The Inflamed Mind

There’s a growing body of research linking mental health and the immune system. In his new book, The Inflamed Mind, Professor Edward Bullmore claims that we need treatments that can break the vicious cycle of stress, inflammation and depression. Speaking on the BBC this morning, Professor Bullmore said it was time to abandon Cartesian dualism and “treat mind and body as if they were more integrated” (Today, Radio 4). Although welcome, this realization comes rather late in the day. Candace Pert recognized that the mind and the body are aspects of a single system back in the 1980’s, and introduced the concept of the ‘bodymind’. That insight has been borne out by neuroscience, embodiment research and embodied therapy, so it’s good that psychiatry is catching up!

The Inflamed Mind book cover

The Inflamed Mind

Candace Pert was the first person to recognize the existence of endorphins, the body’s very own opiates. Endorphins are feel good hormones that are released when we exercise or experience pleasure. The runners high, a chocolate hit and even the kick of a hot curry all depend on endorphins. Endorphins don’t just create feelings of pleasure; they also counteract the effects of stress and play a role in maintaining the immune system.

All this suggests to me that increasing the production of endorphins might be an effective way to treat depression. Kinesthetic meditation – aka ‘the endorphin effect’ – is a simple technique to stimulate the production of endorphins at will. There’s been very little research on kinesthetic meditation, but what evidence we have is intriguing as it was shown to “improve subjective and objective measures of wellbeing” (Bullen et. al., 2006). Kinesthetic meditation also reduces the level of cortisol, a hormone produced in response to stress. This is significant because elevated cortisol is associated with an increased risk of depression and a reduction in the effectiveness of psychotherapeutic treatment.

There’s a complex picture emerging connecting stress, depression, cortisol and the immune system. The interactions between these elements are still unclear, but I think endorphins could play a key role. So could kinesthetic meditation be an effective intervention for the treatment of depression? On paper, it looks promising, but without further research we can’t be sure. Meanwhile it might be worth teaching kinesthetic meditation to people experiencing depression; it has no known negative side effects and it’s free!

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Can ‘Power Posing’ change your life?

Can simply standing in a powerful pose boost your confidence? Back in 2010 psychologist Amy Cuddy, along with colleagues Dana Carney and Andy Yap, claimed that it could (Carney, 2010). There was considerable media excitement, especially after Cuddy delivered a hugely popular TED talk. But subsequent research didn’t replicate the original findings, and suddenly power posing didn’t look cool any more. Dana Carney, the lead author of the original article, abandoned the theory in 2016, announcing that “the evidence against the existence of power poses is undeniable“.

But Cuddy is back with updated research claiming that power posing does have a significant positive impact on “mood and evaluations, attitudes, and feelings about the self” (Cuddy et. al. 2018).

All this is important for several reasons. First, it’s a classic example of how scientific research should work: There’s a claim, it’s tested, refuted and then further research revisits the data. More interesting is how the original research impacted on the public. The media loved Cuddy’s TED talk, with big players like CBS and the New York Times making much of her claims: Sexy science sells. There was much less public reporting when the scientific backlash came and of course now the story is even more complicated!

Man in Power Pose

The author conducts an early Power Posing experiment (c. 1980)

So does power posing work? It probably doesn’t have an impact on behavior: Doing a power pose before you go in for that scary interview won’t enhance your confidence. But a power pose will, on current evidence at least, have a positive influence on your emotional state.

Power posing is a lively topic of discussion amongst trainers and therapists who are interested in embodiment and the body. Power posing is closely related to the work of embodiment trainers like Mark Walsh and Francis Briers. It’s also in line with the kind of embodied therapy that I practice: How a client is sitting, standing, moving or walking says a lot about how they are experiencing their place in the world.

Power posing, embodied training and embodied therapy are all grounded in embodied cognition, the principle that thinking and feeling depend on the body as well as the brain (Robbins and Aydede). Embodied cognition is well supported by cognitive neuroscience and supports the ideas of Merleau-Ponty, Gendlin, Bateson and others who argue that “the body shapes the mind” (Gallagher). Power posing may not change your life, but a better understanding of embodied cognition just might, so keep reading!

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‘Sacred Ecology’ Revisited

Almost a quarter of a century ago I presented a paper called ‘Sacred Ecology’ at a Newcastle University conference (1994), and it’s still my most widely read article. Should I be dismayed that I haven’t come up with anything more popular or pleased that it’s remained relevant?

Sacred Ecology was published 1996 (Harvey and Hardman) and has been republished several times since, both in books and on the internet. When ‘Humanistic Paganism’ re-posted Sacred Ecology in 2015 I added a short introduction to put it into context. I commented that my emphasis on ritual missed something: “While ritual can be very powerful, there are many ways to access the wisdom of the body and some – like Focusing – are arguably more reliable”. Three years on, I’m increasingly curious about a whole range of pathways to the wisdom of the body and what fundamental principles might underpin them. I’ve already discussed several of these pathways in this blog: Focusing, mindfulness and the wilderness effect, but there are many more.

black and white photo of trees with dramatic sky

St. Catherine’s Hill

Since writing Sacred Ecology I’ve gained a better understanding of ritual. Back in the ‘90’s I was heavily involved with Paganism. While that gave me a profound personal experience of the power of ritual, it was in a very specific context. I’ve since explored ritual in other contexts, notably ecopsychology and dance therapy.

Ritual is fundamental to the practical ecopsychology of Bill Plotkin and Joanna Macy. While Plotkin has a more Pagan orientation, Macy’s ‘Work that Reconnects’ is grounded in Buddhism. Both are valuable and widely influential.

Psychotherapy can be a kind of ritual: I’ve argued elsewhere that ritual theory can help us understand the healing process in outdoor therapy (Harris, 2014) and that’s probably true of psychotherapy in general. Moreover, ritual is used explicitly in Family Therapy (Hecker & Schindler), dramatherapy and the dance therapy developed by Anna and Daria Halprin.

Does all this shed light on why Sacred Ecology is still relevant? I wrote Sacred Ecology to illustrate the importance of EcoPagan ritual, but if that’s all it was about I doubt that anyone would bother to read it today. Sacred Ecology hints at something more fundamental: A profound re-connection with the other-than-human revealed thorough the wisdom of the body.

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Nature Connection: Have you got it yet?

When I used to run nature connection workshops back in 2010, it was a struggle to get people to sign up. It seemed that people didn’t get what nature connection was or why they might want more of it. But times have changed and according to The Huffington Post, “Nature Connection Will Be the Next Big Human Trend”!

What happened? Research is part of the answer. The Nature Connectedness Research Group at Derby University have done a lot over the last few years and Miles Richardson, the project coordinator, has a great research blog.

The RSBP are also on the case, having realized that “disconnection from nature is … one of the major problems facing nature conservation”. Deep Ecology got it right; once you recognize your connection with nature, you’ll be actively engaged in protecting it. The health benefits are also very apparent now, with new research consistently demonstrating that connecting to nature is good for you.

Dartmoor ponies drink from a stream

Drink from the source

Elizabeth Nisbet from Trent University in Ontario, has developed a Nature Relatedness questionnaire. If your level of nature relatedness it isn’t already obvious, you might like to try it. Crucially, Nisbet emphasizes that Nature Relatedness isn’t just a romanticized idealization of nature; it’s “an understanding of the importance of all aspects of nature, even those that are not aesthetically appealing or useful to humans, such as mosquitoes, mice, death, and decay”.

Maybe the suggestion that nature connection can improve you health and help save the planet isn’t enough to convince you? Well, research Nisbet conducted with her colleague John Zelenski suggests that nature relatedness may also lead to greater happiness (Zelenski and Nisbet, 2012).

Research has helped increase awareness of nature connection, but people have also begun to feel the need for it themselves. There are an increasing number of workshops to help: Nature Connections draws on an appreciation of bird language to reconnect us, while the Art of Mentoring teaches a range of valuable nature connection practices. Maybe it’s time for me to lead some more nature connection workshops too!

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Can mindfulness in nature help with ADHD?

Richard Louv, who suggests that many of us suffer from ‘Nature-Deficit Disorder’, believes that there’s a link between how kids are raised and ‘attention deficit hyperactivity disorder’ (ADHD). There’s some evidence to support his suggestion. Research suggests that every hour of daily TV watched by preschoolers increased their likelihood of developing symptoms of attention deficit disorders by 10 percent (Christakis et al, 2004).

I’ve written elsewhere about my distrust of psychiatric diagnosis, but there’s no question that increasing numbers of children are experiencing impulsivity, hyperactivity, lack of focus, low self-esteem and aggressive behavior: The diagnosis of children with ADHD increased from 7.8% in 2003 to 11.0% in 2011-12 (US data).

shadow of boy on seascape

Attention overload?

Nature connection seems to help; whether kids play indoors or out has a significant impact on ADHD. Researchers from the University of Illinois found that “children who played in windowless indoor settings had significantly more severe symptoms than children who played in grassy outdoor spaces”. The authors conclude that “contact with nature is systematically related to lessened attention deficit symptoms” (Taylor et al., 2001).

The University of Illinois research was inspired by Attention Restoration Theory, as developed by environmental psychologists Rachel and Stephen Kaplan (Kaplan and Kaplan, 1989). Attention Restoration Theory proposes that natural phenomena like birdsong, trees, or the gentle sound of a stream are restorative because they give our thinking minds time to rest.

Mindfulness is also useful for alleviating the symptoms associated with ADHD. Psychiatrist Lidia Zylowska led the first study of how mindfulness training might help with ADHD and I’ve found her book on this subject useful in my client work (Zylowska, 2012). Recent research has supported her initial findings, concluding that mindfulness meditation “is efficacious in reducing symptom load in adult ADHD” (Hoxhaj et al., 2018).

Given that both mindfulness and nature connection have been shown to help with ADHD, I’m drawn to wonder what might happen if we combined the two. Crucially, this isn’t just adding one to the other: I’ve argued elsewhere that practicing mindfulness in nature, as compared to indoors, creates a synergy between two powerful sources of healing (Harris, 2016). To my knowledge, no-one is pursing this avenue of research so I’m putting it out there in the hopes that I can attract some interest. Watch this space!

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The Wilderness Effect

Ecopsychologist Rob Greenway used to guide people on wilderness treks and after years of research concluded that “civilization is only four days deep” (Greenway, 1995). When people go on long treks in the wilderness they start out enthusiastic: They’re feeling excited and looking forward to the coming adventure. But after a couple of days of hard walking, most begin to get uncomfortable. It’s not just aching muscles that are the problem; people start to miss the familiar civilized world that they’re habituated to. “There’s no fricking phone signal out here!” “When do we get to have shower?” “Damn, it’s quiet …”

But something profound happens after about 72 hours of being in the wilderness. Rob found that almost everyone experienced “an increased sense of aliveness” and “feelings of expansion or reconnection”. Rob calls this phenomena “the wilderness effect” and it’s one of the best established theories in ecopsychology.

I was hugely excited when I first read about the wilderness effect. It seemed to offer a powerful way to reconnect people with nature, and maybe transform our relationship to the world. My excitement was short lived however. The effect Rob had observed happened on extended trips into the American wilderness, so there’s no way to bring it to the millions who yearn for it.

But years later I had an experience that opened my eyes to another possibility. I was living on a road protest site and while it was far from being pristine wilderness, life there slowly deepened my connection to nature. Could it be that something like the wilderness effect happens when we spend a lot of quality time in urban nature?

A camp fire in the woods

Life in the woods

The short answer is yes; ecopsychologists generally agree that “simply spending meaningful time communing with nature” is beneficial (Shaw, 2006) and the full-on wilderness effect is a difference of degree rather than a difference in kind. I’ve written about this in detail elsewhere and I’ll be developing these thoughts in later posts, but for now I’ll close with a quote from Jim Hindle. Jim lived amongst the trees at the Newbury protest site and beautifully describes how his awareness was transformed by that experience:

“I became accustomed to the sound of the wind in the trees at all times. It wasn’t a thing I necessarily listened to, but the silence that fell whenever I stepped inside a building was eerie and disquietening. … It was like being connected to a great river, the source of all life … and years of separation between us and the Land were falling away like an old skin”
(Hindle, 2006).

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The Future of Ecotherapy

My ecotherapy work is featured in the Winter issue of JUNO magazine and the interviewer raises an interesting question: Why isn’t therapy in nature more widespread?

Ecotherapy sounds very novel, but it isn’t really. Doing walk and talk therapy isn’t new: Freud walked though the streets of Leyden with Mahler during a very effective session of psychoanalysis. Doing therapeutic work in nature isn’t a recent invention either. The Renaissance medical pioneer Paracelsus believed that “The art of healing comes from nature, not from the physician”, while Florence Nightingale noted the therapeutic effects of nature in her Notes on Nursing (1863).

Although recognition of the healing effects of nature isn’t especially new, researching into its efficacy is. Evidenced based practice is increasingly in demand, which is partly why Cognitive Behavioural Therapy (CBT) is commonly recommended by the National Health Service (NHS). On that basis, ecotherapy should be more widespread, as there’s extensive evidence showing that it works. I’ve written a summary of the evidence for ecotherapy and the conclusion is clear; therapy in nature is an effective treatment for a wide range of mental health problems.

Ecotherapist and client walking in nature

Walking the path to healing

Given that ecotherapy isn’t especially novel and is backed by robust evidence of its effectiveness, why isn’t it available on the NHS? I think the answer is primarily about modern culture. CBT fits into the culture of the NHS perfectly because it’s something you can quite literally do ‘by the book’; just follow the CBT manual and tick the boxes as you go. Ecotherapy doesn’t work like that; it’s a dynamic interaction that involves the client, the therapist and an unpredictable natural space.

However, some therapists – including me – are developing ways to deliver ecotherapy in a way that the NHS might find more acceptable. The healing power of nature can effectively be harnessed in a group therapy session and that has the added advantage of social interaction. Working with a group of people rather then one-to-one also cuts the cost, which means that more people can be helped sooner. If we continue to apply the research and develop proven, cost effective approaches, ecotherapy could be an approach whose time has finally come.

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’Tis the Season for Holiday Anxiety

I’m delighted to host a guest post by Jennifer Scott, a life coach who’s a passionate advocate for mental health and wellbeing. Jennifer has personal experience of anxiety and depression so her suggestions for getting though Christmas and New Year are especially valuable.

’Tis the Season for Holiday Anxiety

The holiday season can be chaotic for everyone, but busy schedules packed with festivities, friends, and family present additional challenges for those who deal with anxiety. Here are some tips and tactics for managing your mood while still celebrating the season.

Try sticking to your regular routine as much as possible. While travel, parties, family dinners, and even time away from work can make that more difficult during the holiday season, simple rituals such as going to bed around the same time every night, doing a brief morning meditation session after waking, or writing in your journal each day can be even more critical to managing your anxiety this time of year.

Setting realistic expectations can go a long way toward making the holidays less stressful. It’s inevitable that things won’t go exactly as you planned, whether it’s at the office party or the turkey-and-trimmings dinner with your in-laws. Anticipating those temporary detours will help keep anxiety from throwing you completely off track.

Identifying specific situations that increase anxiety can also help make the holidays less hectic. For instance, if travelling stresses you out, pre-plan as much as possible in order to avoid chaos. This might include booking a flight early in the morning, when the airport will be less crowded, or reserving an aisle seat so you can easily get up and walk around a bit during your flight or train journey. This will work to reduce feelings of claustrophobia or other anxiety-related issues, according to the Anxiety and Depression Association of America.

Busy street at Christmas time

The holiday season can be chaotic

While anxiety or depression shouldn’t prompt you to avoid festive events altogether, it’s okay to turn down some invitations. For example, if trying to choose the perfect gifts or braving manic malls is an annual anxiety inducer for you, it’s perfectly acceptable to turn down a shopping date with friends or family in favor of shopping online or opting for gift cards. Trimming some traditions will also help you control your calendar to make time for self-care during the season.

Seasonal self-care could include scheduling a solo massage, taking half an hour at the end of each busy day to curl up with a novel, moderating holiday treats with weekend food prep sessions that help you stick to healthy eating habits on most days, or incorporating exercise into your calendar. While it might not be practical to enrol in a morning boot camp class at your local gym during the holiday season, simply making time for daily walks alone, with a friend, or with a furry family member can increase your brain and body’s release of serotonin and endorphins, two mood-boosting chemicals.

And studies show spending time with a dog also increases levels of oxytocin — a hormone that helps fight stress, boosts relaxation, and increases the desire to create social bonds — for animals and humans alike, according to The Washington Post. So it’s no wonder hospitals, nursing homes, and other institutions are increasingly employing four-legged therapists to provide comfort and companionship to patients and residents. And dogs don’t even need special training to help reduce levels of anxiety and depression for their owners. A growing body of research indicates having a furry friend can improve a human’s health in a number of ways.

If you’re feeling isolated, reach out to religious organizations and other groups to create connections in your community. Volunteering your time and effort toward a good cause can provide a sense of purpose and serve as a great mood booster. And if you can’t shake feelings of sadness or anxiety, are having trouble sleeping, or can’t tackle routine tasks, you should seek advice from a health professional if symptoms persist.

For many, anxiety is as much a part of the holiday season as Aunt Carol’s cranberry relish recipe, but taking care of your mental and physical health can help you celebrate the season with joy instead of jitters.

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Twitter

I’ve recently started using Twitter to put out short and hopefully useful updates about what’s going on. A Tweet is great for passing on a useful link, commenting on a news item or campaigning for better mental health support.

Most recently I’ve:

  • sent to Tweet to my local MP, Ben Bradshaw, asking him to support a new law on the use of force in mental health hospitals;
  • linked to a recent article of mine on how to listen to the wisdom of the body;
  • posted a link to my new video about managing anger and anxiety, and
  • passed on interesting articles about CBT and how to stay happy!

You can follow me @dradrianharris

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The Intuitive Therapist

If you’ve ever watched a filmed therapy session or heard Susie Orbach’s In Therapy, it might seem like there’s not much going on. The client says something and then the therapist says something. What you can’t sense, unless you’ve been there, is the deeper process going on throughout the session. As a therapist I want to be 100% present in the moment and sensitive to every nuance of our complex interaction. I also want to be aware of everything the client has ever said to me, how they might be feeling and how I’m feeling. I need to consider if, based on half a dozen theories of therapy, there’s any pattern in all that. If there is a significant pattern, I need to decide when and how to say so.

When I was training to be a therapist I despaired of ever being able to process all that and stay present with the client. I was so busy thinking about what they’d just said that I kept missing something crucial! It seemed impossibly hard. And I was right; trying to consciously think through the complexity and depth of therapy is impossible.

Uluru sunset

Most of the vast bulk of Uluru lies below ground

I’d assumed that I had to think everything through consciously, but actually about 95% of our cognitive processing happens in the other than conscious mind (Thrift, 2000). I talk about this a lot in my PhD thesis on embodied knowing, but it took me a while to appreciate how this happens in therapy. In therapy – and in everyday life – my “body senses the whole situation” (Gendlin, 1992). The wisdom of the body draws on sensory perceptions, emotions, memories, past experience and much more to decide what to do next. It’s a massive understatement to say that “your body knows much that you don’t know” (Gendlin, 1981).

Malcolm Gladwell talks about this “power of thinking without thinking” in Blink (2005). The book is full of wonderful stories about people who know intuitively what’s going on in very complex situations. There’s the art expert who can unerringly sense a fake but can’t tell you how, and a fire chief who’s gut feeling saved his entire crew from disaster. In each case the ability to correctly intuit what to do emerges from a powerful embodied knowing that’s been developed through training and experience.

In a typical therapy session I’m not constantly pondering what the client had just said: My focus is on staying present. Meanwhile my embodied mind – which has a huge range of input and a vast capacity to process that input – does the work. Drawing on this embodied wisdom is the essence of Focusing Orientated Therapy.

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