A Conversation with Dr. Qing Li about His New Book on Shinrin-Yoku

The Japanese practice of Forest Medicine,or Shinrin-Yoku, has gained quite a bit of notoriety of the past few years. Dr. Qing Li is the person who helped develop this practice and promote it first in Japan, and subsequently around the world. I first worked with Dr. Li in 2011, and had the opportunity to meet with him in 2013 where we presented at a conference about the International Society of Nature and Forest Medicine.

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Qing Li and Mark Ellison hosting the first North American INFOM meeting.

Dr. Li is a physician at Tokyo’s Nippon Medical School, a visiting fellow at the Stanford University School of Medicine, is a founding member and chairman of the Japanese Society for Forest Medicine, a member of the Task Force of Forests and Human Health, and the vice president and secretary general of the International Society of Nature and Forest Medicine.

He has a new book that will be released in April 2018: Forest Bathing: How Trees Can Help You Find Health and Happiness which will provide insights to how nature impacts our health and how to experience Shinrin-Yoku. I recently had the opportunity to get feedback from Dr. Li about his new book recently.

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What is the focus of this book?

“Although there is not much new data in this book, it is written for general readers in an easy to understand manner. The target audience for this book is the general public, not for researchers. There are many forest bathing practices in this book.”

Is Forest Medicine becoming more widely accepted?

“We have to understand that Forest Medicine is a preventive medicine, but not a clinical medicine in the moment. I hope Forest Medicine will be developed into a clinical medicine at least partially.”

What countries are in the forefront of developing forest therapy bases and or integrating access to nature as a primary public health initiative?

Japan, Korea, Finland, China

How do you practice Shinrin-Yoku?

“I always go to forest bathing once a month and visit city park every weekend. I always take hot spring after forest bathing.”

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Dr. Qing Li

Spending time in nature has many benefits for the mind, body, and spirit. Take time to learn more about Shinrin-Yoku in your efforts to maximize your health and well-being.

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Five Ways to Connect to Nature in 2018

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Plott Balsam Mountain Range (North Carolina)

The new year is a fantastic time to rediscover how being in nature can help reduce stress and increase effectiveness. You do not have to make a large commitment of time, just block out some space in your schedule. Here are a few tips that I use to help stay connected to nature.

Develop a Plan Focused on Doing Things You Love

I like to spend time in nature by hiking, cycling, mountain biking, and kayaking, so I set goals in each of these areas to make sure I stay on track. It helps my physical fitness, and also my mental fitness. It is not about the numbers, but that helps me stay motivated. I had 1,300 miles in 2017, so I am aiming for 1,500 in 2018. My body, mind and spirit will thank me for every extra mile.

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Sunset over Great Smoky Mountains National Park as seen from Waterrock Knob Trail (NC)

 

Make Room for Silence

We live in a noisy world. One way to escape the stress that this causes is to allow the silence available in nature to capture your attention. This is not only calming but serves to help restore your attention capacities. Find quiet places to go on a lunch break or for an after work stroll. When you have time for more extended trips, find places that are not near areas with lots of human created noises (eg, roads, airports, neighborhoods).

Reflect While You Are in Nature

Getting away from the things that cause stress and spending time in nature is the perfect setting to reflect. Bring a journal and write about whatever is on your mind. Try writing with your non-dominate hand to help your mind slow down. Draw the things you see in nature. These simple approaches to reflection can help you relax.

Volunteer

There are numerous volunteer opportunities that can get you out in nature more. Perhaps there is a community garden in your area, or a trail maintenance and hiking club such as the Carolina Mountain Club in Asheville, NC. These are great ways to help the environment and make new friends.

Take a Social Media Fast

Social media diverts attention. When you are in nature stop thinking about what pictures you want to take to share on social media. Let yourself become immersed in the experience. You will remember much more about the things you saw during a hike if you are not constantly thinking about what you want to photograph.

Enjoy the new year and get outside as much as you can. There is bountiful research showing that time in nature truly does wonders for your mind, body and spirit.

I hope to see you out on the trail or paddling sometime soon!

The power of the forest is dying as natural silence goes extinct

It was in the forest that I found the peace that passeth understanding.”  Jane Goodall

Silence. Does the thought of if scare you or give you a sense of inner peace? Can you recall the last time you experienced silence? Have you ever?

The healing power of nature impacts, the mind, body and spirit. Research studies demonstrate this, and many of us know this intuitively. One of the primary attributes of nature that provides health benefits is the freedom from human created noise. Half the world’s population now lives in busy, loud urban settings, many not knowing the peace and healing that natural silence offers.

Gordon Hempton, acoustic ecologist, and  founder of One Square Inch of Silence in Hoh Rain Forest, believes that natural silence is going extinct. In an interview on PBS On Being, he indicated that he was aware of only 12 remaining places that offered natural silence of at least 15 minutes. I visited the Hoh Rain Forest several years ago and it is by far one of the most enchanting and peaceful places I have ever been. Hempton has worked tirelessly to help preserve quiet there.

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Standing Indian Mountain (North Carolina)

It seems as though the delicate balancing act between economic growth and preserving natural places for escape has been a struggle for centuries. This has become increasingly important now as our world population continues to expand, demanding more resources, with further urbanization, which creates relentless cascades of noise. The United States has had an on again. off again approach to protecting nature. Over the past eight years many natural areas have been protected. Unfortunately, we are now entering a time when those governing  the country apparently are cynical and uncaring towards the incredible importance of nature to our health, instead advancing legislation to make national parks, forests and wilderness areas more accessible to developers by handing the land over to states. We need more natural areas for recreation, not fewer as the United States and world populations continue to increase. Once these places are developed we are not getting them back. 

The absence of noise is not a luxury. Studies have found that increases in noise are associated with increased crime, stress levels,  and numerous other associated health problems. As a society it seems as though we have become obsessed with creating noise, and needing to have noise to feel safe. How many people do you know that have to always have a television on, have ear buds to listen to music, or be talking?

I am interested in your feedback. Do you value silence? Are you comfortable with it? Where do you go to experience it? How do you benefit from the experience? 

Hiking in Nature = Improved Mental Health?

By Mark A. Ellison, Ed.D.

Fall is a wonderful time to be in nature. The leaves are turning radiant hues, the air is crisp, and the sky is a deep blue. Nature has even more umph to refresh our mind, body and spirit.

Shining Rock Wilderness in the Appalachian Mountains of North Carolina

Shining Rock Wilderness in the Appalachian Mountains of North Carolina

Researchers at Stanford University recently found that walking in nature is not only awe inspiring but provides measurable mental health benefits and may even reduce the risk of depression. Specifically, the study found that people who walked in a nature area for 90 minutes compared to participants walking in an urban area, had decreased activity in the brain associated with a key factor for depression. “These findings are important because they are consistent with, but do not yet prove, a causal link between increasing urbanization and increased rates of mental illness,” said co-author James Gross, a professor of psychology at Stanford.

The study authors note that city dwellers have a 20 percent higher risk of anxiety disorders as well as a 40 percent higher risk of mood disorders compared to people living in rural settings. People born and raised in cities are twice as likely to develop schizophrenia.

This research is important as urban planners identify how to best use limited resources, and national and state parks grapple with how to manage the demands of a growing population on finite public lands. People who live in settings that have constant noise and little nature need a place to escape. It is also critical that children are introduced to nature and learn how to utilize it for maintaining good mental and physical health throughout life.20151006_180640_resized

Continued research on the connections between nature and human well-being are vital. Important work is being done by The Natural Capital Project which is focused on quantifying the value of natural resources to the public and predicting benefits from investments in nature. It is a joint venture of the Stanford Woods Institute for the Environment, The Nature Conservancy, the World Wildlife Fund and the University of Minnesota’s Institute on the Environment.

Being able to quantify and predict the benefits that nature offers to human health may be the strongest case that can be made for preserving nature. A world void of places to escape in nature is truly a depressing concept, one hopefully we will never have to experience. Our mental health hinges on it.

Finding Quiet Can Be Elusive, Even in Nature

By Mark A. Ellison, Ed.D.

Perhaps you noticed that we live in a noisy world. Maybe it is the constant hum of traffic, or the construction near your office, or the neighbors that are constantly using lawn equipment. It is difficult to escape. Over half the world’s population now lives in urban settings, making it extremely difficult to find quiet if you live in these settings. Even in rural areas, finding places free of human created noise is not easy.

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The National Park Service recently created a map that indicates that many people live in areas where night skies and soundscapes are very degraded. The blue areas of the map below indicate places where noise is less prevalent. Unfortunately, most of the eastern United States is brightly colored indicating significant noise and light pollution. The park service also found that even in more natural backcountry settings noise is prevalent due to hikers, maintenance equipment and other sources. Excessive noise is harmful not only to human health, but to wildlife as well. Certain species of animals avoid noisy places. America_Quiet

Fortunately there are places such as the “One Square Inch” project in Olympic National Park that are treated as sanctuaries for silence, to experience the quiet of nature, and used to help build awareness of the need for more areas like it.

A number of research studies have linked excessive noise with increased levels of violence and crime. Humans need to experience some levels of quiet and solitude to remain healthy. Nature provides a primary escape for this. However, if the dwindling areas of nature are not protected, there will no more places offering this type of escape.

Many of us struggle to hear our “inner voice”, to live a balanced life, and to take time to reflect. The Cherokee have a term for living life in balance, duyuktv. Take time to find a quiet natural area nearby and soak in some of the restorative power of nature, to find a sense of balance, of duyuktv. Once you have captured that restoration, share it with others. Then, work together to help protect the natural areas where you live and explore.

Required Reading: Therapeutic Landscapes: An Evidence Based Approach to Designing Healing Gardens and Restorative Outdoor Spaces

By Mark A. Ellison, Ed.D.

The most impressive book I have read in 2014 on the restorative and therapeutic power of nature is by Naomi Sachs and Clare Cooper Marcus titled: Therapeutic Landscapes: An Evidence Based Approach to Designing Healing Gardens and Restorative Outdoor Spaces. This book is the first on the topic published since 1999, and fills a critical gap, addressing emerging issues such as sustainability; the participatory design process; restorative spaces in public places; and gardens for veterans and active duty military personnel with traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD).????????????????????????

The beauty of this book is that it can benefit those dipping their toes in this subject for the first time, or for more experienced researchers and practitioners looking to advance their knowledge base. This really is a wonderful handbook for healthcare organizations on how to incorporate nature into their patient settings. The demand for this type of expertise will only become more prevalent as additional, more natural and holistic methods for promoting healing are sought, and government demands for efficiency and accountability in the healthcare setting increase.

Marcus and Sachs cite a substantial array of research on the links between nature and health. Chapters focus on designing therapeutic gardens for specific populations such as veterans, mental and behavioral health facilities, the elderly and children. There is also a chapter dedicated to funding the development of gardens and the business case for having them.

This book is very impressive and includes over 300 visual illustrations that make it appealing. I highly recommend this book as an authoritative resource on the therapeutic use of landscapes and nature. It should be required reading at all healthcare facilities as they prioritize how to utilize scarce resources in ways that have the greatest impact on patient health and healing, and for any class delving into the study of how nature can impact human health.

An Interview with Therapeutic Landscapes Expert Naomi Sachs

By Mark Ellison, Ed.D.

I recently had the opportunity to talk with Naomi Sachs, ASLA, EDAC, Founding Director of the Therapeutic Landscapes Network, and co-author of the recently published book Therapeutic Landscapes: An evidenced based approach to designing healing gardens and restorative outdoor spaces. Naomi received her MLA from the University of California at Berkeley and is currently pursuing a Ph.D. in architecture at Texas A&M University focusing on access to nature in healthcare environments through the Center for Health Systems and Design. Naomi is an informative and influential voice on the therapeutic use of gardens and nature for human health. Naomi took time to answer a few questions related to her new book, research interests and how to incorporate nature into the home landscape.

Naomi Sachs

Naomi Sachs

Hiking Research: What inspired you to pursue a nature/landscape focused career?

Naomi Sachs: I grew up in a rural town in northeastern Connecticut, and I think having nature all around me (and not much else!) instilled in me a deep appreciation for trees, plants, wildlife, water, and fresh air. My affinity with nature, combined with a love for art, photography, research, and writing made landscape architecture a good fit. I was thrilled to learn about healing gardens in the mid-nineties when I had started looking into graduate schools. This area of the field seemed like (and is) a way to make a positive difference in people’s lives while doing something creative.

Hiking Research: Talk about your new book Therapeutic Landscapes and why you chose to pursue this.

Naomi Sachs: A book on access to nature in healthcare facilities was long overdue. The last books on the subject were published in 1999 (funnily enough, three books related to the subject were published in the same year: Healing Gardens, edited by Clare Cooper Marcus and Marni Barnes; Restorative Gardens, by Nancy Gerlach Spriggs, Richard Enoch Kaufmann, and Sam Bass Warner; and The Healing Landscape, by Martha Tyson). Since then, much new research, and many new issues, have emerged that needed to be addressed – for example, sustainability; the participatory design process; restorative spaces in public places; and gardens for veterans and active duty military personnel with traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD). The book, with practical design guidelines, case studies, and over 300 color illustrations, is user-friendly and accessible to designers, healthcare providers, students, and lay people.????????????????????????

Hiking Research: What research projects are you currently involved with?

Naomi Sachs: First, I’ll say that as hard as it is, I love being a PhD student. I do enjoy design, and still love being the Director of the Therapeutic Landscapes Network. But exploring new ideas and coming up with original research is extremely satisfying. As a student in architecture at Texas A&M University, I have the pleasure of working with incredibly smart, talented, and experienced faculty and students in the Center for Health Systems and Design  For my dissertation, I’ll be focusing on developing a standardized healthcare garden evaluation “toolkit” – a set of research instruments that will allow designers and clients to assess outdoor spaces in hospitals. Right now, no such thing exists and so designers and researchers end up reinventing the wheel with each new study; this makes it hard to compare findings from one study to another—too often, we are trying to compare apples and oranges—which undermines the credibility of the research and our ability to generalize from one scenario to another. The toolkit will not only enable the evaluation of gardens; it will also be used as a tool for research and evidence-based design. In testing the toolkit, I’ll be looking specifically at what design and programming elements influence garden use, and how that affects patient, visitor, and staff satisfaction.

Hiking Research: Describe the Therapeutic Landscapes Network, its purpose, and importance.TLN_homepage

Naomi Sachs: The Therapeutic Landscapes Network is an international, interdisciplinary knowledge base and gathering space focused on healing gardens, restorative landscapes, and other green spaces that promote health and well-being. The network is made up of designers, health and human service providers, scholars, students, gardeners, and nature enthusiasts. Though our focus is broad, our primary emphasis is on evidence-based design in healthcare settings. I created the TLN’s precursor, the Therapeutic Landscapes Database, in 1999 as a sort of online encyclopedia—a way to provide up-to-date information to people all over the world. With the advent of social media, through sites like Linked In, Facebook, and Twitter, we have become much more interactive, which is wonderful. Our vision, “Connecting people with information…people…nature” has become a reality.

Hiking Research: Are healthcare providers embracing nature as an important element in their facilities for patient and employee health and well-being?

Naomi Sachs: I think healthcare providers are really starting to embrace nature as a critical element in the environment of care. As Clare and I often say, it’s no longer just “the icing on the cake.” This is not just true of access to nature. The concepts of patient- and family-centered care; evidence-based design; and “salutogenic design” – design for wellness rather than illness—are all gaining acceptance by designers and clients. Beyond common sense and intuition, there is solid research to validate the profound health benefits that can be derived from contact with nature. Healthcare settings (and by this I mean not just general acute care hospitals but also hospices, assisted living facilities, mental and behavioral health clinics, and so on) are some of the most difficult places for people to be. The patients, visitors, and even the staff are under an enormous amount of stress. Gardens are an excellent way to reduce that stress and provide a life-affirming experience. People in the industry now see the social as well as economic value of providing gardens and other ways to connect with nature.

Hiking Research: What are five suggestions you have for people who want to incorporate nature into their landscape at home?

Naomi Sachs: Well, it’s very personal, especially when it comes to landscape for the home. As with all landscapes, a big part of the design process entails practical issues, like how much space there is, how much time and money the client wants to put into the garden, etc. So it’s hard to suggest five specific elements. Some critical considerations:

  1. The garden must be safe. I know this isn’t very sexy, but whether it’s at home or in a healthcare facility, safety is paramount – especially if the garden is for small children, people with physical or developmental disabilities, or the frail elderly. So, for example, a garden for young children shouldn’t have poisonous plants. A garden for frail elders should have walking surfaces that are smooth and easy to walk on (or roll on with a wheelchair or walker). The garden should also feel safe, and comfortable.
  2. The garden should be a source of fascination, and inspiration. Back when I was doing more design work, I would ask my clients, “What makes your heart sing? What inspires you? What do you really want to do in this garden?” Some people love to entertain; they should have a big space for that. Some people want space for their kids to play, or to do yoga, or to meditate…some people want it all! Creating a healing garden—rather than just a back yard—at home takes some more reflection, some careful thought about what is going to really touch and nurture that person or that family.
  3. The garden should engage all of the senses. We mostly think about sight, but how can the garden delight our sense of smell, sound, touch, and even taste? In a small space, plants that can do “double duty” by engaging more than one of the senses are best. For example, lambs ears are soft and fuzzy and are also a beautiful silver color. Lavender flowers and foliage look beautiful, feel soft to the touch, and are deliciously fragrant. The flowers can be harvested to used for cooking, baking, drinking, or even for medicinal purposes.
  4. Decide what you can and can’t do (or do and don’t want to do). . If you love to garden—to dig in the dirt, plant seeds, pull weeds, harvest flowers, herbs, or food—then that should be a big part of the garden. If you work 60 hours a week and commute a long way and have kids, maybe you want a garden that needs less maintenance, where you and your family can just be in the free time that you have. It’s rather counter-productive to worry about a garden that you don’t have the time, or the funds, to maintain!
  5. Consider how you can enjoy the garden in all of the seasons. If it gets cold where you live and you can’t use the garden in the winter, what can you plant that gives it interest in the off season? Evergreens; plants with berries, or colorful bark, or interesting form; or even elements like a pair of really colorful chairs that stays outside…these can all brighten up the garden and give us something to look at in those dark days. I love to plant things with berries that attract birds, and I put out birdfeeders and heater bird baths. Well, I used to, before I moved to Texas. For people like me who endure hot summers, and mosquitoes and other insects, it’s important to make the garden usable in those times. A big tree, or a screened-in porch or gazebo with a ceiling fan, allows you be partially outdoors, or to feel outdoors, even on beastly days.
  6. And a bonus idea: A healing garden (or any type of garden, really), should be good for the earth. We get so much—physically, mentally, emotionally—from nature. The least we can do is treat her with love and respect. So, avoid pesticides and herbicides; conserve water; use native plants, and plant the right plant in the right place so it thrives. The wonderful thing about most of these strategies is that they also encourage birds, butterflies, and beneficial insects; these creatures can really bring a sense of magic to the garden.

Hiking Research: How can we promote more interdisciplinary collaboration among researchers and practitioners on the links between nature and health?

Naomi Sachs: Healthcare design cannot happen without multidisciplinary collaboration. It just doesn’t work. Research on healthcare design must also be interdisciplinary. I think that the world, in general, is heading in this direction. It’s more challenging for people to step outside of their own bubble, to try to understand and speak someone else’s language, but it is so much more rewarding for the people involved and for the end users. I chose, at least for now, to focus my attention on access to nature in healthcare. Many talented people are doing other fantastic work—Richard Louv with the Children & Nature Network; Robin Moore and Nilda Cosco with the Natural Learning Initiative; Sharon Danks and the International Green Schoolyards Movement; Richard Jackson and Howard Frumkin with issues of urban planning and public health; your work with the International Society of Nature and Forest Medicine…many organizations working with community gardens, urban farming…the list goes on (check out the TLN’s related organizations page for some of these). Part of what excites me about my work with the TLN and as a PhD student is pulling people, research, and ideas from different disciplines together and seeing what grows from that rich mixture.