I was disappointed that none of the ecotherapists I interviewed encouraged me to destroy houses. But some of the simple principles behind ecotherapy are gaining acceptance even in mainstream medicine. And when nature therapy is recommended by a doctor, it tends to carry more weight.
At his office in Washington, D.C., Robert Zarr, a pediatrician, writes prescriptions for parks. He pulls out a prescription pad and scribbles instructions—which park his obese or diabetic or anxious or depressed patient should visit, on which days, and for how long—just as though he were prescribing medication.
Zarr says it’s important to give concrete advice instead of repeating the vague admonitions (Exercise more! Get outside!) that people are used to hearing. “If you came in to me with bacterial pneumonia,” he told me, “I wouldn’t say, ‘You just go to any pharmacy, pick up any antibiotic you’d like, take it for as many days as you’d like, with or without food, and I’ll see you in a month, buddy.’ ” He doesn’t necessarily tell patients what to do at the park, however—just to go.
Zarr is part of a small but growing group of health-care professionals who are essentially medicalizing nature. He relies on a compendium of 382 local parks—the product of meticulous mapping and rating of green spaces, based on accessibility, safety, and amenities—that he helped create for DC Park Rx, a community-health initiative. The Washington program was one of the first in the United States; there are now at least 150 others.
Park prescriptions are a low-risk, low-cost intervention that, in Zarr’s experience, people are quick to accept. And sure, people are more likely to move around in a park than they are when watching TV, but there may be more to it than that. Researchers in the United Kingdom found that when people did physical activities in natural settings instead of “synthetic environments,” they experienced less anger, fatigue, and sadness. A 2015 study in Proceedings of the National Academy of Sciences reported that walking in a park reduced blood flow to a part of the brain that the researchers claimed was typically associated with brooding. And in one of the most famous studies on the topic, patients recovering from gallbladder surgery healed faster and with fewer complications when their room looked out on trees rather than a wall.
Why would natural venues be more therapeutic than built environments? “That gap, we don’t fully understand,” Richard Louv told me. Louv is a journalist whose 2005 book, Last Child in the Woods, is widely credited as the impetus behind the modern American nature-exposure movement. He points to research that says people are attracted to and feel restored by looking at images of nature, particularly savannas. Also restorative, according to an influential essay on health-care-facility design, are slow-moving water, foliage, and “birds or other unthreatening wildlife.”