What's all this "qi" stuff? Does it really work?
When you go to a Western-medicine oriented doctor, physical therapist, or massage therapist, he or she will talk to you about muscles, nerves, bones, and organs.
When you go to a shiatsu therapist, he or she will talk to you about things like "Liver qi" and "Kidney yin".
Understandably, this confuses some people.
The simple analogy I like to use is that if you talk to a physicist about sound, you'll hear about pressure waves and frequency and vibrational nodes and anti-nodes; if you talk to a musician, you'll hear about intervals and scales and harmony. Different models, different ways of thinking, can be used to work with the same phenomena.
It is unfortunate that when some people first encounter the theory of Chinese Medicine behind Asian Bodywork Therapy, they immediately dismiss ABT as incompatible with modern scientific knowledge. This is an error in two ways: it confuses the question of "Does it work?" with "How does it work?", and it misrepresents the nature of Chinese medical theory.
Does it really work?
Obviously I'm going to have a biased answer! As a practitioner, I've seen shiatsu and acupressure have wonderful effects on clients, and I have benefited greatly from these modalities myself (and from acupuncture as well).
But I also consider myself something of a skeptic, and I know that anecdotal evidence is not reliable. So I'd like to present some of the research evidence for the benefits of Asian Bodywork Therapy.
To date, most scientific research on Chinese medicine has focused on acupuncture rather than ABT. However, some studies on shiatsu and acupressure can be found by searching the National Library of Medicine (NLM) PubMed service. (NLM is part of the National Institutes of Health.) You can search for articles on shiatsu and acupressure by following this link.
(Since acupressure treatment of specific points tends to be more readily standardized, most of these studies are of acupressure rather than of shiatsu.)
Some specific interesting studies:
- A study published in the Journal of Advanced Nursing (Volume 52 Issue 2 Page 142 - October 2005) studied acupressure therapy in patients with chronic obstructive pulmonary disease who were using prolonged mechanical ventilatory support. It found statistically significant improvements in dyspnoea, anxiety, and physiological indicators in an acupressure group versus a control group that received massage treatment and handholding.
- A simple but interesting study in the Journal of Alternative and Complementary Medicine (Aug 2005, Vol. 11, No. 4: 673-679) tested the use of acupressure to keep students alert in the classroom. It found that stimulation acupressure treatment yielded a significant change in alertness as measured on the Stanford Sleepiness Scale, corresponding to less fatigue.
- Anesthesia & Analgesia published a study (Anesth Analg 2004;99:1147-1151) that looked at the effect of acupressure on the EEG indicators used to measure the effects of anesthesia.
- A study published in Cancer Nursing (27(4):267-274, July/August 2004) investigated the use of acupressure as a treatment for nausea and vomiting in postoperative gastric cancer patients receiving chemotherapy and found "significant differences between intervention and control groups in the severity of nausea and vomiting, the duration of nausea, and frequency of vomiting."
- The use of shiatsu for post-term pregnancy was investigated in a study published in Complementary Therapies in Medicine (Volume 13, Issue 1 , March 2005, Pages 11-15). It found that women who used shiatsu were significantly more likely to spontaneously go into labor.
- A study in The Clinical Journal of Pain (12(4):326-329, December 1996) examined the analgesic effect of acupressure on postoperative pain and found a positive result.
Some of the limitations of studies on Chinese medicine should also be noted. For example, let's look at a study with negative findings. I haven't found any negative findings for acupressure, but let's look at a study on acupuncture for pain relief published in the Annals of Internal Medicine (5 July 2005, Volume 143 Issue 1, Pages 10-19). This study found that acupuncture was no better than "sham acupuncture" at relieving pain. However:
- the authors note that "a prescription of acupuncture at fixed points may differ from acupuncture administered in clinical settings". In other words, they did not apply the principles of Chinese medicine to the treatment, so what was tested was nothing like acupuncture as it is actually practiced.
- part of the control group received "simulated acupuncture", which will also stimulate points - in some cases, as effectively as needle insertion. Those of us who practice acupressure stimulate points without needle insertion all the time.
Unfortunately, fundamentally flawed studies like this are all too common.
The NCCAOM has started working more closely with the NCCAM, and I hope to see more and better research forthcoming. Meanwhile, it seems safe to conclude that ABT is an extremely safe treatment that seems to clearly have, at a bare minimum, positive non-specific effects in relieving stress and chronic muscle tension, and that there is significant evidence of more specific benefits.
When evaluating the research into complementary medicine in general, I recommend considering this article by Ted Kaptchuk. (I also recommend his book The Web That Has No Weaver for those who would like to learn more about Chinese medicine.)
How does it work?
There are several physiological theories about the meridians and points of acupressure. One involves nerve reflexes between the skin and the visceral organs; there are others involving the electrical properties of fascia (connective tissue), and another involving embryological connections throughout the body that persist into adulthood. It's possible that different points work by different mechanisms. The explanation is far from complete. Certainly the "placebo effect" plays a role - as it does in any treatment. (Google for "placebo surgery", it's fascinating.)
But Chinese medicine gives us a model of the human being that is not much concerned with these anatomical and physiological explanations. This model is a functional, not a structural, one; the Vital Substances, the Zang-Fu organs, and the meridians are best understood by what they do, not by chopping people up looking for structures.
The anatomical/reductionist model of the human being and the Chinese medical model are complementary, not opposed to each other. The relationship between the models is similar to two very different ways we can talk about music. We might describe a certain sound in terms of a time-varying frequency spectrum, or we might say something like "that's an A chord played on a steel-string guitar". The former description may tell you why, when you play it through your amp, it makes your speaker buzz because of some resonance; the latter tells you how it works in the music.
Both models are correct, but emphasize different aspects of our experience.
So what is this "qi" stuff?
Understood in this way, qi is not something that is found in an anatomical structure or physiochemical property of the body, but is something that is experienced. It is not something mystical or mysterious; if you get up in the morning and say "I feel full of energy today!", you have just made an observation about qi.
"O genki desu ka?" is the Japanese way of asking "How are you?"; it can be literally translated as "How is your ki (qi)?" (Specifically, the kanji for "genki" refer to what the Chinese call "yuan" or "original" qi, a specific type related to your basic constitution.) The question doesn't require any objective measurement to answer.
Indeed, can you imagine saying "I have a lot of energy today," only to have a scientist perform a set of measurements and inform you that the total amount of chemical and electrical energy in your body is in fact less than it was yesterday, and so your statement is incorrect?
Obviously, the word "energy" is being used with two different meanings here. When we talk about the energy of qi, we do not necessarily mean the same thing that physicists mean when they speak of energy; the energy of qi is a subjective and experiential phenomenon, not a completely objective one.
(Many other words are used in specialized senses in scientific discussion: the physicist's definition of "work" is such that a weightlifter who returns the bar to its starting point after a set has done no work on the weight, despite what his or her aching muscles say. Similarly, mathematicians who specialize in the field of "information theory" will say that a page full of random letters has more information than a page of meaningful English text.)
Now, take thousands of years of careful observation of this experience of energy and vitality; consider what physical and mental actions, what foods and herbs, what lifestyle choices, and what therapies tend to cultivate it. That's Chinese medicine.
