Walk and Talk Therapy is an approach to traditional talk therapy where the therapist and client take their session outdoors and walk together while discussing the client’s issues. This type of therapy is becoming increasingly popular and provides similar benefits to those found in mindfulness, physical activity, ecotherapy, and more traditional psychotherapy.
Benefits of Walk and Talk Therapy:
Some of the benefits include:
Reduced Stress and Anxiety: Walking is a proven stress reliever and can help reduce feelings of anxiety. Exercise releases endorphins, which are natural mood boosters that help to alleviate stress and anxiety. When you combine walking with talking about your feelings, you get a powerful combination that can significantly reduce your stress and anxiety levels.
Moving Forward: Taking a walk with your therapist can help shift the focus towards moving forward; this added movement and momentum can help in getting unstuck. Walking can also provide a natural rhythm to the conversation, making it easier to stay on topic and keep the conversation flowing.
Bilateral Stimulation: Bilateral stimulation is any method of stimulating the body and brain in a rhythmic right-left pattern. It is often used in therapeutic settings (such as in EMDR therapy) to help reduce the symptoms of trauma, anxiety, and other mental health conditions. Bilateral stimulation can help regulate the brain’s response to stress and trauma, promote a sense of relaxation and well-being, and allow for the processing of emotions and memories previously stuck in the nervous system. Walking is a simple form of bilateral stimulation, stimulating and balancing the right and left brain. (EMDR founder Francine Shapiro was taking a walk in the park when she first realized the potential benefits bilateral stimulation could have on the nervous system.)
Supplemental Health Benefits: Walking is a low-impact exercise that is beneficial for both physical and mental health. When you participate in Walk and Talk Therapy, you get the added benefit of exercising while working on your mental health.
Healing through Nature: Spending time in nature is linked with many physical and mental health benefits, including decreased depression, decreased stress and anxiety, improved ADHD symptoms, increased focus, improved sleep, and improved overall well-being. (For more research, see parkrxamerica.org’s Benefits of Nature page.)
Risks of Walk and Talk Therapy
Like any form of therapy, Walk and Talk Therapy carries some risks. Here are a few things to consider:
Safety Concerns: Being outdoors has inherent safety risks, such as from a sunburn, bug bites, or other injury. If you’re walking in a park or other public space, be aware of potential hazards such as uneven terrain, traffic, or other people.
Weather Conditions: Walk and Talk Therapy sessions are subject to the weather. If it is too hot, too cold, or too wet, it may be uncomfortable or even unsafe to continue the session. Consider having a backup plan (such as telehealth) and be ready to communicate with your therapist concerning any last minute changes.
Distractions: Walking in a public space can be distracting, with other people, animals, or vehicles around. These distractions can make it difficult to focus on the therapy session and may reduce its effectiveness.
Confidentiality Concerns: Walking in a public space may make it more difficult to maintain confidentiality. While therapists will continue to take measures to protect their clients’ privacy, it’s important to be aware that you might encounter someone you know on the trail, or a stranger could overhear part of your conversation.
Is Walk and Talk Therapy the right form of therapy for me?
Here are some reasons why Walk and Talk Therapy might be right for you:
You enjoy being outdoors and find it safe, calming, and relaxing.
You’re tired of traditional talk therapy sessions that take place in an office or clinic, and want to try something different.
You’re feeling stuck and are curious to try a more active and dynamic approach, as compared to more traditional talk therapy sessions.
You need a change in routine. You’re hoping to get in more steps, spend more time in nature, and reap the benefits of regular exercise and time spent outdoors.
As with any form of therapy, Walk and Talk Therapy has its own unique risks and benefits. With proper planning and precautions, many of these risks can be minimized. If you’re curious to learn more, talk to a licensed therapist or counselor to discuss whether Walk and Talk Therapy is a good fit for your specific needs and circumstances, and to address any concerns you may have.
Written By: Jim Rowell, LCSW Currently offering Walk and Talk Therapy in Northwest Hills, Westlake, and East Austin.
Psychotherapeutic training generally includes something called Universality as a healing technique. It stems from Irvin Yalom’s germinal Therapeutic Factors for facilitating group therapy. It basically means that when humans get to hear and witness another human facing something similar to their own experience, this communality engenders a sense of validation and fosters healing. Universality, with its relational delivery, inherently addresses the isolation any human can feel amidst a problem that had felt singular.
Normalizing Responses to Societal Issues
As a trauma-informed and relational therapist who specializes in climate change grief and disaster trauma; this is of interest to me for several reasons. A dominant one is that grief and anxiety created by several ongoing collective traumas are hard to separate from their myriad effects on a single person’s psyche, which at times is simply responding to these threats, pressures, and perils. Living within a colonial, imperialistic, and capitalistic society under threat of both climate change and continual pandemic pressures is not a cakewalk. Even that sentence stresses me out! The waters we swim in matter. Our collective ills contaminate human psyches and can show up as pain, depression, anxiety, panic, and the like. Our collective diseases become individuals’ problems.
And yet, as universality would have it, a clinician understanding these ills—as best they can from the purview of the client—is paramount to good treatment. Coping strategies alone are not sufficient, normalizing the client’s response to the collective deficiencies is part of alleviation of these pressures. Normalizing in this way may look like: “yeah, this is not, or should not be, normal.” This is a bit of disclosure from the therapist– a human to a human, both part of the same culture admitting where things stand.
I don’t think I am going out on a limb to note that our culture is currently struggling. As I write this, in Texas, transgender citizens’ rights are on the line. Gender-affirming care is slated to become criminalized, at times targeting trans children’s parents with threats of abuse. Recently, trans adults were added to the list with SB1029, which targets insurance companies and providers. Abortion is banned, though it is a medical intervention that can be lifesaving. To make matters worse, bounty laws that enforce this are creating an environment that is truculent and dangerously paternalistic. Books are being banned, and educators censored. A new Don’t-Say-Gay-esque bill was proposed just last week, modeled after Florida’s, which threatens an outright book ban around anything mentioning LGBTQ+, as well as censoring classroom discussions around the same. And the effects and human impacts of a climate changed are palpable and ever-increasing–in our area, we are recenrtly off the heels of another freeze. All of this on top of year three of the pandemic and its longstanding disruptions on learning, isolation, mental health, and physical health.
When Diagnostics Are Not Enough
And listen, I am not against diagnosing one’s mental health issues. Diagnostics as a part of comprehensive therapeutic treatment can be incredibly beneficial. They can certainly aid in devising and guiding successful treatment within the therapeutic consulting room. For the client who has been struggling with symptoms; a diagnosis can provide relief, an explanation, and a framework to describe their internal state or external behavior to themselves, family, classmates, work colleagues, and friends. Diagnostics on the whole can open up lines of communication within a treatment team, creating access to intervention avenues at the school level, or equally, funnel information to a psychiatrist who can better medicate. A correct diagnosis can create ease within a family system to remove the label of Identified Patient (IP) from a child’s role and help the system see their child or sibling from a more educated and supportive perspective.
So- we can diagnose the person inside of the room however, we must also pay mind to the collective upheavals, distresses, and systemic issues that contextualize this individual. The medical equivalent might be something like this: we have a town next to a factory that is seeping toxic waste into the town’s water supply–a large and suspicious portion of the town comes down with a respiratory disease. Diagnostics alone would create a closed loop within the local medical system, with continuous siloed individual diagnoses reporting the disease created by this substance. AND/OR; the water supply could be addressed, and toxin mitigated. This is made more complex when we consider mental health as things tend to be created by many factors– and it can be tricky to suss out the causes, and the collective fixes. But complexifying our solutions, and as collectively as possible, is exactly the medicine called for in this era.
Psychologist James Hillman said (and of note, before the internet took hold):
“Of course I am in mourning for the land and water and my fellow beings. If this were not felt, I would be so defended and so in denial, so anesthetized, I would be insane. Yet this condition of mourning and grieving going on in my soul, this level of continuous sadness is a reflection of what is going on in the world and becomes internalized and called “depression”, a state altogether in me ─ my serotonin levels, my personal history, my problem…”
(Hillman, 1996)
Trauma-Informed Care as a Path Toward Healing
I know I am outting my politics, but alas—my last two blogs have been about porn and fairy tales so that cat is already out of the bag. Let’s take the example of gun violence. I see teens and work often with parents with young children. Both demographics are widely impacted by the nations’ lack of legislation on guns and are moreover the compensatorily-devised adaptation techniques that infiltrate our learning institutions instead of real action. If a teen client comes in saying; “I have had [X many] years of Active Shooter Drills at school and I am experiencing nightmares.” Yes, we can work to shift the nightmares, ameliorate the residual fear and treat the existence of such symptoms. But resounding data is against these drills and particular practices within. Why would I simply normalize them?
“Active shooter drills in schools are associated with increases in depression (39%), stress and anxiety (42%), and physiological health problems (23%) overall, including children from as young as five years old up to high schoolers, their parents, and teachers. Concerns over death increased by 22 percent, with words like blood, pain, clinics, and pills becoming a consistent feature of social media posts in school communities in the 90 days after a school drill.”
Similarly, if a parent comes in citing concern their little one is going to be soon introduced to this practice at their new school, it would be wholly inauthentic of me to ignore not just the upset this future event is inciting but to not also see this concern within the structure of the collective climate.
I speak here from a position of activism, allyship, and a desire to move forward as clinicians with eyes open, and as collectively aware as possible. No matter the source, symptoms and their manifestations are treatable. Therapy can provide meaning-making, the healing relationships can be sturdy-ing, and its structure and techniques can actively reify the resilience, connectivity, and vibrancy of the Self. If you love data, therapy has been shown in many forms to change the brain’s structure, namely in the frontal and temporal cortex, which enables more integration, processing capacity, and regulation of neural symptoms. When under the care of a trauma-focused and trained practitioner; trauma can be reprocessed to repair mental injuries from not only the initial trauma(s) but also any newer experiences that have been neuropsychologically linked up with the traumatic experience. EMDR, for example, uses bilateral stimulation as an adaptive information processing technique to reprocess and restore improperly stored, fragmented memories that can otherwise create interruptive and discontented states. The de-fragmentation and integration it engenders can be deeply impactful.
Therapy is helpful, and it is more helpful when it considers itself as a tool within a structure, that keeps in mind the structure’s influence on the clients it is aiming to help. I would be doing a disservice to clients to ignore the wider lens, and I hope that in and of itself is a helping technique.
Becoming an EMDR Trained Therapist is one of the most exciting things I have ever done. It is my honor and my joy to work with persons who have carried terrible burdens of trauma and pain for many years; and to help them unload those burdens, and find healing, hope, and peace.
Alphabet soup
The acronym EMDR stands for “Eye Movement Desensitization and Reprocessing.” That is a mouthful. I would define EMDR therapy as “a powerful way to assist your brain’s natural healing process.” This solidly-researched psychotherapy method helps people recover from trauma, PTSD, anxiety, depression, panic disorder, addiction, and many other difficulties in living.
Your brain knows how to heal
Each day, our brains absorb a huge amount of information. Many things happen to us, both good and bad. Our brains sift out the key information, and store it in a form that will help us handle new experiences. This is how we learn from the past, adapt to our environment, and prepare ourselves for the future.
Your brain knows how to heal, just as your body knows how to heal. When bad things happen to us, our brain heals from them—much as your skin heals from a cut. Much of the daily healing of our brains occurs while we sleep.
Trauma interrupts healing
Trauma interrupts the brain’s natural healing process. Trauma is an intensely disturbing or distressing experience that overwhelms our ability to cope. When you experience a trauma, your brain is unable to do its normal processing of that event. Your brain is unable to put the memory in a form that is useful for the future. Instead, the memory gets stuck in its original, raw, disturbing form—including distressing thoughts, emotions, and body sensations.
EMDR therapy restarts healing
The role of an EMDR therapist is to restart your brain’s natural healing process. The therapist follows carefully-researched methods that guide your brain to heal naturally. One of my mentors compared an EMDR therapist to a midwife. A midwife assists a woman as she gives birth naturally; the midwife intervenes only when necessary. Likewise, an EMDR therapist assists a client as his or her brain heals naturally; the therapist intervenes only when necessary.
Where did EMDR therapy come from?
In 1987, American psychologist Francine Shapiro, Ph.D., made a chance discovery. While walking through a park, thinking about a disturbing memory, she happened to be moving her eyes rapidly from side to side. After her walk, she noticed that while the memory remained, it no longer disturbed her. Fascinated, she dedicated the rest of her life to researching this phenomenon, and developing it into a powerful method for healing. Many researchers all over the world joined in her work. After Dr. Shapiro’s untimely death in 2019, EMDR research has continued.
EMDR therapy has been extensively researched, all over the world, for over 30 years. Research has shown that EMDR therapy is effective not only for trauma counseling and PTSD recovery, but also for anxiety, depression, panic disorders, substance use and addiction, and many other mental health needs. EMDR therapy yields deep, lasting healing. For many clients, EMDR therapy yields results faster than other methods of psychotherapy.
Eye movements
Typically, an EMDR therapist guides the client to move their eyes rapidly from side to side. In some situations, a therapist may choose tapping, or some other form of side-to-side stimulation, instead. It is thought that the side-to-side stimulation, rapidly alternating left-right-left-right, stimulates the left and right hemispheres of the brain to work cooperatively with each other in the healing process.
EMDR therapy is based on the neurobiology of the brain. Neurobiology is a field that has advanced greatly in the past 30 years. New discoveries in neurobiology show that EMDR therapy brings about real, observable, biological healing in the brain.
EMDR therapy may be related to REM sleep
Researchers think that the rapid, side-to-side eye movements used in EMDR therapy resemble the rapid eye movements that we experience during part of the time that we are asleep. Have you ever seen a sleeping person whose eyes are moving side to side, under their closed eyelids? This is called Rapid Eye Movement (REM) sleep. It is thought that REM sleep is an important part of our brains’ healing process.
When the EMDR therapist guides the client to move their eyes rapidly from side to side, this may mimic REM sleep. However, during EMDR therapy, the client is wide awake and fully in control of his or her thoughts and actions.
EMDR therapy is a holistic approach
EMDR therapy is not a quick fix. EMDR therapy is not a technique, or a collection of techniques.
EMDR therapy is an integrated, holistic approach to mental health care. Like any other form of counseling, it is built on the solid foundation of your having a good, working relationship with your therapist. You and your EMDR therapist will take time to build a relationship of mutual trust. A good EMDR therapist will treat you with deep respect, empathy, and unconditional positive regard. He or she will notice your strengths, point them out to you, and help you believe in them.
EMDR therapy accesses the “emotional brain”
EMDR therapy helps make connections between your thinking and your feelings. EMDR therapy helps bridge the gap between your head and your heart.
Our brains have layers. The outermost layer is the “thinking brain,” where rational thought occurs. The inner layers are the “emotional brain,” where our feelings reside, along with our survival instincts. Your “emotional brain” communicates closely with your body. You may have noticed that your emotions influence your body sensations, and vice versa.
EMDR therapy differs from many forms of psychotherapy in that it directly accesses our “emotional brain.” By contrast, some forms of therapy, such as Cognitive Behavioral Therapy (CBT), directly access our “thinking brain.” Even if you have already experienced some form of “talk therapy,” you may benefit from EMDR therapy in addition. EMDR therapy addresses a different part of your brain, and gives a different kind of healing.
Reducing the distress of a memory
Sometimes we wish that we could erase a painful memory, but our brains don’t work that way. Attempts to numb the pain, for example with alcohol or drugs, are temporary—and have many unwanted side effects.
EMDR therapy doesn’t erase the memory. But it reduces the distress associated with the memory. The relief that one experiences from EMDR therapy is permanent, and without side effects.
EMDR therapy helps the mind, emotions, and body to heal from the memory. During EMDR therapy, the memory is processed into a useful form. Our brain makes sense out of it. We learn from the past so that we can cope better in the future. The distressing, volatile emotions are calmed. The body response to the memory is released. Many clients report an overall reduction in distress.
If you have experienced a trauma, it will always be a terrible event. It will always be something that should never have happened to you. EMDR therapy doesn’t change the facts. But EMDR therapy enables you to be at peace with the past, and to look forward to the future with hope.
Touching the memory without reliving it
During EMDR therapy, the client touches the traumatic memory without reliving it. The therapist guides the client to recall the event without being overwhelmed by it. This is like the difference between diving into the swimming pool, or just dipping your toe. For EMDR therapy, you only dip your toe. For this reason, EMDR therapy is gentler to the client than some forms of therapy that involve reliving the trauma.
Healing memories without telling the details
Surprisingly, EMDR therapy works even if the client tells the therapist very little about the traumatic memory. The client needs to recall and notice the memory and their reactions to it. However, healing does not depend on the therapist knowing any details. This is important, since sometimes a client needs to heal from a trauma that he or she cannot talk about in detail. An example would be a veteran who has served on secret missions.
Have you experienced trauma?
No one goes through life unscathed. Even if you do not think of yourself as a trauma survivor, you certainly have had some disturbing experiences.
When we think of trauma, we often think of catastrophic events, such as a devastating car accident or a sexual assault. But our brains are also affected by adverse life experiences—events that may not seem major, but that may impact us. Adverse life experiences can affect us deeply if they are repeated for a long time, or if we were very young or otherwise vulnerable when they occurred.
Are your past traumas affecting your present-day life?
If the answer is “no,” then there is no reason to revisit your past, painful experiences. There is no excuse to ask someone to revisit a painful experience—unless it is necessary for healing.
If painful experiences from your past are truly healed, they do not harm you in the present, and they will not harm you in the future. If, on the other hand, traumas are merely “contained,” not healed, they may impact you in the future. To illustrate the difference, recall stories you have heard about veterans.
You have probably heard stories of soldiers who experienced the horrors of war, but bravely returned to battle day after day. There was no time to heal from these wartime traumas, so the soldiers “contained” them as long as they could—sometimes for years after the battles were over. However, for some veterans, a chance event can suddenly break open the “container” that holds the traumas. Suddenly, the veteran is overwhelmed with flashbacks, nightmares, etc., that make it difficult for him or her to cope. A veteran in that situation would benefit from EMDR therapy.
The goal of EMDR therapy is to heal your past traumas, not merely to stuff them into a “container.” “Containment” is temporary, but healing lasts.
Lingering symptoms of trauma
You may be experiencing aftereffects of trauma that you do not recognize as such. Lingering symptoms of past trauma may include feeling ashamed, worthless, hopeless, depressed, anxious, irritable or numb; feeling emotionally overwhelmed or unable to concentrate; experiencing nightmares, flashbacks, panic attacks, chronic pain, headaches, eating disorders, substance abuse, or self-destructive behavior; constantly being on alert for danger; having blank time periods of your life about which you have few or no memories; feeling as if you or your surroundings are unreal; or feeling as if your body is not your own.
Time and budget
A good EMDR therapist will respect your time and budget. He or she will work with you to create a treatment plan based on your goals. The purpose is to give you as much healing as possible, as efficiently as possible. You may request a short-term, solution-focused plan. Alternatively, you may seek to resolve complex trauma—if you desire deep healing from many, serious hurts.
Sometimes in the course of therapy, new issues can arise. This is true of any kind of therapy, not just EMDR therapy. If new issues arise, you and your therapist can decide together how best to handle them.
EMDR processing of a specific memory is a well-defined project, with a beginning, a middle, and an end. At some point you will say to your therapist something like, “It was still a terrible event, but it doesn’t upset me anymore. I am at peace.” After careful checking, your therapist will say to you something like, “Congratulations! You have completed the processing of that memory. Good work!”
Clients are smart
If you are feeling caution, hesitation, or ambivalence about trying EMDR therapy, I respect that. One of my mentors told me, “Our clients are smart. They know what they are ready for.” A good EMDR therapist will listen carefully to your needs and priorities. He or she will follow your sense of urgency. He or she will respect your sense of caution. Together you will create a plan for how EMDR therapy can best help you.
In collaboration with your therapist, you may choose to start very gently, for example by naming a current source of anxiety in your life, and working to reduce your suffering about this current stressor. Alternatively, you and your therapist may decide together that you are ready to address a major trauma in your past that is impacting your life today.
Key takeaway
EMDR is a powerful form of therapy that gives deep healing. For me it is a great privilege to assist in my clients’ natural healing process. I am often in awe as I witness the beautiful way in which my clients’ brains achieve healing, wholeness, and peace.
[I wish to thank Helen Harris, Ed.D., LCSW-S, Rick Levinson, LCSW, Kasey Salyer, LCSW-S, and Trina Welz, LPC-S, for teaching me the above material. I also referred to a paper by Janina Fisher, Ph.D.]
