Case study: how a course of treatment brought about real change

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Below is an example case study aimed at people who know little about Shiatsu practice or theory. A much more technical version of this case history, aimed at fellow professional shiatsu practioners or students can also be viewed, and I would welcome any feedback anyone has. Please note that personal details have been changed to protect the anonymity of the person involved.

B was a 40 year old single woman. When she came to see me she was working part-time as an IT Consultant and studying part-time. She came to me for 6 treatments over a 3 month period and then moved away from the area.

Reason for Seeking Shiatsu
B had Psoriatic Arthritis.

The Psoriasis started when she was 7 years old, coinciding with an unsettled period of her childhood. At the start of treatment she had large strips of psoriasis symmetrically on both elbows and lower legs. Generally, however, the symptoms were much less than they used to be.

The onset of arthritis was in 1981 when she started her first full-time job. She worried a lot about work and could not leave it behind at the end of the day. The arthritis was significantly better than at its peak. However, her hands, neck and chest joints of her ribcage were still badly affected. Her hand joints were very deformed and many virtually immobile. She also had a slight lower back ache which was partly arthritis, and partly an old slipped disk. Also neck and shoulder pain, which was the arthritis from the neck radiating down.

Additionally B had a slight Candida imbalance, but was currently exhibiting no real typical symptoms - but this can be a cause of psoriasis. She was also awakening 4/5 times a night and her sleep was dream disturbed.

Observations
B was very pale, and her movements were extremely stiff and controlled, especially when turning torso/head sideways. Her body language was careful, protective and closed, and her breathing shallow.

Other information
B said she easily felt stress, and said she was quite ‘driven’; she liked a planned organised life and found spontaneity difficult. She had experienced a relationship breakdown a few years previously, and she said she was generally an angry person who repressed this anger/resentment and had also experienced bouts of depression.

Over the previous 5 years counselling had helped her manage this stress, anger and depression better. For the previous 3 years she had been managing her diet and exercise in a careful manner, to control the arthritis and candida.

Treatment Aims
My aims were to relax her and gently mobilise her joints (working within her limits and being especially careful of the neck). I also aimed to open her chest and strengthen the breathing to allow the Ki (energy) to circulate better.

Treatments
On each occasion I made an energetic diagnosis of the channel imbalances for that particular occasion, and focused my treatment particularly on the indicated channels. However, all my treatments included a lot of work on her joints, especially in the hands, and I spent a long time working and loosening her finger joints from side to side and projecting energy through the joints. I also did a lot of breathing work with her. I used a number of acupoints to help the joints and to strengthen and smooth the flow of energy.

I recommended a number of acupoints and simple Chi Gong (breathing & movement) exercises for her to use between treatments.

Results
After the first treatment, B felt that her joints were 'stirred up', and her arthritic symptoms worsened slightly for a couple of days. Therefore, I was a lot more gentle on subsequent sessions.

Conclusions
B really enjoyed the shiatsu and found it very relaxing. After she relocated, she intended to continue working the recommended points, to try to find another practitioner and hopefully a Chi Gong or Tai Chi class. I believe that shiatsu, along with her willingness to practice the recommended points and exercises, was proving beneficial.

To see a more detailed theoretical analysis of this case, click here.

© Susan Crawshaw MRSS 2001

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