Twelve years ago, in his mid-forties, psychotherapist Andrew Keefe found himself in a very stressful job—working with torture survivors—and really out of shape. Determined to get better, Keefe joined an outdoor fitness class. Hours of burpees and push-ups in London's Finsbury Park helped him get physically fit, but he was fascinated to discover that his state of mind also changed completely.
“Afterwards I would be incredibly relaxed – blissful,” he says.
Keefe decided to join the growing number of psychotherapists who are adding qualifications in physiotherapy and personal training to their resumes. As evidence of the complex and important connection between a fit mind and a fit body grows, more and more practitioners are learning how to treat both.
“I would like us to move beyond the idea of physical therapists and psychological therapists and just have 'therapists' whose training combines elements of both,” Keefe says.
“The knowledge of anatomy and physiology that I gained during my personal trainer training has made me a better psychotherapist. It should be included in every therapeutic training. Imagine a course that qualifies you as a psychotherapist and physiotherapist.”
Some gyms also look at body and mind. This year, Gymbox became the first fitness company to offer classes specifically aimed at mental fitness. Jess Parkinson, holistic master trainer for Gymbox, says the classes were added to the timetable because staff knew how much they were needed.
“One in four people experiences a psychological problem, according to Mind,” she says. “The classes are extremely popular and the most encouraging thing is that people come back when they feel the effects of the exercises. The feedback has been a joy, with members saying they have a better understanding of how to help themselves when they are stressed or having trouble sleeping.”
The link between mental and physical health is well established. The idea of social prescribing originated in Britainand exercise has been available on the NHS since 2019 as a treatment for mild mental health problems.
The Soma Space, a practice opened this autumn in Oswestry, Shropshire, by psychotherapist Kevin Braddock and personal trainer Jo Hazell-Watkins, is one of the few centers that combine exercise and mental health training in a targeted way.
Hazell-Watkins became interested after having a breakdown. “My debilitating symptoms of PTSD were less acute when I exercised,” she says. “So I couldn't understand why the impact of exercise on mental illness wasn't made more explicit by doctors and therapists. Or, on the other hand, the gyms themselves. Why are fitness images based on the aesthetics of losing weight or changing your physical state?”
After his recovery, Hazell-Watkins qualified as a personal trainer with an emphasis on strength training – an exercise This is believed to have a great benefit for PTSD. “It offers so much in building resilience, which carries over into life outside the gym.
“Mental illness often makes us feel 'less' in every part of ourselves, while physical strength makes you feel 'more' of everything – and the sense of achievement is practical and measurable,” she says.
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According to Keefe, there is a growing interest in the therapeutic use of exercise to process memories that cause trauma or depression. “This has led to approaches such as running therapy, which boomed during the pandemic, boxing therapy, trauma-informed weightlifting and mindful running.”
Hazell-Watkins has personal experience with how physical therapy can rewire the brain after PTSD. “There is an assumption that PTSD flashbacks are somehow cinematic, but for me they were overwhelming sensations in my body that would leave me confused for hours,” she says.
“When you lift weights, you have to be fully present to lift safely. Breathing is fundamental, as is getting the form right: it literally rewrites the neurological pathways with new positive patterns, and over time these new pathways start to take over from the more negative ones.”
Braddock is trained as a boxing and fitness instructor and is also a certified psychotherapist. He also practices martial arts. He believes that what is really needed is a fundamental change in the way we view mental and physical states.
“We're still struggling with the Cartesian mind-body divide – I think, therefore I am,” says Braddock. “Practices like tai chi and yoga seem to understand that physical movement creates psychological unity – what we might call mental health.
“Strength training can build self-perception of strength, as well as measurable improvements in actual muscle strength. This is especially valuable for people who think barbells and boxing gloves are only for big, muscular guys and not for them.”