Abstract
More than 60% of children in the United States have experienced a traumatic event. These experiences can have a long-lasting and negative impact on overall development. Historically, trauma treatment has been relegated to top-down (talk therapy and cognitive processes) approaches, often dismissing the body's trauma memory. Trauma-informed treatments that employ bottom-up approaches capitalize on multisensory multisystem involvement in trauma recovery. Trauma-informed nature therapy appears to provide both preventative (e.g., developing unique coping skills) and restorative benefits. It provides a whole-brain whole-body approach that has been shown to calm the limbic system, enhance the prefrontal cortex, expand the support network, provide opportunities for physical mastery, and promote the reconstruction of the trauma narrative. A case study will follow the examination of how engaging in nature can promote resiliency and trauma recovery.
Introduction
In the United States, children are experiencing trauma at high rates, with research suggesting that >60% of children, ∼45 million, have experienced some sort of traumatic event by the age of 16 (National Survey of Children's Health, 2011/2012; Substance Abuse and Mental Health Services Association [SAMHSA], 2022). Adverse childhood experiences can include a wide range of physical, sexual, and emotional abuse, neglect, domestic violence, natural disasters, terrorism, and community violence (Crouch et al., 2019; Fisher, 2019).
These traumatic experiences can have long-lasting and negative effects on children's overall development (Delahooke, 2019; Fisher, 2019; Gaon, Kaplan, Dwolatzky, Perry, & Witztum, 2013; Porges, 2011), including an increased risk for cancer, heart disease, and diabetes, in addition to psychological distress (Felitti et al., 1998; van der Kolk, 2015). The risk for negative physical and mental health outcomes increases with multiple adverse experiences (Hughes et al., 2017). Therefore, mental health providers must be knowledgeable of the impact of trauma and trained in evidence-based techniques that address the specific needs of children impacted by traumatic events (Fisher, 2019).
Trauma and development
According to Porges (2011), the body scans continuously for threats to safety. When exposed to a threat, the body responds to the danger through a series of physiological changes (Delahooke, 2019). In particular, the sympathetic nervous system is activated, and releases stress hormones into the body (e.g., cortisol, adrenaline, and norepinephrine) (Delahooke, 2019; Porges, 2011). This signals the limbic system to “turn on,” mobilizing the body's fight, flight, or freeze response to the threat. This adaptive neurological feature of surveillance and responding to threats to safety (neuroception) can also misread a situation (faulty neuroception) and get “stuck” in a state of hyperarousal for some children impacted by adverse experiences (Delahooke, 2019; Fisher, 2019, 2022; Porges, 2011). As a result, children impacted by traumatic experiences can easily be triggered by stimuli (e.g., sights, smells, and sounds) that bring up memories of the trauma.
Children affected by trauma may also experience dissociative symptoms (Fisher, 2019; Gaon et al., 2013; Herzog & Schmahl, 2018). Children may dissociate or “zone out” to mentally detach from cognitive or sensory stimulation that reminds them of the trauma. This may result in inattentiveness at home or school. In addition, children may develop anxiety or fears increasing their risk of self-harm and emotional dysregulation. Intrusive thoughts and nightmares may prevent adequate sleep resulting in poor concentration and lethargy during the day (Fisher, 2019; Gaon et al., 2013; Herzog & Schmahl, 2018).
In addition to dissociative patterns, emotional dysregulation, and intrusive thoughts and images, children may not possess the language to articulate their fears and feelings and may report a variety of somatic complaints, such as stomachaches, headaches, or nonspecific pain in parts of the body (Fisher, 2019; Gaon et al., 2013; Herzog & Schmahl, 2018). In addition, there may be a preoccupation with death and dying. Children may experience intrusive thoughts or dreams related to the imagined death of themselves or others, or the real death of loved ones.
The impact of trauma on childhood development is pronounced by the negative effect on the neurological hardwiring of children. Children who are impacted by trauma develop changes in the neural pathways that influence how they perceive and respond to the world (Fisher, 2019; Herzog & Schmahl, 2018). Specifically, traumatic experiences can lead to the constant perception of an inevitable response to an unsafe and threatening world. For example, Delahooke (2019) described a young man, Stuart, who was adopted as a toddler. Stuart presented with over-reactions (e.g., explosive outbursts and running away) to everyday experiences. As a result of his early experiences, Stuart experienced common activities as stressful.
However, children are capable of recovery even after a traumatic event. The brain is the most malleable during childhood, allowing for the growth and development of new neural pathways (van der Kolk, 2015). This neuroplasticity combined with effective therapeutic treatment can mediate faulty pathways formed in trauma (Fisher, 2019; Herzog & Schmahl, 2018). Therefore, once Stuart was provided with treatments that addressed the underlying cause of his behaviors (e.g., sensory over-reactivity and implicit memories of past experiences) he was able to experience his body in a calm state and develop emotional and social regulation (Delahooke, 2019).
Trauma treatment may consist of a combination of approaches that capitalize on the brain's natural capacity for neuroplasticity. Historically, a top-down approach has been employed. This involved talking, reconnecting with others, and processing the traumatic event. A bottom-up approach allowed for a full multisensory engagement of the body that promotes experiences of empowerment, strength, and confidence that differ from that of the trauma (Fisher, 2019; Gaon et al., 2013; Herzog & Schmahl, 2018; van der Kolk, 2015). Too often, top-down approaches that rely on talk therapy and cognitive processing are the only interventions employed for trauma (Fisher, 2019; Gaon et al., 2013; Herzog & Schmahl, 2018; van der Kolk, 2015).
This approach omits the library of memories cataloged among the sensory organs, hypothalamic–pituitary–adrenal axis, and musculoskeletal systems, and may only address visible behaviors and not the underlying trauma. In addition, trauma in early childhood often remains preverbal as it rarely reaches the part of the brain used in speech (RB-Banks & Meyer, 2017). In this way, trauma impacts and is stored in all the systems of the body (not just the brain), making it difficult for children to recount traumatic memories (Fisher, 2019; Siegel, 2012; van der Kolk, 2015).
Therefore, talk therapy cannot be relied on as the sole form of treatment (Fisher, 2019; Siegel, 2012; van der Kolk, 2015). Rather, early childhood trauma is best processed through more physical means, including those available in various expressive therapies, such as dance, play, art, drama, and movement therapy (Fisher, 2019; RB-Banks & Meyer, 2017). Ultimately, children need to experience their bodies and sensory organs safely. “For real change to take place, the body needs to learn that the danger has passed and to live in the reality of the present” (van der Kolk, 2015, p. 21).
To capitalize on the body's capacity for resiliency, children need to engage in whole-brain whole-body experiences that promote agency while addressing the trauma. Nature therapy, utilizing the healing elements of engaging in the natural world, is one such approach that provides a multisensory multisystem experience (Buzzell & Chalquist, 2009; Fisher, 2019; Hanscom, 2016; Jordan, 2014, 2015; Jordan & Hinds, 2016; Kahn & Kellert, 2002; Kellert, 2002; Li, 2018; Louv, 2008, 2012, 2016).
Nature therapy
The benefits of engaging in the natural world have long been recognized (Buzzell & Chalquist, 2009; Fisher, 2019; Hanscom, 2016; Jordan, 2014, 2015; Jordan & Hinds, 2016; Kahn & Kellert, 2002; Kellert, 2002; Li, 2018; Louv, 2008, 2012, 2016; Annerstedt & Währborg, 2011). Shinrin Yoku or “forest bathing” (e.g., sitting in a forest for 15–20 minutes) is prescribed by doctors in Japan to promote physical and mental health. Li (2018) found that spending just a few minutes in a forest decreased cortisol, norepinephrine, and adrenaline, increased serotonin, decreased heart rate and respirations, and created a calm and alert state for participants.
In addition, these benefits appear to last for up to 7 days after exposure (Li, 2018). Furthermore, Edward O. Wilson's biophilia hypothesis proposed that because humans and more-than-humans evolved together, there exists an innate connection and an interdependence (Arvay, 2018a; Kahn & Hasback, 2013; Annerstedt & Währborg, 2011) that goes beyond material needs and physiological benefits (e.g., a calm and alert state) but includes psychological wellness and personal identity and a sense of belonging to something bigger than self (Jordan, 2015).
Although there appear to exist many intrinsic benefits of informal engagement with and in natural settings, the field of psychology has integrated more formal therapeutic nature-based approaches. The term ecotherapy, first coined by Howard Clinebell in his book on the topic, is often used to describe a variety of nature-based approaches (e.g., horticulture therapy, animal-assisted therapy, and wilderness therapy) that provide modalities for physical and psychological healing (Jordan & Hinds, 2016). Ecotherapy, also referred to as Nature Therapy, is an ecocentric approach that recognizes the reciprocal relationship between humans and more-than-human species and seeks out and welcomes ecological aspects of self (Buzzell & Chalquist, 2009; Fisher, 2019; Jordan, 2014, 2015; Jordan & Hinds, 2016).
Grounded in relational theory, Nature Therapy explores relationships to self, others, and something sacred, universal, and divine in the context of ecosystems (Jordan, 2014, 2015; Marshal, edited by Chesner & lykou, 2021). A nature therapy intake session will include an informal or more formalized assessment tool (e.g., Connectedness to Nature Scale: Mayer & Franz, 2004) inquiry about the client's relationship with nature. This will aid in the co-creation of an eco-sensitive treatment plan that recognizes the client's eco-identity.
Nature Therapy is an embodied approach that recruits all the senses. A colleague of Carl Rogers, Eugene Gendlin developed a technique called “focusing” that helped people bring attention to the physical self (Brazier, 2017). Intentionally bringing attention to the body can be challenging in a society that dissociates and detaches from the body to avoid emotional discomfort (e.g., self-medicating). Natural terrain provides an opportunity to navigate a variety of spaces and climates. For example, a walk in the woods activates proprioception and kinesthetic sensory systems associated with balance, movement, and behavior (Fisher, 2019).
Getting caught in a spring rain shower recruits tactile and thermal receptors and brings awareness to the body's sensations in the present moment. This sensory awareness can help surface feelings and emotions that are buried (Brazier, 2018; Westland, edited by Chesner & lykou, 2021). Nature Therapy promotes being in the present. In a world that ascribes to a “skim, scan, scroll” approach to processing information (Fisher, 2019) nature therapy promotes experiencing the “here and now.” With a mindfulness approach, nature therapy techniques bring awareness to the moment and quiet ruminating thoughts that often plague clients.
Nature Therapy, as observed in this article is an eco-centered, relational, embodied, and mindful approach. It includes therapeutic activities led by a licensed mental health professional trained in the integration of more-than-human modalities that are grounded in psychological theory. Historically, therapy is “addressed as an indoor, verbal, and cognitive activity, with the relationship between therapist and client at its center” (Berger, 2006, p. 6). Alternatively, nature is not just the location of therapy, but also is a partner in the therapeutic relationship. In Nature Therapy, nature and more-than-human species become the co-therapist interacting with the client and therapist and promoting opportunities for healing and recovery.
Trauma and nature therapy
According to van der Kolk (2015), “all trauma is preverbal” (p. 43) and stored in the sensations of the body. This renders talk therapy and cognitive approaches less effective in accessing and healing traumatic memories. Research suggests that embodied therapies help clients attune to their physiological selves and heal more quickly (Brazier, 2018). Furthermore, Santostefano (2004) proposed that “negotiating and enacting embodied life metaphors, which represent a child's conflicts, has more power to promote change than do discussing and interpreting these conflicts” (p. 17).
Developmentally, the experiences of a child are integrated and form the child's matrix of embodied life metaphors (e.g., multisensory sensations, actions, emotions, and gestures). The embodied life metaphors represent both human and more-than-human interactions and how needs have been negotiated. Traumatic experiences result in a disruption to the matrix and appear to lead children to interact with human and more-than-human situations that promote “opportunities to re-experience stimulations and emotions associated with past trauma” (p. 18). Nature Therapy provides intentional experiences that leverage the need to experience the body and emotions in a safer way.
Nature therapy as an embodied trauma-informed approach can be both restorative and preventative. Engaging in nature promotes healing and recovery from trauma in a variety of ways. Nature promotes the regulating and recovery of an overtaxed nervous system. Before the industrial revolution, humans co-existed with more-than-human species. Our nervous and sensory systems evolved in association with the natural elements (Arvay, 2018b; Mortali, 2019). We are neurologically wired to assimilate and accommodate (and seek out) the sensory experiences found in nature (Louv, 2008, 2012, 2016).
By producing negative ions at its core (Ober, Sinatra, Zucker, 2014), microbes through the soil (Hanscom, 2016), and terpenes in heavy green spaces (Li, 2018), the earth and its biodiverse species create a biochemical exchange that grounds the human body and increases the neurotransmitters serotonin, oxytocin, endorphins, and dopamine (Arvay, 2018a,b; Fisher, 2019; Hanscom, 2016; Jordan, 2014, 2015; Jordan & Hinds, 2016; Kahn & Kellert, 2002; Kellert, 2002; Li, 2018; Louv, 2008, 2012, 2016).
These changes result in the reduction of the body's stress response, increased energy, improved sleep, and accelerated healing from injuries—in addition to a reduction in the experience of anxiety and depression (Ober et al., 2014). The earth naturally interacts with the hypervigilant nervous system of a trauma survivor by calming the amygdala, reducing stress hormones in the body (e.g., cortisol, adrenaline, and norepinephrine), and promoting a calm alert state (Fisher, 2019; Hanscom, 2016; Jordan, 2014, 2015; Jordan & Hinds, 2016; Kahn & Kellert, 2002; Kellert, 2002; Li, 2018; Louv, 2008, 2012, 2016).
In addition to calming the nervous system, engaging in the natural world can ground the dissociative client. Nature provides novel cues (red cardinal against green fir tree) that cause our body to pay attention (Fisher, 2019; Hanscom, 2016; Jordan, 2014, 2015; Jordan & Hinds, 2016; Kahn & Kellert, 2002; Kellert, 2002). For example, a common exercise in Nature Therapy, Sit Spot, invites the client to sit in nature and spot all the things they see, feel, hear, smell, and feel in the body. Bringing attention to the body and the senses serves to ground the client in the present.
Nature as a co-therapist offers preventative features that may act as a buffer to traumatic events by providing children with opportunities to foster the development of a unique set of coping skills (Berger, 2016; Berger & Lahad, 2013; Fisher, 2019). For example, Joseph was a 12-year-old boy who was challenged with social and communication difficulties. His therapy was in a school setting for children with special needs, but Joseph indicated that he did not like the indoor setting. Instead, Joseph invited the therapist to walk with him around the school. In time, the boundaries of the walk grew bigger and bigger and expanded to a nearby riverbank, where Joseph chose a spot to hold therapy under a willow tree.
Initially, Joseph was very intentional about preparing this spot by collecting sticks and rocks and began to create a physical barrier around the willow on the riverbank. The therapeutic goals for Joseph were to expand his social and communication skills, and he became more and more communicative as he created his fort along the river. He and his therapist would brew tea over a fire in the center of the fort and this became a ceremonial aspect of Joseph's therapy. Joseph's communication and connection to the therapist increased dramatically. Therapy continued when the weather turned cold, and sessions returned indoors. However, when a difficult issue came up in therapy, Joseph would lead the therapist back to what he had named “Home in Nature” under the willow on the riverbank:
It was as though Joseph needed to check that the safe sacred space that he and his therapist had physically built together, a space that also symbolized their therapeutic alliance was still there. It seemed like he wanted to see what had changed during the season and what needed to be reconstructed. (Berger, 2008, p. 9)
Joseph's relationship with both the riverbank and the therapist offers a rich depiction of the therapeutic possibilities in a nature therapy approach.
Lahad, Shacham, and Ayalon (2013) developed the Basic Ph (belief, affect, social imagination, cognition, and physiological) model, a unique combination of six different coping styles that appears to help children persevere in the face of adversity and reduces the negative impact of trauma on development. Engaging in the natural world aids in the development of these key elements that contribute to resiliency (Berger, 2016; Berger & Lahad, 2013).
Through nature encounters, children can make meaning of the trauma as they construct and reconstruct the trauma narrative (belief). Nature therapy allows children to reconnect to themselves and others in unpredictable and complex ways that encourage creative and playful engagement. As they strategize how to maneuver a log bridge over a creek or climb a tree, they act out stories that allow them to confront their fears and build confidence (Berger, 2016; Berger & Lahad, 2013; Berger & McLeod, 2006; Fisher, 2019). Overcoming challenges in navigating natural terrain strengthens problem-solving skills (cognition) and promotes confidence in the physical body (physiological). Although they were unable to stop the traumatic event, children can develop mastery of other difficulties found in nature (Berger, 2016; Berger & Lahad, 2013; Fisher, 2019).
As previously mentioned, the biochemical exchange that occurs when interacting with the natural elements helps promote a calm and alert state (affect) (Hanscom, 2016; Jordan, 2014, 2015; Jordan & Hinds, 2016; Kahn & Kellert, 2002). The intentional interaction with natural elements encourages children to be fully present, as opposed to revisiting the past trauma or worrying about how it will impact the future. Nature reorients the child by bypassing the defense mechanisms they use to distance themselves from the trauma (e.g., regression, acting out, and dissociation) and grounds them back to the present moment (Berger, 2016; Berger & Lahad, 2013; Fisher, 2019).
For example, I use natural elements in my grounding exercises with children who experience dissociation or intrusive thoughts related to the trauma. I allow the child to select an item from nature (e.g., a rock, a piece of sea glass, or a seashell) and then instruct them to describe the object in detail bringing their awareness to the sensation of the object. The item chosen may represent stimuli that conjure embodied life metaphors that have been disrupted by the trauma. In addition, the object may interrupt the intrusive thought process by bringing into awareness a more peaceful or happier time represented by the object. Using aromatherapy, sensory bins, or nature soundtracks are other ways to facilitate intentional interaction with nature and promote a calm state.
Nature play stimulates creativity (imagination) (Atkins & Snyder, 2018; Berger, 2016; Berger & Lahad, 2013; Berger & McLeod, 2006; Fisher, 2019). As children reconnect with their inner child and engage in creative expression around the trauma, recovery is fostered. For example, Berger and Lahad (2013) utilized a nature-informed creative expression approach when working with the surviving children of war-torn Liberia.
The children narrated and enacted a story whereby they became the guardians of the forests and land that had been destroyed by the fires of the war. The children returned to the woods, painted their faces with warrior paint, and participated in an induction ceremony that named them Forest Guardians. In their newly appointed role, the children cleaned up the forest and began to create shelters and natural habitats for the animals that had been forced to leave the decimated grounds. Empowered, the children began to rewrite and reenact a healing and hopeful narrative around their trauma (Berger, 2016; Berger & Lahad, 2013).
Finally, engaging with nature also provides children with a sense of support as they connect to the earth and its creatures (social) (Berger, 2016; Berger & Lahad, 2013; Berfer & McLeod, 2006; Fisher, 2019; Kahn & Kellert, 2002; Kellert, 2002). The reciprocal interaction between children and nature is visible in such actions as when a “child waters a seedling and provides it with encouraging words to aid in its growth, or when a dog frantically wags its tail upon seeing a child approach” (Fisher, 2019, p. 86). Interacting with biodiversity (e.g., animals, plants, rivers, and trees) expands the existing relationships within the narrative of the child, and widens the support network, as the following case study illustrates.
Case Study
Anna, a small-framed 15-year-old Caucasian female, sat engulfed by the overstuffed chair in my office. She looked down, past the floor, to the day her world collapsed. She was walking home from school when three men jumped her, threw her against the huge old oak tree that lay on the outskirts of her family's farm, and proceeded to rape her. They left her against the tree, with torn clothes, battered and forever changed.
After a time (how long Anna could not recall), she walked home to her beloved lakeside farm that was just a quarter mile from the assault. She described her home as her “safe place” where she was able to “just be me,” surrounded by her animals, which included horses, dogs, goats, and chickens. After finishing her numerous chores around the farm, she would grab a book and take her kayak to the center of the lake, spending hours immersed in the narratives. This had been her haven…until now.
Anna's mother met her at the door, and Anna collapsed in her arms. The police were called but were unable to make sense of the traumatized youth's story and unintentionally violated her with their dismissal. She was left feeling ashamed, alone, and unlovable. She began isolating herself from her siblings, her friends, and even her animals.
Anna's ability to discuss any aspect of her trauma was enhanced when Max, my therapy dog, joined the sessions. Research seems to support that animals may buffer the impact of adversity and contribute to resiliency (Applebaum, MacLean, & McDonald, 2021). Initially, we would take Max for short walks around the practice neighborhood. On one of those walks, Anna proclaimed her love of kayaking and asked if we might be able to go one day. I had never taken a client kayaking before, and I was unsure of the liability and ethical ramifications. Still, Anna felt strongly that she wanted to go kayaking with me on our nearby creek.
Following consultation with several colleagues, I asked Anna's mother about the possibility of holding a session on the kayaks. To my surprise, Anna's mother enthusiastically agreed and stated, “Anna is a very proficient kayaker and a very strong swimmer. I am happy to consent.”
The following week, we met at the area where I keep my kayaks. Anna had brought her own. We put the kayaks in on the sandy shore of the lazy creek and paddled around for a while. Anna had become more animated since we took our sessions outdoors, and she eagerly pressed for us to move out of the calm water to the more challenging adjoining river. I decided that this was indicative of her trust in our relationship—to venture into deeper, more challenging waters.
As we entered the mouth of the river, I remembered the bulkhead that was just around the bend. I had frequently found myself paddling too close and instantly getting sucked into the undertow, which resulted in my kayak being thrust into a head-on collision with a rock barrier. I knew how to release from the undertow, but I was curious how my eager client would view the challenge.
As we paddled into the river, the waters began to churn, splashing in the wake of passing boats. Anna stayed safely in the middle of the river, while I deliberately ventured slightly closer to shore. Sure enough, the current grabbed my kayak and forced me against the rock bed. Anna remained safely beyond the current and was surprised to see me paddling against the waves and rocks. She called out to me, “Stop paddling! Just let the waves take you in…then release.”
I acted as if I had not heard her wisdom and continued to struggle with the current. Finally, Anna yelled, “Stop fighting it, Dr. Cheryl! You have to let it take you in…to release you! You will be fine. Just let go!”
AH! YES! Don't fight it. Just release it! So, I did…and easily paddled to my very wise (and now frowning) client.
“You knew how to do that all along, didn't you? You were trying to show me that I need to not fight this thing so much, right?” She lowered her head and began to cry for the first time. We adjoined our paddles and for the rest of the session sat in silence in the middle of the river.
The weeks that followed were an emotional roller coaster filled with disclosure, tears, and healing. At the end of one session, Anna announced, “It is time. It is time to return to the oak tree.” She was ready to return to the place where her violation had occurred. To confront the oak tree that had stood witness. The sessions that followed were characterized by imagery and preparation for Anna's journey to the location of the assault.
Finally, she was ready. We met at the site of the rape. We got out of the car and slowly walked to the tree—a huge ancient oak whose branches, now bare preparing for the winter rest, stretched out, welcoming Anna. I could never have been prepared for what happened next. Anna ran to the tree, wrapped her arms around its wide girth, and began to cry, “Thank you!”
Anna had now slipped to the base of the tree and continued, “Thank you! During everything, you stood with me. You held me up. You never left me!”
Anna's mother and I just looked at each other in astonishment. Anna was grateful to the oak tree for holding witness to her assault and remaining with her throughout the entire atrocity. Anna's rape is remembered through, with, and in the context of the land and seas, air, and creatures. She wanted to honor the old oak, so she planted bulbs at its base. In the early spring, Anna returned to find the most beautiful small white flowers peeking up through the late frost…a sign that life can hold beauty even after the devastation. (Reprinted with permission, Fisher, 2017).
Anna initiated therapy 3 years after the rape because she wanted to address the impact the trauma had on her social skills. Anna was awkward around boys and feared physical touch by anyone other than her family and animals. She would sit with her knees folded into her belly and quietly rock during the session, only answering the minimal questions. She would timidly engage in expressive techniques (music, collages, and painting) and while these modalities were illuminating, it was clear that Anna was guarded and scared.
When other-than-human elements were introduced to therapy Anna was fully engaged. She opened up to Max, often cuddling him and kissing his nose during sessions. This connection provided Anna with the safety she needed to open up more in session. In addition to the biochemical exchange of the outdoor setting, adding walks by the river equalized the therapy setting by removing the walls and inherent power hierarchy. In addition, it allowed Anna to experience her embodied life metaphors around safety, animals, and nature while negotiating her trauma story.
It was only when Anna felt safe enough in the therapeutic relationship that she asked about kayaking, a task that gave her great pleasure at home. It was also an opportunity to challenge Anna's sense of safety as the river provided a difficult (but manageable) obstacle. Again, engaging in Anna's embodied life metaphor around kayaking, she was able to identify the life lesson in recovering from an undertow. This allowed her to connect to the part of her that had been so guarded against risk because she was frightened. She recognized in herself that by avoiding risk, she had also been avoiding growth and recovery.
Once Anna felt empowered enough, she was able to return to the rape site and experience the relationship with the oak tree in an empowering and honoring way. Anna reclaimed her life through the organic relationship developed with my co-therapist (Max), the mysteries found in the musings of a winding river, and the fidelity of an oak tree. Through her interaction with nature as a co-therapist, Anna was able to rewrite her narrative and reclaim her life.
Conclusion
The case studies of Joseph, Anna, and the Liberian children presented in this article offer an alternative and more effective trauma-informed approach to traditional top-down talk therapy. Trauma is preverbal and talk therapy as an exclusive treatment for trauma is restrictive and does not capture the multisensory trauma narrative. Nature therapy is a relational embodied bottom-up approach to trauma-informed treatment. In addition to the biochemical exchange that promotes a calm limbic system, a more present state, and enhanced prefrontal cortex engagement, engaging in nature as a co-therapist offers a wide range of whole-brain whole-body experiences.
This allows children to not only gain mastery over their world, and feel supported, but it also allows them to enact their dialectical relationships between their embodied life metaphors and human and more-than-human experiences and reconstruct their trauma narrative (Santostefano, 2004). For children who have experienced violations of trust, care, and support by humans, the more-than-human world can offer a safe and supportive connection that is easier to navigate. For example, Joseph was able to engage in communication and social skills only when he had created a fort that felt safe by the riverside.
The Liberian children were devastated by the war. Yet, they were able to reconnect to the destruction feeling empowered as they played an active part in the recovery of the land and the protection of the animals. They discovered their agency in a situation that had taken so much from them. Finally, Anna lost her sense of safety and innocence because of the rape. She began to participate more fully in therapy when she experienced the safety of connection to Max, the therapy dog. In addition, she felt powerless in her own body. However, she remembered her embodied power as she navigated the challenges of the river in the kayak. These examples of the relational embodied benefits of nature therapy have strong implications for working with attachment issues beyond traumatic narratives.
The limitations of this article include the need for more empirical research comparing a nature therapy approach to a talk therapy approach. However, given the need for innovative therapeutic approaches to trauma treatment, this article provides specific examples of how nature has served as a co-therapist in different settings (e.g., school-based and private practice). In addition, although the impact of nature therapy in trauma recovery for clients has been explored, it would be interesting to examine the impact on the human therapist when having nature as a co-therapist, especially as it relates to secondary trauma and compassion fatigue experienced by trauma therapists.
Footnotes
Author Disclosure Statement
No competing financial interests exist.
Funding Information
No funding was received for this article.