Atlas›Domain XIII · Contemplative & religious disciplines›Guide 118
Guide XIII-118

Daoyin

186 BCEChina
A 32 · L 56 · M 1213 interventions in the Trinity explorer
Client cardCompare
[source: …] where a claim comes from[uncertain] not confirmed in a primary source[synthesis] the writer's reconstruction

1. Introduction

Version followed: two linked versions. (1) The historical tradition as recorded in the Yinshu 引書 ("Pulling Book", Zhangjiashan tomb 247, c. 186 BCE), in Vivienne Lo's annotated translation (Needham Research Institute Working Papers 3, 2014), read with the Mawangdui Daoyin tu 導引圖 ("daoyin chart") silk painting. (2) The modern standardised routine Jianshen Qigong Mawangdui Daoyin Shu 健身气功·马王堆导引术 (Health Qigong: Mawangdui Daoyin Exercises), compiled by the Chinese Health Qigong Association (Foreign Language Teaching and Research Press, 2012; English edition Singing Dragon, 2014). Livia Kohn's Chinese Healing Exercises: The Tradition of Daoyin (University of Hawai'i Press, 2008) is the scholarly reference for the history in between. [source: Lo 2014; CHQA 2012; Kohn 2008 publisher page]

What it is. Daoyin 導引 is usually glossed "guiding and pulling". Lo translates yin as "pull" because in the early texts it covers pulling, stretching, squeezing, bending, massage and breath work, not only stretching. In the Yinshu, daoyin is not a stand-alone therapy. It sits inside a whole-life regimen that adjusts washing, grooming, exercise, diet, sleep and sexual activity to the four seasons. [source: Lo 2014] Kohn's publisher describes daoyin as guiding the qi and stretching the body, the forerunner of modern qigong, in which health and spiritual transformation are "one continuum". [source: University of Hawai'i Press page for Kohn 2008]

History in brief. Kohn traces the practice from the early Han medical manuscripts, through its religious adaptation in Highest Clarity (Shangqing) Daoism, a medieval Daoyin Scripture, and Tang-dynasty Daoist immortality practice, to late imperial forms and modern qigong. [source: Kohn 2008 publisher page] The Zhuangzi already mentions daoyin practitioners, rather critically, and names the "bear" movement. [source: Lo 2014, note on the Bear exercise] Today the most widely taught public forms in mainland China are the state-recognised Health Qigong (jianshen qigong) routines. A 2020 list from the General Administration of Sport of China includes both Mawangdui Daoyin Shu and Daoyin Yangsheng Gong Shi'er Fa 导引养生功十二法 ("Twelve Daoyin Health-Nurturing Exercises"). [source: Sina news report, 2024] Daoyin is also taught within Daoist lineages and temples. [uncertain: not verified in a lineage's own publication]

How change happens, as the tradition states it. The Yinshu's closing treatise lists climate, social position, excess emotion, diet, body temperature, sleep, and the balance of yin, yang and qi as causes of illness. It holds that guided movement and breath, applied to the whole body or to a specific part, keep the person in step with yin, yang and the seasons. [source: Lo 2014] The modern Health Qigong account says the movements open and close, rise and sink, turn and bend, and stretch the sinews. It aims to unblock the channels (jingluo), harmonise qi and blood and balance yin and yang, through "unity of form and intention" and of body and mind. [source: NetEase 163 article on Mawangdui Daoyin Shu] These are the tradition's own concepts. They are reported here as the tradition holds them, neither endorsed nor dismissed. Health claims are attributed. The one-line evidence status: the claims for specific organ or disease effects come from tradition and promotional sources and are not established as treatments for physical disease. [synthesis]

What the psychotherapist does. The psychotherapist does not teach daoyin. Their work is to understand the practice's meaning for the client, to support a client-led integration of it within therapy (with consent, in the client's own frame and language), to refer to qualified instructors, to adapt for trauma and to watch for adverse effects. [synthesis, following the Domain XIII scope for contemplative practices]

2. Framework

Daoyin is a practice tradition, not a psychotherapy. It has no published therapy phases or session counts. The framework below has two parts: the learning progression the tradition itself describes, and a therapist's working framework, which is synthesis.

A. Learning progression as published (Mawangdui Daoyin Shu).

  • Stage 1, learning the form. Beginners concentrate on the outer movement. For intention, they need only know where each movement starts and ends. [source: NetEase 163 article]
  • Stage 2, adding intention. As the movements become familiar, the practitioner gradually brings more mental intention (yinian) into them, letting "form guide qi, and intention lead it". [source: NetEase 163 article]
  • Moving on. The published criterion is familiarity with the form. The routine is described as practised regularly over time. Steady practice is said to matter more than intensity. [source: NetEase 163 article] No source gives a fixed number of weeks or sessions. [uncertain]
  • Format. The CHQA book is organised as origins and development, characteristics, main points (health-preservation concepts; hand positions and stances; breath control and mental concentration), then the movements with tips. Downloadable demonstration video and spoken instructions accompany the English edition. [source: Purple Culture listing of CHQA 2012; Singing Dragon page] Instruction is usually in groups or classes with a trained instructor. [uncertain: not verified]

B. Therapist's working framework. [synthesis]

  1. Assessment and consent. Goal: learn what the practice is for this client (religious cultivation in a Daoist setting, cultural heritage, TCM-framed health care, or secular exercise), how intensively they practise and with whom. Agree whether and how it will be discussed in therapy. Move on once the client has said what role, if any, they want it to have.
  2. Meaning and fit. Goal: understand how the practice links to the presenting problem, values and community. Move on once there is a shared description in the client's own words.
  3. Client-led integration. Goal: where the client wishes, use their existing practice as a resource (for example as a regulating routine between sessions), without the therapist teaching or prescribing the practice. Move on when the client uses it in a way that helps and causes no distress.
  4. Monitoring and review. Goal: check for adverse experiences, over-practice, teacher or group concerns, and health claims that need a doctor. Repeat this at every review. Step back to phase 1 if the practice becomes a source of distress.

No source gives a session count for this work. Integrate it into the client's existing therapy contract. [synthesis]

3. Guiding principles

  • The therapist is not the teacher. In practice: never teach movements or breath routines in session. Refer form questions to a qualified instructor. [synthesis]
  • Client-led and consent-based. In practice: raise the practice only if the client brings it up or agrees after a general spirituality and practice question. The client decides how much it enters therapy. [synthesis]
  • The client's own frame and language. In practice: use the client's terms (qi, jingluo, dantian, yangsheng "nourishing life") with a short gloss, without translating them into clinical jargon or treating them as literal physiology. [synthesis; terms from Lo 2014 and the Shan 2000 paper]
  • Concepts attributed, not adjudicated. In practice: say "in your tradition, qi is said to…". Neither affirm nor debunk. [synthesis]
  • Gentleness and no forcing. In practice: the published routine stresses movement within a comfortable range, gradual progress and no forced stretching. Support the same attitude in how the client relates to practice. [source: NetEase 163 article]
  • Natural breath. In practice: the published Health Qigong guidance is natural, smooth breathing. Do not add breath control, retention or counted breathing. [source: NetEase 163 article; synthesis for the restriction]
  • Steadiness over intensity. In practice: be alert to escalation, such as longer, more frequent or more effortful practice, especially when practising alone. Intensive practice and solitary practice are reported risk factors for qigong-related disturbance. [source: Shan 2000]
  • No medical claims. In practice: tradition health claims are respected as the client's beliefs. Questions about illness, medication or stopping treatment go to the client's doctor. [synthesis]
  • Watch for adverse effects without pathologising. In practice: unusual body sensations are common in contemplative practice and are not by themselves illness. Assess distress, impairment, duration and loss of control. [source: Cooper et al. 2021]
  • Know your own stance. In practice: notice your own religious or secular commitments about qi and Daoist practice. Self-disclose only when it serves the client. Spiritual and religious competence is a baseline professional expectation. [source: Vieten et al. 2013 abstract via IONS page; synthesis]
  • Collaborate when the client wishes. In practice: with written consent, coordinate with the instructor, Daoist teacher or physician. [synthesis]

4. Intervention inventory

The first entry is a public outline of daoyin as the tradition publishes it, so you can follow what the client describes. It is not instruction. Daoyin joins movement with breath and with guiding qi, so this guide gives no movement sequences, repetition counts, durations or breath techniques. Clients learn the forms from qualified instructors and the published official materials. Entries 4.2 onward are the psychotherapist's own work.

4.1 Daoyin as the tradition publishes it (public outline, for the therapist's understanding)

  • Purpose: to recognise what the client is doing and talking about. It is not for teaching.
  • The Yinshu (c. 186 BCE). Lo identifies three parts: [source: Lo 2014]
    • a seasonal regimen for spring, summer, autumn and winter, covering when to rise, washing, grooming, slow walking, drinking water, diet, sleep and sexual activity (the last only noted here, not described);
    • a long section of named exercises (Lo counts 41 set exercises), whose titles describe postures, animal movements (gibbon, bear, tiger, deer, frog, wild duck, owl, snake, dragon) or the ailment or body part they address;
    • a treatise on the causes of illness and how to stay healthy.
  • Breath in the Yinshu. The text names three kinds of out-breath, chui 吹, xu 嘘 and hu 呼, each linked in the text to correcting a particular imbalance; how they are done is not described here. They are reported here as historical concepts only. Do not teach or suggest them to clients. [source: Lo 2014; synthesis for the restriction]
  • The Mawangdui Daoyin tu. A Western Han silk painting from the Mawangdui tombs, Changsha, Hunan, found in the 1970s. It shows captioned figures stretching and moving. Many captions match Yinshu exercise titles, although Lo notes that several illustrated figures are not the same exercise as the text's. [source: Lo 2014; Singing Dragon page]
  • Health Qigong Mawangdui Daoyin Shu (CHQA). A modern routine based on the Daoyin tu. It has an initial and starting stance, twelve movements and a closing stance. The published English names are: Drawing a Bow (wan gong), Stretching the Back (yin bei), Wild Duck Swimming (fu yu), Dragon Flying (long deng), Bird Spreading Its Wings (niao shen), Stretching the Abdomen (yin fu), Hawk Glaring (chi shi), Stretching the Waist (yin yao), Wild Goose Flying (yan fei), Crane Dancing (he wu), Exhaling with Head Raised (yang hu) and Body Bending (zhe yin). [source: Purple Culture listing of CHQA 2012] The movements combine rising and squatting, extending and withdrawing, and bending and stretching, coordinated with mental attention along the channels. [source: Singing Dragon page; Purple Culture listing] Published practice points: natural, smooth breathing; alternating relaxation and firmness; flowing, continuous movement; unity of form and intention; a quiet, ventilated, level space and loose clothing; not practising when hungry, overfull or exhausted; staying within a comfortable range and never forcing a stretch; older adults, people with a weak constitution and people with illness adjusting intensity and seeking professional guidance. [source: NetEase 163 article]
  • Other routines. Daoyin Yangsheng Gong Shi'er Fa is one of the officially listed Health Qigong routines. Its content is [uncertain: not verified]. [source: Sina 2024]
  • Who teaches it. Instructors trained in the Health Qigong system under the Chinese Health Qigong Association, and teachers within Daoist and Chinese-medicine settings. [uncertain: certification structure not verified]
  • Example language (illustrative): "You mentioned the Mawangdui routine. I'm not a teacher of it, but I'd like to understand what it means to you and how it fits into your week."
  • Watch for: assuming every "daoyin" class is the same. Ask whether it is a Health Qigong routine, a Daoist lineage practice, a TCM-clinic programme or an informal online form. Each has different teachers, aims and settings. [synthesis]

4.2 Spirituality and practice assessment

  • Purpose: to learn early whether daoyin (or qigong more broadly) is part of the client's life, in what frame, and how intensively. Use it at intake, or when the client mentions practice. [synthesis]
  • Steps: [synthesis]
    1. Ask a general question about religious, spiritual or body-mind practices and whether the client wants them included in therapy.
    2. If daoyin comes up, ask what form it is, who teaches it, where (class, temple, clinic, video), how often and how long, and whether the client practises alone.
    3. Ask what it is for: health, longevity (yangsheng), Daoist cultivation, heritage, community, stress relief.
    4. Ask about any unusual or distressing experiences during or after practice. Ask about current health conditions and whether a doctor knows about the practice.
    5. Record the client's own words, and agree what role, if any, the practice will have in therapy.
  • Example language (illustrative): "Some people find their movement or spiritual practices are an important part of how they cope. Is there anything like that for you, and would you like it to be part of what we talk about here?"
  • Watch for: reluctance to disclose because of expected dismissal; escalating solo practice; health conditions with no medical input. Working signs: the client describes the practice freely and you have a shared picture of it. For clients whose practice is part of a religious or cultural identity, the DSM-5-TR Cultural Formulation Interview, with its supplementary module on spirituality, religion and moral traditions, can structure this. [uncertain: module content not verified]

4.3 Exploring meaning in the client's own frame

  • Purpose: to understand what the practice means to the client before linking it to treatment goals. [synthesis]
  • Steps: [synthesis]
    1. Invite the client to describe the practice and its ideas in their own terms (for example qi, channels, dantian, harmony with the seasons).
    2. Reflect these back using their words, with short glosses where needed, without correcting or endorsing.
    3. Explore links to the presenting problem, values, family or community (for example a parent who practised, a park group, a temple).
    4. Ask how the practice has helped and when it has not.
  • Example language (illustrative): "When you say the practice helps your qi flow more smoothly, what do you notice in yourself on the days that happens?"
  • Watch for: imposing a secular "it's just stretching" reading, or the opposite, over-identifying with the client's metaphysics. Working signs: the client feels understood and begins to link the practice to their goals themselves.

4.4 Client-led integration as a between-session resource

  • Purpose: where the client already practises and wishes it, to draw on the practice as a regulating routine within therapy goals (for example sleep routines, stress, low mood, rumination), within spiritually integrated psychotherapy (Domain VII). [synthesis]
  • Steps: [synthesis]
    1. Confirm consent and that the client wants this link made.
    2. Ask the client to name a time and setting when the practice reliably helps.
    3. Co-design how they will use their existing practice (as their instructor taught it, at their usual intensity or less, never more) at points the client chooses, such as after work or before a difficult conversation.
    4. Between sessions, the client notes the effect on mood, tension or sleep in a simple diary.
    5. Review at the next session and adjust with the client. Leave changes to the form itself to the instructor.
  • Example language (illustrative): "You've said the morning routine leaves you steadier. Would it help to plan where it fits on the days you're dreading? Keep it the way your teacher showed you. We're just looking at timing."
  • Watch for: the therapist drifting into coaching movements or breath; the practice becoming a compulsory homework that the client feels they fail at; increases in duration or effort; using the practice to avoid feared situations that therapy is working on. Working signs: the client reports steadier arousal and uses the routine flexibly, not rigidly.
  • Cross-reference: for secular, research-based movement or contemplative adaptations, see Domain II (MBSR, MBCT, MSC, CFT), Domain IV (trauma-sensitive yoga) and the qigong and tai chi entries in Domain X. No published secular adaptation specific to daoyin in psychotherapy is cited here. [uncertain: not verified]

4.5 Referral and collaboration (instructor, Daoist teacher, physician)

  • Purpose: to keep each role in its lane. Form and practice questions go to a qualified instructor or Daoist teacher. Medical questions go to the client's doctor. Psychological work stays in therapy. [synthesis]
  • Steps: [synthesis]
    1. When the client asks how to do a movement, breathe or "guide qi", say that this is outside your role and help them identify a qualified teacher. For Health Qigong routines, that means instructors working with the official CHQA materials. For lineage practice, it means a teacher recognised in that Daoist community.
    2. When the client links practice to a physical condition, or wants to replace medical care with practice, encourage them to discuss it with their doctor. With consent, coordinate.
    3. If the client wants it, and with written consent, contact the instructor to share relevant limits (for example, to keep the practice gentle while symptoms are active). Share only what is needed.
    4. Document consent and the scope of anything shared.
  • Example language (illustrative): "That's a question your teacher is better placed to answer than I am. Would it help to think together about how to raise it with them?"
  • Watch for: clients who have no teacher and learn only from videos (solitary practice is a reported risk factor, see 4.8); requests that you vet a teacher's metaphysical claims. Working signs: the client has a named teacher or doctor for those questions, and therapy time stays on psychological goals.

4.6 Trauma-sensitive adaptation

  • Purpose: to help clients with trauma histories practise without being overwhelmed. Movement, interoception and body-focused attention can bring up trauma-related arousal or dissociation. [synthesis; see also Cooper et al. 2021 on trauma history as an influencing factor]
  • Steps: [synthesis, informed by the trauma-sensitive mindfulness approach published by Treleaven 2018; uncertain: book not verified]
    1. Explore with the client whether any part of practice (closed eyes, inward attention, certain postures, being touched or corrected by an instructor, group settings) brings up distress.
    2. Support the client's choice to change these: eyes open, attention on the outside setting or the feel of the feet, smaller range, shorter practice, pausing at any time, declining hands-on corrections.
    3. Agree on a stop-and-ground plan: open the eyes, name things in the room, feel the floor, move normally, talk to someone.
    4. Encourage the client to tell the instructor what they need (for example, no touch), if they wish.
    5. Trauma processing stays in therapy, not in practice.
  • Example language (illustrative): "You're always in charge of how much you do. If something starts to feel too much, it's fine to open your eyes, slow down or stop. That's part of practising well, not a failure."
  • Watch for: freezing, spacing out, flashbacks, rising panic during or after practice; the client "pushing through" because practice is seen as virtuous. Working signs: the client can notice early signs of activation and adjust without shame.
  • Cross-reference: Domain IV, trauma-sensitive yoga.

4.7 Screening before intensive practice, retreats or escalation

  • Purpose: to reduce risk before a client takes up intensive, prolonged or solitary practice, or a retreat. [synthesis; risk factors from Shan 2000 and Cooper et al. 2021]
  • Steps:
    1. Ask about the planned practice: intensity, length, setting, supervision, sleep and diet changes. [synthesis]
    2. Review risk factors reported in the literature: intensive or effortful practice and long or first retreats; trauma history; current life stress; reduced sleep or appetite (Cooper et al. 2021); practising too much, being unable to stop, or practising alone without a teacher; previous psychological difficulties (Shan 2000).
    3. Ask about personal or family history of psychosis, bipolar disorder, dissociation or severe anxiety. [synthesis]
    4. Where risks are present, discuss a gentler plan with the client and, with consent, the teacher: shorter, supervised, with ordinary sleep and meals, and an agreed way to stop. [synthesis]
    5. Agree on warning signs that would prompt a call or an earlier appointment. [synthesis]
  • Example language (illustrative): "Before the retreat, let's think through what might be hard and what you'd do if your sleep went, or if the practice started to feel out of control."
  • Watch for: the client minimising warning signs to avoid being told not to go. Working signs: a concrete plan the client owns.

4.8 Responding to unusual body sensations (energy-like somatic experiences)

  • Purpose: to respond helpfully when the client reports heat, vibration, currents, pressure, tremors or involuntary movements in or after practice. In daoyin and qigong settings these are often framed as qi movement. [source: Cooper et al. 2021; Shan 2000]
  • What the research reports. In the Varieties of Contemplative Experience study of Western Buddhist meditators, energy-like somatic experiences (ELSEs) were the most commonly reported somatic experience. Features included heat, vibration, electrical or jolting sensations, pressure, tremor and involuntary jerking. They were sometimes accompanied by insomnia, racing thoughts and anxiety. Trajectories ranged from hours to years. Some practitioners valued them. Others reported severe impairment, and in rare cases hospitalisation for psychosis or mania. Appraisals included qi imbalance in Chinese medicine, kundalini, Zen "meditation sickness", nervous-system explanations and psychopathology, and often shifted over time. [source: Cooper et al. 2021] Lindahl et al. 2017 describe challenging experiences across cognitive, perceptual, affective, somatic, conative, sense-of-self and social domains. [source: Cheetah House VCE page] Qigong-specific reports describe qi felt rushing to the head, with headache, dizziness and unusual sensations in the lower abdomen (dantian). [source: Shan 2000]
  • Steps:
    1. Listen to the client's own appraisal first. Normalise without dismissing. Being told such experiences are not in themselves pathological often helped. [source: Cooper et al. 2021]
    2. Assess distress, impairment, duration and loss of control. Practitioners used these thresholds to decide whether to seek help. [source: Cooper et al. 2021]
    3. If distressing, discuss reducing the dose with the client and teacher: gentler effort, less intense or shorter practice, a different focus, or a pause. [source: remedies reported in Cooper et al. 2021]
    4. Support grounding: contact with the ground, ordinary physical activity, regular meals and sleep. [source: remedies reported in Cooper et al. 2021]
    5. If symptoms persist or escalate, move to 4.9.
  • Example language (illustrative): "Many people who practise describe sensations like this, and people make sense of them in different ways. What matters most to me is how much it's bothering you and whether it's getting in the way of sleep, work or family."
  • Watch for: insomnia, racing thoughts, pressured speech, feeling unable to stop movements, or fear of losing control. Any of these calls for 4.9. Working signs: sensations settle or become manageable, and the client feels less alarmed.
  • Specialist support: Cheetah House offers a care team, professional consultations and meditation-safety trainings for teachers and clinicians. [source: Cheetah House VCE page]

4.9 Differential assessment: spiritual or religious problem, qigong-related disturbance, or mental illness

  • Purpose: to tell apart a difficult but non-pathological spiritual or practice experience from psychosis, mania, depression or dissociation, without pathologising the former or missing the latter. [synthesis]
  • Background. Chinese psychiatry has described mental disorders arising after qigong practice ("qigong deviation", in folk terms linked to zouhuo rumo 走火入魔, roughly "fire going astray, entering demonic states"). CCMD-2 listed a diagnosis, and the author regards it as a controversial, culture-bound syndrome. Reported forms: psychotic (the most common, with delusions, hallucinations, elation and posturing in qigong postures, often starting soon after practice), neurotic (qi sensations, headache, hypochondriacal fears, anxiety about losing control) and dissociative (altered consciousness and hallucinations), usually acute and brief. [source: Shan 2000] The paper reports that the DSM-IV accepted this syndrome as an acute, time-limited episode. [source: Shan 2000; uncertain: DSM-IV wording not verified] The DSM-5-TR includes a code for a religious or spiritual problem as a condition that may be a focus of clinical attention (Z65.8).
  • Steps: [synthesis]
    1. Take a careful timeline: practice changes, sleep, food, stress, onset of symptoms.
    2. Assess mental state for psychotic symptoms, mood elevation or depression, dissociation, suicidality and risk to self or others, using current standard practice.
    3. Ask whether experiences stop when practice stops and whether the client can step out of them at will. Persistence after stopping and loss of control point towards illness (compare the CCMD-2 criteria summarised in Shan 2000).
    4. Ask how the client's teacher and community view the experience. Check with them if the client consents.
    5. If psychosis, mania or serious risk is suspected, arrange urgent psychiatric or medical assessment. A spiritual frame does not delay care.
    6. If the picture is a spiritual or religious problem without illness, support the client in their frame, reduce practice intensity and involve the teacher.
  • Example language (illustrative): "I take seriously what this means to you spiritually. I also want to make sure your body and mind are safe, so I'd like us to get a medical opinion as well. Those two things can go together."
  • Watch for: sleep loss of several nights, grandiosity, posturing or uncontrolled movements outside practice, inability to stop, suicidal thoughts. Working signs: a clear, shared plan, with the client's frame respected and safety secured.

4.10 Handling health claims and coordinating with the doctor

  • Purpose: to respect the tradition's health framing (the Yinshu names exercises for specific ailments, and modern materials speak of preventing disease and prolonging life) while making sure physical illness is managed medically. [source: Lo 2014; Purple Culture listing of CHQA 2012]
  • Steps: [synthesis]
    1. Hear the client's belief about what the practice does for their body, and attribute it ("in this tradition…").
    2. State the evidence status in one line: these are traditional and promotional claims, not established treatments for physical disease.
    3. Ask whether the doctor knows about the practice and whether any condition limits movement. The published routine itself advises people with illness to adjust intensity and seek professional guidance. [source: NetEase 163 article]
    4. If the client is considering stopping medical treatment in favour of practice, explore this and encourage a discussion with the doctor. Do not advise on medicines.
  • Example language (illustrative): "It makes sense that you value what the practice does for you. I'd want your doctor in the loop too, so the practice and your treatment work together."
  • Watch for: delayed medical care, pain or injury from forcing stretches, practising while unwell or exhausted. Working signs: the client keeps both the practice and medical care.

4.11 The teacher relationship and group dynamics

  • Purpose: to support healthy relationships with teachers and practice groups, and to recognise coercive dynamics if they arise. [synthesis]
  • Steps: [synthesis]
    1. Ask about the teacher and group: how instruction is given, whether questions and leaving are welcome, what is asked in money, time and loyalty.
    2. Explore power: hands-on correction, claims of special powers or healing, demands for secrecy, discouragement of medical care or of outside relationships.
    3. Signs that call for a closer look include isolation from family and friends, escalating demands, punishment or shaming for doubt, sexual or financial exploitation, and pressure to stop medical or psychological treatment.
    4. If the client is leaving a group or reports harm, support grief, identity and religious-trauma work. Separate the practice itself from the group's misuse of it if the client wishes to keep practising elsewhere.
    5. Follow safeguarding and reporting duties where abuse or risk to others is disclosed.
  • Example language (illustrative): "How free do you feel to ask your teacher questions, or to take a break from the group?"
  • Watch for: your own biases about Chinese or Daoist practice groups. Independent misconduct findings about daoyin teachers: none found in the sources consulted, so no one is named. Working signs: the client can weigh the group's demands against their own values.

4.12 Perfectionism and over-scrupulous practice

  • Purpose: to help when correct form, the right time of day or season, or "wrong" qi flow becomes a source of fear, checking or guilt. [synthesis]
  • Steps: [synthesis]
    1. Explore what the client fears will happen if a movement is "wrong".
    2. If the pattern looks obsessional (repeated checking, redoing routines, intolerance of uncertainty about harm from practice), assess for OCD and consider exposure and response prevention, adapted with consent. With the client's agreement, ask the teacher's view of what "good enough" practice is, as clinicians do with religious authorities in religious OCD. [uncertain: IOCDF guidance not verified]
    3. Use the tradition's own published stress on comfort, gradual progress and no forcing as a shared reference point. [source: NetEase 163 article]
  • Example language (illustrative): "Your teacher's guidance talks about staying comfortable and never forcing. What would practising in that spirit look like this week?"
  • Watch for: reassurance-seeking from the therapist about qi or form. Working signs: less checking, more flexible practice.

4.13 Role boundaries, self-disclosure and competence

  • Purpose: to keep the therapist's role clear when a spiritual or body practice is part of therapy. [synthesis]
  • Steps:
    1. Do not act as the client's daoyin teacher, spiritual director or healer. If you practise daoyin yourself, avoid dual roles such as teaching a client in your class. Refer them to another teacher. [synthesis]
    2. Disclose your own practice or beliefs only when it clearly serves the client, and never to recruit them. [synthesis]
    3. Build basic spiritual and religious competence. Vieten et al. (2013) propose 16 basic competencies across attitudes, knowledge and skills as a standard for all licensed psychologists. They note that clients want these issues addressed, but most clinicians have little training. [source: Vieten et al. 2013 via IONS page]
    4. Apply your profession's ethics code on competence, multiple relationships and respect for religion and culture. [synthesis]
    5. Seek consultation or referral when the client's practice is beyond your knowledge.
  • Example language (illustrative): "I'm not trained in daoyin, so I won't advise on the practice itself, but I'm glad to explore what it means for you."
  • Watch for: enthusiasm or scepticism about qigong steering the work. Working signs: the client sets the place of practice in therapy.

5. Handling problems

None of the sources here addresses psychotherapy problems with daoyin directly. Unless a source is tagged, the guidance below is synthesis.

  • The client wants you to teach them daoyin or check their form. Explain your role, and help them find a qualified instructor (4.5). You can still explore what they hope the practice will give them. [synthesis]
  • Overwhelm during or after practice (panic, flashbacks, dissociation, intense body sensations). Stop and ground (4.6). Reduce the dose in agreement with the teacher (4.8). Assess for illness if symptoms persist after stopping or include loss of control, insomnia or psychotic or manic features (4.9). [source for dose reduction and grounding: Cooper et al. 2021; rest synthesis]
  • The client practises more and more to fix distress (longer, more often, alone). Name the pattern gently. Revisit the published guidance on gradual, unforced practice and the reported risk of over-practice and solitary practice. Agree a ceiling with the client and, if they wish, the teacher. [source: Shan 2000; NetEase 163 article; synthesis]
  • Stuck: the practice "no longer works". Explore changes in life stress, sleep or expectations. Ask what the practice meant when it worked. Consider whether therapy goals need other methods alongside it. Do not push the client to practise harder. [synthesis]
  • Non-adherence to agreed between-session use. Treat it as information, not failure. Check whether the plan was the client's own, whether the practice has become a chore, or whether it stirs something difficult. Simplify the plan or drop it. [synthesis]
  • Rupture: the client feels their tradition is dismissed or exoticised. Acknowledge it directly. Ask what felt wrong, and return to their own language and frame (4.3). [synthesis]
  • Rupture: the client feels pushed to practise. Make clear that the practice is optional in therapy and that the client sets its place. [synthesis]
  • Conflict between the teacher's advice and medical or psychological advice. Hear both views. With consent, arrange a conversation between them. Keep safety first. Leave decisions about medicines to the doctor. [synthesis]
  • Family conflict about the practice (for example a relative who sees it as superstition, or one who pressures the client to practise). Explore values and boundaries. Consider a family session if the client wishes. [synthesis]
  • Fear that unusual sensations mean harm ("my qi is going wrong"). Normalise without dismissing, assess impairment, and coordinate with the teacher and, if needed, a doctor. Treat persistent fear and checking as possible health anxiety or OCD (4.12). [source: Cooper et al. 2021; Shan 2000; synthesis]
  • Expectations of physical cure. Respect the hope, state the evidence status, and keep the doctor involved (4.10). [synthesis]
  • Disclosure of teacher misconduct or coercive group pressure. Respond with safety planning, safeguarding and reporting where required, and religious-trauma support (4.11). [synthesis]

Sources

Online sources

Books and works cited

  • Lo, V. (2014). How to do the Gibbon Walk: A Translation of the Pulling Book (ca 186 BCE). Cambridge: Needham Research Institute Working Papers 3.
  • Kohn, L. (2008). Chinese Healing Exercises: The Tradition of Daoyin. Honolulu: University of Hawai'i Press.
  • Chinese Health Qigong Association (2012). Health Qigong: Mawangdui Daoyin Exercises. Beijing: Foreign Language Teaching and Research Press. English edition: Mawangdui Daoyin Shu (2014), Singing Dragon.
  • Lindahl, J., et al. (2017). The Varieties of Contemplative Experience: A mixed-methods study of meditation-related challenges in Western Buddhists. PLOS ONE, 12(5), e0176239. (Citation as given on the Cheetah House page.)
  • Treleaven, D. (2018). Trauma-Sensitive Mindfulness. [uncertain: not verified]
  • American Psychiatric Association (2022). DSM-5-TR: Cultural Formulation Interview; religious or spiritual problem (Z65.8).
  • ICD-10-CM Z65.8, Other specified problems related to psychosocial circumstances (includes 'Religious or spiritual problem')
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