Garden of Hedon

 


7

Garden of Hedon

Clearings. That’s what I needed. Slowly my brain righted itself into spaces unused for months.

— HELEN MACDONALD

In the Gaelic poem “Hallaig,” by Sorley MacLean, a man is forced to leave his favorite grove of trees for America during the land clearances of the nineteenth century. This poem, worshiped by so many in Scotland, speaks directly to the national soul in its tragedy, sentiment and land-love. “I’m finding it difficult not to cry when I think about it, and I’m English,” an ecologist named Peter Higgins told me. The landscape here, as in Finland, is a unifying force, rooted in the bones of people who grew up with it. It’s also rooted in the Gaelic language itself. There’s the word weet, to rain slightly, and williwaw, a sudden, violent squall, and wewire, to flit about as foliage does in wind, and that’s just the W’s. How perfect is this: crizzle, “the sound and action of open water as it freezes”?

For all that landed pride, though, Scotland is a country divided in ways that places like Finland and South Korea are not. It is divided not just over the perennial question of whether to cleave from England. The urban poor are unmoored from the land, and from Scotland’s deep culture of resilience. Some would argue the two are related. Consequently, the country’s attitude toward nature has a more desperate tinge; the survival of a culture and of a people are in play. The idea of spending more time outdoors is emerging as an important tool for regaining health and sanity already lost.


Nowhere is the country’s social divide more evident than in Glasgow. Upon arriving, I was immediately struck by the down-and-out vibe just below my hotel. Edinburgh is all lovingly preserved stone architecture, uni students rushing about, tourists buying tweed, and Harry Potter fans taking selfies in front of the Elephant House café, where J. K. Rowling did some scribbling. But downtown Glasgow recalls the Bowery of the 1930s: sleeveless drunks in the middle of the day, young people smoking sullenly on the streets, Here, the underclass is largely white, hopped up, and pissed off.


Parts of Greater Glasgow face the lowest life expectancies in all of the European Union. In some neighborhoods a man can expect to live to 54, while 12 miles away he will live to 82. Sixty percent of the city’s excess deaths are triggered by just four things—drugs, alcohol, suicide and violence. Alcohol-related deaths increased fourfold between 1991 and 2002. The main cause: economic disparities driven by four generations of unemployment following the dismantling of manufacturing and mining in the 1970s and 1980s.


It’s this divide that gets Richard Mitchell, an English epidemiologist at the University of Glasgow, up in the morning. While the Finnish and Japanese nature studies targeted the educated middle class, Mitchell is looking at the beaten-down poor. He’s spent years researching effective messaging for preventing alcoholism and obesity. Now, though, he’s turned to the environment itself. Long fascinated by why some places breed healthy people and some places don’t, he was intrigued by research in the Netherlands to start looking at maps of green space. Dutch studies had shown remarkable mental and physical health benefits of living within half a mile of green space, including reductions in diabetes, chronic pain and even migraines. Mitchell wondered if one of the main reasons for the association was simply exercise.


This assumption makes sense. When we are out in nature, we are generally self-propelled, breathing in oxygen, liberating our lungs and our cardiac capillaries from their usual cramped, desk-hunched configurations, and arresting, temporarily, the slow backward death march of our telomeres. Exercise as a cure for all things has been so drilled into the public health establishment that it crowds out everything else, with the possible exception of quitting smoking and washing hands.


So Mitchell read the first wave of large European studies about the restorative effects of nature with a great deal of eye rolling. Those studies, published in the early 2000s, linked nearby greenery to everything from longer lives and fewer chronic diseases to higher-birthweight babies. There were simply too many confounds, as he put it. How could any scientist possibly attribute health to nature when the people most likely to be near nature were already healthy, already exercising, already relatively wealthy, and so on? Take Mitchell himself: he grew up tromping around the moors near Exeter in the 1980s with his mum and dad. He read National Geographics in the attic, played bass guitar and enjoyed an early form of geocaching outdoors called letterboxing. His parents suggested he become a scientist, so he did. It would be as preposterous to say it was the windy fens that made him a success as it would be to credit his favorite ham sammies.


Beyond the confounds, “It’s easier to understand exercise than nature and trees,” he said. The neuroscience is bomb-proof on exercise. Physical activity changes the brain to improve memory and to slow aging; it improves mood and lowers anxiety; in children, it increases the capacity to learn; some studies show it is as effective as antidepressants for alleviating mild depression without the unwanted side effects. By contrast, our collective physical inertia, credited with 1.9 million deaths worldwide annually, is new to our species and getting worse. In preindustrial times, we expended about 1,000 kilocalories per day on physical activity; now we expend an average of about 300.


What changed Mitchell’s mind, gradually, was reading the studies from Japan that showed lower stress among forest walkers but not city walkers. There were also some studies showing that people who lived near parks and green areas were healthier, even though they didn’t necessarily exercise in them. There was something else going on. And that something else had the potential to make a difference in people’s lives.


But he still didn’t discount the role of exercise. Time in nature, as the structure of this book suggests, appears to have a dose curve. Five minutes is good; a thirty-minute stroll is better. When you combine exercise and nature, the effects get bigger. “Maybe it’s just additive. But maybe it’s more than that,” he said. To show me, he invited me to join him for some rambling, the favorite national pastime, especially when it involves drinking whiskey.

WE MET AT Mitchell’s walk-up garret of an office on campus, out of which he runs the Centre for Research on Environment, Society and Health. Mitchell is wiry and tall, and had to fold himself into his car for the short drive to the edge of town. We’d be ascending Dumgoyne, part of a chain of volcanic hills circling the city to the north. Kitted out with hiking boots, a knapsack filled with “waterproofs” and two walking poles, he eyed my worn sneakers and array of notebooks, cameras and recording equipment. He offered me a pole, but I declined. It was a beautiful day in June, and the countryside was blindingly green. This is one of the most popular day hikes in Glasgow, and I figured the trail would be dry and solid. I’m used to real mountains, after all.


That was my first surprise about rambling in Scotland: there aren’t really trails. It’s so damp and green that the grass grows faster than human feet can stamp it out. One walks on tufts and clumps of sedges, moss, rock and clover. Straight up, and then straight down.


“This will get your heart rate up,” he said. It did, for about an hour. The landscape was ridiculously, lavishly beautiful. We vaulted ancient stone fences lined with blossoming pink foxgloves. Sheep grazed in the fields and a kestrel circled overhead. At the top, we came upon a small group of Boy Scouts. Behind them stretched a 360-degree view of the soft green carpet of Scotland, piling up toward the nearby West Highlands. The color suffused through the land, erasing the roads and houses.


We ate some sammies and took pictures. Before we’d gone very far on the way down, I banana-slipped, scraping my hands but saving the notebook. Mitchell wordlessly offered a pole again, and this time I accepted. I asked him why rambling, as they call it, is so crazy popular in Scotland. (“Hiking,” a term reserved for overnight backpacking, is considered a bit of a hippie thing.) Mitchell shrugged and said it’s probably because of the country’s friendly and ancient right-to-roam laws, which are more lenient than elsewhere in the U.K. and allow you to tromp anywhere across private land, provided you don’t steal the sheep, dig up the gardenias, or hunt the landlord’s stags. Walking is the most popular sport in Scotland, with Scots taking 2.2 million short walks and 1.8 million long walks per year. I didn’t see figures for attendant tick bites, but Mitchell says he digs two or three ticks out of his skin every year.


But it wasn’t until we ran into a couple eagerly descending on their way to the Glengoyne distillery that I really understood the national obsession. The hills of Scotland are made of peat, and each region has a slightly different mix of soil, moisture, temperature and exposure. Many of the proper single-malts use barley dried with smoke from the surrounding bog. This is Scottish terroir. We passed a creek, known as a burn, whose water supplies the Glengoyne distillery before making its way to Loch Lomond, where Rob Roy hid from the English in a cave and, where, nearly a century later, William Wordsworth would fall in love with a dairy maid. To a Scot, each walk is steeped in poetry and spirits, in blood, rebellion and national yearning.

DOWN FROM OUR ramble and back in the garret, Mitchell showed me some bright statistical graphs. In a study that he and colleague Frank Popham published in the Lancet, they compared early mortality and disease (in those under age sixty-five) in England with neighborhood green space (defined as “open, undeveloped land with natural vegetation including parks, forests, playing fields and river corridors”). It was a huge study, combing records of 40 million people. “We quite like death as outcome,” quipped Mitchell. “We know if they’re dead something is wrong with them.”


In the greener neighborhoods, death rates were lower for everyone after adjusting for income. Notably, though, deaths were not down for lung cancer, which is not a stress-related cancer and was correctly predicted not to be associated with green space. Cardio deaths, however, were down 4 to 5 percent, which is a big deal given the large population size. But when the researchers looked specifically at death and disease per income level, some interesting patterns emerged. The research showed that income-related health disparities were greatest in areas with the least green. Here, poor people were twice as likely to die as their rich neighbors. In the greenest areas, though, poorer people did relatively much better, starting to catch up to the longer lives of the rich. In other words, there was something protective about the greenery for the most deprived people, either by providing more areas for exercise or by otherwise buffering poverty-related stress.


It’s important to issue the standard caveat here; although the study was very large and carefully parsed, it’s a cross-sectional study, not a case-control study, meaning it captures a moment in time, making it hard to say with certainty that it was green space and not something else about those neighborhoods causing these effects. So to learn more, Mitchell later analyzed maps, neighborhood services (not just parks but transportation, shops, cultural amenities, and so on) and mental health data from 21,000 residents of 34 European countries, which he published in 2015 in the American Journal of Preventive Medicine.


“Only one neighborhood service seemed to have a link with inequalities in mental well-being: green, recreational services,” he said. “In fact, inequality in mental well-being among those with the best access to recreational, green areas was about 40 percent less than those with the worst access.” This finding would have thrilled Olmsted; the poorest people were the most helped. Parks indeed appeared to be a social leveler. Mitchell has his own phrases for these green spaces: they are “equigenic,” and “disruptors of inequality.”


But a weird conundrum emerged. When Mitchell turned his attention to Scotland, the pattern wasn’t as noticeable. The poorest of the poor were not accessing green space at all, even when it was all around, and Glasgow, as we’ve seen, is bloody green. Its name means Dear Green Place. But the woodlands near public-housing estates had been neglected, trashed and taken over by ruffians. A favorite park pastime is wheeling in green garbage bins (not the blue ones, they wouldn’t do), lighting them on fire and then inhaling the fumes. Not surprisingly, these emerald areas were actually sources of stress. Jane Jacobs anticipated this in her 1961 classic The Death and Life of Great American Cities, in which she assailed most city parks as places that “exaggerate the dullness, the danger, the emptiness.” Her solution was to throw the baby out altogether, to pave over the parks. Streets and sidewalks, not parks, were the life of the city, she argued. (She was not able to foretell the disappearance of children from sidewalks and the astonishing rise of obesity and chronic diseases.)


Mitchell, on the other hand, saw a failure of civic community. Here was an opportunity for public-health experts to make a difference. And so they are trying. The Scottish government has newly embraced some radical policies. One is cleaning up the woodlands to reinforce medical and mental-health treatment for stressed populations. Another policy, the National Walking Strategy, encourages communities to improve signed trails, organize health walks and otherwise get people off their duffs. It can be a challenging proposition. Consider the scene from Trainspotting in which Renton says, “We’re colonized by wankers. We couldn’t even find a decent race to be colonized by. It’s a shite state of affairs to be in, and no amount of fresh air is ever going to change that.” But change they’ll try.


Government guidelines for the Dear Green Place and beyond state that everyone should have access to safe woodlands within 500 meters of their doorstep. Because for green space to be used, it has to be close. To accomplish this, the country is on a tree-planting and woodland-sprucing-up craze, aiming to increase the percentage of Scotland covered by woodland from 17 to 25 percent. Access to nature is a new national indicator for health in Scotland, and if you squint your eyes and try to imagine the U.S. Congress passing such a standard, you can appreciate just how remarkable this is.

Scotland is so committed to the idea of salvation in the woods, walking or otherwise, that it’s underwriting a program called Branching Out to provide mental-health care outdoors. Kevin Lafferty, the health and recreation advisor for Forestry Commission Scotland, invited me to come watch it in action, which is how I came to be molding a clay face onto an oak tree with a group of ex-felons and addicts. The science-based concept is that three hours per week for twelve weeks in a woodland program can reduce symptoms of depression and increase sociability, physical exercise and self-esteem.


Sometimes you meet someone who so easily wears a career, who seems so fulfilled, so unusually capable and perfectly matched to his work that it’s clear it’s a higher calling. Two such men are Tom Gold and Richard Bolton. Gold works for the Forestry Commission’s recreation department, teaching skills like shelter-building to Branching Out participants, and Bolton is a kind of local park ranger, employed by a massive public-housing estate called Cassiltoun outside Glasgow. On the drive to the Cassiltoun woods, Gold kept the windows wide open on the freeway. “Sorry, can’t quite get my head around air-conditioning,” he’d said as we bombed down the highway.


Tall and wide in a wood-chopping-champion way, Gold had to hunch in the sedan. It was much easier to picture him lumbering through the hills. “My big specialty is bushcraft, the sort of art of making the outdoors a more comfortable place without compromising the resource,” he said. “Food, fire, shelter, there are many ways you can achieve or acquire those things, leaving the place exactly as you found it. It’s different from survival training, with all the camouflage, traps, gear, weapons and a generally less healthy attitude toward the environment. That’s obviously not what we’d do with these guys anyway,” he said, referring to the participants, many of whom had recently emerged from institutions. Gold has spent much of his life in the space that intersects mental health and the environment, first working as a leader for a young offenders program in the Arizona wilderness and later in a secure psychiatric facility in Scotland. They were opposite ends of the containment spectrum. In Arizona, he tried to convince the boys that making fire with flint and steel was more reliable than their lighters. “To demonstrate, I inhaled a cigarette and nearly fainted dead on the spot.” He saw remarkable changes in the boys, but many returned to gangs once they got back home. “I challenge anyone that age not to get back into it, to resist what all their friends are doing,” he said.


In the psychiatric hospital, “nobody was allowed to set foot outside the fence,” said Gold. “If it was possible to make a recovery in a nature-based program, that was not on the agenda.”


Branching Out, he hopes, can provide both the short-term benefits of a “hoods in the woods” program with the long-term behavioral modifications of more classical therapy. Since its inception in 2007, Branching Out has run some 700 participants through the program, which includes activities such as walking, bushcraft, woodland arts, trail maintenance and birding. The idea is to help people transition from institutions to living more independently. It’s been particularly successful in promoting exercise and increasing well-being in the sickest participants.


“We call it ecotherapy,” said Gold. “I prefer the term ‘adventure therapy,’ but it makes some people nervous they’ll get eaten to death by mosquitoes while wearing a scratchy wet jumper.” Branching Out provides transport, Wellies and waterproofs as needed, and all requisite snacks. It has a long waiting list.


We pulled off the highway and drove up to the old Cassiltoun estate carriage house, where we met ranger Bolton, a small, easy-going man with an air of unhurried competence. He explained that Cassiltoun is home to 13,000 welfare recipients. The unemployment rate here is 39 percent. Drug problems afflict 13 percent of residents and mental- health disorders strike at nearly twice the national average.


But Bolton, who has a background in ecology, thinks these woods can help. He led us some distance into the forest. Although it was sunny and leafy, vestiges of the woodland’s delinquent past remained. (In this, the forest is not so different from its users, who retain an air of recent breakage.) I’m not used to seeing tree graffiti, for example. “You should have seen it before,” he said. In the three years he’s worked here, he’s cleared overgrown trails and hauled out 120 tons of trash, including a bus shelter that (along with wheelie bins) people burn to get high. “No wonder they die younger,” he said.


To help convey a sense of safety, he often takes classes of schoolchildren here. He’s helped organize 108 different cultural and educational events in the past year, led evening health walks and sponsored park worker training. Of the housing residents who have trained with him, 70 percent went on to find permanent employment. He is like Puck: mixing everyone up together in the forest of delights and trusting they’ll go back home all sorted out. Like the forest therapists in Korea, Bolton is part naturalist, part social worker, part mythmaker. It’s a job description that didn’t used to exist, because it didn’t need to. We once had a familiar relationship with nature; we knew it on a first-name basis. But now we need professionals to help us reacquaint ourselves with the woods. Soon we may need teachers to remind us how to converse face-to-face. Like a lactation consultant or the people who show us how to bake bread on YouTube, Bolton is a broker in cultural salvage.


At the moment, that meant gargoyles. The small group of depressives, petty criminals and former addicts had assembled on the trail, and Bolton was demonstrating how to make “green men” out of clay and paste them to a tree. The criminal and psychiatric backgrounds of the participants were not revealed to Gold and Bolton. Their job was to work in the present. Bolton kept up an affable monologue as he scurried about. “Along the way I just collected a few wee bits, leaflets; I can start pulling them off and using the shapes, like these sycamore shapes and leaves. Oi! Here’s a holly leaf.” He was picking them off the ground like a discerning rooster. “The good thing about temporary art, if you don’t like it you can start again. You’ll notice some of the leaves have quite hairy textures, some smooth. Should I get more color?”


An older man in a yellow windbreaker said, laconically, “Yep.” Bolton brushed past a tree dusted with shimmering confetti. “A local nursery uses this as a faerie tree,” explained Bolton. “They get a bit heavy-handed with the glitter. This is a lime leaf; it has a nice small point. Woodlands can be your inspiration.”


The group gathered around to watch him make a pointy clay nose and fern mustache. Some of the participants looked baleful, some giddy. Their slickers hung loosely and askew against bodies that had gone slack. For many, this would be their first time out of the house all week. But they were obliging. They were six weeks in, halfway; they knew the drill. One man in his early twenties, pudgy with a mohawk, wearing a saggy blue sweatshirt, told me he goes in more for the bush skills than the art. “I like making fires and camping,” he told me. He used to do that with his grandfather, when he was a child. He told me he had recently been released from a hospital, that he had scars in the back of his neck. He was glad to be out doing things like a regular bloke. He grabbed a fistful of pine needles and patted them into clay for eyebrows.


Everyone seemed absorbed. It was fun. Making temporary art was a way to be both together and in your own space without high stakes. We admired each other’s gargoyles, offering nods and murmurs. The participants, like the gargoyles themselves, represented a wide range of age, color and affect. They were ready for a snack. Gold took over, pulling out an enormous metal pot called a Kelly Kettle. We watched as he demonstrated how to spark a small twiggy fire, first with a bow-like implement out of Sherwood Forest, and when that didn’t work, with flint and cotton balls. It was not, let it be said, as speedy as using a Bic. Eventually, he scooped the burning twigs into a ring around the kettle. It boiled the water surprisingly fast. We took tea and biscuits, because that’s what Scots do, even in the forest. Many people pulled out cigarettes, because that’s what Glaswegians do. They would go home nicely tired, pleased that they’d survived a social outing without any big miscues, looking forward to next week.


For programs like this, the social piece is a large part of it. As Gold put it, “if you’re returning to the mainstream after a long period of treatment for mental health, you’re not going to go to Queen Street station to see how you get on. You’re going to do it in a group where any problems can be examined in a gentle way by people who know only too well where you’ve been.”

BRANCHING OUT IS just the latest incarnation of a long tradition of wilderness-to-build-character enterprises, from the exploits of the seafaring Vikings to Outward Bound. America’s best-known outdoor education program, Outward Bound originated in 1939 with a German-Jewish educator and a Briton who had a crazy nostalgia for rough seas. As war was breaking out, they felt young men weren’t showing enough toughness, leadership or outdoor training. Great Britain didn’t have a lot of wilderness, per se, but it could offer the seas, coastlines and miles of moors. As far as mental-health treatment, Europe had a lineage of psychoanalysis and a tradition of nature-enhanced health spas, so perhaps it was inevitable the two would meet in pastoral hospitals of northern Europe. Interestingly, though, it was an early American psychologist, Benjamin Rush, who first popularized the idea of nature-ish therapy for his mental patients in an 1812 treatise: “It has been remarked, that the maniacs of the male sex in all hospitals, who assist in cutting wood, making fires, and digging in a garden . . . often recover, while persons, whose rank exempts them from performing such services, languish away their lives within the walls of the hospital.”


His notions of reform helped slowly change treatment for the mentally ill in America and Europe. Freud had long blamed cities and civilization, at least in part, for unhealthy repressive tendencies. But after World War I, treatment entered a long, mixed interlude of turning mental-health care over to pharmaceuticals, climate control and managed care. To the extent that nature therapy is slowly coming back into vogue, the Swedes have probably done the most to apply science to the field.


The journey of Johan Ottosson seems a good place to start. On a cold winter day twenty-three years ago, Ottosson was riding his bike to work in southern Sweden when he was swiped by a car. He launched many feet through the air, landing headfirst on a rock. He would spend the next six months in a hospital by the North Sea struggling to regain basic skills (he would never read or write without assistance again). It was a miserable, terrifying existence. Although the doctors and therapists were helpful, what Ottosson says really pulled him out of despair and a deep depression were the land and sea nearby.


“I just felt strongly that I wanted to be outside, where I feel the best,” he recalled when I went to see him in southern Sweden. “I had a strong relationship with the stones. There is this theory that if a person is in bad shape and low energy, you can’t be with other people too much. But you can be with animals, plants, stones and water.” Ottosson became so convinced by the healing power of nature that he pursued a doctorate in the topic at the Work Environment, Economy and Environmental Psychology Department at the Swedish University of Agricultural Sciences.


His compelling dissertation includes more details about the span of his recovery, written in the third person. At first, he could only find comfort in rocks. “It was as though the stone spoke to him: ‘I have been here forever and will always be here; my entire value lies in my existence and whatever you are or do is of no concern to me.’ . . . The feelings calmed him and filled him with harmony. His own situation became less important. The stone had been there long before the first human being had walked past.” As he got better, he turned his attention to the ocean waves, and then, gradually, to vegetation, particularly oak trees.


Ottosson’s work relies heavily on the mid-twentieth-century American psychologist Howard Searles. Best known for his insights into the idea of transference during psychoanalysis (in which the patient projects feelings onto the therapist), Searles also recognized that nature could provide useful objects of transference. Searles worked at a rural mental hospital in Maryland, where he witnessed this firsthand, writing, “The nonhuman environment, far from being of little or no account to human personality development, constitutes one of the most basically important ingredients of human psychological existence. . . . Over recent decades we have come from dwelling in another world in which the living works of nature either predominated or were near at hand, to dwelling in an environment dominated by a technology which is wondrously powerful and yet nonetheless dead.” And that was in 1960.


I visited Ottosson at his campus office in Alnarp. At sixty-three, he has Parkinson’s disease and continues to rely on assistants for reading and writing. As he talked, his upper body snaked gently from side to side. He gives talks all over Sweden and is amazed by how many people tell him similar stories of recovery in nature. But it pains him that the modern medical establishment has largely forgotten the insights of Rush and Searles. “When you built a hospital a hundred years ago, you built it around a nice park. That was self-evident. But after about after 1930 or 1940, man is treated like a machine. He gets energy and medicine and that’s all. We are just now starting to get fuller knowledge back.”


Down the hall from Ottosson in the great historical castle-like building of the landscaping department sits the office of Patrik Grahn, the man responsible for Sweden’s nascent renaissance of “horticulture therapy,” or using plant cultivation and garden settings as a healing strategy. And the man who inspired him? Ottosson. Grahn wasn’t starting from nowhere. As a landscape architect, he’d met the Kaplans in Michigan in the early 1990s, and soon afterward studied the reasons people use city parks in Sweden. He turned up the then-surprising answer of psychological well-being. Then he met Ottosson. “He told me the story about what he experienced and we started some studies. We had wild plans of therapeutic gardens, how they should look,” said Grahn, who grew up picking cloudberries and fishing for trout and salmon in Lapland.


With funding from the university, they started a nearby therapy garden complete with a glass-dome greenhouse, water features, flower beds, vegetable fields, pathways and various small structures. Grahn took me by on a gray May afternoon. The first thing that greeted us was a cheerful red garden kitchen skirted by a wide deck overlooking the small fields. Its motto could be the Emerson quote: “The greatest delight which the fields and woods minister, is the suggestion of an occult relation between man and the vegetable. I am not alone and unacknowledged. They nod to me, and I to them.” Based on what Grahn learned from Ottosson, the Kaplans and his own empirical research, he believes an effective garden should incorporate a number of elements ranging from safety to fascination to naturalism to species diversity.


It was chilly out and drizzling, so Grahn ushered me into the greenhouse, where therapist Anna-María Pálsdóttir plucked a few leaves off a potted plant and brewed up some citron tea. She explained that Alnarp’s standard treatment program runs twelve weeks, like that of Branching Out, but the participants here come four times a week for three hours each time. The Alnarp garden specializes in treating patients with severe work-related stress. They are typically on sick leave, in some cases for years (this being a country that offers sick leave). They are very depressed, lethargic, antisocial and often have other health problems as well. Most take a variety of medications. By the time they get here, “they have cut off everything except trying to stay alive,” Pálsdóttir said.


She described the typical progression of patients, and it resembles the experience of Ottosson during his recovery. For the first weeks, the participants often spend their garden hours lying down alone in the garden, either in a hammock or on the ground. Because the program operates year-round, they wear large insulated snowsuits as needed. “Many cannot feel anything” due to severe depression, said Pálsdóttir. “They’ve almost lost sensory contact from the chin down. As part of healing, the body and the brain connect again. Their interaction with plants trains them to be here and now. They slowly start to pay attention. Things like, what’s the tea today, now I can taste coffee and enjoy it. It helps them calm down.”


As a former participant—a middle-aged mother named Cecilia who had severe depression—told me later: “I found a hammock near the hedges. It was nice to discover anything outside of the life I’d led before. My brain learned to take in the birds and wind, only that. That’s the first thing I remember.”


“We point patients to use their senses,” said Pálsdóttir. “Eventually, we do creative activities, like go and pick a flower that represents your feelings. Compost what you want to compost. We often use nature as a metaphor that symbolizes good things and bad things. You can stay and be on your own, or help with horticulture if you want. You can just noodle.”


“Mindfulness is built in,” added Grahn, who between sips of tea pulled out some graphs based on years of published studies. By the end of the program, the patients show a “20 percent drop in symptoms but it’s actually more significant than that because the difference is between being considered sick and not sick,” he said. According to the World Health Organization, 27 percent of the European population, or 83 million people, experienced at least one mental-health disorder in the past year. If you could speed time to recovery, the savings would be huge. According to Grahn, 60 percent of Alnarp’s patients return to work after one year, a figure higher than for those in other kinds of therapy. Based on six years of follow-up data, “the cost-benefit savings is quite high,” said Grahn. “They go from seeking primary care thirty times a year to ten.” The program is so successful that the Swedish government pays for it and is beginning to replicate it elsewhere. There is a long waiting list to get in.


Grahn is now studying the garden’s impact on traumatized Syrian refugees and stroke patients. About 30 percent of Sweden’s health-care dollars go to mental health, but stroke care is even more costly. Typically, patients learn to rewire their damaged brains through lots of repetitive speech and occupational therapy, but it’s slow and exhausting work. This is where the gardens come in. “There are no established methods of treating mental fatigue,” he said, “so we hope we can find a way of treating it for this group. And we hope the environment can help patients find new ways of functioning. A speech therapist takes an apple and says “apple,” and shows the object. But in a natural environment, patients can talk and smell and taste and use all the senses, so theoretically it’s a more efficient way to facilitate different parts of the brain working together.”

THE REASONS THESE programs seem to improve mental and cognitive health is complicated, and by no means is it just about nature and the senses. Nature appears to act directly upon our autonomic systems, calming us, but it also works indirectly, through facilitating social contact and through encouraging exercise and physical movement.


Here’s the emerging European coda on public health from Finland, Sweden and Scotland: encourage people—especially distressed populations—to walk, often together, and provide safe, attractive and naturalistic places for them to do it. The research also suggests some special places to go: forests and coastlines. Brits go even more crazy for the coasts than they do for the woods. Basically, the closer you live to the ocean, the happier you are. Researchers at the University of Essex School of Health and Human Sciences found that if you live near the scenic western coasts of England, you’re nine times more likely to exercise than other people, even after adjusting for income. As the epidemiologist Ian Alcock put it, if you want to be happy, there is a simple, scientific formula: “get married, get a job and live near the coast.”


Parsing the research apart further, if you are depressed or anxious, social walking in nature boosts your mood, assuming you’re walking with people you like; if you want to solve problems in your life, self-reflect and jolt your creativity, it’s better to go alone, in a safe place.


I find myself most drawn to the fate of the solo walker, because I tend to be one. I love a good hike with a friend, but I consider it a gabfest more than anything. I’m protective of my solo walking time precisely because I have found it to be so helpful in solving problems, personal and otherwise. What is it about that peculiar synergy of walking plus nature? Being in Scotland got me thinking about Wordsworth, creativity and the essence of imagination. Walking lies at the heart of it. Although these topics remain somewhat mysterious to neuroscientists, the poets can offer some assistance.







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