Green Road Construction Under Way

deer stands in a shady forest area

An Oasis of Respite for Wounded Warriors

Service Members and veterans receiving treatment at Walter Reed National Military Medical Center (WRNMMC) will soon have access to a woodland oasis where they can experience the healing calm of nature to aid their recovery from catastrophic injuries and illness.

The Green Road Project, an initiative of the Institute for Integrative Health, is scheduled for completion next fall, offering service members and their families a 1.7-acre natural haven in which to connect and spend time in quiet contemplation, away from a routine of medical appointments and rehabilitation. Once the Green Road opens, researchers on the project team will conduct a study to measure its impact on healing.

The Green Road is the brainchild of Institute Scholar Fred Foote, MD, a retired U.S. Navy neurologist and long-time champion for complementing conventional medicine with exposure to nature and the arts.

“We believe and have evidence to support that if you bring a sick or injured person into a natural environment, it lowers their stress and speeds their healing,” said Dr. Foote. “That’s especially true for the invisible wounds of war: brain injury and post-traumatic stress disorder.”

Service members’ injuries, both visible and invisible, can take a long time to heal. Many patients and their families spend months on the campus, staying in one of the 400 long-term living units at Naval Support Activity Bethesda, the military base where WRNMMC resides.

The Navy is constructing a wheelchair-accessible path that will connect these patient residences to the Green Road’s primary garden, forming a half-mile vehicle-free route across campus.

The garden, to be constructed by the Institute and its partners, will include a communal pavilion for informal gatherings, a streamside path, and a commemorative pavilion for remembering and honoring fallen comrades. Benches, a council ring where Warriors can share stories of valor and loss, and a soothing water feature will enhance the Green Road’s naturally therapeutic environment.

Measuring nature’s healing power

The Institute and its partners will conduct a research study to quantify the healing effects of spending time on the Green Road. Scientific evidence will advance the case for integrating exposure to nature into the prevention and treatment of illness.

“Viewing scenes of nature has been shown to lower blood pressure, respiration rates and the production of stress hormones,” said Institute President Brian Berman, MD. “Nevertheless, the health benefits of nature encounters are under-investigated and under-valued. That’s why advancing the scientific evidence for nature’s healing impact is so important.”

The study will involve examining biomarkers of the stress response, qualitative analysis of journals and stories using natural language processing, and advanced genomics. The research design is under review by the Institutional Review Board of the Uniformed Services University of the Health Sciences.

“When people come into close contact with nature, it has a way infusing their spirit and bringing them closer to their own true nature,” said Dr. Berman. “The impact of that on their psychological well-being, their emotions, and their mental state can be profound. The result of all this can be physical healing. We’re hopeful the Green Road Project’s research will shed light on this process.”

What’s next

A Green Road dedication ceremony is planned for September 2016. Donors, military dignitaries, veterans, Wounded Warriors, and their families will be invited to enjoy the Green Road’s beauty at this ceremony and experience the powers of nature.

Note: This post was updated March 15, 2016. It initially reported the dedication would be in June 2016.

Developing safety, persistence, trust

Healing is facilitated through safety, persistence, and trust.

  • Persistence: “People did not simply progress through this sequence and experience healing. The healing journey was a recursive, back and forth process. They found helpers, used the skills/resources that those helpers provided, found other helpers that provided more resources and used those skills and resources. As this process continued, people experienced a gradual amelioration of their suffering. Although many despaired at times, all demonstrated the quality of persistence—they refused to give up.”
  • Safety & Trust: “To connect to helpers, it was essential for people to feel safe in those relationships and able to trust that the person would be a helper and not a barrier to healing. Persons whose wounds included a violation of trust were especially careful about testing the safety of new relationships.”

Acquiring Resources

Resources support us as we heal. They include reframing, responsibility, and positivity. “Making connections enabled participants to acquire and refine resources and skills that were essential in their healing journey. People also brought their own personal strengths to the journey.”

  • Reframing: “A particularly important skill was the ability to reframe—that is to look at suffering through a different lens.” This does NOT mean minimizing trauma or pain, but rather it often means the opposite: understanding what happened was wrong, unfair, or uncontrollable and that we are not to blame for it.
    • “I think I kept trying to convince him I was crazy. And he kept saying, ‘No, you’re not crazy.’ […] You wouldn’t necessarily say a Vietnam Vet was crazy. You’d say they are responding like you’d expect to extraordinary circumstances.”
    • “I’m not the only one who have [sic] this problem. A lots, millions of people, you know. […] They don’t have nothing to do with that. I guess I have to live.”
  • Responsibility: While we don’t have control over what happened to us, we are the only ones who can help ourselves heal. “A third essential resource that people acquired or refined was the ability to take an appropriate amount of responsibility for their healing journeys. They participated actively in the process of healing. Once again, some participants already had developed this skill, and some acquired or refined it from their helpers.”
    “You need a lot of energy and a lot of work … it takes a lot of work. It doesn’t just happen. It’s not like a magic wand.” This patient understood that they had to actively participate in the healing process.
  • Positivity: “Another resource that people acquired or refined during their healing journey was choose to be positive—that is to have some optimism about their situation.” People have varying predispositions to positivity. In the study, positivity was important in helping people heal. This doesn’t mean a toxic positivity, but rather simply finding some good in life and feeling hopeful about our situations.

Helping Relationships

“Connection to others was an essential part of all the healing journeys.” Humans are social creatures, and even the most introverted of us need close relationships. Friends and family add meaning and value to life and help support us, in good times and bad. When we experience relational trauma, relationships can feel scary, but reestablishing safety and trust in relationships is where the healing happens. (To be clear, we do not mean reestablishing safety and trust with abusers, but rather finding other healing relationships.) “When safety and trust had been established, people were able to connect with helpers. The nature of the behaviours of helpers that fostered healing ranged from small acts of kindness to unconditional love.”

  • “Moving from being wounded, through suffering to healing, is possible. It is facilitated by developing safe, trusting relationships and by positive reframing that moves through the weight of responsibility to the ability to respond.”
  • “Relationships with health professionals were among these but were not necessarily any more important to the healing journey than other kinds of helpers, which included family members, friends, spirituality and their God, pets, support groups, administrators, case workers and supervisors.”

Healing

Healing probably means different things to different people, but one definition that emerged from the study is: “The re-establishment of a sense of integrity and wholeness.” Healing was an emergent property that resulted from each individuals’ complex healing journey, a result of bridged connections between resources and relationships. Healing, in this sense, does not mean cured—none of the study participants were cured of their ailments—”but all developed a sense of integrity and wholeness despite ongoing pain or other symptoms.” In varying degrees, “they were able to transcend their suffering and in some sense to flourish.” When we begin to heal, we find increased capacity for hope, renewed motivation to help others, and are more able to accept ourselves as we are.

Suffering

Suffering is the ongoing pain from wounding. There is debate about whether or not one actually needs to experience suffering on the path to healing.

Wounding

Wounding happens when we experience physical or emotional harm. It can stem from chronic illness or by physical or psychological trauma for which we do not have the tools to cope, or a combination of those factors. “The degree and quality of suffering experienced by each individual is framed by contextual factors that include personal characteristics, timing of their initial or ongoing wounding in the developmental life cycle and prior and current relationships.”