Walking Therapy

Walking and traditional talk therapy can mix.
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One of my complaints with traditional psychotherapy is that it tends to ignore the body and only focus on the mind. It’s as if talk therapy is simply two brains communicating with one another, leaving their bodies behind. In psychotherapy, the body is almost irrelevant because the focus is on the client’s memories, thoughts, beliefs, and words; the body is an afterthought. 

In reality, we are whole, complex beings with bodies that are both a part of the problems we may have, which means our bodies may offer solutions to our problems as well. I feel this discordance in my practice in the form of anxiety, tension, and chronic pain (i.e. knots in my back, stiff neck, sore shoulders, and creaky hips) after absorbing the emotions of my clients for extended periods of time.

Excessive sitting can lead to back and neck pain
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It’s now widely known how dangerous and unnatural it is to be sitting too much (Remember sitting is the new smoking? Dramatic, perhaps, but there’s some truth in it), Most of us have very few ways to physically expel the stress, tension, and trauma we internalize over time. Luckily, this trend is starting to change.  The idea that movement is important has started to permeate office culture in the form of standing desks, walking meetings, and fitness classes integrated into employee benefits. However, psychotherapy is still mostly sitting on a couch, talking to a professional about your problems face to face with little to no movement.

Because of the desire to incorporate the body into healing, I find myself drawn to more body-oriented therapies. Health coaching, while technically not a body-oriented therapy, is a practice that acknowledges your body and brings it into the room.  Your habits (what you eat, how much you move, and how you treat your body) are highly connected to your moods and emotions. EMDR therapy brings you into your body and orients you not just to your emotions, but the bodily sensations associated with them as well. Hakomi and Somatic Experiencing are two methods used to help a person work through trauma by clearing the “memory” of it in their body in similar but unique ways. Tension & Trauma Release Exercises or TRE is a method of using bodily tremors to help release stress, tension, and trauma from the body. Yoga therapy, meditation, and mindfulness practices all incorporate a mind-body connection to facilitate healing. Another way to utilize your body in therapy is to walk while doing talk therapy, which is something I’ve been using in my own practice.

Body oriented therapies are on the rise.
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What is Walking Therapy?

Walking therapy, also called “Walk and Talk Therapy” is just what it sounds like: walking while engaging in talk therapy. My office is located next to the beautiful Laurelhurst neighborhood in central Portland, so I usually take my clients through this quiet neighborhood surrounded on all sides by busy streets.

The neighborhood around my office doesn’t look like this, but it’s nice.
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Benefits of Walking Therapy

Anyone who’s done much traveling can tell you that changing one’s environment can change one’s perspective. While walking, you are constantly changing your environment, which can inadvertently lead to more emotional movement and shifts in perspective. Moving your body can help you get unstuck when you’re feeling trapped in certain feelings or patterns of thinking. 

Exercise has been associated with better learning abilities and enhanced memory, so you may get more out of the session if you’re moving during it. The goals of therapy are often to change your habits, your thinking, your emotional responses, and how you respond to stress. Even gentle exercise can help you achieve that over time. 

Another benefit is that walking therapy can feel less confrontational or intimidating than the typical face-to-face setup of a therapist’s office. While those brief silences can range from slightly uncomfortable to absolutely excruciating when you’re sitting on a therapist’s couch, they can be a pleasant moment to reflect and look around and ground yourself when you’re walking. 

Physical movement can enhance mental and emotional movement.
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Who is Walking Therapy Good For?

Walking therapy is a great fit for many different types of people. If you can walk, walking therapy is likely an option for you. One population that seems to particularly benefit from walking therapy is adolescents. If you are the parent of a teen (or have recently been one yourself) you may know that the best conversations seem to happen in the car. There isn’t such intense eye contact, which can make teens feel chastised or cause them to shut down entirely. Children and teens already have a lot of adults in their lives telling them what to do, so it’s important that therapy doesn’t feel like that for them. Ideally, therapy should build a sense of collaboration and mentorship, and the analogy created by walking side-by-side with a teenager supports that. 

Walking therapy also tends to be a good fit for those in what I call the “maintenance phase” of therapy. This means that we’ve worked through some of the underlying, deeper challenges such as childhood trauma and are now wanting to talk through the current challenges of daily life, such as work, relationships, and symptom management. Some people come to therapy for assistance with these challenges in the first place and don’t initially need to delve more deeply. We can (and typically do) do a combination of walking and office therapy so there’s always the safety of the contained environment available when something extra challenging or vulnerable comes up. 

We can always head back to the office if things get heavy.
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What are the risks of walking therapy?

Besides the risks inherent with walking in a city (you could trip and fall, get rained on, get sunburned, hit by a car, etc.), there are a few additional risks to consider. One obvious one is that there is less of a guarantee of confidentiality. In Portland, it’s common to run into someone you know periodically, especially if you go to therapy in a neighborhood where you work or live. When I worked with teens in their homes and communities, I would talk with them about the risk of breaching confidentiality and they’d decide what they want to do about it. Some were happy to tell people I was their therapist, while others liked to have a cover story. One client insisted to her friends that I was her aunt, and I was happy to play along. We can decide how to handle these incidental meetings ahead of time if it is a concern for you.

The other risk is the lack of containment. While there are times when it feels good to be out in the open and moving, there are also times where that can feel unsafe or unproductive. When dealing with deep trauma or insecurities, or when discussing a topic where you may cry or express emotions deeply, it may not be ideal to be out walking while that occurs. For some topics, you may feel more comfortable talking in the safety of an office than in a public place. 

Lack of containment is a concern with walking therapy.
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When is walking therapy not recommended?

For the assessment phase, we will start indoors. It’s important that we start in a calm, enclosed environment so I can get to know you, your goals, and what you hope to get from therapy. I usually take notes for the first two or three sessions, and I need to be in the office to do that. Once we’ve gotten to know each other a little better, we can decide if and when walking therapy feels appropriate. 

When working through significant trauma, it’s important to feel very safe in order to open up. EMDR, for example, cannot be done while walking, and it’s important that you feel a sense of safety and containment, and that you are not distracted. However, many people like to alternate EMDR sessions with talk therapy, so we could still get outside then. For those who experience dissociation due to past trauma, walking or outdoor therapy can be an excellent way to get into your body and become more mindful of your sensory experience. 

There are times when the therapy office is best.
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For those with mobility issues or physical disabilities, walking may not be recommended or even possible, but there are other ways to get into one’s body through mindfulness or other forms of movement that could be helpful and therapeutic.

Lastly, couples’ therapy would probably be impractical while walking, but there could be times where it would be useful. For example, if one or both parties are highly activated, walking around a bit can help everyone cool off. Family therapy can also be challenging, but I’ve done walking therapy with one parent and a child and that worked well for them. 

If walking therapy interests you, contact me and we can set up a consultation or initial appointment.

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