Originally published in Massage Bodywork magazine, February/March 2003.
Copyright 2003. Associated Bodywork and Massage Professionals. All rights reserved.
Cradled in his arms, children who rarely find a moment's peace find a sea of calm, Jeff Bisdee has offered the aquatic body therapy known as Watsu at The Children's Institute in Pittsburgh since 1997. As the manager of recreational therapy there for the past 17 years, Bisdee was impressed the first time he saw Watsu. "It was an epiphany," said Bisdee. "I was always interested in doing aquatic therapy with patients and when I saw this being done, I knew right then and there it was something I should be doing."
Bisdee's patients at The Children's Institute range from infants to 21-year-olds and most have suffered trauma -- brain and spinal cord injuries, orthopedic issues, congenital and birth defects including spina bifida and autism, as well as a range of neurological disorders. "If the child is appropriate for rehab, we'll see them here," he said.
As a long-time advocate of water therapies at the institute, Bisdee knew Watsu needed to become part of the menu. "I've always been in tune with the water that way." He said the two pools at the institute already allowed patients the opportunity to work on their strength and endurance. Watsu, he thought, would bring them so much more.
Bisdee took the initiative and pursued training. "Learning Watsu was something I had to do for myself. It was bigger than my job; it was more about meeting my own life goals."
Afterward, Bisdee began the arduous task of convincing others that this "alternative" therapy was safe and effective. He started by showing the technique to the staff of physical therapists. When they got excited about it, he demonstrated Watsu for the doctors and physicians. Their enthusiasm prompted Bisdee to take the technique over the final, daunting hurdle -- the administrators. "Being somewhat alternative in nature, the therapy really needed to be introduced carefully, with the goals of the institute in mind as well," he said. It was 1997 when he finally was able to put the Watsu principles in place.Watsu in Action
Unlike other therapies utilized at the center, Bisdee said Watsu has a more intimate approach, and as such, he takes time to explain the work to parents before ever putting a patient into the water. What starts as a somewhat apprehensive moment as mothers and fathers watch their children subjected to a "new" therapy, ends many times with parents in tears. "The main goals for several of these patients are relaxation, an increase in comfort, reduced pain and passive range of motion. The parents see their children in a comfort state and at peace with their body and they become emotional."
Such was the case for the mother of an 11-year-old boy with ankylosing spondylitis (arthritis of the spine). She witnessed that peace in her pain-ridden child. The disease, which causes severe pain in the joints, was prevalent in the boy's back and hips. He was also diagnosed with attention deficit hyperactivity disorder (ADHD).
"He was a wild kid at times," said Bisdee. "He was very bright, but he had a lot of behavioral problems that arose around his pain and his attention disorder. I worked with him three to four times a week with Watsu and it seemed to reduce his negative behaviors, especially through the eyes of his mother, the nurses and staff." More importantly, the boy told Bisdee the therapy reduced his pain.
Bisdee remembers one day in particular. The boy was scheduled for his Watsu treatment in the therapy pool, but three other therapists were busy in the water with patients. The environment was noisy, something counterproductive to what Bisdee was seeking during the session. They decided to proceed anyway. "He ended up falling asleep, or at least going into a different state of consciousness that was shocking for the environment that day," Bisdee said. Not only that, but the boy wouldn't wake up. "We sat there for a good 10 minutes before he finally woke up. He looked around and I told him he had fallen asleep. 'Oh no, I wouldn't have done that,' the boy said." Bisdee looked over and saw the child's mother with tears rolling down her face. She had rarely, if ever, seen her boy so relaxed and calm. "It was quite dramatic for his mother and me," he said.
Plenty of other successes grace Bisdee's resume, but a few hold firm in his mind. "I worked with an 18-month-old girl from Korea who, within the first six months of her coming to the United States, came down with encephalitis," said Bisdee. "She became severely brain damaged to the point where the prognosis wasn't good. They said she wouldn't regain anything; she would be non-functional."
Unable to let the dire diagnosis slow him, the therapist incorporated Watsu into the infant's rehabilitation. "This baby had a lot of tightness in her extremities and was starting to contract in many ways. But doing Watsu with her was an amazing experience." Bisdee said once they were in the pool, the child became so relaxed she fell asleep. Her parents reported that it also helped her sleep at night -- behavior that was rare for her. As the basis for Watsu is shiatsu, working her acupressure points while in the water further enhanced the effects.
While working with an autistic 5-year-old boy, Bisdee learned how to let the client lead the session. Even though there is a set protocol for the initial procedure or sequence of moves, the goal with Watsu is to be intuitive in the work and read clients and their needs through their bodies. "It really was true working with autistic kids, especially this boy. I did free-form with him and he would lead the sessions." Bisdee said the boy was a good teacher.
Probably the most dramatic case for Bisdee was a 15-year-old muscular dystrophy patient, J. J., he started working with two years ago. "I ended up being a single-service provider for him," Bisdee said. The physical therapists who had been working with J. J. in the pool told Bisdee how physically difficult it was to handle him in the water. Usually his sessions required at least two therapists. Bisdee described J. J. as quite physically contracted, emaciated and limited by the rods in his back. "The physical therapist asked if I would consider doing Watsu with him," Bisdee said. "I got the okay to do it and we went from three therapists working with him to just myself. I was able to stretch him from head to toe."
Bisdee was able to counteract J. J.'s neck pain, which was caused by him trying to hold his head up throughout the day, as well as the pain he felt from being confined to a wheelchair. "We ended up getting insurance coverage for him to do Watsu. It's the first time I know of that Watsu was paid for in western Pennsylvania," said Bisdee. J. J.'s mother, Lynette, videotaped sessions and showed them to her son's doctor. "He was impressed," she said, and lent his support for the insurance coverage.
Working with the boy over the course of several months allowed Bisdee and Lynette to track his progress weekly. They evaluated his appetite, sleeping patterns, weight gain and several other factors after each treatment. "We could see that for three days after his Watsu session, he was only waking up once a night, his appetite was better and his attention in school was better," Bisdee said. "He was even able to improve his respiration, staying free of any breathing machines during sleep. After three days, it started tailing off again." So Bisdee asked to do Watsu with him twice a week. It was then the boy "evened out" for the entire week.
"Watsu did more for J. J. than any physical therapy ever did," said Lynette. "I just wish we could have started this years ago." She said one of the biggest advantages of the therapy for her son is the relaxation it brings him. "It's hard to get J. J. comfortable and relaxed. With Watsu you let the water move everything. It's pretty amazing to watch," she said.
Two years later, and Bisdee is still doing Watsu with J. J., but the sessions have been reduced to once a week. Bisdee said the work he does today is really a maintenance program that will increase, and maintain, J. J.'s quality of life. "He looks forward to it every week and it's been a great thing to work with him."The Value of Watsu
Bisdee, the only therapist at the institute practicing Watsu, said he has very few counterparts in the United States. He only wishes more therapists would see its value. "I find it to be the most effective treatment I do here. The feeling you get with the patient in the water is just incredible, even indescribable at times." He said there is an incredible release of energy through the technique that is palpable and powerful.
"Percoset in water" is how one patient described Watsu. Back when the institute served adults as well as children, Bisdee saw a 32-year-old woman with a spinal cord injury. "She had a lot of anxiety and worry about her life at that point, being away from her family, housework, bills -- her anxiety got in the way of her rehab program," said Bisdee. "I offered to do Watsu with her, thinking it would help reduce her anxiety and help her focus more on her program." One of her first comments out of the pool was the Percoset reference. "It stuck with me," said Bisdee. "A lot of alternative approaches like this can be a replacement for pharmaceutical treatment."
In addition to the direct effect of Watsu, Bisdee said he also uses it as a pre-activity for swimming therapies. "I use it with my quadriplegic and spinal cord patients before teaching them to swim again. They don't have much control of their bodies in the water, and Watsu is one of those techniques I can use to gain their trust all while they relearn the principles of the water."
An ancillary benefit of Watsu is the interaction between parent and child. "Now parents hold their child in the pool where before they were just using flotation devices. Some of these patients are quite physically disabled and as they get older, it gets harder and harder for some of these kids to be held by their parents anymore." Witnessing Watsu opens the door for that closeness to still exist. "It allows them that nurturing way in the water," he said.
"Watsu really has become a passion for me and I enjoy seeing how much it can help people -- sometimes short term, sometimes long term," said Bisdee. "I absolutely recommend it for other therapists. I'm quite enthusiastic about it and I wish we had more therapists doing it." Karrie Osborn is the former editor and current contributing editor to Massage Bodywork magazine.