NH psychologist combines running, therapy

If “motion is lotion” for the body, what must it do for the mind? With evidence backing the theory that exercise provides a therapeutic boost for mental health, a small but growing movement in psychology has taken a next step by combining the two. The result is offering movement-based therapy sessions out on the road, beach, nature paths, or rail trails.

Beth Connolly, Psy.D., started her Hampton, NH-based practice “This is My Happy Pace: Therapeutic Running Services,” in 2019, after working in traditional office-based therapy for a decade.

With 95% of her clientele taking advantage of the opportunity to move therapy outside, Connolly has seen record growth since its founding. She spoke with New England Psychologist’s Catherine Robertson-Souter about her work and goals for spreading the message about the connection between movement and mental health.

What was the impetus for you to start a movement-based therapy practice?

I had been exploring the benefits of running and recognizing what a stabilizer it has been for my own mental health and stress management. I had been doing traditional, office-based work in group practice for about 10 years and I was recognizing some of the limitations of trying to help people find motivation to get active.

I started to consider how might I try to integrate this experience that I have personally had with running with my therapy practice.

And then, I found an article in “Runner’s World” magazine about a clinician in Los Angeles, Sepideh Saremi, who had was already doing this [a running therapy practice.] I reached out to her and she became my mentor.

When I started, I hadn’t really heard of anyone on this side of the country who was doing it. Since then, Sepideh has developed a certification program for Run, Walk, Talk therapy.

From a business standpoint, choosing a location for a practice takes so many things into account–population, traffic, parking, overhead, etc. You had to add “run-ability” to that list.

I knew that I wanted to be near the water so I found an office space in Hampton three miles from the ocean. I also have some walking paths in the woods across the street and there are several neighborhoods by the office that are low traffic.

How does your initial intake differ than it might for traditional therapy?

The first two sessions are in the office to assess physical limitations or concerns about the movement we are going to be doing and orienting clients to the expectations they have for our work together, what their goals are…

We do a thorough assessment and evaluation talking about safety, about confidentiality because this is not office-based. From there, they have the choice whether they want to walk or run down by the water or closer to the office where it is a little less busy.

So, are you basically in the best shape of your life?

Sometimes I do feel like I am! It can get tiring, though. Today, for instance, I had my first session at 8 a.m. and we ended up doing about four miles in the hour. My next one was right after that and we did about three miles and then my next one we did about four. I am inside for my next session and then I will be outside and probably do like another three miles or so.

That’s 14 miles!

Yes. You do have to pace yourself very differently than with office-based work. My body becomes a factor in a way that is very different.

I know which clients are quicker runners so I stagger my day to make sure that I am taking that into consideration for myself. Part of this is helping them to recognize what their bodies need and I can only really do that if I am also tuned in to myself.

Some paces must be too fast to also do therapy.

One of the things I talk about with clients in those first two sessions is clarification that this is therapy first and running second. We are not here to hit your splits or focus on your pace or distance. We need to be able to stick to a conversation pace.

There are times when we might jog for five, take one minute off, and then jog five more. We use the running intervals to induce a bit of stress which gives us an opportunity to practice the mindfulness and coping strategies we are working on.

During the one-minute downtime, we can talk about how we might want to try to implement differently and then we do it again. So the running becomes a vehicle for rehearsal for some of those skills.

Can you talk about the science behind movement as therapy?

It is a multi-layered benefit. There is something called the green effect, how our brains respond to natural light. We also know about the neuroscience of how movement impacts circuits in our brains and about how increased heart rate affects our access to stress management. Being able to move with someone can help ward off depressive symptoms.

When you participate in reprocessing, oftentimes, you are changing your associations of that event or topic. Like EMDR, the visual scanning that happens as you are walking can help with the integration of different experiences.

Doing therapy side-by-side is a different dynamic than sitting in a room and looking intensely at each other. I’ve noticed something significantly different about the rapport-building process, a sense of fast forwarding through things that take a little bit longer in an office.

Then in addition to all that, the running and walking gives us a chance to be tuned into the body and reinforces that we can regulate ourselves by changing what we are doing. If we speed up, so does our heart rate, so does our breathing. If we stop or slow down, it will calm our system down. That is a very powerful intervention.

Are there diagnoses that might be contraindicated for this type of therapy?

I think situations where it is potentially contraindicated include those with eating disordered clients who might have had unhealthy relationships with exercise or nutrition.

For clients dealing with addiction, running can be very therapeutic and beneficial, but there is the risk of transferring the addiction because there are overlaps in the parts of the brain that are implicated in both.

Another area that could conflict might be OCD where the running becomes compulsive versus therapeutic. These are all situations where it would require lots of monitoring and evaluation.

How do you handle taking notes?

I try to leave myself a small buffer between sessions to complete documentation. But, one of the things that I find is that not only are my clients having access to more of themselves, but I am also a better therapist because I am also moving.

A Harvard psychiatrist, John Ratey, M.D., talks about how the four hours after a period of elevated heart rate is where your executive functioning is at its best. You are more organized and able to plan and implement good judgment. So I would say that doing the running and walking therapy also allows me to focus differently. I find it easy to come back and document what happened.

Why is this work important and is this something that you would like to see spread further?

It’s important because it transcends the couch. There is so much outside our offices that we have access to when we use this type of approach. People learn more quickly when they are moving. There are studies that have compared antidepressants to a regular exercise routine. There is opportunity for benefit in terms of accessing what we have internally and to stimulate that can be really powerful for the healing process.

What do you see as your future?

I would like to expand to be able to reach more clients through group work, do research on my outcomes and take on some writing to create more awareness about this approach.

Eventually, I would also like to take my practice on the road to some extent and do school seminars across the country to spread the word about the links between movement and mental health.