Why I Run

What I Learned from a Running Therapy Session

A wave of psychotherapists are treating patients by running with them

Run, walk, talk: your running route is the new therapy couch. (Hannah McCaughey)
Photo: Hannah McCaughey running

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“I want you to let yourself get angry,” William Lent tells me.

It’s a steamy July morning in New York City, and Lent, a psychotherapist, is trotting along beside me on the eastern edge of Central Park. For the previous hour, he listened as I narrated a problem I’m having—typical therapy stuff. We began the session in the air-conditioned comfort of his Upper West Side office, then headed out for a jog. As we labor through the humidity, I search for the words to articulate my struggle, but Lent has something else in mind.

“I want you to run at whatever pace feels right and just let it out,” he says before giving me a demonstration. “I hate it!” he screams, to the evident distress of a nearby squirrel.

This is my first experience with running therapy, which seeks to combine the mental-health benefits of psychotherapy with those of physical exercise. Despite foregrounding a fitness component, running therapy isn’t about getting in a good workout. The idea is to inspire introspection through movement. “It’s a way of meeting the emotion you’re having head-on,” Lent says. “You’re not trying to avoid it. You’re trying to run right into the fire.”

Sepideh Saremi, a Los Angeles psychotherapist and the founder of a practice called Run Walk Talk, takes a less confrontational approach. “We’re paying attention to our bodies and to the environment in a deliberate way and using running to facilitate the talk therapy,” Saremi says.

There are several theories about why the convergence of self-examination and motion might be beneficial. One is that running shoulder to shoulder, rather than sitting face to face, helps us feel less exposed. Another is that running boosts candidness when it comes to revealing our inner lives. In his 2018 book Running Is My Therapy, longtime Runner’s World contributor Scott Douglas dedicates several pages to describing how it can wipe away verbal inhibitions. He mentions Indiana clinical psychologist Laura Fredendall, who hypothesizes that running quiets the prefrontal cortex—not unlike what happens after knocking back a few beers.

Running may also help engender a more trusting dynamic between the two parties involved. “The number-one variable is the bond between client and therapist,” says London-based analyst William Pullen, who wrote Running with Mindfulness and offers the therapy to his patients. “I believe that running side by side, with the client seeing you take every step they take, the camaraderie, that shift in power, the physicality, the sweating together, the getting smelly together, the being together—I think it advances the therapeutic effect.”

Pullen isn’t the first to make this observation. In 1976, a San Diego physician named Thaddeus Kostrubala published The Joy of Running, a manifesto on the transformative potential of the sport. Kostrubala first took up running to lose weight, but soon he’d incorporated it into group therapy. “I began to believe, in a shy way at first, that somehow we had discovered a new form of therapy,” he wrote.

In 1980, Kostrubala founded the International Association of Running Ther­apists, with the goal of establishing a set of guidelines for practitioners. (For example, he was adamant that anyone wishing to administer running therapy should train for and complete a marathon first.) The methodology never really caught on, and today there are only a handful of running therapists in the United States. Given its niche status, data on exercise-based psychotherapy is limited. Doug Mennin, a professor of clinical psychology at Columbia University’s Teachers College, notes that he would be “very cautious” about endorsing the practice without solid research to back it up.

However, Mennin points out that the anxiety-reducing effects of exercise are well established, something that running therapists also bring up in support of the practice. Saremi, for instance, believes that because the mental health benefits of exercise and talk therapy are widely accepted on their own, combining them is a logical step.

That isn’t to say running therapy is for everyone. Saremi told me that she doesn’t recommend it for patients who are struggling with a severe eating disorder or are prone to self-destructive impulses. But she does want the approach to feel accessible and stresses that athletic ability is largely irrelevant. In fact, she says that her less active clients are often more receptive to the treatment than exercise fanatics. (The latter group, she suggests, may already be reaping the mental health rewards of running.) Yet she’s adamant that while cardiovascular exercise frequently provides a psychological boost all by itself, running therapy isn’t something that can be self-administered.

“It’s about the relationship you form with the therapist,” she explains. “While running on your own or with a buddy can be therapeutic, it’s not necessarily therapy.”

I didn’t have any breakthroughs (or breakdowns, for that matter) during my accompanied outing in Central Park. But I did feel better afterward. My problems seemed less cataclysmic, and I experienced a flood of optimism as I headed for the subway. In other words, I felt the same way I always feel when I finish a run.

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