Shiatsu with psychological problems (Wilfried Rappenecker)

Translation: Oliver Scheuvens

Psychological problems could be defined as being in a state of feeling uncomfortable or in trouble over a longer period of time. Despite all efforts to describe the human psyche in a way that it can be measured with the tools of natural sciences, because of its very nature, the psychological experiencing is utterly subjective. An intimate observer can perceive the psychological experiencing of another person, but again this perception is subjective. Psychology as an objective natural science loses its meaning for the live experiences of a living human being.

Psychological problems are not only confined to the „emotional “, the „soul“. Every body-worker knows that they show up in the whole human being and hence also in the physical body. More than that, many psychological conflicts show up in the body in the first place, without the concerned person being aware of the inner dimension. We humans have a natural tendency to shut off the uncomfortably threatening, painful experiences from our every-day lives. Especially when we expel unpleasant internal processes from our consciousness, these processes will look for and find the way through the body to manifest to the outside. The body truly shows who we are.

Physical problems on the other side always show in the psychological experiencing of a human as well. This is because the energetic processes that are the basis of any physical difficulties are also present in thoughts, emotions, hopes, fears etc of a person.

Body and soul just cannot be separated from each other. Both are expression of one deeper dynamic, of a fundamental, one could also say: more encompassing energetic process. Both, the body and the soul express the energetic. They are a different expression of the same root and therefore give us the same core information in different ways.

This energetic core can be reached by all the different ways in which people meet and communicate. This may be talking, physical touch, common experiencing, sharing a moment and a lot more. In a Shiatsu treatment all of this takes place, and this is why Shiatsu is a method to offer support to people with psychological problems. Shiatsu is not only body-work, but essentially energetic contact which opens the door to the realm of the psyche. Shiatsu is neither a method to work exclusively with psychological problems, nor one that exclusively treats for the physical symptoms. Shiatsu naturally encompasses both.

The basis of every professional Shiatsu, and this also counts for the work with psychological problems, is on the one hand the perception of the physical patterns in the body of the human as it mirrors the actual life situation, and the emotional situation as well. The treatment starts off with these specific patterns of the body, touches prominent key-areas and looks for the changes that occur as a consequence to the touch. These may be physical patterns that have been consisting for a long time already which mirror the personality and the oftentimes unconscious beliefs of a human. It may however also be patterns, which mirror the actual situation, the experiencing of this day or even of this treatment.

Shiatsu, however, is more than that. Besides the bodywork, Shiatsu also and especially is touching the energetic space of a person. This space is beyond the physical while at the same time the body worker finds it in the body and reaches it with physical touch. This means that an experienced Shiatsu-practitioner perceives the energetic space and its structures equally well as the physical body (e.g. the situation of the energetic organs and meridians but also the energetic pattern, let’s say in a painful joint).

It should be added that the perception of the energetic follows different rules than the perception of the material. Whereas the physical body e.g. has clearly defined shapes and limits, it is the nature of the energetic that it has no such boundaries, but rather, everything is connected to everything. As a consequence of this the energetic perception for example is never really sharp – the clear contours are missing (this is why a beginner often will not really trust it), but it can create a very clear impression anyway.

Despite of this the energetic also shows clear and precise structures, which react more quickly or easily to touch than the physical body, and changes can be perceived equally well. Physical and energetic patterns always exist at the same time, they condition each other, and in the end it is impossible to clearly distinguish the one from the other.

For example, a person in a difficult emotional situation may show great tension in the wrists. If we take such a wrist into our hands, the tension is perceptible at once. If we now feel into this tension with our Inner Awareness we may find that it is not distributed evenly in the whole of the wrist. There may be spots where it is especially prominent while strength and tension may be lacking in other places.

A part of these patterns can be felt by the tactile sense. The essence, however, cannot be perceived by the tactile, physical perception. The Inner Awareness goes further, it allows you to also follow internal strings of energy within the body. Finally it provides the means to travel to every part of the body, as on the material level the physical body is solid, but energetically speaking it is an open space through which we can travel with this Bare Attention.

In the same way as the wrists do, any other parts of the body can show highly specific patterns of tension in a psychological crisis. Typical areas are for example the masseter muscles under the cheek-bone (these can be so very tense that the person literally grinds off her teeth during the night), the throat that can be tense and narrow (maybe with the feeling as if something that has been swallowed got stuck in it), the thorax (e.g. painful blocked ribs or the feeling not to be able to breathe deeply and freely), the upper sternum (where there often is a feeling of pressure or the feeling as if something was blocked there, which may provoke coughing as if one has to clear one’s throat), between the shoulder-blades (e.g. constantly pulling pain or numbness), the upper abdomen (e.g. feeling of pressure, pain, or just very stiff), the lower back, the pelvis, the knees etc. etc.

Basically every part of the body can possibly draw attention in that way and make clear that an issue in this person’s life wants to be looked at more closely and to be understood. This is one thing they all have in common: raised tension as well as lack of tension does not represent a failure of the system; it rather shows that the system is working very well. These patterns have a task to fulfil, a job to do, and they usually do it quite effectively. Basically, their job is about preventing something to happen, something of which subconsciously the human believes that if it would be allowed to just happen it would threaten to disturb his balance.

Almost all kinds of pain (except for example those occurring with physical injuries, respectively in the acute phase of healing of physical injury, as well as pain in the context of acute inflammation and some other acute illnesses), are an expression of wanting to avoid something. This counts for any pain, physical as well as emotional. As the forces that have to be kept under control are quite vivid and strong, the blockades that are set up against them also have to be strong. Their energetic and physical manifestations often are easily perceptible for the trained „eye“ and the Shiatsu-therapist can work with them directly.

It does actually not make any difference whether the energetic blockade manifests in the physical body or in the emotional experience of a person in the first place. With Shiatsu we can work with the underlying energetic pattern and its physical expression in both cases, and the changes that occur can be perceived by the practitioner as well as by the client.

When working with areas of high tension (Jitsu) as well as with areas of opposite quality (e.g. lack of tension, Kyo) directly, we connect the opposites with each other or connect either of them with other prominent areas further away in the body. The evolving change can be perceived right away: the extreme opposites of tension and lack of tonus e.g. fade, the very determined hardness softens, the emptiness fills, in tendency. Such changes usually take place on the energetic level first before they also show out physically, and the Inner Awareness registers the energetic reaction before the physical.

When the extreme opposites become softer, these areas delimit themselves less from each other and communicate better with their surrounding. As emotional and physical suffering are expression of avoiding, delimitation and restricted communication – as already stated above – the person at this moment gets the freedom to allow connections that maybe would not have been possible before. As a consequence, a person could for example simply develop new ideas or a different feeling in her body and in her life. This may lead to a better understanding and enable the freedom to do it differently, to take new routes in life.

The occurring changes are however not only perceived locally, e.g. in a problem area itself. It is rather that also the total expression and „energetic field“ of the whole person changes. The change of the general feeling for life that a person experiences during the Shiatsu-treatment shows up in a way that is clearly perceptible to the outside. To perceive such transformations and developments is of special importance for the work with psychological issues.

It struck me when I discovered that the energetic patterns, which underlie emotional and physical pain are always simple. In all the suffering, all helplessness and complicated personal problems, which seem impossible to resolve, the energetic pattern itself is never complicated. It may be complex but it is always simple. This is very reassuring indeed because it says that in our work we do not have to solve any complicated problems, and that there always is a solution to be found for the client (even in cases when he does not find it). It allows us to have a healthy optimism, which we should not hesitate to pass on to our clients (as far as we have realised it ourselves).

Talking to the client can become very important in such a work. Not in the sense of a verbal intervention as in psychotherapy, but as a dialogue which reflects the experience of the client during the treatment and beyond. To do this, the practitioner uses all of his personal and professional experience to offer more space and more freedom to the client.

The aim is to offer new possibilities to the person through better communication between areas that were separate before; a plus in liberty, new solutions for life‘s challenges. Finally, this freedom is the aim of every holistic therapy. Shiatsu chooses to work with the physical and energetic body in order to also support the client in her psyche.

These are some of the principles of a Shiatsu with psychological and with physical problems (as there is no difference):

• Ask the client for detailed information about his problem.
• Perceive the client and his patterns attentively on the physical as well as on the energetic level and bring these perceptions into a sound context with how the client describes the situation (this is a working hypothesis, not reality).
• Trust your own perception and feeling; at the same time, always be aware of the limitation and the distortion of your perception, and be ready at any time to let go of your own idea, your own image of the client and to replace it by a more suitable one.
• As precisely as possible work with the perceived patterns with the means of Shiatsu using all available resources.
• As far as possible see the whole of the person, especially his strengths and potential.
• Perceive occurring changes and respect how the client experiences them.
• Leave the responsibility for his well-being to the client.
• Trust the deep inner knowledge of the client, which will make him take the way that leads right through the crisis to new possibilities. Only he himself can find the way and walk it.
• Support your client with all your possibilities, and do not or only very rarely interfere, except if there is acute danger that this person may hurt himself.
• Put your own superficial ideas and wishes of what may be good for the client to the back.
• Understand emotional reactions and projections / wishes of the client as being part of his actual situation; where possible, allow them happen and bear what happens (e.g. when a client experiences deep sadness or any other pain during treatment).

Is it really that easy?

At this point, questions arise by nature. Questions, whether it is really that simple and if we can or are allowed to work „just like this“ with people who are suffering of psychological issues. For example:

• Are not many psychological problems caused by traumata experienced in the past, e.g. during early childhood, and are such traumata not to be treated in a psychotherapy?
• Is it not possible that, when working with people with psychological issues, situations emerge that I may not be able to handle without being qualified as a psychotherapist, and can I not possibly cause great damage because of this?
• Is it not necessary for many psychological issues that the cause (e.g. an experienced trauma) becomes conscious in order for healing to take place?

Here are some thoughts to these questions

Are not many psychological problems caused by traumata experienced in the past, e.g. during early childhood, and are such traumata not to be treated in a psychotherapy?

In a society that for the last fifty years and more has been putting greatest emphasis on the human feelings and emotions, and which typically understands especially the painful emotional and psychological inability to go through an actual crisis as a result of negative or traumatic experiences especially during early childhood, many people see themselves as victims of an injustice they suffered in the past. Paradoxically, it is exactly this error that constitutes one of the most important causes for psychological suffering.

From my point of view, times that are experienced as emotionally and psychologically difficult in their core are not to be referred back to formerly suffered traumata. Such injuries in the past can be part of the actual crisis, help to coin its figure, but they are not the cause.

Usually, it is a time of internal transformation, of upcoming change, when life becomes difficult. Under normal circumstances external occurrences only are initiators. During all her life-time the human grows and develops. Her growth does not take place gradually, but in an on and off way. Such shoves are not rarely experienced as difficult and painful, as a physical and/or psychological problem or crisis. Traumatic experience itself can trigger such a crisis. I have written more about this in my article „What is health?“, which you also find in this reader.

Shiatsu during crises of growth in this sense aims at offering the possibility to a human to stand to herself, to take full responsibility for herself, her own way (and possibly how she deals with an injury). It is important to know in this context that we do not have to solve anything for the client; that it is much more about offering company during a difficult time, to support, stimulate, give ideas, so that this person can find her own solutions.

It is telling for our psycho-therapeutic oriented society that in our every-day language we use the term „therapy“ erroneously as synonymous for “psychotherapy”. Psychotherapy is, however, only one of many possibilities to deal with psychological crises. There are many other therapeutic ways for that, one of which is Shiatsu.

Shiatsu is not generally better than or not as good as psychotherapy, it is simply a different method. Which is the adequate method for someone depends on the situation of the person, e.g. on her personality, experiences, information and expectations and on the therapist that she meets. Whether Shiatsu is the right therapeutic method for someone in a psychological crisis also depends on a whole range of factors, of which the expectations of the client and the experience of the practitioner are some of the more important ones.

Sometimes it can be helpful to combine both methods for a while. Shiatsu given in the course of a psychotherapy can for example help to resolve knots faster. A psychotherapy on the other hand can help to give more sense to the physical experiences of the body in a course of Shiatsu treatments.

As Shiatsu is not better than other methods, it can of course also be right to pass a client on to the representative of another discipline, e.g. a psychotherapist. This is especially the case when the client wishes for another method or if the therapist is not sure anymore that he can „hold“ the evolving situation.

In a Shiatsu with psychological problems talking to the client can be more important than it normally is in Shiatsu. However, it is not necessarily so, and it depends on qualification and interest of the practitioner, expectations of the clients as well as on what a therapeutic situation demands.

A word on former traumata

Of course, past traumatic experiences are important potential factors for the emergence of psychological crises and can have a great effect on a person‘s further life. Negative long-term effects of emotional and physical injuries are, however, not in first place produced by the injury itself, but through the individual way of dealing with them.

How we deal with them depends on who we are, what tools we find in our personality to digest such experiences and what support we are looking for (and find). How we deal with traumata, injuries and injustice that have been committed to us, makes a strong statement about our person in general.

The majority of people learn decisively important things for their further lives in the difficult times after traumatic experiences, while they are living them through and digesting them. Yes, these forces can become of the most important forces for the growth of the personality. If such steps of insight and learning after the trauma cannot be made for what reasons ever, the person may get stuck in the experience that has not been lived through.

To negate an experience, to shut it out, reject it, to not want to or not be able to feel it, to feel as a victim (and hence push the responsibility away from oneself – it’s so obvious, who is to blame…) means to interrupt or to block the process. An incompletely processed experience can, however, come back over and over again in a person’s life in the form of crises and sometimes vehemently claim its right to be lived through completely. From this point of view, the cause for the actual trouble is not the past experience but the actual inability to let it fully happen, and thus let it complete, so that it loses the power over this person.

Traumata are above all challenges to find a way, how to consciously deal with the experienced pain. They are a challenge to take back the responsibility for our life and experiencing, which we have often given away long time before the terrible incidence, or which maybe we never really owned. If we do not go and take it back, we will see ourselves as the victim of what has happened and of the person/s who in our eyes are responsible for it. If we regard ourselves as victims, we have given away an important part of the responsibility and power for us and our life, and it will be very difficult to become healthy and joyful again.

In saying this I do not want, by any means, to load the responsibility for an occurred injustice up on the sufferer, in addition to all the pain already suffered. This responsibility stays with the people who have hurt and committed the injustice. The responsibility for processing of, working through what has happened, however, has to stay with who has suffered it.

In the case of past traumata Shiatsu can aim at helping the client out of her role as a victim and to help her on the sometimes painful way to regain dignity and joy of life.

We are the people that we are because we are the way we are! Former injuries have not made us the way we are today! In this sense a psychotherapy, which is concerned with former traumata is not so much researching the causes (even though at the time being that is the way it is widely understood in our society), but a historical research.

This is not to say by any means that it cannot be a valuable healing method to approach the ‘today’ via the past, to experience the actual situation differently by looking at the history in order to understand it better and to find solutions. This approach is however just one method out of many, and it is not at all compulsory to use this method in order to find solutions for a present situation.

Shiatsu takes another way via the body and the energetic patterns that are there now and their living potential for change and liberation.

Is it not possible that, when working with people with psychological issues, situations emerge that I may not be able to control without being a qualified psychotherapist, and can I not possibly cause great damage because of this?

As I have already described above, for the Shiatsu-practitioner working with psychological problems is by its nature not different from the work with physical troubles. Through our work with the body and the energetic spaces, we also reach the soul of a human and his emotional experiencing.

Insofar as the psyche is always involved in physical ailments, we cannot but also touch the soul when we touch the body. From this point of view, it does not make any difference whether we are giving Shiatsu to people with physical or with psychological problems. We do not work with (or even against) the problems, but with human beings who are experiencing these, and who, for us, are energetic beings in the first place.

Of course there are differences in the way we will work with someone complaining of physical ailments as compared to someone who comes with psychological problems. For example in the case of a psychological issue the client may want to talk more about her problems. Since one of the principles of shiatsu is to meet the clients where they are at the moment we will accept that. The core of our Shiatsu will be the same, though, no matter whether it is a physical or a psychological complaint.

Even when people come to us in great need, the focus of the work should not lie on the emergency of the psyche, which is a superficial phenomenon of a deeper dynamic. It is advisable to look for the whole person instead (also for his strength, beauty and his possibilities) and to work with the deeper energetic dynamic.

When we see the strength even in the case of a terrible history we will not step into the trap of pitying (which may take away part of the clients‘ strength). We can see that the human has the power to go through this crisis and to live life with more joy afterwards.

As the energetic patterns, which are the inner root of any problem that people experience are always of simple nature, there is usually also no danger that something would become complicated or unmanageable during a Shiatsu-treatment. There is only one exception to this rule: that we ourselves are afraid; afraid of not being good enough, of not being able to accomplish something, not being able to keep something under control or prevent something. In that case it can indeed become messy for the practitioner and for the client.

The responsibility for her well-being stays with the client

There is no need to divert any trouble of our clients, or to keep control over difficult situations in their experiencing. They are totally responsible for themselves and able to care for themselves. This is indeed an essential pre-condition for such a work and for Shiatsu in general: to resist the temptation of taking over the responsibility for the well-being of our clients.

This temptation is big, as it gives us the feeling of control over the situation, so that “nothing evil” can happen to us. It gives us a feeling of power and seems to protect our clients. The more, it is often our own fear of the uncontrollable inside ourselves that leads us, seemingly in the interest of the client, to keep the control and responsibility for the well-being of our clients. However, this appearing security weakens the client and our work.

In the therapeutic space with our client, we are connected to how she feels, no matter whether her problems manifest primarily in the body or in the psyche. Often, we feel her emotional movements – in weaker form and changed by the filter of our own personality – in the same way as she does. This may be a further reason why we would like to keep up control, as such experiences can be hard to bear for the practitioner, the more as it often touches the practitioner’s own virulent issues.

When we are clear that we leave the responsibility for her well-being to the client and communicate this clearly by our words and in our behaviour, then without any words our clients will understand and accept it.

Offering a secure space for emotional experiencing

There is no reason to assume that in our work situations may come up, which – uncontrolled – will harm the client. Pre-condition for this is that we follow the principles of Shiatsu. The first of these is „not to create any pressure“, which means to accept a client and her situation the way he is, and not to try hard to achieve something. As described above, this also means to admit to the client his full freedom of finding his own way, and to leave the responsibility to him.

Another condition is that we do not misunderstand our work as psychotherapy. Shiatsu-practitioners are generally not psychotherapists and do not have to be. We professionally work with the body and the energetic field and in this way can accompany our clients with full responsibility. We should not allow any unclarity to emerge about this, neither in ourselves, nor for our clients.

If these conditions are fulfilled, even in strong emotional movements that the client may experience as really dramatic, the practitioner can trust that this person will lead it to a good end, that he has the strength of going through this, whatever may happen.

Seen from their energetic nature, emotional experiencing like sadness, anger or most aspects of fear are nothing but a change in the energetic field, or movement. If such emotions are strongly felt in a treatment we can assume that in the past they have not been allowed to express themselves freely, that they had been blocked. Now they complete the movement they then begun and were interrupted. When it has come to an end (and it always does, unless it is actively blocked again), it dissolves and all that stays is a memory. After such an experience the human usually feels relieved.

It is the practitioner’s responsibility to hold such situations in a relaxed and compassionate way and to let IT happen. It is important to resist the temptation of protecting ourselves or the client from anything through activism with words or with our hands, as this is absolutely not necessary. What wants to happen shall happen! Everything that is needed is to give the client the feeling that this is a secure space in which all of this can be.

It is furthermore important to absolutely respect the client’s space and not to hinder him in whatever way. Even a gesture like offering a tissue when tears are showing can be such a hindrance, because the pity that may show in this gesture may narrow the space. If the client accepts the offer and sees himself as being pitiable, then he has usually fallen out of the centre of his experience and has less possibilities to find solutions.

Transference and counter-transference

There will always emerge situations when a client will try to make the practitioner part of her own unconscious inner world and will try to use him in her emotional confusion. In the same way, also the practitioner can make the client a part of his own, unconscious inner world and maybe in that way use her. In such situations it can be difficult for the practitioner to keep an overview over the therapeutic situation. The temptation may be great to dive into this world with the client and to fulfil one’s own needs.

This dynamic has been discussed and made an issue in psychotherapy under the terms of „transference and counter-transference“. It plays an important role in every holistic work that involves other people. Because it is of great importance also for Shiatsu, basic understanding about this typical therapeutic dynamic should be conveyed in a Shiatsu education.

Clients who come to Shiatsu because of psychological problems are a bit more likely to react that way than people who come to Shiatsu with ailments they experience as physical.

For example a client may try to (unconsciously) put pressure on the practitioner in conveying that she feels not enough cared for, does not get enough attention respectively even feels abused. If the practitioner has an unconscious weakness around this issue in his own life (which would be rather normal than the exception), then he may start to feel guilty and make efforts to satisfy the client with special attention, time and strain. As the need of the client, however, can never possibly be fulfilled by its nature, destructive situations of pressure can arise here.

The same thing can, as already said, also work the other way around, i.e. with the practitioner unconsciously trying to use and manipulate the client for his own inner world.

Such dynamics in the relationship between therapist and client are absolutely normal. There is nothing wrong about them and they cannot be avoided anyway. We should however not allow them to influence our therapeutic understanding and acting to a greater extent. Therefore, we need to recognise them early and accept them as a part of the reality of the client and of ourselves. Learning this can become an important source for our work. Any holistic therapeutic work can be understood as a training herein.

Recognise limits and dangers

Even if we leave the responsibility for his well-being to the client, we are still responsible for our own actions and for its consequences for other people. There may be situations in which a Shiatsu-practitioner should pass a client on to a qualified person, for example another experienced Shiatsu practitioner or a trained psychotherapist.

This is for example always true for cases in which the practitioner feels overwhelmed by the occurring processes, respectively does not believe he can bear it, respectively not being able to offer the client what is needed in her situation. It is also valid for people who suffer from a psychopathological or psychotic crisis and who obviously are that “sick” that we do not find access to them.

It may also be necessary when for example a person has lost herself in her inner world of suffering to such a degree that she clings to the practitioner – as described above – putting the responsibility for her state on him, possibly accusing him that he does not care enough about her etc. This can render working together impossible.

It is true in every case when we have the impression that the person who comes to us could get in danger to hurt herself (e.g. danger of suicide) or to loose ground otherwise.

If a practitioner in his clinical practice develops a greater interest in working with clients in a psychological crisis (or in case more and more clients in such a situation ask for his help), it may be advisable to achieve a higher qualification for his work e.g. by training in counselling or in trauma work.

Is it not necessary for many psychological issues that the cause (e.g. an experienced trauma) becomes conscious in order for healing to take place?

Emotional experiencing, from the point of view of the energetic, is a rather superficial phenomenon, no matter how strong it may be. Emotions are changes in the energetic field (i.e. are energetic movements), which can be experienced very differently, even antagonistically by people, depending on their life situation at the given moment.

Anything we experience is based on an energetic dynamic; if that changes, also what we experience will change – and the body, too. Such changes may take place on a rather superficial level, but they can also reach very deep. In order to have a deep effect on the psyche and the body it is not really necessary for the psychological processes to become conscious.

Moments of healing, on the contrary, are often characterised by a sudden stillness without any words, when a solution becomes possible inside. Absolutely nothing dramatic needs to happen on the outside, and the every-day consciousness of the client does not have to understand what is going on either.

To let a deeper psychological dynamic become conscious is a technique, which is being practised e.g. through verbal intervention in different psychotherapeutic disciplines. It is one technique besides others in the work with the psyche. In fact, raising deep dynamics to the level of consciousness and allow them to act there is an effective tool in any holistic work. Also in Shiatsu, things that become conscious are likely to change. Such a process however is not a crucial precondition for change and development, neither in Shiatsu, nor in other therapeutic disciplines.

Pre-conditions for the work with clients in psychological crises

Besides a well-founded technical and theoretical basis which one can get in a good Shiatsu training programme, it is above all experience that is needed to work with people who explicitly come to us with and because of psychological crises. In first place this is the practical experience in a professional Shiatsu, and here especially in the therapeutic encounter. The more one has worked with other people also in difficult situations, the clearer one will be able to see the possibilities as well as the limits of Shiatsu. A feeling will be there for how Shiatsu works and what (surprising) ways it can go.

We also need to be experienced with our own person, though. Especially general life experience is important, but also the experience of ourselves, as we can gain it in our own therapy, supervision, meditation and in an open observation of the own self in Shiatsu practice.

Further on, from my own point of view, experience in the energetic perception is also important, or at least very helpful. One can learn the foundation for this in a good Shiatsu training, it is however only through years of practice that one will understand what it really means.

The subtle energetic perception helps a lot to understand and estimate a person’s psychological situation. This is not only true for the perception of the meridians, but also for the vibrational quality of the energetic organs e.g., or of the energetic space in the body, respectively in parts of it.

The perception of the therapeutic space that the practitioner and the client together create and share is also an energetic phenomenon. It allows the practitioner to observe and assess the situation of the client and the own work during treatment.

When we give Shiatsu to people in psychological crises, we furthermore need knowledge. Knowledge about how important it is that the client keeps full responsibility for herself and her suffering (as well as her joy) in the contract that we have, and which she cannot give to the practitioner without causing harm to herself. The knowledge and the experience, not to weaken the client through pity but to see her strength and beauty and her ability to find a good solution for her conflict.

If we fully accept the responsibility for our own therapeutic acting without exception we will be able to perceive the effect of our actions more and more subtly, thinking and feeling of the client. It becomes a natural need for us to support the dignity, the responsibility and the freedom of our clients in the Shiatsu we give and to recognise our own impulses that are counter-acting this aim more and more clearly.

Acquaintances are needed as to the nature of the relationship between therapist and client, with the traps in there as e.g. the phenomena of transference and counter-transference, the nature of projection, typical conflicts between certain personality types and others. In my opinion, all of this should be transmitted in a good Shiatsu training.

Finally, besides the knowledge of the limits of our own work we also need to know about the dangers in which clients may get (themselves) into during the time we treat them (e.g. danger of suicide). It is helpful to look for addresses and telephone numbers of competent specialists and institutions early enough, where we can send our clients to in the case of an emergency.

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© Wilfried Rappenecker, born 1950 near Köln (Germany), is director of the “Schule für Shiatsu Hamburg” (D-22769 Hamburg, Oelkersallee 33, http://www.schule-fuer-shiatsu.de), co-founder of the GSD und author of two books dealing with shiatsu. As physician for general medicine he mainly works with shiatsu. This article is part of the congress volume “European Shiatsu Congress Kiental 2004”.