Watsu and the Theraputic Use of Self

Jeanne Marie Shepard, MS, OTR/L

(Preprint, accepted for print publication in ADVANCE for Occupational Therapists, to appear.)

These days, most OTs ask, when considering a continuing education option, is it really going to help me in my practice? How much does it cost? And will it help me enough to make it worth the cost? As an aquatic therapist, I was curious about Watsu, a kind of aquatic bodywork, as soon as I heard about it and wanted to know all these things.

Watsu is defined as water shiatsu; the founder of the practice Harold Dulls is reported to originally be a practitioner of Zen Shiatsu. (I don't how that differs from ordinary Shiatsu.) Watsu is done in a heated therapy pool with a 1:1 therapist client ratio. It is recommended for a variety of problems, including but not limited to fibromyalgia, neurological conditions and sports injuries. Contraindications include sensitivity to heat and skin lesions. Photos of Watsu show practitioners supporting the heads and limbs of their clients in positions that remind me of a mother cradling a child. The clients shown look peaceful and relaxed.

These images intrigued me. I could imagine the feeling of being gently supported as I floated in warm water, being rocked and stretched .It seemed enticing. But the at the same time, I nervously wondered how it would feel to be so close to a person I didn't know with so little on.

I decided that there was only way to find out. Armed with a list of local practitioners, I began calling the females (no point in adding to the stress by having a male body to contend with). I contacted and made an appointment with Lori Geyman. Lori gave me directions to a retreat center in Fall City, (near Seattle) where she works with many of her clients. I arrived on a dark, stormy night to emerge from the rain into an enclosed building with an indoor pool. The light was dim. As I made my way in I could just make out two figures in the water. The woman was behind the man, supporting him as he floated gently in the water. To my great surprise and discomfort, they were both nude. My anxiety level shot up 50 points. For a second I was not sure of what I wanted to do. (Now don'' get me wrong, I believe that nudity, like everything has its place. After all, I worked my way through OT school as an artist's model. But nude bodies together in a warm pool were another story.) "Perhaps this is a little bit too New Age for me. Maybe I need something a little more mainstream..." were some of the thoughts that went through my mind. But I was still interested and just resolved that I would not be talked out of my comfort zone, or my bathing suit. In a few more minutes the session ended and I made Lori's acquaintance. "Suits are optional here. Whatever you feel comfortable with..." We both wore suits at my request.

We got in the pool and Lori asked me about myself and my experiences with bodywork. . She also took a relevant health history (heart disease? diabetes? etc.) and asked if I was uncomfortable with water in my ears, as I would be partially submerged. I explained to her that I was game to try this but that it seemed uncomfortable and awkward to me to relax into a strange person's arms. She suggested that we play it by ear.

We started with me with my back to the pool wall for support. Lori gradually came closer, asking about my comfort level each time. Eventually I was sitting on her knee. She led me backwards into the water so that I was lying back in her arms. I was beginning to feel a little tense about giving up control a this point when I was startled to hear her say, "You seem to be having a reaction to this. Let me bring your head up and explain what's happening to you so it will seem more clinical." I was amazed that she was so sensitive to what was going on with me- I had intended to grit my teeth and tough out the uncomfortable moments for the sake of experiencing the session. But here was someone who could tell when I was just beginning to be nervous, and knew what to do about it. I began to feel that I was, literally, in good hands.

It's not in the scope of this article to describe the course of the treatment. It felt more like a dream than any bodywork experience I've ever had, probably because I could hear so little (mostly Lori's breathing and occasional humming - is this what a fetus hears?) and because of the warmth. There was a lot of spinning and side to side movements that caused my spine and neck to crack in a pleasurable way. Eventually I had to ask for less spinning as I was getting dizzy. Lori showed me how the knees could be supported with a foam noodle for even less hands on contact. At the close of the session, I ended up back at the wall, as I had started. We closed with some talk about how I was feeling, (very warm, slightly dehydrated and quite relaxed), which of my aquatic clients I might try certain movements on and opportunities for more practice and training.

I spent some time thinking about this experience before I got around to writing it up. It had been my intention to share my impression of whether or not Watsu was a useful modality for aquatic Occupational Therapists to learn. Watsu is a useful technique to help people relax in the water and might be a useful modality for an OT who was already working in aquatic therapy. The price to become a certified Watsu practioner is steep, but there are less expensive workshops that teach some simple maneuvers that could be incorporated into a stretching/relaxation routine. And there is a local organization in my area (Seattle) that meets monthly for inservices, which welcomes outsiders. But that's not the most important thing I experienced.

In an Advance for Occupational Therapists column Claudia Stahl quotes Marilyn Cole of Quinnipiac College about the therapeutic use of self. Stahl reports that Cole, talking about the therapeutic use of self, says:

Students learn to relinquish most of the control in therapy to the patient through unconditional positive regard (acceptance of client's feelings and actions) and empathy... 1

In order for this to happen, the therapist must always be present and attending to what is going on with the patient.

In my case, if Lori had not been able to sense my discomfort and adjusted the therapeutic environment to accommodate my comfort range, I probably would have not been able to relax enough to benefit from the physical modality. But another important part to this is that I think it's unlikely that a therapist is capable of having this sort of empathy without being in touch with his/her own feelings about bodywork and handling clients is an intimate way. Occupational Therapists considering using Watsu as a therapeutic modality, or, indeed, any intimate physical modality, need to explore this issue thoroughly.

  1. Stahl, Claudia, Therapeutic Use of Self, Advance for Occupational Therapists, Feb. 9, 1998.