Flexibility in Treatment: A Trial of Walking Psychotherapy

Flexibility in the psychotherapeutic frame of treatment arises from many sources, from the general to the personal, and can take several forms. This article looks at walking while conducting psychotherapy with patients and explores the ways in which flexibility in treatment can enhance the alliance, how walking side by side brings the body into focus with its implications for transference and countertransference, and how associations to landscape evoke past memories and access emotions. Issues relating to self-disclosure and boundaries, as well as patient responses to the psychotherapist's personally driven request to consider walking during psychotherapy are addressed. Since writing this article, the coronavirus pandemic has swept across the world and required psychotherapists everywhere to bend the frame of treatment and meet with patients virtually-by phone or video conference-to maintain social distancing and prevent the spread of infection. The hardships posed by this shift in treatment frame combine with benefits not dissimilar to those found with psychotherapy while walking.