One of your major specializations is working with all forms of PTSD [posttraumatic stress disorder], especially among members of the U.S. military returning to bases in Germany. Our German colleagues are also dealing with symptoms of war-related PTSD as more German soldiers return from service in Afghanistan. What is your advice to your colleagues who may be new to this specialized therapy?
A Berlin Shiatsu student asked this question because his brother chose to go to Afghanistan to get away from their dysfunctional parents, thus escaping from an unhappy home into war.
Germany doesn’t have such long deployments as U.S. forces do, but there are already in place treatment facilities for soldiers who have seen combat and suffer from PTSD as a result of their experiences. My advice, unless the shiatsu practitioner is also a member of the military and understands the dynamics of this group, is to respect at all cost the exclusivity of the military community. Stay focused on the actual condition of the client and keep personal opinions about religion, politics and war to yourself.
(Debra) This seems to be good clinical advice, regardless of the presentation of PTSD or not.
What guidelines would you give your colleagues beyond being aware of the usual symptoms of PTSD—for example, sudden reactions during the treatment, anxiety attacks, flashbacks, sudden feelings of rage or violence, all of which may come up during a shiatsu or massage experience for the first time?
Most importantly, should any sudden reactions of anxiety come up during treatment, acknowledge this and keep calm. If clients want to continue with treatment, then continue. If not, then offer whatever they need—a tissue, a towel to yell into, a listening ear, or some time alone—while you “hold the space” so clients can feel safe and protected. Accept the clients’ reactions as real without trying to stop their anxiety or extreme sadness. In the case of rage or violence, make sure you are safe while still protecting the integrity of the client. Don’t run from the room. Seek help if necessary, but do this calmly and discreetly. Keep in mind that not all PTSD sufferers are the victims of violence; some have actually perpetrated terrible suffering on others. I am talking about members of the military who torture prisoners for “information.” They are the truly frightening clients, who caused me to learn about my fight or flight response in a new way. This is a real dilemma I experienced with two interrogators, even though we had some illuminating conversations during the sessions. Interrogators love to talk and are proud of what they do, why they do it, and the high salaries they earn. I sometimes wondered if such interrogators were themselves survivors of child abuse.
If our colleagues happen to treat such clients, what is your advice?
When such clients start to talk, stay calm and just listen. Absolutely do not answer any personal questions, as that triggers their interrogator role. Do not offer any information about yourself. My conversations (prompted by one such client) were about death and forgiveness, and what it means to heal and on what level. “Healing” for him meant no longer being wounded or sick, or healing at the moment of death, as in seeing and understanding the beauty of life. I want to believe that, somewhere inside, he was looking for forgiveness and healing on some level. I sense he recognized his profound level of exhaustion from keeping up the strenuous role he had been playing (probably all his life).
(Pamela) One does not need to empathize with a client’s work to give a comprehensive treatment. The important thing is to sow silent seeds of compassion so clients begin to question themselves. One of our shiatsu colleagues in Berlin was a former member of a really tough police SWAT team, accustomed to kicking in doors and beating up suspects. After learning shiatsu, he had to drop out of the SWAT team because of the transformation he felt in his hands—which he loved.
(Debra) Pamela and Marianne, you both make good points here. Also, you do not have to get enmeshed in a client’s life or profession to have the most positive and profound impact. An unmarried colleague of mine in marriage and family therapy once said, “You don’t have to be a horse to be a good veterinarian.” Similarly, you don’t need to take on a client’s pain or any issue they are working through during a session.
Sometimes that’s a challenge for me.
(Debra) Can you share any particular example of such challenges with us?
Recently, I gave volunteer shiatsu at the Fisher House at Landstuhl military hospital near Heidelberg. I worked on an officer who had lost his left leg and suffered head injuries after his tank hit a land mine and all his fellow soldiers were killed. There was no need to explain meridians or energy. He told me he still felt as if the leg were there, and he felt a lot of phantom pain. When I asked if I could work in the “space” of the missing leg, he seemed relieved to find a practitioner who acknowledged his pain and agreed. He watched as I applied qi to the meridian in the empty space. His whole body language changed. He let go.
I was affected by this particularly hard, because during the treatment, the officer began to talk in a direct way about everything he had experienced from the time of the explosion till the present. His story was tragic in huge proportions. I understood deeply and probably over-empathized with his pain, mentally and physically, because his injury was so new. I think this happens to every practitioner at some point. A client just somehow gets to us for some reason. Perhaps I was tired, or perhaps his energy overpowered mine with the weight of his tragedy. I am still working through this feeling.
(Pamela) Marianne—at the time, I remember advising you to use your qi gong expertise and training to help you “shield” yourself without taking on the pain or trauma of a patient. This does not mean you give less or are less compassionate. It means you surround yourself with a bubble of qi, and surround the patient with a bubble of qi. Otherwise, you run the risk of depleting your own qi. Sometimes we all learn the hard way, especially when our over-caring results in a day or two of anxiety or an inability to treat someone else for a few days.
(Debra) Marianne, you have seen a lot of tragedy. Why did his case strike you so deeply?
Once I learned he was from Eastern Europe, I couldn’t help thinking, what in the world are you doing here? This war has nothing to do with you! Now of course I know I am wrong. The United States has set up bases in Eastern European countries providing jobs to those struggling new economies. Years ago when I began my shiatsu training, I paid for classes by working as a gardener, which was mostly picking up garbage and pulling weeds in green places surrounding Heidelberg and along the autobahn. Guest workers from the Eastern Bloc countries—Poland, Russia, the Balkan countries—were pouring into Germany, and I spent six years working side by side with some wonderful people—all of whom had university degrees. One was a PhD and spoke seven languages. Yet there we all were, picking up garbage from the streets summer and winter. I got many hours of shiatsu experience practicing on my new colleagues. I got to know them, their sincerity and endurance in the desperate struggle to support their families. This was around the time communism was breaking up in the Eastern Bloc countries, and these men and women were literally thrown far and wide into a market economy with no idea how to make a living. Still, their sense of humor, really black at times, kept me laughing during some of the toughest days we spent working together. I still have contact with some of them. Why did the case of the officer strike me so deeply? I just couldn’t stand to see him broken.
(Pamela) Quite the contrary, I saw a marked and positive change in the officer’s body language after you worked on him—and the brisk way he wheeled himself out. Don’t underestimate the effect you had on him, not just by easing his phantom pain, but by “tuning into” him. I feel you are overloading the situation with your feelings instead of taking a step back and accepting the impact of your interaction with him. You relieved his pain and gave him hope.
Yes, I noticed the vigor with which he wheeled off. He has a long road ahead to recovery after he receives his prosthetic leg, and he is going to need all the support he can get. Sometimes we stumble over our own feelings while treating someone and get caught up in their net of suffering and feel it as if it is our own. It should not happen, but it does, even to those of us with years of advanced qi training.
You also work a lot with children who have experienced war, or the trauma of losing parents to war or active service. Can you share some examples?
Children seem to hold on to hope the longest before letting go. Mostly what I have seen in my shiatsu work with children and young people whose lives are being directly affected by wars is the hope that they can save their families, rescue their parents, and make everything alright again. In my packed classes, I constantly hear comments like “How can I use shiatsu to help my mother? She is so nervous” or “My father has this problem in his neck. Teach me something I can do for him.” It was the same story in Bosnia and among Israeli and Palestinian children brought to Germany. I heard similar stories from American kids whose parents were deployed in Iraq or Afghanistan, like the six- and eight-year-old brother and sister whose grandmother moved to Germany to take care of them while both parents spent over a year in a war zone. She brought the kids to me, and they would watch the shiatsu treatments and say things like “I am going to do this for Mom just as soon as she gets home.” The most effective treatment of those kids was to teach them how to do some simple shiatsu techniques, because they wanted to use it as a tool to keep their hope alive. I used to let brother and sister play with our new litter of kittens after the shiatsu sessions. They loved playing with the kittens, and they sketched pictures of them to send to their parents!
(Debra) This is a great angle to acknowledge children in the scheme of things in this world. I love it. I can’t help thinking of another side of the viewpoint though—with “adults” in training who may be socially immature or inexperienced and not always able to handle some issues of clients adequately or appropriately. Also, I think it is great that youths are eager to tap into their innate healing abilities, but it leaves me pondering that we should be cautious not to overburden them with responsibilities that exceed the carefree and joyous aspect of childhood.
(Pamela) Debra makes excellent points here, especially about the inadequacy of certain practitioners to deal with problems outside of their direct scope of training or “textbook” references. Alas, few kids experiencing war in any dimension can enjoy the luxury of a “carefree and joyous” aspect of childhood, and not all practitioners have the depth and maturity to handle such complexities. Kids in Beirut—who grew up in civil war—developed anxieties when the sounds of war ceased, because for them, war was their reality, whereas peace was not. I have worked for years with a Middle Eastern RN whose childhood was punctuated by war in Amman and Beirut. As a young teenager, she became her mother’s major caregiver because of terminal illness. She thrives in crises; she worked at the 9/11 site in New York for weeks and would call me almost daily. But when her life is calm, she falls to pieces. She is one among thousands of similar cases. Teenage suicide has actually increased in Belfast since the end of the Troubles. As practitioners, all we can do is offer a supportive structure and try to keep short- or long-time survivors of war on track emotionally so their qi does not become even more fragmented. We can also point out their repetitive patterns. We always need to emphasize whatever positive learning experiences they have acquired to help them navigate life.
Children should not be overburdened with the responsibility of saving their families. It is not the role of children to be the protectors. However, war kids have been denied the carefree and joyous aspects of childhood. Any positive learning experience prompts them to rush home to share this with their families to try and restore a sense of equilibrium.
Many of our shiatsu colleagues in Europe are working among survivors of various wars, areas of conflict, and especially civil war. Can you tell us more about your own work in the “Vacation from War” program sponsored by the Committee for Basic Rights and Democracy?
In Neum, Bosnia, I had the great opportunity to work with shiatsu practitioner Snjezana Pruginic, who is a Croatian refugee from the Balkan war. Her family had fled to Canada as the war escalated, and so they were spared the horrors of combat. However, she held “survivor’s guilt” feelings for years because of the friends and members of her extended family whose lives were destroyed by that war while she took refuge in Canada. She is a graduate of Shiatsu School of Canada’s 2200-hour diploma program.
In her early twenties, Snjezana not only knew shiatsu, but also spoke all the languages of Bosnia/Croatia/Serbia. Our summer camp attendees were close to her in age, between fifteen and twenty years old in the summer of 2004. All had direct experience of war. Snjezana was a treasure to work with side-by-side for those two weeks. It was incredible to observe her shiatsu expertise and her ability to communicate with our young clients. Summer camp is supposed to be fun, but it’s also serious work for those kids attending conflict resolution workshops together, touching on very real issues affecting their daily lives. These young people come from opposing sides of the extended Balkan conflicts. The camp gave them a neutral space to come together, to communicate. All of them were conceived and born during the worst fighting. Most of them were orphans, or some had families who could not care for them. There were also “rape orphans”—children given to the orphanage because of the stigma they represented to their families when rape was used by opposing militia as an instrument of war. Similarly, kids born to sex slaves held captive by soldiers were also dumped in orphanages. From the moment of birth, all these kids knew nothing … but conflict and deprivation. But they responded dramatically to shiatsu.
Could you share specific details of their response to Shiatsu?
The kids who came to us were so eager to experience the positive touch effects of shiatsu they seemed to float into another dimension. The evaluations were filled with comments like “It connects my mind and body” or “I feel new!” During the treatments, we observed a lot of twitching, kicking motions of the legs and muscle spasms rippling through the entire body. I feel shiatsu bridged the gap between conflict and trauma-associated patterns of behavior. Kids learned positive, empathetic ways to connect with each other, and expressed this in their evaluations. Snjezana read several of them to me, including that of one young sixteen-year-old boy who wrote, “After shiatsu I feel so refreshed, now I have more energy for Ella” (a sixteen-year-old girl at the camp). It was a clear sign that life goes on, and even teenage war refugees fall in love at summer camp! I found the perfect farewell gift for Snjezana in a bookstore in Dubrovnik. It was a book in her native Croatian about shiatsu. She promised to send it to her parents so they could better understand her work, as they were never really sure what kind of studies they were paying for at Shiatsu School of Canada!
You also worked with young Israelis and Palestinians who were brought to Germany in 2006 by the same “Vacation from War” program. Similar projects use art, theater, and music (as in the orchestra West–Eastern Divan created by Daniel Barenboim and the late Professor Edward Said) to help youths bond and communicate across troubled lines of political conflict. Tell us about your experiences.
I volunteered to give shiatsu to young Israelis and Palestinians aged between fifteen and twenty-five years, and I had to be quite sensitively prepared. I was given a Christian chapel to use as a shiatsu room for Muslim and Jewish participants, and so I draped it with beautiful scarves to create a neutral and meditative space where everyone could feel comfortable. It looked like something out of Arabian Nights! These courageous young people had just left an actual combat zone involving Israeli, Hezbollah, and Hamas forces, where rockets and gunfire had killed family members and destroyed homes on all sides. A United Nations–brokered ceasefire opened a window, giving this group the chance to travel under harrowing circumstances to Germany to meet face to face to discuss the conflict, helped by translators and professionally trained counselors and mediators. Their facilitators were nonetheless courageous in getting them there. One facilitator was in mourning because his brother had been gunned down the previous week. During shiatsu, he held his eyes open wide and constantly kicked himself really hard in the leg whenever he started to drift off. One fifteen-year-old girl was so disassociated by trauma, it was as if she came in two parts to shiatsu. Her body lay on the mat, yet I felt her spirit stood about ten feet away. In her case, I tossed aside everything I knew about kyo and jitsu. I just did the best I could to extend my qi to include both body and spirit in the treatment. She was able to stop crying for about twenty minutes, something she hadn’t been able to do for about a week. It was touching to see the support she had from her friends, who brought her to the shiatsu room, stayed with her, and walked her back to the group afterwards.
How did you interact with the entire group, given that the Israeli kids came from the occupying side, and the Palestinian kids from the occupied side?
I saw the need to offer more than just shiatsu sessions, so I opened up the room in the evenings for shiatsu workshops, which were packed each night. I have never seen such bravery from young people exhausted after years of violence and desperate to find a way to communicate with one another. And again, shiatsu gave them a physical tool to explore empathy. It was a real test of maturity for a shiatsu practitioner. But for shiatsu students, the experience—under strict supervision—would be an invaluable way of teaching them how to behave in such cross-cultural crossfire situations and still stay focused on shiatsu.
Aside from war, you also work with trauma/PTSD in adults who experienced abuse of one form or another as children. Tell us about your fifty-year-old client “Keri.” She had approached other shiatsu practitioners (Japanese and German) who were unable—or unwilling—to deal with her trauma. What do you feel would be the ideal training for shiatsu practitioners to enable them to work with such complexities—or to at least recognize the symptoms—and be knowledgeable enough to restore some reassuring sense of physical safety? Shiatsu practitioners are not psychotherapists, and we all know they should be aware of where and when it is appropriate to refer a client.
Shiatsu alone could not possibly treat Keri’s complicated, many-layered, and unique form of PTSD. Any form of treatment requires an openness and readiness on the part of the clients to accept their childhood experiences as traumatic and see the effect it has taken on their adult lives. Shiatsu students should also understand that, many times, future clients will come to them with problems that mirror their own—the practitioners’—problems. Ideally, shiatsu training should require you to take a good long look at your own personal life history and, through that, to find out what is really motivating you to want to learn and practice shiatsu on other people.
(Debra) Personally, I think this is true and should be required of all those entering the helping professions.
(Pamela) Basically what you are both saying is that shiatsu practitioners-in-training should be required to go through some form of counseling themselves, as is required of clinical psychologists or psychotherapists to resolve or clarify any residue from past experiences that may present stumbling blocks—or potential counter-transference—when they become fully fledged professionals and interact with clients. Some shiatsu schools are aware of this, but one such school had difficulties with instructors in psychotherapy who weren’t also trained in shiatsu, as they couldn’t relate to the role of qi, meridians, and points in a comprehensive mind–body approach to clients.
That’s vital. Shiatsu students need to be trained to interact with clients on all levels—to experience the way trust develops between therapist and client when sensitive life issues are being explored. I felt that Keri’s sense of relief came through a combination of therapies: shiatsu, qi gong, and Pesso therapy. Shiatsu addressed damaged wei qi and, in particular, damage to the Lung Meridian (skin and respiratory problems and vulnerability to infections), Large Intestine Meridian (digestive disorders), Bladder Meridian (recurring bladder infections) and Liver and Gall Bladder meridians (severe migraines). I recognized deeply buried signs of chaos in her energy field. Qi gong helped repair the holes and gaps. Most importantly, qi gong gave Keri a tool to regain control (one thing that is lost in cases of abuse) and to restore energetic borders that were damaged by her experiences of abuse.
What exactly is Pesso therapy?
Pesso therapy’s formal title is Pesso Boyden System Psychomotor (PBSP). Al Pesso and Dianne Boyden were professional modern dancers in New York City. Their system of movements evolved and developed over decades. They used the dancers’ own emotional experiences as a way of rooting their physical movements and integrity. As a therapy, Pesso and Boyden developed a systematic way to re-enact memories on a cognitive, emotional and physical level. They combined elements of psychology, psychodrama, cognitive–behavioral therapy, and family reconstruction therapy.
Can you describe the way this worked for Keri?
Through group role-playing, Keri reconstructed the scenario of her abuse in childhood, and then followed that with the “ideal” situation she wished had happened, in which someone would step in and stop the abuse. The therapist helped choreograph the role-playing to maintain safe boundaries for the group. Keri was at first skeptical—till after her first session, when she described feelings of safety and calm, all of which were new for her—so new, it knocked her off-balance for a couple of days. She decided to sit and observe this change. She began to reach a sense that the original transgression (sexual abuse in her childhood) was being healed. She began to identify her own boundaries. As a practitioner, she also released a prior impression that her shiatsu clients’ trauma would automatically diffuse into her. What PBSP did for Keri was to let her soul find its own path to healing. As a dancer, Keri related completely to this method.
How did qi gong, Pesso therapy, and shiatsu complement one another?
For Keri, identifying those energetic boundaries was one step, being able to read their surfaces was another. Shiatsu helped her understand her many physical and emotional spinoffs from the abuse and helped restore her inner qi. Qi gong practice strengthened the qi body surrounding her—protecting her and helping her to repel any invasion of negative energy. This brought her more in tune with nature: her own personal nature as well as the nature surrounding her. Keri discovered, through Pesso therapy and qi gong practice, that she did in fact have a personal nature. Something that hadn’t ever occurred to her, as most of her life was spent waiting for something dangerous to happen to her and then disassociating when it did. That is why those feelings of safety, calmness, and contentment literally knocked her off-balance. Qi gong practice taught Keri to move in this new space with a sense of peace. This also changed the way in which she worked as a practitioner. She described a shiatsu treatment she gave where she saw how the energy transforming in her client bumped off her energy field and avoided her completely.
Did your experiences with Keri give you such rare insights that even more complex clients came to you for shiatsu?
Oh yes! Recently, I worked with a woman who had been beaten up by her husband after she refused to indulge his abusive efforts to get her to “perform” sexual acts for him with strangers solicited off the Internet. I offered to drive her to a secluded women’s shelter and even offered to collect her belongings. The woman refused, saying that that would give her husband “power” over her. At the time, I wondered if my shiatsu session had in fact given the woman enough confidence and strength to return to her abusive husband.
(Pamela) This same dilemma hits army medical doctors, who patch up soldiers, only to see them return to the front to face perhaps more severe injuries or death (the message of the television series M*A*S*H ). Similarly, I knew doctors employed by the mines in apartheid South Africa, who had sleepless nights over patching up mine workers, only to see them return underground to face yet more crippling injuries from mine blasts, and collapsing shafts. How to resolve? Including dilemma scenarios in a practitioner’s ethics training for discussion and role-playing might help to prepare us in advance.
(Debra) This is a really important phenomenon to acknowledge. It’s difficult to resist the urge to rescue a client, when sometimes rescuing is not the most beneficial thing we can do for him/her in that moment. Pam, I like your suggestion. I am an advocate of using ethics training workshops to grapple with these scenarios and at least mentally prepare the practitioner prior to encountering an actual dilemma in a session.
How did you deal with the dilemma of that particular client—especially when the woman canceled her next appointment and wouldn’t give you a contact phone number? How would you deal with the situation if she ever returned for another session? (With or without a bandaged head?)
Accepting the fact that I was powerless at the time to do anything was difficult for me. I don’t understand what makes a person return to an abusive situation, but I have tried to expand my own insights and experiences by reading specific texts and by talking with the staff of the women’s shelter. This phenomenon is complicated. And if she ever returned for another session, I would try again to get her motivated to want to get out of her abusive situation. I don’t give up hope. I think about Amy Winehouse singing “I Can’t Help You If You Won’t Help Yourself.” When my client reaches that point, I will be there for her.
(Debra) Responding to the client’s story without blame or judgment is key to building the client’s trust in the concept of accepting help beyond the actual shiatsu treatment. Akin to working with addiction and recovery, the first step is for the client to acknowledge a problem and then most importantly, to want to seek and accept help.
(Pamela) Alas, people become numb in situations of abuse—emotionally blunted. They lose perspective and become filled with fear and unable to make decisions. They also feel humiliated and experience a sense of failure, alongside a hope that things will change, get better. For emotional and economic reasons, it takes a jolt of bravery—or desperation—for anyone to move out and seek the protection of a shelter. As shiatsu (or any form of bodywork) practitioners, sometimes we are the first to recognize the scars or symptoms, and this presents a huge responsibility. I arranged an offsite clinic for my students at a shelter for battered woman and children, so they could gain insights no textbook would give them. They also discovered that shiatsu, because it is so gentle and noninvasive, was very physically healing, especially for the children. We also need to be very aware of any cross-cultural issue here—where, say, an immigrant client may be subjected to an abusive situation and not know about the protection offered under German (or Swiss or Austrian) law. This presents a dilemma, because she also runs the risk of alienation from her family—or death in the case of honor killings—if she seeks help under the laws of the host country. For example, if a girl is being forced into an unwanted or arranged marriage, she can seek police protection in Germany. So any shiatsu practitioner, or any therapist dealing with an immigrant or refugee population, also needs to be very streetwise and aware of social services and the law.
We also have to obtain consent before we can offer any outside help. We can offer vital referrals—a card listing the numbers of social services and shelters—but if the person is too afraid to take that step and call those numbers, there isn’t much we can do. It is best to be informed as well as possible of the local services available. I think it is a wonderful idea for students to experience working in the women’s shelters. There is no other way to get to know the intricacies of that population.
(Debra) Marianne, you have spoken about the impact of this case and the amputee case on you emotionally and physically. Yet you are a teacher of qi gong ! How do you preserve and restore your own qi energy?
Being outside in nature is like a cure for me. My whole body relaxes watching how light filters through trees and how water flows. I can be standing still or practicing qi gong or power-riding through the woods on my bike—just being out there and part of the natural breath of trees and the movement of water. It was Hans Selye, the founding father of stress research, who said, “The best thing one can do for the body and soul is to crawl on the earth.” When I practice or teach qi gong to my group near the Rhine, my favorite place is a small island in a lake, home to all kinds of birds. We all believe the birds are watching us as we move slowly into postures like the Crane Dance or the Deer Walk. We imagine the birds are laughing at us trying to imitate them! The Canada geese like to fly right at us, then swoop up at the last minute as if to say “You’ll never fly like this!” There is a swan family with two fuzzy chicks who swam to the shore near us and looked up at us on the bank. It was so funny to see mama and papa swan hasten their young chicks along. We’re enjoying seeing the chicks lose their yellow fuzz for white fuzz. Recently, they stretched their little heads just as we were raising one hand in the Deer Walk. I think they want to play with us!
Pamela Ellen Ferguson , Dipl ABT (NCCAOM): AOBTA and GSD-CI 1, Debra Persinger , PhD 2, Marianne Steele , AOBTA and GSD-CP 3
Private practice;, 1 Executive Director, Federation of State Massage Therapy Boards;, 2 Pacific Spirit (private practice), Bruhl Rohrhof, Germany.3
Pamela Ellen Ferguson and Debra Persinger, co-authors and co-editors of Sand to Sky—Conversations with Teachers of Asian Medicine (Bloomington, IN: iUniverse; 2008), interview Marianne Steele in Germany on her shiatsu and massage therapy work in various forms of trauma and posttraumatic stress disorder. The interview was conducted in a series of e-mail exchanges and telephone calls during late 2009 and early 2010 and is intended for a future German edition of Sand to Sky.
Pamela Ellen Ferguson is a Diplomate in Asian bodywork therapy of the National Certification Commission for Acupuncture and Oriental Medicine, and a Certified Instructor of the American Organization for Bodywork Therapies of Asia and the Shiatsu Society of Germany. She is a Licensed Massage Therapist and a Massage Therapy Continuing Education Provider (#1356) in the State of Texas. She has pioneered workshops on trauma and posttraumatic stress disorder (PTSD) in Europe and the United States and has given volunteer shiatsu at Fisher House, Landstuhl U.S. military base, Germany. She is the author of several books, including the major textbooks The Self Shiatsu Handbook (New York: Berkley–Perigee; 1995) and Take Five: The Five Elements Guide to Health and Harmony (Dublin: Gill and Macmillan; 2000). German editions were published by Thieme/Trias Verlag (Stuttgart).
Debra Persinger is executive director of the Federation of State Massage Therapy Boards. She completed her masters and doctorate degrees at Kansas State University, after undergraduate and teacher training in her native New Zealand. Persinger is a popular presenter of ethics workshops at national bodywork conventions. She has published several works, including A Survey of Adolescent Knowledge, Attitudes and Behaviors Regarding Sexuality and AIDS in New Zealand (Ann Arbor, MI: ProQuest UMI Dissertation Publishing; 1995) and a Study Guide and an Instructor’s Manual to accompany J. Kenneth Davidson Sr and Nelwyn B. Moore’s Marriage and Family: Change and Continuity (Boston, MA: Allyn and Bacon; 1996), co-authored with M.B. Bergen.
Marianne Steele is a Certified Practitioner of the American Organization for Bodywork Therapies of Asia and the Shiatsu Society of Germany. She is also certified by the Wu Tang Physical Culture Association of New York to teach earth energy medical qi gong for women, and she volunteers as a shiatsu practitioner for the “Vacation from War” program of the Committee for Fundamental Rights and Democracy. Born in San Francisco, California, Steele lived and worked in Japan and Taiwan from 1980 to 1990. She trained in shiatsu in Japan and Germany and has lived in Germany since 1990. Her Pacific Spirit clinical and teaching practice in shiatsu and qi gong is based in the Rhine town of Bruhl Rohrhof near Heidelberg. She is also under contract at U.S. Army Garrison Heidelberg Campbell Barracks fitness center and at the wellness center of Heidelberg Army Medical Center to teach qi gong and give shiatsu and traditional Hawaiian lomilomi nui massage. She also volunteers in shiatsu at Fisher House, Landstuhl U.S. military base. After years of practice in shiatsu, Steele trained in Hawaiian bodywork in Frankfurt with Jutta Hahr of Aloha International.