Shiatsu: Japanese Connection

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Japanese discipline born in the early 1900s and spread like wildfire throughout the world since the 1960s, based on Chinese medicine and ancient Japanese techniques and philosophies. Everyone has heard of it, but what is it?

Shiatsu is like the mother hugging her baby.”

Shizuto Masunaga

Let me start by saying that this is not a technical article on shiatsu, but a simple and clear way to explain to non-experts what it is, how it works, the benefits and any contraindications. For technical work on the origins of shiatsu, I refer to my related article. Shiatsu, to date, is part of the holistic disciplines: those techniques that deal (or should occupy) with the person in his physical, psychological, affective and spiritual wholeness, as opposed to the scientist tendency to divide and analyze the human being in separate and disjointed parts (both in the body, it is sufficient to see all the specializations of medicine, as well as in the various aspects of the person).

Shiatsu Japanese connection

A brief history of Shiatsu


The term Shiatsu (指 圧) means “finger pressure“. It developed at the beginning of the 20th century but, is in fact, based on very ancient techniques and knowledge, especially of Chinese derivation. This term is coined to break away from other traditional disciplines (such as Anma and Anpuku) that no longer enjoyed good fame and were relegated to working-class environments and considered to be ineffective. Thanks to the work of personalities such as Tenpeki Tamai and Tokujiro Namikoshi (graduate in physiotherapy), who associated modern studies of anatomy and physiology with traditional techniques, Shiatsu effectively enters the Japanese health system in 1964 as an autonomous technique. University studies and a state certification exam are necessary to be able to practice it. It is thanks to Namikoshi if Shiatsu begins to be known in the West.

Shizuto Masunaga and Zen Shiatsu

A disciple of Namikoshi, graduate in psychology, Masunaga was the one who gave Shiatsu the dignity of 5,000 years of history and made it famous throughout the world. Detaching from Namikoshi after 10 years of teaching at Japan Shiatsu College, in 1968 he founded the IOKAI institute, which for decades will become a centre of studies with people from all over the world. Masunaga himself will travel the globe teaching his discipline in the US and Europe.

What was his great revolution? Surely the psychological approach (without taking anything away from the medical anatomical-physiological one) and the knowledge of Chinese medicine. Masunaga, in fact, re-enters the meridian theory (energy channels on which acupuncture is based) by developing and further elaborating it, the principle of Yin and Yang (especially in the concept of deficiency/excess), Tsubo (pressure points or acupoints) and the theory of the five elements (or movements). It gives its technique the name of Keiraku Shiatsu (Shiatsu of the meridians) but in the West, it will be presented as Zen Shiatsu.

Zen Shiatsu: characteristics

Holistic approach

When we talk about holism it means everything and nothing. Quite often there is a negative view given by the diffusion of dubious techniques and disciplines. In this mare magnum, however, there are arts like Shiatsu which are supported by 5,000 years of history and modern medicine, as can be seen in Japan. When we talk about holism, we must always think of a unitary approach towards the person, which concerns him/her in him/her being body, mind, emotions and spirit as a unity. ALL oriental disciplines (Chinese medicine, Shiatsu, Thai medicine, etc.) are based on a set of techniques that make sense when they are all practised and taken into consideration.

To begin with, there is the first division into disciplines that the individual practices on him/herself in everyday life (health exercises, called Do In in Japanese, Dao Yin in Chinese) and those that the operator practices on a recipient (An Kyo/An Kiao). From here it is understood that health, in a complete meaning, is a work to which the patient must first be dedicated, doing specific exercises every day, taking care of diet and lifestyle. In the West, we have a tendency to do nothing for ourselves and, when we are ill, to delegate everything to the doctor and to medicines.

Subsequently, when one goes to a Chinese or Japanese doctor, he does not limit himself to giving us a physical evaluation, he also asks questions about the psycho-emotional and spiritual situation. Then, he proceeds putting the needles, giving a massage, giving herbs, prescribing a specific diet with exercises and giving us indications about personal life. As can be seen, the whole sphere of human existence is covered. The patient’s task is to act actively for his own healing, changing not only lifestyle, diet but also the mental approach to life. In the West, unfortunately, these oriental disciplines have been separated and when we go to the acupuncturist, he/she simply put the needles and nothing more, leaving out the herbs, the diet, the massage and the psycho-emotional consultation, as well as the exercises at home. To get all this, in the West, we must visit 4 or 5 different specialists!

The abdomen

Masunaga‘s great job was to create a method that fits the person and does not follow established protocols depending on the problem. Each person is different and reacts differently from another with the exact same problem. Masunaga, therefore, has developed a diagnosis based on Anpuku: abdominal massage. The intestine is called the second brain and has a number of nerve cells second only to that of the brain. It is not by chance that it is called the enteric nervous system or second brain. Since ancient times, in Chinese and Japanese medicine (see Chi Nei Tsang and Anpuku for further information) vital importance was recognized in the abdomen. For the Chinese and the Japanese it is the source of Qi (or Ki in Japanese: the vital energy that permeates all things). Not by chance the samurai, to take their own lives, practised the seppuku: they pierced themselves with the sword impaling it in the abdomen. The belly in Japan is called Hara. This suicidal practice is also called Hara-kiri, not surprisingly.

There are now many studies that claim that emotions are connected to the intestine, but the Chinese and Japanese people had understood this for hundreds of years. Thus with Zen Shiatsu, the first contact with the recipient is made through the abdomen. The practitioner listens and feels in order to “deciphers” its state. Each area of ​​the abdomen is connected to a meridian, an organ, the function of the organ and a relative emotion. Once an energy diagnosis has been made, work is carried out on the meridians.

Meridians and 5 elements

The method of Masunaga takes up the 5000 years of Chinese medicine and its main elements. One of these is certainly the energy channels or meridians system. According to this theory, the vital energy of the human being (Qi or Ki) flows along privileged channels and thus allows all the organs and bodily functions to function properly and to maintain a balance throughout the psychophysical-system. The main meridians are 12 and correspond to their relative organs: Lung, Large Intestine, Stomach, Spleen, Heart, Small Intestine, Bladder, Kidney, Pericardium, Triple Heater, Gallbladder and Liver. The meridians alternate in Yin and Yang and proceed in pairs: Lung is connected to Large Intestine, Stomach to Spleen and so on.

Each pair is a manifestation of one of the 5 elements or movements: Metal, Earth, Fire, Water and Wood. Fire is the only one that includes 4 meridians instead of 2. These elements are not really physical substances (as could be the case for the 4 elements of ancient Greece) but they are different qualities of the same energy, and therefore in continuous transformation and movement. Each has precise characteristics and yin and yang aspects: Lung is yin with respect to the Large Intestine which is yang, both belong to Metal. These categories, which seem so abstruse and fanciful, are actually simple methodologies developed by the ancient Chinese trying to create a map of creation: observing nature and based on the belief that the macrocosm and the microcosm follow the same laws and characteristics, they used the same categories for the human body.

Yin and Yang

We talk about it a lot and often inappropriately. It is a simple binary system of decoding reality. By now even contemporary scientists have come to the conclusion that the universe is based entirely on a binary code. The Chinese had understood this millennia ago. Yin represents the shady side of the hill while Yang is the sunny side. It is clear that what is now in the sun will then be in the shade. This explains well how yin and yang are not two absolute entities but two aspects of the same energy. In fact, it is fundamental to understand that Yin and Yang are two relative concepts, never absolute. Yin will always be in relation to a Yang. Each of the two always contains some of the other. When the Yin reaches its maximum, it will begin to become Yang. One cannot exist without the other. The laws that determine them are 4:

  1. Yin and Yang are opposites
  2. They have a mutual origin
  3. The growth and reduction of one is inversely proportional to that of the other
  4. They alternate and mutually transform each other.

In general we can associate features to the Yin: darkness, moon, night, night, feminine, passive, cold, negative, north, west, earth, water; and to the Yang: light, sun, day, clear, masculine, active, warm, positive, south, east, heaven, fire. Tendentially, the Yang energy rises, leads upwards while the Yin energy goes down, pushes down.

In Zen Shiatsu, as well as in relation to the Ki of the meridians and organs, Yin and Yang are used to determining the “quality” of the single Tsubo or acupoint. In fact, from these concepts, Masunaga developed those of Kyo (deficiency) and Jitsu (excess). It is deficient or in excess with respect to the Ki of the meridian. The deficiency is clearly a lack of energy the excess is a stagnation of the same. Energy must flow and when it does not, imbalances are created which eventually lead to the development of the disease. The Kyo, in addition to the energetic void, represents the hidden need. This is the real root of the malaise, which is manifested by excess on another side (Jitsu). The real purpose of the Shiatsuka (Shiatsu practitioner) is to find the Kyo, the hidden need, and to bring to it Ki by unlocking the Jitsu, which is the outward manifestation of hidden need.

Shiatsu Japanese connection

Why Zen


Although the term Zen Shiatsu was not intended by Masunaga, when they proposed it to him, he did not reject it. This is because the approach is the same: no dogma, no writing to believe blindly, only practice and experience and so much listening. The method of Masunaga involves the simultaneous use of two hands during the treatment: one hand stands still and acts as a support, called the Mother hand, the other moves and presses on the meridian, called the Child hand. Both hands listen, even if in a different way, creating an energy bridge of which the operator is the intermediary. In fact, it is not the Shiatsuka that takes care of the recipient, it is him/herself that self-heals through the operator. The purpose of techniques like Shiatsu is this: not to eradicate an illness or a malaise, but to make the individual stronger and more aware, giving him the tools to overcome illness and sickness alone.

A treatment and not a massage

Many believe that Shiatsu is a massage. In fact, the hands are used (but not only, but also elbows, knees, feet) but it is not limited to a manipulation of the tissues (be they the connective tissue, the epidermis or the muscles). Shiatsu is a treatment that involves intense and profound manual skills combined with energy work. It is a royal technique due to its dual aspect. It is not like Reiki that only works with energy, nor is it a massage therapy that merely works on tissues, but a combination of both. The focus of Shiatsu is acupressure: perpetrated through pressure with the thumbs, the palms, the knees, the elbows, the feet. Even intense pressures, sometimes (depending on individual cases). But still pressures that go to work even on energy channels as well as on tissues.

Stretching and Makko-Ho

An important part of Shiatsu that often Western operators omit is that of stretching. The meridians, although not physical entities, are closely related to the body. Every movement of the limbs activates or not certain meridians. Thus stretches have been developed to work on the energy of the single meridian. They are exercises often used only as a diagnosis of the energy channel. Where there is a restriction in the movement of a limb, there is also an energy imbalance in the relative meridian. In addition to stretching performed by the operator on the receiver, Masunaga has developed a series of meridian stretching exercises that anyone can do at home, every day. They are very similar to yoga positions: in the theory of yoga the nadis, energy channels, are known and the postures certainly have the intent to work on the energy of these nadis (although by now no one in the West teaches more about these things related to yoga). Masunaga wrote a whole book on these exercises and considered them an important part of the treatment of imbalance.


Shiatsu was the first holistic technique I studied and remains my favourite, for many reasons. It does not need any particular care: it does not need oil, no massage beds are needed, the recipient can remain dressed, it can be done practically in any place, at any time. Furthermore, it is a fantastic tool to work on the psycho-emotional aspect, as well as on the physical and energetic aspects. This close correlation between meridians and emotions allows us to perceive and with certain clarity the emotional state of the recipient and therefore to be able to work on it, with the collaboration of the recipient (fundamental element: if there is no openness and collaboration, we cannot do almost anything).

For this reason, an important aspect of a Shiatsu treatment is the pre and post-treatment dialogue (and sometimes even during), in which one can share what has come out and be so as a mirror to the other, so as to make one another aware of one’s own situation. It is not for everyone: many do not want to get psychologically naked in front of a stranger and even less to take responsibility for their own situation, which always implies putting themselves on the line and changing their approach to existence and lifestyle.

Here is a link to learn more about the benefits, contraindications and Shiatsu in general:


What makes Shiatsu special, in addition to all that has been said and that you can find in any book or article that deepen this topic, is the operator’s approach. What matters, in fact, more than the technique itself, is the fact that the operator makes emptiness inside himself to allow him to welcome the recipient in the best possible way and treat him in the way most suited to his needs. For this reason, it is essential that an operator is a person with a profound work on himself, who has an ego reduced by intense and radical spiritual experiences. These characteristics are extremely personal and it is not easy to understand if the person in front of you has made a real journey on himself or if instead he is limited to using these techniques to increase his ego. It is easy to mistake fireflies for lanterns and to judge by appearances. Surely a person who continually advertises and claims to have the truth in his pocket will rarely be one who has created the emptiness within himself.