Into the Deep

OT Caterina Pietrobon uses her own experience to explore the impact that open water and competitive swimming can have on mental health and wellbeing

Ihave been practicing as a pediatric occupational therapist for the past 25 years primarily using sensory integration, play therapy and the Model of Human Occupation. I have never taught swimming as a therapeutic activity but included it in many home programmes and discussions with parents. As an extracurricular activity, swimming tones muscles, supports the development of praxis, bilateral integration, body awareness, endurance and self-regulation. Apart from being an important life skill for survival, team swimming has the added benefit of facilitating socialisation and creating a sense of identity

and belonging. Water provides buoyancy which makes it easier to move than in air, making it ideal for children with additional needs. I have always been drawn to water, despite growing up in suburban Johannesburg, a landlocked city at high altitude. I learnt to swim on my own in the local municipal pool aged five, and immediately fell in love with it. At primary school, there was no pool, but high school provided a chance to join the swim team. The regular team swim practice that took place in the early mornings before school left me feeling invigorated and ready to learn. After leaving school and living and working in various cities, I discovered other recreational pursuits - running, hiking, scuba diving and yoga, but always kept up swimming laps as a fun and meaningful mind-body experience and stress reliever. My more recent personal journey however has led me to discover the incredible power of open water and competitive swimming. In 2018, I took a sabbatical to complete a master’s in counselling. My goal was to understand how trauma and resilience intersect, and how individuals can use meaningful and purposeful activities to self-regulate and heal from trauma. The internship for the practical hours for the master’s degree took me back to South Africa. When COVID-19 and total lockdown hit in March 2020, I was totally unprepared for the void left by the loss of structure, lack of occupation, social interaction and the freedom to leave the house. Gone were the daily meaningful leisure activities like walking the dogs, hiking up the hill or photographing the lagoon. As lockdown progressed, I noticed that my motivation to do diminished, and my mood was down. I used daily ADL rituals and routines as anchors for structuring my days and learnt new skills like Zoom and how to access online professional development courses. What followed was a journey through the grief cycle, which I watched both as a spectator and as a participant knowing full well that this journey was inevitable and had to be walked to be processed. Keeping a daily journal and doing yoga helped me cope, but I longed for the outdoors and the power of nature. In October 2020, when lockdown restrictions were partially lifted, months of reflection on what activities gave me meaning spurred me to explore swimming in the local area. I joined the closest gym that had a 25m pool and a team of like-minded Masters swimmers of all ages, some with visual impairments and some with physical impairments. Being in the group gave me courage to swim in the local fresh water lakes and rivers for the first time. Swimming in open water came with subtle fears: getting stuck in the reeds, not making it the whole way, fear of what lies in the dark depths (thanks Jaws for planting silly ideas), losing my sense of direction. Then I realised approaching open water swimming could be seen as a metaphor for life “embrace change”, “feel the fear but do it anyway”, and “nothing ventured nothing gained”. The sense of exhilaration and wellbeing at the end of my first open water swim was unique. Once I calmed my fears, I began to feel part of the water and revelled in the magic moments of feeling connected to nature. Each stroke became a meditative action and my breathing was rhythmical and smooth. I stopped to visually reorient myself periodically, but felt safe and like I belonged in the environment. My sleep after swimming was deep and restorative. Each subsequent swim was easier and I eventually committed to swimming four times a week as a fixed routine, developing new skills like butterfly stroke, perfecting tumble turns and working on performance components like streamlining and dolphin kick. My identity as an athlete was forming and I had a new role that I could carry long term. Masters Swimming Gala 2021 was cancelled due to COVID, but I participated in my first Masters swimming championship in March 2022. The pool competition was about team building and participating for team points not medals. We dressed up in carnival attire and had fun. The 1km open water swim was on a rainy day and the road there was muddy and many cars got stuck. We pushed through and did our swim, and the same feeling of achievement and joy emerged. The oldest participant who successfully completed the 1km challenge was on our team and was 80 years old. August 2022 presented the opportunity to participate in a charity one hour challenge swim and I managed to do 2.3km which was better than I ever dreamed. The whole experience has illustrated how our values, interests and personal story interact with our environment and shape our choice and execution of occupations in a dynamic and systemic way. It also reminded me of the power of occupation and how it heals, transforms and creates new roles, identities, endeavors and outcomes. We are privileged to be able to help our clients achieve their best quality of life through occupation and participation in purposeful and meaningful activities throughout the lifespan.