Category Archives: Therapeutic Wisdoms

Horticulture and Health According to Three Wise Men

By Lesley Fleming, HTR

Hippocrates, Roger Ulrich, and E.O. Wilson…their perspectives on how nature impacts human health brought about seismic changes in medicine, research, healthcare facility design and much more.

Hippocrates, 460BC-370 BC, who is considered to be the father of medicine, introduced Vis Medicatrix Naturae — the concept of the healing power of nature. It became a guiding principle across disciplines and is still considered today to be powerful and relevant, linking nature (including horticulture) to human health.

Roger Ulrich, 1984, conducted research which revealed that views of nature influence faster health recovery in hospital patients. Frequently cited for this research and his work on evidence-based healthcare design, Ulrich has had global influence on nature-health connections.

E.O. Wilson, 1986, popularized the hypothesis that humans have an instinctual need to connect with nature. This concept — and Wilson’s book of the same name — Biophilia has come to signify the need to integrate nature into our lives…using it to find balance and understanding of the inter-relatedness of all living things.

A Tale of Tree Rings: Relating a Tree’s Story to One’s Personal Experiences

I recently did a therapeutic horticulture program with a group of women who are from Afghanistan and clients of a local social services organization serving resettled refugees. On this rainy day, we gathered in the one-bedroom apartment of one of the women. Some of us sat on the floor, while others sat on couches. Our hostess passed around cups of hot tea and cookies. A couple of children played around us while we visited with each other. We communicated via a translator, gestures, and lots of smiles.

To start the session, I passed around some of my favorite sensory plants – lavender, pineapple sage, basil, lemon balm, lamb’s ear, mint, among other – and explained about what I do in my job. I talked about how plants and nature benefit us in many different ways – from lowering stress and anxiety to improving our mood and encouraging physical movement. The group made lavender sachets to keep.

The conversation transitioned to hobbies because gardening is a favorite American pastime, and I asked the group about their hobbies.

Then, to deepen the conversation, I talked about one of the reasons that I like to tend to my garden. I explained that I look to nature to provide perspective on my life. One example is the changing of the seasons and the cycle of life, death, and rebirth – as seen through the lush foliage of summer, followed by the falling of autumn leaves, to the dormancy of winter, then to the first buds of cherry trees and other spring flowers, and back again. How can you relate to the cycle of life to your personal experience?

Then I started talking about trees.

TreeRingsTreeCookieTherapeuticHorticultureHave you ever taken a look at the cross section of a tree? There are a bunch of rings, and if you count them, you can determine the age of the tree. And if you look closer, each ring is slightly different. Sometimes the rings are really close together. Other times the rings are further apart. Sometimes there are blemishes in the rings, and other times they are misshapen.

Why are the rings different from year to year? Well, some years the plant receives all the water, nutrients, sunlight, and other things that it needs in order to thrive – those are indicated by the “healthy-looking” or further spaced rings.

Other years, the rings are close together. That may indicate that the tree didn’t receive all the “goodies” it needed to grow vigorously.

Still other years, the rings may have blemishes or are oddly shaped. That may be due to diseases or insect pests that attacked the plant and affected it. Or, maybe there was a fire that scorched one side of the tree. Or, perhaps someone used a string trimmer around the tree and accidentally nicked the bark of the tree.

HanddrawnTreeRingsTreeCookieTherapeuticHorticulture
Don’t have a “tree cookie” (or cross section of a tree) to look at? Draw it yourself. This is my hand-drawn illustration used during this program. Note: larger and smaller tree rings are shown.

Each ring tells a different story for each year of the tree’s life. Some years were great, and the tree grew and flourished. Some years weren’t so good, when it appears that the tree struggled. Sometimes that indicates that the tree may have succumbed. Or sometimes it shows how the tree, resilient as it is, made it through the challenges and came out on the other end, still bigger than it was the year before.

I have to admit that when I started this last part of the conversation, I could feel a shift in the mood of the room…to a quieter, more reflective mood.

Consider how each of us handle challenging situations. One person may be easily angered when encountering a tough situation and react loudly or in an outward fashion, where people nearby may notice immediately. In the same type of situation, another person may be quiet and prefer to handle her emotions internally, with or without others noticing. I relate that to walking through a forest.

If you look at a forest, there is a wide variety of trees and other plants. Some trees grow up big and tall, reaching for the sun. Some trees are smaller and prefer to be in the understory, shaded by the other trees. No one tree is “better” than the other. They just grow that way and have unique individual responses to their environment. Each tree has a different story to tell. And shouldn’t we celebrate their differences?

 

Horticulture and Health

I am thrilled to host our first guest post from Lesley Fleming, MA, HTR. Lesley is a registered horticultural therapist who has worked with elder, youth, veteran, rehab, and inmate populations through her private practice in Florida. She served as editor-in-chief of the AHTA News Magazine, a publication for the members of the American Horticultural Therapy Association (AHTA), and is a former AHTA board member. Lesley continues to be a prolific and passionate writer and public speaker on a variety of horticultural therapy and people-plant related topics. Here, in her eat|breathe|garden guest post, she addresses the benefits of nature and horticultural activities on human health and wellbeing. Enjoy!

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By Lesley Fleming, MA, HTR
Cover photo: L. Fleming

How does horticulture impact human health?
HandholdingfernHorticulture, defined as the art and science of cultivating flowers, vegetables, ornamental plants, and fruit, can encompass a wide ranging variety of activities that can span all of the health domains: physical, emotional, social, spiritual and intellectual. Health practitioners from across disciplines shed light on the scope of impact horticultural elements can have on human health and well-being. Substantiated by a growing body of evidence, both anecdotal and empirical, society seems intrigued by connections between horticulture and health in our current technology-heavy lifestyle.

What are some of the connections between horticulture and health?

The healing power of natureVis Medicatrix Naturae concept attributed to Hippocrates, refers to healing powers of nature (including horticulture), as a guiding principle for human health and medicine. Ecotherapy, ecopsychology and nature-based therapies are emerging as viable treatment approaches. Rooted in what E.O. Wilson emphasized as the biophilic need for humans to connect to the natural world, these nature-based therapies are often mentioned as antidotes to society’s increasing reliance on technology, environmental decline, increasing mental health issues, and low levels of contact with nature. Environmental psychologist Stephan Kaplan’s 1995 research on the restorative benefits of nature have been embraced by many in the medical and therapeutic communities and are the basis of attention restoration therapies used for treating many patients, especially those dealing with cancer.

Physiological benefits from plants and gardening – Research continues to demonstrate the health benefits from growing, being near, and even breathing in fragrances from plants. Research conducted by Qing Li, Nippon Medical School, Tokyo has provided data that blood pressure, cortisol levels and NK (cancer fighting) activity can be improved through ‘forest breathing,’ where aromatic compounds called phytoncides release chemicals that when breathed in, can improve physical well-being. Research published in the Journal of American Geriatrics Society suggests that walking a reflexology path, which stimulates the feet’s pressure points, can improve blood pressure when done on a regular basis. Smelling lavender and rosemary can address the body’s ability to fight disease and decrease levels of cortisol. Research continues to explain other physiological benefits from plants and gardening activities.

The emergence of gardens in healthcare settings – Gardens in hospitals have a long history dating back thousands of years. In the last 15 years, more and more healthcare facilities have integrated green spaces into their physical facilities. In part responding to the Joint Commission for the Accreditation of Hospitals Organization’s 1999 report calling for opportunities for patients and visitors to connect with nature, as well as a response to client-based preferences for views of, and access to plants, both of these reflect Ulrich’s (1984) research conducted in a hospital setting where patients with views of nature had faster recovery time.

Social movements rooted in gardening activities – These include community and school gardens, World War II victory and allotment gardens, permaculture communities, community social agriculture (CSA), fair trade, poverty and social justice concerns, social groups–garden clubs, master gardeners, 4-H, Future Farmers of America clubs, and high school environmental clubs, to name a few. Often correlated to food security, social movements involving gardening activities have been able to sustain themselves because they address a basic human need—growing food—while providing social, educational, recreational, and political connectors.

Horticultural therapy and other treatment modalities – including recreation, physical, occupational, and eco- therapy have incorporated gardening and plant-based activities (assessment and treatment) into their disciplines. Though the historical roots of gardening for rehabilitation can be traced back to the 1800s, the popularity of therapeutic practices using horticultural activities has dramatically grown in the last decade and a half. Newer approaches like nature-based therapies (NBT), ecopyschology, and wilderness therapy have broadened how nature and horticulture are used to improve human well-being and target specific health deficits.

Veteran to farmer programming – Integrating vocational, therapeutic, educational, social enterprise, and rural community restructuring elements into innovative programs for those transitioning from military to civilian life, it is the connection between horticulture and health that has spurred the development of alternative approaches for addressing the mental, physical, social, and economic challenges faced by Post 9/11 soldiers. Likened to European care farms, this hybrid model of social, vocational, and health programming has as its core value, connecting human to nature. Few of those who have initiated veteran to farmer programs use terms like horticultural therapy or therapeutic outcomes to describe their programs or the changes observed in participating veterans, but this is another example of how horticulture (one aspect of nature) connects to human health. (The author’s research, titled “Veteran to Farmer Programs: An Emerging Nature-Based Programming Trend” was published in 2015 in the Journal of Therapeutic Horticulture 25 (1) pp.27-48. )

In summary
The positive health outcomes attributed to contact with nature, specifically horticulture, continue to be recognized and validated through empirical research in a wide array of health disciplines. Linking horticulture to health – be it through treatment, social engagement, improved nutrition, garden design, or other – speaks to the impact plant-based activity can have in all health domains. The sense of hope for cancer patients growing their own healthy food, reduced recidivism rates for incarcerated individuals who participate in horticultural therapy programs, greater parent involvement in their children’s school gardens, active aging populations who socialize at community gardens—all serve as examples. No longer relegated to the narrow category of fiber, food, or medicine, plants and their related plant-based health services broaden the scope of impact horticulture is having on human health and well-being.

References
Atsumi, T, and K Tonosaki (2007). Smelling lavender and rosemary increases free radical scavenging activity and decreases cortisol level in saliva. Psychiatry Research 2007; 150:89–96.

Farmer Veteran Coalition (2014a). About Us. http://www.farmvetco.org/about-us

Fleming, L. (2015). Veteran to farmer programs: An emerging nature-based programming trend. Journal of Therapeutic Horticulture 25(1) 27-48.

Grahn, P. et al. (2010). Using affordances as a health promoting tool in a therapeutic garden. In C. Ward Thompson, S. Bell & P. Aspinall (Eds.), Innovative research in landscape and health (pp.116-154). London: Taylor & Francis.

Hiroshi, H. (1998) “On Vis medicatrix naturae and Hippocratic Idea of Physis” Memoirs of School of Health Sciences, Faculty of Medicine, Kanazawa University 22:45-54 http://sciencelinks.jp/j-east/article/199907/000019990799A0162403.php

Kaplan, S. (1995). The restorative benefit of nature: Toward an integrative framework. Journal of Environmental Psychology 15(3), 169-182.

Li, F., Fisher, J. & Harmer, P. (2005). Improving physical function and blood pressure in older adults through cobblestone mat walking: A randomized trial. Journal of the American Geriatrics Society 53(8), 1305-1312.

Ulrich, R. (1984). View through a window may influence recovery from surgery. Science 1984; 224:420–21.

Wilson, E.O. (1984). Biophilia. Cambridge, MA: Harvard University Press.

The Five Ways to Wellbeing

I was recently introduced to the concept of “The Five Ways to Wellbeing.” The Five Ways succinctly summarizes the actions people can take towards positively affecting their wellbeing and improving their “mental capital.”

Connect
Be Active
Take Notice
Keep Learning
Give

Essentially, they encourage people to:
> Connect and engage with people – and I would also argue to engage with the world around you, not just the human inhabitants, but also the landscape and its furry and photosynthesizing friends who live in it;
> Be active by moving your body – and I would also suggest “exercising” your mind;
> Take notice of what’s going on in the world – be curious, be in awe, be in the moment;
> Keep learning, whatever your age, ability, or interests;
> Give to others, whether it’s volunteering your time, supporting a friend, or simply offering a smile or a compliment to someone.

Considering how wordy and verbose I am, you can imagine my delight when I came across these! As a therapeutic horticulture practitioner, I’m in the business of promoting wellbeing for people through directed experiences with plants and nature. When reflecting on these basic guidelines, I see how they already are an integral part of my programs, and now I have the simple words to summarize it.

The Five Ways were developed by the new economics foundation, as a user-friendly tool for condensing and communicating the overall message from the research presented in the 2008 UK publication from the Foresight Project on Mental Capital and Wellbeing. Check out the nef’s website on The Five Ways to Wellbeing to read more.