From cold-water swimming to gardening, the psychological benefits of the great outdoors have inspired a growing genre of books, but can nature improve our mental health?
There is a revealing moment in Isabel Hardman’s book where the author, a political journalist who lives with post-traumatic stress disorder, joins a forest therapy session. The therapist encourages her to “connect” with herself and “experience nature better”. Hardman wanders through the wood and finds a small hornbeam, which is twisting up towards the light, struggling to make its way in the shade of a mature oak. She is attracted to its shape, admires its bark, and draws parallels with her own life: how long it takes to heal and grow, how the scars we gather can still be beautiful “like the zig-zagging trunk of this young tree”. She reaches up and snaps one of its twigs: the tree is dead.
“Serves me right for being so dreadfully whimsical,” Hardman writes. “There seemed to be no neat life lesson here, nothing you’d want to write on a fridge magnet or share on social media. I’d come here hoping to connect with myself, and instead I’d been drawn to a tree that was secretly dead.”
It is a valuable lesson in Hardman’s The Natural Health Service, a practical and self-aware account of the relief from mental illness to be found outside. Hardman, and the many people she meets, identify respite, recovery and resilience in walking, running, cold-water swimming, gardening, “forest bathing”, birdwatching, botanising, horse riding and caring for pets. The common denominator is what Hardman calls “the great outdoors”, that plangent, hearty Victorian-sounding cliche. But as she shows, other species and their ecosystems can be rebellious medics. At times, the “natural” world resembles the magic mirror that undercuts Snow White’s stepmother: rather than reflecting back ourselves, it is alive with its own agency, a challenge to our narcissism.
The Natural Health Service is one of a rapidly growing forest of new books that examine cures found in nature. This winter alone has brought the publication of The Wild Remedy by Emma Mitchell; Losing Eden by Lucy Jones; Rootbound by Alice Vincent; and Wintering by Katherine May. One of last year’s unexpectedly prominent books – unexpected because it was rejected by publishers and crowdfunded via Unbound – was Bird Therapy by Joe Harkness. Just as trend is followed by takedown, so this spring sees a potential debunking in the form of Natural: The Seductive Myth of Nature’s Goodness by American philosopher Alan Levinovitz.
The idea that human health can be salved by “nature” has been around for as long as we have regarded ourselves as a species apart from other living things. It truly arrived in Britain with the Romantics, for whom prosperity enabled a more reflective and worshipful relationship with the landscape that others had to toil in for a living. Keats and Byron loved swimming; sea-bathing was an upper-class health fad that inspired the first seaside resorts. The popularisation of nature’s healing power peaked after the industrial revolution, when later Victorians were beset by fears of the all-conquering machine. Fresh air, exercise and healthful hobbies, from collecting butterflies to finding fossils, were prescribed in much the same way as GPs today are experimenting with “prescribing nature” to patients. Hardman reminds us of the prescience of Octavia Hill, the social reformer and co-founder of the National Trust in 1895, who campaigned to save urban land for city parks. London commons that could make developers fortunes had greater value as outdoor space, Hill argued: “To my mind they are even now worth very much; but they will be more and more valuable every year – valuable in the deepest sense of the word; health-giving, joy-inspiring, peace-bringing.”
In Losing Eden, Jones shows that, ahead of today’s scientists, even Florence Nightingale was aware of how green space and plants can assist recovery from physical illness. In 1859, Nightingale wrote that when she had been ill, her recovery quickened after she received “a nosegay of wild flowers”. The nurse noticed in her patients that there was “most acute suffering when [the] patient can’t see out of the window”; Jones and Hardman both cite a more modern scientific study by Roger Ulrich who examined the records of 46 patients recovering from gall bladder surgery between 1972 and 1981. Some patients were randomly assigned a hospital bed with a view of deciduous trees; others a view of a brick wall. Those with a view of trees had shorter post-operative stays, took fewer painkillers and had fewer minor complications. And yet 40 years on, hospitals are run as “sterile” environments without plants, as Levinovitz notes in Natural: “An entirely unsuperstitious take on natural healing would recognise the importance of being around life – of facilitating hospital garden walks, say – instead of systematically excluding it.”
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As the climate and extinction crisis quickens, so there is a rush for a literary cure. In Britain it began with Richard Mabey’s Nature Cure in 2005. In many of the most popular recent examples of nature writing, other species and wild places have played a healing role – for bereavement in Helen Macdonald’s H Is for Hawk, and alcoholism in Amy Liptrot’s The Outrun. Nature Cure (briefly) details Mabey’s mental breakdown after completing his magnum opus, Flora Britannica, and the succour he found by forgoing his childhood home in the Chilterns for the bleaker plains of south Norfolk. When I ask Mabey if he regrets being midwife to the nature cure subgenre, an emphatic “yes” spills forth. “I feel slightly guilty about the title, which was my idea and it was very euphonious, but I quite soon began getting letters from people saying they loved the book but that it was not much to do with nature curing me. If a pedantic scholar counted the paragraphs that were to do with the illness, it probably amounts to about six pages,” he says. “Really it’s a book about encountering and adapting to a quite new landscape, which you could say was a post-cure experience.” Mabey had to reach a certain stage of recovery to write Nature Cure. As he, Hardman and other nature cure writers emphasise, they can be too ill to leave the house to imbibe the healing wild, and too ill to write, too.
“It’s wonderful when it occurs; people in distress find that encounters with the natural world do restore them,” says Mabey. But two things concern him about the concept of a nature cure. “I’m worried that it’s become mooted as a kind of panacea – green Prozac. And if there’s anything wrong you just go out and look at the pretty flowers and you’re going to be marvellous. That’s a tall order if the natural world is in a state of crisis with the insect apocalypse and British songbirds collapsing all around us. There is also a danger that therapeutic nature becomes another way in which nature is reduced to service provider. The foregrounding of us being the centre of attention, the central agents of change and growth, all form part of a mindset that I think is obsolete. We need to rethink where we stand in relation to all these other organisms and what the transactions are between us, and stop saying they are all for our benefit, even though most of them probably are.”
In an insightful essay on nature cures, Richard Smyth quotes the poet Polly Atkin, who is diagnosed with chronic illnesses Ehlers-Danlos syndromes and genetic haemochromatosis, a metabolic disorder that leads to a toxic accumulation of iron in the body. Like Mabey, Atkin has misgivings about this literary blossoming. “There is very little published work that points out how problematic it is – largely because the people who understand the problem are mainly those with incurable conditions and they’re often too busy being incurable to write books about nature,” she says. “More importantly, mainstream UK publishing is so attached to the ‘nature cure’ narrative that it can’t imagine another story to tell about how we relate to the world around us.”
The stage is set for a debunking of the literary nature cure but in Natural, it never quite arrives. At the end of the book, despite Levinovitz taking smart aim at the snake-oil salespeople of late capitalism – those selling expensive natural remedies, natural “cures” for cancer, or loudly advocating “wholly natural” childbirth, sex or sport – he concludes that there is something innately glorious about the non-human natural world.
What Levinovitz critiques is what he sees as a religious attitude towards nature. An appeal to natural goodness – with “unnatural” as its evil twin – is among the most influential arguments in all human thought, ancient and modern, east and west. In fact, every human-made object is extracted from our planet; everything is “natural”. Levinovitz argues our veneration of “nature” is dangerous, citing former South African president Thabo Mbeki’s desire for Aids patients to take beetroot and other “natural” treatments. What Levinovitz does is help us to identify the “propagandists, bigots, demagogues, and marketeers who wrap their rhetoric in the mantle of ‘what’s natural’”.
When it comes to making money from nature, the small, poorly renumerated band of writers proselytising for its health benefits do not enter Levinovitz’s line of fire. While H Is for Hawk will long stand as a literary classic, nature cure writing has taken a practical turn. Hardman and Harkness’s books are squarely self-help. Their qualities include brutal honesty and generous advice. Both authors, alongside others such as Jones and Mitchell, make clear that while time in the natural world has ameliorated their mental illnesses, so too have antidepressants and talking cures. These writers don’t succumb to the requirement for a happy ending either: no one suggests they are cured.
We might wonder if a writing cure is also part of their wider recovery, but it is not always so. John Clare, who died in 1864, has long been the most notable nature writer with mental health problems. The Northamptonshire farm labourer, whose superb poems made him a literary sensation in the early 19th century, could be considered both evidence for and against the theory that nature makes us well. Did he only fall ill once embraced by literary London, psychically uprooted from his rural heartland? Or was he ill despite surrounding himself with nature? A country life is no guarantee of mental wellbeing: depression is a major problem in modern farming; plenty of farm workers endure it.
There is an echo of Clare’s experience in Harkness’s account of life since the publication of his debut, Bird Therapy. “I will never write about nature again,” says Harkness bluntly. He has been diagnosed with obsessive-compulsive disorder and generalised anxiety disorder – mild medical terms for the crippling anxiety that Harkness vividly describes. After an attempted suicide and a breakdown, he began walking and discovered the exhilaration of encountering birds. “Of all the therapies I’ve tried,” he writes, “nothing has had the prolonged and positive impact that birdwatching has.” He spotted that the requirements of birdwatching matched the five ways to wellbeing devised by a project endorsed by the charity Mind: to connect, to take notice, to give, to keep learning and to be active.
As Harkness’s profile grew on social media, he decided to write a book, receiving high-profile endorsements, including an incisive foreword by the naturalist Chris Packham, who declared it an “exceptional” publication because it would save lives. Eight months on, Harkness recognises that his book has brought positive things: his honesty about mental illness has encouraged others to reciprocate. He has been told by readers that it has indeed saved their lives. Unfortunately, the online platform that enabled him to promote his book also damaged him. “The more open I was on social media, the less people engaged with me. If you’re already struggling with self-esteem, it is hell to be on it. The only way I could deal with it is not use Twitter any more,” he says.
He has also shed his illusions about the “guild” of nature writers. He imagined this literary world would be an inclusive salon for the free exchange of ideas about nature and mental health; instead he found a workplace, “a competitive market with a lot of emphasis on product and what you’re selling”, where “people become very focused on themselves”. One nature writer, he says, told him that Bird Therapy only sold well because of Packham’s foreword. Harkness, who is a special educational needs co-ordinator working with vulnerable young people, says he is so glad that writing is not his job. His post-book cure has been to remove himself from social media and literary “backslapping” and simplify his birdwatching regimen. “I don’t drive to birdwatch any more. I walk from my house. I’m under no pressure to see anything exciting. I’ve stopped commodifying it. I just think of being out where I should be. Whenever I do that I’m really thankful for it. Nature is not there to make me feel better. It’s something we can use to help us but ultimately we have to be there for it as well. And we’ve got to make wholesale changes to how we live.”
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Most nature cure books, both literary triumphs and practical manuals, are overwhelmingly about us. Perhaps we should catch more glimpses of other species as we look into the mirror? Mitchell’s The Wild Remedy, a diary of a year with severe depression, throws welcome attention on natural medicines – the thrilling dash of a sparrowhawk, or the cosy sight of ladybirds clustered together during winter in a knapweed seedhead. She recreates her encounters with other species around her home in Cambridgeshire in paintings, sketches, photographs and cabinets of curiosities. But, she says, “I’m not using my garden and the wood beyond my cottage as a sort of green Tesco, burgling myself some green serotonin and dopamine. It’s much more of a two-way relationship.” Mitchell, like Harkness, initially connected via social media with readers and others who lived with mental illness. She is not always well enough to visit a nearby wood every day. When she does, she monitors, observes and records the wildlife, and relays it to her audience. A biologist by training, Mitchell hopes her writing and art enlighten our increasingly urban society. “I’m trying to use the place where I live as a source of education for people who may not know what cherry plum blossom looks like – ‘This is coming into flower, go and see if you’ve got it on your patch,’” she says. Awakening readers to other species around us is a gift to those species, and it is bequeathed by almost every nature cure writer.
Last summer, an area of flowery meadowland in the wood near Mitchell exploded with life. The hot summer of 2018 must have produced “a metric fucktonne of caterpillars” she laughs: the following year there emerged hundreds of marbled white butterflies. “The dose of dopamine was just off the scale.” She filmed it for her social media followers. A few days later, in full flower, the meadow was scalped because of fears it contained ragwort, a flower that can in rare cases prove fatal to horses (and which landowners sometimes mistakenly believe they are obliged to control under an arcane “injurious” weeds law). An exquisite ecosystem was cut down at its peak. Alongside Mitchell’s enjoyment of this meadow emerged a deep connection with it, and a responsibility for it. “My connection with this land is not as a commodity. This is not skincare I get from a beauty parlour. This is not a monthly subscription to sniff some dead-nettle flowers. This is something that has changed my ability to live with my depression,” she says. In this case, she went into battle with her local council, at some personal cost – “I’m a spokesperson for thousands of invertebrates because they’ve got no voice,” she says – and succeeded in changing the cutting regime. The meadow won’t be cut again this year until the flowers and invertebrates have finished flowering and flying.
Mitchell’s experience also reveals that in the Anthropocene, an era in which humans are reshaping all life on Earth, it is hazardous to pin our wellbeing on the fragments of non-human life that remain. Lucy Jones’s Losing Eden is a passionate and thorough exploration of the growing scientific evidence showing why humans require other species to stay well – from a diversity of microbiota in our guts to a diversity of species in nearby green space. But she is aware that “the medicalisation of nature” also “demonstrates that we still see ourselves as takers and overseers, the authority figures, rather than being on an equal footing with the rest of nature”. Just as Mabey wonders if we can extract wellbeing from an environment we are traducing, so Jones considers the 21st-century challenge posed by ecological grief. Is the epidemic of mental illness in wealthy western societies in part because “some part of our spirits [is] afflicted by the mass burglary humanity has committed on the Earth?” Jones writes. “I know that I feel rotten and out of sorts when I am selfish or hurtful to the people around me”. The ecopsychologist and activist Chellis Glendinning diagnosed western culture as suffering from “original trauma” caused by our severance from nature and natural cycles. She noted that the symptoms were the same as PTSD: “hyperreactions; inappropriate outbursts of anger, psychic numbing; constriction of the emotions; and loss of a sense of control over our destiny”.
The Earth is our home and we are making ourselves homeless. Jones quotes the farmer-thinker Wendell Berry: “We are involved in a kind of lostness in which most people are participating more or less unconsciously in the destruction of the natural world, which is to say, the sources of our own lives.” Perhaps some of our lack of awareness, Jones thinks, is an instinctive denial of death; just as we block out our own mortality, so too we pretend our compulsive consumption is not hastening the premature end of our species’ enjoyment of the planet.
As Jones argues, despite all our writing about “nature”, we still lack the language to bring its jeopardy – our jeopardy – to the forefront of our troubled minds. Western consumption has made the planet ill, and now we are patients too. Grief and mental illness can be introspective and paralysing or they can inspire action. Which path will we as individuals, societies and as a species choose?
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