Shiatsu (Namikoshi) and Zen shiatsu (Masunaga)

Domain X · Body, movement, breath & physical · Tokujiro Namikoshi, Shizuto Masunaga, Tamai Tempaku · 1919 · Japan

What it is

Shiatsu is a Japanese hands-on therapy. Its name means "finger pressure". It combines pressing, kneading, tapping and stretching, and the client stays clothed, usually lying or sitting on a floor futon. Japan's Ministry of Health is reported to define it as pressure from thumbs, fingers and palms,…

Format

• Shiatsu course (delivered by the practitioner). The practitioner usually takes a history covering health, lifestyle, medical history, diet, sleep and emotional wellbeing, and may check with the GP. Treatment is on a futon, clothed, and lasts about an hour. A Zen-style practitioner assesses through…
• Integration in psychotherapy. In your own sessions, process the body experiences, emotions and memories that come up. This runs alongside Phase 4.

Who practises it, and how they are trained or regulated

• Shiatsu does not use a staged protocol with fixed session counts. The published sources give a session structure and a training and regulatory framework. The phases below are the psychotherapist's path alongside a client's shiatsu, with each school's own session structure inside Phase 4.
• Who delivers it and how they are regulated.
• Japan. Under Act No. 217 of 1947 (あん摩マツサージ指圧師、はり師、きゆう師等に関する法律), a non-physician who practises anma, massage or shiatsu as a business needs a licence: 「医師以外の者で、あん摩、マツサージ若しくは指圧…を業としようとする者は、…免許を受けなければならない。」 In short, practice as a business requires a licence. The Minister of Health, Labour and Welfare grants it after at least three years at an approved school and a pass in the national examination (Art. 2).…

Evidence status, as the guide reports it

• Evidence status. There is "no scientific evidence that shiatsu can cure or prevent any type of disease". A 2011 systematic review (Robinson, Lorenc & Liao) found nine shiatsu studies of "insufficient quantity and quality". Acupressure had stronger evidence in some areas, such as some pain…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• your own assumptions, either exoticising the practice or dismissing it.
• a client who downplays conditions, or a practitioner who brushes cautions aside.
• a client asking you to switch roles, which may signal a wish for closeness to explore, not act on.
• practitioners who call every reaction a 'healing crisis', and emotional dysregulation that lasts days.
• self-blame, minimising ("maybe it was a technique"), and the client staying in contact out of obligation.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.