Shiatsu – Helping social anxiety disorder

Shiatsu case study – Social anxiety disorder

Shiatsu terms

According to the Oriental Theory of medicine there are 14 channels or meridians where vital energy/life force Ki (Chi) flows in. Each with a specific physical and psychological function which combines together to make the whole person function as one. Outside elements and internal systemic changes constantly impact to change and influence these energy patterns causing imbalances all the time.

Sometimes, these imbalances lead to illnesses or symptoms but other time the effects are unnoticeable. So unlike in the Western concepts of good or bad health and ill or healthy, implying a black and white view that you are either well or ill there are no certainties in the Oriental Theory, just imbalances. A diagnosis isn’t bad or good, it is just the way things are/were at the time. It is a naturalist way of thinking.

Jitsu/Kyo
These are the two terms used in Zen Shiatsu to explain a diagnosis, they are similar to Yin/Yang, Jistu means too much or too full (excessive) and Kyo means empty or too little (deficient) of Ki. Jitsu or Kyo the symptoms associated with the imbalance are similar. It is thought that Kyo causes Jitsu to be too full by giving up most of its’ Ki and Jitsu symptoms more manifest while Kyo symptoms are hidden and underlying.

So the treatment is about identifying and bringing these two opposing forces of Ki (in the 2 meridians) back to the middle to harmonize and balance, thereby harmonizing and balancing the whole system. The body (and mind) then takes over and translate this into physical and mental wellbeing. This is a natural and holistic way of maintaining health.

Shiatsu case study introduction

Name: JC
Age: 36
Gender: Male
Occupation: Risk Analyst

JC was the winner of a Shiatsu gift voucher at an event I provided Shiatsu in November 2008.

Main Complaint (on 1st session)
Just recovering from a bout of chest pains, went to A&E yesterday and was ok. Feeling tired today, very busy at work, suffers from social anxiety disorder, prone to palpitations, but never been to hospital before, work is very stressful, relocated to UK in Sept 08 from Switzerland having to get used to the change of scenery added to the stress.

Medical History
Has been suffering from Social Anxiety Disorder for 4/5 years (symptoms were there longer but diagnosed then.) Symptoms of SAD manifests in palpitations, light sleep – keeps waking up several time during the night, nervous stomach – 4/5 bowel movements a day, frequent urination, has dizzy spells during the day. Has consulted a doctor few months ago, a blood test found nothing then.

1st TREATMENT – 20/12/2008
JITSU: Triple Heater
KYO: Liver
Diagnosis – Symptoms: Social anxiety disorder (feeling vulnerable, on guard), disturbed sleep, slight cold/ runny nose, tight shoulders, tiredness, erratic energy (possibly due to SAD and waking up several times during the night), stiff hips & neck.

2nd TREATMENT – 04/01/2009
JITSU: Triple Heater
KYO: Stomach
Diagnosis – Symptoms: Still feeling vulnerable/anxious/stressed at work, disturbed sleep, many bowel movements a day. Recommended papaya enzymes for nervous Stomach, also Landmark Forum seminar for social anxiety disorder symptoms.

3rd TREATMENT – 18/01/2009
JITSU: Triple Heater
KYO: Liver
Diagnosis – Symptoms: Soar throat, disturbed sleep, feeling vulnerable, exhaustion/tiredness/erratic energy due to sleep problems, stress at work and frequent bowels and urination which adds to the stress, rigid calf muscles. Requested to keep a sleep diary to find out if there is a pattern to it.

4th TREATMENT – 01/02/2009
JITSU: Kidney
KYO: Large Intestine
Diagnosis – Symptoms: Stress, anxiety, restlessness/sleeplessness, stiff shoulders, frequent bowel movements and urination.

5th TREATMENT – 14/02/2009
JITSU: Kidney
KYO: Triple Heater
Diagnosis – Symptoms: Tired after a night out, frequent urination, stiff shoulders, disturbed sleep, slight runny nose. Just started taking papaya tablets. Advised to keep taking it as it can take time.

6th TREATMENT 01/03/2009
JITSU: Stomach
KYO: Triple Heater
Diagnosis – Symptoms: Recently noticed getting dizzy spells at work possibly due to stress, has seen a doctor about it who will book an appointment for a blood test but a previous test proved negative. Advised regarding symptoms of hypoglycaemia which is similar to the symptoms described but cautioned this needs to be looked at properly.

Advised to try a tea spoon of glucose when he notices dizzy symptoms, if symptoms ease off after, then he may have hypoglycaemia (low blood sugar). Also taught a relaxation exercise to help calm anxiety and stress symptoms.

Shiatsu case study analysis

Main Complaint/Medical History
Social Anxiety Disorder is rooted in emotional/psychological aspects of one’s health which then leads onto physical symptoms associated. Dealing with and finding solutions for psychological aspects of the symptoms are as important as dealing with the physical symptoms.

In Oriental Theory of medicine the Triple Heater meridian governs feeling at ease with one’s surroundings and fitting into the environment especially in relation to dealing with people. The Liver meridian governs emotions, being positive and boundaries. And the Stomach meridian governs acceptance of people and situations and being able to take in other people and human interactions.

In JC’s symptoms of Social Anxiety Disorder deficiencies in Triple Heater, Liver and Stomach meridians could have impaired the normal psychological functioning of these meridians as described above which could have affected the symptoms of stress resulting in palpitations and anxious feelings which is called SAD and these symptoms then further results in his physical symptoms of frequent bowel and urinary movements, sleep disorders and spells of dizziness.

Correlations
In the 6 sessions with JC Triple Heater meridian imbalances came up 5 on occasions, as Jitsu (excessive/full) in the 1st 3 sessions and as Kyo (deficient/empty) in the last two sessions. This correlates with his experience of persistence of symptoms. But as explained before Kyo is the cause and Jistu is the effect, diagnosis in the 1st 3 sessions were TH/LV, TH/ST and TH/LV so the Liver (metabolism, positivity & setting boundaries) and Stomach (acceptance, ingestion, digestion) are causing Triple Heater symptoms (disturbed sleep, weak immune system, feeling vulnerable or on guard when dealing with people & work situations). And then in the middle session the Triple Heater was not in the diagnosis. In the last two sessions it is the Triple Heater meridian that is Kyo (KD/TH, ST/TH).

This looks like there is a vicious circle type situation where physical/emotional symptoms of Liver and Stomach meridians causing the Triple Heater to excess and then physical/emotional symptoms of Triple Heater meridian is casing Kidney and Stomach to excess.

In addition Liver, Stomach and Kidney also came up at least twice. In addition to the Triple Heater meridian Liver, Stomach and Kidney meridians are all associated with; Emotional balance (LV), acceptance (ST) and the ability to relax and manage stress (KD). So the common symptoms both emotional (anxiety, stress etc) and physical (digestion, urination, sleep problems, dizziness) experienced by JC correlates with impairment to the normal functioning of these meridians.

Large Intestine meridian is attributed with (psychologically) the ability to release negativity, letting go, moving on and living life fully. But when imbalanced (Jitsu or Kyo) the opposite is happening. In the 4th session the diagnosis was Kidney Jistu and Large Intestine Kyo. Stress, anxiety, restlessness, stiff shoulders, frequent urination are all symptoms of Kidney disharmony caused by a weak Large Intestine meridian.

Conclusions
It is too soon to draw any conclusions based on the sessions so far as it has thrown many questions rather than answers, which can happen in a holistic treatment. JC says that he enjoys the relaxation that comes with a Shiatsu session but contrary to both our expectations he has experienced no change to his symptoms after these sessions.

I explained to JC that sometimes it takes time to find why the rebalancing of Ki during a session is not translating to relief of symptoms, especially when the body gets used to a set of symptoms over a long period and may rebel against new changes or may be something (food or psychological) is preventing the progress. At the end of each session JC is relaxed and at ease now, but that too was slow in coming as in the first session or two, the level of affect felt after a session wasn’t that good. But I assured him that if he wants to continue with Shiatsu, the process of elimination will discover a solution.

So far I have recommended papaya enzymes tablets to help regulate his digestion which he has been taking for a couple of weeks. But as these are natural medicines it takes a while to translate into noticeable progress. I also talked further about experimenting with aspects of his diet.

As a 1st step I have recommended he avoid carbohydrates from his diet completely for a couple of days because I noticed JC’s erratic digestive symptoms are associated with carb/sugar related foods. But if he gets any more dizziness he should try dissolving a tea spoon of glucose (can be bought from any chemist – Boots, Holland & Barrett etc) in a glass of water and drink to see if this makes any difference.

It is also clear that JC’s SAD plays a major part in his symptoms so it is essential that he looks at methods of resolving this as it absolutely possible to gain control of SAD. There are many possible vehicles for this; Hypnotherapy, TFT – Thought Filed Therapy, NLP – Neuro Linguistic Programming or as I have already strongly recommended JC the Landmark Forum. In the mean time I have taught him a relaxation technique (takes 5 minutes) which he could try any time to help him relax and relieve symptoms of stress or anxiety.

About The Author

Ken Hettiarachi has been a full time Shiatsu practitioner since November 2007. Since childhood, he has been interested in Oriental Theory and Zen Buddhism but never knew how to integrate these philosophies into his work and then 5 years ago stumbled onto Shiatsu.

It is the fact that he can make a direct impact on another person’s health in a positive way that inspires him to be a Shiatsu practitioner.

For more information visit Ken’s therapist page here


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