The beginning of a new year is associated with tackling the Christmas and New Year excesses as well as general resolutions to become healthier. Weight loss programs experience a surge in attendees. Exercise objectives are coupled to this and many use social media to log their progress at reaching so many days or kilometres of walking. For those who partake in Lent, the objectives are bolstered, often at a critical stage when the resolutions start to slide! Some of this is the fact that we are in a continuum rather than a new beginning. We are the same people we were at the end of the previous year and the reasons for our behaviours won’t have changed as the New Year is rung in. 
Although there are a number of therapies that help people to understand and change painful emotions and problem behaviours, it is also commonly accepted that certain lifestyle changes can help people improve mental and physical wellbeing. Getting adequate sleep, treating physical illness and pain, eating a balanced, nutritious diet and getting a minimum amount of exercise, all impact significantly on our emotional health. Research supports the effectiveness of exercise in improving depression, anxiety, insomnia, weight gain and other health difficulties. Exercise stimulates the brain to release ‘feel good’ chemicals called endorphins, thus improving mood and promoting relaxation and self esteem. I have rarely met anyone who, despite initial resistance to the idea, has not felt better after a good walk! There is no doubt that our senses are sharpened adding a distinct advantage to any creative activity we undertake after. Sensory engagement is also very important for resetting neural pathways in acute anxiety and depression – seeing the colours, smelling the scents, touching the plants, hearing the sounds and tasting salt air on our lips shows how a walk in nature can engage all our senses simultaneously. 
When an individual comes for psychotherapy, the therapist may want to know about their eating and sleep patterns and what, if any, exercise they are taking. The therapist may want to ensure they are eating nutritiously and regularly - basically a good breakfast, lunch and dinner. However, a distressed client may find regular eating (and sleeping) an issue never mind the nutritious content of their meals! This can physically and emotionally deplete an individual and they may very well be in this state when they come for therapy. Offering a client support is re-establishing a good pattern of eating and exercise is an important aspect of therapy and can often be a very early requirement in the treatment. Some psychotherapists integrate exercise into their sessions and go as far as to say that counsellors and psychotherapists could do a better job of incorporating exercise into the treatment plan [1]. 
It is not always easy to motivate clients crippled with anxiety or depression. It is important to keep the targets small to begin with. Tapping into a deep interest often helps - if you love(d) gardening or nature, a walk in the garden or by the sea can be an enticing and realistic target. Like many psychotherapists, I love nature and find a therapeutic effect in walking by the sea or through a forest. Just like Wordsworth’s daffodils that “ flash upon that inward eye,” I find the same affect from a seeing a forest floor covered in bluebells. It’s something that you can take home with you to revisit in your mind, until you can return again. One aspect of nature that people find very appealing is walking by the sea. People remark how the ebb and flow of the tide on the beach is like breathing – in and out. Some find the ebb and flow movement on the sand, a very tactile sensation. Many of you will know that the womb’s amniotic fluid is similar to seawater in terms of pH (~7.3) and mineral composition and it has been suggested that in this, humans retain a trace of the origin of life in the sea – that when animals moved on to land, they took the sea with them, inside their bodies. When people are attracted by and comforted by the sea, they are perhaps returning to the sensations and soundscape of the womb, returning to mother but finding her in nature instead. 
Getting out in the fresh air also helps to maintain Vitamin D levels within normal limits. It is thought that one in eight Irish people are deficient in Vitamin D [2]. This may be because we are not outside often enough and when we are outside, we layer on SPF, thus blocking the tanning UVB rays that naturally produce vitamin D. A correlation between depression and a lack of Vitamin D has been established - the lower the Vitamin D level, the greater the chance of depression [3]. This is something psychotherapists must also bear in mind, when assessing clients presenting with depression. There are usually co presenting symptoms to note also and a trip to their GP may be necessary to have this checked out [4]. Bearing in mind that it can take some months before even high dose supplements can bring levels back towards normal, the sooner it is spotted, the better. A simple blood test confirms the deficiency and subsequent restoration of levels to normal. 
Attention to a client’s nutrition and diet may also alert the psychotherapist to an undetected eating disorder (ED) since some of these conditions co-exist with other conditions that lead an individual to seek or be referred for psychotherapy. It has been reported for example that anorexia nervosa is found with depression in up to 63% of cases and with OCD in 35% of cases [5]. It is important that such clients are also receiving medical attention for physiological complications. Similarly, it is important for GPs to ensure that if an ED is suspected, that the patient receives appropriate mental health support [6]. 
Psychotherapy has a lot to offer the client who is frustrated by failed attempts at losing weight through ‘dieting’. In the course of the therapy, some root cause issues can be uncovered and allow the client integrate a more benign inner voice and strengthen self esteem. In Freudian terms, the psychotherapist introduces and establishes over time, a more benign superego. 
A holistic approach to health is the reality of body mind integration, the whole person. Looking after our mental health impacts positively on our physical health and is also supported by a balanced diet and gently exercising in nature …. any time of the year! 
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