April 29, 2020


Healing power of outdoors: Alexander Larman reviews The Natural Health Service by Isabel Hardman (Alexander Larman, May 2020, The Critic)

Hardman's account of her partial recovery from her breakdown, is a considerably more interesting and accomplished book than a simple wallow in the details of her ordeal. The title is easily misread. Rather than either a social history of the NHS or an autobiographical account of what befell her, Hardman instead examines the healing powers of nature and the great outdoors, arguing that their therapeutic powers can contribute immeasurably both to our mental and physical health. It is deeply unfortunate timing that the book is being published at a moment when her readers are largely confined to their homes for their own health and safety, but the central message will outlast any pandemic.

Hardman is a precise, lucid writer, never afraid to offer well-argued opinion but always careful to delineate it from factual reporting. She writes, "It is only recently that society, and even the medical establishment, has started to acknowledge that our physical health and our mental health aren't as separate as we assumed." To those who grew up knowing the maxim "mens sana in corpore sano" -- "a healthy mind in a healthy body" -- this may not be the revelation that Hardman presents it as, but at a time when enlightened GPs prescribe birdwatching and long walks alongside pills and psychological treatment, a greater belief in the natural, as well as national, health service will ultimately do Britain a substantial amount of good.

The sainted NHS itself does not emerge from Hardman's book with particular credit, especially when it comes to mental health care, which she regards as underfunded and loaded with stigma. One professor describes a phenomenon known as "diagnosis creep", which can lead to otherwise healthy patients being medicated because they feel justifiable anxiety or depression about a circumstance such as a bereavement, or indeed a national disaster that confines them to their homes for months.

As the NHS's national mental health director puts it, "drugs and therapy alone cannot bring about healing", although one has to hope that we never end up in the absurd situation that some other societies have arrived at, where an ever-growing number of "assistance animals" are said to be invaluable to their owners' mental health, although Hardman makes a convincing case for therapy dogs.

The unwell can be helped in less zoological ways. Hardman was a keen gardener even as a child ("I was unusual in knowing the common and Latin names of most garden plants by sight") and views it as a straightforward way of keeping oneself occupied and happy. She runs long distances and swims in freezing seas and rivers, relishing the necessary endorphin release of the "runner's high". In the case of swimming, "the most powerful antidepressant I have ever encountered", she plunges into water in the depths of winter even as she tacitly acknowledges that there is a masochistic element to how far she pushes herself. Better to cause some physical damage, which will swiftly heal, than endure mental distress, which could last indefinitely.

Natural Health Service is rich in interesting and unusual details. Birdwatching is considered a useful way of distracting oneself; twitching, a more specialised pursuit requiring a near-obsessive interest in the travels of particular birds, is not.

Posted by at April 29, 2020 12:00 AM