Hawaiian lāʻau lapaʻau, hoʻoponopono, lomilomi and kahuna

Domain XI · Traditional medicine & indigenous healing · Mary Kawena Pukui · 1972 · Hawaiʻi

What it is

This is not one therapy. It is a living Indigenous healing tradition with several practices, each with its own practitioners and its own lines of authority. Hawaiʻi statute names four: lāʻau lapaʻau (herbal or plant-based healing), lāʻau kāhea (spiritual healing; one Hawaiian legal scholar glosses…

Format

• Hoʻomalu. A silent time-out the haku can call at any point to cool tension, rest, eat or reflect. It may last minutes, hours or days.
• Format. Sessions are private, unhurried, often held in the family home, and may run for hours or over several days. There is no set session count. The haku decides whether to continue, pause, postpone or end.

Who practises it, and how they are trained or regulated

• Kupuna councils. Under Act 153 (2005), traditional healers certified by a kupuna council convened by Papa Ola Lōkahi are exempt from the state medical licensing law. Each council is independent of the state, has at least three Hawaiians proficient in traditional healing, and sets its own rules for recognising practitioners.
• The kāhuna's own position. The master practitioners convened after Act 162 issued a "Kāhuna Statement" holding that certification belongs to the Hawaiian community through its kūpuna, not to government.
• Lomilomi is also practised under Hawaiʻi's massage licensing, which was the only route left for it after the state repealed its healing law in 1965.

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?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• 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

• Coming across as dismissive of the client's spiritual seeking. It is working when the client chooses with full information.
• Treating culture as pathology, or making history the explanation for everything. It is working when the client draws on cultural identity as a strength.
• Harm framed as tradition, and tradition mistaken for harm. It is working when the person is safe and still connected to culturally appropriate supports.
• Elders speaking for younger members. Confidentiality conflicts between members. It is working when members describe the problem more alike and conflict lessens.
• Sharing more than the client consented to. Treating the healer as an "adjunct" who works under you. It is working when the client experiences one coherent circle of care.

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.