May 08 2007

“I go to nature to be soothed and healed, and to have my senses put in order.”

John Burroughs, American naturalist and essayist As they methodically prepare the ground for planting poppies, the group simply looks like a team of gardeners lost in thought.

But the men are veterans suffering psychological trauma after harrowing tours in combat zones, and their labours are a form of therapy designed to treat their illnesses.

This is the first time horticultural therapy has been used to treat former service men and women with post traumatic stress disorder (PTSD) and other combat-related mental health problems.

The simple act of gardening and working outside in the fresh air, away from medical wards, staff and patients, is already used in several hospital settings and is useful for helping patients relax and become more susceptible to treatment.

Now at Auchincruive, the Scottish Agricultural College near Ayr, veterans from nearby Hollybush House, the treatment centre run by the charity Combat Stress, are using gardening to complement the psychotherapy they already receive.
Anna Baker Cresswell, who founded the Gardening Leave charity to oversee horticultural projects for veterans within walled gardens, is running the two-year pilot project.

“We are using the medium of plants to achieve certain clinically defined goals,” explains Cresswell. “The task of the horticultural therapist is to assess veterans’ physical, cognitive and emotional needs and skills, and encourage them to undertake tasks that will motivate, benefit and reward them during their time in the garden and beyond.”

A peaceful garden is the antithesis to the backdrop the veterans are used to, having experienced the horrors of conflict in the Falklands, Iraq, Afghanistan and other theatres.

But the choice of a walled garden is significant, as it allows them a clear view and there are no hidden corners, important factors if they are to relax.

“It is hoped the veterans attending the project will benefit by improving their social skills by engaging in conversation; their motivational skills, such as punctuality; and their personal skills such as appearance, health and fitness,” says Cresswell.

“Because gardening goals can be broken down into simple tasks, it is possible to start and finish something in a short space of time.

“In the case of a strawberry plant, by potting on its runners, hope for the future and confidence in the cycle of life can both be engendered and promised.”

Cresswell is working with military psychiatrists at the Ministry of Defence to devise a programme of assessments to determine whether horticultural therapy is a useful tool in treating veterans with PTSD. If successful, it could be rolled out to the other treatment centres run by Combat Stress.

Initial results appear promising, with veterans keen to incorporate the therapy into their recovery programme.

Fittingly, Auchincruive is also the home of the National Poppy Collection, although in recent years the collection of 170 cultivars has gradually decreased as plants have either died or been stolen.

Through Gardening Leave, Cresswell hopes to rejuvenate the collection with the veterans by sourcing as many of the early cultivars as possible.

Cresswell initiated the project after witnessing the devastating effect of PTSD when a friend returned from serving in the Falklands with emotional scars.

Then when Cresswell’s mother, a Nightingale nurse and passionate gardener, became ill with Parkinson’s disease, she cared for her until her death. “Both experiences had a profound effect, and prompted me to set up the Gardening Leave project,” explains Cresswell, a horticulturist who hails from Northumbria. She adds: “Gardening is such a diversionary activity, but I am encouraged that the veterans see this as therapeutic treatment rather than just a leisure activity.”

It is hard work, but it has been amazing and worthwhile to see the difference we can make here

Veteran Jim Edwards, 53, who has been visiting Hollybush for five years, was enthusiastic about the project. “Being out here in the fresh air and concentrating on the job is helping me to forget about my problems,” he says. “While I’m pottering about I have nothing in my mind and I’m just doing my best.”

A former company sergeant major in the Royal Irish Ulster Defence Regiment, he spent 20 years in Ireland and experienced significant levels of combat that have left him with chronic PTSD and a severe injury to his right leg.

Last year he spent several weeks in a psychiatric hospital and admits: “If it wasn’t for Combat Stress I wouldn’t be here now.

“The organisation helped me when I was in the depths of despair and I think this is one of the best projects they have ever done.

“It is hard work, but it has been amazing and worthwhile to see the difference we can make, and I am proud to say that I’ve had a hand in transforming the garden and helping to reinstate the poppy collection.” He adds: “Hopefully, the next time I visit Hollybush the garden will be in bloom.”

PTSD, also sometimes known as shell shock, can manifest itself many years after an event, leading to drug abuse, alcoholism, depression or suicide.

Roughly 8000 veterans in the UK are receiving treatment from Combat Stress, and Hollybush House is one of three centres run by the charity to help veterans.

Gary Walker, clinical manager of Hollybush House, says: “The value of therapeutic horticulture has been well documented over the years, especially for people with mental health problems, to increase confidence and promote self-esteem because it relies on creating something, yet remains undemanding.”

Hollybush House deals with more complex cases of PTSD among veterans of all ages, many of whom have been in combat several times. The charity can fund up to six weeks a year for veterans.

“This therapy is not compulsory, but feedback has been very positive from patients. It is also very nice that they, as former service people, are reinstating the National Poppy Collection.”

Clive Fairweather, an SAS Commander who now works as a fundraiser for Combat Stress, saw horticultural therapy in practice during his former role as Scotland’s chief inspector of prisons.

He said: “Several of the more successful lifer establishments had walled gardens within their high perimeter fences, where volunteer prisoners could work outdoors on various supervised projects.

“The aims were not too dissimilar to the project at Hollybush: an opportunity to work in peace, in the company of a few other like-minded souls, away from the noise and clamour of every day life; chances to notice the changing seasons, to see, smell or even eat a rewarding final end-product, and something which might be returned to at a later date, as a small but important answer to idle hands, when finally returning to an empty home.”

He added: “Getting back close to nature may not suit everyone, but for others, the end result may be a brand new way of communicating and creating; and one which could become a cherished lifelong companion.”

Gardening as therapy dates back to classical Egyptian times, says Fiona Thackeray, the director of Trellis, the Scottish Therapeutic Gardening Network.

“It was also used in the Victorian asylums, but when they came to an end the technique was thrown out with the bathwater,” she added.

“But I fervently believe it is good for the majority of people. Gardening is a flow activity, in that you become absorbed and lose track of time.

“This is important for health and happiness, and is the opposite of stress.”