# Motivation and emotion/Book/2020/Forest therapy and emotion

* Multimedia presentation (3 min)

## Overview

* Lara's case study
* Lara lives in an apartment building in a bustling city. She only ever seems to leave her house to go to work. Work has been particularly busy lately and she hasn't had any time for herself. Even when she’s at home, her mind is still preoccupied by everything she has to do at work. At times, Lara feels so overwhelmed with all the stresses of her day to day life that she cries. One of Lara's co-workers notices that Lara seems really stressed and suggests that Lara looks into forest therapy.
This chapter focuses on the relationship between forest therapy and emotion. Forest therapy is a practice that utilises our innate connection to nature to enhance our emotional wellbeing (Hansen et al., 2017). This chapter firstly explains the process of forest therapy and the nature of emotions. Then it discusses relevant theories surrounding forest therapy, including the biophilia hypothesis, attention restoration theory, and stress reduction theory. Lastly, research about forest therapy is discussed in relation to its potential applications. Ultimately, this chapter finds that forest therapy has a positive effect on emotion and therefore holds an array of implications for the future.
* Focus questions
* What is forest therapy?
* What theories attempt to explain the relationship between forest therapy and emotion?
* What are the applications of forest therapy?

## What is forest therapy?

Forest therapy emerged from the Japanese concept of Shinrin-Yoku, which means forest bathing (Hansen et al., 2017). Forest bathing is a practice that involves spending time within a forest in an attempt to enhance your wellbeing (Hansen et al., 2017). Forest therapy has a similar process, it involves immersing oneself in nature with the intention of psychological healing (In my nature, 2020). An example of forest therapy is shown in figure 1.
During a typical forest therapy session, the participant takes a guided walk through a forest (In my nature, 2020). The guide encourages the participant to use all their senses to immerse themselves in the forest; to look around and observe the colours and shapes of the forest, to listen and take in the sounds of the forest, to feel the breeze, and to smell the scents of the forest (In my nature, 2020). Participants are also encouraged to practice gratitude and mindfulness so they can focus on the now instead of the stresses of everyday life - this means leaving any technology behind. Participants are directed to take their time while walking so they can rest, listen, and observe as needed (In my nature, 2020). Forest therapy can be guided by an official forest therapy guide, or self-guided by the participant (In my nature, 2020).
Forest therapy is just one type of nature therapy. Nature-based therapies aim to promote healing by connecting with nature and disconnecting from industrialised life (Hansen et al., 2017). This means, theoretically, forest therapy does not have to be performed in a forest to be effective. Any area of nature that is completely void of technology and urbanisation could be used as a setting for nature therapy.
Forest therapy is intended to have a direct effect on emotions. It aims to increase positive emotions and decrease negative emotions (Song et al., 2015). The following sections explain the nature of emotions and why they are influenced by forest therapy.
Test yourself!
Which item is NOT an important part of forest therapy?
Using all your senses to observe, smell, hear, and feel the forest.
Being mindful and practicing gratitude.
Documenting your session on social media.
All of the above are important to the forest therapy process. :

## What are emotions?

[Direct quotes need full citation include page numbers. Even better, write about the idea in your own words.]
   Emotions determine the quality of our lives. They occur in every relationship we care about—in the workplace, in our friendships, in dealings with family members, and in our most intimate relationships. They can save our lives, but they can also cause real damage. They may lead us to act in ways that we think are realistic and appropriate, but our emotions can also lead us to act in ways we regret terribly afterward.
   — Paul Ekman, “Emotions Revealed”
The above quote from Paul Ekman, a psychologist who laid the groundwork for the study of emotions, highlights the important role emotions play in our lives and the important effect they can have on our quality of life. There are many definitions of emotions, however most modern approaches agree that an emotion is a response to an environmental stimuli that involves feeling, physiological arousal, purpose, and facial expressions (Fredrickson, 2001). Biological theories of emotion, such as the James-Lange theory, suggest that emotions arise as a response to our physiological symptoms (James,1994). Whereas cognitive theories of emotion, such as appraisal theory, posit that it is our cognitions that determine our emotions (Barrett, 2016). The evidence suggests that aspects of both perspectives play a role in creating our emotional experience (Barrett, 2016). Different theorists present different suggestions on to the amount of emotions that exist. Ekman (2003) identified seven basic emotions: fear, anger, disgust, sadness, happiness, and surprise. However, there are many more complex emotions that deviate from these core seven (Ekman, 2003). Ultimately, emotions may be categorised as either positive or negative (Fredrickson, 2001).
Test yourself!
True or False? According to biological theories of emotion, physiological symptoms precede emotional experience.
True
False :

## Relevant theories

Multiple theories attempt to explain the effect that forest therapy has on emotions. The most relevant of these include the biophilia hypothesis, attention restoration theory, and stress reduction theory.

### The biophilia hypothesis

The biophilia hypothesis states that humans have an innate desire to connect with nature (Kellert & Wilson, 1993). This desire is considered to be genetically based and largely unconscious (Kahn, 1997). From an evolutionary standpoint, humans may have an underlying preference for nature as many nature scenes were essential for our survival in our early evolutionary stages (Kahn, 1997). For instance, a river may symbolise life-giving water and food opportunities. Support for the biophilia hypothesis includes the tendency for humans to prefer nature scenes over urban scenes (Kellert & Wilson, 1993). Therefore, our innate preference for nature may induce positive emotions and remove negative emotions when exposed to natural settings, such as in forest therapy. Use Figure 2 to consider if you have a preference for nature scenes or urban scenes.
* Which scene do you prefer?
* nature scene
* urban scene
Figure 2. A nature scene and an urban scene are shown. This is a typical comparison made in the biophilia hypothesis.

### Attention restoration theory

A distinct theory that attempts to explain the effects of nature on the human psyche is attention restoration theory. Attention restoration theory posits that the positive effects of being in nature are due to its relieving of attention fatigue (Kaplan, 1995). Attention is the ability to direct one's focus to a specific task. Attention fatigue occurs when our cognitive capacity to direct attention is used up (Ohly et al., 2016). This may be because a task is very specific, not intrinsically motivating, or there are more interesting tasks competing for your attention (Ohly et al., 2016). Attention fatigue has a negative effect on our emotions as it can leave us feeling frustrated, overwhelmed, and uncomfortable (Ohly et al., 2016). During forest therapy, one practices mindfulness and focuses on the intrinsically rewarding forest, this may relieve attention fatigue, and the negative emotions associated with it.
* Video break
* An interesting and informative Ted Talk about attention restoration theory - Restore your brain with nature
* Click here: access video

### Stress reduction theory

A third explanation for the relationship between nature and emotions is stress reduction theory. Ulrich (1981) first proposed that viewing nature can have an automatic effect on the physiological signs of stress. This hypothesis is supported by findings that indicate physiological signs of stress, such as heart rate variability or cortisol levels, a reduced when exposed to a nature scene as opposed to an urban environment (Kim et al., 2009; Song et al., 2015). Song et al. (2015) indicate that this reduction in physiological symptoms is matched with an increase in psychological feelings of relaxation. From a biological perspective, emotions are caused by an interpretation of physiological symptoms (James, 1994). Reducing the physiological symptoms associated with negative emotions, such as increased heart rate, would therefore reduce negative emotional states[grammar?].
Test yourself!
According to stress reduction theory, going on a nature hike would
be more stressful than walking through a city.
increase feelings of relaxation.
increase your cortisol levels.
make you feel anxious. :

## Applications

Forest therapy has important applications for increasing positive emotions and decreasing negative emotions. Forest therapy can be useful for improving the emotional wellbeing of the general population, and those with psychological disorders such as depression and anxiety.

### Improving emotional wellbeing

Emotional wellbeing is characterised by the experience of positive emotions and a perceived ability to cope with life's stressors (Spiteri et al., 2013). Forest therapy can enhance emotional well-being due to its positive effect on our emotions (Ochiai et al., 2015). Figure 3 shows a young girl experiencing positive emotions. Additionally, forest therapy may also improve coping abilities by reducing stress (Morita et al., 2007). These positive effects apply to a general population (Morita et al., 2007). Table 1 summarises several studies that look at the effect forest therapy has on emotional well-being.
These findings have important implications on both an individual and a policy-maker level. Individuals can aim to increase the amount of time they spend outdoors. For instance, going on a regular weekly hike. On a more macro level, policymakers should ensure funding is directed towards the upkeep of forests and forest paths. These small changes have the potential to make a big difference in our emotional lives.
Table 1
Research on emotional wellbeing and forest therapy
| Researcher | Findings |
| (Ochiai et al., 2015) | Middle-aged, Japanese, females who received forest therapy reported an increase in positive emotions, such as "comfortable" and "Relaxed" and a decrease in negative emotions such as "anxious" and "tense". |
| (Morita et al., 2007) | Forest therapy reduces stress levels in healthy adults. |
| (Hansen et al., 2017) | A systematic review of 64 relevant studies found forest therapy significantly reduces emotional distress. |

### Depression

Depression is a mood disorder categorised by feelings of worthlessness and guilt (Malhi & Mann, 2018). There are many negative outcomes of depression, for instance, emotional regulation skills are typically poorer in those with depression (Malhi & Mann, 2018). Therefore, forest therapy's positive impact on emotional states may be beneficial in the treatment of depression. Kim et al. (2009) found that simply performing regular treatments for depression in a forest setting increased the effectiveness of the treatment[Provide more detail]. Table 2 shows specific examples of how forest therapy can help with depression.
These findings have important implications for the way depression treatment is delivered. Incorporating aspects of forest therapy into regular treatments for depression, such as delivering treatment in a forest environment, is one way these findings can applied. Another option would be providing forest therapy sessions in conjunction with regular treatment for depression. It should be noted there is no evidence to suggest forest therapy should replace traditional depression treatments, instead it should be used to enhance traditional treatment methods.
Table 2
Research on depression and forest therapy
| Researcher | Findings |
| (Lee et al., 2017) | A systematic review of 28 relevant studies indicated that forest therapy is effective in decreasing depression levels in adults. |
| (Kim et al., 2009) | Receiving cognitive behaviour therapy in a forest environment led to decreased depression scores on the Hamilton Rating Scales for Depression and an increase in remission in patients with major depressive disorder, when compared to patients who received treatment in a hospital setting. |

### Anxiety

Anxiety refers to feelings of worry and fear, which when persistent and excessive may be classed as an anxiety disorder (Craske & Stein, 2016). Forest therapy has been shown to effectively reduce physiological symptoms of stress and anxiety as well as psychological feelings of anxiety (Song et al., 2015). Forest therapy's effect on anxiety gives support to stress reduction theory; exposure to the forest reduces physiological symptoms of anxiety, which in turn positively influences emotions. Table 3 summarises the research on forest therapy and anxiety.
These findings have important implications for the treatment and reduction of anxiety. Forest therapy can be used to reduce anxiety in a variety of populations including general populations and clinical populations (Ochiai et al., 2015; Bielinis et al., 2019). Again, there is no evidence to suggest forest therapy should replace traditional therapies in those with clinical disorders, but instead that it is a great treatment addition. In those feeling anxious at a non-clinical level, forest therapy is a great stress management option (Song et al., 2015). Table 3
Research on anxiety and forest therapy
| Researcher | Findings |
| (Ochiai et al., 2015) | Forest therapy decreased reported feelings of anxiety and lowered physiological symptoms of anxiety such as decreasing cortisol levels and decreasing heart rate. |
| (Bielinis et al., 2019) | Patients with psychotic disorders reported decreased feelings of anxiety after a forest therapy session. |
| (Song et al., 2015) | A reduction in physiological symptoms of stress and an increase in positive emotions such as "relaxed" was found after a forest therapy session. |
Test yourself!
Which symptoms of anxiety are reduced after forest therapy?
Heart rate
Cortisol levels
Anxious emotions
All of the above symptoms are reduced :
* Lara's case study revisited
* After hearing about forest therapy from a work friend, Lara decides to check it out. She visits a local forest therapy centre and enlists in a session. During the session she walks down a forest path with a group of other people. She looks around and takes in the views of the forest. At times, she closes her eyes and focuses on the sounds of the forest. Lara is focusing on nature and the present moment instead of her worries and fears. When the session is over, Lara feels calm and relaxed.

## Conclusion

Forest therapy is a type of nature therapy that aims to immerse one in nature. The forest therapy process involves taking a mindful walk through a forest and can be guided or non-guided. Overall, forest therapy appears to have a positive impact on our emotions. The biophilia hypothesis posits forest therapy may increase positive emotions as humans have an innate desire to connect to nature. Attention restoration theory suggests forest therapy reduces negative emotional states by reducing attention fatigue. Stress reduction theory indicates that nature reduces the physiological signs of stress, which in turn reduces our negative emotions. Forest therapy has been shown to increase positive emotions and decrease negative emotions, as well as, decrease levels of stress, depression, and anxiety. Therefore, forest therapy has important implications for improving emotional wellbeing, depression, and anxiety.
* The take-home message: Forest therapy is a nature-focused practice that has the potential to improve our emotional states.