Giovanna Boriello is a specialist in forest medicine and Forest Bathing, disciplines that study the positive impact of contact with nature on psychophysical health. The practice of Forest Bathing, known in Japan as Shinrin-Yoku, is based on conscious immersion in the forest to reduce stress and promote wellbeing, with benefits increasingly supported by scientific research.
- Giovanna, how did your interest in Forest Medicine and Forest Bathing come about?
My interest in Forest Therapy (FT) was born in the midst of the COVID-19 era, in April 2020, thanks to my acquaintance with the young veterinarian of my dogs, who had been enrolled a few months ago in the course for expert facilitator in Forest Therapy. She introduced me to this reality and made me passionate about it, of which I was aware with respect to the basic rationale, but I did not know at the time that an association existed in Italy as early as 2018, namely AIMeF (Associazione Italiana Medicina Forestale), created to promote its dissemination and to involve users in Forest Bathing experiences.
My great love of nature, which has accompanied me since I was a child, combined with the opportunity to learn the basics of this discipline in depth and, above all, to be able to prescribe forest bathing on the basis of specific expertise, prompted me to enrol on the course and, shortly afterwards, to become fully involved in the management of the association in the role of scientific officer and coordinator of the scientific committee.
- How did your path lead you to become interested in Narrative Medicine and to attend the ISTUD Master’s course? How do these two subjects intertwine?
As far as narrative medicine is concerned, having been dealing with multiple sclerosis (MS) for 25 years, a disease that is extremely complex and varies from person to person, I have been able to verify how much the experience of each individual affected person is decisive in the management of symptoms, treatment compliance and the evolution of the clinical picture. Caring for people with MS requires great listening skills, empathy and a willingness to recognise that each person (and their family) bears the burden of the disease in a different way. Not wanting to take into account individual characteristics and experiences risks losing the focus of patient care, which is not to find the right drug among the many fortunately now available (or rather, not only that), but above all to ensure an adequate quality of life and the possibility of maintaining one’s dreams, expectations, and peculiarities. The need to give a structure to these skills and intuitions led me to narrative medicine and the ISTUD master’s degree; a unique opportunity to delve into this approach that is unfortunately still little applied and developed in terms of its potential also in the field of health economics and burn-out protection.
- What are the main documented benefits of forest medicine on patients with chronic diseases such as multiple sclerosis or mental health disorders? Are there also benefits for health professionals and caregivers?
The documented benefits are many and relate in particular to psychological well-being, physical endurance, the ability to manage the severity of symptoms and their fluctuations, pain relief and reduced reliance on medication to treat various symptoms (spasticity, anxiety, asthenia and pain). On some dives I organised, I witnessed an immediate and lasting improvement in physical and mental parameters; in particular, a reduction in anxiety and anger, even after a single 4-6 hour dive. The caregivers present and the caregivers themselves reported tangible benefits in terms of release of muscle tension, improved mood and sleep, and prevalence of positive thoughts.
- What kind of training is required to become a qualified forest medicine practitioner?
The training provided by our school includes a course that is partly distance learning, with lectures and webinars available on a platform and therefore accessible at any time; seminars and in-person training activities; and an intensive in-person course lasting 5-6 days to put into practice what is learnt during the lectures. A final examination must be taken with discussion of a thesis that the candidate develops with the support of one of the school’s tutors. This course is open to all, with different examinations depending on the individual’s background. For example, it is not necessary for medical doctors to take the human physiology exam, while the plant physiology exam is indispensable, which is not required for biologists and herbalists. The course lasts approximately six months if one maintains constant attendance and study.
- How can we make the health world and the public aware of this practice?
Raising awareness in the health world is one of the fundamental points of our mission, because especially in Italy, at an institutional level, Forest Therapy is little known, as are its many benefits on psychic and physical health, such as the possibility of approaching it in terms of preventive medicine in so many areas, such as metabolic, autoimmune, allergic, and psychic diseases, in the phases of rehabilitation and post-operative recovery, and in the prevention of obesity and social withdrawal syndromes and dependence on technology in children and adolescents. Talking about this approach in schools and community settings would certainly be a good way to make FT practices and its objectives known.
- Is it possible to include Forest Bathing in urban contexts? If so, what are the most effective solutions, are there any virtuous examples?
As a matter of fact, there are many FT experiences to date, even if they are not adequately known, covering all Italian regions, both in the context of projects for the qualification of woodland areas and of activities to bring people closer to nature for all age groups, but also for people suffering from chronic pathologies (in particular, our attention is focusing on oncological diseases).
Villas and city parks, especially those far from city traffic, lend themselves well to FT experiences, especially if they last for at least 4-6 hours, during which group games, mindfulness or meditation activities, or yoga practices can easily take place. In Rome, the city where I live and work, immersions in Villa Pamphili or the Pineto Park are frequent. Throughout Italy, our expert facilitators organise activities in city parks: in Cremona, for example, our graduates Chiara Maracci and Giovanni Bosio have organised many creative and meditation courses and activities in city parks and kindergartens. In Sicily and in the Sila mountains, we have organised important woodland qualifications, as well as in Tuscany in the Casentino. In recent years, I personally have been following very closely the activities involving the Certosa di Trisulti in Ciociaria – a beautiful and little-known land in terms of its forest heritage – to integrate oncological monitoring protocols in women with gynaecological cancers with forest diving.
- How do you see the future of forestry medicine in Italy in the coming years? Are there any ongoing collaborations or pilot projects?
I am very optimistic about the future of FT. In particular, in the application of integrated and complementary medicine projects for chronic patients, in population prevention against today’s increasing pathologies such as dysmetabolic, psychological and oncological diseases. We have numerous ongoing collaborations with very serious and deep-rooted associations, such as the WWF, and with a number of universities (Florence, Catanzaro, Naples), but above all with dedicated outpatient clinics in various hospitals in the area, both in the neurological field and for pathologies of the airways (including COVID) and oncology. The aim is to make a growing number of doctors, nurses, health workers and educators aware of the potential and easy applicability of FT, disseminating the experiences gathered, sharing existing scientific data and those in the pipeline.