Here are some of the theories and ideas behind the effect of movement in therapy, from yoga and kickboxing, to dancing and walking in the park.
There are theories about the mind-body relationship that support Outdoor Therapy (OT). Bessel van der Kolk (1) says that it is likely that people who suffer emotionally do so not only in their minds, but that their symptoms also appear in their bodies, for example, how they sit, how they position their shoulders, how they breathe, how they sleep, in their digestive process and in their attitude towards exercise. He talks about his client, Annie, who managed to heal herself by combining yoga with her sessions. She realised that her body stored its experiences, but then she could let them go. They didn’t have to stay or leave, instead she could use them as information. She simply learned to have her feelings without them kidnapping her. In Humanistic Integrative Counselling (HIC) we help the client connect with the experiences they notice in their body while they talk to us.
Kolk works primarily with trauma, and says that being traumatised means continuing to organise your life as if the trauma continued to happen in the same and immutable way, and that each new encounter or event is contaminated by the past. The client focuses on suppressing inner chaos at the expense of spontaneity in their life. This strain can result in physical symptoms such as fibromyalgia, chronic fatigue, and autoimmune diseases. Therefore, it is necessary to involve the entire organism, the body, the mind and the brain. It talks about the importance of the ‘cook’, the ‘smoke detector’ and the ‘watchtower’ in the brain’s process of dealing with adverse experiences. We respond in the thalamus (within the limbic system) which acts as the ‘cook’. It blends all our perceptions into a coherent experience that gives you an idea of what is happening to you. The sensations then go down to the amygdala (deeper in the limbic system) which acts as ‘the smoke detector’. Its function is to identify whether new information is relevant to our survival. If it detects a threat, it sends a message to the hypothalamus and brain stem so that the stress hormone system and the autonomic nervous system (ANS) orchestrate a total body response. This happens before the information reaches the frontal lobes where our consciousness, or the ‘watchtower’, is located.
The stress hormones released increase heart rate, blood pressure, and breathing rate, preparing us to fight back or flee. Under normal conditions the body returns to normal, when no danger is perceived. But if there is any blockage in the recovery process, the body activates to defend itself, making the person feel restless or agitated. In this case, trauma can increase the risk of misunderstanding whether a situation is dangerous or not, lead to misunderstandings in personal or work relationships, and the person being unable to regulate their emotions. If the process in the thalamus (the cook) breaks down, what we originally perceived (sounds, images, smells, touches) is encoded as isolated dissociated fragments, and the normal processing of making the memory is undone. Time freezes, and it seems that the current danger will last forever. The amygdala (the smoke detector) works to prepare you to fight back or flee before the frontal lobes (the watchtower) can advise the information, but in a normal situation, you regain your balance to avoid a stress response.
We need this ability to be able to regulate our emotions and interpret those of others, to then have healthy relationships with other people. There are people with trauma that remain in a highly emotional state who become frightened when hearing loud noises, become angry with small frustrations, or become paralysed if someone touches them. While the trauma is not resolved, the stress hormones that are secreted to protect the body continue to circulate and defensive movements and emotional responses are reproduced. People are not aware of what is happening to them, so they make the situation worse over time, which is exhausting. In fact, they will try to organise their lives to protect themselves, for example by exercising obsessively or taking drugs. As the trauma becomes more and more embedded in their minds, it becomes increasingly difficult for them to enjoy life.
The therapist must see the body as a type of marker of the emotional experiences that the client has experienced, and take it into account in the same way as his or her verbal account. For example, a woman who was sexually abused as a child at the hands of other children suppressed her own anger and her desire to respond to those who had hurt her. Her mind was tuned to please the desires of others, even if they asked for unreasonable or unpleasant things. She learned to keep her body very calm because the risk of expressing herself exuberantly brought the risk of retaliation from others. The woman was afraid of her own vitality. A difficult past can clearly cause us mental and physical problems. van der Kolk recommends doing a physical activity alongside talking therapy, for example, kickboxing or karate, jogging or competitive swimming, which are activities that the woman rejected because she had an intimidating relationship with their own strength. You could also try a rhythmic activity with chanting or drumming to release your desire to claim your right to be. Traumatised people either have their bodies too alert (responding abruptly to every sensation), or too numb (closed, heavy, and immobile).
Treatment attempts to find a comfortable middle ground between these extremes. People who have not received the necessary emotional care in childhood have withdrawn from their bodies, and as a consequence they feel very uncomfortable, if someone touches them on the shoulder, for example. It may seem disgusting to them because it would remind them of the opinion of the people who should have taken care of them. van der Kolk might first recommend a therapeutic massage to help them gain basic confidence in their skin and limbs. He says the body can also be a source of memories and evidence when the mind has become paralysed, or when we doubt the legitimacy of our own emotions. The client can ask themselves, in therapy sessions, what has happened to them, and at the same time focus on how they are sitting, how they breathe, and how they feel when someone they love wants to hug them. This is combined with physical activities to meet their needs with the aim of healing. The woman in our case was helped by doing visualisations and breathing techniques at first, to learn to live with her emotions, and later she managed to do outdoor work, which consisted of dancing to classical music, which was her idea.
Humanistic Integrative Counseling, in conjunction with Outdoor Therapy, works to help the client take their trauma on board, and there are physical activities (breathing exercises and focusing on the body) that can help them heal. van de Kolk refers to ‘focusing’ to talk about when we put the focus of attention on the body, to access our own wisdom, which comes from felt experience. By doing so, we obtain information that is different from what we are more accustomed to hearing from reasoning and thought, which allows us to move away from analytical thinking, which is where we generally think and decide, to bodily felt knowledge that gives us deeper and more personal meaning.
In the article by Cooley, Jones, Kurtz and Robertson (2), they saw how movement also helps therapists connect with clients psychologically. Revell and McLeod (3) say that ‘you tune into the rhythm of their movements – so it’s a type of physical empathy’. They say that ‘They have things in their heads, and things in their bodies and they don’t integrate the two. When we do the walking and talking, their minds and their bodies integrate… If they get stuck on something, it helps to just walk forward and get going.’
- Bessel van der Kolk. (2014). El Cuerpo Lleva la Cuenta (Capítulo 4 Body-Brain Connections) Penguin Books Ltd.
- Sam J. Cooley, Ceri R. Jones, Arabella Kurtz, Noelle Robertson (2020) Into the Wild: A meta-synthesis of talking therapy in natural outdoor spaces: Clinical Psychology Review, Volume 77, 101841 https://www.sciencedirect.com/science/article/pii/S0272735820300295
- Revell, S., & McLeod, J. (2016). Experiences of therapists who integrate walk and talk into their professional practice. Counselling and Psychotherapy Research, 16(1), 35–43. https://doi.org/10.1002/capr.12042