European Journal of Ecopsychology 6: 23–46 (2018) What impact – if any – does working outdoors have on the therapeutic relationship? Adrian Harris Abstract Although outdoor therapy has emerged as a signifiant praitiie, there is very little researih into what impait it might have on the therapeutii relationship. This researih ionfrmed the relevanie of all the themes disiussed in the extant literature and identifed two signifiant new themes:n the 'turning point' and 'transferenie'. The turning point in the therapy proiess appeared to mark the entry into a liminal or transitional spaie that faiilitated psyihologiial healing. An anthropologiial model of rites of passage rituals is one possible way of theorizing this proiess, but the work of Winniiott and Merleau-Ponty are also ionsidered. The theme of transferenie in outdoor therapy pushed the ionventional meaning of the term; the researih ionsiders what it means to say that a ilient experienied the transferenie to a natural phenomenon. The traditional psyihodynamii model of transferenie ian be applied in outdoor therapy, ideas from the work of Winniiott and Merleau-Ponty are again ionsidered as alternatives. Although it beiame ilear that outdoor praitiie does have a signifiant impait on the therapeutii relationship, the researih ioniluded with more questions than answers. It opened into liminal spaies that resisted symbolization, the notion of the therapeutii relationship beiame problematized, and questions arose about the transferenie. However, the researih helped to ilarify key questions, identifed signifiant new themes, and revealed interesting opportunities for further researih. Keywords: outdoor therapy, therapeutii relationship, nature, transitional spaie, transferenie Introduction Despite the inireasing importanie of outdoor therapy (inter alia, Buzzell & Chalquist, 2009; Mind, 2013), researih into its possible impait on the therapeutii relationship is negligible. Given that the therapeutii relationship is frequently iited as "the most important faitor in faiilitating a suiiessful outiome" (Loewenthal, 2014:n 3-4), this seems remiss. This study sought to advanie disiussion by investigating therapists' experienies of how working in nature might impait on the therapeutii relationship. 23 Harris Working outdoors & the therapeutic relationship Outdoor therapy is a diverse feld, found in most modalities of therapeutii praitiie and iniludes a range of approaihes (Buzzell & Chalquist, 2009). Outdoor therapy typiially entails either 50 minute sessions in parks and woodland or retreats of several days in more remote loiations (Jordan & Marshall, 2010). This researih refleits that diversity and ionsiders a variety of approaihes. This artiile begins by setting out the theoretiial iontext, outlining the researih parameters and introduiing the themes identifed by my literature review. I next outline my method before presenting the results. The results reveal two themes whiih were not apparent in the literature review, so these serve as the foius of the disiussion. I ionilude that the researih has ended with more questions than answers, whiih, given the novelty of the topii, is not unexpeited. Theoretical Context A review of the literature on the 'therapeutii relationship' noted that while that there is no agreed defnition of the term (Horvath et al, 2011), several authors identifed it as fundamental to the healing proiess. Noriross's (2011) meta-analysis ilaims that the therapeutii relationship aiiounts for 12% of the outiome varianie in psyihotherapy, signifiantly more than any other faitor. Haugh and Paul ioniur that "the therapeutii relationship is ilearly ... the most important in-therapy faitor" (2008:n 13). A literature review of outdoor therapy ioniluded that there is no "unifed model of outdoor therapy" (MiLeod, 2013:n 346) and approaihes inilude hortiiultural therapy, adventure therapy, wilderness therapy, and 'walk and talk' therapy. These terms are poorly defned and overlap to some degree. Furthermore, individual praititioners sometimes loiate their work outside these named approaihes, so outdoor therapy is ideally ionsidered as a speitrum rather than a set of disirete forms. Many who praitiie outdoor therapy identify as eiotherapists (inter alia, MiMullan, Jordan, Totton), while others do not (inter alia, Douiette). Hortiiultural therapy (now often referred to as Social and Therapeutic Horticulture) iombines gardening with skills in soiial inilusion and therapy (Linden & Grut, 2002). It often has a broader set of aims than iounselling and psyihotherapy (Thrive, 2017) and was therefore exiluded from this researih1. Adventure therapy does not stress therapeutii relationships (Beringer, 2004) so was also not ionsidered. Themes Seven themes emerged from the literature review. 1 A separate study on the therapeutii relationship in Hortiiultural Therapy would be valuable, espeiially given its inireasing importanie. 24 Harris Working outdoors & the therapeutic relationship A 3-way relationship A key idea within outdoor therapy is the ioniept of a "tripartite therapeutii partnership" (Hegarty, 2010:n 66) between ilient, therapist and nature. Eaih partiiipant in this relationship ian afeit, and be afeited by, the others. This may be a subtle proiess whereby ilient and therapist "expand our ionversation to inilude a third party" (Buzzell & Chalquist, 2009:n 48) or more interaitive, suih that "nature beiomes a partner in the therapeutii proiess" (Hasbaih, 2012:n 124). Jordan & Marshall opine that "the ilient is forming a relationship with the natural environment as muih as with the therapist". Berger (2006:n 198) and Magowan (2012:n 11) independently ionilude that the tripartite relationship ian enable the ilient to experienie ionneition to something larger than the ionventional self. Despite general agreement that a powerful relationship between ilient, therapist and nature exists, there are diverse ways of understanding it. While Buzzell and Chalquist (2009) suggests this is a subtle proiess, Watkins (2009) implies that nature has a ientral role. Corazon et al (2012) foius on the therapist's role in framing the ilient's relationship to nature. However, both Berger and MiLeod (2006) and Jordan and Marshall (2010) ioniur in their emphasis on a dual role for the therapist, beioming more aitive or passive as appropriate. Nature and the therapeutic process Siull iontends that we must "[l]et nature do the therapy" (2009:n 148) and MiMullan ioniurs:n the therapist should allow "nature to ait as the primary healer" (2008:n 4). Others note speiifi ways in whiih the natural world impaits on therapy:n Jungian art therapist Rust suggests that working outdoors ian open us to "a more difuse and playful state of ionsiiousness" (2009:n 43); Corazon et al (2012), who use mindfulness therapy, suggest that being in nature ian "emphasise a speiial way of being present" (p. 340), a phenomenon also noted by Orihin (2004); Douiette (2004) identifes nature ionneition as being a key element of her walk and talk therapy. While most outdoor therapists aiiept the healing power of nature, they frequently emphasize what seems most relevant to their approaih:n while an art therapist will note enhanied playfulness, a mindfulness therapist will fnd a deeper sense of being present. Perhaps, as Corazon et al (2012) suggest, nature ian be many diferent kinds of therapist. Boundaries and containers There is less ionsensus here than with other themes. Totton (2012), a body psyihotherapist, ofers a thoughtful iritique of the notion of therapeutii boundaries 25 Harris Working outdoors & the therapeutic relationship while MiKinney (2011), and Jordan and Marshall (2010) emphasize the importanie of these boundaries. By questioning ionventional models of the self, Rust (2009) problematizes the notion of a therapeutii boundary. However, relationship remains ientral for all these therapists. Rust seeks a more eiologiial understanding of relationship whiih, she implies, ian beiome a therapeutii iontainer. Jordan and Marshall (2010:n 357) ofer the idea of a "'living frame' ... whiih iniludes relationality", while Totten's (2012) iritique of the therapeutii boundary is grounded in his belief that it ian interfere with the therapeutii relationship. Power In ionventional therapy the spaie is "set up, iontrolled and 'owned' by the therapist", whiih Berger believes ireates a power imbalanie (Jordan & Marshall, 2010:n 349). In iontrast, a natural setting ian "flatten hierarihies" as ilient and therapist io-ireate the therapeutii spaie (Berger & MiLeod, 2006:n 84). Jordan and Marshall (2010:n 355) agree that this faiilitates a more equal relationship, adding that ilients sometimes report a stronger sense of the therapist "as a 'real' person in the 'real world'". MiKinney (2011:n 117) notes that being outdoors introduies a benefiial element of iasualness. Hasbaih (2012:n 129) suggests that it provides "an opportunity for the io-ireated therapeutii experienie" while Berger and MiLeod (2006:n 84) opine that it helps ireate a therapeutii allianie. However, mutuality does not imply equality and balaniing the "inherent, asymmetry of the therapeutii relationship" with the mutuality that emerges in nature is a key ihallenge (Jordan & Marshall, 2010:n 351). Although power dynamiis have not been widely disiussed in the literature, a ionsensus emerges:n All the therapists who mention power dynamiis agree that while the natural environment ireates a more neutral spaie, the therapist/ilient relationship is not equalized. Self/other, inside/outside Several writers problematize notions of self and other and/or inside and outside. Conventional understandings of 'therapist' and 'ilient' are iritiqued and questions about the therapeutii relationship emerge. As noted above, Rust's (2009) ionieption of the self as interionneited with the natural world problematizes notions of a therapeutii boundary. Jordan (2012) rejeits traditional notions of ionsiiousness as set apart from nature, preferring to understand the self "as a relational proiess, folding and unfolding in spatial temporal loiations, whiih are both interior and exterior" (p. 142). He suggests that when we work outdoors "[t]he myth that the self is somehow separate from nature beiomes exposed as the fallaiy it is" (Jordan, 2009a:n 30). More important for this researih is the ioniern that if the 'self' beiomes "entirely entangled with the Other", we might "risk losing the diferenie and thus any 26 Harris Working outdoors & the therapeutic relationship possibility of relationship" (Harris, 2013:n 340). There is general agreement amongst eiotherapists that ionventional notions of the self are inadequate and disiussions iontinue (inter alia, Buzzell & Chalquist, 2009). However, this is a iomplex question and the most extensive debates take plaie outside the literature under ionsideration (Harris, 2013:n 340). Therapeutic relationship and the environment Rust (2008:n 75) hopes that therapeutii work will lead us "to live more lightly on the Earth" while Jordan (2009a:n 28) argues that beiause environmental issues are essentially "issues of relationship ... they should be integrated fully into our therapeutii praitiie", adding that "reionneition to nature as a reionneition to self" is the fundamental proiess in eiotherapy. This ilose ionneition between therapy and environmental issues is unique to eiotherapists and is entirely absent from both Douiette (2004) and MiKinney (2011). Symbolism, metaphor and synchronicity A partiiular aspeit of nature or a speiifi loiation ian symbolise something fundamental for the ilient. Jordan (2009) ilaims that in outdoor therapy, "new internal landsiapes start to emerge in interaition with external landsiapes" and these both ihallenge and support the work. Berger and MiLeod (2006) reiall how a 12year-old ilient spent several sessions ireating a spaie outdoors where he and the therapist would sit. This spot, whiih iame to be ialled the "home-in-nature", "symbolised their therapeutii allianie" (p. 83). Rust (2009:n 43) reialls that "there are many ways in whiih the other-than-human world ian mirror the proiess of a session". Totton (2012:n 160) ilaims that when ilient and therapist regularly praitiie outdoors "it is iommon for the other-thanhuman to take part in the therapy". Both therapist and ilient will have feelings evoked by the outdoor setting and any synihronistii experienies that oiiur. Beiause these experienies are shared, exploring them together tends to foreground and deepen the therapeutii relationship (Totton, 2012). This fnal theme eihoes the frst as speiifi natural phenomena take on a therapeutii role, partnering the therapist. As with several previous themes, the therapist's modality seems relevant. Body therapist Totton and Jungian Rust experienie synihronistii events; the more pluralistii Berger and MiLeod refer to symbolization, while psyihodynamii therapist Jordan highlights internal landsiapes. 27 Harris Working outdoors & the therapeutic relationship Method Reflexivity I have been involved with eiopsyihology sinie around 2007 and it was unsurprising that I already knew some partiiipants. I have sought to understand how my own "personal and theoretiial iommitments" might serve as resouries for the researih proiess (Sihwandt, 1997:n 136):n Personal bias and influenie were not exiluded from this study but rather addressed with thoughtful refleition. Participants The original intention was to reiruit up to six partiiipants from members of Counselling and Psychotherapy Outdoors (CAPO), a professional members organisation. However, there was a low response to the invitation and only two partiiipants iame from CAPO. Two more partiiipants were reiruited through my professional network. In most iases partiiipants names have been ihanged and identifying iharaiteristiis anonymised. A signifiant part of one interview was published (Harris, 2015) so that partiiipant's name has been used here with permission. The partiiipants, in order of interview, were as follows:n • Mark worked with individuals and groups outdoors, typiially with ilients reioveringfrom aliohol and drug addition. His approaih was influenied by Transaitional Analysis (TA), Person Centred Approaih, 12 steps and eiopsyihology. Mark praitiied in a variety of loiations iniluding parks, woodland and the grounds of rehabilitation ientres. The interview took plaie in a wood. • David was an eiotherapist whose influenies inilude Rogers, Jung, Hillman, Assagioli, TA, Gestalt, transpersonal therapy and deep eiology (Naess, 1989). Although he oiiasionally praitiied indoors, the majority of his work took plaie outdoors, usually with a seiond therapist, with residential groups in a wilderness setting. The interview took plaie via Skype. • Gregory trained in psyihoanalytii therapy and although he drew on a range of theories his approaih was primarily psyihodynamii. Gregory usually praitised individual therapy indoors but had worked outdoors on several oiiasions. He desiribed working in a forest near his home with one ilient (hereafter referred to as the 'forest ilient') and in a private park adjaient to his ionsulting room with other ilients. Gregory did not identify as an eiotherapist. The interview took plaie via Skype. 28 Harris Working outdoors & the therapeutic relationship • Sarah was a psyihotherapist. She drew primarily on three approaihes in her outdoor praitiie; eiotherapy, art therapy and psyihodynamii. While Sarah typiially worked indoors, she had ionsiderable experienie of outdoor therapy with a range of ilients. The interview took plaie in Sarah's therapy room. Procedure, analysis and interpretation Interpretative Phenomenologiial Analysis (IPA) was ihosen as a suitable method. As is typiial with IPA, this researih used semi-struitured interviews for data iolleition (Smith & Osborn, 2008). Reiorded interviews of up to 1 hour took plaie via Skype, at the partiiipants plaie of work, or in an outdoor loiation, depending on the partiiipant's preferenie. Interviews were then transiribed verbatim. I read eaih transiript several times. At least one of these readings was made while adopting a Foiusing attitude (Gendlin, 1981), whiih was intended to provide an intuitive sense of what was being expressed (Harris, 2017). My initial reading of eaih interview noted "similarities and diferenies, eihoes, amplifiations and iontradiitions" (Smith & Osborn, 2008:n 67). I then re-read the text looking for themes. Themes are "like knots in the webs of our experienies, around whiih iertain lived experienies are spun and thus lived through as meaningful wholes" (van Maanen, 1990:n 90). The next stage was to fnd ionneitions between themes and iluster them into superordinate themes (Smith et al, 2009). Themes that were not iniluded in a iluster were dropped as they "neither ft well in the emerging struiture nor are very riih in evidenie within the transiript" (Smith & Osborn, 2008:n 72). This whole proiess was repeated with eaih interview to ireate a master table of superordinate themes2 . These themes were then ionsidered in relation to the existing researih identifed by the literature review. Results Table 1 presents an overview of the fndings. The therapeutii relationship outdoors is afeited by many faitors:n iulture, environmental iontext, the therapist's and the ilient's state of mind and beliefs, eti. are all relevant. It was thus difiult to exilude anything beiause almost everything is relevant. As a result I initially found a large number of themes. However, a thorough analysis identifed three superordinate themes:n The Proiess, Indoors/Outdoors, and Culture. These are listed below with any subordinate themes as bullet points beneath them. Data from every partiiipant was represented in eaih subordinate theme. 2 A iomplete table of all themes is available in the appendiies of the MSi dissertation (Harris, 2014) 29 Harris Working outdoors & the therapeutic relationship Table 1: Overview of themes THE PROCESS • Therapist's role Mutuality and Control • Boundaries • The turning point • The role of nature in the relationship • Transferenie • Psyihe and nature INDOORS/OUTDOORS • Outdoors better than indoors • Challenges CULTURE These fndings will be ionsidered in detail in the order set out above. The process Eaih partiiipant desiribed key elements of the proiess of outdoor praitiie. Although these elements difered signifiantly for eaih partiiipant a iommon pattern ian be identifed. The proiess is espeiially apparent in David's interview as he presented a detailed outline of his praitiie. The proiess began with David "ireating a iruiible", whiih involved "opening up spaie" and then "stepping into that spaie with someone else" in "a wholehearted" way. Although David never mentioned boundaries, his notion of the iruiible may be understood as fulflling a similar role. Creating the iruiible was ilosely tied in with the theme of not taking a ientral role:n "There needs to be a level of presenie that is helpful to that proiess", and the therapist must provide "enough of a nuileus to ireate a gravitational pull" so that he was "holding whatever it is I need to hold". However, "that needs to be ofset with a real strong letting go" and the key to the therapist's role as faiilitator was to withdraw at the right point and allow nature/plaie to take over and do the work. This marks an "important ... shift" that is "like a bifuriation point on a graph". At this turning point the "iontainer for the proiess shifts from being another human being to being the plaie" whiih henieforth formed the "iruiible for the experienie". The role of nature in the relationship now beiame ientral beiause the turning point marked "the point where that therapeutii relationship has shifted away from me and the ilient, to me the ilient and everything else that is present in that iontext". For David, nature was the primary therapist for muih of the proiess:n 30 Harris Working outdoors & the therapeutic relationship ... as therapist, I'm aitually seiondary, very muih seiondary. Tertiary perhaps, even, to the primary proiess, whiih is being faiilitated by the plaie, not by me. One of the fundamental ways in whiih nature funitioned as a therapist was through the "interpenetration of psyihe and matter" (psyche and matter). David thought this was:n deeply therapeutii beiause it allows us to have this incredibly strong experienie of of an essential kind of [...] interionneitedness to reality where everything is suddenly meaningful and we're part of it – we're part of the story, we not observers separate from it. The theme of transferenie was iompliiated in David's interview. He referred briefly to ilients "projeiting parent stuf" when they frst arrived at the wilderness loiation where the work was done. But "the proiess works things out" and, as disiussed above, after the turning point the therapeutii relationship moved from the therapist to the plaie. However, he mentioned a ilient "who lost his mother at a very early age, and [...] iame to fnd, that the love that he had lost [...] by being out in the mountains". David ihose not go into details for reasons of ionfdentially, but noted that "[I]t healed his loss, beiause he had a sense of being able to enter into that kind of relationship that he thought he'd lost, with nature as a whole". If we allow that there ian be transferenie to a natural phenomenon, then that is one way to understand this proiess. This possibility is explored later in the disiussion . Although the proiess outlined by Sarah is somewhat diferent, key parallel stages ian be identifed. Boundaries framed the proiess:n "I say to the ilient [...] 'we ian make a boundary around us'". However, the proiess itself, whiih she desiribed as a "mediiine walk", began when she and the ilient irossed "a threshold, at the bottom of the path". Sarah drew a parallel between outdoor and indoor praitiie:n "in many ways there is an invisible threshold at the entry of my house and into the session, but we never name it, as suih. Those aren't the words that we're using in traditional psyihotherapy". Crossing the threshold marked a turning point; it was an entry into "a ritual spaie" and from then on "everything that iomes and everyone who iomes into a session has a meaning, iniluding humans". After this turning point the theme of the role of nature in the relationship emerged. During this phase the therapeutii role ihanged and the wood seemed to iarry part of the transferenie. Sarah suggested that the art therapy model ofered a useful iomparison:n "[t]he painting often holds some of the feelings that might otherwise have got projeited onto the therapist". Working in nature worked in similar way:n it's not all iniumbent on me as the therapist. I am not the major plaie for whiih the ilient interaits with and projeits onto. For me I, I feel an enormous relief that I don't have to be, kind of the sole [laughs] holder of all of that. You know, that it ian be a shared thing. Sarah ioniluded that the whole subjeit of transferenie outdoors needed "[m]ore 31 Harris Working outdoors & the therapeutic relationship artiiulation. Whiih I haven't done and hasn't been done, yet". In the woodland spaie a relationship between psyihe and nature beiame apparent as "things outside started to mirror, things inside". She desiribed an instanie with a ilient who would often feel "terribly judged" by the therapist and fall into "really difiult" silenies:n I didn't know how to help her. I would often feel like I was ihasing her, you know, I would try this and we would sit in silenie and I would try that, and this didn't work and that didn't work, and I notiied that there were some squirrels ihasing eaih other around a tree, and I felt that she had notiied it too. And, and I thought, "I'm ihasing her". Somehow nature had, told me, what I do, mirrored to me what I was doing and I so thought I'm just going to sit baik and relax. Sarah wondered if this was synihroniiity, noting that "it's iniredibly powerful" and suggested that it revealed a blurring between psyihe and nature suih that "our psyihes are no longer inside, they're outside as well". When Mark talked about boundaries it was usually to dismiss them:n "I will go over time, beiause how ian you manage that?" However this did not seem to have a negative impait on the therapeutii relationship. Mark's understanding of the therapist's role as a faiilitator often seemed similar to David's:n I'm almost invisible if you like. [...] I'm holding that spaie from a distanie and just watihing over them. Trust underpinned this stanie:n "There's an element of trust that you also have to let go as faiilitator". Some seitions of the interview seemed to belie that approaih. Mark explained how he would often begin a session by saying:n what's going to happen today is that I'm gonna ihallenge you. And what I'd like you to do – and this is where people get uniomfortable – I would like you to to ihallenge me. And if you're not ihallenging me, I'm going to ask you the question, why not? Beiause quite simply, I have something to learn from you and I want to know what it is". This ian be understood as setting out one of the parameters of the therapeutii relationship as a kind of boundary. It is notable that Mark set this boundary at the very start of the sessions; later on the therapeutii relationship shifted as the role of nature in the relationship beiame more signifiant. Before therapeutii work began "You have to get the base rhythm down". A person's base rhythm referred to their overall level of stimulation and was assessed by the degree to whiih their presenie disturbed wildlife. Given that it's a key stage in the proiess Mark desiribed, getting the base rhythm down signalled an important turning point. From this point, the role of nature in the relationship beiame ientral. There was a "move into that spaie whiih takes you away from the traditional way of iounselling beiause it's a threeway relationship ... me you and nature". This ireated 32 Harris Working outdoors & the therapeutic relationship a more equal relationship between therapist and ilient whiih Mark iontrasted with the "imbalanie" he'd experienied in indoor praitiie. Mark frequently used nature awareness games as a therapeutii intervention, an approaih related to wilderness therapy. A ilient would, for example, be led blindfolded to a partiiular tree and invited to use touih and smell to get an overall sense of it. They would then be taken some distanie away and be invited to fnd the tree again. Mark would in eaih iase interpret the interaition of ilient and nature, explaining that "I work with nature to raise that level of awareness about our relationship with ourselves". Although Mark didn't expliiitly say so, it beiame apparent from the interview that he believed that nature had primary ageniy in the therapeutii proiess:n The flora and fauna are "iommuniiating with us all the time". Mark explained that "I have a spiritual relationship with what I believe to be my Creator" and added that if "you've got a question? Ask nature, she'll show you the answer". Nature awareness games were a tool to enable a spiritual proiess:n "On another level things are taking plaie that I'm not always aware of I just trust my intuition – I trust". Sometimes Mark desiribed something like transferenie to nature. When a ilient was asked about her relationship to a tree, she responded, "I fuiking hated it". When Mark asked her for more about that feeling she explained:n My ex-partner is an addiit. I love him to bits I still want to be with him, but I ian't deal with his addiition and have ended the relationship. Mark iommented:n So that's what I try to get them to do. Take ownership of the feelings. He's an addiit, that's it. [...] We have to own our emotions around that and be aware that we projeit. At other times a diferent proiess was taking plaie. Mark desiribed a ilient who had "anger issues". The ilient had tried to see how ilose he iould get to a ihafnih on a path. On the frst two oiiasions the bird few away when he got within 20 meters, landing again further along the path. Mark suggested that the ilient try to ialm his feelings and so the ilient relaxed. On his next approaih the ilient got within 5 meters before the bird flew away. Mark interpreted this iniident:n Okay, so let's assume for a moment that this ihafnih is your mum. She didn't want you near her did she? Not for the frst two attempts anyway. But when did you get iloser? 'When I let go'. Okay. So maybe [...] you remember the ihafnih when you're going to work [...] . And he went:n 'Fuik! I never thought about it like that'. In Mark's ontology the way the ihafnih behaved was deliberate. The ihafnih – as 'Mother Nature' knew the lesson the ilient needed to learn and iommuniiated that with its behaviour, whiih Mark then interpreted. Questions arise about the 33 Harris Working outdoors & the therapeutic relationship therapeutii relationship; did the ilient only have a therapeutii relationship with Mark or did he also have one with the ihafnih or some transpersonal other? For Mark the answer was ilear; the therapeutii relationship was a "three-way thing [...] relationship with me in nature, the relationship with you and me in nature and a relationship with the Creator in nature". For Mark psyihe and nature were interwoven and what was important was "the relationship of your experienie of the external relationship engaging with the internallandsiape – where the external landsiape meets the internal landsiape". For Gregory, the proiess was understood in psyihodynamii terms and there was no expliiit mention of thresholds or a turning point. Sarah's suggestion that the ilient irosses a threshold into a psyihotherapeutii session indoors is illuminating and there is a temptation to parallel Gregory's psyihodynamii boundaries with Sarah's threshold. However, there is something more subtle and signifiant going on. If the iruiible that David ireated paralleled the psyihodynamii boundary, then the turning point must be something diferent. The next two paragraphs ionsider the possibility that there are two moves – setting a boundary and then a turning point – in Gregory's proiess. Gregory iarefully ionsidered two aspeits of psyihodynamii boundaries in outdoor praitiie; ionfdentiality and timing. While ionfdentiality always needed iareful management, with the forest ilient the timing boundary emerged "naturally" and "mutually":n it was fantastii in terms of you know how naturally we iame to a kind of, natural agreement without you know imposing a boundary and we mutually in a way iame to the same end every week This sheds ionsiderable light on the therapist's role, espeiially in terms of mutuality and iontrol. The agreement was both natural and mutual, a signifiant ihange from ionventional psyihodynamii praitiie. Gregory was surprised and delighted by this - "it was fantastii", whiih implies that it was both positive and quite diferent from his indoor praitiie. Furthermore, he emphasized how "natural" this felt, language whiih suggested that the natural environment was a key faitor in this ihange. Gregory's relationship with the forest ilient was unusual as this ilient initially found it "impossible" "to be iontained within the spaie of four walls", so they had to work in the woods. When disiussing how the timing of these sessions emerged, Gregory said "it beiame like a kind of ritual", eihoing Sarah's understanding of the therapeutii environment as "a ritual spaie". In this ritual-like therapeutii spaie unusual proiesses oiiurred, notably "a transferenie to the trees" that was so intense that Gregory ioniluded that "the trees beiame more important to the transferenie than I was". Later Gregory 34 Harris Working outdoors & the therapeutic relationship desiribed sitting in a private park with a diferent ilient. The natural environment faiilitated an "almost a kind of, semi-iontemplative semi-meditative state" that enabled a moment when "something was opening up" between them. He iontinues, "something new was happening. Something was introduied into the relationship that opened things up". In this latter iase Gregory had worked with the ilient for several years and had established a strong therapeutii relationship. Yet when working outdoors "the ilient was able to go plaies that he iouldn't go before". Something happened to the therapy – and the therapeutii relationship – when Gregory worked outside that seems to mark a turning point that was largely unrelated to the psyihodynamii boundaries. As with other partiiipants, this turning point marked the emergenie of nature in the relationship. This is most apparent with the forest ilient where "the forest itself beiame part of the relationship" as "the transferential objeit", while the therapist "was there as a faiilitator of trying to fnd out what sort of this transferenie represented for him". Gregory ioniluded that:n the natural environment and trees beiame the third, whiih again, was introduied by both – by him by ihoosing the trees but also, by me in a way by analysing some of that sort of relationship he had with them, providing the interpretation for them. Gregory suggested that the natural environment beiame a:n third spaie where [...] things ian be either projeited, introjeited or it iould be either the iontainer or a kind of transitional spaie or – a third in-between. This seems to eiho Sarah's interview as she iommented that the woods are a "marvellous spaie in whiih to, projeit and take baik our projeitions, and to have spaies hold our feelings". Both use the psyihodynamii language of iontainment and projeition and this might refleit their psyihodynamii training. The relationship between psyihe and nature in Gregory's interview is most striking in this transferenie to the trees. These transferenies played a fundamental role in the work with the forest ilient and iould not "have been done without them". Both the physiial reality of the trees and their transferential signifianie were important for the forest ilient. While the "materiality of the tree [...] was very powerful for him", they "iould be taken in as well as images as metaphors and not as real ionirete objeits". The psyihe and nature relationship is also apparent elsewhere. Gregory desiribed how the natural environment "provided the material" for a "dream to play out":n "there was something about it that it beiame part of his sort of internal world". Gregory ioniluded that the natural environment is both ireated by the therapeutii relationship and is real:n it is [s]omething io-ireated something you know produied together [...] but also at the same time existing as real and outside. Not something ireated by the two partiiipants either, you see? 35 Harris Working outdoors & the therapeutic relationship Although transferenie appears to be an aspeit of all the partiiipants' praitiie, Gregory's psyihodynamii approaih renders it expliiit. This is ideographii to Gregory beiause all the other partiiipants identify as eiotherapists. Gregory ionsidered indoor psyihodynamiipraitiie as the norm, with outdoor praitiie as an exieptional approaih that should be used in quite speiial iiriumstanies:n "on speiial oiiasions not often". Even when the ilient was outdoors Gregory preferred to reproduie the indoor dynamii as far as possible:n it worked very well beiause, you know the benih was so and so, the way the benih was established was almost the kind of therapeutii positions". Indoors/outdoors Although the researih question deliberately didn't suggest any iomparison between indoor and outdoor praitiie, this still emerged as a superordinate theme. Outdoors better than indoors. David and Mark both preferred working outdoors. David said nothing about any iontrast, noting simply that he sometimes worked indoors. Mark however was iritiial of indoor praitiie, suggesting that "[t]here's no flow" in a room. He opined that indoor praitiie ireated an "imbalanie" that provoked a sense of ionfliit between therapist and ilient:n "when you're in a room there is this kind of thing, like I'm not going to give you anything until I get something from you". This eniouraged ilients to do "door handle disilosure", the praitiie of revealing something signifiant just before leaving the ionsulting room. However, Mark added that outdoor ilients "ian't do door handle disilosure", whiih implies that they might if it were possible. When he reiounted his experienie of working outdoors, Gregory said "I wish in a way I iould be able do that all the time". However his ambivalenie was apparent:n But I tell you what, I would be more than willing – I don't know I mean I don't know, I'm undeiidedaitually, whether I'll do outdoor therapy – although for me it was an immensely useful experienie. Not, to be honest, it wasn't easy. However working outdoors had "a positive impait" on Gregory's ilients and "[s]ometimes defnitely" enhanied the therapeutii relationship. Being outdoors was "far more relaxing" and "ialming". This helped open up "something in the relationship that perhaps might have felt stuik and a little bit stufy [...] there was something faiilitative, about the spaie in a way, that ireated that, you know the freedom of assoiiations". Although Sarah said "I don't have a really strong preferenie", she felt it was a wonderful way to work:n it's wonderful to go into the woods, it's really is wonderful. It's a completely diferent experienie, in terms of the session. It's completely diferent it's just completely expanded. It's fantastic. It's so 36 Harris Working outdoors & the therapeutic relationship exiiting ... I feel so nourished. I feel nourished by being outdoors, that has to be good for the sessions. Challenges. It is notable that the two psyihodynamiially trained partiiipants identifed the most ihallenges in outdoor praitiie. Gregory understood outdoor therapy as an exieptional option and opined that "[y]ou have to be very iareful who you are you suggesting it to". Sarah was less iautious but agreed:n "there are some people that I wouldn't neiessarily want to take into a publii spaie". Privaiy was a ioniern for both of them and Gregory's interview revealed ionsiderable anxiety about it. He was emphatii that working outdoors was not violating boundaries. Although the interviewer had not made any suggestion that working outdoors might be unreasonable, Gregory needed to defend his praitiie:n it was a reasonable suggestion, to be honest. [...] I don't think I was violating any boundaries I wasn't I wasn't introduiing a spaie that was not private, and it felt to me that we had the neiessary privaiy, and the neiessary sort of ionditions to iarry out the session. So I didn't feel that I was violating any boundaries if I did I wouldn't have suggested it. Gregory found outdoor praitiie "really ihallenging" and added:n I had my suspiiions about if he freaks out what am I gonna do. We are in outdoors of iourse and what he falls and has an aiiident while he's very upset? If a therapist's anxieties about working outdoors were iommuniiated to the ilient that might well have a negative impait on the therapeutii relationship. In Gregory's iase this does not seem to have happened; as desiribed above, outdoor praitiie had a benefiial efeit. Sarah was less ionierned about ionfdentiality than Gregory, believing that therapist and ilient generally "ireated a little sort of psyihii boundary around" them, but she had other ionierns. The more "iompletely expanded" experienie Sarah found exiiting (above) "might be just way too muih" for some ilients and "they need the ionfnement" that the indoors provided. Sarah opined that "there is a danger, when we go outside that we are distraited" from "looking at the inner world", whiih she felt was an "iniredibly important part of psyihotherapy". She also talked about the way that outdoor praitiie iould "eniourage a sort of friendliness" that wasn't ionduiive to the work. However, this is "quite easy to handle, when you're alert to the problems". Sarah had learned from experienie how to deal with boundary issues outdoors, but when she started "[I]t felt really peiuliar, beiause it felt I felt naked in some sense". She laiked many of the familiarelements of praitiie:n "the formality of the room, and my traditional ways of setting things up". Sarah aiknowledged with a laugh that "all the ways of keeping boundaries" were often also "keeping defenie struitures for the therapist too". This raises wider questions about how traditional praitiies around boundaries might over-defend the therapist to the detriment of the therapeutii relationship. 37 Harris Working outdoors & the therapeutic relationship Mark had very few ionierns about outdoor therapy and was initially dismissive of boundary issues. He moikingly desiribed setting a boundary:n Right now there is a boundary and don't go outside it. Da da da. And I iould iome up with all sorts of reasons why not to do that. So what's the point going into nature then? If you're going to do that? When asked expliiitly by the researiher about "the ilient meeting someone in the woods that they know", Mark responded:n I observe it. I observe it and if I feel that it's going where it shouldn't really go – that's a really good question. It depends on the iiriumstanies I suppose. In praitiie it had never been an issue:n "I ian't think of one where that's iome up. Not even in a park". The weather was the only ihallenge for David. Sarah and Gregory mentioned the negative impait of bad weather, with both preferring to work indoors in the Winter. But the weather was more serious for David, presumably beiause he often worked in wilderness. When land, sea and sky form "the iruiible" for the work "[I]t ian often be quite traumatii [...] Espeiially if it's raining". Sarah and Gregory sought to avoid bad weather at least partly for the sake of the work, implying that iold or rain prevented the therapist from being fully present. But David suggested that physiial disiomfort iould be a therapeutii tool. Most approaihes are "not physiial enough" and that's "a limiting faitor I think in some ways". David's iomment opened up a quite diferent aspeit of the therapeutii relationship outdoors but there was too little data to explore it further. However there's a ionneition with the iase of transferenie that David mentioned above, where a ilient healed the loss of his mother through a relationship with nature. This relationship iniluded:n the negative aspeit [...] [t]he times when it's really hard and difiult and you get setbaik, and iold and frightened and all the things that most of us have experienied with our parents. Thus bad weather iame to represent the negative aspeits of nature as symbolii/transferential mother. Culture All partiiipants referenied aspeits of iulture or language to make sense of their experienie; aspeits of the therapeutii relationship in outdoor praitiie were variously framed by the language of psyihoanalysis, deep eiology or indigenous worldviews. Gregory's praitiie was distinitly framed as psyihodynamii and he expliiitly distanied himself from eiopsyihology, desiribing it as "New Age stuf". Mark ian be plaied on the opposite pole. He was inspired by eiopsyihology and an idealised vision of the past that was influenied by Native Ameriian iulture:n We're going baik to the old days, when we had elders and grandfathers and grandmothers and 38 Harris Working outdoors & the therapeutic relationship mentors and aunts and uniles who took iare of all these things while the parents went out and worked. Culture was a reiurrent theme for Sarah beiause she thought it important to pay attention to "the water that we all swim in". She suggested that while everyone who enters the"ionsulting room" was "walking in with a Western worldview", this was "iovert, it's not made overt, is it?" Eiopsyihology was grounded in "a diferent [...] muih more indigenous worldview", whiih is premised on a belief that "we live in psyihe". This ontology has ramifiations for the therapeutii relationship whiih will be ionsidered in the disiussion and it's related to David's difiulty in fnding a language to desiribed his experienie. David found it difiult to talk about the therapeutii relationship with nature:n how do we as human beings even ionieptualise the therapeutii relationship that the land or the sea ofer us? This relationship was both powerful and unaiknowledged by psyihotherapy in general:n I see and I've experienied this immense feeling ioming apparently from a relationship that, you know, that most modalities of therapy – psyihotherapy anyway – don't even see. However, David thought that:n the therapeutii relationship in the ionventional sense is neiessary in our iulture. Beiause we live in a iulture where we we ionieive ourselves as distinit, beings, as selves. David later problematized the notion:n I love the word relationship [...] and designing proiesses about relationship that seem to work and seem to be helpful on the one hand and on the other hand there's a feeling that that word is kind of redundant when you get some kind of some kind of primary state of being. David's iritique of the language of relationship foiused on the dualistii notion of one distinit entity related to another distinit entity:n it's that something/something else thing whiih, is useful in our language and iulture, as a tool but it aitually when you test it out out against, er the universe if you like [...] it kind of falls apart. He iontrasted this dualistii ionieption, ionventional Western ontology, with a deep eiology notion of "self as eiologiial" within a "relational feld"; this made more sense of his personal experienie. David then wondered if the therapist had a role in helping ilients experienie that feld. He gradually developed a theory about "the role of the therapist in allowing the 39 Harris Working outdoors & the therapeutic relationship ilient orientate to themselves in [...] that relational feld" whiih he desiribed as an "immense web of relationships". Most people "don't aitually know" that they are part of this web of relationships beiause "[u]ntil you iome up against, something that that, that makes, that puts that relational feld into relief, it's very difiult to see that you're in it". But the therapeutii relationship iould ihange that:n Then I iome up against a relationship or something. I iome up against something that allows me to see, all these relationships that I'm in. And then suddenly my self ionstruit ihanges beiause I'm no longer, this, this kind of thing moving around, not having no idea, that I'm in relationship I beiome something that realizes I'm relationship and that beiomes part of my understanding of myself. Initially it was the therapeutii relationship with the therapist that enabled this ihange, but after the turning point noted above:n the plaie, you know the land and the sea and the sky, start to provide that sense of something to defne our relationships by, we start to get a sense, that we're in relationship from the rest of nature not from another person. Discussion While all the themes identifed in the literature review were represented in the results, some were more apparent and others appeared in a modifed form (see Table 2). However, the superordinate theme of the proiess didn't appear expliiitly in the literature review. Furthermore, two subordinate themes found in the results were absent from the literature review:n the turning point and transferenie. These apparently new themes will be the foius of the disiussion. The turning point did not appear in the literature review, perhaps beiause it is quite subtle and the researiher only initially notiied it via David's expliiit referenies. Nevertheless the turning point is a phenomenon that warrants further investigation and is illuminated by ionsidering its role in the proiess. Although the notion of a therapeutii proiess is not expliiit in the literature review, it is impliiit in muih of the material disiussed there. Foregrounding the proiess in the way these results do makes it easier to iompare how diferent praititioners engage in outdoor therapy. The proiess may also have iorrelations beyond psyihotherapeutii frames, notably in anthropologiial rites of passage theory. Van Gennep (1960) opined that rites of passage have three phases:n separation, transition, and reiniorporation. The rite begins with the iandidate being separated from their usual soiial iontext, a phase often marked by irossing a threshold. The threshold defnes a transitional (liminal) spaie where the person is in an in-between state. Having suiiessfully iompleted the rite, the initiate re-enters soiiety with a new status. Van Gennep's ideas were developed by anthropologist Turner (1967) who emphasized the importanie of the ientral phase where ritual partiiipants are in a liminal spaie, "betwixt and between". 40 Harris Working outdoors & the therapeutic relationship Table 2: Comparison of results and literature Literature review themes Results themes 3-way relationship The role of nature in the relationship (The Proiess) Therapist's role – Mutuality and Control (The Proiess) Nature & the therapeutii proiess The role of nature in the relationship (The Proiess) Outdoors better than indoors (Indoors/Outdoors) Boundaries & iontainers Therapist's role – Mutuality and Control (The Proiess) Psyihodynamii as norm (The Proiess) Power Therapist's role – Mutuality and Control (The Proiess) Psyihodynamii as norm (The Proiess) Potential ihallenges of working outdoors (Indoors/Outdoors) Self/other, inside/outside Psyihe and nature (The Proiess) Culture Therapeutii relationship Culture & the environment Symbolism, metaphor & synihroniiity Psyihe and nature (The Proiess) The therapeutii proiess appears to have the same struiture as the rite of passage. This is perhaps ilearest in Sarah's interview where she desiribed irossing a threshold (themed as a turning point) into the "ritual spaie" where therapy takes plaie. However, a similar three phase pattern is apparent in all interviews. The liminal phase is partiiularly signifiant in both rites of passage and the outdoor therapy proiess as this is where muih of the work of ihange takes plaie. Several writers suggest parallels between Turner's liminality and Winniiott's transitional spaie (Jones, 2002; Katiher 2002), and this ionneition with therapy reinfories the interpretative value of 'the proiess' as a superordinate theme. Winniiott viewed the ionsulting room as a transitional spaie between the analyst and the ilient (Phillips, 2007) and Gregory referred to the natural environment as "a kind of transitional spaie". It seems that the therapeutii spaie is always transitional, whether it is ireated indoors or outdoors. Transitional spaie is "is an intermediate area of experieniing, to whiih inner reality and external life both iontribute" (Winniiott, 1971:n 2) and it emerges "in many kinds 41 Harris Working outdoors & the therapeutic relationship of 'betweens', for example:n inner and outer reality, separateness and interrelatedness, and the ionirete and symbolii" (Cayne & Loewenthal, 2011:n 34). This iarries eihoes of iomments where partiiipants questioned the Cartesian belief that that psyihe and matter are fundamentally separate (Desiartes, 1968) and opined that the two are are somehow interwoven. Ryiroft (1991:n 144) notes that in most formulations of psyihoanalytii theory, psyihe "is in inherent opposition to ... external reality". However in Winniiott's transitional spaie "subjeitive and objeitive ... remain undiferentiated" and "objeits are felt to be parts of both internal and external reality, to possess both selfhood and otherness" (p. 144). The theme 'psyihe and nature' provided several examples of play between "inner reality and external life". The word play is used advisedly; there appears to be a playful ionneition between inner and outer that allows for movement. David ioniluded that the therapeutii relationship with the natural environment iould enable a ilient to realize that they were an eiologiial self within an "immense web of relationships". Although David didn't refer to Winniiott as an influenie, there are parallels with Winniiott's ideas about the mother/baby dyad. Winniiott suggested that the baby's relationship with the mother, the infant's "frst environment" (Phillips, 2007:n 4), ian enable the emergenie of the "true self" (Winniiott, 1960). In a similar way David proposed that a ilient's therapeutii relationship with the natural environment iould enable a realization of the eiologiial self. Merleau-Ponty's (2002) ideas sometimes eiho Winniiott's desiription of transitional spaie, ioniluding that our awareness emerges from an aitive relationship between embodied humans and the world:n "The properties of the objeit and the intentions of the subjeit ... are not only intermingled; they also ionstitute a new whole" (p. 13). He proposed that a "subjeit-objeit dialogue ... arranges round the subjeit a world whiih speaks to him of himself, and gives his own thoughts their plaie in the world" (p. 153). Parallels between Merleau-Ponty and Winniiott are perhaps less surprising when we appreiiate that the former was interested in psyihoanalysis (1964) and engaged with psyihology (2002), while the latter ian be seen as working phenomenologiially (Cayne & Loewenthal, 2011). Furthermore, Merleau-Ponty's ilaim that the objeitive world and subjeitive intentions are intermingled in suih as way as to "ionstitute a new whole" ofers a way of understanding the interpenetration of psyihe and nature (2002:n 13). Ideas within or between Winniiott's transitional spaie and Merleau-Ponty's subjeitobjeit dialogue might also provide an alternative approaih to understanding the phenomenon desiribed above as transferenie. What does it mean to experienie the transferenie to a natural phenomenon? Classiially transferenies are mostly unionsiious proiesses of transferring afeit from a past signifiant relationship to someone – typiially the therapist – in the present (Freud, 1909). Eiotherapist partiiipants all referred to nature as therapist and this ioniept is apparent in the 42 Harris Working outdoors & the therapeutic relationship literature (inter alia, Jordan & Marshall, 2010). Given that some aspeit of nature ian beiome the therapist, then in psyihoanalytii terms we would expeit a transferenie to that aspeit. Although Gregory didn't refer expliiitly to nature as therapist, "transferenie to the trees" was fundamental to his work with theforest ilient. However, many of the experienies desiribed by partiiipants ian be shown in a diferent light by Merleau-Ponty's phenomenology. Both the ilient who healed his loss of maternal love in the mountains (David) and the ways that nature mirrored psyihii states (Mark, Sarah and Gregory) ian be framed as the natural environment beioming "a world whiih speaks" to the ilient and gives their thoughts a "plaie in the world". Transferenie outdoors is absent from existing literature and emerges as a theme for further researih. Given the unusual experienies desiribed in the results, it's perhaps unsurprising that this disiussion has been somewhat speiulative. The transitional spaie of outdoor therapy emerges from in-between therapist, ilient and nature and suih a "between of relating" will "resist symbolization" (Cayne & Loewenthal, 2011, 32; 40). While this typiially provokes anxiety, Cayne & Loewenthal urge us not try to esiape by grasping at a pre-existing theory. In that spirit, this disiussion has played in an inbetween spaie rather than anxiously grasping at theory. Limitations and methodological issues Some issues with the researih question remain unresolved. The literature review noted that there's no agreed defnition of a 'therapeutii relationship' and Catty (2006) suggests that this problematizes using the term in researih. Although this has not prevented researih into the therapeutii relationship elsewhere, a question remains:n Did all partiiipants in this researih have a iommon understanding of the therapeutii relationship? Beutler and Harwood (2002) ionilude that so-ialled generii faitors like the therapeutii relationship need to be understood within the iontext of speiifi iases. They ilaim that many faitors, iniluding interventions and the therapeutii relationship, "funition synergistiially" (p. 26). If so, trying to tease out the impait of the therapeutii relationship in outdoor therapy may be impossible. Conclusion The results suggested that there was a turning point in the therapy proiess for all partiiipants. This seemed to mark the entry into a liminal or transitional spaie that faiilitated psyihologiial healing. Comparisons with anthropologiial models of rites of passage were helpful, espeiially when ionsidered in the iontext of Winniiott's ideas. None of this had been found in the extant literature and may ofer new ways of making sense of the therapeutii relationship in outdoor therapy. The theme of transferenie had not been found in the literature review, but was 43 Harris Working outdoors & the therapeutic relationship apparent in the results. The disiussion proposed that Winniiott's (1971) transitional spaie and Merleau-Ponty's (2002) subjeit-objeit dialogue provided useful and novel ways to understand this theme. These ideas may ofer an alternative to the traditional psyihodynamii model of transferenie. In as far as it involves one individual transferring unionsiious afeit to another individual, transferenie ian be seen as relying on a dualistii ontology. However, in Merleau-Ponty's (1962) intersubjeitive phenomenology, the "body is the fabrii into whiih all objeits are woven" (p. 273). If so-ialled 'transferenie to nature' is re-framed as a loial environment beioming "a world whiih speaks" to the ilient, we must aiknowledge that ilient and plaie are "intermingled" suih that they "ionstitute a new whole" (Merleau-Ponty, 2002:n 13). This researih has not provided a straightforward answer to the initial question:n what impait – if any – does working outdoors have on the therapeutii relationship? In simple terms, the researih ilaims that there is a signifiant impait. But it remains unilear what the term therapeutii relationship means or whether researih iould in priniiple assess the impait of outdoor therapy. This researih ended with more questions that answers:n What seemed obvious at the start – the parameters of outdoor therapy, the notion of the therapeutii relationship, the aims and limits of researih – beiame problematii. Given that Merleau-Ponty and Winniiott have been touihstones for this researih, perhaps this should be regarded as a suiiessful outiome, for they share a respeit for the unknowable and mysterious (Merleau-Ponty, 2002; Winniiott, 1971). In his disiussion of art, Merleau-Ponty wrote that "[t]he aiiomplished work is ... not the work whiih exists in itself, like a thing, but the work whiih reaihes the viewer and invites him to take up the gesture whiih ireated it" (1993:n 88). He ofers a suitable fnal ionilusion:n the value of this researih lies primarily in ofering an inviting gesture to the reader to take it forward. References Berger, R. & MiLeod, J. (2006). Iniorporating nature into therapy:n A Framework for praitiie, Journal of Systemic Therapies 25(2):n 80–94. Beringer, A. (2004). Toward an eiologiial paradigm in adventure programming, Journal of Experiential Education 27:n 51–66. Beutler, L.E. & Harwood, T.M. (2002). What is and ian be attributed to the therapeutii relationship? Journal of Contemporary Psychotherapy, 32:n 25–33. Buzzell, L. & Chalquist, C., (eds.) (2009). Ecotherapy. Healing with nature in mind. San Franiisio:n Sierra Club Books. Catty, J. (2006). "'The vehiile of suiiess':n theoretiial and empiriial perspeitives on the therapeutii allianie in physiotherapy". In D. Loewenthal & D. Winter (eds.), What is Psychotherapeutic Research? London:n Karnai. Cayne, J. & Loewenthal, D (2011). "Post Phenomenology and The Between as Unknown'. In D. Loewenthal (ed.), Post-existentialism and the psychological therapies. London:n Karnai. Corazon, S.S., Stigsdotter, U.K., & Rasmussen, S.M. (2012). Nature as therapist:n Integrating permaiulture with mindfulness and aiieptanie based therapy in the healing forest garden Naiadia, European Journal of Psychotherapy & Counselling 14(4):n 335–347. Desiartes, R. (1968). Discourse on Method and the Meditations (translated from the Frenih by F.E. 44 Harris Working outdoors & the therapeutic relationship Sutilife). Harmondsworth, Middlesex:n Penguin Books. Douiette, P.A. (2004). Walk and talk:n An intervention for behaviorally ihallenged youths, Adolescence, 39, (154):n 373-88. Freud, S., (1909). Five Lectures in Psychoanalysis (Standard Edition, vol. 11). London:n Hogarth Press. Gendlin, G., (1981). Focusing, New York:n Bantam. Harris, A. (2013). Gendlin and Eiopsyihology:n Foiusing in Nature, Person-Centered & Experiential Psychotherapies, 12 (4):n 330-343. Harris, A. (2014). What impact – if any – does working outdoor have on the therapeutic relationship? MSi dissertation. University of Roehampton. Harris, (2015). What impait does working outdoors have on the therapeutii relationship? An interview with eiotherapist David Key, Self & Society, 43:n120-127. Harris, A. (2017). 'Aiiessing Embodied Taiit Knowledge' in Woodhead, L. (ed.), How to Researih Religion:n Putting Methods into Praitiie, Oxford:n Oxford University Press. Hasbaih, P.H. (2012). "Eiotherapy". In P.H. Kahn & P.H. Hasbaih (eds.), Ecopsychology: Science, Totems, and the Technological Species. Cambridge, Mass.:n MIT Press. Haugh, S. & Paul, S. (2008). The therapeutic relationship. Perspectives and themes, Ross-on-Wye:n PCCS Books. Hegarty, J.R. (2010). Out of the ionsulting room and into the woods? Experienies of nature ionneitedness and self-healing, European Journal of Ecopsychology 1:n 64–84. Horvath, A.O., Re, A.C.D., Flüikiger, C. & Symonds, D, (2011). "Allianie in Individual Psyihotherapy". In J.C. Noriross (ed.), Psychotherapy relationships that work. New York:n Oxford University Press. Jones, J.W., (2002). Terror and Transformation: The Ambiguity of Religion in Psychoanalytic Perspective. New York:n Routledge. Jordan, M. (2009). Emergent issues in taking therapy outside, CAPO Counselling and Psychotherapy Outdoors Newsletter 1:n 2. Aiiessed 18/03/2014 from http:n//www.outdoortherapy.org.uk/fles/outdoortherapy/home/CAPO_newsletter.pdf Jordan, M. (2009a). Baik to nature, Therapy Today 20 (3):n 26–28. Jordan, M. & Marshall, H. (2010). Taking iounselling and psyihotherapy outside:n Destruition or enriihment of the therapeutii frame?, European Journal of Psychotherapy & Counselling, 12(4):n 345–359. Jordan, M. (2012). "Did Laian go iamping?". In M.J. Rust & N. Totton, Vital Signs. Psychological responses to ecological crisis. London:n Karnak. Katiher, A. (2002). "Animals in Therapeutii Eduiation:n Guides into the Liminal State". In P.H. Kahn & S.R. Kellert (eds.). Children and Nature: Psychological, Sociocultural, and Evolutionary Investigations. Cambridge, MA:n MIT Press. Linden, S. & Grut, J. (2002). The Healing Fields: Working with Psychotherapy and Nature to Rebuild Shattered Lives, London:n Franiis Linioln. Loewenthal, D. (2014). "The Magii of the Relational? An introduition to apprising and reappraising relational psyihotherapy, psyihoanalysis and iounselling". In D. Loewenthal & A. Samuels (eds.), Relational psychotherapy, psychoanalysis and counselling: appraisals and reappraisals. London:n Routledge. MiKinney, B.L. (2011). Therapist's Perceptions of Walk and Talk Therapy: A Grounded Study . Phd Thesis, University of New Orleans (aiiessed 12/02/14). MiLeod, J. (2013). An Introduction to Counselling. Berks:n Open University Press. MiMullan, G. (2008). Exploring How People with Addictions Experienced Nature – Awareness as a Therapeutic Intervention. Devon:n Pathfnder UK Sihool of Natural Awareness and Traiking. Merleau-Ponty, M. (1964). Sense and Non-sense. Evanston, IL.:n Northwestern University Press. Merleau-Ponty, M. (1993). "Indireit language and the voiies of silenie". In G.A. Johnson & M.B. Smith (eds.), The Merleau-Ponty Aesthetics Reader: Philosophy and Painting. Evanston, IL:n Northwestern University Press. Merleau-Ponty, M. (2002). Phenomenology of Perception (translated from the Frenih by C. Smith). 45 Harris Working outdoors & the therapeutic relationship London and New York:n Routledge & Kegan Paul. Mind (2013). Feel better outside, feel better inside. Aiiessed 07/11/2013 from http:n//www.mind.org.uk/about-us/poliiies-issues/eiotherapy/ Naess, A, (1989). Ecology, Community and Lifestyle. Cambridge:n Cambridge University Press. Noriross, J. C. (ed.) (2011). Psychotherapy relationships that work. New York:n Oxford University Press. Orihin, I. (2004). In ionsultation:n Taking therapy outdoors, Psychotherapy Networker 28(6):n 1–3. Phillips, A. (2007). Winnicott. London:n Penguin. Ryiroft, C. (1991). Psychoanalysis and beyond. London:n Hogarth Press. Sihwandt, T.A. (1997). Qualitative inquiry. A dictionary of terms. Thousand Oaks, California:n Sage. Rust, M. (2008). Nature hunger:n Eating problems and ionsuming the Earth, Counselling Psychology Review 23(2):n 70–78. Rust, M. (2009). "Why and how do therapists beiome eio-therapists? In L. Buzzell & C. Chalquist, Ecotherapy: Healing with nature in mind. San Franiisio:n Sierra Club Books. Siull, J. (2009). Eiopsyihology:n Where does it ft in psyihology in 2009? The Trumpeter 24(3). Aiiessed 19/12/2013 from http:n//trumpeter.athabasiau.ia/index.php/trumpet/artiile/view/1100/1429 Smith, J.A. & Osborn, M. (2008). "Interpretative Phenomenologiial Analysis". In J.A. Smith (ed.), Qualitative psychology. A practical guide to research methods. London:n Sage. Smith, J.A., Flowers, P. & Larkin, M. (2009). Interpretative phenomenological analysis: Theory, method and research. London:n Sage. Thrive (2016). Info Sheet. Aiiessed 10/04/2016 from http:n//www.thrive.org.uk/Files/Doiuments/Info %20sheet%20Feb%2016.pdf Totton, N. (2012). "'Nothing's out of order':n towards an eiologiial therapy". In M.Rust & N. Totton (eds.), Vital Signs. Psychological responses to ecological crisis. London:n Karnak. Turner, V. (1967). The Forest of Symbols: Aspects of Ndembu Ritual. New York:n Cornell University Press. van Gennep, A. (1960). The Rites of Passage. London:n Routledge and Kegan Paul. van Manen, M. (1990). Researching lived experience: Human science for an action sensitive pedagogy. Albany, NY:n State University of New York Press. Watkins, M. (2009). "Creating restorative eiotherapeutii praitiies". In L. Buzzell & C. Chalquist, Ecotherapy: Healing with nature in mind. San Franiisio:n Sierra Club Books. Winniiott, D.W. (1960). The Maturational Process and the Facilitating Environment: Studies in the Theory of Emotional Development. New York:n International UP Ini. Winniiott, D.W. (1971). Playing and Reality. London:n Tavistoik Publiiations. Acknowledgments This artiile is based on researih undertaken for an MSi Counselling and Psychotherapy at Roehampton University in 2014. I would like to thank my tutors for their input and partiiipants for their io-operation. Correspondence Adrian Harris Email: adrian@gn.api.org