Josh Short MD
Updated: Apr 20
“It has been proposed that administering psychedelics in natural settings known to elicit awe may enhance treatment efficacy of psychedelic therapy if safety is ensured. “
Western Medicine appropriately has a mixed reputation. We have become increasingly aware of the downstream consequences of for-profit health care and our focus on pharmacological disease management instead of preventative care. It’s very hard to bill an insurance company for an illness that you prevented. Western medicine’s reliance on correctly interpreted evidence excludes intuitive approaches and types of healing that are untestable. It’s hard to conduct a study about the outcomes of doctors actually caring about patients enough to have a real relationship with them. But I’d hate to tell a medical student not to care too much about their clients because there wasn’t any evidence supporting that approach.
But interpreting and discussing evidence to produce standards of care is an invaluable safeguard against roguish practitioners or doing things just because an expert recommends it. The reliance on evidence for medical decision making can be a valuable tool for preventing harm and is the basis for a popular saying in emergency medicine: “don’t just do something, stand there.” Taking a moment to use and interpret information well can defeat the hubris that can accompany healing as a profession.
For many, our emphasis on nature connection as a way to improve our innate healing capacities does not need questioning or explaining. I find it telling that amidst the dangerous surge in divisiveness and polarization in our culture, there seems to be consensus that taking some time to do nothing outdoors is generally good for humans. I have yet to encounter someone who argued that time in nature is bad for people even on social media, a place where nonsense is regularly and sanctimoniously validated.
Nonetheless, there is high quality data that supports the use of nature as a healing modality. The practice of Japanese forest bathing (shinrin-yoku) has been well studied and meta-analyses have found consistent improvements in physical and mental health, if health can even be divided between mind and body. We know that hospital patients with views of natural scenery recover more quickly with fewer postoperative complications. Richard Louv’s research suggests that “nature deficit disorder” may lie at the heart of the many health challenges we see in children.
A compilation of research in ScienceAdvances in 2019 does a nice job of summarizing the existing research with several consensus statements which I have quoted below. Sources are in the original article cited at the end of this blog.
“A wealth of studies has demonstrated that nature experience is associated with psychological well-being. These include investigations of single as well as cumulative occasions of nature contact, and range from experimental to observational designs. The forms of association include evidence that links nature experience with increased positive affect; happiness and subjective well-being; positive social interactions, cohesion, and engagement; a sense of meaning and purpose in life; improved manageability of life tasks; and decreases in mental distress, such as negative affect. In addition, with longitudinal studies, as well as natural and controlled experiments, nature experience has been shown to positively affect various aspects of cognitive function, memory and attention, impulse inhibition, and children’s school performance, as well as imagination and creativity.”
Can you think of any other drug or procedure in western medicine that could make a similar claim? And that is also free? And enjoyable? Sometimes science glosses over miracles but these results are worth spending a few minutes thinking about. “Happiness..sense of purpose..creativity” I wonder if most drug manufacturers would refer to these as side effects. The article continues with the following:
“Nature experience has been associated with improved sleep and reductions in stress, as assessed by self-report and various physiological measures and biomarkers of acute and chronic stress. These impacts on sleep and stress may entail decreased risk for mental illness, as sleep problems and stress are major risk factors for mental illness, especially depression. In addition, there is growing evidence that nature experience is associated with a decreased incidence of other disorders, including anxiety disorders, attention deficit and hyperactivity disorder (ADHD), and depression.”
If you consider the immense toll that anxiety, depression, and ADHD have on individuals and society in general, the costs and side effects of pharmacologic treatment, and the hours and dollars spent on therapy, the benefits of nature therapy are immense. And, again, nature exposure is free, lacks side effects, and is almost universally available.
In the article “Human nature connection and mental health: What do we know so far?” by Divya Chavaly and K.P. Naachimuthu which is cited at the end of this piece, we find the following:
“Short-term exposure to forests, urban parks, gardens and other semi-natural environments has been found to reduce stress and depressive symptoms, increase self-reported positive emotions, improve self-esteem, mood, perceived mental and physical health and produce physiological and psychological relaxation. Long-term exposure to natural environments, such as residing in areas with high greenness or in diverse landscapes, has been associated with reduced mortality and to improved mental health.
Outdoor time has been linked with physical activity increase and lower chronic disease risk, including cancer, cardiovascular diseases, diabetes and obesity.
Exposure to green or natural environments has been found to be particularly important during prenatal development and early life. Birth weight of infants was seen to be positively influenced by their mother's neighborhood greenness. Local greenery has also been linked to prevalence reductions of obesity in children and shown to have a positive effect on adolescents' blood pressure.”
While most people will find it unsurprising that time in nature benefits their health, the fact that this is provably true and that we still have not incorporated nature connection into our healthcare system is a little embarrassing to say the least. It’s almost as if drug and insurance companies would be opposed to a cheap, universally available, side-effect free preventative to the drugs commonly prescribed in western medicine.
At Asheville Integrative Psychiatry, our focus is on nature connection and supporting our client’s inner healing intelligence. We know from intuition, experience, and evidence that this is a good idea. And while it is easy to imagine that the effects of psychedelic medicines and nature connection are synergistic, we don’t have to. Again, existing research shows that increased connectivity associated with both psychedelics and nature connection is improved by combining these approaches. Interestingly even using psilocybin indoors has been shown to steadily and reliably increase nature relatedness, which is eerily mystical.
Sam Gandy MD, PhD has written extensively about the synergy between psychedelics and nature experiences. In his article, “The potential synergistic effects between psychedelic administration and nature contact for the improvement of mental health”, he details the many similarities in outcomes between psychedelics and nature experiences. Perhaps the key overlap is in their mutual ability to inspire awe, the emotion of being overwhelmed by wonder and inspiration.
“The experience of awe has been linked to enhanced well-being, life satisfaction, prosociality, and reduced negative affect, and mental distress, in addition to being associated with nature relatedness and pro-environmental behavior, all enduring effects associated with psychedelic use. Psychedelics have been found to elicit feelings of awe, and an enhancement of awe may persist beyond the acute experience. This in turn has been linked to enhanced feelings of connectedness and empathy. Nature can be considered a prototypical inducer of awe, with experiences of awe more reliably triggered by exposure to natural rather than built environments.
It has been proposed that administering psychedelics in natural settings known to elicit awe may enhance treatment efficacy of psychedelic therapy if safety is ensured.
Experiences of awe in nature may be associated with perception of large natural objects such as mountains or vistas, events such as storms, or objects with infinite repetition, including waves and fractal patterns, such as trees, clouds, rain and birdsong – and a ‘smallness of self’ in this context. Perception of fractal patterns is also commonly associated with the visual imagery elicited by psychedelics. Awe is deeply tied to feelings of spirituality, and spirituality and nature relatedness appear to be strongly linked.”
We know in our hearts and in the research setting that time in nature helps humans be their best. Other than the occasional sunburn, bug bite, or surprise thunderstorm, nature exposure has few potential downsides and is widely available for free. Why not make it part of your daily regimen of self care immediately?
1. Nature and mental health: An ecosystem service perspective, ScienceAdvance, Vol 5, no. 7, 7/24/2019
2. Human nature connection and mental health: What do we know so far? Indian Journal of Health and Well-being 2020, 11(1-3), 84-92
3. The potential synergistic effects between psychedelic administration and nature contact for the improvement of mental health, Health Psychology Open July-December 2020: 1–21