RESEARCH LETTER

NATURE, MIND, AND MEDICINE: A MODEL FOR MIND–BODY

HEALING
Jason A. Kaufman, Ph.D., Ed.D.#

Objective: The human mind-body possesses a remarkable continuum of intervention through the use of guided medi-
innate ability to heal. Grounded in the evolutionarily conserved tation and ultimately hypnotic suggestion. The result may be
systems of the brain and body, nature appears to function as the an improved ability to promote greater executive functioning
fundamental source of wellness along the two vectors of attention and more robust immune regulation. The time has come for a
and relaxation. Yet, our species is moving away from nature at a more holistic medicine guided by the hand of nature.
time when humanity is just beginning to rediscover its benefits.
Conclusions: Exposure to natural environments may provide (Explore 2018; 14:268-276 & 2018 Elsevier Inc. All rights
a "window" of healing that can be extended through a reserved.)

The recognition that nature can act as treatment has existed extends through the power of meditation (mind) to stimulate
among our species for millennia,1 perhaps since its nascence healing through cortical mechanisms. Finally, the continuum
more than 6000 generations ago. Indeed, the human mind– of intervention encompasses clinical hypnosis (medicine) as a
body possesses an innate ability to promote health and even more potent tool for health that utilizes suggestion to
healing. This ability is grounded in the evolutionarily effect change. The result may be a readily available antidote
conserved systems of the brain and body and was forged on to the allostatic pressures of modern urban life7 in which the
the phylogenetic landscape of our earliest ancestors. By this mind–body can better predict and respond to the needs of
logic, nature is the fundamental source of wellness, a concept the individual.8 Although the deepest elements of health and
summarized by the naturopathic tenet of vis medicatrix healing continue to remain elusive, decades of research
naturae.2 Nature acts on the mind–body by promoting a demonstrate the bidirectional influence of psychological
relaxation response while simultaneously focusing attention and physiological variables on health.9,10 Such factors appear
in a gentle and positive manner.159 Such a natural healing to demonstrate functional exaptation,11 if not outright
environment presupposes an absence of perceived threat, be it conservation, of neurological processes across phylogenetic
real or imagined, by the individual exposed to it. In a history.12 In this sense, modern allostatic medicine might be
functional sense, nature offers itself as a ground for best reconceptualized as a vital adjunctive in the service of
intervention. The innate ability to heal allows for a achieving more holistic wellness.
continuum of intervention along which the discoveries of
the basic and clinical sciences may be leveraged to afford
improved functioning. When extended through the use of AN URBAN SPECIES
meditation, the natural ability to heal can be strengthened vis There is no doubt that living in a city offers a range of
imaginativa, through the power of the imagination.3 Indeed, benefits. Constructed homes protect individuals from inclem-
meditative imagery has been recognized as a potent agent to ent weather and pests, and urban development is necessary to
facilitate healing. Achterberg4 argued that mental imagery is provide such affordances as trade, schools, museums, and
vital to medicine. Further research on subconscious hospitals. Yet, the urban environment remains an “evolutio-
processing5 indicates that the utilization of suggestion narily unfamiliar habitat.”13 At a time when humanity is just
through clinical hypnosis may provide even greater access beginning to rediscover the benefits of nature through
to effecting mind–body change.6 empirical evidence, so too is our species moving away from
Such a continuum of intervention is rooted in the potential it. According to the United Nations (UN News Centre),164
of the natural environment (nature) to facilitate health. It most individuals globally now reside in urban areas (Fig. 1).
Concurrent evidence documents an ongoing decline in the
United States of nature-based recreation14 and a growing
Department of Educational Leadership, Minnesota State University,
separation from natural environments worldwide.15
Mankato, MN. Simultaneously, cities continue to encroach upon their
#
Corresponding author: Department of Educational Leadership, Min- surrounding natural environments.16 The risk is a denaturing
nesota State University, 7700 France Ave, Suite 360, Edina, MN of modern life in which the city presents humanity with an
55435 environment that continues to be evolutionarily novel and

268 & 2018 Elsevier Inc. All rights reserved. EXPLORE July/August 2018, Vol. 14, No. 4
ISSN 1550-8307/$36.00 https://doi.org/10.1016/j.explore.2018.01.001
 such an integration of the technological with the natural. In
the meantime, urban life is more typically characterized by a
more-faster-better mentality and a concomitant loss of time to
think.28 What is required is a reorientation of the healing
professions toward the natural ability of the mind–body to
achieve wellness.

Fig. 1. Graphical representation of human history.

ATTENTION AND RELAXATION
Kaplan and Kaplan29 proposed that exposure to natural
promotes mind–body stress.13,17 One pervasive stressor inher- environments can motivate recovery from the fatigue of
ent to urban life is air pollution. Samet et al.18 found that modern urban life. Ulrich30 argued that exposure to nature
mortality rates were higher among urban areas in the United has the potential to prompt a reduction in stress. The mind–
States than more rural locales. Artificial lighting might also body maintains a remarkable suite of abilities that afford
pose a health hazard of modern living. Urbanites are regularly health and healing.31 Such adaptive skills appear to be
exposed during the night-time to lights, be it from streetlights undergirded by pathways of reciprocal influence between
or the glow of smartphones, that can disrupt circadian brain and body.9,10,32 Nature appears to manifest its saluto-
rhythms and sleep.19 Indeed, Krause160 recently echoed this genic effects via at least the two vectors of attention and
concern regarding the increasing commonality of short- relaxation that ultimately have the potential to result in
wavelength (i.e., bright white) LED street lighting across improved executive functioning and a more robust immune
American communities large and small. Exposure to such response. The synergistic result of these two pathways appears
light sources on our streets and in our homes appears capable to be that exposure to natural environments or elements
of promoting illness.20,21 It is quite different than the thereof may afford a healthier cognitive style33 improved
environment experienced by humanity during preindustrial creativity,34 more innovative thinking,35 and more robust
times.22 physical health.36 Nature may afford improved resilience to
It further appears that the modern urban landscape has stressors37 and an overall reduction in arousal.38
become an attentionally distracting environment. Much of Attention restoration theory (ART)29 maintains that
this distraction may result from the presence of increasingly exposure to natural environments promotes improved
ubiquitous computing and the resultant information over- cognitive functioning by presenting a sensory environment
load experienced by many. There is little question that that is rich with stimuli but low in arousal. The result appears
technology has become integrated into daily life.21 Much to be a shift away from the effortful, voluntary attention
commends the extension of human interaction via social necessitated by the busy urban environment toward a gentler,
media.23 However, the increasingly superordinate position of involuntary attention that is less conscious and possibly more
technology in society24 has led to what Carr25 recently labeled contemplative. Early on, Talbot and Kaplan134 found that
a “culture of distraction and dependency” (K 16) driven by individuals immersed in wilderness for several days reported
unfettered Internet access in all but the most remote changes in their thinking toward the calmer and less self-
locations. This potential for such information overload was referential. Additional evidence suggests that exposure to
noted as early as 1945 when Vannevar Bush157 explored the nature may confer improved memory skills39 as well as
importance of being able to meaningfully access and greater mindfulness.162 In essence, it may be that natural
association knowledge amidst a growing sea of information. environments prompt a therapeutic benefit to a range of
Yet, perhaps all is not lost to the seemingly inexorable cognitive functions40 by mediating a more meditative
march of information flow. In a seminal paper, Weiser26 cognitive stance41–43 and thus positively affecting the atten-
offered the counterargument that computing technology tional systems of the frontal cortex.44
eventually achieve a sort of balance. Utilizing the imagery In complimentary fashion, stress reduction theory (SRT)30
of nature, Weiser suggested that computers would become so posits that exposure to nature can promote a reduction in
integrated into daily life that their use would serve to counter sympathetic nervous system arousal and thereby reduce stress.
information overload. According to Ulrich et al.,45 the tendency for the mind–body
to relax within a natural environment is an evolutionarily
Most important, ubiquitous computers will help over- conserved response set. Such a supposition is congruent with
come the problem of information overload. There is the broader literature on the stress response, “a particular kind
more information available at our fingertips during a of relationship between person and environment”46 (p. 3).
walk in the woods than in any computer system, yet
The effects of this relationship thereby can be altered through
people find a walk among trees relaxing and computers
frustrating. Machines that fit the human environment manipulating the environment toward the more natural.
instead of forcing humans to order theirs will make using Whereas stress is characterized psychophysiological
a computer as refreshing as taking a walk in the woods. dysregulation,37 improved regulation has been found to
(p. 104) follow from environmental interventions as simple as views
of tress through windows.30,47
Although technology might provide part of the solution,27 It remains unclear the extent to which a “dose” of nature
it appears humanity has some way to go before it achieves may be sufficient to prompt healing.48 The individual is

Nature, Mind, and Medicine EXPLORE July/August 2018, Vol. 14, No. 4 269
always situated within an environmental context that may For example, the Japanese practice of forest-bathing has long
help or hinder functioning.49,50 Moreover, the ability of been demonstrated to reduce stress.67,68 Auditory elements of
nature to effect health assumes an absence of threats in the the natural environment might also foster health and healing.
natural environment (i.e., plants, animals, and events in It has been argued that there exists a human preferences for
nature can prove fatal). Absent such iatrogenic concern, in a natural sounds.69 Medvedev et al.70 found that the sounds of
very real sense nature can manifest clinical relevance as a form nature can promote the restoration of attention, most notably
of treatment.51 The question is not whether such potential in response to birdsong.71,72 Recovery from stress similarly
exists, but whether we choose to recognize and then utilize it. appears to result from natural sounds,73 with birdsong again
The utility of natural environments to promote healing via appearing to manifest potency.72,74 Relevant to modern daily
changes in attention and relaxation is not limited to direct life, the incorporation of natural elements into classrooms via
exposure to natural environments (e.g., walking in a verdant windows or “green walls” may improve the academic experi-
park and camping in the wilderness). These complementary ence75 (van den Berg et al., 2017).165 Even the presence of
mechanisms provide access to a continuum of intervention wood in the indoor environment might decrease arousal.76
that capitalizes upon our innate ability to subconsciously Nature thus can therapeutic benefit to human functioning by
process information and direct immune resources. softly focusing attention and motivating relaxation.
There now exists a robust literature demonstrating that
high-level processing can occur below the threshold of
conscious awareness. Dijksterhuis and Nordgren5 MIND
demonstrated that individuals can deliberate upon complex Meditation may offer additional potency along the contin-
cognitive tasks without directed, effortful attention. Such uum of intervention by leveraging the same cortical mecha-
subconscious problem-solving appears to be constrained by nisms as nature but through more intentional direction. It has
the outer boundaries of learned rules, but does not necessarily been recognized for some time that the broad range of
follow them in the logical fashion typical of conscious techniques representative of meditative practice alter brain
thought. In addition, subconscious processing appears functioning77,78 in support of greater parasympathetic nerv-
capable of influencing seemingly otherwise conscious ous system activation and thus mind–body health.79 It is
decision-making.52,53 In a sense, the subconscious processing likely that the practice of meditation specifically fosters
of information may function much as a gatekeeper of increased directed attention and guided relaxation. These
behavior54 without being overly restrained by the limits of two influences, more potent in dose–response relationship
conscious reality, an ability that might have offered an (but consider80) than the gentler influences from nature, seem
evolutionary advantage55 (Hoffman and Prakash, 2016). This to be driven by the instantiation of imagery, intentional or
ability may result from the wide-scale interconnectivity otherwise, as an avenue of healing.6 Imagery is intentionally
observed across sensory and interoceptive networks in the taught in such practices as guided visual imagery, but is
human brain,56 and by extension the remainder of the body.57 nonetheless prevalent in most if not all other forms of
The result may be that subconscious processing such as gently meditative practice as an automatic response to verbal
guided by the natural environment may provide a “window” of guidance.
common mechanisms58 into wellness through a continuum of Imagery is powerful. It can improve attentional training
intervention (i.e., nature, meditation, and clinical hypnosis) by and do so relatively free of interference from distraction.81 As
altering the very concepts through which people perceive Schmidt et al.82 opined, “imagery is not the mere
themselves and the world around them.57,59 representation of mental content but rather an active
construction process” (p. 222) that can be taught to direct
attention and guide relaxation. Perhaps meditation really does
CONTINUUM OF INTERVENTION afford the potential for functional adaptation through
Exposure to natural environments can produce restorative imagery.83 This would be congruent with Austin’s assertions
effects on human functioning.158 Not only might nature regarding the role of the thalamic gateway in the development
foster happiness,60 but it appears to afford improvements in of less self-referential processing.84,85 Imagery is typically
emotional regulation,61,62 short-term memory,39 and immune practiced through the visual perceptive system, but this need
functioning.63 Question does remain regarding the potential not be so. Even tactile imagery may have potency.
dose–response relationship between exposure to nature and Meditative practice, which inherently though often unin-
its therapeutic effects,64 and Hartig et al.65 were quite correct tentionally generates relevant imagery, has been shown to
to assert that “much work remains to be done to rigorously improve attention,86,87 decrease mind-wandering,88,89 and
assess the theoretical claims regarding the components of improve cognitive flexibility.90–94 The result appears to be
experience that sustain attention restoration and stress opportunity for greater creativity95 and improved decision-
recovery” (p. 221). Nonetheless, research suggests some making,96 perhaps brought about by augmented
potential avenues of explanation. interhemispheric communication within the brain (Bob
et al., 2013).156 Evidence also indicates that functional
changes courtesy of long-term meditative practice may be
NATURE lasting or even permanent.97,161 Meditation also guides the
At the most basic level, exposure to natural visual stimuli relaxation response.98 The benefits of this effect appear to be
such as forest imagery can result in improved attention.66,163 myriad. Practice can act as a buffer if not outright inoculation

270 EXPLORE July/August 2018, Vol. 14, No. 4 Nature, Mind, and Medicine
against against exposure to stressors.99,100 Indeed, meditation take with nature the better, the rule being never to do more
has been known for decades to promote a salutogenic than enough” (p. 103). Suggestion might modulate
immune response.101–104 Meditative practice has also dem- expectation and thus alter consequent behavior.130 More
onstrated the promotion of accelerated surgical recov- provocatively, perhaps hypnosis promotes a fundamental
ery,102,105 reduced inflammation in response to physical shift in brain functioning in which concerns about self
insult,106,107 and seemingly positive genomic changes.108 become less salient126 and the energy previously required to
Thus, meditation appears to exist farther along the maintain an adequate suite of defense mechanisms may be
continuum of intervention regarding potency in support of redirected toward health and healing.131
health and healing.

NATURE REDUX
MEDICINE Humanity did not evolve to reside in cities. With its constant
Even farther along the continuum of intervention and call for attention and regular presentation of environmental
potentially more potent than either nature or meditation and social stressors, modern urban life affords myriad oppor-
alone is the clinical practice of hypnosis.109,110 Hypnosis has tunities for illness.132 Such risks in urban environments can
been historically associated with the induction of an altered affect brain and body down to the level of the genome.133
state of consciousness known as trance.111,112 While debate Extended exposure to natural environments, at least those
continues in regard to the meaning of the term, it is clear that that are devoid of real or imagined threat, may provide an
hypnosis can alter mind–body functioning.113–115 Central to antidote.134,135 We can also alter our homes and places of
such altered functioning appears to be an enhanced receptiv- work in ways large136 and small137,138 to help counter the
ity to verbal instruction through administration of hypnotic challenges of the urban landscape. Technology might even
suggestion. As Rainville et al.116 explained in their oft-cited afford an especially fertile avenue through which humanity
paper, the power of hypnosis may reside in the “actualization can reconnect with nature to heal139 if we can figure out how
of various types of suggestions involving alterations of the to move past the distraction. As Kahn140 observed
meanings of perceptual experiences” (p. 119; italics in original).
An extension of meditative training that incorporates the use We’re a technological species within a scientific culture,
of verbal suggestion, hypnosis is typically enacted via and the challenge over the decades ahead is to integrate
these parts of ourselves and our culture with deep
meaningful imagery.116 Achterberg117 defined an image as
connections with nature that go back tens even hundreds
simply a reproduction of a form, and symbol as an image that of thousands of years in our evolutionary history.
has been given meaning… . The image, or imagery function, (p. 243)
appears to have an intimate and primal association to the
physical body… . The image can be conceived of as a bridge, The continuum of intervention is grounded in nature.
or transformational zone, between functions of mind and Elaborated in potency through meditation and even hypno-
body, interpreting and transmitting information from psyche sis, it provides one potent perspective through which our
to soma and vice versa. (p. 2) species might better learn to heal. Perhaps the attendant
In this light, it is conceivable that the language of clinical changes in attention and relaxation will eventually be found
hypnosis118,119 can affect change through verbal suggestion to result from the instantiation of suggested and symbolically
that modulates top-down effects from the executive through potent imagery. Broom et al.141 suggested that mind–body
sensorimotor to more visceral functional networks.56 disorder can be conceptualized as a failure to symbolize. In
Research demonstrates that hypnosis manifests a range of their own words, “the symbolic realm of language and image is
positive effects on human functioning. Through the use of by implication highly linked to internal structure and function”
suggestion, hypnotic practice appears to decrease the like- (p. 19) of the mind–body. Such a nature-based approach to
lihood of responding habitually (and thus maladaptively) to intervention offers the potential to usher in a new mindset
events.120 This benefit might be the result of decreased necessary to foster a medicine that truly addresses the concerns
perceptions of internal conflict or threat.121,122 The practice of the whole person.142,166
of hypnosis has also been observed to improve the regulation Allopathic medicine has traditionally focused on address-
of the immune response to insult or injury123 and accelerate ing disease in the body and disorder in the mind.143 Yet, a
wound healing.124 Hypnosis has even been utilized as the sole medicine grounded in our evolutionarily conserved abilities
anesthetic for surgical procedures.125 to heal naturally offers a more holistic approach toward health
Much remains unknown as to why suggestion offered and healing recognizes the potential of conceptualizing all
during hypnosis can compel such profound mind–body illness as maladaptation in need of rehabilitation (Fig. 2). The
changes. For example, how is it that imagery can be so question then becomes how nature, meditation, and hypnosis
powerful a tool? Fully absorbed in attention and deeply might be utilized to promote more effective adaptation to the
relaxed, “the subject may simply and automaticallyidentify physical and psychological diatheses of modern urban life.
with the suggested action, sensation, or lack of sensation, as it Nature can provide a ready framework to guide treatment. At
is suggested”126 (p. 113). The result can be a major degree of its core, such an approach must recognize the central roles of
functional and perhaps structural plasticity that allows for attention and relaxation for wellness, and how mental
growth and change,127,128 that is, rooted in our inherent imagery can play a major role in their promotion.144
nature.129 As Hammond125 advised, “the fewer liberties we Imagery motivates not merely a placebo response based

Nature, Mind, and Medicine EXPLORE July/August 2018, Vol. 14, No. 4 271
Fig. 2. Graphical representation of how a continuum of intervention may effect salutogenic changes in human functioning. Relevant practices
appear to work through the simultaneous instantiation of changes in attention and relaxation moderated by subconscious processes,
potentially lessening the negative effects of the current allostatic load. Affordances of attention may act via mechanisms that result in a
functional shift away from a bilateral, dorsal cortical stream and toward a ventral, right stream of cortical activation. Concurrently, affordances
of relaxation may shift autonomic balance toward greater activation of the parasympathetic nervous system coupled with decreased release of
stress hormones by the hypothalamic–pituitary–adrenal axis and a likely decrease in gut dysbiosis. The potential result is a decrease in
maladaptive cognitive conditioning leading to improved executive functioning coupled to a decreased inflammatory response promoting
improved immune function. ACC ¼ anterior cingulate cortex; dlPFC ¼ dorsolateral prefrontal cortex; FEF ¼ front eye fields; HPA ¼
hypothalamic–pituitary–adrenal axis; L/R ¼ left-right; PCC ¼ posterior cingulate cortex; sal./C-M ¼ salience/conflict-monitoring; SAM ¼
sympathethic-adrenal-medullary axis; vmPFC ¼ ventromedial prefrontal cortex.

expectation, but the chance to leverage meaning through the The Roles of Imagination in Health. Amityville, NY: Baywood
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