor
Some people are confined indoors due to illness, disability, safety concerns or work or family obligations. Interestingly, it seems our bodies and minds respond to nature even when we can’t physically get outside to experience it. There’s evidence that listening to nature sounds—particularly “birdsong, wind and water”—can improve mood and cognitive performance, as well as reduce perceived stress levels[6]. Looking out the window at a tree, caring for houseplants or visualizing green space can also bring at least some of the positive benefits of time spent outside.
Easy Access
With such robust evidence of the benefits, it seems your friend might be onto something.
One note: If you’re going out alone or far from home, it’s important to be sure your surroundings are safe, you have water and food available (as needed) and you have a way to reach out in case of emergency.
But the truth is you don’t have to go farther than your front stoop to take a breath of fresh air. I find people frequently underestimate how accessible and impactful the outdoors can be.
With a little sunscreen slathered on, try going outside more often to see how it feels—even if only for a few minutes a day.
“Hey, Health Coach” is for informational purposes only and should not substitute for professional psychological or medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions about your personal situation, health or medical condition.
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