Real Sweat Therapy - Blog

Blog 05/03/26

Sweat Therapy: Sauna as a Psychotherapeutic Technique

I’ve been beating this drum for a long time now, more than 30 years. The essential idea that sauna can be used as a powerful psychotherapeutic technique has been a major part of my career as a psychologist. 

I remember me and my fiancé (now my wife) in my pickup truck driving on Rt 666 into the Navajo reservation in 1994 excited. I was taking a new job as psychotherapist in the only residential treatment center for children located on an Indian reservation. We talked about how the Navajo must have developed their own sophisticated and effective ways of treating mental illness and promoting wellbeing, just as every lasting society has. And we were going to learn about them. But I was still caught by surprise when the traditional healer took me to my first sweatlodge ceremony. That started my study of sweat rituals.

Sauna is a great place for individual or group work, including psychotherapy groups, support groups, psychoeducational groups, and personal development groups. It is perfect for marking the beginning or completion of a program. The specific way the process is done is only limited by the creativity of the users.

What I hope to do here is clearly and succinctly highlight what I see as the most salient therapeutic features of the sauna experience that make it a useful psychotherapeutic technique.

1. Sauna puts people in a state of readiness for change.

Two things that go on when you are exercising is that you develop a positive feeling state and you are maintaining thoughts characterized by positive coping. That is a nice state to be in if you want to engage in problem solving and creativity. As a psychologist working with a patient, that’s going to make my job a lot easier. Sauna is a form of physical exercise and we find similar effects. People commonly feel more upbeat, revitalized and relaxed by sauna. Sauna also results in positive cognitions reflecting strength, persistence and sense of accomplishment. Get a person in a positive emotional state of improved mood and attitude and you have a real opportunity to start making some goals and plans.

2. Insight through Introspection

Sauna promotes insight through multiple pathways. The stress of exercise brings thinking inward and one becomes more acutely aware of their personal concerns. While in an exercise state, people are also less likely to engage in denial and intellectualization. The longer one sits in a sauna at 190F, the more this is true. Another pathway to insight is the physical environment of sauna. The structure is small and intimate. The lighting is dim. Sound is at a minimal. Distractions are few. It is a perfect place for meditation and contemplation which is often a main purpose of the experience reported by sweat ritual users throughout the world. The last major pathway to insight that I have to mention here but will elaborate on later is through dialogue with others in close interpersonal interaction, getting feedback from others, both positive and negative.

3. Initiation and Transformation

If you want to mark the beginning of a personal journey or a commitment to change, I can’t think of a better ritual than sauna.

Whether it was in pre-Columbian North America, the land of the Finnar, or in ancient Greece or Rome, the longest standing forms of sweat practices were used for rituals of initiation and transformation including rituals of birth, puberty, weddings, and death. 

We all need time to reflect on our circumstances and to be sensitive to our emerging needs to change and to grow toward a superior and more mature stage of development. The next step after deciding what to do, is commitment. Rites of initiation and transformation provide us space to be contemplative and the force to sanctify our most important commitments. There is a complex interaction of physiological effects, symbols and metaphors involved in sauna that make it an ideal vehicle for rites of initiation and transformation.

Individually, the sweating experience provides an ordeal that one submits to. Change is symbolically represented by basic elements (earth, air, fire, water) changing forms. Fire burns wood turning to smoke. Rocks glow red with heat. Water thrown on super-heated rocks changes to steam and intense heat. One withstands the heat as proof of fitness and commitment. The experience is a lesson in humility as the intensity grows. Just at the point of feeling wiped out, the person emerges from the sauna… they begin to recuperate and drink wholesome life-giving water. Then comes the feeling of strength and rejuvenation. The invigorating ritual brings the participant to life again. Through submission and ordeal one becomes wiser and learns a lesson in humility by experiencing a rite of death and rebirth that marks the passage to a higher level of maturity.

4. Sauna Accelerates Group Dynamics

If I had to pick just one therapeutic feature of the sauna experience that makes it so useful as a psychotherapeutic technique, it is definitely the effect on group dynamics. My research on sweat rituals started with a qualitative descriptive study with Navajo youth using the sweatlodge ceremony (Colmant & Merta, 1999). This led to the next study with youth with conduct disorders using a sauna (2000). In the early 2000s, I led two randomized/controlled research projects investigating the effects of sauna on group dynamics with college students. The first one was with 24 students and the second with 85. In both studies we randomly assigned students to one of two conditions: Group Counseling in a Sauna (Sweat) or Group Counseling in a Standard Office Setting (Non-Sweat). We used various methods of measuring group dynamics including audio recordings of sessions, questionnaires, the experience of group leaders, and basic attendance and dropout rates. In both studies the results were same – The sauna experience accelerated and intensified group dynamics (Colmant et al., 2005; Eason et al., 2009). Participants in the sweat condition perceived a greater availability of therapeutic factors, especially for group cohesion and interpersonal learning, and had better attendance, less attrition, and reported sessions to be more useful. People made very personal disclosures fast in the sauna, sometimes in the first session. Group members bonded. Some of the sweat groups kept meeting after the study was done.

Think about the sauna compared to a standard office setting. In sauna, everyone is half-naked. The enclosure is small and the space intimate. The lighting is dim. And now everyone is enduring intense heat exposure, together. Pretensions and facades fade fast.There is a feeling of acceptance and universality. People naturally become less defensive and open up. For the group leader, participants view that person as more genuine and involved in the experience.

Conclusion

The interest in sauna in popular culture and science for health and overall wellbeing has gradually picked up momentum over the past 25 years. Today you almost can’t watch a health-related podcast without mention of sauna. However, there is still a long way to go. There is still a myopic view of only seeing the experience as high ambient temperature inside a box. Compared to the biological research on sauna, the psychological research is still in its infancy and those studies are almost always narrow in scope – “What effect does the heat-alone have on depression”. 

Human beings are complex and so is sauna. We can’t study it with human beings like we would with rats. We still need holistic research with both clinical populations and for the promotion of wellbeing. Sauna is a multidimensional experience with archetypal and metaphorical importance. At the same time, it is important to put sauna into perspective. We are not talking about some strange foreign, completely uncharted activity. Sauna includes multiple scientifically well-established health-promoting features including exercise, meditation, and close interpersonal interaction – all taking place within an hour-long experience. If I told you I had people exercise, meditate, and help one other and it resulted in improving their wellbeing, would you really be surprised?

References

Colmant, S. A., & Merta, R. J. (1999). Using the sweat lodge ceremony as group therapy for

Navajo youth. Journal for Specialists in Group Work, 24(1), 55–73.

Colmant, S. A., & Merta, R. J. (2000). Sweat therapy. Journal of Experiential Education, 23(1),

31–38.

Colmant, S. A., Eason, E. A., Winterowd, C. L., Jacobs, S. C., & Cashel, C. (2005). Investigating

the effects of sweat therapy on group dynamics and affect. Journal for Specialists in Group

Work, 30(4), 329–341.

Eason, E. A., Colmant, S. A., & Winterowd, C. L. (2009). Sweat therapy: Theory, practice, and

efficacy. Journal of Experiential Education, 32(2), 121–136.

Beyond Heat: Rethinking the Scope of Sauna Research

Embracing the Multidimensional Nature of Sauna as an evidence-based integrative practice.

Stephen A. Colmant, PhD

Independent Researcher / Prescribing Psychologist

Las Cruces, NM, USA

Introduction

Most current sauna research is grounded in a reductionist paradigm—treating the sauna primarily as an exposure to high ambient heat and measuring outcomes like heart rate, blood pressure, or metabolic shifts. While these studies yield meaningful insights, they often fail to account for the richly layered context in which sauna use unfolds. This article challenges the reductionist trend, arguing instead that sauna practice can be conceptualized as an evidence-based integrative practice, composed of multiple component processes—exercise, self-regulation variables, interpersonal factors, and metaphorical contextual elements—each of which is independently supported by a substantial empirical literature.

Critique of Current Research: The Limits of Reductionism

A dominant approach in sauna research is to isolate heat as the independent variable, controlling for temperature and humidity and tracking physiological markers. This reductionist approach has been essential for establishing physiological mechanisms; however, it is insufficient for explaining the full experiential and health impact of sauna practice. Focusing on control, quantification, and replicability imposes significant limitations. Stripped of its cultural, social, and psychological context, the lived sauna experience becomes a sterile laboratory stimulus, missing the elements that make sauna both unique and enduring.

Moreover, by foregrounding physiological endpoints, researchers often neglect or ignore the psychological, cultural, and ritualistic variables that mediate or moderate sauna’s effects. Sensations of relaxation, strengthened social bonds, and the meaning-laden rituals embedded in sauna traditions are rarely—even minimally—measured. Without these perspectives, many findings lack ecological validity and fail to capture the full spectrum of sauna’s influence on well-being.

Sauna as an Evidence-Based Integrative Practice

The case for sauna as an evidence-based integrative practice builds upon an important insight: sauna is not a single-component intervention but an experiential tapestry woven from multiple, well-researched therapeutic factors. Its core elements—physical exercise, self regulation, close interpersonal interaction, and metaphorical contextual elements—carry a substantial evidence base for health benefits on their own.

• Physical Exercise: The sauna experience, with its induced sweating and cardiovascular stimulation, parallels low- to moderate-intensity exercise, which is robustly linked to improved metabolic and cardiac health.

•  Self-Regulation: Saunas offer a contemplative, often silent space. Mindfulness and meditation are well-documented for reducing stress and enhancing emotional regulation—effects that sauna may facilitate through its sensory and ritual environment.

•  Close Interpersonal Interaction: Social connection, a key feature of traditional and contemporary sauna use, is strongly correlated with both mental and physical health outcomes. Sharing a sauna fosters intimacy and trust, breaking down barriers and nurturing community.

•  Metaphorical Contextual Elements: For many, sauna is deeply ritualistic, providing meaning, a sense of belonging, and symbolic cleansing. Sauna creates a symbolic context for spirituality—understood here as the process through which individuals construct meaning and purpose in their lives.

Heat and fire serve as universal metaphors for challenge and transformation, while the enclosed, shared environment promotes safety, authenticity, and connection. Intentionally enduring physical intensity—followed by rest, hydration, and cold immersion—functions as an embodied metaphor for goal formation, resilience, and commitment to personally meaningful aims.

Given that each of these dimensions is individually supported by substantial research, it is compelling to view sauna as an evidence-based integrative practice that combines the proven benefits of its parts into a potentially even greater whole.

The Multidimensional Nature of Sauna Experiences

Sauna use exists within a vibrant, multidimensional context. In Finland and other sauna-rich cultures, the sauna is a social hub, a locus of tradition, a place for contemplation, and a ritual woven into the rhythms of daily life and special occasions. The ambiance—the aroma of heated wood, the gentle hiss of water on stones, the interplay of light and shadow, the pause between silence and laughter—creates a sensory tapestry that shapes every moment.

Psychologically, sauna can foster deep relaxation, introspection, and altered states of consciousness akin to meditation or therapy. Socially, the shared vulnerability and intimacy of sweating together break down barriers, promote trust, and support meaningful conversation. These dimensions are not peripheral; they are central to the sauna’s meaning and effects. Any research that ignores them risks yielding an incomplete and possibly misleading picture of sauna’s true value.

Personal Narrative: The Ritual of Sauna

My own backyard sauna by the pool has become a site of ritual and renewal. The process begins with preparation—the careful heating of stones, the setting aside of time, the anticipation. Entering the sauna, I feel the immediate quiet, a shift from the noise of daily life into a space that invites reflection. The ritual unfolds: the rising heat, the rhythm of steam enveloping the senses, moments of solitary thought or shared conversation, and the revitalizing plunge into cool water outside.

Each element—the environment, the sequence, the company—converges to create a profound sense of clarity and relaxation. It is not heat alone that delivers these effects, but the totality of the experience: anticipation, sensory immersion, collective participation, and symbolic cleansing. This layered complexity cannot be reduced to a single variable and underscores the need for research that honors the ritualistic and psychosocial dimensions of sauna use.

BBC Article Critique: Nuanced Perspectives and Research Gaps

A recent BBC article on sauna’s health benefits offers a more nuanced take than previous popular coverage, acknowledging both promising findings and persistent uncertainties. Notably, Dr. Massey is quoted: “So there's definitely some benefit to using the sauna but the question is whether that's a long-term health benefit or more of a psychological one.”

This statement encapsulates a persistent and problematic dichotomy in health research and reporting: the false division between long-term health and psychological benefits. In reality, enduring improvements in psychological health—such as learning to think less extremely, consulting others rather than acting impulsively, or cultivating greater resilience—are themselves meaningful, long-term health outcomes. The separation of “physical” and “psychological” health is increasingly recognized as artificial, as decades of research affirm the bidirectional influences between mind and body.

The BBC article represents progress in recognizing sauna’s complexity, but also highlights the urgent need for research that systematically investigates its psychological, cultural, and ritualistic dimensions. Without this, our understanding of sauna’s true impacts will remain partial and potentially skewed.

The Sweat Therapy Theoretical Model: A Holistic Framework

The Sweat Therapy Theoretical Model, articulated in the Journal of Experiential Education (2009), provides a comprehensive framework for understanding sauna not simply as a heat exposure, but as a holistic, experiential process. The model positions sweat-inducing rituals—including saunas—within a spectrum of experiential therapies that bring together physical, emotional, social, and spiritual dimensions.

 Call for Holistic Research: Toward a Multidimensional Science of Sauna

To truly advance the field, future studies must transcend reductionism and embrace sauna’s multidimensionality. This requires research designs that integrate qualitative methods, ethnographic observations, and measures of psychological and social outcomes alongside physiological markers. Theoretical frameworks like the Sweat Therapy Model should guide inquiry, ensuring that meaning, ritual, and context are not afterthoughts but central focus points.

Collaboration among health scientists, psychologists, anthropologists, and sauna practitioners will be vital for capturing the full richness of sauna experiences. Only by attending to the entire spectrum of influences—cultural, ritualistic, social, aesthetic, and psychological—can research do justice to sauna’s enduring appeal and therapeutic promise.

Conclusion

Sauna is much more than passive exposure to heat; it is a complex, multidimensional ritual intricately woven into human life. The limitations of current research highlight the urgent need for holistic approaches that account for cultural, psychological, and social factors as central, not peripheral, to health. The Sweat Therapy Theoretical Model offers a valuable blueprint, while personal and media accounts underscore the richness and complexity of sauna traditions. By embracing sauna as an evidence based integrative practice—an integration of empirically supported therapeutic dimensions—future studies can yield more accurate, nuanced, and transformative insights into this ancient practice.

References

Colmant, S. A. (2011). Sweat Therapy: A Guide to Greater Well-Being. Amazon. ASIN: B004NIFPA0).

Eason, E. A., Colmant, S. A., and Winterowd, C.L. (2009). Sweat Therapy Theory, Practice, and Efficacy. Journal of Experiential Education, Volume 32, 2 pp 121-136.

Rufo, Y. (2025 December 29). Do saunas really boost your health? BBC News. https://www.bbc.com/news/articles/c5yj3g0p26ro

Author Note

Stephen A. Colmant, PhD, is a prescribing psychologist and the author of Sweat Therapy: A Guide to Greater Well-Being. His work explores experiential, integrative approaches to mental and physical health.