In Shiatsu, diagnosis and treatment are the same.
Diagnosis is treatment; treatment is the process of diagnosis. Masunaga and Kishi both stressed this point; it is the Japanese Shiatsu way and for Kishi this was the dynamic moment of Seiki Soho. But, it can be hard to achieve in practice.
Our modern, western language and ways of thinking tell us that we can separate diagnosis and treatment. The English language certainly does, other European languages may have nuances I know nothing about, but my guess is that they are essentially the same on this. In any case, language does not map onto reality piece by piece. The word ‘table’ has no actual relationship to the thing that is or is not a table; ‘me’ is the name I call myself, it is not who/what I am.
The fact that we use two words, ‘diagnosis’ and ‘treatment’, gives the impression that actual diagnosis and treatment can be separated and performed as distinct steps, but that impression is an incorrect reading of reality and, as a side-effect, misunderstands a basic tenet of Shiatsu, the thread of which we pick up in Seiki. The split runs deep in our psyches and undermines the hands-on work unless we work hard to stop it.
Language represents a shared way of interpreting the world. It gives meaning, so we can operate in apparently coherent and collaborative ways. But this coherence is the merest gossamer covering, hiding the unimaginably powerful dynamics of eternity. That thin web of meaning is fragile, and it reflects only a tiny fraction of what is true. A film in front of our eyes, it obscures and distorts.
The contract we have with each other as social beings operates within this distortion. It has its uses and enables some community and stability. But it is also a menace because it filters what we know of the world and reduces it; it is a substitute for reality that muffles us from the zing and colour of life; it gets in the way of real relating and is very hard to escape from. In the end it kills most of us. Kishi told me he had only ever known one person die from actual old age, most people die from some kind of suicide.
It takes a huge task of will, or the intervention of a cataclysmic event, to get away from the dualistic thinking that separates syo diagnosis into two steps. In separating, we miss the moment; the meeting with infinity that Shiatsu, certainly Seiki (Soho) offers. Since the work is all in the timing – ki do ma – that is everything.
Splitting diagnosis and treatment is a basic tenet of modern, western medicine and it can be life-saving in that context. Doctoring is about seeing what is wrong and then addressing the symptoms and, sometimes, the cause.
But the Shiatsu of Masunaga and the Seiki of Kishi might look like healing but were never meant to be medicine. We make them medical by interpreting the form through the filter of modern, western thinking. Masunaga’s Shiatsu, his king of medicine aimed to use dualism to get past dualism and Kishi’s contribution is that he achieved it with Seiki Soho. But working against this, all the time, like wading through a quagmire, is this model of medicine we are familiar with in concert with our language structure. They pull diagnosis and treatment apart and time and again, making it hard for us to really appreciate what the Japanese masters regarded as so basic it did not need to be said.
This appreciation of reality and language is not the sole preserve of the east. Western theology points to it repeatedly and philosophers, at least as far back as David Hume (1711-76) have told us that there is no such thing as cause and effect; it is a connection that takes place in our imagination, not in fact.
And you may, at this point be thinking, ‘but of course there’s cause and effect…I put the kettle on – it boils!’ Yes, of course you are right. This is how we operate in daily life. It is hard-wired into us and it has value. But that does not make it true except in a mundane way. It is not the only truth. Slow it all down….slowly……….slowly………………slowly and we see that something else is going on; or nothing. There are spaces; everything is just itself.
Diagnosis and treatment might have been separated at first in order to make teaching easier. It is relatively straightforward to explain something in linear terms. It has its place and, even with Shiatsu, step by step exercises can provide a framework that helps us start to feel and understand. But it is an elementary stage we must avoid getting stuck in.
The problem was given a boost, worldwide, by the spread of the printing press in the 16thcentury which was a stage in the externalisation of knowledge. I am not denouncing the book, but it had unintended consequences. Writing things down started out as a useful aide memoir for the learned and became a straightjacket that places more authority on the fixed word than on the experience. The Word is a vital part of our evolution, but we need to use the dynamic it sets up to develop and not stagnate.
This is an over simplification; the briefest of histories. In short, the separation game was already well established in the west when Shiatsu came along in Japan, just 40 years or so after that country, closed for over 200 years, opened its doors to the outside world and began consuming western ideas in hungry gulps, fearful of being left behind. Shiatsu is a 20thcentury take on touch therapy and, ironically, owes its popularity to language. It is because it was described in western physiological terms that it spread.
This was done in the 1940s during the American administration in an attempt to differentiate Shiatsu from massage and have it recognised under its own license. The researchers, including Namikoshi and Masunaga, found a way. They knew they had not nailed the essence of Shiatsu but some of them decided it was good enough for the moment; it served the purpose at hand. With plausible-sounding explanations, which are not exactly wrong but not exactly right, it was possible to roll out a training at Namikoshi’s Japan Shiatsu School. He knew that once it was explained in western terms, it could be monetarised. The cost was that the heart went out of it. Masunaga left to pursue his own way of explaining and working with Shiatsu and Kishi worked with him for ten years, then left with his own development of the Shiatsu tradition, Seiki.
When Kishi talked of Namikoshi’s touch, it is evident that this was a long way from what his school taught. It was in keeping with the inner arts of Japan which were not directly spoken; like Shinto, the heart of Japan, the shrine behind the outer, Buddhist temple and trappings. We know we cannot speak of this, only experience it, but those who seek and see will follow the little path behind the Buddha, into the hills, to the rocks and trees and dark, to the mirror and the kami…..
Kishi was astonished and impressed by the western ability to articulate the inner, we can’t do that, he told me, showing me a documentary about western classical music in which musicians spoke of their work, listen to that! A Japanese would never be able to explain that, we speak in metaphors, never exactly saying. We find this so impressive.
It is a real offering to the world: being able to explain. It comes at the centre from the opposite side of meaning to the quiet way of the Japanese. Both have their upsides and dangers. The hints and feather-touch require us to be quiet and practiced in listening for the still small voice in order to follow it. Bellowing, clumsy westerners are not always in a place to recognise the inner.
Conversely, the literal, the detailed, the explained can leave poetry behind as it fills in all the gaps; removing doubt. When the poetry is scared off by the heavy steps of utility, the heart of the thing we thought we had will die. And yet it is helpful to be able to say what we mean. It is part of how we become ourselves and learn. Understanding the differences and marrying the best in both is quite difficult.
Westerners recognised something in Shiatsu that they wanted. When they tried to study, few if any were permitted to enrol in Namikoshi’s official school. But Masunaga allowed some to join his postgraduate course; he had a separate stream for westerners. He thought them ill-equipped – not only had they no license, so could not work in the public clinic, but they lacked subtlety. He did not recognise the construct of meaning from which they operated and they, in turn, read his work through their filter and did not always catch the nuances.
In transferring what they observed and heard from Masunaga (and from Kishi, who taught many of those who came to see Masunaga in the late 1970s and early 1980s such as Ohashi and Suzaki) into western categories of thought, these students did a good job, considering. But it was and is a great deal harder to achieve than we think – both for the Japanese and for us. We can happily share a joke and a glass of beer, but the journeys and assumptions that brought us to that meeting point are often worlds apart. Arguably this is less and less the case as globalisation flattens out difference, but it was certainly still the case with Kishi up to 2012, when he died. If anything, I wonder if the difficulties increase as we become familiar with the outward appearances of each other’s cultures.
Or perhaps the original students and translators knew the difficulty of transferring it to a new culture but understood the practice well enough, so they could use unsatisfactory terms and still retain the essence of the practice. Or the western categories would not allow western students to understand Masunaga’s work as it was taught. Probably a mixture of these things. Shiatsu was translated, imperfectly but enough, perfectly but not in quantity; through touch and feeling which run deeper than words. But it has been disseminated in language that does not fit.
Syo diagnosis
Seeing the client is both recognition and balm; recognition is treatment. We do not have to do more, but this is difficult: the seeing and the not-doing are both at odds with our inherited meaning complex. Seeing things as they truly are is why we are here. We must do it as though our lives depended upon it; because they do. We can be sleepwalkers through life or we can keep on cleaning our souls; shining, shining, shining, until the obviousness of how things actually are finally has more reality for us than the drama.
This means we must stop performing a diagnosis to then apply it in treatment. You can do this, but it limits the work. Syo diagnosis might not look that different from what you do now. The line between separating things into two and operating in the dynamic tension of a paradox is tiny, tiny and ENORMOUS. What will change is the idea of what is going on which will change the whole feel of the work and what is possible within it. Clients feel that difference and love it; practitioners come, in time, to new certainty and fulfilment.
The way to find this out in practice is by asking yourself, what am I doing? What is here? What do I feel? The answer, or maybe the diagnosis, does not matter. It is only important while you do not know. As soon as you identify what you feel, as soon as you are conscious of something, then it is meaningless, gone. By then you are on to the next question, what is this? What do I feel?…..
The practice is in bringing the diagnosis to the surface and letting it go, over and over. Not in finding it and treating it. What is it you think you are treating? Reality is perfect, always perfect, oblivious to our tinkering. When you ‘treat’ it, you miss it, you trap it, you name it and you give it meaning it does not have and keep yourself and your client imprisoned in the meaning game. Only by recognising and letting go; by finding a comfortable place with the paradox and by understanding that you cannot change reality do you start evolving again.
Syo diagnosis can only take place in the moment. As soon as you apply an idea/diagnosis to a person, then it has ceased. A person is so different from an idea that it impossible to describe in words. Syo diagnosis takes place now and now and now.
The job we have as practitioners is to keep looking; looking until we see things as they truly are. Our clients may not know it, but that is why they come to us: they want to be seen. Even if we do not entirely understand, we must set language-meaning aside in order to attempt to see our clients. Eventually insight and sense begin to reveal themselves. We cannot make this happen. It arrives in the clearing we make when stop filling the gaps up with stuff and refresh our vision.
