Home All The Psychology of Spas and Wellbeing (Book Review)

Emiliya Zhivotovskaya, MAPP '07, is the founder of Flourish, an organization dedicated to using research based tools to enable individuals and organizations to flourish. Emiliya fuses the best of Eastern philosophy with Western science to provide people with holistic tools to increase their happiness, well-being, and sense of flourishing. Full bio.

Emiliya's articles are here.

Rotorua, New Zealand

Rotorua, New Zealand, is one of the top places to experience natural wonders in the world. Its geysers, hot springs, and other geothermal activity make it a popular tourist destination, well-known for its spas. When I visited in 2007, I was looking forward to a relaxing getaway; I was even considering get a massage or a mud bath.

Prior to my visit, I filed spa treatments in my brain under luxurious indulgences. Rotorua transformed that belief because, for the native Maori, spa is essential for well-being. The Maori way of life focuses on massage, relaxation, cleansing, exercise, healthy natural foods, and water treatments. The broad availability of inexpensive services blew me away—-a one-hour massage was a fraction of the typical cost in the United States! Price reduction unimaginable elsewhere is possible because so many people frequent the establishments.

My beliefs about the relationship between spa and wellness have expanded once more this month with my reading of Jeremy McCarthy’s new book, The Psychology of Spas and Wellbeing. McCarthy explores the history of spas dating back to Ancient Rome, and argues that the reason many spa and healing practices have not changed in 2,500 years is because they promote increased well-being in those who use them.

McCarthy has compiled compelling research on the many components of the spa industry, explaining the physical, psychological, and spiritual benefits of those practices. This book is an essential read for anyone working solidly or marginally in the wellness industry including spa owners, massage therapists, healers, body workers, estheticians, personal trainers, and yoga teachers. That said, even for those who are not professionally involved in the wellness industry, this book has much to teach on what our bodies need by way of food, exercise, touch, relaxation, and senses of renewal and rejuvenation.

Lessons for Spas

McCarthy weaves the tapestry of positive psychology theories together to understand the interplay between spa services, stress reduction, and well-being. By providing simple, research-based suggestions for the spa industry, McCarthy illustrates how spas can improve their services without needing to change much of what they already do. Two wonderful examples are his application of peak-end theory and paradox of choice theory to spa facilities:

  • The peak-end theory states that client’s judgment of their overall experience will be greatly influenced by the peak of their experience and how it ends. Therefore, if the best, most beneficial and enjoyable portion of treatment comes at the end, the customer is more likely to remember their experience favorable.
  • The paradox of choice theory states that when people get too many options, they are likely to not make any decision at all due to feeling overwhelmed and fear of the opportunity cost of making the wrong choice. If spas limit the number of choices they offer, customers are more likely to feel confident that they have made the right choice.

McCarthy’s book also provides existing spas with the opportunity to enhance their work by emphasizing positive interventions, using exercises already known to increase well-being. A great example of this sort of intervention comes in McCarthy’s discussion of how many spas currently offer “anti-aging” services to reverse the aging process. He suggests that instead of denying the inevitability of aging, spas can adopt a positive health model that concentrates on helping clients continue to flourish at all ages by expressing wisdom, experiencing positive emotions like joy, and having meaningful, positive relationships with others. All of these are powerful research-based interventions to cultivate well-being at any age.

Individuals and wellness practitioners will benefit from the abundant research that McCarthy has collected and synthesized. He summarizes the physiological, emotional, and cognitive benefits of many spa treatments including massage, healing touch, water treatments, and aesthetically pleasing surroundings. He connects these benefits to scientific theories on the placebo effect, stress, and the ability of the simple expectation of doing something positive for one’s health to facilitate healing. Readers will be inspired to revisit their exercise regime and to prioritize time for deep relaxation.

Lessons for Places of Healing

For me, the message of greatest impact that McCarthy delivers is that there is a great need and opportunity for all places of healing, including hospitals, rehabilitation centers, and doctor’s offices, to learn from the spa industry. Spas treat and prevent illness using a holistic model. Why don’t our doctors’ offices and hospitals make us feel safe, nurtured, and welcome? Why are our rehabilitation centers and other places of healing designed to make us want to leave as soon as we walk in the door, rather than designed to be calming and aesthetically pleasing? Similarly, we know from research how important touch is to healing. Why aren’t nurses encouraged to hug patients or pat them on the back when appropriate?

My mother fought ovarian cancer for 10 years. Because of her illness, my family and I spent a lot of time in hospitals, clinics, treatment centers, rehab centers, pharmacies, and other places that are supposed to function as places of healing. When I visit a spa or holistic practitioner whose emphasis is on healing, relationships, and nurturing the whole being, I feel supported and cared for in a way that was totally absent from my experience of “places of healing” during my mother’s illness. Medical institution directors, educators, architects, and interior designers ought to read McCarthy’s book to gain greater awareness of ways they could improve their customer experiences and understand how these enhancements would escalate client healing.


Lessons for Individuals

If you are a spa lover like me, read this book so that you do not feel guilty or self-indulgent when you take the day off to go to the spa.

If you tend to shy away from all of these stress reduction modalities, read this book to understand the fundamental needs of your mind, body, and spirit, for touch, healing, relaxation, engagement, and pleasure.

If you are a practitioner in the wellness industry, read this book to better market your services and empower your clientele by teaching them what is happening within their bodies when they are experiencing spa services.

In summary, The Psychology of Spas and Wellbeing offers a clearly stated, scientific investigation of the mind-body connection and the psychology of relaxation, beauty, touch, and holistic wellness.

The Psychology of Spas and Wellbeing is available both on Kindle and PDF, with a hard copy edition coming out soon!


McCarthy, J. (2013). The Psychology of Spas & Wellbeing: A Guide to the Science of Holistic Healing. Createspace Independent Publishing.

Rotorua-North Island-New Zealand courtesy of Tyler Ingram
Roman Baths in Bath courtesy of Kevin Botto
Beau Monde Spa in Victor in the Finger Lakes courtesy of Valerie Knoblauch
Thai Massage at Rama Day Spa Frankfurt courtesy of Thomas Wanhoff

Edited by Natasha Utevsky

Not seeing the pictures for the book links? Disable Adblocking for this site to view them.

You may also like


Senia 26 July 2012 - 12:30 am


Thanks so much for this review. I think Jeremy’s a superb example of integrating positive psychology research into his career, and sharing it in such a way (through his blog, his articles here, his participation on the APA listserv) that people see benefits from both his spa background and his thoughts on the research – as well as from the integration of the two. This book seems to be at that intersection of two fields that Jeremy knows so well, spas and research. Thanks for a taste of what is in the book – looking forward to reading it.

I especially like the examples you gave: the peak-end rule, the paradox of choice, and reframing services to highlight wisdom, joy, and awe over age.


Bridget 26 July 2012 - 6:03 am

Hi there Emiliya

Fabulous review, thanks, you’ve certainly sold it to me! I’d like to get the PDF copy but the link you’ve included doesn’t work – could you repost it please?

Warm wishes

Christine Duvivier 26 July 2012 - 7:59 am

Thanks, Emiliya, for the great review– you’ve sold me! Jeremy, congratulations on your book– I can’t wait to read it!!


Jeremy McCarthy 26 July 2012 - 10:56 am

Emiliya, thank you! Not only did you do a great job of capturing the message and content of my book, but you enriched it by sharing your personal stories. My original dream for this book was to weave in personal stories from spa-goers, spa professionals and healing professionals from around the world that would bring the research to life. Your examples from Rotorua and your mother’s medical experience are perfect examples of the beautifully illustrative stories about healing in our culture that I hear over and over again. Unfortunately I didn’t have the time to dedicate to this more comprehensive look and I wanted to get the research out before it became too dated. (This is also an infinite subject as I continue finding new data points, new studies and new examples that would sometimes strengthen and sometimes completely change my arguments.) perhaps some day there will be a 2nd edition and if that day comes I may reach out to have you help me write it!

Sara Firman 26 July 2012 - 1:09 pm

Another good review reinforcing the value of this book in asking what spas (and spa staff) actually do well, what they could do better, and how they can provide honest and effective services while still operating as profit-making businesses.

As Jeremy says, examples are helpful because they show what happens in practice or at least how clients interpret this. Spa covers such a broad palette these days. Still I find myself asking many questions after reading this review, and spa-related media in general. For example,

How do indigenous Maori people feel about Rotorua? Does it reflect their ancient healing practices? Do people go there (in numbers enabling low-cost treatments according to Emiliya) because they know they’re getting evidence-based treatments or because they love the natural water setting or …?

Are spas and healing treatments actually the same as they were 2,500 years ago? What was the nature of ‘spa’ in those times? How did those cultures fare? What happened to them? what effects have dominating religious and scientific worldviews had on those early ways? Have we lost anything along the way?

Is it valid to equate spas with hospitals and vice versa? Is it true that spa staff in general are more compassionate, caring, knowledgeable than hospital staff (who must deal with crisis, illness, death)? For integration to happen won’t we need to let go of as many preconceptions as we can?

[See Thomas Moore’s The Soul of Medicine for a good exploration of what is already changing in medicine.]

Within spa circles there are some who are willing to stand up and ask why, after all these years of education about health, are people getting sicker? Is it because of the illness model in medicine? Is it because not enough people go to spas? Is it something much deeper than we care to explore?

I don’t have the answers. I don’t believe that our current spa industry has them either. I’m glad that Jeremy’s book is out there and I’m hoping that it will be used to inspire questions and explorations that challenge us to ask if the world is actually becoming a healthier place for all through spa.

Dr. Marsha Snyder 26 July 2012 - 3:27 pm

Excellent book and excellent review!! Unfortunately, only those people with enough money to afford the services in the US can take advantage of these wonderful holistic treatments, unlike other countries such as New Zealand. Medicine, particularly in the US, is very much illness-focused as opposed to wellbeing-focused, as it should be. In addition, because healthcare in the US is a business largely run by the health insurers, only necessary testing and procedures for documented illnesses are covered. Only recently are insurers beginning to cover and encourage wellness services.
In medical schools all over the world the first year curriculum focuses on the hard sciences of disease, such as pathology, histology, microbiology, anatomy/physiology, biochemistry. However, our knowledge has advanced to disease-prevention and wellbeing maintenance, and medicine is primarily a human endeavor involving ethics, professionalism, complex interpersonal skills (such as emotional intelligence, empathy, communication skills, the ability to listen, etc), and deep meaning and purpose.
I have developed a new one-semester curriculum for first-year medical students and their clinical instructors based on the principles of positive health, resilience, professionalism, and meaning and purpose. I am scheduled to be presenting it at the University of Pennsylvania medical school to their incoming freshman class. Other medical schools have shown interest. It is only a small step forward, but perhaps one that will lead to bigger changes in medicine and healthcare.

Editor S.M. 26 July 2012 - 4:44 pm


Thanks for the catch – the PDF link is now back to working.

oz 26 July 2012 - 5:30 pm

Emilya – I’m uncomfortable with spas as a way to wellbeing. Realistically if you look at return on investment then a 3 month gym membership is probably more useful than a single spa treatment. Or perhaps spending the time volunteering might be more productive. The spa industry sort of reinforces self indulgence as a way to wellbeing.

Any process that involves purchasing wellbeing is always problematic as it excludes the less well off.

Emiliya Zhivotovskaya 26 July 2012 - 5:36 pm

Dear Oz,

Thanks for your feedback. I agree that there is never just one pathway to well-being. What I think Jeremy presents in his book is not research supporting the Spa Industry it’s research supporting how the experience that Spas create support people’s well-being.

What Jeremy’s book describes is relaxation, stress reduction, breathing, aesthetics, touch, etc.

You don’t need a spa to get that, you just need to value those experiences and make them a priority.

Warm wishes,

Jeremy McCarthy 27 July 2012 - 5:43 am

Sara, all great questions. Your post highlights what I mentioned above about this being an “infinite subject”. Questions answered lead to more questions. In response to your question about if spa people are more nurturing than other health care professionals . . . I don’t think this is a function of the people or types of people who do these lines of work, it’s a function of the way these systems work. To Oz’s points above, spas are expensive, and therapists are compensated to spend time with their clients. To be successful they have to make their clients feel good which is what will ensure they come back again (making sure they receive their “ROI” as Oz mentioned.) In health care, the system is about creating efficiency, so while the people may be just as compassionate or nurturing, their measure of success is based on how quickly they can get their patients in and out. In order to avoid liability, there is also pressure for them not to diverge from pre-established protocols which tend to leave out human aspects of treatment (see Emiliya’s comment about nurses in the article.) But to clarify, I think the people who pursue these kinds of work are equally compassionate and nurturing individuals just guided by different systems due to the mechanisms of their industries.

Jeremy McCarthy 27 July 2012 - 5:48 am

Thank you Marsha! Your course sounds wonderful and I do think this can make a difference although these professionals will still get out into their careers and find themselves constrained by the systems around them. But I also think it’s important not to be resigned to the system as it is. The system is ultimately made up of a huge network of individuals and the more the individuals change, the more the network changes. I would love to learn more about it and maybe feature on my blog.

Jeremy McCarthy 27 July 2012 - 5:57 am

Oz, I agree with Emiliya’s response above. Also, a part of understanding the science of wellbeing is to figure out how to deliver it in more accessible and impactful ways. Both you and Marsha mentioned the cost of spa and I agree this is one of the biggest problems of the spa industry (although new models are coming out geared towards making spa accessible to a broader audience. Here in the US for example there is a massively successful new franchise called Massage Envy offering “no-frills” massage services for about half the price of a typical luxury hotel spa. There is also a huge trend towards social bathing spas where people can go and experience community while enjoying the facilities without having to pay for an expensive treatment.)

My argument is that many of the benefits of the spa do not require a specific treatment: time for silence, time for reflection, separation from technology, caring healers, touch, etc. In an ideal world, you would not need a spa to get these important aspects of wellbeing but spas do fill a gap (for those who can afford it) in a culture where time and touch are short.

Jeremy McCarthy 27 July 2012 - 6:00 am

I forgot to mention in my response to Sara that she also published a wonderful review of the book on her blog and I hope those interested will check it out: http://www.visionsparetreat.com/2012/07/jeremy-mccarthy.html. I like Sara’s approach to the spa industry because like me, she is passionate about understanding the science behind it without being blinded by the scientific dogma.

Sara Firman 27 July 2012 - 7:07 am

I am thrilled to see these kinds of discussions happening. Jeremy’s reference to systems – hospital systems, spa systems – is important. Recently, I’ve noticed the word culture being used in the place of system as it seems to imply something more human than machine. Sometimes that is justified, sometimes not. A friend of mine (who has recently despaired of the world of spa and returned to her private healing practice) envisaged synergies rather than systems. In her synergies everyone sees themselves as part of the whole experience, as equal in the whole experience.

Since this review and discussion is on a positive psychotherapy blog, I think we might mention that when people feel valued and respected as equals with different roles, the overall outcome is better than when hierarchies are in place. As a hospital volunteer I’ve witnessed the iniquities of hierarchy, as a spa therapist and manager the same. In my review of Jeremy’s book (thank you for your kind mention J) I have highlighted the importance of the frontline service providers – those who actually do the touching and listening. Much of what Jeremy references is in their hands.

My anecdotal and personal observation is that in spa these people are not always given the support and compensation and asked to rise to the level of responsibility that their role as the caring face of spa implies. I’m hoping that books like this, and managers and educators like Jeremy (and like Dr Marsha Synder in medicine)will help to shift the systems/ cultures/ synergies further in that direction. In my own stint as spa manager I aimed (and almost succeeded) in placing all spa staff on the same salary level – from receptionists to me. My intent was to underscore this concept of all working together.

In that ideal world perhaps we would see spa becoming more accessible to more people. Perhaps we would begin to redress some of the imbalances of power and consumption that remain such a problem in our world. Perhaps we would then know if spa does operate under a system that is based in health for all rather than in profit for some. These are tough questions but I think they are important to ask of an industry that is wanting to demonstrate its good intent and aiming to be in high service to its community. Jeremy McCarthy has shown himself to be someone who is not afraid to face such questions and still come from a place of energetic optimism.

Elaine O'Brien 27 July 2012 - 10:02 pm

Thanks for a fantastic article, Em! Can’t wait to read the book. Congratulations, Jeremy!

oz 28 July 2012 - 2:34 am

Jeremy – I suspect you are spinning this this just a little. Imagine if the dollars people invested in spas were spent on more productive ventures.

Emilya – I think you have seen one side of the maori experience – the other side is a group of people with extraordinary health issues – see http://www.health.govt.nz/our-work/populations/maori-health

Jeremy McCarthy 28 July 2012 - 12:21 pm

Oz, imagine if the dollars people invested in automobiles, junk food, and plasma TVs were spent on spa.

Oz 28 July 2012 - 2:49 pm

jeremy – im not sure i get your point.

i dont dispute spa fills a gap. but it really doesnt fix the problem – i cant see how its any better than retail therapy

Dr. Marsha Snyder 28 July 2012 - 4:16 pm

I think Jeremy’s point might be that with a truly professional spa experience, people are touched in a positive way which, in itself is therapeutic, and many of their aches, pains and ills can be addressed. Even if the spa experience is a beautifying one, like a facial or a pedicure, in the correct hands it has a caring and a healing aspect to it. This is far different than going out and spending your money on a new suit or a fancy dress(retail therapy). Right now, I am in Toronto, Canada, giving a presentation. I have an autoimmune disease that affects my CNS, limits my ability to ambulate and move, and there is no longer any medication available to me for treatment. When I first got here from the plane trip, I was stiff and in great discomfort. I had a body treatment done that involved heat and gentle massage at the hotel spa. It cost me $200, but it offered me more emotional, physical comfort and relief than my last 5 doctor’s appointments, which cost $180 each, of hearing him say that there are still no new drugs available for my illness.

oz 28 July 2012 - 9:25 pm

Marsha – I’m glad it works for you. But we do need to be careful extrapolating for everyone. Interestingly I was having a discussion with a Dr and he was lamenting that people are more disinclined to take care of their health as they have this belief that medicine will fix it now or discover something to fix it in the future.

Marie-Josee Shaar 30 July 2012 - 1:43 pm

Oz, maybe you should give the book a read? I think you’d enjoy it more than you anticipate. It emphasizes a lot of what you believe in – stress reduction, proper breathing, time to think alone, stepping away from technology for a while, intentionality and caring human contact. While reading it, I have also learned about a lot of research showing how spa experiences can serve as part of a sound pro-active, preventative maintenance routine. I don’t necessarily think spas are meant to solve issues all that much. Now of course there is never a one-size-fits-all and Jeremy doesn’t claim that spas will heal all wounds either. But it is a good strategy to consider using as part of a wellness routine. That to me, is a productive venture, and it deserves credit.

Jeremy – I’ve said it before but to reiterate, I was very impressed with your book, and learned a lot from it. Congrats once again!

Emiliya – I enjoyed your review, and as Jeremy pointed out above, reading about your experience with your Mom drove the point home really well. Well done!


Oz 30 July 2012 - 3:51 pm

emily, jeremy, mj – i guess the issue is teach a man to fish and …… spa is like a fishmonger albeit one that sells quality fish

PsychedinSF 6 August 2012 - 1:12 am

We love this idea of freeing the mind and allowing yourself to absorb the experience and let it recharge your spirit!- PsychedinSF

Jeremy McCarthy 10 August 2012 - 9:12 am

Oz, if you read my book you might find that I spend a good deal of time suggesting that spas could be a place where people learn how to fish.


Leave a Comment

This site uses Akismet to reduce spam. Learn how your comment data is processed.

WP Twitter Auto Publish Powered By : XYZScripts.com