Prescribing a Walk in the Woods- A Doctor’s Journey Into the Forest of Healing
Being an area predominantly used for farming, the Yorkshire Dales National Park has not seen great forests for centuries. My experience of trees and the life they bring as a child was, therefore, limited in the immediate vicinity to a small area of woodland about ten minutes’ walk from home. The woodland had started out as a garden, housing multiple exotic plant species from abroad and were now overgrown and forgotten to the point of crumbling. This place exuded a magic and mystery that would keep my brother and I enraptured for much of our youth.
It instilled in me a lasting love of the natural world and the strong belief that our own wellbeing is inherently linked to the environment around us.
Whilst a rural start to life brought with it its own restrictions and frustrations, as I’ve grown older I’ve come to appreciate and see the value of it more and it was therefore with trepidation that I made the move to the ‘big smoke’ of London as a junior doctor to embark on my General Practice training.
It was during my pre-travel research for Japan, my most recent placement, that I first came across the concept of 'forest bathing' or 'Shinrin Yoku', whilst reading about the strong link between man and nature in the Japanese culture. I was inspired to develop the project following a period of work in General practice in which I'd become increasingly aware of rising mental health and psychosocial needs in London and had felt at times at a loss as to how to help patients presenting with these problems.
I was therefore interested in the healing aspect of the practice of Shinrin Yoku and, owing to my own childhood experiences, could very much relate to the documented benefits of being in and around nature.
I was particularly intrigued to read about the practice originating in Japan, within a population that has not traditionally spoken about mental illness in a medical sense but is evidently aware and accepting of the stresses of life and progressive in applying techniques to combat them.
The town is built in a natural break in the Tadami beech forest, a biosphere reserve and UNESCO world heritage site.
It was forest like I'd never really experienced before; dense, dark and full of treasures, entering it was as easy as stepping off the road and into the undergrowth.
Straying off the path always brought rewards, sometimes in the form of a troop of wild monkeys and often in the form of a temple of worship. A majestic archway followed by the beginning of a winding staircase was usually the only hint at the site to come, often hidden deep in the forest, illustrating the importance of harmony with nature within both the Buddhist and Shinto philosophies.
The natural surroundings of Tadami frequently came up in my interviews with members of the community and at least 90% of people identified the physical environment as one of the most positive aspects of living there.
Many spoke about the benefits of living near the forest in terms of wellbeing and a few even disclosed that their reason for moving to Tadami had been to improve their or a partner’s mental health. On hearing this I was somewhat surprised to encounter the empty paths and peaceful glades when exploring at weekends, imagining that in view of many of my conversations I would find people actively 'experiencing nature' during their time off work.
My Western 'urban dweller' mind has been conditioned into thinking that the only way to 'experience nature' is to actively participate in it in a recreational way. Being in rural Japan amongst many who didn't feel this impulse challenged my perspective and introduced the idea of nature being more a part of daily living. Whilst those wishing to scale mountains for fun were few, I met many who spent time in the forest foraging for food or their evenings bent double tending to their vegetable fields. I began to see how, for them, being a part of their surroundings wasn't an effort or an extra-curricular activity but an integral part of who they were. In listening to and witnessing this for myself, I have no doubt that this philosophy contributes to the longevity of life in Japan.
My hosts, forever passionate about making my trip a success, met my request with enthusiasm, and therefore one very rainy Saturday I found myself walking the Iyashi No Mori (Healing Forest) trail trying to keep up with our guide.
Walking the forest with a local resident, who not only knew the trails and trees but had chosen to spend his working life amongst them, was an incredibly rich experience. His love of his environment was palpable as we measured trunks to estimate their age and stopped by edible plants to observe their patterned leaves.
We also lost any sense of time; a trail that might have taken twenty minutes to walk without stopping lasted over an hour as we drank in our surroundings and ‘bathed’.
During these moments two thoughts occurred to me: firstly, how calming it was to simply stand still in such a setting and, secondly, how rare it is to stand still for any length of time at all in day to day life.
It is a phenomenon I see often in my patients: an unhappiness triggered by life becoming almost too overwhelming, too full of things they feel they have not achieved in the face of others succeeding. It can be a toxic cycle leading to depression and anxieties and speaks of a lack of contentment and perhaps lack of space to ‘just be’.
In a forest, there is space.
I’d read about the physical effects of being in such a place and for the first time on that rainy Japanese day, I really noticed them. Not being near a telephone with signal or an e-mail delivering device of any kind definitely helped but, more than that, the sense of calm seemed to come more from an increased awareness of my surroundings, which in turn surpassed thoughts of anything else going on in the rest of my life at that moment in time.
I have seen the negative impact of emotional distress on the physical and mental health of patients, friends and family -and of course myself- both at home and now globally. As our lifestyles change and new stresses evolve I believe it is our responsibility, as doctors, to seek new ways in which to see and treat our patients holistically and I feel the natural environment could and should play a part in that.
But will there ever come a day when we can prescribe a walk in the woods? I hope in the near future we can come close.