A friend just wrote me after attending the Washington Spa Alliance’s First Annual Symposium entitled New Realities: Redefining the American Spa Experience, March 24, 2011:
'They had an impressive line up of presenters and it was truly well done, but I left with a real sense of anxiety.
This organization has an impressive Board, who are tremendously focused on wellness programs. These include the well respected practices of Acupuncture, Meditation, Yoga, Tai Chi along with diet, nutrition and fitness programs.
There was no mention of hydrotherapy, and specific touch therapies, the base of the traditional spa and the bread and butter of the revenue produced in spas.
All spa therapies were lumped under the title of 'Touch and the Placebo effect'. While everyone acknowledged there is value in the Placebo effect, it does not sound like they intend to research this topic in the evidence based program they are driving.
The other main concern for the use of water in the spa industry is of course environment - I understand this... we need to find solutions.
I am wondering who the "grinch" is that stole spa from our industry.'
I've been wondering too and I'd like to share some thoughts, and to invite you to chime in also. I've presented my response under the headings 'The call for evidence-based spa practice' and 'Diminishing spa waters'.
There is much more that could be said; and some of that I have tried to articulate here on Vision Spa Retreat: Reflections on Spa, Soul, and the Role of Water. I hope you will find this post thought-provoking.
The call for evidence-base spa practice
What my friend says about the above symposium answers the question Should spas reinvent themselves as global scientific healthcare corporations? (link to my earlier series of posts) with a resounding 'Yes'.
The mention about spa therapies having been lumped under 'Touch and the Placebo effect' indicates that corporate science/ medicine, linked with global medical tourism and the destination spa resort industry, may have strong interests in this venture.
A placebo is a sham or simulated medical intervention. It is generally used as a derogatory term that underscores an emphasis on objectivity vs subjectivity - the mantra of science. Below is an extract from Wikipedia which shows just what a baffling concept it is - defying research rules.
I like to think the placebo effect is actually the untamed (and untameable) spirit of healing. It is the healing that cannot be explained by current science and is therefore assumed to be anomalous. It is the miracle that medicine cannot see because it does not fit the model.
The placebo effect could only be documented in studies in which the outcomes (improvement or failure to improve) were reported by the subjects themselves. The authors concluded that the placebo effect does not have "powerful clinical effects," (objective effects) and that patient-reported improvements (subjective effects) in pain were small and could not be clearly distinguished from reporting bias. Other researchers (Wampold et al) re-analysed the same data from the 2001 meta-analysis and concluded that the placebo effects for objective symptom measures are comparable to placebo effects for subjective ones and that the placebo effect can exceed the effect of the active treatment by 20% for disorders amenable to the placebo effect, a conclusion which Hrjartsson & Gzsche described as "powerful spin". Another group of researchers noted the dramatically different conclusions between these two sets of authors despite nearly identical meta-analytic results, and suggested that placebo effects are indeed significant but small in magnitude.
The use of this term implies that the 'patient' can't really assess or take care of their own health and well-being without the proof of research and expert guidance of the scientific and medical kind. This is not to say that such input is not helpful but it is not all that matters in questions of health and healing.
I'm not at all sure that the answers to health concerns for people in general can be provided by a spa industry redefined as a healthcare agency, especially when that call comes from business allies with vested interests in cornering a market - including a particularly wealthy sector known as 'baby boomers'.
Perhaps the marketing people are also seeing an opportunity to dress medicine as usual in friendlier and trendier clothes. They are seeing spa as an ideal umbrella under which to shelter a number of different interest that have customer appeal. See the earlier two-part series: When is a spa like an umbrella.
It all sounds quite good - and it might be - but I think that all who subscribe to it would do well to be fully aware of the implications and honest about their intentions. There is a big difference between seeing the world as a place of shared values and linked wonder and seeing it as a vast market.
Read: Writing the World: On Globalization (Terra Nova), including Arundhati Roy on the "colonization of knowledge" in her essay "The Ladies Have Feelings, So... Shall We Leave It to the Experts?"
Also: The Quants and the Poets (Dark Mountain Project), by Paul Kingsnorth who is struck by how 'nothing is seen to be "real" unless it is sanctioned by the priesthoods of either Science of Business, and preferably both.'
From the website for Washington Spa Alliance’s First Annual Symposium:
' ...[T]he Symposium will gather leading minds in the disciplines of health, food, science, beauty, travel and sustainability for a discussion of common issues. The Symposium is the first to acknowledge that the spa industry is the field that envelops all of these areas. The event will illuminate the importance of working together to promote the wellbeing of the nation.
This is a singular time in our nation’s history, when Washington is looking closely at how our country can be healthier. Americans increasingly have turned to spas to learn the importance of diet and exercise, the benefits of organic plant-based diets, to redefine ideas of beauty and wellbeing, and to learn techniques of stress-reduction, and preventive medicine.'
It is true that spas have played an important role in providing venues where health ideas - generated in the alternative health community and sometimes brought from overseas - could be offered outside of the medical system.
Spas also have provided settings in which these different approaches to health and a great array of healing modalities could be explored and developed under the influence of both cultural and business trends. For better or for worse.
I wonder if the spa 'industry' really understands and values this creativity and independence? Establishing another increasingly regulated system for educating people about health may not be all that it at first appears.
Unless the people are given a real voice also. One way to do that would be to create an independent reporting database (real-life experiences, sometimes rather dismissively called 'anecdotal information') alongside the scientific evidence database (research studies).
This would help maintain a healthy balance between the patient/ consumer and the service-provider/ industry. It might also protect mystery and meaning - essential parts of our creative and subjective response to life that contribute to well-being in ways that will always defy formulation.
Read Is modern medicine more science or religion? by Larry Malerba, DO for more on some of the problems inherent in the medical model.
Could it be that the spa 'industry' is actually more interested in influencing people than being influenced by them. Is 'redefining spa or the spa experience' a marketing move? Who stands to profit? Who stands to benefit?
A stay at one of the destination spas - whose owners are among some of the strongest proponents for the new medical alliance - can be 'extremely expensive...you could easily take a vacation to Europe at the same cost (or cheaper)' [Source]. This is clearly not open to all.
Perhaps in answer to any suggestion of elitism, one of these destination spa resorts, Canyon Ranch, has created the Canyon Ranch Institute aimed at catalyzing 'the possibility of optimal health for all people by translating the best practices of Canyon Ranch and our partners to help educate, inspire, and empower every person to prevent disease and embrace a life of wellness.'
From the website:
Canyon Ranch Institute will work with its partners to help:
* Accelerate a cultural transformation to redefine individual and community health in terms of disease prevention rather than disease treatment;
* Integrate and translate innovative and evidence-based wellness best practices into the fundamental knowledge and social base of every community;
* Eliminate health disparities by ensuring that all people have the ability and opportunity to embrace a life of wellness.
Examples of their programs. The intentions and actions outlined on the Institute's website are impressive. And yet, these 'spas' have gone a long way from the source of spa in health through water.
There are community-minded spas of a different ilk - the developing eco-resort Avalon Hot Springs in Northern California is just one example - that remain firmly based around natural hot springs, their healing value, and a recognition of spiritual mysteries of all kinds. Here is Avalon Springs statement of core values.
Obviously, these days 'spa' means many different things to many different people. We can't really talk in general terms any more. We'll need to keep asking 'What do you mean by spa?' and 'Who are the people who go to these spas?'. It's not actually as simple as the trendsetting spa blurbs and 'leaders' in the spa industry suggest.
Although I am hoping that all such expressions of healthful living - whether with scientific or spiritual foundations - can live harmoniously side-by-side, I am worried that the driving force behind the medicalization of spa will not be so generous.
And, in keeping with the origins of spa, I'd love to see water returned to central stage.
Diminishing spa waters
Regards the role of water in spa, on Vision Spa Retreat's opening page I wrote:
Many people are attracted to the images of health and reinvigoration associated with spa-retreat. However, the underlying essential value and role of our physical and social environments is often overlooked. Spa - sanus per agua (health through water) - should not be a luxury commodity.
Water as an indicator of health and also a tool for health, is central to the spa-retreat offering. Water, as a metaphor, provides many insights into human behavior and human potential, as the Taoists knew well. Water and humans need to be free and to have depth and clarity to thrive.
My friend hinted that the environmental issues around water have been used to support the idea that linking spa with water therapies is no longer useful or practical. Perhaps so, when viewed solely from a business perspective.
Suggesting that environmental issues around water mean that it can no longer be included as a central focus could also be a reflection of our lack of responsibility, respect and reverence for this essential element and its unique healing qualities.
Aside from any historical or linguistic connection with spa, we all need water to live and we are mostly water ourselves. We recognize something of our own origins in water. Water is the element that defies science too. It is most unusual in its properties.
Here are a couple of recent articles illustrating how water continues to intrigue researchers:
Extraordinary liquid: explaining the mystery of water (Feb. 2010)
The mysterious properties of water and its healing power (July 2010)
Thinking of water as a resource is also quite different from thinking of it as a living thing, or as Theodor Schwenck said as 'nature's sense organ'. Water can quite reasonably be viewed as a sensitive indicator of health - that of the planet and of ourselves.
Apart from its physical qualities, water has been considered by humans as the element of the unconscious, of dreams, of emotion, of nurturing, of creativity, and so on. Water takes us deep into the realm of imagination. It also presents us with the risk of the unseen and uncontrollable.
Could it be that how we treat water has implications for all these things? When we leave out water, we may also - in intangible but important ways - leave out direct experience with nature and deep emotional engagement with life.
This is the realm of subjectivity and soul. Science has difficulty with these things because they cannot easily be defined, controlled, regulated, anticipated. Healing is not the same as curing - it is elusively personal.
Though marketers and politicians might try to appeal to these more subjective elements of our human experience, they also can never really control them. Just like water, the soul, cannot easily be grasped or contained and still remain vital - it requires freedom of expression.
There is another important aspect to consider here, and that is the shadow side of human experience. We can't have the light without the dark. Golden Ages and Gold Standards in spa or science have their limits - they are not panaceas - whatever the marketing message might want us to believe.
It has been suggested that leaving a bad marriage without having acknowledged the parts of oneself that contributed to the troubles will only lead to a repetition of those troubles in the next relationship. Until the industries and corporations that developed from science and medicine have fully and publicly faced up to their shadow sides, any marriage or alliance with spa is likely to fail.
For all these reasons and more, water - shapeshifter par excellence - continues to provide a powerful focal point for a consideration of spa as far as I am concerned. My passion for spa has more to do with a quest for the wisdom of water reflected in human spirit than with the strivings of an industry. From that perspective, something doesn't feel right in the redefining of spa as a global healthcare industry sans water.
Has spa been stolen? And by whom?
[The Grinch is a fictional character created by Dr. Seuss, for the 1957 children's book, How the Grinch Stole Christmas! Read more.]
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