Atlas›Domain XII · Complementary, energy & biofield›Guide 001
Guide XII-001

Reiki (Usui) and its lineages

Mikao Usui1922Japan
A 32 · L 43 · M 2520 interventions in the Trinity explorer
Client cardCompare
[source: …] where a claim comes from[uncertain] not confirmed in a primary source[synthesis] the writer's reconstruction

1. Introduction

Version followed: the International Center for Reiki Training (ICRT, William Lee Rand) Usui/Holy Fire Reiki curriculum, Code of Ethics and Ethical Standards, with Japanese-style techniques as the ICRT presents them. Where this guide covers Takata-style (Western Usui Shiki Ryoho), Jikiden, Karuna, Seichim, Holy Fire and Kundalini Reiki, it says which statements come from which source. Each lineage's own manuals take precedence for its practitioners.

What it is. The ICRT describes Reiki as a Japanese technique for stress reduction and relaxation, given by "laying on hands". The practitioner's hands rest lightly on, or just above, a fully clothed client in a series of positions. [source: ICRT FAQ; NCCIH] In the method's own terms, an unseen "life force energy" sustains life. Low life force is held to go with stress and illness, and the practitioner is understood as channelling this energy rather than using their own. The ability to channel it is said to be passed from teacher to student through an "attunement" (ICRT Holy Fire: "placement" and "ignition"). These are the method's own concepts, reported here as the ICRT holds them. [source: ICRT FAQ; ICRT history]

How change is said to happen. The ICRT holds that Reiki raises the flow of life force and so promotes relaxation and the person's own healing response. It says Reiki "respects free will" and works only when invited, and it frames the energy as spiritual but not a religion. [source: ICRT history; ICRT FAQ] Psychotherapist-practitioners publishing through the ICRT describe a further mechanism. In their account, Reiki brings body memories, emotions and associated thoughts into awareness, and these are then worked through with conventional psychotherapy. [source: Curtin & Prebluda, ICRT article]

Lineages, as their sources report them.

  • Usui Reiki Ryoho (Japan). Mikao Usui (1865–1926) founded the Usui Reiki Ryoho Gakkai in Tokyo in 1922 after a meditation retreat on Mount Kurama. Techniques attributed to him include Gassho, Byosen scanning, Reiji-ho, Gyoshi-ho and Seishin-to-itsu, repeated attunement (Reiju-kai), and three Okuden-level symbols. The five admonitions (the Reiki Ideals) come from the 1927 memorial inscription. [source: ICRT history]
  • Hayashi. Chujiro Hayashi founded the Hayashi Reiki Kenkyukai. Clients lay on a table and received treatment from several practitioners at once, and his recorded hand positions became a guide for use when Byosen scanning was not possible. [source: ICRT history]
  • Takata / Western Usui Shiki Ryoho. Hawayo Takata brought Reiki to Hawaii and the US mainland and taught 22 Masters before her death in 1980. She simplified the system into a fixed "foundation treatment" on the head and torso, with optional back positions. ICRT sources differ on how many positions it had (seven vs eight) [uncertain: sources differ]. The Reiki Alliance and the Office of the Grand Master as custodians of Usui Shiki Ryoho [uncertain: not verified].
  • Jikiden Reiki. Tadao Yamaguchi's school, presented by the ICRT as preserving the Hayashi style. Yamaguchi learned from his mother, who had studied with Hayashi. The institute's own curriculum, level names (Shoden/Okuden) and certification route [uncertain: not verified].
  • ICRT lineages (William Lee Rand). Usui/Tibetan (taught 1989–2013). Karuna Reiki (developed 1993–95). Holy Fire Reiki (from 2014, now Holy Fire III), which replaced the Tibetan elements and replaced attunements with "placements" and "ignitions". [source: ICRT history]
  • Seichim, Kundalini Reiki (Ole Gabrielsen). These are listed as Reiki lineages, but their founders, curricula and organisations [uncertain: not verified]. Follow each lineage's own published materials.

Evidence status (one line). NCCIH: Reiki "hasn't been clearly shown to be effective for any health-related purpose", and no harmful effects have been shown. [source: NCCIH]

Not a disease treatment. The ICRT Code of Ethics tells practitioners to inform clients that Reiki does not provide a cure and is not a substitute for licensed care. Nothing in this guide presents Reiki as treating any physical or mental disorder. [source: ICRT Code of Ethics]

2. Framework

Reiki is a practice tradition with graded training, not a phased psychotherapy. It has two frameworks: the training route that qualifies the practitioner, and the structure of a client session. How Reiki is placed inside a course of psychotherapy is set out below. [source: ICRT class outlines; ICRT FAQ]

A. Training and certification route (ICRT Usui/Holy Fire).

  • Reiki I. No prerequisites. Covers history, the Reiki Ideals, Gassho, Byosen scanning (self and partner), Reiji-ho, a standard session with all hand positions, Kenyoku, the Hayashi Healing Guide, self-treatment, client release forms, fees, and the Code of Ethics and Standards of Practice. Includes a Reiki I placement/attunement. [source: ICRT class outlines]
  • Reiki II. Covers the Reiki II symbols (kept private by the tradition and not reproduced here), distant healing, Gyoshi-ho, group distant healing (Enkaku chiryo), and practice exchanges. A symbol test must be passed. [source: ICRT class outlines]
  • Advanced Reiki Training (ART). Covers crystals and Reiki grids, an advanced symbol, moving meditation, and Reiki aura clearing. [source: ICRT class outlines]
  • Master. Covers Holy Fire ignitions, the Healing Attunement, Holy Fire meditation, a "Spirit Release" process, how to give the placements of each level, teaching, ethics, and practice development, with membership of the Reiki Membership Association. Certificates are issued at the end. [source: ICRT class outlines]
  • Format. Reiki I, II and ART are a day each and Master is two days, a suggested five days in all. Reiki I and II may be taught together or apart. ICRT also offers Holy Fire Karuna Reiki Master training. Who certifies: the teaching Master issues the certificate within their lineage, and the ICRT licenses its own Master Teachers. [source: ICRT class outlines; ICRT FAQ; ICRT teacher list page title] There is no statutory licence for Reiki in the main jurisdictions [uncertain: not verified]. Before practising, a psychotherapist should check their own board's rules on adjunctive methods and touch. [synthesis]
  • Other lineages. Japanese-style schools use repeated reiju and intuitive placement. Jikiden and Takata-lineage organisations certify through their own levels [uncertain: not verified]. Name your lineage and teacher in your consent material. [synthesis]

B. Structure of a client session (as published).

  1. Arrival. The client stays fully clothed and usually lies on a table, though seated or standing is possible. [source: ICRT FAQ]
  2. Treatment. The practitioner places hands on or near the body in a series of positions (head, shoulders, stomach, feet), holding each for several minutes. A full session is commonly about an hour or longer. [source: ICRT FAQ] Placement follows one of three approaches: the fixed foundation sequence (Takata style), intuitive placement by Byosen and Reiji-ho (Japanese style), or both. [source: ICRT "Western and Japanese styles"]
  3. Close. End with Kenyoku and a check on how the client feels. Common reports are deep relaxation and warmth, and some clients fall asleep. [source: ICRT class outlines; ICRT FAQ]
  4. Number of sessions. Takata advocated many treatments. No fixed course is published. [source: ICRT "Western and Japanese styles"]

C. Integration with psychotherapy (as ICRT-trained psychotherapists describe it). Curtin and Prebluda describe four steps, with the client's understanding of the changes as the goal: [source: Curtin & Prebluda]

  1. Assess the presenting problem psychologically and "energetically".
  2. Sweep the energy field.
  3. Give Reiki, with dialogue guided by the client's impressions.
  4. Move into talk-based methods (emotional release work, cognitive restructuring, trauma work, imagery, breath, movement, mindfulness) as patterns surface.

Neither the ICRT nor these authors give criteria for moving between phases. Suggested criteria for a therapist [synthesis]:

  • Start Reiki only after a stable alliance has formed, the client has given written informed consent for touch or hands-off work, and a trauma and dissociation screen has been done.
  • Move from Reiki to talk when emotion, imagery or memory emerges that the client wants to explore.
  • Return to verbal-only work if the client becomes dysregulated, the dual role muddies the frame, or the client starts treating Reiki as a substitute for medical care.

Professional-body positions. The ICRT Code says Reiki "works in conjunction with" medical or psychological care and requires referral to licensed providers. Its rules also ban diagnosis, prescribing, changing prescribed treatment, asking clients to disrobe, and touching the genital area or breasts. [source: ICRT Code of Ethics; ICRT Ethical Standards] The UK Reiki Federation publishes a Code of Ethics & Professional Practice, but its content [uncertain: not verified]. Positions of psychotherapy licensing boards on Reiki within therapy [uncertain: not verified]. Check your own board's position. [synthesis]

3. Guiding principles

  • Reiki Ideals (the five admonitions). In paraphrase: just for today, do not anger, do not worry, be grateful, work diligently, be kind to others. Usui's students recited them morning and evening. Practical meaning: practitioners use them as a personal discipline. Offer them to clients only as a reflection the client opts into, never as a religious requirement. [source: ICRT history; synthesis]
  • Invitation and free will. The ICRT says Reiki heals only when invited. Practical meaning: no Reiki is given, in person or at a distance, without explicit permission, and permission can be withdrawn at any moment. [source: ICRT history; synthesis]
  • Complementary, never a substitute. Practical meaning: tell the client that Reiki is not a cure. Ask about medical care and encourage it. Never suggest changing medication or treatment. [source: ICRT Code of Ethics]
  • No diagnosis. Practical meaning: impressions from the hands, such as heat, tingling or "byosen", are never presented as a medical or psychological diagnosis. [source: ICRT Ethical Standards]
  • Respectful touch. Practical meaning: the client stays clothed, no breast or genital contact, consent comes first, and a hands-off option is always offered. [source: ICRT Code of Ethics; Lipinski; NCCIH]
  • Client sets the pace. Practical meaning: check in often, let the client keep their eyes open, and never position yourself behind the client without saying so. In Lipinski's words: "NO SURPRISES!!" [source: Lipinski, ICRT]
  • Don't press for the story. Practical meaning: with trauma, Reiki does not require disclosure, and pressing can re-traumatise. [source: Lipinski]
  • Practitioner is a channel, not the source. The ICRT holds that the energy is not the practitioner's own. Practical meaning: keep a non-directive, receptive stance and let go of any attachment to outcome. [source: ICRT FAQ; Lipinski; synthesis]
  • Transparency. Practical meaning: state your training, lineage, what a session involves, and fees before the client agrees. [source: ICRT Code of Ethics]
  • Plain language. Practical meaning: in clinical settings, describe Reiki as relaxation and stress reduction ("straight Reiki") and avoid psychic readings or esoteric add-ons. [source: ICRT "Reiki in Hospitals"; Lipinski]
  • Stay within competence. Practical meaning: do not practise beyond your training. Refer severe or continuing reactions to the client's healthcare provider. [source: Lipinski; Shewmaker, ICRT]
  • Practitioner self-care. Practical meaning: do daily self-treatment and use supervision to manage compassion fatigue. [source: ICRT class outlines; Lipinski]
  • One frame, clearly held. Practical meaning: when a psychotherapist adds Reiki, the psychotherapy contract, confidentiality and records stay primary. Reiki is a consented, named component, not a hidden one. [synthesis]

4. Intervention inventory

This inventory covers techniques a practitioner uses on clients, techniques the practitioner uses on themselves, and the steps a psychotherapist adds to combine Reiki with therapy safely. Attunement, placement and ignition procedures, symbols and mantras are taught privately in class by a Reiki Master. They are named here but not described.

4.1 Suitability screening before offering Reiki in therapy

  • Purpose / when: Run this before any Reiki in a psychotherapy setting, to decide whether to offer it, offer it hands-off only, refer to a separate practitioner, or not offer it. [synthesis; informed by ICRT Code "Refer" and Lipinski]
  • Steps:
    1. Ask what the client knows and expects of Reiki, and why they want it now.
    2. Ask about their religious or spiritual views on energy healing. The ICRT says Reiki is spiritual but not a religion, and some clients may still object on faith grounds.
    3. Screen for trauma history (especially interpersonal or sexual), dissociation, psychosis, mania, and touch-related distress.
    4. Ask about current medical care. Encourage the client to keep it, as the ICRT Code requires.
    5. Assess the alliance and any transference around care or touch.
    6. Decide among: in-session Reiki, hands-off only, referral to an independent Reiki practitioner, or none.
    7. Document the decision. [synthesis]
  • Example language (illustrative): "Before we decide anything, I'd like to understand what draws you to Reiki and what you hope it might do. I'd also like to check how you feel about touch, even light touch over clothing."
  • Watch for: expectations of cure, hopes of replacing medical or psychiatric care, a wish to please the therapist, and difficulty saying no. Any of these suggests verbal-only work or an outside referral. It's working when the client can state a realistic aim (for example relaxation, or body awareness to explore) and can decline without strain. [synthesis]

4.2 Informed consent and the touch agreement

  • Purpose / when: Before the first Reiki session, and again whenever the plan changes.
  • Steps:
    1. Explain that Reiki is complementary and not a cure or a substitute for licensed care. [ICRT Code]
    2. Describe what happens: the client stays fully clothed, usually lying or seated, and the practitioner's hands rest lightly on or just above the head, shoulders, torso and feet. [ICRT FAQ; NCCIH]
    3. State the touch rules: no breast or genital contact, and the client is never asked to undress. [ICRT Code]
    4. Offer hands-off throughout, and agree a stop signal. The client can stop or change from touch to hands-off at any time. [Lipinski; synthesis]
    5. Give the evidence status in one line (NCCIH). [NCCIH]
    6. State your lineage, training level, and fee or no fee. [ICRT Code "Transparency"]
    7. Record written consent. Re-check verbally before touching and at each change of position. [synthesis]
    8. Agree on chaperone or open-door arrangements where the client or your service prefers them. [Lipinski on open doors; chaperone policy: synthesis]
  • Example language (illustrative): "Reiki is a complementary practice. Research hasn't clearly shown it treats any health condition, and it's never a replacement for your doctor. If we use it, you stay fully dressed, and my hands rest lightly on, or just above, your head, shoulders, front of the body and feet. I won't touch your chest or groin. You can say 'stop' or 'hands off' at any moment and I'll stop straight away. Shall we try with hands just above the body first?"
  • Watch for: a quick "yes" with a flat or frozen face, or a request to skip the explanation. Slow down and offer hands-off. It's working when the client says back what will happen and names their stop signal. [synthesis]

4.3 Practitioner preparation: Gassho meditation and the Reiki Ideals

  • Purpose / when: A short centring meditation (Gassho) and reflection on the Ideals before giving Reiki. Taught in Reiki I and done before placements in class. [source: ICRT class outlines; ICRT history]
  • Steps:
    1. Settle in a quiet moment before the client arrives or at the start of the Reiki segment.
    2. Do Gassho as your teacher instructed. Its detailed form is taught in class [uncertain: not verified].
    3. Bring the five Ideals to mind (in paraphrase: do not anger, do not worry, be grateful, work diligently, be kind).
    4. Set the intention that the session is for the client's wellbeing as they define it. [synthesis]
  • Example language (to self, illustrative): "Just for this session: steady, unhurried, kind."
  • Watch for: rushing in from a previous client, or pressure to produce an effect. Its absence shows up as a calm, unhurried start. [synthesis]

4.4 Byosen scanning

  • Purpose / when: A Japanese-style technique in which the practitioner uses the sensitivity in their hands to find where the person "needs Reiki". It is taught in Reiki I, both on partners and as a self-scan. [source: ICRT "Western and Japanese styles"; ICRT class outlines]
  • Steps:
    1. With consent, move the hands slowly over or lightly on the clothed body, typically just off the body for clients new to touch.
    2. Notice sensations in your hands, which the tradition reads as indicating need.
    3. Stay longer, giving Reiki where sensations are strongest.
    4. Do not interpret the findings medically. [ICRT Ethical Standards]
  • Example language (illustrative): "I'm going to move my hands slowly a little above you, from your head downwards. I'll let you know before I move to a new area."
  • Watch for: any pull to tell the client what is "wrong" in their body. Don't, because that is diagnosis. In therapy, invite the client's own experience instead ("What do you notice as my hands are near your shoulders?"). Detailed sensation categories (hibiki) [uncertain: not verified]. [synthesis]

4.5 Reiji-ho (intuitive hand placement)

  • Purpose / when: A Japanese-style technique in which the practitioner receives intuitive guidance about where to place the hands. The ICRT introduces it as more advanced and suggests Takata's "cause-finding" is a simplified form of it. [source: ICRT "Western and Japanese styles"; ICRT class outlines]
  • Steps:
    1. After centring (4.3), ask inwardly for guidance as your teacher instructs.
    2. Allow your hands to move to areas, then hold them there.
    3. Announce each move in advance and keep within the agreed touch zones. [synthesis]
  • Example language (illustrative): "I'm going to move my hands to rest near your forearms now. Is that okay?"
  • Watch for: "intuition" overriding the client's stated boundaries. The consent agreement always wins. [synthesis]

4.6 Standard (foundation) hand-position treatment

  • Purpose / when: The Western (Takata) fixed sequence on the head and torso, plus feet, shoulders and optional back positions. ICRT teaches it as a standard session "with all hand positions". Use it when a predictable routine helps the client feel safe. [source: ICRT "Western and Japanese styles"; ICRT history; ICRT class outlines; ICRT FAQ]
  • Steps:
    1. The client lies clothed, face up, or sits.
    2. Hold positions in order at the head, then the shoulders and front of the torso (avoiding breasts and genital area), then the feet, with back positions if the client turns over and agrees.
    3. Give each position several minutes.
    4. Tell the client before each change of position.
    5. Exact position counts and order follow your lineage's manual. Sources differ on the Takata count [uncertain: sources differ]. [ICRT FAQ; ICRT Code]
  • Example language (illustrative): "We'll go in the same order each time: head, shoulders, the front of the body, then your feet. I'll tell you before each move. Hands-on or just above, whichever you prefer."
  • Watch for: breath-holding, guarding or startle at transitions. Pause, check in, and switch to hands-off. Signs it is working, in the tradition's terms: slower breathing, warmth and relaxation. Some clients fall asleep. [source: ICRT FAQ; synthesis]

4.7 Hayashi Healing Guide

  • Purpose / when: Hayashi's recorded hand-position guidelines, used when Byosen scanning is not possible. ICRT teaches them in Reiki I. [source: ICRT history; ICRT class outlines]
  • Steps: Follow the guide as taught. In psychotherapy, use it only for positions within the touch agreement. Never present it to a client as treatment for a named illness. [ICRT Code; synthesis]
  • Example language (illustrative): "This is a traditional sequence of hand placements. It isn't a medical treatment, just a way of structuring the session."
  • Watch for: clients reading the guide's illness headings as a promise of cure. Restate that Reiki is complementary, and refer to their doctor. [synthesis]

4.8 Hands-off (off-body) Reiki

  • Purpose / when: Hands held just above the body. NCCIH lists it as a standard form. Lipinski recommends starting this way with trauma survivors. Use it as the default whenever touch is uncertain. [source: NCCIH; Lipinski]
  • Steps:
    1. Hold the hands a short distance above the same positions as in 4.6.
    2. Announce each move.
    3. Offer light contact later only if the client asks for it. [Lipinski]
  • Example language (illustrative): "My hands will be a little above you, not touching. If you'd like contact at any point, you can tell me. If not, that's completely fine."
  • Watch for: anxiety about not knowing where your hands are. Narrate their location, or let the client keep their eyes open. [Lipinski; synthesis]

4.9 Kenyoku (closing cleanse)

  • Purpose / when: Described by the ICRT as a method for cleansing the body and energy field, used at the end of a session. [source: ICRT "Western and Japanese styles"; ICRT class outlines]
  • Steps: The practitioner performs Kenyoku on themselves as taught in class (form [uncertain: not verified]). Then let the client sit up slowly and reorient before any talk. [synthesis]
  • Example language (illustrative): "We're finishing now. Take your time, open your eyes, and sit up when you're ready. Notice your feet on the floor."
  • Watch for: drowsiness or spaciness. Allow time before the client leaves or drives. [synthesis]

4.10 Self-Reiki (self-treatment)

  • Purpose / when: Once attuned, a person can treat themselves. ICRT teaches self-scan and self-session hand positions in Reiki I. For the therapist it is daily self-care. For clients, it is only for those who have trained independently. [source: ICRT FAQ; ICRT class outlines]
  • Steps:
    1. The practitioner gives themselves a session using self-positions on the head, torso and so on, as taught.
    2. If a client who already practises Reiki wants to use self-Reiki between sessions, explore it as one self-soothing strategy among others and track its effect on mood and arousal.
    3. Do not teach or attune clients yourself, because that is a dual role. [synthesis]
  • Example language (illustrative): "You mentioned you do Reiki on yourself at night. What do you notice before and after? How does it compare with the breathing practice we've worked on?"
  • Watch for: self-Reiki used to avoid needed medical review, or as a compulsive ritual. [synthesis]

4.11 Distant Reiki (including Enkaku chiryo) and its consent

  • Purpose / when: Taught at Reiki II. The ICRT says Reiki can be sent using a photo, a written name or the thought of the person, and that distance makes no difference. Enkaku chiryo is a group distant practice for named people and world situations. [source: ICRT FAQ; ICRT class outlines]
  • Steps (consent-first, synthesis):
    1. Send distant Reiki only to a client who has explicitly asked for it and agreed a time frame. Never send it covertly, and never to a client who has declined or ended work.
    2. Record the request.
    3. Do not use it in place of contact when the client is at risk. Follow ordinary risk procedures.
    4. ICRT ethics documents do not address distant-Reiki consent. This consent step is synthesis, based on the ICRT principle that Reiki works only when invited. [source: ICRT history; ICRT Code; synthesis]
  • Example language (illustrative): "Some Reiki practitioners send Reiki at a distance. I only do that if you ask me to, and you can withdraw that any time. Would that be meaningful to you, or would you rather keep Reiki to our sessions?"
  • Watch for: blurred boundaries (the client feeling "held" by you outside sessions), magical thinking, and dependency. Explore these in therapy. [synthesis]

4.12 Gyoshi-ho and Koki-ho

  • Purpose / when: Japanese-style techniques. The ICRT describes Gyoshi-ho as sending Reiki through the eyes, used in place of "beaming" in Reiki II. Koki-ho is described as healing with the breath. [source: ICRT "Western and Japanese styles"; ICRT class outlines]
  • Steps: These are taught in class [uncertain: details not verified]. In psychotherapy, explain beforehand what the client will see. Sustained gazing or directed breath can feel intrusive. [synthesis]
  • Example language (illustrative): "For the next part I'll keep my hands still and just look softly toward your shoulders. You can keep your eyes closed or open."
  • Watch for: discomfort with being looked at, which is common in shame and trauma presentations (Lipinski notes that clients "may not like being watched"). Drop the technique if the client is uneasy. [source: Lipinski; synthesis]

4.13 Reiki-informed assessment and "sweeping" (Curtin & Prebluda model)

  • Purpose / when: In the integrated model of two licensed, ICRT-trained psychotherapists, Reiki and sweeping open and guide psychotherapeutic exploration. Use it with clients who have consented and want body-oriented exploration. [source: Curtin & Prebluda]
  • Steps:
    1. Do a psychological assessment of beliefs, emotions and behaviours linked to the problem. The authors also frame it across physical, emotional, mental, interpersonal and spiritual levels.
    2. Sweep the energy field generally, then locally over distressed body areas and the chakras the authors associate with them.
    3. Begin Reiki at the feet or head to get a "reading" of the field.
    4. Turn your impressions into open questions or a body scan led by the client, not into statements.
    5. Treat further areas while continuing to assess. [source: Curtin & Prebluda]
    • Chakra-emotion links are the authors' framework, not established fact. Offer them only as questions. [synthesis]
  • Example language (illustrative): "As my hands are near your stomach, I'm curious what you notice there, if anything. Any sensation, feeling or image is fine, or nothing at all."
  • Watch for: suggestion. Clients may adopt the practitioner's impressions as "truth", especially about memories. Never suggest that a memory or abuse lies in a body area. It's working when the client generates their own observations. [synthesis]

4.14 Moving from Reiki into talk-based work

  • Purpose / when: When patterns surface during Reiki, Curtin and Prebluda make talk central. They draw on emotional release work, cognitive restructuring, problem solving, trauma work, imagery, breath work, movement and mindfulness, and aim for the client to understand the changes they are making. [source: Curtin & Prebluda]
  • Steps:
    1. Pause or lift the hands.
    2. Invite the client to sit up if they wish.
    3. Reflect what emerged in their own words.
    4. Choose the established method that fits, and use it as you are trained to.
    5. Close with integration: what was noticed, what it means to the client, and one next step. [Curtin & Prebluda; synthesis]
  • Example language (illustrative): "You said a heaviness came up in your chest and you thought of your father. Shall we sit up and stay with that together for a bit?"
  • Watch for: flooding. If arousal climbs, switch to grounding (4.16) before any exploration. [synthesis]

4.15 Trauma-adapted Reiki session

  • Purpose / when: Lipinski's adaptations for clients with PTSD, drawn from her teaching at a VA medical center. Use them for any client with a trauma history. [source: Lipinski]
  • Steps:
    1. Ask permission first, and start hands-off until touch is comfortable.
    2. Let the client set the pace and ask what would help them feel comfortable. Check in often.
    3. Leave the door open and let the client face it, and choose music carefully.
    4. Allow eyes open.
    5. Never stand behind the client without telling them first.
    6. Use the client's name, make eye contact, and speak plainly, without esoteric language.
    7. Do not press for the trauma story.
    8. Start slowly and prioritise trust.
    9. Have a therapist to refer to and consult (for a psychotherapist-practitioner, this is your supervisor or a colleague). [source: Lipinski]
    • Additions: titrate by limiting the first session to a short, hands-off segment. Agree a stop signal. Check dissociation (for example, ask the client to rate how present they feel). Prefer a seated position if lying down feels exposed. [synthesis]
  • Example language (illustrative): "You're in charge of this. Door open or closed? Sitting or lying? Eyes open is fine. I'll tell you before I move, and I'll never be behind you without saying so."
  • Watch for: startle, breath-holding, a fixed stare, going quiet, or a drop in responsiveness. Stop and ground (4.16). It's working when the client asks for adjustments and stays present. [Lipinski; synthesis]

4.16 Responding to flashbacks or dissociation during Reiki

  • Purpose / when: Use immediately when a client shows signs of flashback or dissociation. [source: Lipinski]
  • Steps:
    1. Break contact at once and remove your hands.
    2. Say the client's name, and reorient them to place and time.
    3. Encourage eye contact and invite them to sit up.
    4. Do not touch again without new permission.
    5. Move to their side rather than standing over them.
    6. Ask them to count aloud, and give them time.
    7. Then use your usual grounding and stabilisation methods, review whether to continue Reiki at all, and document. [Lipinski; synthesis for the final step]
  • Example language (illustrative): "[Name], I've taken my hands away. You're here in my office, it's Tuesday afternoon. Can you look at me? Let's count together out loud, one, two, three…"
  • Watch for: recovery of orientation, eye contact and normal speech. If there is no recovery, or the client is at risk, follow your crisis protocol. [synthesis]

4.17 Responding to post-session reactions ("healing crisis")

  • Purpose / when: Some ICRT authors describe a "healing crisis". In their account, emotions, memories or physical symptoms such as headache or tiredness may surface after Reiki or an attunement. [source: Shewmaker, ICRT; ICRT FAQ]
  • Steps:
    1. Tell the client beforehand, calmly, that feelings or memories can surface.
    2. Be part of their support system. Encourage them to observe difficult emotions without getting caught up in them.
    3. Severe or continuing physical or emotional reactions mean the client should see their regular healthcare provider right away. [source: Shewmaker]
    4. Never attribute a new or worsening physical symptom to "healing crisis" in place of medical assessment. [synthesis]
  • Example language (illustrative): "Sometimes feelings or memories come up in the days after a session. Let's plan what you'll do if that happens. Any new or worrying physical symptoms are something to check with your doctor, not to wait out."
  • Watch for: the "healing crisis" idea being used to explain away deterioration, suicidal thinking or medical symptoms. Assess risk as usual. [synthesis]

4.18 Advanced and Master-level ICRT techniques (named only)

  • Purpose / when: ICRT ART and Master classes teach Reiki grids and crystals, Reiki aura clearing (also called "psychic surgery"), the Healing Attunement for personal issues, Holy Fire meditation and "Holy Love" experiences, and a "Spirit Release" process. [source: ICRT class outlines]
  • Steps: Use these only as your lineage teaches them and within your board's rules. In psychotherapy, they add spiritual and explanatory frames (for example "spirits" or "attachments") that can feed suggestion or fear. The default is not to use them with clinical clients. If a client asks for them, refer to an independent practitioner and explore what they mean to the client. An ICRT article on aura clearing and psychotherapy exists, but its content [uncertain: not verified]. [synthesis]
  • Example language (illustrative): "That's part of some Reiki trainings, but it isn't something I bring into therapy. Can we look at what you hope it would do for you?"
  • Watch for: clients with psychosis, paranoid ideation or obsessional fears about contamination or spirits. These frames can be destabilising. [synthesis]

4.19 Reiki in hospital, hospice and integrative settings

  • Purpose / when: The ICRT describes hospital programmes staffed by trained nurses, other staff and volunteers. Examples include pre-surgery sessions and volunteer "Reiki Rooms". Reiki is given only to patients who request it and understand what it is, and is presented as relaxation and stress reduction, so-called "straight Reiki". [source: ICRT "Reiki in Hospitals"; Baldwin book review]
  • Steps:
    1. Follow the institution's policy and credentialing.
    2. Offer Reiki, then give it only on request.
    3. Explain it in plain terms. If asked, say it is spiritual in nature but not a religion.
    4. Coordinate with the treating team.
    5. Psychotherapists in psycho-oncology or palliative care support the patient's choice without claims of disease effect. [source: ICRT "Reiki in Hospitals"; synthesis]
  • Example language (illustrative): "Our volunteer Reiki service offers a gentle, clothed, relaxation session alongside your medical care. It isn't a treatment for your illness. Would you like to hear more, or not today?"
  • Watch for: patients feeling obliged to accept, and families pressing Reiki as an alternative to oncology treatment. Address these openly and involve the medical team. [synthesis]

4.20 Documentation, coordination and role separation

  • Purpose / when: In every case where Reiki and psychotherapy meet. [synthesis]
  • Steps:
    1. Record consent (including touch/hands-off and the stop signal), lineage and training, the positions used, client responses, and any adverse reactions in the clinical record. ICRT documents do not set record-keeping rules [uncertain: lineage bodies' rules not verified].
    2. With consent, tell the client's physician or psychiatrist that Reiki is being used as a complementary practice.
    3. Never sell Reiki classes, attunements or products to therapy clients. Refer to independent teachers if asked, and record the conflict-of-interest discussion. Professional ethics codes on multiple relationships apply. The APA Ethics Code is relevant, but its provisions [uncertain: not verified].
    4. Keep confidentiality rules at the stricter of the two standards. The ICRT Code requires written consent before disclosure, and a parent's or guardian's for under-18s. [source: ICRT Code of Ethics; synthesis]
  • Example language (illustrative): "I don't teach Reiki to people I see in therapy, because it would mix our roles. If you'd like to learn, I can give you some questions to ask any teacher you consider."
  • Watch for: drift, where sessions become mostly Reiki and the therapy contract fades. Review goals at agreed points. [synthesis]

5. Handling problems

The sources say little about problems inside psychotherapy. Items marked [synthesis] are the author's own guidance.

  • Client feels nothing, or "it isn't working".
    • Published response: Takata advocated many treatments, and the ICRT says outcomes cannot be predicted. [source: ICRT "Western and Japanese styles"; Lipinski]
    • Response: normalise, and return to the client's stated aim (relaxation, body awareness). Agree a review point. If there is no benefit by then, stop Reiki and continue verbal work. Do not escalate the number of sessions to chase an effect. [synthesis]
    • Example (illustrative): "Noticing nothing is a perfectly valid result. Shall we decide together whether it's worth continuing, or put our time elsewhere?"
  • Over-investment or cure expectations. The client stops or delays medical or psychiatric treatment, or expects Reiki to treat a disease.
    • Published rules: restate that Reiki is not a cure and not a substitute for licensed care. Never advise on medication. [source: ICRT Code]
    • Response: suspend Reiki. Explore the meaning of the choice (control, fear of side effects, distrust). With consent, contact the prescriber. Assess risk. [synthesis]
  • Resistance or ambivalence about touch. Default to hands-off and offer seated positions, or drop Reiki. Never persuade. [Lipinski; synthesis]
  • Overwhelm, flashback or dissociation. Follow 4.16. Then return to stabilisation-phase work, and resume Reiki only if the client wants it, after a fresh consent conversation. [Lipinski; synthesis]
  • Unexpected sexual feelings, arousal or erotic transference.
    • Response: stop touch and move to hands-off or verbal work. Discuss the feelings respectfully as therapy material, seek supervision, and document.
    • The ICRT Code forbids sexual comments or contact and breast or genital touch. [source: ICRT Code; synthesis for the rest]
  • Recovered-memory risk. The client reports new "memories" emerging during Reiki.
    • Response: do not confirm or interpret them, and do not link them to body areas. Explore them neutrally, aware of suggestibility under relaxation, and consult supervision. [synthesis]
  • Ruptures. These include the client feeling judged for wanting or rejecting Reiki, or feeling the therapist "pushed" it.
    • Response: name the rupture, take your part, and re-negotiate whether Reiki stays in the work. [synthesis]
  • Non-adherence to self-practice. Self-Reiki is optional. Explore what the practice means and what gets in the way, as with any home practice. Never frame it as a duty. [synthesis]
  • Spiritual or religious conflict. The client fears Reiki conflicts with their faith, or a family member objects.
    • The ICRT says Reiki is spiritual but not a religion and asks no change of belief. [source: ICRT FAQ]
    • Response: respect the client's own reading, and offer verbal-only alternatives without loss of care. [synthesis]
  • Psychosis, mania or severe dissociation. Avoid energy and spirit frames and advanced techniques (4.18). Prefer established grounding methods, and coordinate with the psychiatric team. [synthesis]
  • Children and adolescents.
    • The ICRT Code requires written consent from a parent or guardian before any information is disclosed for under-18s. [source: ICRT Code]
    • Response: obtain parental consent and the child's assent. Keep touch hands-off or minimal, with a parent present or the door open. Never let Reiki substitute for medical care or vaccination. Follow safeguarding procedures if a child is denied medical care. [synthesis]
  • Pregnancy. The ICRT FAQ presents Reiki as safe in pregnancy. Defer to the obstetric team for any medical question. [source: ICRT FAQ; synthesis]
  • Commercial pressure. Clients may be offered expensive tiered trainings, repeated attunements or "Master" levels by others.
    • Context: the ICRT reports that Takata reportedly charged $10,000 for Master training, and that later teachers lowered fees. [source: ICRT history]
    • Response: help the client weigh costs and motives, and never benefit financially yourself. [synthesis]
  • Practitioner fatigue, or wanting to "fix" the client. Lipinski warns of compassion fatigue in prolonged trauma work. Use self-treatment, supervision and a manageable caseload. [source: Lipinski; ICRT class outlines; synthesis]
  • Complaints or boundary concerns. If a client complains about touch, stop Reiki pending review and inform your professional body or insurer as required. Lineage bodies have their own complaint routes [uncertain: not verified]. [synthesis]

Sources

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