Most exercise physiologists claim that the physical, and very likely also the psychological, effects of other aerobic forms of exercise, such as bicycling, swimming, and cross-country skiing, are essentially equivalent to running. So, until we know otherwise, we will assume that what is true of running is likely to be true of other types of exercise that make similar demands on the body, and we will focus here on running.
Dr. Kostrubala has attempted to describe a particular approach to running that seems to have definite psychotherapeutic value. More is involved than donning a pair of running shoes and starting out, as we will see.
Dr. Kostrubala has found that running is emotionally or mentally therapeutic under certain conditions. First, you need to make sure that you are in medically good condition to begin a therapeutic running program. It would be prudent to have a thorough physical and, if you are over forty, also a stress test. You need to do warm-up exercises, which any good book on running describes in detail, and then you need to build up your endurance—gradually and patiently—until you can run a minimum of three times a week for an hour each time, without stopping, and with a pulse rate of at least 75 percent of your maximum heart rate. (Your maximum heart rate is 220 beats per minute minus your age. If you are 40 years old, your maximum heart rate is 180. Seventy-five percent of 180 yields a pulse rate of 135 beats per minute. If you are 40, you would want to run for an hour so as to maintain a pulse rate of 135 beats per minute during your run. By way of encouragement, you may want to know that 75 percent of a person's maximum heart rate represents, for almost everyone, a slow, easy jog.) Second, you must have a noncompetitive attitude toward running. Whether you're comparing yourself to others or just trying to beat your own running record, a competitive drive rivets your attention on a goal separate from yourself. This misplaced emphasis will undermine the therapeutic value of the activity.
You also should either run alone or with someone who won't distract you by talking. Direct your attention within—to the rhythm of your pace, the regularity of your breathing, maintaining relaxation in your shoulders, back, and feet. To prevent distraction it is also important to run in an area or around a track that is familiar to you. For slow long-distance running to have a therapeutic effect, you cannot be a sightseer. The novelty of unfamiliar surroundings will distract you from being inner-directed, which is therapeutically important.
Finally, be aware of the physical risks. If you begin to feel dizzy, stop running. In hot weather, dizziness is a first warning sign of heat exhaustion, which can lead to heatstroke. If you feel a snap in one of your running muscles, stop. An internal snapping or popping noise can mean that a muscle or tendon has torn, or a small bone has broken. Make sure you are all right before resuming. If you have a cramp-like pain in your side, which is very common, try slowing down, exhaling forcefully, giving a yell, or singing. You can often keep going, and the pain will subside. If it does not, or it gets worse, you'll need to stop to rest.
WHAT RUNNING AS THERAPY FEELS LIKE
The psychological effects of regular, slow long-distance running can be impressive if you follow the directions above.
During the first twenty minutes, you may feel slow and stiff and not very inspired about the run. You may find yourself in a sour mood. (There is even a term for this phase: dysphoria.) Persuade yourself that it is not important and keep going.
Between twenty and thirty minutes, if you are dysphoric, that feeling may peak; some people even begin to cry. This is not necessarily depression; it may actually feel good. (Another reason to run alone: other people won't understand and may want to "rescue" you from your therapeutic endeavor.)
At some point, after about thirty minutes of running, you will probably find that your mind refuses to do any more problem solving. You stop worrying, problems you may have been dwelling on simply begin to feel distasteful, and your mind clears. (After a good run, when you do return to the problem, you may well find that it is less difficult to think through.)