UKC

Has anyone come across this    https://www.climbing.com/skills/climbing-as-a-form-of-therapy/   It's an article backed up by a lot of research over the last 6 years in Germany. It says that bouldering is as good as CBT and better than structured exercise in terms of reducing depression in adults.I've been working with a group called Urban Uprising introducing disadvantaged and often depressed young people to bouldering for a couple of years. The article looks like a nice bit of hard scientific evidence to suggest bouldering might have a measurable effect as an antidepressant. It also mentions a psychotherapist (and boulderer?)Lisa Vigg who is living and working in England proposing to implement 10 week bouldering therapy courses, but i've failed to find her so far. Has anyone come across her?  Harder scientific stuff here ->   https://bpspsychub.onlinelibrary.wiley.com/doi/full/10.1111/bjc.12347

Thanks for that. I've considered climbing as therapy for many years - particularly indoor bouldering.

Current events in my life have seen me throw myself at the wall that little bit harder. I wondered if it was selfishness, 'running away', or escapism if not a form of therapy. It's nice to have some suggestion that it is the latter.

Interesting, but some observations (based on a quick read and my not being an expert in this field):

1. The improvements were seen when psychotherapy was used in the context of bouldering rather than suggesting that bouldering alone could show improvements.

2. The conclusion was that this approach (BPT) was "no worse" than CBT.

3. The point that bouldering may be more effective than other physical exercise was speculated rather than tested. The trial only tested psychotherapy+bouldering against CBT.

Having said that, I've always found any form of climbing to be mentally 'healthy' (post-work stress relief), albeit for someone who's not been clinically depressed.

1)I was interested in how they devised the sessions, but there was little info on that,which is why I looked to find Lisa Vigg. I thought the outline included much of what some bouldering coaches use(tell me I'm wrong -I'd like to know)as in thinking about objectives, wellness exercises, games such as blindfold bouldering etc

2) Given the plaudits CBT has received in recent years as a talking therapy for depression I thought that was pretty good and a definite alternative for people not wanting to engage in talking

3) Sorry, see this link for exercise compared to bouldering. It was part of the same study (so same standard of rigour?) that ran in Germany until recently. There are a number of papers from various authors all involved in comparing bouldering, CBT and home exercise https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-020-02518-y

I can totally believe it.Climbing was one of the first activities studied when theories of the flow experience were developed.By uniting your mind and body you often can shut off internal dialogue (not always) Surely this is an ability that constitutes a large part of the journey back to mental wellness ?

I don't mean to sound negative, but there's a world of difference between what you (the generic 'you') believe, what you *want* to believe and what may actually be true. We humans are all very good at defending delusions that make us feel better! I liked what I read of the trial - it seemed to have been done and reported with commendable rigour - but the results didn't support the contention that  climbing ".... constitutes a large part of the journey back to mental wellness". I'm interested to see how their work progresses, but let's not pretend that it has (so far) come to any remarkable (and defensible) conclusions beyond "it's no worse than CBT".

A few years ago I published an article in the final (sadly online, sadly no longer available) Climb magazine on climbing and depression. FWIW, I'm copying it below. May be of interest.

***

The last time I got seriously depressed was the spring of 2016. Looking back, I brought it on myself.

After a year on new medication I’d been feeling good. Really good. So good, in fact, that the pills seemed to have done their job. And from February I was heading to sunny California for three whole months of academic research leave, dodging the last of the vile British winter. Obviously, I was better now. So at the end of December, I tapered off the pills.

The truth is, nobody likes being on medication. Especially for a mental health disorder. And the thing with anti-depressants is that when they are working, you forget what it was like to be depressed. You also forget that it’s the drugs that are making you OK. Precisely because they are doing their job, you think you don’t need them anymore.

I crashed in mid March. Hard. The old thoughts about the pointlessness of my life (and of everything else) returned. So did the anxiety. The racing heart and the inability to think sanely about what I’d done in the past (all bad) and what I’d do in the future (all hopeless). I stopped wanting to see the new friends I’d made. I started getting out of bed later and later. I was eating more and more 6-packs of $1 Walgreens cookies, alone, in front of Netflix.

But I’d been here before, and so I knew a few tricks. Exercise – as any doctor will tell you – is hugely beneficial in fighting depression. And it happened that I was training for a marathon at that point (my first, and most definitely my last). But if you’re depressed, long runs have a downside. Before the post-exercise reduction in anxiety and despondency, you spend hours on your own. Thinking. Endlessly. About how everything is pointless. About how soon you’ll be dead anyway, so you may as well just hurry up and get it over with now. Rumination is one of the most brutal aspects of depression. Being trapped in a cycle of your own negative thoughts is the essence of the condition – and often the hardest thing to beat.

So I knew that whilst I had to keep on with the marathon training, there was somewhere else I needed to go: the bouldering wall.

*

In a recent study from the University of Arizona, researcher Eva-Maria Stelzer conducted a controlled trial that aimed to determine whether bouldering could help individuals with severe levels of depression.[1] The results were striking. Those individuals who began a bouldering course ahead of a control group of wait-list patients improved markedly by comparison. Although bouldering was not offered in isolation - it was introduced along with mindfulness techniques and pyschoeduation – the effects seem nonetheless to be real.

This is only one study. More will be needed to prove conclusive links. But it is worth noting that in Austria and Germany climbing is now well-established as a form of therapy for both physical and psychological problems.[2] And as Stelzer has been keen to emphasise, there shouldn’t be anything surprising in her findings. This is because alongside the known link between exercise and treating depression, bouldering offers something else: intense concentration on the problems being climbed.

Given that ceaseless negative rumination is at the heart of much depression, finding a way to switch that off for just a couple hours is far from trivial. When you’re bouldering (and I’d say this is also true of route climbing) you have to be present to the task in hand. There just isn’t enough capacity in the human brain whilst climbing to think about anything other than what your hands, feet, and core are doing. Put simply: you won’t be able to ponder the pointlessness of existence when you’re crimping hard, or trying to make that final jug. You’re in the moment. And in the moment, you’re not depressed.

There’s also the fact that bouldering is highly sociable. Climbing in general is a friendly sport, and most people at gyms are happy to help each other improve technique, swap beta, joke around, and so on. This, again, is not trivial. Self-imposed isolation and anxiety about associating with others are key features of depression. What a bouldering gym offers is low-stakes human interaction. You can just chat about climbing the problems, not about life and its horrors. Similarly, the fact that some neutral thing is being focused upon removes the specter of small talk, and the potential awkwardness of interacting with strangers that can be terrifying for those suffering from depression-linked anxiety. Again, these may seem small or incidental benefits. But to those that need them most, they are invaluable.

*

In that spring of 2016, I think I’d figured out by accident what Stelzer’s study seems to show. I’m certainly not surprised by her findings. Anecdotally, I can corroborate them. And whilst it would be an exaggeration to say that Iron Works gym in Berkeley saved my life, it definitely made my life easier to get through for several crucial weeks.

Luckily I didn’t sink so low that I couldn’t even motivate myself to climb. And in truth, what ultimately got me through was the support of friends old and new, plus a $200 trip to the emergency clinic for a new prescription. Climbing was no magic bullet – but it helped me cope, and it helped me get better.

Since returning to the UK, however, I’ve found that climbing can actually be even more than just a short-term coping device. When I was in America I became close to a colleague, Nick, and his wife, Katherine. Both avid climbers, they looked out for me when I wasn’t doing well, and hung out with me at the gym. They also took me on trips outdoors to the semi-secret Gold Wall, as well as putting me up my first Yosemite crack.

I completely sucked at climbing routes back then, and they were blessedly patient with me. But what I saw in the process was just how much they made climbing a part of their lives: beyond a hobby, into a lifestyle. And I saw the deep satisfaction it gave them. When I bemoaned that Cambridge (UK) is three hours from the Peak District, so I could never climb outdoors, they laughed at the idea of three hours being a long drive. In fairness, Americans really don’t have any comprehension of how different our windy, round-a-bout filled roads are! But I took the underlying point to heart. If I wanted, I could climb a heck of a lot more. I just needed to choose to make it happen.

After I got back to the UK, once the marathon was out of the way I started taking climbing a lot more seriously, moving from casual bouldering to a dedicated approach. I’m an obsessive person, so this was pretty easy (especially as there were now marathon-sized holes of training time to fill). But in the process, something interesting happened.

All of my neurotic energies – which previously went into either academic research, or self-loathing – started going into climbing. It also helped that I met a girl, Ali, who’s not only willing to come climbing (at least some of the time), but has a good instinct for which of my nonsense to tolerate, and which to tell me to cut out pronto.

Ali says I’m too obsessed with climbing. And she’s right. But pouring over topos, or doing endless ARC training at the gym, are vastly preferable to reading David Foster Wallace alone, for hours on end, eating too many Walgreens cookies, and thinking “well he killed himself, so I probably should too”. And if I’m going to over-indulge, better to be a hopeless grade-chaser than dependent on the bottle, or worse.

Depression isn’t something I’ll ever entirely beat. There’ll be bad times again. And climbing is no miracle cure. I still need my meds, and without my friends, I’d be lost. But when the black dog bites – and someday it will – at least I know I’ll always have the wall.

[1] https://uanews.arizona.edu/story/bouldering-envisioned-new-treatment-depres...

[2] https://www.ukclimbing.com/articles/page.php?id=8502

I've worked in mental health for 25 years as a nurse and a qualified counsellor.Ive seen clients (on a top rope) shut their voices down once focussed/engaged with the climb.Climbing can teach you to access intense concentration( absorption in the moment) and shut off for that moment internal demons (eg hearing voices).What I would say is climbing /bouldering can't help everyone so comparing it to CBT is pretty tricky.Ditto CBT it's simply not going to be for everyone.Neither should   to be prescribed generically.

Just a quick point here - the article says that Lisa Vigg is a Psychologist, not a Psychotherapist.

I know this may seem like I'm being unnecessarily pedantic, but as a Psychology graduate I've spent the last 20 years or so trying to explain to people the differences between a Psychiatrist, a Psychologist and a Psychotherapist.  

Of course she may be a Psychotherapist as well as a Psychologist but let's not get into that....  That's like trying to explain to a non climber, having had the "free climbing" conversation, what an aid solo is!

Thank you. I do understand the problems of explaining the difference, if not understanding the difference very well. It may well help in my quest though. The research paper mentions her but I can't find any other references to her and I do feel intimidated by questioning a German research psychotherapist on their scientific method.

Had a quick look to see if I could help you find Vigg but no joy. There don’t appear to be any psychologists registered with the HCPC under that surname. HCPC aren’t the only regulating body for psychologists, but I’d expect anyone working in a mental health context to be.

One possibility is that the article got it wrong and she is in fact a psychotherapist after all. In which case a search of the BABCP, BACP and UKCP registers might help you find her. 

It’s also not uncommon for healthcare workers to be e.g. registered under a maiden name and go by a married name. Although most stick to whatever name they are registered under for anything work-related.

She could also not be a psychologist in the chartered and regulated sense. Technically, anyone can call themselves a psychologist. The protected and regulated titles are more specific e.g. clinical psychologist, sport psychologist, forensic psychologist etc. 

You could maybe ask the article author to pass on a message. They presumably have some contact details for her. 

Given the recent positive reception of the article about climbing on here it's worth pointing out that CBT is borderline useless, or even harmful, for common causes of depression in autistic people, it basically just says to pretend it's not an issue and fake it 'til you make it. For neurotypical causes of depression that can work, if you're depressed because you keep experiencing sensory overwhelm it's like trying to run a marathon on a broken leg.

If someone can deal with the sensory environment of a climbing wall I'd say it's probably applicable to a greater range of the population.

So I'm guessing here, but to map those terms into my field:

Psychologist -> Theoretical physicist (develops plausible concepts)

Psychiatrist -> Experimental physicist (tests whether those concepts makes sense in the real world)

Psychotherapist -> Engineer (uses the output of the above to actually try and do something useful).

Is that about right?

That’s not the principle of CBT. That sounds more like a case of CBT being inexpertly delivered by people who don’t have an adequate understanding of either CBT or autism. 

Yeah along those lines, but it’s a bit more complex than that as you get lots of different types of each - clinical psychologists, research, occupational etc… 

Easist way to remember it 

Psychologist - Somebody who has studied psychology. Often a doctorate degree in it (much more in depth than my crappy little BSc!)

Psychaitrist - Actual proper qualified medical doctor who specialises in mental illnesses. Can prescribe medicines.

Psychtherapist - Could be one of the above, or neither. It’s basically anyone who is providing talking therapy to a client. Not a protected term and there are some people out there calling themselves this who really give this role a bad name.

This is I guess how I remember it, but it’s not great, and it’s been over 20 years since I’ve been anywhere near it, so if please forgive me if this isn’t good!

No, not a good analogy I'm afraid. I don't have a good alternative analogy for you though, sorry. There's also a lot of overlap which complicates things.

Clinical Psychologist (there's other types but this is the one you'll find in the same places as psychiatrists): Doctor (non-medical). Average of 13 years to qualify, usually working clinically in NHS services. Assumes that we can treat psychological suffering most effectively by combining an understanding of human functioning and an understanding of an individual's situation to identify and change causal patterns that are creating and maintaining problems in someone's life. Generally picks up the most complex cases in any given service.

Psychiatrist: Doctor (medical). About 11 years to qualify, usually working clinically in NHS services. Assumes that we can treat psychological suffering most effectively through precise (although not scientifically valid) labelling of symptoms, and prescribing treatment based on that label. Most treatment is in the form of medication.

Psychotherapist: Can mean all sorts. Usually postgrad diploma or masters qualification. Qualify in 4-5 years. Trained in delivering a single type of therapy so if that isn't appropriate they aren't necessarily able to adapt the treatment plan to fit the person in the way the other two can.

This is a far better explanation than mine.

Thanks for that. Interesting.

20+ years of going back an fore to the doctors with stress / anxiety. CBT has always just given me one more thing to stress about, though talking therapy has occasinaly provided perspective.

Same as journaling. I paid for a 6 week mindfulness course once when suffering a lot of work and academic stress. The trainer was keen on the journaling and reflective practice side of things. But the idea of having just more forms to fill out killed it for me. The trainer just couldn't understand the problem! Same as a lot of app based support.

I miss bouldering but it gets a bit 'all consuming' and with my nearest wall a 40min trip each way its hard to get there more than once a week, which makes progress pretty tough! I do find it one of the most mindful & effective ways of managing mental health though.

That's an interesting angle. We all need to find our jam, I guess.

"When the student is ready, the teacher arrives."

Maybe accept that one size rarely fits all and we always need to look for a range of solutions to problems humans have. 

Aren't we just still exploring what autism is. I think sorting depression if you are autistic is a whole other area of study as far as most neurodivergent people are concerned. I certainly feel completely out of my depth just writing this.

I quickly scan read the article....I'm not convinced there is anything unique to bouldering rather than other activities or sports, but, for sure being active, engaging in physical exercise, having company and good banter is really helpful for mood related difficulties. 

There is quite a lot of evidence, of different types in the Occupational Therapy world relating to therapeutic activity  including some climbing related!

Sounds good what you are doing with the kids you are working with....I work in a consultation service for looked after children and young people but often wish I was doing something like this and being a bit more connected through activities etc...

Lisa used to climb at a wall in Devon, but moved back to Germany a few years back.

Talk to Urban Uprising https://www.urbanuprising.org/

Given the number of climbing walls keen to put something back into their local community around the Peak they may take up your offer.

This is quite interesting but I dont think that bouldering is somehow hugely different from other sports in allowing you to think about other things other than your depression, and creating an environment for exercise that is known to help some people that suffer from depression. Its probably hugely individual, like CBT or other therapies such as Music therapy, walking therapy, clay therapy, baking therapy, yoga therapy, etc. Some might work for some people and others will probably not work for others, thats why there is such a diverse range of therapies that people try and engage in. One size does not fit all. One thing that bouldering does that is not exclusive to bouldering but probably helps people with depression is that it can help some people that have social anxiety or depression to engage with others in a friendly environment. This can help get you come out of your depressive phase as you interact with others, even if it is only for a little while. It can help you build up some confidence and help you come out of the fog that you sometimes feel perpetually surrounded by. It could also help you think about other things, especially if you suffer from racing thoughts. It can break this cycle of thoughts forcing you to figure out a problem that you have to solve. Again, this could help break up the enforcing thought patterns in your head. It could also help with self worth. 

However the thing is you could find these things in other therapies as well. It will also not be for everyone. If you dont like the feeling of dry hands or heights, then probably not ideal. If your anxiety presents itself through handwashing or other coping mechanisms then it might also not be ideal, but again might help. If being around a lot of other people triggers a panic attack then also not ideal. This is unless you really want to go in on exposure therapy, which can help some people. I climbed throughout my depression and still do. I cant say if it actually helped because when I was deeply depressed I could not even fathom leaving my bed, let alone opening the door and getting an anxiety inducing bus ride to the bouldering wall where I might then have to buy a day pass (interact with people) and then pray no one talked to me. People laughing, paranoia when on the wall, the burning self awareness when trying a boulder, making eye contact and having the feeling people are judging me and looking into my soul simultaneously. The list of anxiety triggers is prett much endless.  In this scenario while bouldering itself can present itself as a useful therapy, it also brought with it a lot of anxiety and often presented itself as a huge hurdle in itself. What I am getting at is that there is a lot that goes into bouldering that is not just a short therapy session at the wall, there are loads of other factors that affect you and whether it can help or even make it worse.

Thank you for this. I'll go back to contacting the researchers in Germany.

Possibly not the principle of CBT, but that is how a lot of autistic people seem to perceive it. I remember being given lots of worksheets about reframing my thought process, it was totally inappropriate as a methodology to treat someone experiencing suicidal depression as a result of child abuse and regular sensory overwhelm, it may be useful if you are having a short term issue, or something without a very clear cause.

The efficacy of CBT is far from the only area where the medical profession is appallingly out of step with the needs of autistic people though, it is much more well attuned to the needs of parents of autistic kids than it is those kids, or autistic adults.

It's pretty well defined how it affects people and that it is something you have to work with/ around rather than cure (anyone who claims to have a cure at the moment is a charlatan). The exact genetics are unclear (unfortunately research in this area has been held back by unethical practices in the past).

Lots of stuff that works for neurotypical people will work for autistic people too. Psychoeducation can be amazing, CBT was a waste of time so that my GP could say they were doing something. You need to consider more factors in terms of treating depression in autistic people such as their sensory environment at home and in work.

Thanks for this Phil. I've now contacted the Erlangen University to see if they have any further information about the programme they used in their study and if it's been tried outside of the trials. 

The systematic reviews and meta analyses of research generally conclude exercise is as good as talking therapies or SSRIs for mood disorders. There are suggestions that dance, aerobics, running, and weight lifting are particularly effective but the differences in effect sizes are quite small. I've sat on research grant awarding committees where people have said, paraphrasing, 'we don't need any more studies on different flavours of exercise or CBT, we know they work'.  

Climbing has not yet been included in a large meta analysis to my knowledge but I'm choosing to think of it as a marriage of dance and weight lifting! It's hard to imagine it won't be helpful for people who are already interested in the idea. The two German studies linked recruited partially by mass media advertising so anyone who didn't like the idea of climbing excluded themselves. This applies to many studies of this nature and we don't know the proportion of the wider population with depression likely to find climbing helpful. This also applies to dance, weight lifting, yoga, or any other kind of exercise for that matter.  

All clinical trials take the average outcomes from a whole bunch of people of course (and often the hard-to-help are excluded from research) and thankfully not everyone works in the same way. If climbing is good for your mood that's great.  It's not for everyone - even people who have previously been keen climbers - and folk should try not to feel bad if they can't climb because of their mood or it doesn't give them a lift.