Introducing the application and clinical practice
of the 'Visceral Yin and Yang Tides'
‘Tradition is not the worship of ashes, but the preservation of fire.’ Gustav Mahler (1860-1911)
In this article I share my journey towards a more integrated practice and how I came to apply both Eastern and Western bodywork modalities through the lens of Classical East Asian medicine (1). I will use this opportunity to introduce one aspect of my work, namely how I understand the different rhythms of the body, first described in Osteopathy as the Craniosacral rhythms (2) and the Visceral rhythms (3) of the body, through that lens. In particular this will introduce the concept of the Visceral Yin and Yang Tides, and how awareness of these ‘tides’ has benefited my ability to help my patients.
In my ongoing quest to understand more about the origins of Shiatsu, I have come to learn more about Ampuku and its central place in Shiatsu’s history. This understanding has led me to incorporate Ampuku techniques into my Shiatsu practice, together with techniques from Osteopathy, Abdominal Acupuncture, and Chi Nei Tsang, which I had learned previously.
Through the work of Tamai Tenpeki, Kaisen Tanokura and other teachers who coined the name Shiatsu in the 1930s, I came to a better understanding that the bodywork they were pioneering was very much influenced by contemporary Western anatomy and Western bodywork modalities. Tanokura states clearly that his book, ‘Shisho Ryoho Hiroku’ 指掌療法秘録, stands for ‘oriental therapy combined with American-style osteopathy and chiropractic’. This comes as no surprise when we consider the era in which they were developing modern Shiatsu.
As an analogy we can look at the work of the great Japanese novelist Natsume Soseki, to see how, some decades earlier, he fully integrated the Western and Eastern traditions. In his masterpiece ‘Kusamakura’ (4) he freely quotes and refers to a variety of Japanese, Chinese and European poets and writers. Soseki, along with those pioneers of Shiatsu, were well-versed in their own traditions but also open to integrating other perspectives into their respective arts and, in so doing, to transforming them.
In my own practice of Shiatsu, meridian work has held a central place for over 30 years. At the same time, I have been integrating other modalities into my practice. Alongside my continued learning about Shiatsu, I have also studied with teachers from a range of different disciplines, in my endeavour to work with all aspects of our being. This is how I came to study, among other approaches, Visceral therapy, Craniosacral therapy, Fascia therapy and Chi Nei Tsang.
This has given me the opportunity, over time, to learn about the different maps and languages of the body. Touching and communicating with the energetic anatomy of meridians and vessels, as well as listening to and treating the subtle anatomy of the connective tissue, membranes, lymph and cerebrospinal fluid, and interacting with the denser anatomy of muscles, tendons, bones and organs.
One challenge encountered when learning different modalities is that East and West have very different worldviews and languages. It took me quite some time to be able to integrate these languages, let alone to explain what I was doing in my treatments using these different perspectives. Then, I didn’t make distinctions between what I had learned - be it from the East or West - everything that worked I called ‘Shiatsu’, even if some of the techniques originally came from other sources. After all, the people who come and seek my help are less concerned with the origins of techniques than with their effects.
Over time it became clear that, in order to explain what I was doing, I needed to develop a comprehensive model. At first I struggled a lot with this, until I finally understood that the model of East Asian medicine - the model with which I was most familiar - was in fact already the most comprehensive model. I see it as offering a map to guide our understanding of the human experience - playing out between heaven and earth, connected to the changes and rhythms that occur within the wider macrocosm of life, while simultaneously offering an intricate map of the different layers, patterns and tides of change that occur within the microcosm of our body.
On my continued path of learning Shiatsu, I regularly got lost between the different layers of theory. In the practical execution of techniques however, I could connect and communicate with the unity and holistic nature of Shiatsu through the correct application and use of the body mechanics I had been taught. This helped me to work with flow, and from the Hara, while connecting with the receiver. In this way I could experience alignment and unity. In fact that sense of unity - and communicating through the language of touch with another human – comes rather easily for me. I am convinced that this direct nonverbal communication, and the ability to listen, is the true essence of Shiatsu - and its real strength.
Understanding and applying the theory of East Asian medicine was a more daunting task... For years I struggled to navigate between the many different aspects of theory and how to bring them together into one comprehensive matrix which would be useful in practice with my patients. I often felt overwhelmed and lost then. Different teachers and different books tended to focus more on one aspect or another, none necessarily presenting the comprehensively ‘bigger picture’ I was striving for.
This bigger picture became clearer to me only after I encountered the work of Elisabeth Rochat de la Vallée and Heiner Fruehauf, both experts on the Chinese medical and philosophical Classics. Their work further illuminated my understanding of the theory and, for the first time, offered me an all-encompassing and comprehensive model. Heiner Freuhauf (5) clarified for me the deeply symbolic nature of the meridians and points. Elisabeth Rochat de la Vallée’s work elucidated the central and essential role of numbers within classical Chinese thinking – with their symbolism inferring quality more than quantity. ‘Numbers used to signify the process of life and the order of the world. They reveal the sequential unfolding, while maintaining a connection to the One, The Unity, which (6) sustains and contains all’ or in Laozi’s words: ‘The Dao gives birth to One. One gives birth to Two. Two gives birth to Three. Three gives birth to the myriad of things.’
With this map of the unfolding of life in my hands, I could more easily navigate and understand the order in East Asian medicine. Its map of unity - unfolding into the yin and yang pair, then further in the 3 dantien, the 4 territories, the 5 transformations, the 6 divisions, the 8 forces of nature, the 10 Heavenly Stems, the 12 Earthly Branches and the 64 hexagrams - at last gave me a clear compass to deal with the myriad of things I met in my practice, while staying connected to the unity of existence.
With much practice and perseverance, this unfolding map helped me learn to see and navigate the changes that are inherent to all life. It helped me more effortlessly to recognise in my treatments the patterns at work and the imbalances or obstructions that lay at the root of illness and discomfort. It also helped me to integrate meridian work with other bodywork modalities, while staying true to the elaborate and unique language of Qi and change that Classical East Asian medicine has to offer.
The Visceral Yin and Yang Tides Integrating Ampuku and Visceral Osteopathy into my own practice opened me up to a whole broader perspective. I came to understand the visceral motility of the organs - the 7-8 cycles per minute inherent to their movement - through the language of Yin and Yang. Visceral Osteopathy’s motility made more sense to me once I understood it as the ‘Yang and Yin tides’ of the organs. Sensing an intrinsic lateral movement of an organ away from the median axis of the body, I now saw as the Visceral Yang Tide. This made more sense to me than the term ‘inspire’ which is what Osteopaths call this movement. Equally, I now recognised the movement of an organ towards the median axis of the body as the Visceral Yin Tide. Placing these movements in the broader framework offered by Yin and Yang theory, and understanding motility as ‘Yin and Yang tides’, also gave me a broader diagnostic tool. I have found this especially helpful when sensing restrictions in either the Yin or the Yang tide, as well as sensing the overall quality of the tides.
Understanding visceral motility through the lens of East Asian medicine also helped me to integrate it more easily with meridian work. A whole new dimension opened up for working in a more holistic way with the connective tissue, with the internal and external pathways of the meridians, the Extraordinary Vessels and the motility and mobility of the organs.
Ampuku Visceral work - a Case study Some 20 years ago, when I had my practice and school in Sweden, a young lady who had suffered a whiplash injury came to seek my help. With constant pain, she could hardly sleep at night. When she could sleep, it was only in the sitting position with cushions around her as support. When she walked in to my practice I could see the desperation in her eyes. Desperation not only from the pain but because its precise cause could not be diagnosed. The multitude of scans she had undergone had not revealed any reason for her continuing pain, so conventional medicine had given up on her - a terrible ordeal with two small children in her care.
I started the session with the usual Hara diagnosis, which revealed Spleen Kyo and Gall Bladder Jitsu. The 3-dimensional visceral listening technique (that I had learned in Visceral Osteopathy) revealed a restriction in the left spleen especially in the visceral articulation towards the left kidney. Listening to the craniosacral rhythms revealed a restriction in the sphenoid bone of the skull. I continued my treatment by tuning in to the cranial tides and allowing more space in the movement of the sphenoid bone. In the Daoist tradition the sphenoid bone is seen, because of its central position, as belonging to the Earth phase. Not very much happened except that I could sense more relaxation in her tissues, especially in the neck where she had been experiencing most pain.
Then I went on to work the Spleen and Kidney meridians in the legs before starting to work on the abdominal region and diaphragm, mainly working with fascia techniques on the internal pathways of the Stomach and Spleen. After that I started to feel the Spleen and its Visceral Yin and Yang tides. It became clear to me that the Visceral Yang tide was very restricted. By staying with those tides - and especially by gently encouraging and allowing the Visceral Yang tide to move freely - I sensed first a release in the neck and then the sphenoid bone starting to move more freely.
As the theme of the treatment was very much about strengthening the Earth phase, it felt appropriate to stay with the Earth energy. I contacted some points along the Yin Qiao Mai and held its opening and coupled points, KID 6 and LU 7, to conclude the treatment. I could see her breathing had become much deeper.
Later she reported that, on the way home after the session, she had to stop the car for quite some time because her whole body was trembling. Once home, she realised that the pain had gone! Convinced by this personal experience of the extraordinary power of bodywork, she subsequently went on to train and become a successful Shiatsu practitioner. She is still in practice to this day.
I hope this account may help to stimulate and encourage Shiatsu practitioners towards integrated ways of working and, in so doing, to keep alight the fire of our tradition as initiated by those early pioneers of Shiatsu. In gratitude for the rich path of Shiatsu which has given a deeper purpose to my life.
1. Classical East Asian Medicine I understand to be the Classical medicine from China and Japan, distinct from the modern and more materialistic practice of TCM or ‘Traditional’ Chinese Medicine.
2. Introduced by the American Osteopath W G Sutherland
3. Introduced and popularised by the French Osteopath Jean-Pierre Barral
4. ‘The Grass Pillow’ novel published in 1906 by Natsume Sōseki 5. Heiner Fruehauf - Classical Chinese medicine scholar https://classicalchinesemedicine.org/ 6. Elisabeth Rochat de la Vallée ‘The Symbolism of Numbers in Classical China’
This article was first published in the UK SHIATSU JOURNAL JANUARY 2023
Philippe Vandenabeele is a Senior Shiatsu practitioner and teacher based in Fukuoka Japan.
With more than 30 years of clinical and teaching experience, Philippe has consolidated his knowledge, insights and practical experience to de- velop his own unique approach: Ampuku Visceral Therapy.
For more information about his work: www.shinzui-bodywork.com. Ampuku Visceral Therapy is a whole-body manual therapy firmly rooted in Eastern bodywork traditions with a special focus on abdominal work, meridian work, and enriched with Western visceral, craniosacral, fascial and musculoskeletal bodywork.
He is the author of ‘Ampuku Abdominal Acupressure: The Classics at the Heart of Japanese Bodywork’ which includes the first complete English translation of the ‘Ampuku Zukai‘ and the chapters on Ampuku and Fukushin from the ‘Anma Tebiki’