Integrating Nature into Psychedelic Treatments

Many people’s most memorable and enriching psychedelic experiences have taken place in a natural setting. For the same reason, psychedelic ceremonies and retreats are often held in nature. Natural settings and features can enhance aspects of the psychedelic experience. For instance, some examples are positive mood and nature-relatedness (how connected one feels to the natural world). Research has also begun to confirm these benefits.

“Incorporating nature-based settings into psychedelic treatment models could elicit a potential beneficial synergy.”

Dr Sam Gandy et al. [1]

However, understanding the synergy between nature and psychedelics presents a challenge to psychedelic therapy. Evidently, this is because this form of therapy typically takes place in a clinical setting. For this reason, the duration of the session happens indoors. But this doesn’t mean psychedelic clinical trials or clinics can’t (or haven’t) been designed with natural features in mind. Other psychedelic researchers also underscore how nature can be better incorporated into psychedelic therapy.

How Contact with Nature Improves Our Mental Health

In 2020, a literature review by Dr Sam Gandy et al. was published in Health Psychology Open. Specifically, it explores the synergistic effects between psychedelics and nature contact [1]. The researchers involved draw attention to a plethora of studies on how nature contact benefits mental health. Contact with nature is associated with:

• Reductions in mental distress, anxiety, and depression
• Reductions in rumination and stress levels
• Improvements in mood and memory in patients suffering from major depressive disorder
• Improvements in the symptoms of post-traumatic stress disorder (PTSD)
• Elevations in well-being
• Increases in vitality, self-esteem, and positive affect

Even 5–10 minutes spent in a natural setting can improve psychological well-being and lower anxiety and stress levels. 

What’s more, spending time in nature is also linked to increases in nature-relatedness. This is a measurable trait that refers to how closely one self-identifies with nature. In addition, it can be defined as a sense of oneness with the natural world. Alternatively, an awareness of how interrelated one is with the rest of nature. 

A substantial body of literature shows a strong association between nature-relatedness and psychological well-being. Subsequently, this trait has been linked to:

• Enhanced vitality
• Greater perceived life meaning
• Feelings of worthwhileness
• Greater happiness and positive affect
• Reduced levels of anxiety
• Higher levels of self-reported personal growth
• Enhanced psychological functioning and resilience
• Physical activity
• Pro-environmental attitudes and behavior—which themselves are tied to enhanced well-being and prosociality
• Life satisfaction
• Transcendent and awe-inspiring experiences
• Higher valuations of intrinsic aspirations (e.g., personal growth, intimacy, and community) as opposed to extrinsic aspirations (e.g., money, image, and social status)

The Synergy Between Psychedelics and Nature Contact

Gandy et al. emphasize several ways in which there can be a potential synergy between psychedelics and contact with nature. Evidently, both can create the following effects that benefit our mental health:

• Positive neurobiological effects. This refers to reduced activity in the default mode network, or DMN. The DMN is an area of the brain that has been linked to rumination.
• Greater connectedness—to self, others, and the world. This is important, as disconnection, alienation, and isolation are implicated in many forms of mental distress, including depression and PTSD.
• The experience of awe.
• Reduction of negative affect.
• Increased mindfulness—or being attentive to what is taking place in the present.

Better Trips

By incorporating nature contact into psychedelic treatment, beneficial effects could potentially be magnified. Certainly, contact with nature immediately improves our mental health. Moreover, as a result, it could help foster positive psychedelic journeys and minimize the likelihood of difficult trips. As Gandy et al. write, “Given that anxiety is a predictor of challenging or anxiety reactions to psychedelics…the importance of a psychologically soothing setting cannot be overstated.” They add:

“Given the capacity of nature contact to reduce rumination and encourage present moment focus…holding psychedelic sessions in natural environments could counteract mental preoccupation which has been associated with increased likelihood of challenging experiences with psychedelics”.

Greater Therapeutic Effects

Nature appears to act as an amplifier of therapeutic effect. A 2009 study looked at cognitive behavioral therapy (CBT) applied in a forest environment. Indeed, it found that this led to better outcomes than the same therapy delivered in a clinical setting [2]. Forest therapy refers to engaging one’s senses in a forest environment. In addition, a 2012 study also revealed that forest therapy can ameliorate depression in people with alcohol dependency [3].

Psychedelics are commonly referred to as ‘non-specific amplifiers’ (a term derived from psychiatrist Stan Grof). In brief, this means they can amplify whatever mental state or environmental context they are applied to. Accordingly, a beneficial implication of this is that they can act as catalysts or amplifiers of psychotherapeutic practices and processes.

“The importance of a psychologically soothing setting cannot be overstated.”

Dr Sam Gandy et al. [1]

Gandy et al. state, “If both psychedelics and nature can act as amplifiers for therapeutic effect, this is suggestive that incorporating nature-based settings into psychedelic treatment models could elicit a potential beneficial synergy.” They add that “feelings of interconnectedness with the natural world [elicited by psychedelics] are likely to be more prominent in outdoor nature-based settings”.

How Can We Better Incorporate Nature into Psychedelic Therapy?

The ‘set’ (immediate psychological state) and ‘setting’ (sociocultural and environmental context) are key factors that influence the psychedelic experience’s quality. In clinical settings, psilocybin is typically administered in a hospital room or living room-like environment. People in these sessions normally wear eyeshades and headphones playing music. The therapists will instruct the patients to focus their attention inward. All of this helps to limit distractions and facilitate the processing of autobiographical content. 

However, in such sessions, there are many instances where the participant removes the eyeshades. For instance, discussions with the therapists tend to happen when the eyeshades are removed. And during this, the participant will be aware of the surrounding environment.

Incorporating Nature into the Session Space

Despite all the potential benefits offered by a natural setting, there are major barriers to holding psychedelic sessions in nature. Issues include disturbances, privacy, and weather. Indoor settings, on the other hand, offer a greater amount of control, comfort, and safety than wild outdoor settings. Based on these trade-offs, Gandy et al. state:

“In situations where a clinical room is needed, bringing some natural elements into the clinical space can be beneficial, for example, plants (including those that belong to the session participant), nature-based photography and art, and a nature-based backdrop. Screens depicting woodland scenes were incorporated into the clinical protocol of the Phase II psilocybin for major depression treatment room at Imperial College London”.

They add:

“Even better than this would be the use of a hybrid indoor/outdoor secure, sheltered structure incorporating biophilic design elements… in a nature-based setting with large skylights and windows. This would allow the therapist to titrate the amount of nature immersion according to the client’s needs as the session progresses. Structures incorporating biophilic design elements, sheltered gardens, based in a rural, nature-based setting will be utilised by the Usona Institute in their future psychedelic therapy treatment centre.”

Nature Contact During the Preparation and Integration Phases

Furthermore, even when psychedelic sessions take place in a clinical setting, nature contact can still be incorporated. This can be done in the preparation and integration sessions. Gandy et al. suggest some nature immersion exercises that could be helpful in this respect. Horticulture exercises are one example. Before the session, they write, “Individuals and groups could spend time weeding a patch of land, and tilling the soil, and adding compost as a ritual to mark the cleansing and preparation of the inner landscape (the psyche) ready to receive new insights, and experience psychological growth.”

Similarly, after the session, horticultural exercises could be useful. The researchers note that “planting a seed in the freshly tilled soil” can be viewed “as a ritual to mark a new beginning, and a commitment to provide the psychological conditions for personal growth.”

Another nature immersion exercise used to enhance preparation and integration could be the practice of Shinrin-yoku (forest bathing). This nature therapy and mindfulness practice contains exercises that help people get out of their heads and into their environment. Another option is sitting in a calming, sheltered garden and focusing on one’s sensations. And another, taking an awe-inspiring walk in a natural setting.

The researchers conclude, “Future studies should seek to investigate the benefits of natural settings and how they may complement (or supplement) clinical or indoor settings in greater detail, employing fine-grained assessments of the settings in question, with thorough attention to potential risks.” This kind of research will help clinicians deliver psychedelic treatments with nature contact in mind. Simultaneously, a high priority can be placed on efficacy and safety.

References

1. Gandy, S., Forstmann, M., Carhart Harris, R.L., Timmermann, C., Luke, D., and Watts, R. (2020). The potential synergistic effects between psychedelic administration and nature contact for the improvement of mental health. Health Psychology Open, 7(2), https://doi.org/10.1177/2055102920978123. 
   
2. Kim, W., Lim, S.K., Chung, E.J., and Woo, J.M. (2009). The effect of cognitive behavior therapy-based psychotherapy applied in a forest environment on physiological changes and remission of major depressive disorder. Psychiatry Investigation, 6(4), 245–254. https://doi.org/10.4306/pi.2009.6.4.245
   
3. Shin, W.S., Shin, C.S., and Yeoun, P.S. (2012). The influence of forest therapy camp on depression in alcoholics. Environmental Health and Preventive Medicine, 17(1), 73–76. https://doi.org/10.1007%2Fs12199-011-0215-0