Ecotherapy and mental well-being: An integrative narrative review

 Corresponding author: Nikolaos Klioumis Copyright © 2025 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution License 4.0. Ecotherapy and mental well-being: An integrative narrative review Nikolaos Klioumis 1, *, Konstantinos Evangelinos 2, Evdokia Vassalou 1, Valasia Moskiou 1, Thomas Zacharis 1 and Constantina Skanavis 1 1 Department of Public and Community Health, School of Public Health, University of West Attica, Greece. 2 Department of Environment, School of Environment, University of the Aegean, Greece. World Journal of Biology Pharmacy and Health Sciences, 2025, 23(03), 172–185 Publication history: Received on 02 August 2025; revised on 07 September 2025; accepted on 10 September 2025 Article DOI: https://doi.org/10.30574/wjbphs.2025.23.3.0824 Abstract Urbanization poses a challenge to mental health and increases demands for cognitive resources. The literature shows that exposure to nature is associated with improved mental health and sense of well-being. This narrative review analyses the most prominent theories regarding Ecotherapy and mental health: Stress Reduction Theory, Attention Restoration Theory, and Biophilia Hypothesis; and connects them with contemporary accounts of the Default Mode Network and self-referential processing. Stress Reduction Theory describes rapid psychophysiological stress recovery in non-threatening nature. Attention Restoration Theory supports the idea that natural settings offer soft fascination, allowing the recovery of directed attention. According to the Biophilia Hypothesis humans have an innate tendency to seek connection with nature. Read across these strands, the evidence seems to point to a possible sequential picture. Natural contexts promote an autonomic downshift and affective recovery, this relief in turn permits restoration of directed attention, and under that lower cognitive load self-referential processing shifts away from ruminative patterns toward more constructive self-reflection. We formalize this as the Nature Tuned Self-Regulation model, a probabilistic, context-sensitive account that emphasizes sequential adjustments that together mount up towards specific benefits for mental health. The model aims to clarify how nature can contribute to improved mood and well-being by examining the regulation of the large brain network, the DMN, and offers an integrative framework for designing and evaluating nature-based interventions. Keywords: Ecotherapy; Mental Health; Default Mode Network (DMN); Rumination; Nature Tuned Self-Regulation (NTSR); Attention Restoration Theory (ART); Stress Reduction Theory (SRT); Biophilia 1. Introduction The rapid rate of urbanization has led to significant challenges for mental health and mental well-being [1, 2]. More than 50% of people now live in urban areas, while by 2050, this proportion will reach 70% [3]. Urbanization is associated with increased levels of mental disorders and mental discomfort. It is imperative to detect and promote possible solutions to ensure a healthy and sustainable living for individuals. More and more studies are converging on the conclusion that the natural environment, such as green spaces, positively influences mental health and can ameliorate negative mood [4]. According to Dovijanić (1978), people in modern society are cut off from nature, which interferes with their social, psychological, and physical development [5]. The fact that we spend 90% of our time indoors contributes to this disconnection [6]. Urbanization is associated with negative emotional states and conditions related to stress [7, 8]. According to a longitudinal study that tracked the well-being and mental distress of more than 10,000 participants, it showed that living close to green space significantly improves well-being [9]. A significant number of studies suggest World Journal of Biology Pharmacy and Health Sciences, 2025, 23(03), 172–185 173 that spending time in nature enhances self-reported well-being, memory, and attention [10, 11]. These results imply that ecotherapy may have significant positive effects on mental health. Ecotherapy may provide an efficient, affordable, and scalable solution to foster mental health and ameliorate the symptomatology of existing mental health disorders. The effect of Ecotherapy can also function as a preventative mechanism against the manifestation of negative affective states and thoughts. Under the umbrella of Ecotherapy, programs that demonstrate a nature-based approach to well-being have emerged. Existing ecotherapy theories tend to describe the mechanisms separately, in the fashion of parallel paths that, nevertheless, often converge to similar conclusions. Consequently, a unified, comprehensive framework might add to a better understanding of how these mechanisms might interact in union to promote mental well-being. This review will examine the prominent theories in the field of Ecotherapy: Stress Reduction Theory, Attention Restoration Theory, and the Biophilia Hypothesis. It will also analyze the role of the Default Mode Network as the mechanism for introspection, proposing a new model of understanding the positive impact of nature on mental health, the Nature Tuned Self– Regulation (NTSR) model. 2. Methods This paper presents a framework to understand the impact of Ecotherapy on mental health and well-being, particularly in relation to self-reflection and mental narrative. Our purpose is to summarize and synthesize the literature across several fields, including Ecotherapy, nature exposure, greenspace/green space, blue space, natural environment, park, forest, green exercise, forest bathing, shinrin-yoku, self-referential processing, and rumination. This narrative review is nonexhaustive and explores the relationships between nature, stress, attention, internal thoughts, and self-regulation. By drawing on concepts from multiple disciplines, we have synthesized a discussion of nature’s impact on mental health and mental well-being. A 3-step process was used to develop and refine the literature and concepts presented. Initially, the authors met and identified research fields upon which the review would focus: Ecotherapy, Psychology, Stress Reduction Theory, Attention Restoration Theory, Biophilia Hypothesis, and Default Mode Network. PubMed and Google Scholar were then used to identify significant literature relating to Ecotherapy in these fields. Second, the authors discussed the recurring concepts in the literature, and a more in-depth search was performed, including a review of references of relevant sources. Finally, the articles identified were examined and thematic groupings were developed based on consensus with the research team. Only experimental (with or without control and quasi-experimental) studies with human participants with full text availability and published in English were included. Based on these criteria, excluded from the review were non-peer-reviewed reports, grey literature, studies without full text availability, and commentaries, as well as studies without human subjects (animal studies). Additionally, articles published in languages other than English and studies without full-text availability were excluded. Finally, emphasis was placed on papers published within the last ten years to capture the most recent developments in the field. Still, seminal studies, such as those by Ulrich and other foundational research, were not overlooked and were incorporated to ensure theoretical continuity and scientific rigor. 3. Literature review 3.1. Mental health and mental well-being Well-being can be generally defined as a state in which individuals can function at their full potential. Regarding emotions, the presence of positive emotions is prominent, and the negative emotions are absent [12]. It has a central role in determining both somatic and mental health, satisfaction with the individual's life and the quality of life. Mental well-being is comprised by various dimensions regarding the ways the psyche of the individual's functions [13]. According to Ryff and Singer [14, 15], six main dimensions are responsible for regulating the state of mental well-being: environmental mastery, personal growth, self-acceptance, a sense of purpose, positive personal relationships and autonomy in thoughts and actions. 3.2. Stress and its relation to mental health Stress is a physiological and psychological response to difficult, challenging, or demanding situations. It is a response to different stimuli, which can be physical, emotional, or environmental stressors. Positive stress (eustress) stimulates, increases productivity, and produces a sense of accomplishment. Adverse stress (distress), however, has repercussions on a person's mental health and general well-being [16]. Long-term stress amplifies the physical effects of stress, World Journal of Biology Pharmacy and Health Sciences, 2025, 23(03), 172–185 174 including increased heart rate, accelerated breathing, headaches, muscle strain, fatigue, gastrointestinal disturbances, weakened immune responses, and an increased risk for heart attack or stroke. Individual brief episodes of stress may not pose a significant threat to the well-being of young and healthy individuals who can adequately deal with such challenges [17]. If the stress persists intensely or for an extended period, it can elevate the likelihood of developing mental disorders such as Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD) [18]. According to research by Wang et al (2016), urban nature-based scenes offered a rapid restoration after exposure to stressors in comparison to urban scenes [19]. 3.3. The impact of Ecotherapy on mental health and mental well-being: The prominent theories 3.3.1. Stress Reduction Theory The Stress Reduction Theory (SRT) is an impactful theory within the field of Ecotherapy. The theory explains how our connection to nature enables both psychological and physical recovery. It is a theory initially advanced by Roger Ulrich in 1983. The underlying hypothesis of SRT is that when we are exposed to nature, our bodies naturally react to the experience with a biologically based reduction in stress, leading to a better state of well-being [20, 21]. Our natural affinity for nature is deeply ingrained in our biology, and our natural fondness for nature is the result of our very existence as a species. Ulrich suggested that our natural fondness for nature is the result of our very existence as a species. Through thousands of years, the habitats that nourished us have become ingrained in our bodies. The same environments now are stimuli that automatically, subconsciously provoke a reaction of relaxation and peace [22, 23]. Ulrich investigated the psychological impact of viewing natural sceneries on student stress [25, 26, 20, 27] and on medical recovery rates [28]. His research revealed alterations in mental states following students' observation of "natural" scenes linked to the environment. These scenes enhanced positive emotions of affection, friendliness, elation, and playfulness. Exposure to non-nature-based views, such as urban environments, predominantly elicited a singular emotion: sadness. Observing urban environments sometimes heightened hostility and anger, whereas watching natural settings typically diminished these emotions. Natural landscapes and ecosystems promote positive emotions while reducing anger and aggressiveness. In Ulrich's 1984 study, "View through a window may influence recovery from surgery" [24], which laid the cornerstone for the formal articulation of Stress Reduction Theory (SRT), he demonstrated that patients recovering from surgery who had a view of a natural landscape through their window experienced significantly faster recovery, reported less pain, and had a reduced need for pain medication compared to those who had a view through their window to a "brown brick wall". This was one of the first studies to provide strong evidence and establish SRT as a reliable scientific theory. Since then, it has been adopted as one of the central frameworks for studying the relationship between mental health and the natural environment. The autonomic nervous system (ANS) has two separate systems: the parasympathetic and sympathetic systems. These systems work together to manage body functions, and they complement but oppose one another [29]. The Sympathetic System, called the "fight or flight" system, is the body's activator during instances of perceived threat [30]. On the other hand, the Parasympathetic System is responsible for "rest and digest," and it operates to maintain and restore the energy stores of the body. It actively inhibits the sympathetic system, allowing tissues to relax and repair damage. Its activation can result in a lowered heart rate and peaks during mental and physical relaxation and sleep [30]. According to Stress Reduction Theory (SRT), contact with nature enables the parasympathetic nervous system and diminishes the function of the sympathetic system. This leads to a quick and measurable decrease in stress, including a lower heart rate, reduced blood pressure, reduced muscle tension, and lower levels of cortisol, the stress hormone [21]. The bulk of the relevant literature supports that exposure to nature is linked with a reduction in both diastolic and systolic blood pressure, as well as a decrease in stress in comparison to exposure to an urban environment and urban scenery [3,21]. Cortisol is the body's primary stress hormone, and elevated levels are linked to chronic stress and health issues. Studies demonstrate that even a short 20-minute exposure to nature can substantially decrease salivary cortisol levels [22], offering a biological measure that nature can ameliorate stress. Electromyographic (EMG) recordings have also been used to capture the reduction in muscle tension. Studies have shown that viewing natural scenery or listening to natural sounds reduces EMG activity, reflecting a state of increased physical relaxation [21]. Another study [31] demonstrated that exposure to natural landscapes, such as forests, results in a reduction in both systolic and diastolic heart rate and blood pressure, indicating a shift towards a more relaxed state. World Journal of Biology Pharmacy and Health Sciences, 2025, 23(03), 172–185 175 Besides the physiological response, SRT also focuses on the role played by emotion. Contact with nature supports positive emotions as people experience feelings of serenity, calm, and pleasure, and feelings of fear, anger, and anxiety are minimized [32]. Another interesting find is that this process does not require conscious effort. An experiment by Ulrich and colleagues in 1991 [21] examined stress restoration processes. Researchers induced stress in participants by showing them a video of accidents, then exposing them to images of natural or standard urban settings. They recorded physiological reactions (heart rate, muscle tension, skin conductance) and self-reported mood. The results suggested that nature led to faster and more complete physiological recovery and improved emotional state, whereas urban environments maintained the levels of stress or even increased them. These findings also suggest that even digital/artificial exposure to nature can have a positive affective impact. 3.3.2. Biophilia Hypothesis The word "biophilia" is a compound word of Greek origin, composed of «βίος» (bios) meaning life and «φιλία» (philia) meaning love or attraction, therefore the literal meaning is "love or attraction for life". The Biophilia hypothesis, created by Wilson [24], posits that humans have a genetically based affinity for nature and the natural environment. Wilson's contribution was to define this tendency in an evolutionary biological framework. Humans' ability to understand, recognize, and interact with nature and the natural environment was a critical survival mechanism [24]. This connection is wired into human biology, and the modern urban organization of everyday life can disrupt this connection, leading to mental health deficiencies. Humans have adapted to respond positively to elements of nature that were beneficial to their survival (evolutionary adaptation). Furthermore, the Biophilia Hypothesis suggests that because our brain developed as an adaptive response to nature, it functions better in natural environments or in settings that mimic natural characteristics. This is why activities like gardening, hiking in the forest, and swimming reduce stress, improve mood, and generally promote mental and physical well-being [33]. 3.3.3. Attention Restoration Theory During the development of Attention Restoration Theory (ART), the Kaplans drew inspiration from William James, one of the founders of modern psychology, who distinguished between voluntary attention and involuntary attention [34, 35, 36]. The former requires effort and deliberate focus, whereas the latter does not. The Kaplans preferred to refer to James' voluntary attention as directed attention [36]. Rachel and Stephen Kaplan, working in the field of environmental psychology, developed ART to explain why individuals often reported a sense of renewal after exposure to wild nature and other natural environments [37], as well as to address the problem of directed attention fatigue. Involuntary attention can allow the mechanism of directed attention to rest, enabling it to function effectively again. This process occurs primarily (though not exclusively) in natural environments, both wild (e.g., wildlife refuges) and domesticated/structured (e.g., gardens). Concepts such as "being away," "soft fascination," "extent," and "compatibility" aptly describe the human–nature relationship and serve as descriptive characteristics that natural environments must possess to enhance the restorative experience. ART has recently expanded into multiple domains, explaining not only the restoration of concentration but also overall human well-being and the facilitative role that nature plays in this "therapeutic" process [36]. Our ability to pay attention is one of our most potent and essential resources to achieve our goals and function efficiently [35]. Within ART, there are two types of attentional states required for information processing in any environment: directed attention and involuntary attention [38, 39, 40]. Directed attention involves volitional and effortful control of attention [38, 39, 40, 41]. It is essential for rational and socially acceptable behavior, participation in education, concentration during tasks, and complex cognitive processes [39]. Essentially, it is a form of focused attention that demands substantial mental energy to be retained while at the same time filtering out distractions through inhibitory mechanisms [38, 40, 41, 42]. Natural environments engage involuntary attention through soft fascination, which is effortless, moderately intense, and requires no exertion (since natural stimuli are intrinsically attractive), in contrast to the typical environments (i.e., urban settings) most individuals are exposed to in their daily lives, which demand intense directed attention [43]. Soft fascination attracts attention calmly and pleasantly, leaving space for the mind to wander and for serious reflection about significant problems in life [41]. This theory is grounded in the idea that mental health can be enhanced by reducing stress and increasing the capacity for focus and concentration [44]. It assumes that a change in the environment enables the individual to feel released World Journal of Biology Pharmacy and Health Sciences, 2025, 23(03), 172–185 176 from the demands of directed attention that are required in non-restorative settings [40]. Such an environment allows engagement with cognitive content unrelated to the immediate situation or need (e.g., daydreaming) [45]. 3.4. The Default Mode Network The Default Mode Network (DMN) is a large brain network that becomes more active in states of rest. It seems to be a core component for functions like social interaction, affective processes, self-reflection, episodic memory, empathy, and mental narrative [46]. According to a meta-analysis by Shulman et al. [47], certain areas of the brain exhibit increased activity during periods of rest, and this shows that when the brain is not focused on a task-oriented activity, it does not remain inactive; instead, it continues to be active. A review of the literature on the DMN also reveals that it increases its activity during goal-directed cognitive tasks, if experimental conditions require participants to engage in directed forms of self-generated thought [48]. Such tasks that increase the activity of DMN happen when individuals must employ autobiographical and episodic memory, confront moral dilemmas about themselves, must appraise the mental states of other people, and imagine novel scenes. Nevertheless, the DMN is not a network that works separately from other large-scale brain networks but constantly communicates and interacts with different networks. The executive control network (ECN) is highly activated in processes like decision making, cognitive regulation, and goal-directed behaviour, but at the same time, a reciprocal relationship with the DMN is detected. Specifically, during periods that demand high cognitive effort, the ECN activity increases and the DMN activity decreases. This dynamic relationship seems to aid the shift between introspective states and task-oriented states. The Salience Network (SN) appears to function as the mediator between the DMN and the ECN. Upon the identification of a silent stimulus, the SN diminishes the DMN activity and increases the ECN activity, to guarantee that the critical information is prioritized and the emotions are regulated with efficiency [49]. These findings have shed light on the network connectivity of the brain, supporting the notion that brain activity adapts in relation to external and internal processes. As a result, the dynamic communication among the DMN, ECN, and SN can strongly influence emotional and cognitive flexibility [50], thus promoting the adaptation to environmental cues [51]. 3.5. DMN and MDD Major Depressive Disorder (MDD) has several diagnostic criteria, but the main ones are loss of interest or pleasure, or persistent negative mood [52]. Individuals with depression exhibit differential DMN connectivity at rest, as well as differential DMN activation during a focused oriented task [53]. That shows that the dysregulation of the DMN is associated with MDD. These changes can contribute to symptoms such as rumination, self-criticism, and recurrent negative thoughts [54]. Several studies are beginning to show that DMN also dysfunctions in Generalized Anxiety Disorder (GAD), Social Anxiety Disorder (SAD), attention deficit hyperactivity disorder (ADHD), Post Traumatic Stress Disorder (PTSD), and autism spectrum disorder (ASD) [55, 56, 57, 58]. These findings suggest that the function of the DMN is correlated with mental health and mental well-being. At the same time, it becomes clear that the decoding of the function of the DMN is of significant interest for different disciplines like medicine, psychology, neuroscience, and others. 3.6. Rumination Rumination is defined as a mode of responding to distress that involves a monotonous and often constant repetition of negative thoughts [59, 60]. Rumination is strongly and consistently related to depressive symptoms [61]. A study by Bratman et al [3] showed that an experience in nature, even of brief duration, specifically a 90-minute walk in a natural environment, decreased both neural activity in the subgenual prefrontal cortex (sgPFC) and self-reported rumination. In contrast, a walk of the same duration in an urban environment revealed no effects of neural activity or self-reported rumination. Evidence from prospective longitudinal and experimental studies has emphasized the role of rumination in the onset and maintenance of depressive symptoms and MDD [62, 63], as well as leading to the onset of depressive symptomatology in non-depressed people and increasing risk of depressive relapse in remitted patients [62]. Rumination has also been observed in anxiety disorders [61]. Individuals with a ruminative pattern of thoughts have a strong tendency to focus on threatening signals, internal and external, and exhibit higher cognitive arousal; thus, they are living in a constant state of anxiety and affective distress [65]. 3.7. DMN and Rumination Because DMN has a central role in self-reflection, it must be pointed out that thoughts about self can facilitate innovative plans and solutions to resolve problems, as well as imagining the future [66]. That does not mean that such self- World Journal of Biology Pharmacy and Health Sciences, 2025, 23(03), 172–185 177 generated thoughts are necessarily happy and free of distress; thus, mind wandering can also lead to rumination. As a result, the dysregulation of the DMN can lead to self-generated cognitions that are not adaptive but harmful. One of the prominent theories is the Internal Mental Activity Hypothesis. The internal mental activity hypothesis, also known as spontaneous cognition, is a theory that describes the role of DMN in the generation and manipulation of internal thoughts during periods of rest and introspection. This hypothesis was first proposed by Christoff et al. [67]. According to this theory, when individuals are not engaged in external or externally directed tasks, the DMN becomes active, facilitating reflection on the self, the retrieval of personal memories, the mental simulation of past and future events, as well as the planning of imaginary scenarios. Internal mental activity involves processes such as selfawareness, self-reflection, and mental prospection, in which individuals explore and elaborate on their own thoughts, feelings, and experiences. This hypothesis highlights the importance of DMN in facilitating spontaneous cognition and building a more elaborate self-awareness, contributing to the understanding of internal mental processes and selfawareness [67]. Similarly, sadness is associated with specific patterns of DMN activity, with greater activation of DMN regions during states of sadness and rumination [68]. This hyperactivity of the DMN may contribute to the perseverance of negative thoughts and emotions, characteristic of depressive disorders [54]. The interaction between the DMN and other brain regions, such as the anterior cingulate cortex and the amygdala, can modulate adaptive emotional responses and influence the expression of sadness. Dysfunctions in the DMN have been associated with sadness-related disorders such as depression and mood disorders [56, 69]. People with depressed moods describe themselves more negatively and less positively. Therapeutic approaches that aim to modulate the activity of the DMN, such as CBT and exposure therapy, may represent promising strategies for the treatment of these emotional disorders related to sadness [70, 71]. In that sense, it also implies that psychotherapy is a biological therapy or at least can influence biological changes to the human brain. 3.8. DMN and the prominent theories of Ecotherapy The prominent theories in Ecotherapy have focused on the physiological reduction of stress (SRT) or the cognitive restoration of attention (ART). However, the restorative power of nature provides a unique environment for active readjustment and development of the mind. The mechanism of this process could be linked to the Default Mode Network (DMN) In urban environments, which are often stressful, DMN is more susceptible to manifesting negative rumination, a continuous loop of self-critical or anxious thoughts. On the other hand, nature's lack of urban stressors and the presence of soft fascination, as described by ART [72], help the DMN towards more constructive functions. Nature provides a safe environment for recalibration and allows the mind to process information as an active, internal function that leads to problem-solving, insightful thinking, and higher self-awareness. The brain creates a healthy self-narrative when the DMN goes from negative rumination to productive thinking. This helps people feel better about themselves because they realize they can grow and improve. Nature provides a safe space for us to reset and engage in an active, internal process that helps us solve problems, think more deeply, and become more aware of ourselves. Being part of a healthy environment, free from judgment and competition, can help individuals overcome past traumas, such as feelings of abandonment, and foster a stronger sense of security and self-worth [3]. Attention Restoration Theory (ART) is the necessary precondition that "turns off" the directed attention. Soft fascination is the critical stimulus that releases the mind from the obligation to focus. This effortless interest acts as the trigger for the restorative process to begin [72]. The deactivation of direct attention may help regulate the Default Mode Network (DMN). DMN is the brain's internal "processor" that takes over for introspection, reflective thinking, and creative problem-solving [74]. Being in the natural environment, free from the pressures of urban life, can redirect DMN's activity away from negative rumination. The brain transitions to more constructive functions, such as connecting disparate ideas and creating new narratives about the self, rather than recycling worries and negative thoughts. Social cognition, which refers explicitly to the ability to comprehend other people's emotional, mental, psychological, and behavioral states, has been a central topic of investigation [75]. Recent studies have highlighted the strong involvement of regions within the DMN in tasks related to understanding and interacting with others. These tasks include perceiving and interpreting emotional states, demonstrating empathy, and inferring beliefs and intentions [76, 77]. They observed that certain forms of moral judgment activated default network regions [78]. In particular, the default network was most active when evaluations included personal moral dilemmas (e.g., considering whether it would be morally acceptable for you to push one person off a sinking boat to save five others) [78]. World Journal of Biology Pharmacy and Health Sciences, 2025, 23(03), 172–185 178 Furthermore, looking at negative pictures elicited a significantly greater increase in activity in other DMN regions (amygdala, parahippocampus, and hippocampus) in depressed than in control subjects. These data suggest depression is characterized by both stimulus-induced heightened activity and a failure to normally down-regulate activity broadly within the DMN [80]. In the literature there is a large number of studies that converge to the conclusion that nature exposure promotes mental health by reducing anxiety and generating positive feelings [73, 33, 21]. The main theories in the field of Ecotherapy that were described in the previous sections have offered solid mechanisms that explain how this phenomenon occurred, especially regarding the reduction of anxiety and negative thoughts. Concerning the emergence of positive symptoms, they have been observed through many studies and experiments, but the mechanism is not as clear and specific as it is for the reduction of anxiety and negative thoughts [81]. Moreover, most studies typically select one theory to connect with the results. That means that the above theories seem to advance in parallel paths that often arrive at similar results from different theoretical beginning points. This does not imply the absence of a degree of overlap and common elements among theories. What it means is that they seem to be utilized in isolation from one another. The DMN, a relatively new discovery regarding an aspect of how the brain works, is a complicated network of the brain that has yet to be fully understood and encoded [74]. We know that it plays a significant role in social interaction, affective processes, self-reflection, episodic memory, empathy, and mental narrative [82]. The DMN exhibits increased activity when we are free from task-oriented behaviors, particularly during periods of rest when our minds can wander, excluding sleep, which is a distinct process. In the rest state, our consciousness can wander and dive into self-referential thoughts [83]. While a comprehensive understanding of the DMN is still an area of ongoing research, we have strong indications that when we are not focused on externally directed tasks the DMN becomes more active in such mental and cognitive domains as reliving and reevaluating past experiences, facilitating introspection, self-awareness, and generally an elaboration of our own thoughts, experiences and feelings [84]. When the DMN is dysregulated, a number of detriments have been observed and recorded. Specifically, there are ruminations [85], negative self-reflection, a pessimistic view of the future and a tendency to interpret social cues in a negative way [86]. This is similar to the cognitive distortions, according to Aaron Beck, another prominent figure of the Cognitive Behavioral Therapy (CBT) school of thought, such as catastrophizing thoughts, mental filter, and others. Considering that, according to Beck, it is the thoughts that shape and determine our emotions, a positive thought pattern can lead to positive feelings [87]. The everyday demands of navigating life within urban settings do not leave much room for the DMN to function properly [8]. The sensory overload of modern cities, particularly in heavily urbanized areas, exposes individuals to numerous cues that the mind prioritizes for assessment [88]. Technological proliferation (i.e., smartphones) has created a new challenge to DMN function, with their constant notifications and stimuli, demanding almost continuous attention [89]. As a result, it is not rare for the DMN to be dysregulated. Of course, that does not mean that the personality and genetic predisposition, the way of life, age, and other factors do not impact the proper function of the DMN. 4. A proposed integrative model: Nature Tuned Self-Regulation (NTSR) The NTSR is a probabilistic mechanistic model that attempts to unify the above theories and link them into a sequence where the benefits in mental health as described in each theoretical framework are put into an order where one mechanism paves the way for the activation of the next mechanism. The restorative power of nature provides a unique environment for active readjustment and recalibration of our thoughts and mental cognition. The mechanism of this process is linked to the Default Mode Network (DMN). Within the natural environment, the DMN can stop processing and appraising external stimuli, thus allowing the emergence of its functions that are essential for mental health and a positive attitude. But we propose that this is not a fragmented and isolated function due to nature exposure, but it is a distinct link in a cascade of interrelated processes unique to nature exposure. It can be supported through literature and empirically that nature offers a safe, biologically “familiar” and aesthetically pleasing environment. The theoretical starting point is Biophilia. Initially, contact with nature provides a framework for profound emotional and existential experiences that shape the way we perceive ourselves, creating a familiar and safe framework. A state of calmness begins to emerge. Negative thoughts begin to dissipate, and we experience an improvement in mood. 4.1. SRT This is where appraisal of safety happens. In SRT there is reduced sympathetic arousal and higher activation of the parasympathetic system. We enter further into a state of calmness as cortisol levels; heart rate and blood pressure World Journal of Biology Pharmacy and Health Sciences, 2025, 23(03), 172–185 179 reduce the physiological aspects of stress. While experiencing stress reduction, it becomes easier to replace negative thoughts with positive ones. The brain lowers its alert for any impending threat, thus freeing space and cognitive resources for other processes to be activated without obstacles. With more cognitive resources available and lowered arousal, the brain can afford to slip into effortless engagement as described by ART. 4.2. ART The soft fascination that nature provides deactivates the directed attention and enables the involuntary attention, which requires minimal or no mental/cognitive effort to be sustained. Thus, the individual is put in an effortless mode of attention, and the brain can begin the restoration activities as described in the relevant section of the review. At the same time, mental space remains and becomes more accessible for self-reflection [35]. The executive resources are allowed to recover, replenish and rest. The fourth link is the conceptual pivot for NTSR. 4.3. DMN The preconditions created by Biophilia, SRT, and ART have positioned the individual in a state of improved mood and a more relaxed body. Now the DMN can be recalibrated and regulated. The absence of external stimuli, which causes distractions and disrupts the brain's rest state, combined with the soft fascination of nature, allows the mind to wander freely, creating novel associations and integrating unrelated concepts [85]. During this restful state, self-reflection and mental prospection can become, in some cases, spontaneous [79]. Reduced stress can help switch the process of personal narrative from rumination to a constructive introspection without self-judgment. Now the perceived problems that cause anxiety can be reframed by a solution-oriented thought process instead of fear, thus breaking the cognitive deadlock of rumination. The experiencing of this positive and relaxed state will help with goal clarification and adaptive internal mentation. In other words, DMN can now regulate emotional and cognitive flexibility. Thus, offering an alternative path to processing emotions with a more accurate and non-catastrophizing cognitive clarity. Nature could be the ideal context for DMN regulation and cognitive restoration. We choose the word “tuned” for the following reasons • Because it helps the respective brain systems and subsystems to adjust and be regulated. • The individual’s physiological system and mental processes receive the positive influence of the natural environment and thus they are “tuned” to nature. • The third reason is that each stage “tunes” the individual in certain aspects. For the above reasons, we chose the term "tune" as the most explanatory, descriptive, and more accessible to comprehension. The NTSR model suggests that nature helps the individual to reconnect with their innate sense of self by regulating the mind and its internal processes. This reconnection, as emphasized by the Biophilia Hypothesis, is the final step in this restorative cascade, helping to strengthen healthy self-esteem and foster a deeper sense of personal meaning. 5. Discussion This review examined why natural environments frequently correlate with stress reduction and mental well-being, and how traditional theories may be moved forward in a combined fashion rather than parallel progression. We detected three patterns across our literature research. First, in non-threatening natural environments, individuals exhibit a relatively fast psychophysiological shift that corresponds with Stress Reduction Theory. Second, natural environments with these four characteristics soft fascination, being away, extent, and compatibility support the recovery of directed attention and replenish cognitive resources, as Attention Restoration Theory indicates. Third, the mental state generated by the above processes helps self-referential processing to become less ruminative, a finding consistent with recent research regarding DMN dynamics. These mechanisms may be most coherent if they are viewed as a sequential enablement rather than separate phenomena. The Nature Tuned Self-Regulation attempts to propose a testable and falsifiable theory. The exposure to nature begins the cascade, as the Biophilia Hypothesis supports. The SRT enables the parasympathetic nervous system and diminishes the function of the sympathetic system, thus diminishing the levels of dysphoria or even leading to a state of calmness. Now the individual is relieved from the cognitive load of directed attention and bodily signals of stress, like elevated heart rate, are diminished, as indicated by ART. The way is paved so that self-referential processes can be transitioned from negative mental narrative and self-thoughts to more constructive structures of self-reflection. Current research World Journal of Biology Pharmacy and Health Sciences, 2025, 23(03), 172–185 180 shows that when DMN is regulated, rumination decreases significantly. The NTSR model incorporates neurobiology with adherence to the available evidence. The model is probabilistic and not deterministic. The word "tuned" refers to three reasons. First, it helps the respective brain systems and subsystems to adjust and regulate. The individual's physiological system and mental processes receive the positive influence of the natural environment and thus they are "tuned" to nature. The third reason is that each stage "tunes" the individual in certain aspects. The model does not rely exclusively on neural measures but takes them into account, maintaining compatibility with the findings of the recent literature in the field. Interpretations and theories that fit every outcome are not scientific. An unfalsifiable claim does not belong in science. If we claim that nature helps, this is not testable. But if mechanisms and conditions are explicitly specified, then scientific discipline is followed. The NTSR claims are falsifiable in the following cases: If the aforementioned serial cascade is disproven, for example, if well-being is improved but there is no change in the second stage, or every other stage, the model fails. It also fails if the order is different. Moreover, in the case that a non-nature but restorative environment exhibits the results that are claimed then the nature-specific condition is not supported. In addition, if rumination diminishes without any reconfiguration of the DMN, then such a result is not consistent with the theory. Limitations Future Directions Future research should compare DMN activity and associated mental health outcomes in diverse natural versus highstimulus urban environments [91, 92]. Beyond this, there are some limitations for future research that warrant consideration: The NTSR model proposes a sequential activation of Biophilia, SRT, ART, and DMN regulation. Experimentally isolating and testing the precise causal links and the exact order of these mechanisms presents a significant methodological challenge. The NTSR model posits that nature provides a unique context for DMN regulation. In addition to this, future research could compare the effects of natural environments with other restorative, yet non-natural, environments on DMN activity and mental well-being outcomes. The term "nature" is broad. This review, and much of the existing literature, often generalizes across various types of natural environments. Future research should differentiate the specific characteristics that contribute most effectively to restorative outcomes, particularly in relation to the nuanced mechanisms of SRT, ART, and DMN regulation. While studies indicate that even brief exposures to nature can be beneficial, the optimal "dose" (duration, frequency, and intensity) of nature exposure required to elicit significant and lasting mental health benefits is not yet clearly established. Longitudinal studies are needed to determine the long-term effects and ideal exposure protocols for different populations and conditions. 6. Conclusion It is our view that Biophilia, SRT, ART and DMN processing are cogs of the same machine. The NTSR describes a sequence of stages. It begins with a deep intimacy in an environment that we are evolutionarily programmed to connect with and appreciate, and it is like an automatic sense of familiarity and belonging. It continues with a physiological downregulation and a recovery of directed attention, ending up in less ruminative and more optimistic and constructive self-focus. All together are followed by improved mood and mental well-being. This model is a modest attempt to integrate the fundamental theories of Ecotherapy, while taking into account evidence from neurobiology. It proposes effects that can be visible and measurable. Relying on reliable findings, the NTSR may help practitioners to design nature-based interventions with a specific map in mind. Regardless of its future and its place in the field of Ecotherapy, the proposal of a model in the direction of unification might help to propel similar endeavors that are so needed. Compliance with ethical standards Disclosure of conflict of interest The Authors proclaim no conflict of interest.