Ecotherapy for the end of life

(Veronica Wiley (they/them) is an ecotherapy facilitator with an MBA, Experienced Registered Yoga Teacher (E-RYT) certificate, and is an INELDA end-of-life doula who has been a yoga instructor for over a decade. Veronica has E-RYT and continuing education provider credentials through Yoga Alliance. The focus on end of life care was inspired by the sudden illness and passing of Veronica’s father in July of 2021 after witnessing resistance and aversion to conversations with family and medical providers about death. The original version of this article, used with permission, can be found online at https://inelda.org/ecotherapy-for-end-of-life/.)

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Ecotherapy, as defined by Jordan and Hinds in the 2016 publication Ecotherapy: Theory, Research and Practice, is psychotherapeutic activities (counseling, psychotherapy, social work, self-help, prevention, public health activities) that are: undertaken with ecological consciousness or intent; often use natural settings, activities, or processes as an integral part of the therapeutic process; focus on ecological aspects of self, identity, and behavior; and are at various scales, from personal to planetary.

A less clinical view of ecotherapy can be described as a process for healing the relationship between humans and nature. The idea that nature exists outside of us, and is something that takes effort and intention to connect to, reflects our modern society. Eastern culture and philosophy often emphasize that the causes of human suffering arise from this myth of separation from nature and universal life-force energies.

Witnessing the cycle of life and death in nature can create more ease in conversations of death and dying. Dispelling the myth of separation between humans and nature – placing the human experience of life and death within the contextual container of natural processes – has been shown to even bring physical, emotional, and spiritual comfort at the end of life. Nature is an access point for everyone, of any age, to contemplate and understand the rhythmic ebb and flow of seasons, growth, change, transformation, life, and death.

A 2017 critical analysis in Journal of Pain and Symptom Management reviews 225 scholarly documents, revealing several environmental factors to be considered for improving the quality of life and minimizing suffering in end-of-life settings. Nature is at the top of the list of “positive distractions,” due to results indicating that exposure to nature reduces patient stress and improves psychological well-being in hospital environments – nature can be viewed as a spiritual healer that enables people to reflect on life, making it a valuable element in fulfilling existential needs.

The palliative grief parks project in Alberta, Canada, was intended to measure and evaluate the relationship between death, grief, and public parks. The study sought to understand individual perspectives and values regarding parks and nature at the end of life through a narrative process that revealed three dominant themes:

• Death brings people to parks and nature.
• Parks and nature reveal death and life.
• Nature teaches people to grieve.

Deborah Kelly’s 2017 dissertation through Middlesex University London, An Inquiry Into the Nature of Therapeutic Space in Palliative Care Groups, Working With Nature and Imagination – part of which was included in Ecotherapy: Theory, Research and Practice – examines and notes the positive effects of nature on caregivers and facilitators while working with groups of palliative care patients.

Everyone can benefit from the reminder that we are of the earth. Whether or not someone is able to be in the outdoors is irrelevant to the ability to connect with nature. Here are some simple ways to honor the connection to the innate (inner nature):

• Deep breathing with guided visualization focused on natural elements – the sound of the wind/ocean, the smell of a forest, the sensation of sun on skin;
• Meditating on images of natural landscapes;
• Pet/animal therapy;
• Meditation on natural objects such as shells, rocks, pine cones, twigs, leaves;
• Movement – even small, coordinated movements of touching fingertips together in rhythm with the breath – can have significant impact on the nervous system and somatic experience, not to mention the impact that other movement practices such as dance, yoga, tai chi, etc., can have in helping individuals to process difficult emotions.

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Final Exit Network (FEN) is a network of dedicated professionals and caring, trained volunteers who support mentally competent adults as they navigate their end-of-life journey. Established in 2004, FEN seeks to educate qualified individuals in practical, peaceful ways to end their lives, offer a compassionate bedside presence and defend a person’s right to choose. For more information, go to www.finalexitnetwork.org.

Payments and donations are tax deductible to the full extent allowed by law. Final Exit Network is a 501(c)3 nonprofit organization.