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THIS ISSUE:
Bringing
Energy
to Health Care
Swedish Institute on-line newsletter for our students, faculty and community.
Energetic Evaluation
by Tom Banasiak, L.M.T.
The revelation of Eastern therapeutic modalities is that there is an energetic nature to the physical body. The body is, of course, that which we can most easily get our hands on because it is the most physical part of us. That said, the converse is also true: The physical body is the least energetic part of us. In the practice of Shiatsu we accept the premise that the human body has both energy (Qi) and substance. If the physical is easiest to grasp, how do we, as bodyworkers, work with the subtle nature of Qi? How can I, as a practitioner, evaluate and access that which has no physical quality?
Shiatsu practitioners begin their energetic observations of the
body at the Hara (the abdominal area) and the meridians because Qi can more
readily be felt there. The Hara and meridians are considered the interface
between the physical and energetic natures of the body. Evaluating the flow of
Qi in these areas involves more than "feeling" something purely on the
physical level. We will need to use the body and mind in unique ways to make our
assessment.
Energetic Palpation
Where does one start? I begin my assessment of the energetic nature of the body by first increasing my awareness of Qi. At the start of a session with a client, I sit beside that person quietly and let go of the idea that I have to do or find anything. I place my hand on the person's Hara, allowing time to focus my mind, soften and align my body, and expand my energy field. That is, I alter my perceptions so I am not thinking about one thing, but I become present to what is.
This process is not part of our reasoning and logical thinking.
If it was, students would have an easier time doing it. But if it is not logic,
then what is it? To communicate with a client on an energetic level, one more
subtle than the physical, we have to let go of the word-dominated mindset. One
of the challenges of Shiatsu practice is to quiet the mind so wordless
perceptions can arise. We focus instead on how a client feels by
assessing the physical sensations the client presents and then we interpret
those sensations to form a session plan.
Assessing Kyo and Jitsu
One of the ways we describe the energy we perceive in the Hara or meridians is through the relative descriptions of Kyo and Jitsu. When we talk about Kyo and Jitsu, we say that Kyo is soft and empty, while Jitsu is hard and full. These descriptions are practical, two dimensional and logical. But in reality, Kyo and Jitsu are more complex and more subtle.
The Kyo and Jitsu meridians will be the most palpable because of their strong need to assert their existence. Shizuto Masunaga, who developed the theories and practice of Zen Shiatsu, defines Kyo and Jitsu as two opposite distortions of the flow of Qi. Kyo represents the under-active state, while Jitsu is the over-active state. Masunaga further explains Kyo as the desire and need to be filled with Qi. Thus, treatment focuses on bringing Qi to the Kyo meridian, the one that has the strongest need to be filled with Qi.
Alignment and Presence
The experience of energetic evaluation depends on more than the sense of physical touch. It necessitates a sense of empathy, detachment from expectation, and a reverence for the client as the center of his or her own life. The practitioner opens up to become an energetic presence without any judgment, just acceptance, compassion, and loving kindness. Doing so encourages the client to adopt the same attitude, a concept known as “energetic modeling.”
We cannot logically deduce energetic states. We must visualize them and open our Heart. This is the essence. Cultivating this attitude can be beneficial in both our professional lives and personal development.
Tom Banasiak, LMT, is a faculty member in the Massage Therapy Program. He teaches all levels of Shiatsu and Clinical Strategies. Banasiak is a Diplomate of Asian Bodywork Therapy (NCCAOM), an AOBTA Certified Instructor and is certified in Zero Balancing.
Contact Tom Banasiak through our Locate a Practitioner feature.
Shiatsu or Acupressure?
Shiatsu is a form of body work which originated in Japan, though
it has roots in the meridian system of Chinese medicine. The focus is on
stimulating the flow of Qi along the meridians and throughout the body. It is a
complete system of evaluation, treatment and theory.
While "acupressure" shares some similarities to Shiatsu, acupressure as a practice is often based on the use of points alone and does not necessarily incorporate the larger system of thought that Shiatsu represents.
For more information
American Organization for Bodywork Therapies of Asia (AOBTA) at www.aobta.org.
Supporting Flexibility During the Winds of Change
by Michael Alicia, L.M.T.
History
The client is a 51-year old male diagnosed as HIV positive nearly 15 years ago. At that time he changed his lifestyle significantly by quitting smoking and reducing his consumption of alcohol, red meat and sugar. He has a history of bronchitis, eczema and allergies, which are exacerbated in spring, exhibiting dry green patches at the elbows. He has two jobs and often works 14-hour days, but both jobs allow a flexible schedule and multiple vacations. He has been in a committed relationship for 30 years. He has a history of stuttering since childhood, which resurfaces during times of stress. At the end of last year (‘05), he was diagnosed with first stage melanoma in the neck/shoulder/axilla area and had it removed along with lymph nodes in the area. He currently is taking Naltrexone (an opioid drug that some doctors prescribe for HIV to boost the immune system) and Valtrex (an antiviral for herpes.)
Evaluation
My Shiatsu evaluation consists of Bo Shin (looking), Bun Shin (listening), Mon Shin (asking) and Setsu Shin (palpation). From listening to the client and asking questions, I learned that at this session he was feeling a general depression and malaise. While this may be common at the height of winter, it was exacerbated by his recent surgery for melanoma. He also expressed fears that surfaced during a recent trip to Florida. He had returned feeling upset because due to the melanoma diagnosis he couldn’t walk in the sun, a common practice for him and his partner on vacations. Feelings of loss of control had also come up, because friends had exerted demands that interfered with the social plans during vacation. The client reported that changing and unpredictable weather had been bothersome, especially at night. He felt like he was fighting a cold, and had a sore throat. He also had a canker sore on his tongue, and an “acid stomach”, which he thought might have been caused from his diet that week. He spoke with a slight stutter while discussing his symptoms, and had difficulty with articulation of ideas.
Setsu Shin, that is, palpation of the Hara (abdomen), back and meridians, revealed the following:
The Hara showed that the Liver energy was Kyo, with Triple Heater and Gallbladder presenting a false Jitsu condition. (See Tom Banasiak’s article for a discussion of Kyo and Jitsu.)
Palpation of the back revealed that the Bladder and Kidney meridians were Kyo.
Of the Shu points on the back, the Stomach Shu point was most notable for its Jitsu condition.
In general, the tenderest area on his body was the Gall Bladder meridian, along with muscular soreness in the area of the neck.
Session Strategy
My strategy for this session was to tonify (strengthen) the Bladder meridian (Water element) so it would help the client deal with his fear, which is associated with water. Tonifying Water would also support the Liver and Gallbadder meridians (Wood element), helping the client respond with more flexibility to the changes occurring in his life. He doesn’t like change and has endured a fair amount recently, both in the weather fluctuations and in his recent surgeries. Even his vacation plans were altered because of his inability to take his usual walks with his partner and the additional demands friends exerted on his ability to socialize.
The Wood element would control the Earth element, or Stomach meridian, showing an excessive condition through palpation of the Shu point and the appearance of a canker sore along with increased acidity. Bringing the Earth element into balance with the other elements would also create a greater sense of stability for the client.
I tonified the Triple Heater meridian in order to help support his immune system in overcoming the sore throat and cold symptoms. Tonifying Triple Heater would help with the sensitivity to fluctuations in weather. I included tonification of the Pericardium and Heart meridians to help him better endure the changes in his relationship with his partner and friends.
I completed the session by working on the zone of the neck to reduce tenderness, adding range of motion exercises and active stretching (Sotai) to alleviate muscular imbalances.
Outcome
Immediately after the session the client reported feeling more relaxed. His stuttering seemed to subside. His Hara showed a shift, with the Triple Heater taking on a softer, less Jitsu feel, while the Liver felt full, which is its more natural state. His cold symptoms had abated; the sore throat was gone, though some sinus stuffiness remained.
The following week, the client reported a continued reduction in his anxiety. He attributed it mostly to being back home and in his routine. He generally loves vacationing, though all the added variables this time really seemed to alter his sense of balance in a profound way. A visit to his psychotherapist later in the week, during which he spoke about his emotional upset over the vacation, also further eased his mind and contributed to his adjustment to the changes he was experiencing.
Michael Alicia teaches Shiatsu I, Shiatsu II, Swedish Massage I, Introduction to Sotai and Introduction to Thai Massage in the Massage Therapy Program. Michael Alicia can be reached through his website: www.massagespacenyc.com.
Pre-hospital Acupressure Relieves Pain
Acupressure reduced pain, anxiety and heart rate in victims of minor trauma before they reached the hospital, according to a study conducted by researchers at the University of Vienna Department of Anesthesia and Intensive Care, the Vienna Red Cross, and the Research Institute of the Vienna Red Cross.
Sixty people, ages 19 to 99, participated in the study once initial medical intervention, such as bandaging, was complete. They all suffered from similar small injuries, such as simple fractures, small wounds and contusions. At the site of the accident, a paramedic measured victims' blood pressure and heart rate, and asked them to rate their pain and anxiety on a scale of zero to 100. Subjects were also asked to rate their belief in acupressure as a treatment for pain. They were then assigned to one of three groups: true acupressure, sham acupressure or no acupressure.
Another paramedic performed acupressure (using either the sham or true points) for approximately three minutes, then brought the subject to the ambulance. Upon arrival at the hospital, subjects were again asked to rate their pain and anxiety; blood pressure and heart rate were measured. Subjects were also asked to rate their overall satisfaction on a scale of zero to 100.
In the true acupressure group, 89 percent of the subjects had a significant heart-rate reduction. This group also experienced a significant decrease in pain and anxiety, and had significantly better patient-satisfaction scores.
In the other two groups, measurements of pain and heart rate remained unchanged. Although there was a decrease in anxiety for both groups, it was not statistically significant. Belief in acupressure did not differ among the three groups. The study's authors conclude that acupressure could be an effective treatment for pain in first aid and emergency trauma care.
Source:
University of Vienna Department of Anesthesia and Intensive Care, Vienna Red Cross, and the Research Institute of the Vienna Red Cross. "Prehospital [sic] Analgesia with Acupressure in Victims of Minor Trauma: A Prospective, Randomized, Double-Blinded Trial." Authors: Alexander Kober, M.D., Thomas Scheck, M.D., Manfred Greher, M.D., Frank Lieba, Roman Fleischhackl, Sabine Fleischhackl, Frederick Randunsky, and Klaus Hoerauf, M.D. Originally published in Anesthesia & Analgesia, 2002, Issue 95, pp. 723-727.Read the article from Massage Magazine.
Search for Shiatsu or acupressure (357 citations) in the CAM literature available in the PubMed database.
Quantum Shiatsu
Eastern bodywork practices such as Shiatsu add the concept of energy to human physiology. Practitioners focus on evaluating and moving energy, however, controversy exists around this basic premise, as it exists outside of current scientific paradigms. One of the practitioners working to bridge the divide is Diego Sanchez, a former Swedish Institute student, now a practitioner, teacher and filmmaker.
Sanchez has been working with the renowned teacher Pauline Sasaki, the creator of Quantum Shiatsu, on a documentary about the energetic dynamics of human touch. "With this film, we hope to help people trust their experience of energy, although the vocabulary to talk about it is still limited, " said Sanchez. "We hope the documentary will help people recapture all that belongs to the body-the physical, energetic and spiritual.
Part of the difficulty in discussing Shiatsu is that its assessment method is highly subjective, which critics want to dismiss as being merely "intuition." Sanchez makes a passionate argument for expanding definitions of intelligence to include the felt sensations of the body. "Asian medicine is based on a very elegant and logical system that has intuition and personal observation at its core. In the West, we tend to think that intuition is the opposite of logic. However, if you are working with Shiatsu, you will not be able to separate the two.
“The theories and practices of ancient medicine are ways to organize one's inner messages, instead of ignoring them. The evaluation methods help you understand the information that intuition is giving you, and the practices provide ways to do something about it. Then you have to use your intellect to reflect on the response of the receiver and evaluate the effects. In this way, a practice in Shiatsu, or other forms of therapy that involve energetics, will lead to an informed use of intuition.”
As practitioners, we have seen how one Shiatsu session can transform a day, even a life. Such an effect is significant, yet it cannot be captured by quantitative methods alone. We await new forms of measurement, yet to be discovered, that will bring energetic practices like Shiatsu into an integrated health care system that will benefit both patients and physicians.
Diego Sanchez, L.M.T. is a Diplomate of Asian Bodywork Therapy (NCCAOM) and a Certified Practitioner (AOBTA).He completed the Swedish Institute Massage Therapy Program in 2000 after training at the London Shiatsu College in England. He has a private practice in his home of Montevideo, Uruguay and in New York City, where he often teaches continuing education courses at the Swedish Institute. He also teaches in Holland, Germany, Italy, Switzerland, England and Uruguay. He is a former staff member at Columbia University Medical Center's Integrative Medicine Program in NYC, where he provided Shiatsu for open heart surgery patients. Contact him through his website: www.sohoshiatsu.com.
Watsu Arrives in Williamsburg
Add water to Shiatsu and you have Watsu, a relative newcomer in the world of bodywork that was created in California in 1980. Watsu has been described as "a passive form of aquatic bodywork/therapy that supports and gently moves a person through warm water in graceful, fluid movements."* Two Swedish Institute graduates, Ben Watts and Tiina Dohrmann (both '93), recently opened a Watsu pool in Williamsburg, the first such dedicated pool in New York City.
Watts and Dohrmann learned Watsu in Harbin Hot
Springs, California, where it was created by Harold Dull, who had
studied Shiatsu in Japan and brought the practice into
body-temperature water. At first the work was done on a surfboard,
which was used like a massage table in the water. Today, the Watsu
therapist provides the support for the receiver, which gives the
potential for a very fluid treatment with lots of movement.
Ben Watts finds that Watsu's advantage is to "remove the element of gravity from the bodywork session. That alone makes it quite profound," he said. "Plus, there's a lot of passive movement that allows a person to get quickly in touch with where their muscles are restricted."
The amount of movement within a session depends on the receiver. One of Dohrmann's regular clients is a five-year old boy with cerebral palsy. Throughout his sessions she keeps him cradled close to her trunk. For people with neurological disorders like cerebral palsy, Watsu helps decrease hypertonicity, including spasticity and rigidity. The rhythmic, gentle motions, combined with trunk rotation and trunk elongation, help to decrease abnormal muscle tone. "For this young boy, one important result was the reduction of seizures," Dohrmann explained, "which used to occur up to 15 times an hour; he can now go for long stretches without any." His parents bring him faithfully three times a week. Dohrmann has also been helping the boy learn how to work from within himself to, as she put it, "move away from a seizure when it first begins."
With other clients, Watsu may involve applications to
pressure points, as well as being pulled through the pool both above
and below the water. The Watsu pool in Williamsburg,16 feet in
diameter and four feet deep, allows that kind of movement. Without the
restrictive surface of a table, Watts and Dohrmann can apply a
multi-directional movement of the limbs that is useful in freeing
joints, especially the shoulder girdle and hips. They find that the
receiver's awareness shifts as the body-temperature water softens
muscles and leads to a corresponding reduction in mental tensions. Dim
lighting and candlelight in the pool area complement the relaxed mood.
Their clientele is diverse, coming through word-of-mouth from the local area, as well as from within the international Watsu community.
This couple has stayed dedicated and excited about massage therapy throughout the past 13 years. Though they gave up dance careers to become full-time therapists, now that they are doing Watsu they say they feel like they are dancing again.
For more information
*
Definition from the website of the World Aquatic Bodywork Association (WABA), www.waba.edu. Articles and video tapes available on this site.Find out more about Watsu or massage sessions with Ben Watts and Tiina Dohrmann at their website www.greenspancenter.com .
Licensed massage therapists interested in becoming practitioners of Watsu can take an 8-hour introductory workshop or a 200-hour certification program at their Greenspan Center in Williamsburg.
Read Watsu: Freeing the Body in Water by Harold Dull, published by Harbin Springs Publishing in 1998.
Watsu is also practiced in Manhattan at the Cornelia Day Spa by Massage Therapy Program faculty member Tammy Day, L.M.T.
Wall Street Journal: Shiatsu Becomes More Popular
The Wall Street Journal reported on the growing use of Shiatsu worldwide in an article entitled "Shiatsu Becomes More Popular" (October 18, 2005, D.7). Reporter Andrew Morse interviewed practitioners in Japan, the United States and the United Kingdom; citing the increased number of professionals in Japan (98,148 in 2004), the growing number of recipients in the U.S. (49 percent of respondents to a 2004 AMTA survey) and in the U.K. (increased awareness according to the Shiatsu Society, Britain's largest Shiatsu group.) According to the report, a research study done in Japan found that Shiatsu helped reduce pain and decrease the need for medication for patients undergoing surgery for cancer.
Room for Mystery?
If we can never fully understand what Qi is, does this mean we should not study it? . . . It is unlikely that we will ever fully understand another human being, yet who would sacrifice the enrichment of life that comes from even partial glimpses of the spirit, depth and complexity of those who share our lives?
Reflections on Qi by Gary Khor. Australia: New Holland Publishers, 2004, page 9.
Your comments, suggestions and questions are welcome. Please e-mail me here at the Swedish Institute.
Barbara Goldschmidt, editor.