Five steps to mental wellbeing

As I was walking home one evening I saw a card lying in the street. I picked it up and realized what it was; the five steps to wellbeing developed by the New Economics Foundation (NEF). This little card is a brilliant reminder of the 5 steps so I now make sure I see it everyday.

The Five Steps to Wellbeing

The five steps are simple and powerful.

Connect – I’ve often written about the importance of connection; in fact I think it may be the most fundamental source of wellbeing. The NEF research concurs: Having less than four close relatives or friends puts you at high risk of future mental health problems. On the other hand, wide social networks “promote a sense of belonging and well-being” (NEF).

Try to connect with the people around you:

  • Talk to someone instead of sending an email or text;
  • speak to someone your don’t know yet;
  • don’t just ask how someone’s weekend was; really listen when they reply.

Be active – In Exeter, there’s no excuse! Walking, cycling, kayaking, climbing, swimming, football or, of course, rugby! You don’t have to take on anything too demanding; just find an activity you enjoy and make it part of your life. I often recommend physical exercise for clients who are experiencing depression: Exercise can boost your endorphins and moderate aerobic exercise can help with emotional regulation (Bernstein & McNally, 2017).

So why not go for a walk, try a sport, take up yoga or maybe tai chi? If you walk to a colleague’s desk instead emailing them, you get a bonus social connection!

Take notice – Research shows that paying attention to your immediate experience and ‘savouring the moment’ enhances wellbeing. It can also deepen self-understanding, thus helping you to assess and reaffirm your priorities. Taking notice is related to mindfulness which has been shown to promote positive mental states and facilitate emotional self-regulation.

  • Cultivate your curiosity; look out for the unusual.
  • Notice the changing seasons.
  • Just pause to notice your sensory experience: Really be with this moment.
  • Remember to check in with your self: How are you feeling right now?

Keep learning – lifelong learning promotes optimism, enhances self-esteem and improves overall life satisfaction. Learning new skills also encourages social connection and is associated with a more active life. Why not join a class, a book club or learn to play an instrument?

Give – Remember the injunction to “practice random kindness”? It seems the Hippies were onto something! Evidence from a range of sources suggest that giving promotes wellbeing. It doesn’t need to be much: Research found that just one act of kindness a week boosts wellbeing. A simple smile or a kind word can count. Start small and maybe you’ll be encouraged to do more, like volunteering for a local community project.

While the NEF research notes the importance of contact with the natural world for wellbeing., they don’t highlight it. I think they’ve missed a crucal step there as these five steps work beautifully in nature. You could easily weave all five steps into a bird watching walk with friends, volunteering for a local conservation group or helping out a neighbour with their gardening!

Nature and the therapeutic relationship

I completed my Masters dissertation back in 2014, so it was interesting to re-work it into a journal article several years later. My question was whether working in a natural environment had an impact on the therapeutic relationship. It does, of course, but how?

The existing literature noted seven key themes:

  • 3-way relationship;
  • Nature and the therapeutic process;
  • Symbolism, metaphor and synchronicity;
  • Power;
  • Self/other, inside/outside;
  • Nature and the therapeutic process;
  • Boundaries and containers.

I found all of those in my research, as well as two completely new themes; the turning point and transference. The term ‘transference’ comes from Freud and it describes the phenomena of ‘transferring’ our feelings about someone in our past to a different person in the present. The person in the past is someone of deep importance to us, typically our father or mother. I’d guess we’ve all experienced that, even if we didn’t realize what was going on at the time! My research found something rather odd and potentially very significant: It’s possible to transfer strong feelings about some significant person in our past to a natural object or phenomena. A tree, for example, can come to represent someone’s father or stormy wild weather can powerfully evoke emotional echoes of a mother/son relationship. I wonder if this plays into the idea of ‘Mother Nature’?


There’s a key moment in therapy in nature, a turning point where the client and therapist pass a threshold and enter into a liminal space. I draw parallels with anthropological theory about rites of passage, which highlights the importance of that in-between space where the initiate is neither who they were nor who they are to become (Van Gennep). In a rite of passage there’s a midpoint of transition where, for example, the person is no longer a girl, but not yet a women. The anthropologist Victor Turner emphasized the importance of this central liminal phase where the ritual participants are “betwixt and between” (1967).
What has all that to do with therapy? Turner’s notion of liminal space seems to be closely related to what psychotherapist Donald Winnicott calls “transitional space”. Transitional space is “is an intermediate area of experiencing, to which inner reality and external life both contribute” (Winnicott, 1971). Is where therapeutic healing happens?

I’m ending this post with some big questions left open. No apologizes for that: I did the same in my dissertation! Sometimes the value of research comes from the questions it asks rather than the answers it claims to offer. I’ll end here with the same quote from Merleau-Ponty that concluded my dissertation:

“[t]he accomplished work is … not the work which exists in itself, like a thing, but the work which reaches the viewer and invites him to take up the gesture which created it” (1993).

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).

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.

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.

Pinakarri: Aboriginal deep listening

‘White Fella Dreaming’ writes about Pinakarri, a practice from the Aboriginal Mandjilidjara Mardu people of Western Australia. Pinakarri literally means “ears standing up” and is usually translated as ‘deep listening’, a listening with the whole bodymind. It struck me because of the similarities with practices I’m familiar with from ecopsychology, spirituality and therapy.

This is a slightly edited version of the guide to Pinakarri from White Fella Dreaming:

  1. Sit quietly and sense where your body connects with whatever is supporting you right now; the ground, chair or cushion.
  2. Feel the weight of your body and notice how the earth supports it. No matter what you are sitting in, it is made of earth in one way or the other. The gravity that holds you there was created with the beginning of the Universe.
  3. Become aware of your breath. Listen to the difference between the in breath and the out breath. This is how the Universe sounds when it sings through your body.
  4. Become aware of the slight difference in temperature between the in and out breaths. This difference is what you give to the act of breathing. The heat involved in that change comes from the Sun. It is warming up life through your body and you are a channel for this process. You embody the energy of the Sun. You are completely unique and absolutely universal at the same time.
  5. Now listen to the beat of your heart. This began in the womb and stays with you until death. It beats out a particular rhythm and sound.
  6. Find the first point of tension you become aware of. Breathe into that spot and consciously relax it with the power of the Sun and the universal energy you are now aware of. Breathe out the tension.

While much of that sounds like Buddhist breathing meditation, several elements recall a Western Pagan earthing ritual (Starhawk, 2004) and other aspects echo the practice of ‘grounding into being here’ from Whole Body Focusing. All of it sits beautifully within certain strands of ecopsychology (e.g. Bill Plotkin and David Abram). Have these approaches appropriated Aboriginal practice? I very much doubt it. Although there has been a lot of influence on Western Paganism and ecopsychology from indigenous wisdom, I think it’s likely that people across the planet have learnt this kind of deep listening simply by virtue of being embodied and aware.

It’s not what you know …

… it’s the way that you know it. I sometimes have a name ‘on the tip of my tongue’. I’m sure you know that odd feeling; you both know and don’t know at the same time. We make sense of these experiences by talking about an unconscious knowing that we can’t always bring into full awareness.

But there’s a curious flip side to this: You can ‘know’ something consciously without really ‘getting it’ at a deeper level. My therapy clients will sometimes comes to a realization – an ‘Ah ha!’ moment – when they grasp something in a new way. “I knew that already, in my head, but now”, they add with a touch to the heart or stomach, “I know it here”. The difference is profound.

I first wrote about this 25 years ago in Sacred Ecology:

“Besides the cerebral knowledge we all possess, the words & ideas stored in our heads, there is a deeper knowledge held within the tissue of our bodies. It is a somatic, physical knowing which comes from direct experience. This is the knowledge of faith, of emotion, of the gut feeling”.

I later discovered that I was describing embodied knowing and went on to do a PhD on the subject (Harris, 2008).

Conscious knowing is just the tip of the iceberg

Embodied knowing is fundamental to my work as a therapist. In many cases a client knows exactly what’s needed, but doesn’t have conscious access to that knowledge. At other times someone will know something consciously, but lack an embodied grasp of it. The therapist is rarely – if ever – the expert. Our role is facilitating the client’s journey of growth and self discovery, which typically involves integrating their embodied knowing.

There’s another vital aspect to this which takes me back to where I started. In Sacred Ecology I wrote that we need to understand our deep relationship with the other-than-human world at the level of embodied knowing. Unless you’re avoiding the news, you’ll know, in your head at least, that there’s a climate crisis. The facts are clear and have been for years, but nothing much gets done. Action on climate change is characterized by denial and broken promises and time is running out: We may have less than 18 months to avoid catastrophic change. But unless we get that at a gut level, really feel what it means, we’ll remain in what Zion Lights calls ‘passive denial’. You may know the facts about climate crisis but, painful though it is, you have to experience the reality in your body. That wisdom of the body is like taking the red pill; there’s no going back.

When I wrote Sacred Ecology I believed that myth & ritual offered the best route to the wisdom of the body. I’ve since recognized that there are many pathways to embodied connection. These include practices that are already advocated, like mindfulness and nature connection. We need to focus in on these pathways and learn how to use them more effectively. This is embodied ecology and may be our best hope for a future.

The psychotherapy of place

How we are in the world emerges from the matrix of mindbody and place. Although it seems very obvious that where I live or grew up will influence how I feel or even who I am, that reality is largely neglected by psychotherapy. The traditional Freudian model focuses on individuals caught in Oedipal family relationships and place is all but ignored. Psychotherapy in general seems to have forgotten embodiment, although there are notable exceptions like Focusing, body therapy and some Existential approaches. But even in the more embodied psychotherapies, place is rarely discussed. The term embodiment implies place – we are all embodied somewhere – but it often seems that those working with embodiment treat place as a mere background, an adjunct to the important business of having a body.

Merleau-Ponty suggests that we have “a knowledge of place which is reducible to a sort of co-existence with that place” (2002 [1962]). It’s not that I am sitting in my room – I am in a co-existence with that space. Gendlin is even more radical: the body “is an ongoing interaction with its environment” (Gendlin, 1992). To be clear, there isn’t a typo there: Gendlin isn’t saying that the body is in an interaction, but that the body actually is that interaction.

Ecopsychology engages with the wider world, and ecotherapists might well ask about a client’s relationship to nature. But how often do therapists consider the places that we live in more generally? We typically ask about siblings, parents, intimate partners and the like, but when do we wonder about the everyday landscape of our client’s lives? “How do you feel about your home? What’s your local area like? Do you drive to work, walk or take the bus? Where did you play as a child?” If ecotherapy is about the environment rather than just the ‘natural’ world, (whatever that means), these questions are vital.

Clients sometimes talk about the fields they played in as children, how they feel when they wake up in the familiar space of home or what the corridor outside their flat means for them. I’m increasingly curious about these things, perhaps because I’m aware of the importance of this dimension of our existence. Where do we go with this? Ecopsychology has opened new pathways and my Focusing practice is sensing into this edge. There are also clues in the work of Gaston Bachelard, who proposes a new strand of psychoanalysis he calls topoanalysis. Topoanalysis “would be the systematic psychological study of the sites of our intimate lives” (Bachelard, 1969 (1958]). I haven’t had time to study Bachelard yet, but watch this space.

Forests and minds

My work as a psychotherapist sometimes leads me to imagine the mind as like a dark forest. Such metaphors have a rich history, and Inger Birkeland comments that place in general “is a concept that mediates between body and mind, nature and culture” (Birkeland, 2012).

For some indigenous peoples – and in many myths – forests are liminal places that offer the potential for change. These ancient motifs are widespread in our culture: Shakespeare’s As You Like It it came to my mind today, and serves as a rich example. In the play the Forest of Arden becomes a mysterious place away from the civilized city where dramatic transformation take place. The play is a complex exploration of contrasts and conflicts; forest/city, nature/civilization, masculinity/femininity, child/parent, love/hate. Shakespeare doesn’t provide simple resolutions of these confrontations, but leaves us to make of it what we will – as you like it, indeed.

trees_damp_21_rt_blog

The dark forest can serve as a metaphor for the inner world that the psychotherapist and client explore together. In our wandering we must accept the reality of the unknown without fearing it. There may well be something frightening in the darkness, but finding it could be transformative. We need to feel our way through the trees, not blast at the darkness with the cold analytic beam of an electric torchlight. And as joint explorers of this forest, we must stay close.

This metaphor offers some valuable insights for psychotherapy. The therapist needs to feel safe with the unknown and not try to push it away prematurely with the intellectual light of theory. Instead, the therapist stays close to the experience of their client, helping them feel their way towards change.

CBT: The ‘gold standard’ for therapy?

Cognitive behavioural therapy (CBT) is like Marmite for many therapists. Some emphasize the research results which arguably show that it’s the “gold standard of the psychotherapy field” (David, Cristea and Hofmann, 2018). Others, like Richard House, see it as a “therapeutic technology” backed by a research regime that misses vital aspects of therapeutic practice; “subtlety, intuition, discernment and ‘the tacit’ in human relational experience” (2010).

Given that my original therapeutic training was with two of the most vehement critics of CBT – Richard House and Del Loewenthal – it seemed odd to some colleagues that I completed a Professional Certificate in CBT. One jokingly suggested that I’d “gone to the Dark side”!

At first CBT didn’t sit well with my existing approach, which is very much grounded in those qualities Richard extolled; subtlety, intuition and tacit embodied knowing. But I sensed that there was something of value here, notably because I’d unwittingly used CBT techniques to tackle my own anxiety in the past. Several years ago I started getting anxious about whether I’d locked the front door. I’d be about to cycle off to work when the thought would come: ‘Did I lock the door properly?’ My rational mind knew very well that I had: I’d  been successfully locking my front door every day for years! But the doubt nagged at me. The first couple of times I went back to check and it was, of course, fine. But I knew this wasn’t right because I was pandering to my irrational concerns. So I stopped checking. Sometimes it was quite hard. That voice in my head said: ‘It’ll only take a second to check, and then you won’t have to worry any more.’ I countered that with reason: ‘There’s no need to check. I already know it’s fine’. That’s a classic CBT approach and it worked very well: The worry went away instead of growing into full blown OCD!

But CBT doesn’t work for everyone. I’ve had several clients tell me that they tried CBT and it just didn’t work for them. Typically their CBT was provided on the NHS and the therapist didn’t know any other way of working. Why bother to learn anything else when CBT is the “gold standard”? This is part of the reason why CBT has such a bad name amongst some therapists: CBT is presented as the solution in a ‘one size fits all’ approach.

There’s some evidence that CBT is becoming less effective. A paper from 2015 looked at 70 CBT trials and found that the impact of the treatment for depression was falling (Johnsen and Friborg). The authors suggest several possible reasons for this decline, with the most likely being a reduction in therapist competence. What made CBT so attractive to the NHS was that it can be done by the book. In theory anyone who knows how to follow a step-by-step guide and can demonstrate the exercises to a client can be CBT therapist. But we know from extensive research that technique contributes no more than about 20% to the outcome of therapy. Those vital elements that Richard House highlighted above – subtlety, intuition, discernment and tacit knowing – are much more important.

I’m pleased I persevered with CBT. My trainer – a therapist with many years of experience – emphasized that CBT works best when it’s used creatively by an empathic, open minded therapist. It also opens the door to further training with the ‘third wave’ of CBT that integrates it with mindfulness.

CBT isn’t just one more technique in my ‘tool box’: It’s more like another pattern to weave into the rich tapestry of my therapeutic practice. As Richard House points out, the key to good therapy is how it’s practised, not which techniques are used (ibid.). To put it more crudely, it’s not what you do, it’s the way that you do it!

Focusing in Nature

Put simply, Focusing is a means of opening our awareness to the “bodily sensed knowledge” which Eugene Gendlin calls the “felt sense” (Gendlin, 1981). The term ‘felt sense’ describes those fuzzy feelings that we don’t usually pay much attention to – those vague ‘gut feelings’. As you become more aware of a felt sense it will often open like a bud, revealing an otherwise hidden embodied knowing. I discovered Focusing when I was doing my PhD research and it’s become central to my spiritual practice and personal wellbeing. It subsequently become the foundation for my psychotherapy when I trained as a Focusing Oriented Therapist.

Focusing is usually done indoors, but it occurred to me that it would be interesting to see what happened if I tried it in nature. It’s an obvious step and  it came as no surprise that other people were already doing it. What did surprise me was how powerful it could be. My first experiments were a revelation:  Focusing in nature quickly softened the perceived barrier between ‘me’ and ‘the world’, enabling a much more intimate relationship to place.

A boat sits on a still Loch at dawn

This was amazing! In minutes I could get a deep sense of connection to the natural world. Was it just me? I read about other peoples experiences and did some interviews. Although different people had different experiences, that sense of profound connection came up again and again.

As Deep Ecology has noted, that connection is fundamental to changing our environmental behavior. Herbert Schroeder, an environmental psychologist working for the U.S. Department of Agriculture Forest Service found that Focusing in nature “was a first step toward articulating the ineffable, experiential value that natural environments have for me” (Schroeder, 2012: 141).

There’s much more to be said and done. If you’d like to know more, see my article, Gendlin and ecopsychology: focusing in nature in the Person-Centered and Experiential Psychotherapies journal.