Breathing as a Gateway to Emotional Regulation in Shiatsu (Eduard Tripp)

German Version

First, a fundamental clarification: Shiatsu and psychotherapy are not only clearly distinguishable methods; they are also based on different theoretical frameworks, use different ways of working and pursue different objectives – and are therefore not interchangeable. Shiatsu is not psychotherapy and should not be understood or used as such.

However, this by no means implies that Shiatsu cannot also be effective on a psychological level or produce effects similar to those we recognise from psychotherapeutic contexts. On the contrary: Shiatsu practitioners repeatedly observe how beneficial Shiatsu is, not only for the body but also for the emotional well-being of their clients. Shiatsu can help people feel calmer and more centred, instil a sense of security, strengthen their sense of their body and of themselves, stimulate emotional processes and, at times, open up inner spaces where feelings, memories or needs of which they were previously only dimly aware can be experienced more fully.

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It would, however, be a mistake to infer from such effects that Shiatsu can therefore be used ‘just like that’ as a psychotherapeutic method. Equating the two would be similarly problematic to equating a professional psychotherapeutic relationship with a friendship. Friendships, too, can offer comfort, provide stability, instil a sense of security, open up new perspectives and facilitate profound personal changes. Nevertheless, a friendship is not psychotherapy, for a method is defined not only by the effects of a relationship or intervention, but also by its theoretical background, its objectives, the setting, the roles of those involved and the professional competence required to work with the processes it sets in motion.

Perhaps this relationship can be described most vividly using an analogy from set theory: Shiatsu, psychotherapy and friendship – just like numerous other forms of supportive interpersonal interaction – have an area of overlap. This includes, for example, care and appreciation, empathic resonance, acceptance, the building of trust, a sense of security, stress reduction and the experience of being seen and accepted by another person.

Beyond this shared ground, however, each approach offers its own distinctive possibilities and characteristics. A professional Shiatsu treatment can facilitate physical and energetic experiences that do not arise in quite the same way within an ordinary friendship – not even if the friend is also a Shiatsu practitioner. This is because different relationships create different kinds of space for experience.

A key difference lies in the clearly defined professional setting. In a treatment session, roles and responsibilities are allocated in a fundamentally different way from those in a friendship. Friendship is based on reciprocity: both parties may expect care, interest, support and consideration from one another. The professional treatment relationship, on the other hand, is deliberately asymmetrical in this respect. For the agreed duration, attention is largely focused on the client. The client is expected to honour the agreed arrangements – such as payment, keeping appointments and treating the practitioner respectfully – but is under no obligation to look after the practitioner’s emotional well-being or meet the practitioner’s personal needs. It is precisely this clear allocation of roles that creates a distinctive space for experiences that may be difficult to access in everyday relationships.

A similar overlap can also be found between Shiatsu and psychotherapy – yet at the same time, there is a significant difference in methodology. In professional Shiatsu practice, the focus is on supporting the client’s self-regulation and energetic balance. Contact between practitioner and client, mindful touch, physical and energetic resonance, and the calm rhythm of the treatment are central to its effects. At its core, Shiatsu works in a supportive, stabilising and strengthening way: it draws on existing resources and, in a sense, invites the organism to regain a greater capacity for regulation and inner balance.

Psychotherapy – particularly in psychoanalytic and psychodynamic approaches – focuses its attention explicitly on psychological processes and on the patterns that shape a person’s experience, thinking, feelings and relationships. A person’s way of relating to others – and thus, ultimately, to the world – finds expression in their relationship with the therapist. Psychoanalytically oriented approaches refer to this as transference.

Past relationship experiences, needs, desires, fears and expectations are – usually without the person being consciously aware of it at first – reawakened in present-day relationships. In psychotherapy, such processes are not only recognised and held within the therapeutic relationship but, depending on the approach, are deliberately made a focus of therapeutic work. The aim is to recognise recurring patterns, understand their origins and function, and develop new ways of experiencing and acting.

This is where a crucial distinction from Shiatsu lies. In Shiatsu, the primary aim is not to uncover, interpret or deliberately change psychological patterns of relating. Rather, the focus is on the immediate physical and energetic encounter and on supporting regulatory processes. However, this does not mean that transference and countertransference processes do not occur in Shiatsu. On the contrary: through touch, non-verbal communication, close, attentive care and the reduction in conscious control associated with deep relaxation, very early relational experiences can be evoked and corresponding emotional reactions activated.

This is precisely why the distinction is so important: the fact that a process arises in Shiatsu does not mean that it can or should be addressed using the methods of Shiatsu. For whilst psychotherapists are trained to recognise, reflect upon and purposefully incorporate transference and countertransference dynamics into the treatment process, Shiatsu practitioners understand their role primarily as maintaining a safe, clear and supportive framework. This includes, in particular, clarity of roles, self-reflection and the ability to recognise the limits of one’s own method and professional competence.

The common ground between Shiatsu and psychotherapy therefore lies less in their doing the same thing than in the overlap between some of their effects. Both can promote a sense of security, self-awareness and self-regulation; both can touch on experiences of relating to others; and both can set in motion developments that extend far beyond momentary relaxation. However, they do so in different ways.

It is precisely this difference that makes their connection so exciting and fruitful: Shiatsu does not need to become psychotherapy in order to have psychological effects. Nor does psychotherapy need to become Shiatsu in order to recognise the significance of the body, touch and non-verbal resonance. A fruitful relationship between Shiatsu and psychotherapy develops when practitioners understand and draw on what the other approach can offer, while keeping their distinct roles and areas of competence clear. Blurring these distinctions would be methodologically misguided and could impair the effectiveness of each treatment. It may also initiate or intensify processes that cannot be adequately supported without appropriate training, particularly in people who are psychologically distressed or vulnerable.

Further reading

Eduard Tripp (2025): Shiatsu meets Körperpsychotherapie. Berührungspunkte zwischen Shiatsu und Psychotherapie. [Shiatsu meets body psychotherapy: Points of contact between Shiatsu and psychotherapy.]

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