Twelve years ago, when he was in his mid-40s, psychotherapist Andrew Keefe found himself in a very stressful job – working with survivors of torture – and really out of shape. Determined to improve, 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 had also completely changed.
“After that 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 CVs. As evidence of the complex and important connection between fit minds and bodies grows, 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,” says Keefe.
“The knowledge of anatomy and physiology that I gained through training as a personal trainer made me a better psychotherapist. This should be included in all therapeutic training. Imagine a course that qualifies you to be a psychotherapist and a physiotherapist.”
Some gyms also look at the body and mind. This year, Gymbox became the first fitness company to offer classes specifically to help mental fitness. Jess Parkinson, holistic master trainer for Gymbox, says the classes were added to the timetable because staff knew how much it was needed.
“One in four people experience a mental health problem, according to Mind,” she says. “The classes have been hugely popular, and the most encouraging thing is to see people return when they feel the effects of the exercises. Feedback has been a joy, with members commenting on a greater understanding of how to help themselves when stressed or struggling with sleep.”
The connection between mental and physical health is well established. The idea of social prescription originated in the United Kingdomand exercise has been available on the NHS as a treatment for mild mental health issues since 2019.
The Soma Space, a practice that opened in Oswestry, Shropshire, this autumn psychotherapist Kevin Braddock and personal trainer Jo Hazell-Watkins, is one of the few centers that combines exercise and mental health training in a focused way.
Hazell-Watkins became interested after experiencing a breakdown. “My debilitating PTSD symptoms were less acute when I exercised,” she says. “So I could not understand why exercise’s impact on mental illness was not made more explicit by doctors and therapists. Or, from the other side, the gyms themselves. Why are fitness images based on the aesthetics of losing weight or changing your physical condition?”
After recovery, Hazell-Watkins qualified as a personal trainer with a focus on strength training – an exercise understand that it has great benefit for PTSD. “It offers so much in building resilience, which flows into life outside the gym.
“With mental illness, we often 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 increasing interest in using movement therapeutically to process memories that drive trauma or depression. “This led to approaches including step therapywhich rose in the pandemic, boxing therapytrauma-informed weightlifting and mindful running.”
Hazell-Watkins has personal experience of how physical therapy can rewire the brain after PTSD. “There’s an assumption that PTSD flashbacks are somehow cinematic, but for me they were overwhelming sensations in my body that would suppress me for hours,” she says.
“When lifting weights, you need to be fully present to lift safely. Breathing is fundamental, as is getting the form right: it’s literally rewriting or rewiring the neurological pathways with new positive patterns, and over time these new pathways begin to take over from the more negative ones.”
Braddock is trained as a boxer and fitness instructor as well as a qualified psychotherapist. He also practices martial arts. He believes that what is really needed is a fundamental factor change in how we view mental and physical states.
“We still operate under the Cartesian mind-body divide – I think that’s why 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 a 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.”
