With Nature in Recovery: A Qualitative Exploration of Experiences With Nature and Friluftsliv in Everyday Life for Persons With Eating Disorders

Abstract

This thesis explores and discusses persons with eating disorders’ experiences with nature and friluftsliv, etymologically translated as a free or open-air-life, as part of everyday life recovery. Recent research has emphasised a contextualisation of recovery as processes situated in a person’s everyday life. This has been argued to be an important an validating perspective for individuals experiencing mental health challenges, defining them as persons, not by their symptoms or diagnoses. However, the prevailing approach to eating disorder recovery remains influenced largely by clinical perspectives and diagnostic frameworks. To broaden the understanding of what recovery processes for persons living and dealing with eating disorder recovery may entail, researchers must emphasise the first-person accounts of lived experiences and focus on identifying supportive strategies for daily life.

Along with growing global concern related to mental health challenges, interaction with nature has received increased attention with regard to health promotion and recovery. Although the benefits of a healthy relationship with nature are promising, further research is needed to elucidate the qualities of human–nature engagement. Moreover, while much research has centred on various outdoor therapies (such as adventure therapy and wilderness therapy), there is limited knowledge highlighting experiences with nature and friluftsliv as part of mental health and recovery processes for persons with eating disorders in non-clinical, everyday settings.

This research project is influenced by a hermeneutic phenomenological approach. In addition, the project has involved collaboration with a competence group, consisting of six persons with experiences with eating disorders and/or mental health challenges and with interests in nature and friluftliv, throughout the research process. The thesis builds on an epistemological approach seeking closeness to participants’ descriptions, recognising knowledge as co-created, temporary, and contextual. My reflexive engagement in a process of exploring, discussing, and reflecting has been important. This thesis is article-based and consists of three sub-studies.

The first study encompasses a systematic literature review with the objective of establishing the current knowledge base of friluftsliv as part of a person’s eating disorder recovery processes. In addition, the review investigates how friluftsliv may contribute to changes in factors related to a person’s eating disorder recovery processes. Thirteen studies were deemed eligible and included in the review. The findings indicate that participation in friluftsliv supported an improved body image, appreciation and acceptance of one’s body, and enhanced self-esteem. However, the review also reveals the limited existing research in this area, particularly related to perspectives on nature and friluftsliv as part of recovery processes in everyday contexts.

The second study is qualitative, based on individual semi-structured interviews and ‘going together’ as method. The aim is to explore embodying experiences with nature related to recovery in everyday life for persons experiencing eating disorders. Eight participants with an interest in nature and friluftsliv, all of whom had experiences with bulimia nervosa and/or binge eating disorders, were interviewed twice. The interviews took place in nature, and the findings reveal how embodying experiences with nature enabled a (re)connection with one’s body. Nature accentuated feelings of calmness and invited engagement with the senses. Moreover, the participants described nature as nonjudgemental and as a place providing room for self-care. In the article, my co-authors and I explore perspectives on recovery as relational and contextual, related to human–nature interaction. Particularly, we discuss how experiences with nature challenge body mind dualism and assert the need for further research to create a holistic approach towards the body in eating disorder recovery.

The aim of the third study is to explore subjective experiences of how friluftsliv can support processes of recovery for persons living with eating disorders. The empirical material is based on the same data-generation process used in the second study. This material was analysed again in accordance with the aim of the third study. The findings from this study indicate that friluftsliv encompass nurturing environments and occupations that centre aspects of life other than the eating disorder. Friluftsliv was defined as involving relational processes that facilitate recognition of the participants’ needs, as well as a learning and practice arena for reclaiming control over their recovery and, indeed, their lives. Moreover, the participants described how friluftsliv supported a new sense of self through (re)establishing oneself as an outdoor person. The experiences of the participants illustrate recovery for persons with eating disorders as dynamic processes, including times when the eating disorder could be shifted to the background and times when it felt more present.

The findings from the three sub-studies depict experiences with nature and friluftsliv as nurturing environments and occupations that provide valuable breaks from the distress associated with an eating disorder. In this regard, the participants described friluftsliv as important supportive strategies for managing everyday life. The overall discussion in the thesis centres upon how experiences with nature and friluftsliv can be understood as embodied, relational, and related to perspectives on everyday life. The participants’ descriptions of their embodied and relational engagement with nature highlighted eating disorders as complex and multi-layered. Nature facilitated a (re)connection between body and mind. Furthermore, the participants emphasised the benefits of experiences with nature and friluftsliv as shifting their focus to something ‘outside’ themselves. Moreover, an everyday perspective on experiences with nature and friluftsliv recognises the participants’ resources and efforts to support their recovery processes.

However, it is important to note that spending time with nature did not necessarily heal or erase the entire struggle experienced. The project participants primarily described their relationship with nature as providing important breaks and a change of focus that were supportive in dealing with a difficult situation. Moreover, the point is not to claim that friluftsliv is a meaningful part of recovery for all persons experiencing eating disorders. Rather, this project advocates for the continued exploration of multidisciplinary approaches to recovery, recognising eating disorders as encompassing broader health concerns and affecting a person’s wellbeing and quality of life.

Experiences ‘with nature in recovery’, as indicated in the title of this thesis, contribute to extended knowledge on how participation in meaningful occupations and healthy environments can support persons in living and dealing with the recovery processes related to eating disorders.