Description of a Session
Acupressure is usually performed utilizing the thumb or fingers only. A constant reassessment of the individual is made throughout each session and the course of treatment, with the ultimate goal of having the individual assist in balancing his or her own Chi and maintaining that state of good health. In shiatsu, the practitioner’s hands are called the “mother hand” and “messenger hand,” and provide constant feedback by sensing the energy flow. There is no rigid set of procedures, and the practitioner’s schooling and sensitivity will influence the course of each session. Comfortable loose clothing is recommended and the client usually remains dressed throughout. Sessions take about one hour, although the first session may take longer since it will usually include an assessment of the health condition. This can include various positions such as side lying, prone (face down), supine (face up) and seated. Generally, acupressure or shiatsu is performed on body cushions or mats on the floor. However a seated position may be used if the patient cannot lie down.

A case history is taken at the first session in order to get an overview of the situation. This includes questions regarding the complaint, past medical history, food, habits and lifestyle issues, and anything else that may be significant. In acupressure, assessment may include tongue and pulse analysis and trigger point identification as well as questions about lifestyle and habits. In shiatsu, assessment is done with East Asian Medicine’s four methods of observing phenomenon: bo-shin (observation usually of the shape and color of the body), bun-shin (listening to the sound of the voice and observing the odor of the body and breath), mon-shin (questioning the person about the history of the illness, habits and lifestyle) and setsu-shin (touch diagnosis before and during treatment). This will assess where the person may have too much or too little energy. Touch diagnosis (a popular method in Japan) is often done through what is known as hara diagnosis, where areas of the hara (abdomen) are gently palpated to determine areas of fullness or deficiency. Diagnosis can also be done through observing different areas of the back or by feeling the quality of energy within the meridians.

The actual techniques employed may vary. The whole body may be worked on while the practitioner begins to hone in on the areas of most need. In tense areas, the chi will be released while in deficient areas various stimulating techniques will be employed to bring in energy. An area is manipulated until the practitioner can feel that the energy begins to fill it. This can take several minutes. Sometimes changes can be felt by the practitioner in the form of sounds and movement within the abdomen. Actual techniques can include stretching, pressing, holding and rotating gestures.

After a session, the patient will usually feel relaxed and energized, with a sense of calm and even a desire to sleep. If there has been an emotional release (see side effects) the patient may desire a blanket or warm drink. When leaving the treatment room the receiver should keep warm and try to rest for awhile.

Course of Treatment
The number of sessions depends on the nature of the problem. Three or four sessions spaced out over a period of four to six weeks are often recommended. The more deficient or blocked the energy, the more sessions are needed to reinforce and monitor the changes taking place and to support the patient in the process of healing.

Side Effects
Sometimes when a tense area is manipulated and the energy released it can be accompanied by an emotional release as well. The tension may have been a means of protecting this underlying emotion and now it can surface through a sense of relief, tiredness, shivering or even tears. This feeling eventually subsides and is replaced with a sense of well being. Because of the stimulation to major body systems, there may be other healing reactions — cold or flu-like symptoms, aches and pains or headaches may follow the initial treatment. These symptoms usually lessen after a day or two and subside with subsequent treatment. This is actually a positive indication that the body is making an attempt to correct itself naturally. Deep pressure work can feel aching and occasionally painful, though the identification of a painful acupressure site necessitates that it be “worked out” to be released of blocked energy.

Safety Issues
When provided by a trained practitioner, treatment is considered safe within specified guidelines. Acupressure/shiatsu is not advised in the first trimester of pregnancy. Because pressure is applied to the body it is also to be avoided directly over areas of osteoporosis or the site of an operation or fracture. It is generally not used for situations in which there is high fever, especially when accompanied by infection, inflammation or infectious disease, cancer, heart disease, and areas where there are open wounds, scar tissue, injury or swelling. However, the individual practitioner may consider use of some of the holding techniques in these situations. Dynamic positions should not be used on elderly or frail individuals.

Other Modalities that Work Well with this Approach
Other massage therapies, yoga or acupuncture may be used in association with acupressure or shiatsu. Meditation is considered a part of zen shiatsu treatment. Nutritional or dietary recommendations often accompany treatment as well.

Finding a Practitioner
Several national organizations have practitioner locators on their sites. These include:

American Oriental Bodywork Therapy Association (AOBTA)
www.aobta.org

American Massage Therapy Association
www.amtamassage.org

Associated Bodywork and Massage Professionals (ABMP)
www.abmp.com

International Macrobiotic Shiatsu Society (IMSS)
www.imss.macrobiotic.net

Jin Shin Do® Foundation
http://www.jsjinc.net/

National Certification Board for Therapeutic Massage and Bodywork (NCBTMB)
www.ncbtmb.com

Content last modified on Aug 3, 2009