Treating Anxiety: Using the Wilderness as my Co-therapist

Posted by David Johnson, Therapist at Entrada on May 29, 2015

Recently, I was sitting across from a client conducting an assessment of anxiety and starting to understand the sheer variety of phobias she experienced. All of a sudden, she looked down at her legs and shrieked! I quickly leapt to her side, kneeling in the dirt. I looked closely at her pants following her gaze. A lone ant was traversing her pant leg and creating panic-like symptoms in this client.

After a quick mental assessment of the therapeutic alliance and trust already formed between us, I invited her to participate in our first exposure and response prevention therapy session. After securing her hesitant agreement, I taught her relaxation breathing to help gain some mastery over the physiological aspects of fear. I then took the ant and allowed it to walk on my hand, a technique called modeling that evoked specific catastrophic thoughts from the client: “It will bite you”, “You’ll be in extreme pain”, “You’ll become ill and die”. After seeing that none of these feared outcomes materialized, the client agreed to a certain amount of time holding the ant. Over the next several weeks she graduated to longer periods of time and increasingly larger bugs, including the pictured beetle common in our field area. At this point she was feeling entirely calm due to a process called habituation, whereby emotions stabilize over time due to homeostasis (a natural instinct for the body to return to a baseline state from arousal). And equally important, her cognitive distortions (“twisted thinking”) were self-correcting because she incorporated accurate up-to-date information into her mindset about fear.

beetle

Exposure became a therapeutic theme of this client’s wilderness stay. She used various experiential exercises to conquer fears of social rejection, the darkness, and even existential issues such as death and the afterlife. In a recent group, the client began discussing fear about sharing a vulnerability and looked over at me. She smiled and said, “I know exactly what I need to do to overcome this” and went on to face her fear. I can think of no more fitting environment for many young adults to conquer anxiety and learn the skills necessary to keep anxiety disorders in the backseat of life.

Check out this fact sheet on anxiety disorders from the Association for Behavioral and Cognitive Therapies for further learning on this topic.

Stay tuned for more blog posts on how I treat other specific anxiety disorders, such as OCD, Panic Disorder, and Generalized Anxiety Disorder as well as trauma-related issues, especially PTSD.


 

Comments

Nice work David; It's a Darkling Beetle for those who are interested -- https://www.sanelijo.org/animal-guide/darkling-beetle

Posted by Ed

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