Back to Nature: Understanding Nature Immersion Therapy

I am a naturopathic medical doctor and classically trained acupuncturist, a profession I chose, in large part, due to a life-changing healing experience I had in nature. During my dual-degree training, I studied the teachings of natural healing of both Western naturopaths and classical Chinese sages, incorporating the common threads of nature cure in both traditions in my thesis, titled “Ren Fa Di – Humans Follow the Earth”. By the end of my studies in medical school, I saw first-hand working with patients how natural therapies including nutrition, homeopathy, and botanical medicine can be quite effective tools, especially as alternatives to conventional pharmaceutical therapies. However, we still had our patients popping handfuls of capsules, and we did very little to help our patients connect to the natural world in a deep and profound healing way. I vowed to help the profession “return to nature” and put “nature” back into naturopathic medicine.

Almost 20 years later, there is a growing field of nature immersion therapies which can be prescribed by holistic providers to help their patients and clients connect to nature and help heal the body, mind, soul - and even planet Earth. I have begun implementing these therapies in my new clinic and am excited to share these techniques and experiences in the form of this Nature Cure series of articles. This first article details my own healing journey and begins exploring the importance of nature immersion therapies with the increasingly popular and researched Japanese therapy called shinrin-yoku (forest bathing).

Healing on an Alm in Tirol, Austria

After graduating from college, I became very ill with Crohn’s disease. I had terrible diarrhea, stomach pain, nausea, and would vomit daily. Conventional medical approaches, including pharmaceutical medications, were not helpful for me. This continued for many years before having an amazing healing experience while immersed in the nature of the Tirolean Alps, near the home of my wife, Brigitte.

Growing up in the suburbs, I did not spend extensive time immersed in the wild. This changed when we spent a couple weeks high up on an Alm helping my in-laws, taking care of the cows, making cheese and butter from the prized grass/herb grazed alpenmilch (milk) and taking care of the hiking guests. One day, I felt called to go for a hike and go up the mountain by myself. While hiking up the mountain alone, my senses became alive. The nature was so intense. I felt the sun warming my arms, smelled the sweetness of the forest, felt the dirt kicked up by my boots, and listened to the chatter of the birds and babble of the stream. My mind was quiet, but then came the realization that I no longer felt sick. In just a few short days, my symptoms simply vanished. 

I had forgotten what health felt like. I had been drinking water from a crisp, clean mountain stream, breathing fresh unpolluted mountain air, and eating simple, unadulterated, and very nourishing food. On my hike, I gazed out to the mountain peak across the valley. I was moved to tears with emotion. It was here, amongst the evergreens, the blue birds and marmots, on this particular spot on this very large Earth, in this place in which my heart recognized as home, that I heard it. “It” was my calling, and it spoke to me with all my senses.  “It” was my voice deep inside my chest, and it was my voice inside my head, but it was also the voice of the mountain and the trees in front of me. This is how I need to live my life. I want to live in tune with nature, and help people - not just the sick - to learn how to live a healthy life. I want to learn this, teach this, and put “nature” back into naturopathic medicine.

What is Nature Immersion Therapy?

With an emphasis on "returning to nature," practitioners like myself balance the tried and true healing modalities of the past with evidence-based modern natural therapies, focusing on holistic healing through the interconnectedness of the individual, family units, community, and our natural environment. Today, the field of nature immersion therapies is growing as providers help their patients and clients escape from human-built structures and technology-based activities to help them fully participate with all their senses in nature, engaged in the living landscape.  This may include going up to the forested hill and teaching yoga and Qi Gong, story telling, stimulating group sessions of landscape painting, forming poetry to forest bathing, hiking, or huckleberry picking. It’s about connecting to the land, plants, animals and experiencing being part of this more-than-human earth.

Nature therapy is often led by a trained, supportive professional, such as a therapist or guide. There are many types of activities that can be classified as nature immersion therapy, but it should focus on creating a more deep and profound connection with nature using all of the senses. Examples of such therapies include ecotherapy counseling, wilderness therapy, arts and crafts, therapeutic farming, green exercise, and adventure therapy. This article will focus on the well-researched practice of forest bathing.

Shinrin-Yoku (Forest Bathing)

Perhaps the most well known type of nature immersion therapy is shinrin-yoku, which translates literally as “forest bathing”. It is the traditional Japanese practice of immersing oneself in nature by mindfully using all five senses. Much more than simply hiking or jogging through a forest trail, it  is focused on slowing down and connecting with the forest through our senses of sight, hearing, taste, smell, and touch. During the 1980s, shinrin-yoku surfaced in Japan as a pivotal part of preventive health care and healing in Japanese medicine. Incorporating forest bathing trips into a healthy lifestyle was first proposed by the Forest Agency of Japan in 1982.

The Health Benefits of Forest Bathing

Research on the practice of nature immersion conducted in both Japan and China points to a host of positive health benefits for the human physiological and psychological systems. One 2020 review study found that “...forest bathing interventions were effective at reducing blood pressure, lowering pulse rate, increasing the power of heart rate variability (HRV), improving cardiac-pulmonary parameters, and metabolic function, inducing a positive mood, reducing anxiety levels, and improving the quality of life of pre-hypertensive or hypertensive participants.” Other studies have found forest bathing can improve the immune system and help prevent cancer by increasing human natural killer (NK) cell number and activity, balance stress hormones (such as DHEA, cortisol, adrenaline and noradrenaline), balance serum fat hormones (such as adiponectin), increase the activity of parasympathetic nerves and reduce the activity of sympathetic nerves, and has been shown to bring emotional balance by reducing the scores for anxiety, depression, anger, fatigue, and confusion.^{1, 2}

Some of these benefits are due to breathing in fragrant molecules, called terpenes, which are natural chemical components found in the essential oils of the forest trees. Conifer forests contain terpenes such as α-pinene, β-pinene, camphor, limonene, menthol, and myrcene. Studies in recent decades have demonstrated that terpenes exert anti-inflammatory effects by inhibiting various proinflammatory pathways in ear edema, bronchitis, chronic obstructive pulmonary disease, skin inflammation, and osteoarthritis.³

One of the most common terpenes identified is pinene. Pinenes, found in high levels in pine trees, have been shown to be neuroprotective, helping with Parkinson's disease and decreasing seizure activity in epilepsy. Studies have also highlighted pinene's other pharmacological activities, such as antibiotic resistance modulation, anti-anxiety, anticoagulant, anti-tumor, antimicrobial, antimalarial, antioxidant, anti-inflammatory, and analgesic effects.⁴

The Importance of Forest Bathing

Dr. Qing Li is one of the most important early pioneers in researching shinrin-yoku. In his recent book “Forest Bathing – How Trees Can Help You Find Health and Happiness," he reviews the history, research, and importance of shinrin-yoku.

“We all know how good being in nature can make us feel. We have known it for millennia. The sounds of the forest, the scent of the trees, the sunlight playing through the leaves, the fresh, clean air – these things give us a sense of comfort. They ease our stress and worry, help us to relax and to think more clearly. Being in nature can restore our mood, give us back our energy and vitality, refresh and rejuvenate us.” - Dr. Qing Li

As humans, we must come to understand that we are not separate from the natural world. Our rhythms are still connected to the rhythms of nature.  Dr. Qing Li studies forest medicine to find out all the ways in which walking in the forest can improve our well-being. As we walk slowly through the forest, seeing, listening, smelling, tasting and touching, we bring our rhythms into step with nature. By opening our senses, we bridge the gap between us and the natural world. When we are in harmony with the natural world, we can begin to heal.  As Dr. Li says, “Our nervous system can reset itself, our bodies and minds can go back to how they ought to be. No longer out of kilter with nature but once again in tune with it, we are refreshed and restored. We may not travel very far on our forest walk but, in connecting us with nature, shinrin-yoku takes us all the way home to our true selves.”

The Wisdom of Nature

There is so much wisdom all around us. We see it in the life force and vitality that surrounds us - in stones, plants, and the mountain brook. We intuitively know that nature is healing for us. Science is catching up and recognizing the important health benefits of nature immersion therapies. As practitioners and patients, we now need to make these types of therapies integral to our healing practices.

References

1 Peterfalvi, A.; Meggyes, M.; Makszin, L.; Farkas,N.;Miko, E.;Miseta, A.; Szereday, L. "Forest Bathing Always Makes Sense: Blood Pressure-Lowering and Immune System-Balancing Effects in Late Spring andWinter in Central Europe." Int. J. Environ. Res. Public Health 2021, 18, 2067. https://doi.org/10.3390/ijerph18042067

2 Stier-Jarmer, M.; Throner, V.; Kirschneck, M.; Immich, G.; Frisch, D.; Schuh, A. "The Psychological and Physical Effects of Forests on Human Health: A Systematic Review of Systematic Reviews and Meta-Analyses." Int. J. Environ. Res. Public Health 2021, 18, 1770. https://doi.org/10.3390/ijerph18041770

3 Toxicol Res. 2017 Apr;33(2):97-106. doi: 10.5487/TR.2017.33.2.097. Epub 2017 Apr 15.

4 Cho, KY; Lim, RY; Lee, KH; Lee, JS; Lee, JH; Lee, IS. "Terpenes from Forests and Human Health." https://pubmed.ncbi.nlm.nih.gov/28443180

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