Forest Bathing: Big Medicine for Big and Little People

Forest Bathing: Big Medicine for Big and Little People

Originally published by Free Forest School on August 19, 2019

As a child, I remember lying in the grass looking up at the clouds, losing myself in an imaginary storyline. I remember watching ants and other insects for long periods of time, becoming fascinated with their tiny, busy worlds. To this day, I can conjure up the fragrances of a pile of autumn leaves, the peas and zinnias in my grandmother’s garden, the sap from the gnarly evergreen my friends and I used to climb. I can bring back the feel of that same sap when it was stuck to my fingers, the sensation of wading in a cold creek, and the tickly way it feels to hold fireflies in my hands. Unstructured nature play experiences, throughout my childhood, rooted me in nature from a young age.


Today’s children spend a minute amount of time in unstructured play, and that even less of that takes place outdoors. A colleague shared with me that he had recently taken a group of urban kids outdoors. One of them was shocked to notice that there were clouds in the sky. . . and that they MOVE! Many kids today are disconnected from the natural world, and the myriad health benefits time outdoors offers us all.


I’ve seen the benefits of nature firsthand, as a mom and as a physician who prescribes nature. Through my own healing from physician burnout, from fighting a broken system for my son with autism, and from the grief of losing a spouse, I rediscovered my love of nature. I rediscovered my love of outdoor adventure and I rediscovered the magic of slow, quiet time outdoors. I discovered the practice of shinrin-yoku, or Japanese forest bathing, and nothing has been the same since. I offer the practice to my patients and have found very often that greater healing occurs in two hours of forest bathing than with any pharmaceutical drug.


Forest Bathing Encourages Us to Lose Ourselves in Nature


Forest bathing is a practice that was started in the 1980s in Japan, where the fast-paced, bright light, noisy, frenetic lifestyle in Tokyo has been linked with severe mental health problems and high rates of suicide. Doctors Qing Li and Yoshifumi Miyazaki offered urbanites the opportunity to leave the city to experience the sensory effects of mindful, quiet, contemplative time spent in a forest. They took blood and saliva samples and checked various health parameters (blood pressure, heart rate variability, and so on), before and after people took part in this practice. Later, Amos Clifford brought the practice of forest bathing to the United States, founded the Association of Nature and Forest Therapy (ANFT), and set about training guides who would share it with others.


Distinct from a hike in the woods or a nature identification walk, guided forest bathing walks are slow and silent, with the guide using a series of techniques to lead the participant out of the active “monkey-mind” state and into a deeper level of consciousness, known as the liminal state. In other words, guides are reminding us how to lose ourselves, as children inherently do, in the wonder and awe of nature!


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The Physical and Mental Benefits of Nature

Among the many health benefits of forest bathing is the discovery that plants in the forest (and especially evergreen trees) emit chemicals called phytoncides. These phytoncides serve to protect plants and trees against invasion by viruses, bacteria and fungi, and are inhaled and ingested by humans who are simply spending time in a forest. It turns out that they offer these antimicrobial features to us, then, as well. Time spent in nature therefore reduces our chances of succumbing to infections—quite a bonus for young kids!


Dr. Li also discovered that when people participated in a three-day and two-night forest bathing excursion that they had a boost in their Natural Killer (NK) cells; cells in our immune system that locate and destroy cancer cells. Dr. Li’s team was excited to find that the number and activity of these NK cells remained elevated after this three-day experience by not only seven additional days, but for thirty days after the forest bathing excursion. This means that when we spend time in nature, the health benefits—specifically the cancer-fighting benefits–last for up to a month afterwards.


In terms of brain health, a number of studies have found that time spent in nature is beneficial. One such study found that a form of bacteria in soil called mycobacterium vaccae seems to make us smarter when we ingest and inhale soil particles, just by being outdoors. Mice that  were exposed to these bacteria were found to navigate a maze twice as fast as those that were not exposed to it.


Another study (that I constantly quote to my kids), found that memory and attention span increased by 20% after just one hour of interacting with nature. The benefit was found to occur even if the participants in the study did not enjoy their time outdoors! So, whine all you want, kids –it’s still good for you!


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Forest Bathing Invites ‘Embodied Awareness’

ANFT-certified forest therapy guides use a specific system of “invitations” known as the Standard Sequence. This sequence brings the participants into a state of embodied awareness by guiding them through the senses in a prescribed and replicable fashion. As participants begin to leave the stressors of the day behind and immerse themselves in nature, I have witnessed both mental and physical transformations occur. I highly recommend experiencing forest bathing with an ANFT-certified guide for everyone, at least once, and guides can now be found all over the world. (Visit and navigate to “Find a Guide”.) Meanwhile, here are some invitations to try on your own:


Pleasures of Presence

Although it is often much easier for children to mindfully “drop in” than it is for their parents, there are some simple standard invitations that work well for adults and children to do together. The Standard Sequence always begins with the invitation known as “The Pleasures of Presence.” A simple way to do this with kids might be to invite them to pick up an object such as a rock or a pinecone, ask them to sit or stand with their eyes closed, and walk them through silently becoming aware of their object through the various senses. One might guide them to silently notice the weight, texture, temperature and other tactile characteristics of the object, whether it has any kind of smell, what it sounds like if it is manipulated with the hands, and on and on through as many sensory characteristics as one can come up with. This can take up to ten minutes before inviting the child to open their eyes and look at the object as if they have never seen anything like it before. You can enhance this idea by suggesting that they are a creature who has just arrived from another planet and is witnessing this object for the very first time. After completing this “Pleasures of Presence” invitation, ask the child or children to share what they noticed during the experience.


What’s In Motion

Children (adults, too!) tend to become lost in the invitation, “What’s in Motion?” To do this, simply walk slowly and silently for a set period of time (perhaps ten minutes) looking for things that are in motion. Look up, look down, look under leaves and rocks and just concentrate on seeking things that are moving. At the end of the time period, the group may share what they noticed about what, in the forest, is in motion.


Deer Ears / Owl Eyes

The sky is the limit when it comes to creating forest bathing invitations. Children enjoy walking silently with their hands cupped around their ears as “deer ears,” noticing how the sounds of the forest are altered by walking this way. They enjoy placing their hands on the sides of their faces and seeing the world through “owl eyes,” taking in a larger field of vision than we often experience when walking in the woods.


Tactile Invitations

Tactile–or sense of touch–invitations contain special magic. Try removing shoes and socks and walking barefoot on a dirt trail or shallow creek. Invite children to hug a tree (yes, literally!) and to share a story, a secret, or a worry with a tree of their choosing, while hugging, sitting or leaning against it. After each and every invitation, come together and share (and this is always optional) something of the experience.


Tea Ceremony

Forest bathing is traditionally concluded with a tea ceremony. Before foraging for plants for

consumption, however, it is absolutely IMPERATIVE that one has adequate knowledge of plant medicine, that foraging is permitted on the land in which you are forest bathing, and that chemicals such as herbicides and pesticides have not been used there. There are a number of resources, including my book, The Outdoor Adventurer’s Guide to Forest Bathing, that teach basic herbal medicine and explain how to conduct a tea ceremony. Children often enjoy the “tea party” aspect of tea ceremony and it is a great time to reflect upon the forest bathing experience and to pay respect to the plants, trees, animals and insects of the more-than-human world as well as to the ancestral humans who tended the area long before us. An easy way to learn the ancestral name(s) of the land is to use the interactive app found at


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I often imagine what the world would be like if all children were taught practices such as mindfulness, meditation and forest bathing. Not only would the world be filled with more tolerance, but a sense of commitment to the more-than-human world and to the beautiful outdoor spaces of our amazing planet would be fostered at an early age. It gives me great hope and happiness that Free Forest School exists today because of parents who know this in a deeply visceral way. Continue believing in both the teachings and the healing properties of the forest. As you know in your heart, the medicine is real.


~Suzanne Bartlett Hackenmiller, MD, FACOG, ABOIM

Ditching the Doctor’s White Coat, June 2, 2016

“After last week’s workshop, I took my family on a mindfulness nature walk!  They loved it.” 

“Instead of eating lunch indoors during an all-day seminar last week, I decided to walk around the pond behind the conference center during my break.  It was so therapeutic!” 

“I did my own little Shinrin-yoku one day this week.  I definitely need to remember to do this more often!” 

THREE people who attended my recent workshop series, “Invitations to Wholeness: Nature and Wellness,” made these statements to me after participating in a one-hour Shinrin-yoku forest bathing activity.  I was astounded.  After all, how often do people follow through with assigned homework or prescribed treatment?  This was spontaneous.

I’m technically a physician.  But I happen to be a physician who is drawn to the out-of-doors.  My heart physically aches to be outdoors.  I have actually become tearful on several occasions describing the degree of challenge it is for me to work in an indoor setting, seeing patients in an exam room.  I have often said that healing would be more profound and permanent if we could leave the exam room and see patients outdoors.  My goal and, I will dare say, my dharma–my truth, my life’s purpose–is to combine nature and healing.

It can’t possibly come as a surprise to us that nature is healing.  But science is now even proving it.  The results of a Japanese study on Shinrin-yoku in 2010 showed that spending time in a forest environment lowers our cortisol levels, heart rate, blood pressure, and sympathetic (fight or flight) nerve activity (Park, et al., 2010).  Another study showed improvements in depression, tension, anger and vigor after participants experienced walks in nature (Park, et al., 2011).  At the microbiological level, researchers have found that substances released from plants called “phytoncides” actually boost the immune system, protect against bacteria and viruses, possess tumor-fighting properties, and improve mental health in terms of depression, anxiety, ADD and self-esteem.

So this spring I decided to try my hand at a little Shinrin-yoku.  I had read about it a few years ago, requested a booklet on the practice, and then decided I would just give it a try with a group of twenty-five lovely, engaged participants at my workshop at Prairiewoods.

Prairiewoods Retreat Center in Hiawatha, Iowa, is a beautifully serene place founded and operated by the Franciscan Sisters of Perpetual Adoration (FSPA).  Among the 80+ acres of property lie a retreat center, a labyrinth, a sweat lodge, a meditation room, an art room, and two and a half miles of nature trails along a babbling stream.

In the end of April, we gathered at the lodge on a beautiful sunny evening for the nature and wellness workshop.  I explained the mindful forest therapy practice upon which we were about to embark and we silently walked down the trail, passed through a small arch, and formed a circle.  We took a moment to center, express gratitude, and breathe in our surroundings.  I then explained the first exercise.  We explored the Shinrin-yoku activities using the visual sense: focusing on the dark, owl eyes, and noticing motion.  Between each, we rejoined in council to share our experiences.  I couldn’t help falling into the meditative space, myself, as I led the participants through these exercises.  Using “Owl Eyes” broadened my focus with a softened gaze, allowing much more to be taken in than during a typical walk in the woods.  The “motion” exercise brought a host of revelations, and participants shared of seeing snakes, birds, movements of plants, and various patterns of current and eddies in the stream that they had never noticed before.


My back story is that I studied and trained for a career in Obstetrics and Gynecology.  I forged my way through many years of solo practice in a small rural hospital–along the way having two children (one diagnosed with autism), divorcing, remarrying, and losing my second husband to cancer—straight through to a serious, off-the-charts case of physician burnout.  Somehow, six years ago the world of integrative medicine made its way to my consciousness, and I completed Dr. Andrew Weil’s two-year fellowship in integrative medicine through the University of Arizona, left the frenetic world of OB-Gyn as I had known it, and began treating patients in ways I never dreamed possible. Whereas I previously wrote up to 150 prescriptions per week, I now prescribe lifestyle changes that include such far-fetched ideas as NATURE THERAPY!  Interestingly enough, my patients are doing. better.

I did have some premonitions toward this work.  I will never forget the open air well baby clinics I worked in during my medical school clerkship in the developing country of Vanuatu.  We set up shop on a picnic table and babies were weighed in a scale hung from a tree branch!  I remember thinking “this is how all clinics should be!”

But it was not until many years later when a very special patient encounter drove the point home for me.  A couple I had known for years brought their daughter who has autism to see me.  It was not that Betsy had a gynecologic problem; her parents were simply desperate for someone in the medical community to listen to them and to help them negotiate the mystery of the healthcare system.  They trusted in my experience with autism.

When I walked in the room, I knew it was not going to go well.  Betsy is close to my age, and is nonverbal.  She was very agitated to be in an exam room, having seen many different doctors in recent months.  It did not take long for me to punt.

I took off my white coat and we went outside.

Betsy, her parents, the nurse from her group home, and I walked around the walking path surrounding the hospital.  I spoke and asked questions to Betsy as the entourage behind us answered for her.  Halfway around the trail, a priceless thing happened: Betsy took my hand.  Her mother gasped as this happened.  “This is very unusual for Betsy.  She really trusts you,” she said.

“I took off my white coat and we went outside.”  A defining moment of my career, a permanent shedding of that white coat, and a commitment to re-explore nature.


I collected a brief survey following our recent Shinrin-yoku exercise.  Sixty-one percent of my participants reported feeling improvements in both depression and tension after our forest bathing activity.  Sixty-five percent reported reduced feelings of anger, and 70% reported feeling more vigorous; findings consistent with the 2011 study above.  But the proof is in the pudding.  There was unanimous enthusiasm for a full three-hour Shinrin-yoku program we have now scheduled for later this summer at Prairiewoods.  And, even better, my patients are already living it.  My patients are healing in nature.