Moving forward with walking therapy

Humans have known for millennia that nature heals. The ancient connection we have to nature promotes a sense of calm, peace, and a way to ground ourselves in times of stress. However, only in recent decades has research formally demonstrated the physical, mental, and spiritual benefits of outdoor environments. 

There is no one-size-fits-all approach to therapy, and many providers have been intrigued by the idea of enriching therapy with movement, offering more creativity and dynamism. This is where the concept of walking therapy (sometimes called walk-and-talk therapy) comes in.

What is walking therapy? Essentially, it functions like traditional therapy sessions, but is conducted while walking outside rather than seated in an office the entire time. This has been around for awhile—Sigmund Freud walked with patients through the parks of Vienna in the early 1900s—and has evolved from then. Many of the same processes that make regular therapy effective also apply to walking therapy: being attentively listened to, challenged to contemplate new ways of thinking and being, and given the opportunity to make sense of and organize difficult experiences. That said, there can be meaningful differences between a traditional office appointment and walking therapy.

Why might this approach be worthwhile?

As a form of physical activity, walking improves our mood and helps us think more clearly and creatively. We know that movement is essential to being healthy. Physical activity releases endorphins and “feel-good” neurotransmitters like serotonin, dopamine, and epinephrine. All of these produce that natural “high” that invigorates us, boosts our mood, and helps us think clearly. But beyond physical benefits like lower blood pressure and cholesterol, reduced muscle tension, and improved circulation, countless studies have also demonstrated the benefits of movement in dealing with mental health concerns, especially depression.

The benefits of walking begin at the cellular level with changes that improve your ability to process information. When we are stressed or upset, our body is experiencing a fight-flight-freeze response. Cognitively, this results in a sort of “tunnel vision,” sharpening our attention to only the problem in front of us while disregarding everything else. Also, our prefrontal cortex, the part of our brain responsible for decision-making and critical thinking, becomes more sluggish when we are sedentary. This happens because our evolutionary instincts equate sitting with resting or eating, which do not require active thinking. As a result, we often feel stuck, trapped, or overwhelmed. Many mental health issues result from this cognitive inflexibility: We keep engaging in behaviors that are not helpful to us, we struggle to take in new information, and we’re limited in our ability to see a way forward.

But when we walk, we literally get our brain working in a different way. Our brain takes cues from our open body language and active state; it gets the message, “Now is time to get going!” The freeze response subsides and our brain can consider the big picture. We get better at divergent thinking, or the ability to think more expansively, critically, and creatively and arrive at novel solutions to our problems. We gain cognitive flexibility, with which we can consider our circumstances with more clarity and entertain alternative perspectives.

Walking in a natural environment expands our perspective. Moving our bodies in a natural environment improves our health and well-being by creating a shift in perspective. Beyond the benefits of walking itself, doing so in nature in particular may benefit us emotionally and cognitively for a number of reasons:

We have a natural inclination toward being outdoors. Many of us have natural positive associations with being outdoors, whether a work break, play, sports, recreational activities, or vacations. Research has found that green environments improve self-esteem and mood (with the presence of water creating even greater effects) in both the short- and long-term. When we feel trapped, we are often naturally inclined to get a breath of fresh air, to find a wide-open environment. Humans’ blood pressure even lowers in nature (check out forest bathing if you’re curious about this). We have an instinctual connection to the earth, and many feel a sense of expansiveness and awe when outdoors.

Walking is active movement forward. When we sit indoors, we send a message to our brain that we are eating, resting, or healing; accordingly, we do not feel energized and our brain is not as alert. However, walking is an active choice to move through our environment, and many liken this to moving forward in their problems. Literal movement helps us figuratively become “unstuck” and work through challenges. We start to feel there is possibility for change. There is a sense of vitality in movement, which helps dislodge heavy emotions.

Walking in nature is a metaphor for inner exploration. You have likely encountered the metaphor of a path or road for making sense of our experiences and life journey. It is a popular metaphor for a reason—it works! When we think about taking our bodies and minds “off the beaten path,” we open up to contemplating what life could look like if we chose differently. We can start to sort out which lines of thinking make sense, and which do not serve a purpose.

Nature shows us comfort in both stability and change. We see transitions and flux in the natural environment, and we come to appreciate that life is often the same way. At the same time, nature is a timeless, reliable source of comfort, a way to return to our deeper selves. Even when we and our circumstances change, we can depend on nature to provide familiarity and a sense of belonging in this world.

Spending time in nature promotes mindfulness. Whether a formal practice or not, walking is a form of meditation. Nature introduces so many sensory experiences to which we can mindfully attend in the moment. We feel a sense of wonder admiring the details of beautiful plants and animals, landscapes, and weather. We become fully immersed in the moment, letting the unhelpful, distracting mental chatter fall away. When we are attuned to the present, we also become more familiar with our inner world, and we start to notice and better name what we are thinking and feeling. As a result, we can tap into the many benefits of engaging in mindfulness practices.

Walking + psychotherapy = a comfortable, effective alternative to traditional therapy.

If walking is good for mental health, and psychotherapy helps many as well, why not combine them? Especially for those of us new to therapy, we may be intimidated by the prospect of sitting face-to-face with a therapist in a small office. In moments of silence, or in confronting a difficult emotion, we may grow anxious or feel a sense of pressure in a static, enclosed environment. Taking therapy outside puts people at ease. This is especially true for men, who are often socialized not to show vulnerability or to share private or painful concerns.

Why is it easier to talk while walking? Part of this increased comfort is the interesting, relaxed environment with walking therapy. When engaged in a multisensory experience— colors, sounds, temperature—not all of our focus has to be on intense conversation, and we feel less pressure. Natural pauses in conversation are filled with soothing scenery and sounds. Therefore, we may feel less anxious in session and more willing to open up. 

Another element that makes walking therapy helpful is walking in parallel. In traditional therapy, one can sometimes feel like the therapist has all the power in the conversation. It is anxiety-provoking to be “under the microscope,” under someone’s gaze. Walking side by side, this power differential decreases and conversation becomes more natural. You and the therapist are moving in unison, aligned together as you explore the problem. Walking helps the therapeutic relationship feel more equal and less formal. Another way the roles become equal is your ability to call the shots—you choose the pace, whether to stop and sit, or even whether to take a familiar route or try somewhere new.

You likely also have a more engaged therapist while walking, because the therapist is experiencing the same benefits as you! Your therapist may feel invigorated, refreshed, and focused. They may think more flexibly and creatively as they help you process and solve your problems. In seeing the path ahead, they may instill even more hope about the possibilities for the future.

Finally, with your expanded thinking, you may be able to get more out of therapy, including being more open to feedback and suggestions. You may find yourself problem-solving more easily and reaching clarity sooner than you would otherwise. More freedom and less concern about confrontation can make for a better therapy experience.

Although walking therapy is not for everyone, many feel drawn to the novelty and promise of this innovative approach. As we’ve seen, there are many compelling reasons to try it—but always trust your inclinations about what is best for you.

Tips for walking for your mental wellness:
– Together with your physician, consider gradually implementing a walking program to improve your physical and mental health.
– Research natural areas in your community that may be good for walking. Look for peaceful, safe nature trails, open fields, winding hills—whatever intrigues and excites you. If you live in a city, search for neighborhoods with more trees and less noise, or make your way to a park. If you have significantly limited access to nature, even fresh air combined with nature simulation (footage, sounds) can help.
– Make your walk more mindful by paying attention to the little details: What are the conditions outside, and how do they make you feel? Is there something on this route you hadn’t noticed before? What noises do you hear, or if silent, what emotions does that elicit? If you change your pace, how does it affect your mood? How does the fresh air feel as it enters your body? What do you notice in your body as you scan head to toe?
– Consider consulting with a therapist who offers walking therapy to see if it is a good fit for you. (Embrace has this option!)

Recommended Reading
The Joy of Movement, Kelly McGonigal
Walk With Your Wolf, Jonathan Hoban
Walking Your Blues Away, Thom Hartmann
Shinrin-yoku: The Japanese Art of Forest Bathing, Yoshifumi Miyazaki
https://www.apa.org/monitor/2020/04/nurtured-nature#:~:text=From%20a%20stroll%20through%20a,upticks%20in%20empathy%20and%20cooperation