Psychotherapies Originated in Japan

KEY WORDS
Psychotherapy, Japan, Morita therapy, Naikan therapy, Introspection psychotherapy

Psychotherapies being currently performed in Japan are numerous. Most of them have been introduced to Japan from Western countries, while there are two psychotherapies originated in Japan. They are Morita therapy (Morita, 1921, 1937) and Naikan therapy or Introspection psychotherapy (Yoshimoto, 1965, 1971).
Those two psychotherapies are as follows. Morita therapy is described more briefly here since it is better known among westerners.

1. MORITA THERAPY

This is a psychotherapy for neuroses devised by Masatake Morita, a professor of psychiatry of Jikei medical college, in around 1920.

Morita thought the origin of neuroses existed in

(1) hypochondriacal state,

(2) reciprocal mental interactions (a vicious circle where the patientﾕs interest is concentrated on the symptom, which sharpens his/her physical sense, and the symptom becomes felt more keenly),

(3) obsession with the symptom, and

(4) strong desire to live. Conse-quently,

Morita insisted that the patients could recover from neuroses by getting out of the obsession with the symptoms and adopting an attitude of life, so called ﾒthey are as they naturally are.ﾓ

Usually, hospitalization takes 40-60 days, which consists of:

1st	period	: confined to bed (4-7 days)
2nd	period	: light working (1-2 weeks)
3rd	period	: heavy working (1-2 weeks)
4th	period	: life training or rehabilitation (1-several weeks)

In addition to this, outpatient therapy, correspondence therapy and meetings with other patients (that is; a society to discover how to enjoy life) are also available.

2. NAIKAN THERAPY OR INTROSPECTION PSYCHOTHERAPY

This psychotherapy was devised by Ishin Yoshimoto in 1937. The method is as follows:

[Sitting]

Sit facing a wall. A sick person can remain lying. Eyes can be open or closed.

[Mental Preparation]

Telling oneself that ﾒIﾕm going to get a grip on myself from today.ﾓ

[Introspection Method]

For example, set the theme of the introspection as oneﾕs mother, and determine that ﾒ Iﾕm going to thoroughly examine myself in my relationship with my mother.ﾓ Then, remember what she did for you in your elementary school days, junior high school days and so on up to the present in chronological order, and remember what you did to/for your mother, and whether or not you troubled her. (In brief, examine three facts: what she did for you, what you did to/for her in return and how you troubled her, in a ratio of 1:1:3)

After thinking about your mother, do the same for your father, brother(s), sister(s) and others such as your spouse, child(ren), friends, teachers and superiors in the office whom you are concerned about, as to whether you have been good or bad to them.

[Way of Life during Naikan]

Naikan is to be strictly observed from about 6 a.m. to 9 p.m., during which time you should not leave your seat except to go to the toilet. Listening to the radio, watching TV, reading a book or newspaper, and talking with anyone other than a leading advisor is strictly prohibited. Also, meals should be taken in the spot.

[Process]

In the first two days, your memories just come out randomly or you cannot understand the point and only get silly impressions which may make you want to stop the introspection. However, after this period, your thoughts gradually become integrated and on around the 5th day, you become aware of yourself clearly, filled with gratitude, joy and a spirit of voluntary contribution to others, while feeling a power which makes you want even to shout out. And you can be wonderfully gentle.

[Leading advisor]

It is much better if a leader is available during the above period. The leader meets you once every two hours for about 3-5 minutes and asks and advises quietly and kindly about ﾒ Now who are you thinking about at the time of how old you were?ﾓ and ﾒ What do you think of it ?ﾓ The leader also asks, ﾒ Do you have any questions?ﾓ

[Dispersed Naikan]

After the completion of 7-day intensive naikan or introspection psychotherapy, the patient should implement self observations (or dispersed naikan) for two hours at any time everyday in an appropriate manner. If you spend your days in this way, you will be able to feel gratitude even in any adversity and spend the days with a cheerful spirit.

To sum up, repeatedly consider the three items of ﾒ what were done for youﾓ by intimate people like your family, especially by your mother, ﾒ what you did for themﾓ and ﾒ how much you troubled them,ﾓ firmly and clearly. This makes you aware of yourself surrounded by their affection, and changes your inclination from blaming and punishing others to being self-reflective. Also, the awareness of being loved makes you feel gratitude and expands your activeness, which improves the personality.

This psychotherapy is used for the treatment of neuroses and personality disorder and is also used in the reformatories.

Yoshimotoﾕs treatment technique was further developed by Rokuro Ishida (Ishida,1972, Kasahara & Shimazono, 1978).

Morita therapy and Naikan therapy need to be further tested and studied in order to assess their efficacy though they seem to be effective at least in certain cases.

REFERENCES

1. Ishida R. (1972): Clinical Medicine of Naikan Therapy (in Japanese), Bunkodo.
2. Kasahara Y., Shimazono Y. (Ed.)(1978): Modern Psychiatry Series 5A (in Japanese), Nakayamashoten.
3. Morita M. (1921): Nature and Treatment of Neuroses, 25 yearsﾕ Anniversary of Prof. Kure.
4. Morita M. (1937): Psychotherapy of neuroses (in Japanese), Shinkeishitu 8; 280.
5. Yoshimoto Y. (1965): Forty years of Naikan (in Japanese), Shunjusha, Tokyo.
6. Yoshimoto Y. (1971): Method and Practice of Naikan (in Japanese), Igakushoin.

Received on September 15, 1996 and accepted on December 18, 1996
1) Department of Psychiatry, School of Medicine, Keio University
35, Shinanomachi, Shinjuku-ku, Tokyo 160, Japan
2) Japan Womenﾕs University

2-8-1, Mejirodai, Bunkyo-ku, Tokyo 112, Japan