Rock climbing

Climbing as therapy – Climbing

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For Miriam Pracki, a 36-year-old German, starting rock climbing was an essential step in overcoming years of mental health obstacles. In 2000, when she was a teenager, she developed an eating disorder. By 2010, she had been hospitalized three times, and regular patterns of depression and self-harming behavior caused her to suspend her university classes. But when Pracki, who had always been active and passionate about the outdoors, heard that a new climbing gym was opening nearby, she decided to give it a try.

The skills she learned in rock climbing eventually paved the way for her recovery. “While you’re climbing, the only important thing is the present moment,” she says. “You can’t think about your body weight, or your job, or anything.” Sport made her strong; she fondly recalls the strain in her heart as she completed her first bouldering problem on a steep horizontal roof. “It was such a cool feeling,” she says. “Being strong in climbing made me stronger in general. I was able to transfer that success and positivity into everyday life.

In the four years since her first trip to the climbing gym, she recovered, returned to a healthy weight, was diagnosed and treated for ADHD, and completed her education. Now she is married with children – her husband is also a climber – and works as an interior designer. She continues to boulder and sport climb both in the gym and outdoors.

Sport holds therapeutic promise for many reasons. Climbing can bring the mindfulness, the focus on the moment that Pracki has experienced, which is key to treating depression, says Katharina Luttenberger, a psychology researcher at the University of Erlangen in Germany. It’s also objective: either you overtake or you don’t. This makes it harder for those struggling with self-esteem to discredit themselves, since you can’t just send a route because you got lucky. Sport is also loaded with metaphors. “A depressed patient needs to regain a grip on life, or you need to come out of your depression, you need to let go and move on,” says Luttenberger.

In a movement currently centered in Germany and Austria but gaining traction around the world, practitioners like Luttenberger are evaluating block psychotherapy – which typically involves a combination of talk therapy and rock climbing – in controlled studies and applies it in hospitals and private practices. With a growing body of evidence and expert support, these psychologists hope to persuade health officials that this therapy is a valid alternative to more traditional talk therapy approaches.

Luttenberger and his colleagues have developed a ten-session program over nearly a decade of research. Each session begins with a meditation. Then the instructor talks about the topic of the day, such as self-esteem, confidence, or social relationships. The therapist then leads a climbing exercise that illustrates this theme. For example, patients may block blindfolded with the guidance of the instructor or other patients to explore fear, which usually dissipates once they learn to rely on the guidance of others. The exercise is then followed by a discussion and another meditation or relaxation exercise.

A March article in BMC Psychiatry found that a rock climbing therapy program was a more effective treatment for depression than other exercise regimens that did not involve therapy, and was also effective than established methods of talk therapy. The trial followed 240 patients: one-third took part in block therapy, another third underwent cognitive-behavioral therapy (a common form of talk therapy) and the final third started an exercise program at residence. The group that received the climbing treatment improved significantly more than those in the exercise program and similarly to the group that received cognitive behavioral therapy. “CBT is powerful and has a long history,” says Luttenberger, who led the study. “And we were able to show that block therapy was not inferior to CBT, which is great.”

Creating a control group for physical activity without a therapeutic component was critical to the study, as exercise, in general, has been shown to have positive effects on mental health. The first study by Luttenberger and his team, conducted in 2012 with 47 participants, found that levels of depression decreased significantly in participants who attended the OR, compared to a group placed on a waiting list as a control, but that didn’t prove block therapy was anything better than just getting your heart rate up and moving your body. The 2020 study expanded the parameters and made a better case for an escalation therapy with real potential.

“The way people approach a boulder problem is very similar to how people approach life outside of bouldering,” says Lisa Vigg, ​​a psychologist who helped with Luttenberger’s research and guided his own patients through block therapy routines in Germany. It reveals patterns of behavior that therapists and patients can then work on in the climbing gym, which serves as a safe place to practice new skills.

Alexis Konstantin Zajetz, an Austrian psychotherapist, has been exploring climbing therapy since the early 2000s and founded the Institute for Climbing Therapy in Salzburg in 2005. A dedicated climber himself, he saw the potential of this sport because of the intense concentration it requires and the strong emotions it can evoke, and he has begun to incorporate bouldering sessions into talk therapy with some patients. During one session, when Zajetz asked one of her patients to choose an easy-to-climb route, she refused to go below a moderate grade. “She demanded so much of herself,” Zajetz says, because she was afraid of what other people would think if she didn’t climb to a certain difficulty. After that, he was able to work with her on her difficulties in judging herself, both inside and outside the gym.

Compared to other adventure sports, bouldering is relatively accessible and affordable. All you need are shoes and chalk. Plus, it’s fun and intuitive for many people, adds Zajetz. Even on day one, most people can complete a route with minimal instruction, bringing a sense of accomplishment, with little time spent perfecting technique. Advanced and beginner climbers can train side by side, working on separate routes, which makes the sport especially inclusive, says Vigg.

“Anything that makes people with depression physically and socially active is a good thing,” Catherine Forneris, a psychiatrist at the University of North Carolina, said of the research team’s findings. She adds that there are many “unanswered but intriguing questions” about the approach. What existing studies can’t tell us is which aspect of the therapy is most powerful: is it the block itself? Is it practiced in a group? Is it the lessons of mindfulness? Maybe all of them contribute, but at this time it is unclear to what extent different parts of the program are beneficial. Forneris adds that future work should seek to replicate studies with different patient groups outside of Germany.

The other goal is to gain wider recognition. In January, the first climbing therapy conference was held in Germany, with around 200 participants. It included workshops on mental disorders such as addiction, depression, anxiety and PTSD. Pracki also gave a talk on the role of rock climbing in his recovery. “The attendees were so happy to meet other people working in the climbing field,” says Zajetz.

In Germany, several clinics and hospitals have climbing walls, so therapists can prescribe a bouldering exercise as part of a procedure. Outside of this setting, however, it is more difficult for patients to access block psychotherapy. Zajetz’s patients pay him privately for block sessions. Luttenberger hopes that the situation will change in the coming years so that block treatments are finally officially recognized and covered by health systems. As she points out, it could be a good alternative for people who might otherwise be wary of the stigma of conventional therapy. Over the next few months, she plans to release a manual for therapists based on the program she refined through her research. Zajetz also organizes regular trainings at the Institute of Climbing Therapy for instructors and psychologists interested in the approach.

After leading sessions for Luttenberger’s research, Vigg, ​​who lives in England, says she now plans to turn her entire practice into block therapy. “It’s definitely worth getting out of the therapy chair and being active with patients,” she says. “I have worked with psychotherapy, both inpatient and outpatient, with groups and individuals, and I would say from experience that it is the easiest and most joyful way to do therapy for people. patients and therapists.”