A Report on the Panel Discussion from the ÖDS Days, Vienna, 13 June 2019
Dr. Eduard Tripp, Karin Koers and Achim Schrievers.

Translation: Chris McAlister (Braucht Shiatsu Forschung? Und wenn ja, welche Forschung braucht Shiatsu? 
Shiatsu Journal 98, Autumn 2019)

 

In answering the first question, the panel participants agreed spontaneously: Yes, Shiatsu does need research! But what do we mean when we talk about research and what do we hope to achieve through it?

We do research in order to expand and deepen our knowledge. The most natural way to gain knowledge is experience. As children, we learn to sit, stand and walk and thus learn about gravity and how to deal with it. But we are not aware of this knowledge. Awareness comes when we begin to think about the experiences we have had. With reflection comes an understanding of the laws behind the experiences and knowing these laws we can plan ahead.

Traditional Chinese Medicine (TCM) has an immense wealth of experience. Through reflection on experience, an understanding of the laws of nature has developed over the millennia. This understanding forms the basis for the teachings of Yin and Yang, the five phases of transformation, the meridians and their functions, as well as the acupuncture points and their effects.

With the advent of evidence-based science, an additional way of gaining knowledge has developed in the West. In relation to Shiatsu, evidence describes the scientific proof of patient safety and effectiveness in order to scientifically justify the professional recognition of Shiatsu and its status within the public health service.

This is not the sole focus however, for another question arises beyond that: as Shiatsu practitioners, what kind of knowledge should we strive for to suit our own purposes? The range of what is feasible extends from "classical" research approaches, such as those currently existing within medicine, to basic research and the co-development and co-design of new research as well as documentation approaches that are suitable for the depth and diversity of Shiatsu.

The participants panel, moderated by Dr. Sonia Raviola, MSc, reflected this diversity:

  • Fernando Cabo: Great Britain, author of the study "Shiatsu and Acupressure Two Different and Distinct Techniques"
  • Achim Schrievers: Germany, co-author of the pilot study "Shiatsu as a way into mindfulness practice"
  • Karin Koers: Germany, collaboration on the pilot study "Shiatsu as a way into mindfulness practice"
  • Patrizia Stefanini: Italy, co-author of the study "Modeling Meridians Within the Quantum Field Theory"
  • Kristina Pfeifer: Austria, coordinator of the Shiatsu Research Network
  • Eduard Tripp: Austria, professional representative of the Austrian Shiatsu Association, the ÖDS.

PodiumsdiskussionBesides basic research, such as the proof of meridians with methods from quantum physics, which was presented by Dr. Patrizia Stefanini, there are several other approaches to researching on what goes on during Shiatsu.

Qualitative research such as the Depth Interviews project under the direction of Achim Schrievers creates both a knowledge gain for us as Shiatsu practitioners and can at the same time form the basis for the development of hypotheses for follow-up projects.

Questioning clients is one way of quantifiably learning more about the effects of Shiatsu from the perspective of the recipient. The subjectively experienced effects of Shiatsu depend among other things on the cultural imprint and socialization of the clients. It may be assumed that the perceived effects of Shiatsu on the psyche in Western countries, where individual feelings and needs play a major role, are different from those in Asian cultures, where the collective is of primary importance. This opens up an interesting field of research.

Another example is the treatment of cancer patients. In addition to the conventional medical treatment of the tumour, there is also the matter of coping with the overall situation and dealing with the side effects of the therapy. Experience has shown that Shiatsu can be of help here - Fernando Cabo described a study that was carried out in England in order to scientifically prove what Shiatsu practitioners know from experience in this area.

Generally speaking, research projects based on the evidence criteria of medicine can produce statistically reliable results. This can generate positive influences for the professional position of Shiatsu both in the field of research and within health care. The research project "Shiatsu and Mindfulness" under the direction of Karin Koers follows this approach.

The project is conceived as a multinational study, with 300 volunteers from Germany, Austria and Switzerland. The aim is to investigate the effect of Shiatsu and the mindfulness exercise "the four anchors" developed by Achim Schrievers on stress load, perception and mindfulness. The study will be conducted through interviewing the respondents using standardised questionnaires and documentation of the sessions by the Shiatsu practitioners. These will be supplemented by measurements of cortisol levels in saliva as a physical stress parameter. It is hoped that the promising results obtained in the pilot study from 2017 in collaboration with Prof. Dr. Kohls from the Coburg University of Applied Sciences of Coburg, will be validated.

The question of what influence the client's self-perception has on the success of the treatment is another interesting aspect of this study. Karin Koers explained that it is not only in the pilot project that a connection was found between the awareness existing at the outset and the effect of the treatments; other studies such as the in-depth interviews as well as the results of her bachelor thesis also seem to suggest such a connection.

The question of financing studies and that of compliance with scientific research standards together form an essential basis for promising projects. For eaxample, the publication of studies in relevant journals requires the prior approval of an ethics committee, as Dr. Kristina Pfeifer illustrated with a recent example. The only exception to this rule is when a pure survey of clients is carried out and the treatment/intervention takes place independently of participation in the study. Fernando Cabo demonstrated this using the previous example of the study of cancer patients at a London clinic.

The coordination of research topics and cooperation in research projects are also important factors. The Shiatsu Research Network (SRN), founded in 2017 by Dr. Kristina Pfeifer during the the European Shiatsu Congress in Vienna, may be useful here. Its goal is the sharing of information and research results and to support the establishment of structures on which subsequent research projects can be based. It aims to facilitate exchange and to promote constructive and perhaps even - scientifically speaking - controversial discussion.

The panel also considered treatment documentation, ie case reports that demonstrate the positive effects of Shiatsu. As Achim Schrievers and Dr. Eduard Tripp emphasized, it is important that such documentation take into account both the objectives of Shiatsu and the existing legal framework. Though Shiatsu improves some complaints and illnesses, the focus of Shiatsu is clearly on the holistic treatment of the human being. The goal is the energetic harmonization of the treated person and the stimulation of self-regulating functions. On this basis, many things can change and even diseases can be managed.

Podiumsdiskussion

The experience of Shiatsu clients, as collected in the project "Depth Interviews - Treasures of Shiatsu", shows that the usual division into wellness, health promotion and therapy does not do justice to Shiatsu. In order to grasp Shiatsu in its entirety, it is necessary to immerse oneself in the subjective experience. This is where the limits of science reveal themselves, i.e. the intention to examine and understand life processes externally or "objectively".

For example, even if a sex researcher evaluates all data relevant to sexuality, he will never grasp the secret inherent in love. A link is needed between the experience itself and external scientific observation of the process. Science uses the mind and thinking to investigate life processes. The value of Shiatsu however, lies partly in the sinking into deep consciousness, which coincides with the cessation of thought. These two paths - comprehension through experience and understanding through scientific observation - should ideally complement rather than oppose each other.

Fernando Cabo cited the example of Dr. Edzard Ernst, former holder of the chair of alternative medicine at Exeter University in Great Britain, to show that science can also be used unfairly. Edzard Ernst vehemently opposes all methods that do not have scientific evidence and explicitly warns against Shiatsu: "the possible benefit is not worth the risk". He has even argued that Shiatsu is a high risk method, since there is a strong possibility of negative reactions, including stroke.

Problematically, his conclusions are not justified, since his primary source for risk assessment presents an almost contrary result and his secondary source refers to a massage chair, a "shiatsu type massager". For those who do not penetrate any deeper into the subject or those who trust doctors and professors more than Shiatsu practitioners, this might constitute a reason to avoid Shiatsu. Such tendentious representations can however, be countered with correct research results.

Fernando Cabo further argued that Shiatsu research is in a poor state. He cited several studies that allegedly investigate Shiatsu but have nothing to do with Shiatsu, instead using some form of acupressure, some even partly carried out with instruments. His wish, he stated, and the reason he participates in the Shiatsu Research Network, is to establish a clear research protocol for Shiatsu to distinguish it from other methods.

As important as the demarcation is, common ground is also vital. Dr. Tripp explained that studies are very helpful for the professional recognition of Shiatsu, since they demonstrate the professionalism of Shiatsu as well as its safety and effectiveness. At this level, studies in the field of acupressure, and possibly even acupuncture, are also helpful if they prove the effectiveness of, for example, Pericardium 8 (P 8). Since these methods are based on some of the same principles as Shiatsu, proving the efficacy of P 8 for various forms of nausea is also helpful for Shiatsu. What is needed is a recognized and regulated European profession: cross-country, cross-association and even cross-method. For this, common forces are necessary - and here the strength of the community and the spirit of Shiatsu can manifest itself.

  
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 About the authors:

  • Eduard Tripp, Psychotherapist, supervisor and Shiatsu teacher, director of Shiatsu Austria, professional representative in the Austrian Shiatsu association and author of various professional articles.
  • Achim Schrievers,  Shiatsu, Taiji and Qigong teacher, author of various books and specialist articles. He has studied sports science and spent two years in Japan studying the interplay between mind and body.
  • Karin Koers, Graduate information management, B.Sc. in complementary therapy, Shiatsu practitioner (GSD), coach (FH) and author. Research for Shiatsu as a complementary method for stress-related strain through a combination of physical (Shiatsu) treatment and cognitive approaches (solution-oriented, short-term counselling and mindfulness exercises).