I stepped down into the pool. Cold. Nice. I had a lot on my mind.
I started justI started just focusing on the motions. Up, down, side. “Am I doing this right?” “Do I care?” I thought about my worries. My hopes. People in my life. Back and forth. Thinking. Sending well wishes. Processing. As I left, my mind felt clearer, ready to greet the rest of my clients for the day.
Swimming is a nice mix of strategies. For me, it is exercise, a mindfulness practice, a way to let go of tension, and a way to process. To my knowledge, there is no research investigating this particular application. Still, as a therapist who practices eye movement desensitization and reprocessing (EMDR), I have sometimes wondered if the back-and-forth motions of swimming can mimic the bilateral stimulation (the eye movements, tapping, or other sensory pieces) that facilitates processing EMDR. Who knows. Anecdotally, I can say it helps me out.
Swimming as a Wellness Tool
People have probably used swimming as a wellness tool since we met water. It is naturally relaxing and enjoyable. Research has shown multiple benefits to swimming. A study of 33 children diagnosed with attention deficit hyperactivity disorder found improvements in stress, depression, and selective attention after an eight-week swim program.
Similarly, research investigating an intervention of twelve swim situations of adolescent girls’ self-concept found significantly greater improvement when compared to a control group in multiple areas of self-concept (Tavakolizadeh et al., 2012).
Research has also explored the effects of swimming in natural bodies of water on mental health. A review of 14 studies found repeated positive effects relating to swimming in nature, ranging from improvements in mood to mindful presence (Overbury et al., 2023). Few would argue that swimming, on its own, has some merit as a wellness tool, just like hiking, writing, or dancing.
But what about its use in psychotherapy?
Swimming as an Experiential Therapy
A Confucian proverb states, “What I hear, I forget. What I see, I remember. What I do, I understand.” This is the philosophy of experiential therapy. Experiential therapies integrate activities such as interaction with animals, movement, arts, and ropes courses as a part of intervention. Often, a piece of the intervention is learning through the process.
These types of therapies are common within residential treatment, wilderness programs, and other settings where individuals are receiving intensive therapeutic intervention on an inpatient basis. These are less commonly available on an outpatient basis.
Swimming can be integrated into traditional evidence-based practices, such as cognitive behavioral therapy (CBT) or acceptance and commitment therapy (ACT). For example, it can be used as exposure therapy for someone with a swimming phobia or to enact a metaphor in ACT. I spoke with Rebecca Brand, a licensed clinical professional counselor in Illinois, who has provided this kind of therapy.
Rebecca shares, “It is overcoming a trauma. Mastering a skill. It’s empowering to know the water will keep me up, not to be afraid.” Indeed, trauma expert Van der Kolt shares the need for somatic, experiential intervention in healing trauma in his book, The Body Keeps the Score: Mind, Brain, and Body in the Healing of Trauma. The act of swimming itself is a building of mastery and getting unstuck.
There is also a limited number of structural approaches using swimming in therapy. Among these is aquatic relational experiential therapy (ARET), a therapy utilizing swimming in a multidimensional way to assist in improving one’s relationships with self and others (Garaglass et al., 2022).
In Closing
Swimming can be therapeutic, particularly when combined with other evidence-based practices. While experiential therapies of this kind are most frequently used in residential settings, swimming also has a place in outpatient therapy.
References
Garzaglass, M. R., Garza-Chaves, Y., Williams, M. P., Fauster, L. K., & Freeney, L. G. (2022). The buoyant self: A conceptual journey of aquatic relational experiential therapy. The Humanistic Psychologist, 50(4), 607.
Overbury, K., Conroy, B. W., & Marks, E. M. (2023). Swimming in nature: A scoping review of the mental health and wellbeing benefits of open water swimming. Journal of Environmental Psychology, 102073.
Silva, L. A. D., Doyenart, R., Henrique Salvan, P., Rodrigues, W., Felipe Lopes, J., Gomes, K., & Silveira, P. C. (2020). Swimming training improves mental health parameters, cognition and motor coordination in children with Attention Deficit Hyperactivity Disorder. International journal of environmental health research, 30(5), 584-592.
Tavakolizadeh, J., Abedizadeh, Z., & Panahi, M. (2012). The effect of swimming on self concept’s girl high school students. Procedia-Social and Behavioral Sciences, 69, 1226-1233.
Van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Viking.