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«The Importance of Nature in Coping Creating increased understanding of the importance of pure experiences of nature to human health Johan Ottosson ...»

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The Importance of Nature in Coping

Creating increased understanding of the importance of pure experiences

of nature to human health

Johan Ottosson

Faculty of Landscape Planning, Horticulture and Agricultural Science

Department of Work Science, Business Economics and Environmental Psychology


Doctoral thesis

Swedish University of Agricultural Sciences

November 2007

Acta Universitatis Agricultureae Sueciae

2007: 115

ISSN: 1652-6880

ISBN: 978-91-85913-14-5

© 2007 Johan Ottosson, Alnarp Cover illustration: Ebba von Sparr Ottosson Print: SLU Reproenheten, Alnarp 2007 Abstract Ottosson, J. 2007. The importance of Nature in Coping. Acta Universitatis Agriculurae Sueciae. Doctoral Thesis No. 2007: 115 The aim of the present dissertation is to create a greater understanding of the importance of pure experiences of nature for human health. The dissertation consists of five articles and a frame story.

The first two articles report on an introspective study of my own experiences of the nature areas surrounding Orup Hospital, where I spent time rehabilitating after a brain injury.

I describe a feeling for nature that was different from anything I had experienced previously. The interplay between human beings and the natural environment is described in detail, based on the interaction between the author and strong elements in nature, e.g. stones and water.

The findings from Article III and IV may be interpreted as follows:

Elderly people, in general, recover more quickly from directed attention fatigue after having rested in a garden than after having rested indoors, as could be measured by different tests of concentration.

Elderly people with low psycho-physiological balance were most affected by a stay in a garden, as could be measured by changes in heart rate and blood pressure.

The study shows, first, that an outdoor visit is important for recovery from stress and fatigue and, second, that the improvement is especially significant for those who are most susceptible.

The findings from Article V may be interpreted as follows:

Experiencing nature seems to have a more powerful influence on the rehabilitation potential of people greatly affected by a crisis.

Taking a walk also has a significant influence, although not of equal importance.

The social factor seems to have more influence on the rehabilitation potential of people affected by a crisis to a low/moderate degree.

Having access to nature in everyday life can have a buffering effect on people’s mental state. Individuals who have many experiences of nature are less affected by their crisis than are those who have few such experiences.

The above results are discussed and interpreted in the frame story by linking them to new and older research in the area of health and the physical environment. I suggest that stays in sound natural environments function as stays in enriched environments.

Sound natural environments contain certain qualities that mediate an effectual emotional tone. The scope of meaning as well as brain research can provide explanatory models of the effects of nature experiences on emotions and recovery from a crisis.

Keywords: Restorative effects, affects, health, crisis, nature, gardens, elderly people, brain injury, introspection, enriched environment, emotional tone, scope of meaning.

I would most like to thank my wife Ebba and my four children Katarina, Henrik, Martin and Hampus. They have had to bear a heavy burden, but have never wavered in their support.

Author’s address:

Johan Ottosson, Department of Works Science, Business Economics and Environmental Psychology, SLU, Box 58, 230 53 Alnarp, Sweden E-mail: Johan.Ottosson@ltj.slu.se Table of Contents


List of papers


Problem formulation


Theories and earlier studies


An explorative approach


The different approaches chosen

The Venues (Ottosson & Grahn 2005a, b)

Overview of the Articles

Abstract 1: Naturens betydelse i en livskris

Abstract 2: The importance of Nature in Coping with a Crisis: a photographic essay........ 28

Abstract 3: A comparison of leisure time spent in a garden with leisure time spent indoors:

on measures of restoration in residents in geriatric care

Abstract 4: Measures of restoration in geriatric care residences: the influence of nature on elderly people’s power of concentration, blood pressure and pulse rate

Abstract 5: The role of natural settings in crisis rehabilitation

Interpretation of experiences described in the introspective study: The importance of nature in coping with a crisis

Phase I, Inert objects

Phase II, Plants and greenery

Phase I + II, Nature

Phase III, Animals

Phase IV, People

Change - Scope of meaning


Hypotheses and findings

A graphic illustration of the results based on triangulation of methods and theories.......... 53 Scope of meaning

Scope of meaning and its effect on senses and body awareness

An effectual emotional tone

Enriched environments and plasticity of the brain and the sensory system





Concepts in the dissertation

List of papers Paper I-V

The present thesis is based on the following papers:

–  –  –

Ottosson, J. & Grahn, P., 2005a. A Comparison of Leisure Time Spent In a Paper III Garden with Leisure Time Spent Indoors: on Measures of Restoration in Residents in Geriatric Care. Landscape Research. 30, 23-55.

Ottosson, J. & Grahn, P., 2005b. Measures of Restoration in Geriatric Care Paper IV Residences: The influence of nature on elderly people’s power of concentration, blood pressure and pulse rate. Journal of Housing for the Elderly, 19 (3/4), 227Ottosson, J. & Grahn, P., 2007. The role of natural settings in crisis Paper V rehabilitation. Landscape Research, accepted.

Preface The present doctoral dissertation consists of five articles and a frame story. The frame story describes my problem formulation and the methods I have chosen, and it is here I summarize the observations made during the course of my dissertation work. By way of conclusion, I reflect on my results and try to position them in a theoretical framework. The five articles are included to the frame story.

My dissertation work was conducted within the research program Public Health – Animals and Nature in Urban Environments for Recreation and Health, in the core areas Work Environment, Economy and Environmental Psychology, Swedish University of Agricultural Sciences (SLU).

The dissertation program has been supported by funds from the Faculty of Landscape Planning, Horticulture and Agricultural Sciences (LTJ-fakulteten), SLU Alnarp, as well as by a grant from FORMAS, the Swedish Research Council for Environment, Agricultural Sciences and Spatial Planning.

Problem formulation In the early stages, he knows that he took walks around the hospital grounds – short ones at first, staying close to the hospital – and longer and farther as he began to find his way. One of his problems after the accident was a state of confusion. There was always a risk that he might not find his way home. The need to be out of doors was countered by a fear of getting lost. However, this fear did not stop him, and, although he could not explain it, the daily walks seemed urgently important.

(Ottosson, 2001, page 166).

Han vet att han gick promenader runt sjukhuset – först små och nära sjukhuset – och sedan promenader allt längre och längre bort, allt eftersom han lärde sig hitta. En av svårigheterna efter hjärnskadan var just orienteringsproblemen. Han riskerade hela tiden att inte hitta tillbaka. Behovet att vara ute i natur stod emot rädslan av att gå vilse.

Det gällde att göra en lagom avvägning – att våga lagom. Rädslan av inte hitta tillbaka kunde dock inte stoppa honom. De dagliga promenaderna kändes som livsviktiga – varför visste han inte riktigt, men känslan var utan pardon (Ottosson, 1997, s. 12).

I have described my powerful experiences of the nature areas surrounding Orup Hospital, where I spent time rehabilitating after a brain injury, in my book entitled “Naturens betydelse i en livskris”, and in the article “The Importance of Nature in Coping with a Crisis: a photographic essay” (Ottosson, 1997, 2001). During rehabilitation, I sought out nature without any particular thoughts behind it – I simply did it.

To my great surprise and joy, the book was very well received, both by my colleagues and by the general public. I experienced a transition from being quite uncertain and afraid, regarding how my future would take shape following my brain injury, to having accomplished something positive. Since its publication, the book has played a central role in my life and research. Although I have published other studies and research findings, people’s interests have always been focused on the book. I have found strength in always being able to return to my own powerful experiences, which I am able to keep with me, thanks to my book.

Work with my dissertation has taken a great deal of time, owing to my disability, but this has also given me time for reflection.

The aim of the present dissertation is to create increased understanding of the importance of experiences of nature for human health and thereby our ability to function and/or be rehabilitated.

In my introspective study of my own experiences of the nature areas surrounding Orup Hospital (Ottosson, 1997, 2001), I describe a feeling for nature that was different from anything I had experienced previously. These personal experiences developed into an interest in the importance of nature for our well-being. I experienced a sense of calmness and harmoniousness in nature that was in sharp contrast to the insecurity and fear that often came over me when I was inside the hospital. My nature experience was dependent on my predicament.

Based on my experiences from my introspective study, three hypotheses were


1. Being in the outdoors affects different people to different degrees.

2. The impact and significance of being in the outdoors will vary, depending on the individual's life situation.

3. An individual’s preferences for features of the outdoors (solitude or being in a group; a sunny summer day or a violent autumn storm, etc.) will vary according to his/her frame of mind, that is, his/her capacity to absorb and process the impulses the experience involves (Ottosson & Grahn, 2005a, b).

I was interested in investigating whether other groups, who could be expected to be in a difficult situation, had had similar experiences of nature’s importance. One large and growing group of people who find themselves in a vulnerable situation are the oldest old. Therefore, it is natural to try to understand how this group is affected by experiences of nature.

Findings from my study on the elderly and my introspective study aroused questions and inspired me to continue investigating the importance of nature experiences for people reacting to a crisis. Here, a natural continuation involved working with a larger group.

Introduction For thousands of years, spending time in natural surroundings has been assumed to have a positive effect on human health (Knopf, 1987; Stigsdotter & Grahn, 2002).

Sunlight, fresh air and greenery per se are all believed to have beneficial qualities.

This thinking was particularly central to both the so-called theories of miasma and pythogenesis, which were highly influential throughout the 18th and 19th centuries (Urban Parks and Open Spaces, 1983; Warner, 1998). These two schools of thought were the reason why hospitals and sanatoria were built in attractive natural settings, with pleasant gardens for the patients’ recreation. In the 1930s, however (ibid.), a diametrically opposed theory gained currency, and throughout the Western world hospitals and therapeutic institutions were built without giving a thought to patients’ access to the outdoors, which had been a basic principle up until that time. There are, however, exceptions to this rule. In psychiatry, activities for patients in gardens, parks and nature were still considered important at least up to the 1960s, and the area of Horticultural Therapy has grown in the US and England (Schmidtbauer et al., 2005;

Grahn, 2005).

In recent decades, many studies have demonstrated the influence of sunlight on human health.

Individuals’ exposure to sunlight has been shown to have a bearing on disturbances to the diurnal rhythm, bone growth, vitamin status, etc. (Küller & Küller, 1994; Küller & Lindsten, 1992; Küller & Wetterberg, 1996; Boldeman et al., 2006). Similarly, in recent decades, a greater understanding of the value of fresh air has been achieved: in most cases, air outdoors is of better quality than air indoors, even in heavily trafficked urban areas (Grahn, 1992;

Bramryd & Fransman, 1993; Wallace & Howard-Reed 2002; Matson, 2004). Wallace and Howard-Reed (2002) found that indoor air was 2 to 20 times more polluted than outdoor air in cases where activities were taking place indoors. Matson (2004) found that, with regard to the very smallest air particles, contents indoors were 1.5 to 2.5 times higher than outdoors if activities were taking place in the indoor environment. It was not until 1984, however, that the first measurable health effects of greenery per se – the visual access to nature (the view from a window) – were reported (Ulrich, 1984). This study was soon followed by others (Grahn, 1994; Kaplan & Kaplan, 1989; Küller & Küller, 1994; Ulrich et al., 1991; Ulrich, 1999;

Verderber, 1986). Two effects of natural environments were apparent: stress reduction and improved concentration.

Starting from my hypotheses, the resources at an individual’s disposal might influence his/her prospects of enjoying a rich and varied everyday life. Antonovsky (1987,

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