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Acupuncture Today – April, 2003, Vol. 04, Issue 04

Constitutional Facial Acupuncture: Changing the Face of Aging, Part Four

Spa Life vs. Private Practice: A Look at Spas and Healing Centers

By Sunanda Harrell-Stokes and Mary Elizabeth Wakefield, LAc, Dipl. Ac., MS, MM

In our last column, we discussed a chronic skin condition, rosacea, from a TCM, allopathic medicine and Western herbal perspective.

In this issue, our focus will be on the development of a new and most welcome trend: the incorporation of healing and health modalities by destination spas, day spas and wholistic centers.

According to certain sources, "spa" is actually an acronym for the Latin phrase "salus per aquam," meaning "health by (means of) water." It seems that a certain Roman emperor, confronted with battle-worn, weary troops, prescribed some rest and relaxation in the local waters. This involved a revivifying soak in hot natural springs, followed by a plunge into a cold pool. Another viewpoint is that the word originates with the name of a town in the Belgian province of Liege, Spa, noted for its hot springs.

When Mary Elizabeth lived in England, she visited Bath, one of the most famous Roman spa locations. She was astonished to witness the sophisticated underground heating network for the water, and awestruck by the beauty and healing power of those remarkable pools.

From these beginnings, spas sprang up throughout Europe, in towns and villages that possessed miraculous hot springs. In Germany, Austria and Switzerland, they were referred to as kurbaden, or cure-baths.

The Romans, like many from the ancient world, seemed to have an innate understanding of the curative powers of water, and utilized the yang qualities of the hot springs to open the pores, soothe aches and purge toxins, balanced by the cold plunge into the yin to close pores, astringe and tone the body.

But let's leave ancient Rome, and journey to 21st-century America, where a recent survey by the International Spa Association cited 9,632 spas scattered across the United States, generating $11 billion in revenue per year.

This is a booming business, and it has become an ideal venue for integrative health practices. The present trend seems to focus on well-being, preventative medicine, and healthy lifestyle education.

Issues of balance, healthy living and integrative awareness have fostered receptiveness to the unique nature of the energetic medicine of acupuncture and herbal therapy. Now, some years later, other spas (i.e., destination or day spas) and centers are following suit and are synergizing wholistic concepts of health and healing with medical treatment; acupuncture; sound healing; yoga; Thai massage; psychotherapy; treatment by estheticians, etc. Such a development is indeed encouraging for the acupuncture profession, and opens doors to a wider range of employment possibilities, with new understanding and respect for an ancient system of healing that is still potent and timely.

Along with traditional acupuncture, constitutional facial acupuncture has started to become a popular modality in these spas and centers. There is nothing like a little "healthy vanity" to entice patients to enter a new realm of awareness and healing. We are riding the crest of a powerful new wave of healing, and the potential is simply enormous for this new field.

Spas are beginning to conceive of "beauty" as synonymous with longevity, "healthy" aging, quality of life and balance. Moreover, the noun "beauty" is derived from the Latin bellus, which means "pretty" and is akin to the adjective "bonus," which translates as "good." This implies that there is goodness in beauty - "the aggregate of qualities in a person or thing that gives pleasure to the senses or pleasurably exalts the mind or spirit."

American society, which exalts the Puritan work ethic, has an ambivalent attitude toward beauty at best, and rather tends to see the pursuit of pleasure as frivolous. In contrast, this original notion of beauty as embodying goodness implies the existence of a union between body and spirit, creating an opportunity for us to experience delight, joy and well-being. This definition of beauty reflects a multifarious tapestry of possibilities for health and balance, and for walking a joint path of sensuous enjoyment and longevity. This hearkens back to the classical Greek idea of the golden mean, which was also expressed in sacred geometry, i.e., creating balance and symmetry in all aspects of life. These principles also find their expression in Chinese medicine.

In light of this new and exciting evolutionary movement in the spa environment, we - who have trained acupuncturists in spas, and have our own individual private practices - would like to illustrate some of the differences between the two, focusing on protocols and decorum in particular.

The Spa as a Network

Ideally, the spa network is a matrix of connections among different departments designed to address various aspects of health and well-being. It is a community of practitioners living in close proximity to one another; a village of healers with the shared intention of providing each guest with optimum health awareness and an experience of enhanced vitality.

Clearly Define and Educate

In establishing an identity as a facial acupuncturist in a spa setting, it is important to promote interaction with other departments, and to clarify, for example, how a facial acupuncture treatment differs from an esthetician's facial. One should also strive to educate the other departments about this special modality. This will serve to foster an understanding of how these services may be cooperative, instead of competitive. For example, a guest who is a corporate executive in a high-stress position has an appointment for constitutional facial acupuncture with symptoms of neck and shoulder tension, acne and low back pain. In the context of treatment, it would be appropriate to suggest that she consult the nutritionist, neuromuscular therapist and esthetician, resulting in an effective synergy of treatments to help her achieve her health goals more readily - in other words, establish a permeable membrane between departments and with the other practitioners.

Network Guidelines

  • Use the other spa departments as sources of referrals (e.g., recommend the esthetician's facial as a means of cleaning the guest's pores prior to your facial acupuncture treatment).
  • Maintain the language of the profession in outlining your services. For example, the words "poultice" or "plaster" are more specific than the generic "mask" in communicating the healing benefits of the herbs. This will serve to eliminate a feeling of competition caused by the impression that your treatments merely duplicate those of another department.
  • Stress the fact that other services are complementary to yours, and, to reiterate, that you can indeed "refer" guests to each other. For example, give a facial acupuncture treatment to the esthetician, a doctor or other spa practitioner, and allow yourself to experience their treatments in return. Make a sincere attempt to engender openness and rapport with your practitioner colleagues.

Conversely, in private practice, networking is also important, but not at the level of this intense community, which poses some interesting challenges.

  • Take it upon yourself to educate plastic surgeons about the value of facial acupuncture treatments prior to and after cosmetic surgery. Impress upon them the understanding that your treatment is constitutional in nature, and can serve as a useful adjunct.

This approach can be pursued to good effect in private practice, and in an integrative spa environment.

Etiquette and Dress Code

The dress code in a spa is customarily elegant or upscale professional. The practitioner does not always wear a lab coat!

Image Is Important

Your dress and manner; sense of inner and outer beauty; humor; and self-esteem impart a direct message to your clients from you, as a representative of the spa, and of the services you offer.

To illustrate: while Mary Elizabeth was being driven back from a "monsoon-like" seminar held in an isolated mountaintop retreat in Hawaii last year, her sponsor, still at the wheel, and just now barely within the confines of civilization, glanced down at her toes, spattered with mud, and exclaimed, "Oh my, that won't do; I need a pedicure pronto - someone will look down at my toes while I'm working in the spa!" She was keenly aware of her spa "image," protocol and personal hygiene. Such scrupulous attention to detail might not always be necessary in private practice.

"The Guest Is Always Right," or the Complaining Guest

Diplomacy and the ability to deal with a difficult guest are very important in a spa situation. Some guests make it their "hobby" to complain about services. You must be very clear in your actions, and communicate directly with your supervisor or the spa owner about the situation immediately after you've experienced a problematic guest. Forewarned is forearmed, and this intention of clarity may alleviate the disharmony.

No Streaking in the Spa, Please

Make certain your guest or client is covered and comfortable without any exposed areas, except for the décolletage. Honor your guests' sense of privacy; most people are extremely sensitive about their bodies.

The Bruising "Blues"

Bruising the face can be viewed as a tragedy in a spa situation; guests pay a good deal of money for their treatment, and their expectations are correspondingly high. Be aware that some guests may not only expect nurturing and care, but may similarly project a fervent desire for their seemingly lost youth onto the practitioner. Take care to avoid falling into this trap; maintain well-defined boundaries, and use discretion in your treatment, especially in an initial session.

If the guest has an important public appearance in the next few days, it might be prudent to avoid facial acupuncture, and employ other modalities, such as microcurrent, acupressure or an LED (light-emitting diode).

Remember that the destination spa guest is in residence only a week or less; it is better to err on the side of caution in your treatment, and avoid undesirable side-effects. This will ensure you have a clientele that will seek out your services in the future.

Self-Care and Living in Balance: "Being Beauty"

One of your significant functions as a practitioner is to inspire your guests. Getting a pedicure prior to your consultations, i.e., maintaining hand/foot nail care, is only a part of necessary and healthy self-nurturing. It is paramount that you reflect and embody the ideal of beauty to which your customers aspire; you must "be" beauty for them.

Earlier in this article, we spoke about goodness being a component of beauty, and that the celebration of the body can likewise exalt the spirit. This awareness should become indispensable for the practitioner who desires to work in a spa setting in which the focus is not merely on "fluff-and-puff," but also healthy lifestyle change. Such a shift in personal consciousness is the first step on a transformative journey that ultimately requires the practitioner to infuse their intentions and actions with the qualities of compassion; clarity; self-care; humor; wholeness; and goodness.

Our English verb "pleasure" means "to please" (related to the French plaisir). Embracing the pursuit of pleasure in the manner we have discussed demands that we "become" beauty within and without, evoking joy and delight. We should be willing both to please and be pleased, while still maintaining our dignity and personal center. These are important attitudes to adopt prior to the decision to immerse oneself in a spa environment.

Day Spas

Recently, we had a chat with Sky and Andrea, who are in the process of introducing facial acupuncture at their spa in Rochester, New York. They were kind enough to educate us somewhat further regarding day spas.

Their interest in incorporating facial acupuncture into their course of treatments is indicative of a commitment to alternative medicine and healthy lifestyle training. Their spa is a "high-end spa without the high-end attitude," and our conversation was imbued with friendly humor and sincerity.

Attributes of the Day Spa Environment

  • teamwork;
  • an excellent front desk;
  • ambience and atmosphere (a sensual experience);
  • "tiny touches": attention to details;
  • sharing, i.e., "the practitioner has not totally learned something until he or she has shared it with someone else";
  • education for clients and staff;
  • a consistent level of excellence;
  • listening to the client;
  • "open door" communication, for clients and practitioners;
  • the cultivation of trust;
  • an open attitude toward alternative medicine; i.e., acupuncture and healthy life style;
  • your importance as the spa owner/practitioner;
  • relationship/special services;
  • nurturance through touch;
  • laughter; and
  • repeat customers: day spas are required to maintain a consistent standard of excellence and to match their clients' expectations after their return from the glamorous destination spa experience.

With respect to repeat customers, Sky amusingly observed, "It's like having your mother-in-law coming in for a visit every week; you're always on your toes."

In conclusion (mother-in-laws aside!), many factors need to be weighed in choosing to work in a spa or healing center. We hope this article illuminates some of these considerations, and will motivate you to examine the potential of this innovative career track within our profession. Additionally, as a little incentive, you might entertain the idea that the word "spa" can refer not only to a Roman bath or a Belgian village, but also the following:

Spa Positions (for) Acupuncturists!


The Facial Acupuncture column is a collaborative effort of several acupuncturists who are pioneers in the field of "healthy living." Sunanda Harrell-Stokes is one of those pioneers, having co-created the Marisandaú constitutional facial protocol. Since 1973, she has offered a unique combination of scientific and humanistic skills gained from a background in microbiology, psychotherapy, wholistic health and Oriental medicine.

Sunanda is licensed as an acupuncturist in four states and is certified by the NCCAOM. She is a graduate of Syracuse University and the Academy of Chinese Culture and Health Sciences, and has completed advance work in traditional Chinese medicine at Nanjing College in the People's Republic of China. She has studied facial diagnosis, acupressure and acupuncture for facial rejuvenation with Lillian Garnier, Shogo Mochizuki, Alex Tiberi and Mary Elizabeth Wakefield. Sunanda's practice focuses on biological individuality applied to conditions related to aging; stress; PMS; menopause; sinusitis; headaches; and musculoskeletal pain.
Click here for previous articles by Mary Elizabeth Wakefield, LAc, Dipl. Ac., MS, MM.


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