Therapy Gardening and Permaculture

Simon Lacey
Friday, 19th April 2019

Though the garden is the backdrop, Simon Lacey explains how permaculture adds a new dimension to horticultural therapy.

At Headway Cambridgeshire, we use permaculture in our work with people who have had a brain injury.

Before I go on to say more about this work, it’s worth saying a little about what brain injury is. Brain injury can happen to anyone at any time resulting from a simple fall to a major stroke, and it affects people in as many different ways as you could possibly imagine, from the physical and cognitive to the psychological and emotional. After an injury, I may not be able to walk without help, write a note to a loved one or hold onto my cup of tea. I might struggle to plan or problem solve day to day tasks like doing the weekly shop or catching a bus or I may suffer with crippling anxiety or deep depression.

Three years ago Headway secured funding from the Department of Health and Social Care’s Innovation Fund to run a nine-month permaculture gardening course. At the time of writing we are just completing our third course.

Each course has a mix of people who have had a brain injury, people who have experienced other kinds of challenges e.g. anxiety or depression, and those who wish to gain experience of supporting others. 

Why Gardening?

Gardening is unique among therapeutic practices, in that as gardeners we engage with living things and natural cycles. But change and loss are part of the cycle – there can be no birth and growth without decay and death. Through this perspective, the kinds of losses we might experience through illness or injury can be set within a wider context and engaged with more acceptance. We are able to be more open to loss and change when we see it as part of a continuous cycling where new birth and growth will follow. 

Disrupting Patterns of Thinking

In Nature, disturbed ground is often the catalyst for new growth. The first of our weekly sessions begins by exploring the role of the gardener and the function of a garden, helping people to challenge their preconceptions from the outset. Who or what is doing the ‘gardening’? This also helps us to rethink our assumptions about illness and injury.

Course attendees do not know at the outset which of their fellow participants are ‘injured or ill’ and who are ‘well’. This gives everyone the opportunity to learn that we all have contributions to make, that those contributions often come out of our ‘difficulties’ (as opposed to being in spite of them), that there is more that connects us than separates us, and the labels we are given can sometimes do more to cloud our understanding than to illuminate.

Sumita, who is on the course this year, says, “It does remove social barriers. I had my preconceptions, but when you strip that all away we are just a group of people working together. It breaks down that isolation.” 


When I first studied permaculture with Graham Burnett around 18 years ago, the thing that I came away with more than anything else was that I could do something. The problems of the world weren’t insurmountable and I didn’t have to be an expert to affect change. In fact being an expert could get in the way of creative solutions – once you think you know what you’re looking at, you stop looking. This applies no matter what, or who, you’re looking at (including yourself).

On the course, we value the insight of the beginner over the person who has done the job before. Beginners are more likely to ask new and interesting questions that the seasoned expert may overlook as they have ‘seen it all before’.

When we work on a task together, the person who has never done it before is the person who leads the discussion and challenges the group. Although this can be daunting at first, people soon settle into it and become more confident in the value of their contribution. What matters is not the information that we have but the questions that we ask.

The Problem is the Solution

Questioning is key when approaching classic garden ‘problems’. ‘Weed problems’ or an outbreak of a ‘pest’ offer oppor-tunities to observe. What is a ‘weed’? What is its function in this system? Is it repairing soil or cycling nutrients? What would happen if we waited a little longer before intervening? How does this affect how we see ‘problems’ in other areas of our lives or labels like ‘disability’ or ‘illness’?

Because of this approach, when we intervene, we usually introduce more elements – mulch, companion plants – rather than taking things away. We end up enriching the system rather than diminishing it.

As a result, many Headway clients tell us they have been able to find a place in our gardens where they have felt able to contribute and that their contributions have real value. 

Abundance Thinking

Opening people’s eyes to the opportunities and resources that are already present in their lives is key in cultivating hope and empowerment. As Jo, a participant on the course in 2017 put it, “I went home and I looked out into my garden, and I realised I had everything I need.” 

One of the ways that we can encourage this is by speed exercises, identifying functions in a system – by taking any element and quickly using automatic thinking to generate as many different functions as possible. Using this process, one group was even able to find worthwhile contributions to the system from the element ‘Donald Trump’ (though it wasn’t easy!). People are then able to look about them and see all the things that make their lives work. They shift from a concrete sense of valuing the material, to an expanded sense of worth which includes the psychological and emotional.

Carol is on the course this year. “I don’t feel as hopeless anymore – I used to keep looking at jobs and thinking there’s nothing I can do, but since I’ve been coming here there are jobs that I know I will be useful for.”

Valuing the Marginal

Like most allotment-holders we make use of reclaimed materials in our gardens. This doesn’t just save money and make environmental sense, it encourages us to value dis-carded and undervalued materials in our environments. By extension this helps us to see the worth in others and our-selves when society may not value what we have to give. This can really help with building confidence and enabling us to get involved.

We also focus on the idea that the strength of a system comes not from a small number of key contributors – the ‘well’ as opposed to the ‘unwell’ who are seen as relying on and taking from the system – but instead from diverse and multiple connections. 

Course attendees may show up to a session about soil thinking they will learn about earthworms, and leave not only having discovered an interconnected community of microorganisms and mycorrhizal networks beneath their feet, but an appreciation for the web of relationships that support their own lives and communities. This is a model which not only makes space for people with disability but actually depends upon them and values their contribution. 

A Web of Connections

One of the key themes of permaculture which we apply in our gardening work is the importance of relationships and connections. So often people in recovery are told that they need to develop resilience and independence – ‘toughen up and go it alone’. Instead, we work with permaculture principles to celebrate resourcefulness and relationships, cultivating integration as opposed to segregation, collabora-tion not competition, often using natural systems as a starting point.

For example, our clients begin any gardening project by forming as a guild and thinking about what resources, e.g. skills or experience, they have and what possible beneficial relationships they can cultivate between plants, animals and people. Everyone has a part to play and no plant or animal is too small to make a contribution to the overall system – the yields of the group and the situation are limited only by our imaginations. This approach allows for new forms of recovery to emerge which we could not have predicted or hoped to achieve ourselves.

An illustration of this is the client who had lost his job as a result of his injury. Through the course he connected with someone who presented an opportunity to volunteer in a local garden. This led to developing confidence and coping strategies and ultimately he started his own gardening business working with isolated people in his local community.

Nettie, who is just coming to the end of this year’s course, describes it as “ …not just about growing stuff, but about the whole way the world works and communities and the way we can work together – the total is greater than the sum of the parts”. 

Capture and Store Energy 

Connections extend not just between elements in a system, but between sources and flows of energy. Recovery is sometimes seen as something you have to ‘get through’ so you can get on with living. We work with people to recognise parallels between their recovery journeys and seasonal energy flows, valuing contractive periods of rest and repair as well as expansive periods of activity.

After illness or injury people often think that the job is to get back to where they were before. By drawing on models of growth and change from the natural world, people see that they can never go back, but only forwards. In a moment of realisation, Paul, who attended the course in 2018 said, “Why would I want to go back to where I was before my injury? That’s what made me ill.”

The Tyranny of Technique

Something which is often a barrier to moving forward is the feeling that we cannot do something because we lack technical know-how. By focusing on understanding underlying processes we help people see they don’t need it. For example, instead of teaching people lots of different propagation techniques, we work on being able to see where the life is in the plant – how does it naturally try to propagate itself? In the same way we may be able to identify within ourselves or others the seeds of future growth even when we are in the earliest stages of recovery, when we might be re-learning how to speak or walk.

New Patterns

Our clients get a great deal from engaging with permaculture as a creative and positive model of growth and recovery, offering new patterns of thinking. The principles of perma-culture and the underlying themes (hope, creativity, possi-bility, relationships) have a much-needed contribution to make to the lives of people who have experienced illness and injury and find themselves marginalised as a result. 

“Working in the garden in this way makes you look more closely at what it means to be alive. Often a garden is viewed mainly as a facility with a function, but gardening at Head-way makes you focus on what the garden gives to you and what you can give to it,” says Andrew, a participant on last years course.

Permaculture enables us to reframe the prevailing social narrative – those of us who have suffered are a burden on those of us who have not – to a more truthful view of the world where we are all dependent on each other and that that is where any group derives its strength and capacity to make things happen.

Simon Lacey works as a horticultural therapist and permaculture teacher for Headway Cambridgeshire, and has a private psycho-therapy practice based on an organic farm just north of Cambridge. For more information, please contact: [email protected]