Mindfulness for outdoor adventurers

Lessons from the leading medical doctor in nature and forest therapy

By Leziga Barikor

The practice of mindfulness and outdoors sports would seem to oppose one another, but for Suzanne Bartlett Hackenmiller M.D., they make the perfect combination. Bartlett Hackenmiller serves as the medical director for the Association of Nature and Forest Therapy and leads workshops that combine outdoors sports with forest bathing. She has spoken nationally and internationally on the topics of nature therapy and integrative medicine.


See my full interview with Dr. Suzanne Bartlett Hackenmiller here.

Starting nature therapy

Bartlett Hackenmiller’s journey to becoming the leading doctor in nature therapy and integrative medicine didn’t start until after she had began practicing medicine. She is was and still is board certified by the American Board of Obstetrics and Gynecology, but as her personal life grew more hectic, her journey into mindfulness and nature therapy began.

“I practiced that [OB-GYN] for several years and found myself to be fairly burned out in the late 2000s,” Bartlett Hackenmiller said. “And it was about that time where I learned about integrative medicine and that there’s a fellowship in it.”

Bartlett Hackenmiller then went on to start and complete the fellowship in integrative medicine through the University of Arizona finishing in the winter of 2013.

“But along that time my husband was dealing with lung cancer and ultimately passed away from lung cancer in 2012,” Bartlett Hackenmiller said. “He was part of my journey for sure, into how this all happened.”

“I found myself after his death trying to reconcile death and dealing with kids and dealing with my practice that I was still kind of struggling through, conventional medicine and all of that. And learned about this idea of forest bathing, during the same time that I was spending a lot of days outdoors in outdoor adventure.”

As part of her treatment for grief and burnout, Bartlett Hackenmiller was spending a significant amount of time outdoors doing activities like hiking, mountain biking and trail running. It was during this time that she became aware of the pros and cons of outdoor adventures and mindfulness and found the balance between the two activities.

“I learned of this idea of forest bathing in about 2014 and started kind of dabbling in it shortly thereafter,” Bartlett Hackenmiller said.

The Japanese practice of forest bathing also known as Shinrin-yoku is one activity that Bartlett Hackenmiller has specialized in and leads various workshops. She is certified with the Association of Nature and Forest Therapy as a forest therapy guide.

“Now I serve as the medical director for that organization,” Bartlett Hackenmiller said.

The Association of Nature and Forest Therapy certifies guides all over the world and there are currently several hundred guides internationally according to Bartlett Hackenmiller.

Forest bathing

On Saturday, April 20 from 10 a.m. to 12 p.m., Bartlett Hackenmiller led a workshop at the Hartman Reserve in Shinrin-yoku or forest bathing. The guided meditative walk encourages people to engage with their surroundings. The workshop was limited to 20 participants.

“It’s always fun to take people out for the first time,” Bartlett Hackenmiller said.

The basic rundown of a forest bathing experience involves mindfulness.

“It’s about taking in nature through the various senses,” Bartlett Hackenmiller said.

She described the standard sequence that guides go through which is to take participants deeper and deeper out of their everyday conscious which she refers to as the “monkey mind” and into the subconscious mind which she calls the “liminal state.” The whole process takes at least two hours.

“We don’t cover a lot of ground,” Bartlett Hackenmiller said. “It’s not a nature identification walk or a hike for physical fitness or anything like that, it’s a very slow mindful walk.”

During the walk there are various pauses called “counsel” where participants share what they’re currently experiencing. It helps solidify the memories in their mind, according to Bartlett Hackenmiller. The forest bathing also always ends with a tea ceremony.

“We actually forage a plant from the woods,” Bartlett Hackenmiller said.

It is also during this time that she explains the herbal and medicinal properties of the tea that they begin to brew. All this knowledge comes from her background in herbal medicine.

Bartlett Hackenmiller has completed a 500-hour course in herbal medicine with the well established Dr. Tieraona Low Dog. Low Dog is a founding member of the American Board of Integrative Medicine, has worked for health related bureaucratic government committees and authored various books and research articles on integrative health.

“There’s so much that we can use from nature for healing whether it’s taking it in and using plants medicinally or just the chemicals that are emitted from plants as we’re out in nature,” Bartlett Hackenmiller said.

A post from Bartlett Hakenmiller’s blog explored the long term effects of forest bathing walks. She cited various attendees from her workshops and conducted a survey with the participants. According to her research 61 percent of her participants reported improvements in both depression and tension after the forest bathing activity. She also cited that 65 percent reduced their feelings of anger and 70 percent felt more vigorous.

New book for outdoor adventurers

Even while actively practicing medicine and leading workshops, Bartlett Hackenmiller has had time to write a new book on the topic of forest bathing. Her book, “The Outdoor Adventurer’s Guide to Forest Bathing,” is set to release on July 1 and can be pre-ordered today.

“It’s a combination of all the things I love,” Bartlett Hackenmiller said.

She was contacted a year ago by Falcon Guides a year earlier and asked to write about forest bathing. As she started working with her editor on the book, the idea of looking at various types of outdoor activities through the lens of forest bathing was one they both liked.

“It’s something I do on a regular basis whether I’m out kayaking or biking or hiking or trail running,” Bartlett Hackenmiller said.

The activities which will be included in the book includes those mentioned above and cross-country skiing and climbing. People interested in various activities from paddling, hiking to biking can find a forest bathing guide including in this book.

For each activity, Bartlett Hackenmiller includes an invitation of forest bathing and she also combines what she calls “plant wisdom” to it as well. She said that she hopes people will be able to experience the medicinal qualities of plants more in depth than they might usually when on an outdoors adventure.

Healing outdoors

There is a challenge Bartlett Hackenmiller faces with having to practice medicine indoors when, as she writes, her heart “physically aches to be outdoors.”

“I think I’ve often felt very confined seeing patients in four sterile walls of an exam room, and often thought ‘Why can’t we just take this outside?’” Bartlett Hackenmiller said. “I’ve spent some time in a third world country in the South Pacific where they had open air clinics.”

Bartlett Hackenmiller continued: “I’ve always kind of clung to that feeling, ‘Why can’t we be outside? Doesn’t greater healing take place outdoors?’”

She explained a story about a patient she had who had autism. This patient was agitated in the examination room, leading the doctor to suggests to the caregivers going outside for the treatment. The results after a few minutes outside were drastic.

“A calming came over her and she took my hand at one point,” Bartlett Hackenmiller said. “That was very monumental to her parents and we were able to get to the bottom of what was going wit her and at least come up with a plan.”

For Bartlett Hackenmiller, that was defining moment for the idea of healing and the outdoors being connected. She said that she doubts there would have been progress had they continued indoors.

Nature therapy and outdoor adventures

In another story, Bartlett Hackenmiller recalls helping a group of adults with intellectual disabilities forest bathing. She ran into the challenge of some of them having wheelchairs.

“We managed to do it on a paved sidewalk behind the conference center we were at where there was a grove of trees and there was a garden of wildflowers,” Bartlett Hackenmiller said. “And it was a really great experience for me, and also I believe the participants.”

She also includes ways to get people in special populations in her upcoming book.

Getting outdoors daily

For most business professionals facing the challenge of fitting in an experience like a forest bathing workshop could make it seem like an impossible task.

“I feel like forest bathing is something that’s accessible to just about anyone and you can do it in a city, do it at a resort, you can do it in a courtyard, I’ve done it on a golf course with people,” Bartlett Hackenmiller. “It’s something that as long as you don’t take ‘forest’ too literally, as long as there are some elements of nature you can make it work.”

Taking even a brief moment to step outside of the office and walk can give people therapeutic nature health benefits .

To encourage more people to do just that, Bartlett Hackenmiller started the hashtag #OutdoorAdventurer365. The goal of the challenge is to go out for maybe 10 minutes a day and enjoy nature. She has seen a good amount of feedback from the tag on Instagram.

“I just think that there are ways that we can take little tiny breaks even in our day and appreciate nature and I think it does something for us when we do,” Bartlett Hackenmiller said.

For more information on the doctor and her workshops, visit her website here: https://integrativeinitiative.com/

She sees both patients both in Webster City, Iowa and online through eVisits.

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