Abstract

The current rhetoric which is disseminated in connection with women in Japan who are thought to be vulnerable to trouble at menopause is examined in this paper. It is shown how this rhetoric is one part of the much larger ongoing internal debate in Japan, in connection with the The Selfish problems and value changes associated with modernization and Housewife internationalization. The ideal middle-class housewife is set up in the and debate as the "model" modern Japanese woman. The self-discipline and Menopausal behavior which are expected of her are based upon traditional values, and women who suffer from the "disease" of menopausal syndrome are Syndrome in believed to be those who no longer follow the traditional "disciplined" Japan life-style or alternatively, those who are neurotically "over-disciplined." The attempted medicalization of women at menopause and its lack of success to date is examined with reference to survey research and by interview data. Margaret Lock About the Author McGill University Margaret Lock is Professor of Medical Anthropology in the Departments of Anthropology and Humanities and Social Studies in Medicine at McGill University and past president of the Society for Medical Anthropology. She has carried out research into the traditional and modern medical systems of Japan and has also done comparative research in Japan, North America, and East Africa into life cycle transitions and the use of the body as a medium for the expression of distress. Working Paper #154 December 1987

Women and International Development Michigan State University 206lntemational Center, East Lansing, M148824-1035 Ph: 517/353-5040 Fx: 517/432-4845 Email: [email protected] Web: http://www.wid.msu.edu

See back page for ordering information and call for papers Copyright 1987, MSU Board of Trustees '!HE SELFISH lKlUSE.WIFE AND MENOPAUSAL SYNI:R:'HE IN JAPAN

My l'IXJther is rather tall for a Japanese. She is intelligent, IOOdest, unselfish, and always thoughtful of the other members of the family. She is particular about her manners, and :inpresses everybody she meets with her graceful dignity. strict with herself, and fonnal, she plays the part of a sanrurai's wife, majestically, as if in a dramatic perfonnance. She rises earlier and retires later than anybody else in the family. She has never allC7NEd herself to enjoy a lazy SUn:lay lI'DmirY;J in bed, and the sickbed is the only place for her to rest. Nobody ever saw her sit in a relaxed manner: she is always erect, wearing her Jd.Joono tightly with her heavy sash folded on her back •••.

My l'IXJther uses polite words only, never li.kin:] to pick up the vulgar words spoken in the street. She never betrays unpleasant feelings. "Errlurance" and "repression" are her greatest ideals. She says to me, "Errlurance a wanan should cultivate lI'Dre than anyt:hin;J else. If you en:lure well in any circunstances, you will achieve happiness."

My l'IXJther was especially assiduous in educating her children. She made every effort to further their developnent rut her feudal concept of "man first, wanan to follCM" was clearly seen in her treatment of her sons and daughters... ''Unselfistmess, sacrifice and erxhlrance for wanan. '!hat is all-sufficient" my honorable l'IXJther maintains.

Facing Two Ways: '!he story of my Life Shidzue Ishincto 1935

'!he passage cited above, written by a well-known Japanese feminist, provides an exanple of the way in which power in Japan has, for many years, been inplE!ll'el1ted primarily through the creation of a "disciplined" body (Foucault 1979).

One fear which is voiced very frequently in official documents and the mass media in conteJrp:lrary Japan is that self-control and discipline are no longer taught properly in the family or in schools, and that this situation is a threat to the continued progress of Japan as a leading econanic power in the world today (Ikemi 1982, line 1980). A body of popular literature has been written about each member of the Il1'Ddel" nuclear family: the salaried maJVfather, the schoolchild, and the housewife/l'IXJther. '!his genre includes popular medical literature, often written by eminent doctors, which appears in newspapers, magazines, and soft =ver books, and which describes the type of illnesses and family problems likely to beset the men, wanen, and children of IOOdern Japan. 'lhis literature often considers, usually very explicitly, the way in which control, discipline, and loyalty to groups, and also the supposed negative offshoots of IOOdernization, irxlividualism and selfistmess, have an inpact on health and ill-health, respectively (Japan Times 1984, Takahashi 1984). -2-

'!he transfoDDation which took place in Japan duriIx;J the course of the twentieth cerrtuIy into an uman-centered, contractually-based eoollany has been acx::arpanied by an incessant debate about the novel concept of irxlividualism. 'Ibis ''western'' value is often equated with selfishness am generally peroeived to be in qp:lSition to the traditional values of self-control, devotion to work, am loyalty to groops (MOeran 1984), the ethos upon which Japan is believed to have been II'Odernized. An increase in irxlividualism is often, therefore, viewed as a threat to further econanic develcpnent, that is, if develcpnent is to continue to deperxl upon the values of selflessness associated with "Confucian capitalism" (Rohlen 1980). Men, waren, and children are all thrught to be vulnerable to the blight of irxlividualism, and contenporary observers believe that the recent rapid internationalization of Japan has precipitated a current crisis of national identity on a massive scale in which the topic of irxlividualism is central. '!he vast production of popular literature which keeps this cultural debate well fueled is known as nihonjinron (essays on beiIx;J Japanese) (Befu 1983: Moller am SUg:iJroto 1983).

In this paper I will examine the rtletoric of nihonj inron which is associated with the person thrught to be focal in the rruclear family, the housewifejnDt:her. Her role, behavior, am state of mental am Ibysical health are subject to particularly close scrutiny in popular literature in Japan, since she is responsible for maintainiIx:J the health of the entire family am her fears about her peroeived lack of discipline as she wallows in the supposed freedan am material cctnforts of the ncdem autanated household create a potent anxiety for same ccmnentators. viewed through the lens of traditional Japanese values, a ncdem housewife is, in effect, a type of deviant since she has been structurally eliminated from participatiIx;J fully in the work ethic (so central in Japan). 'Ibis is partly because of household autanation am partly because she is responsible for the care of a nuclear (rather than an exterrled) family whose members are rarely at heme due to the demards of work am school. (Work am school can occupy men am children fully for five am a half days a week, fourteen hours or IlDre a day on weekdays). A housewife is, therefore, scmewhat of an ananaly am hence threatenin;J to the social order, especially since it is generally regarded as inappropriate for her to seek errployment outside the heme.

'!he data on which this paper is based are the preliminary results of a cross-sectional questionnaire survey on Oller 1300 Japanese waren between the ages of 45 am 55. '!he sanple is divided into three groops: middle-class housewives, fanning waren, am waren who work in factories. I also carried out open-eOOed interviews in their homes with 150 waren from the survey sanple, am with 15 gynecologists, 15 general practitioners, am 6 practitioners of traditional medicine. I will focus in particular on current beliefs about menopause in Japan including recent atterrpts to medicalize this part of the life cycle. It will be shown that the rtletoric used by medical practitioners, both traditional am ncdem, am by waren themselves to account for trouble at menopause reflects the current internal debate in Japan (as it is made manifest in nihonjinron, with all its contradictions am self-scrutiny about the effects of !lDdernization, the rise of the nuclear family, am the fosteriIx;J of the concept of irxlividuality). 'Ibis rhetoric serves as a "C<:Nert form of oppression am control" (Smart am Smart 1978:2), since supposed personality defects am behavioral faults of individual waren are exposed to national -3-

scrutiny ani used (not necessarily consciously) as a displacement 1OOCh.anism for diffuse but potent political oonoerns aboot internationalization, economic growth, ani national identity. It will be awarent that I draw upon Foucault's work on the micro-politics of power, in that I accept that the subjective experience of distress is often largely constituted by a topical discourse or met:oric. I also wish to shaw, however, that in the case of 1!Iel'lCtlausal syOOrare in Japan IlEdicalization ani its associatoo rhetoric touches the lives of lIOSt Japanese wanen only inlirectly. Nor is the relevant nedical knowledge groun:1ed in either subjective experiences of distress with any great ~, or even in anyt:hin:J which can be quantifie:i (the usual Japanese test of reality) , to any degree of significance. '!his political/medical rhetoric drifts arourr::l, largely unrelatoo to the experience of real people ani does not awear to shape the lives of m:>re than a vulnerable few.

Medicalization, which usually embraces a daninant rhetoric, such as nihonjinron to justify Ptysician intervention, is not necessarily all bad, ani not sinply the nake:i enactment of power over duped subjects. PcpJ.lar medical literature, no doubt, often written in an effort to produce a market for the nedical care of many "normal" life experiences, can partly serve to create an awareness that one's distress is not a unique event but rather sanet:.hin:} share:i by many others (I.ock 1987). It can function therefore, to break dcMn the isolation which is especially prevalent in IOOdern uman life. Private suffering, the experience of the embodie:i self, often resonates with the stories of others. Although in the books ani articles written for the plblic by Japanese Ptysicians, blame for the occurrence of an illness in usually laid at the feet of the victim, a small portion of the literature el!plicitly suggests that there are social ani political variables involve:i; hence the way is opened for the social origins aJItllron to nuch distress to be made conscious, perhaps for the first tine, ani hopefully to lead to greater political sophistication (Bourdieu 1977). 'lhe rhetoric can then be torn apart, so that what was taken as "CUI.IOll knowle:ige" ani "natural" becxtl03S subject to tentative questioning: the ''muntaJrings of a shadowy CCAlJlter-iInage," (Parkin 1984:362) which can potentially evolve into a gran:l chorus.

'lhe "Selfish Ha.JSeWife"

Mothers Should be strong-Mimed

It is said that juvenile delinquency arises when there is no hl.m1an Jtin:mess put into a m:>ther's cooking. . ...A m:>ther should season rice balls by ham, only then is her care properly el!presse:i. Package:i rice balls that are bought in the supennarket are not adequate. • ••. It is inpJrtant that m:>thers get up early in the m:>rning for children's sake in order to make them a meal.... I have coine:i the Ptrase: "Juvenile delinquents are born through food." canmentary by an educator Mainichi Shimbun 1984a

'lhe rise of the uman nuclear family is largely a post-war phenanenon in Japan, ani the full-tine "professional" housewife, as she is knc:Jwn, has came to represent the epitane of a IOOdern Japanese woman. Her life is assumed to be devoted to the care of her husbarrl ani two children, ani to her parents-in­ law who will in all probability be incorporatoo into the household as they -4-

grow old ani infinn. 'lhe fCA.U'rlation f= the !IDdern role of housewife, traditionally summed up as "good wife; wise nother" (ry/5sai kenbo) was laid down in the Meiji era at the ern of the last oentmy. Modeled in part on European ideas which ~ current at the time, the argl.IDI9I1t was based on the assuIlption that a wanan' s nature best equips her to nurture others (Nakamura 1976) • It was officially acknowledged, for the first time, that -women could be l:egarded as IOOre than sh!ply a "borrowed womb," ani they ~ encouraged, within the confines of the domestic ~, to becane the guardians ani educators of their children. Hence, above all, they should be educated in IOOrals ani religion ani should expect to a degree, to exe=ise power within the household. Fran the perspective of the latter half of the 20th oentmy, it is difficult to appreciate the revolutionary nature of early Meiji ~ on -women. Comparison with 18th century treatises, the best known expression of which is Onna Daigaku (Greater reaming for Wallen), is revealing:

WcFan has the quality of yin (passiveness). yin is of the nature of the night ani is dark. Hence, because cx:xtpared to man she is foolish, she does not umerstani her obvious duties .... She has five blemishes in her nature. She is disobedient, inclined to an;Jer, slan:lerous, envious, stupid. Of every ten -women, seven = eight have these faili.n;Js •••• In everyt:l1in;J she I!P.lSt sul::8nit to her husbarrl. Kaibara Ekken (1672) translated in Joyce Ackroyd (1959)

'!he struggle for rights for -women in Japan is a story which started fran a position of extreme subservience at the ern of the feu:lal regime. ruring the first wave of major in:iustrial expansion in the latter part of the 19th century, -women of all classes, including the wives of many ex-samurai, ~ coerced into working in appalling con:titions on production lines in factories (Sievers 1983). Since the ern of the last oentmy the -women's l'OCJVeIlIeI'lt has a history which closely parallels lOOst of the turtJulent times in the West (Sievers 1983), but !IDdern Japanese -women have not so far attained the same degree of civil rights as North American ani lOOst European -women. Today, just over 50 percent of -women Oller 15 years of age in Japan work in the labor force. Many of them are still thoroughly exploited since they are kept pennanently in a ~ status, therefore available for periodic hiring ani firing according to the vagaries of the Japanese ani world eoonanies (Cook ani Hayashi 1980). 'Ihese -women, however, hardly figure at all in the pop.l1ar image of the average lOOdern Japanese wanan: this is a role reserved for the middle-class housewife whose daily rounj is sardonically described as san shoku biro ne t:suki (an easy, permanent jab with three meals ani a nap thrown in). '!he housewife is the inheritor of the Meiji image of the "good wife ani wise ll'Other"; her life is circurnscribed by the danestic rounj which, with the spread of affluence ani the develc:pnent of household technology, has becane somewhat of an anomaly in a society where the work ethic prevails.

Recent studies ani govermnent surveys indicate that lOOSt middle-class -women are largely satisfied with their roles as housewives ani lOOthers of two (Kokumin Seikatsu Hakusho 1983; I.ebra 1984; Rla= 1976; White ani Molony 1979). Many of them repmt that they enjoy ~t to an outsider appears to be a relatively easy life of material camfort , but this role, like those of other ''nDdel'' members of the nuclear family, the salaried man, ani the schoolchild, is replete with contradictions ani paradox (lDck in press). -5-

Shitsuke, the behavior and discipline whidl is eJqlE!CI:ed of the IrOdem housewife, is based upon an assorted mixture of values created in part fran the rules laid down in feudal times for the wives of sanurai, and often portrayed today as orma rashiisa, wananly behavior. '!he Confucian ideal erx::ooraged discipline in wanen, not for militaJ:y service, b.tt in order to practice urquestioni.n:J subnission and obedience. Modern Japanese wanan are taught to believe, like their predecessors in feudal tilres, that patience, diligence, en:lurance, even-t:enplredness, OClIplianae, and gentleness all contrib.tte to wananliness. It is believed that lOOral tra:inirg in these virtues leads to the right k:in:i of personality. '!his intemalized behavior is complE!ll'ellted by discipline of the body language usage (Iebra 1984:46). '!he existence of those female language fonns whidl are associated with subnissiveness and gentleness still goes virtually urquestioned by anyone (Ide 1982) • Ccmteous greetin;Js, good posture, a neat appearance, good manners, elegance in the hanlling of thin;Js, an orderly house, and established routines in one's lifestyle are all associated with wananly behavior (Iebra 1984:42). Modesty, reticence, and a soft voice are considered iIrportant, and covering with one's ham the unsightly partly open ll'ClUth created by a smile is still COllilon anon:J many wanen. Housewives often describe themselves as "weak" if they do not keep up the appearance of gentle b.tt finn control in their daily lives. Competitive pride is frequently taken in being the first up in the household at 5:30 or 6:00 a.m. each day in order to prepare breakfast and boxed lunches for the family, and in staying up last in order to organize the house for the next day and close it up at night. 'lhese traditional values are c:x:mp:lllIrled by newer images of Western influence:

••• YOU!'l3", cute, smiling and apparently mute girl-wcrnen are on every genre of ['IV] program at any hour of the day or night. Why does this phen<::m3non exist? Television personalities reflect the ideals and values of any given society, and the wanen that appear on television are therefore only "ideal" wanen •••• in Japan, wanen, in order to fit the definition of the ideal wanan, nrust not only be youthful and pretty, b.tt they should also be sweetly silent • .. • according to Taooyo Nonaka, a newscaster... "People think of wanen as flowers and if there were no wanen on 'IV it would be a bit· bizarre. So they think, 'O.K., let's p.It a nice flower on the table' ,. .. 11. 'lhese televised blOSSClllS do not only represent idealized wanen b.tt they also act out the ideal role between wanen and men. '!he reason that these women are not outspoken is because they I!P.lst be properly deferential towards men. Women are usually referred to as assistants rather than co-hosts •••. the role of an assistant is to ''make a man stand out and bring out his good points" •••• It nrust not be assumed, hcMever, that all women in television are in real life subservient or opinionless •.. Kikuko Itasaka Mainidli Shimbun (1984b)

Not only should it not be assumed that the housewife is necessarily subservient or opinionless (as above) rut a few housewives say that they are raising their daughters today with little concern for wananly behavior. -6-

'lhe middle-class housewife is associated with many stress-related problems includi.n:J "the kitchen syOOrane," in which a variety of severe somatic synpt.ans are experienced every time one enters the kitchen to prepare the evenin;J meal; aparbrent neurosis; childrearirx] neurosis; ''menopausal syOOrane", am so on.

'!here are several contradictory t.henes associated with each of these afflictions which can be illustrated by describ~ the etiologies which are thought to contribute to the menopausal syOOrane. It is said that ~ who are busy, who hold a job, am who do not have time to dwell on their problems will not notice menopause nor experience any synptatatology. ''Menopausal syOOrane" is described as a lUXUIy disease (zeitakubyO), sanethin;J which occurs in ~ who are selfish am turned in on themselves or in ~ who just "play arourxi" all day. People like this are thought to lack a real identity, to have "no self" (iibun ga nai), am to be deficient in the willpower am erdurance characteristic of their Jrothers. It is believed that such women are likely to raise children who are urrlisciplined or deviant.

A secon:l set of etiologies associated with trouble at menopause (these two E!l!planations can be offered by the same person but usually about different ~), states that ~ who are "OITer-socialized," OITer-controlled, too concemed with tidyness am order, am of nervous teItp3rament (shi.nkeishitsu) are vulnerable. 'lhese ~ are thought to produce children who suffer fran psychosomatic illnesses or problems such as "school refusal syOOrane." 'lhe stiflirx] a~ that they create in the hare am its effect on the children is described by one commentator thus: "'lhe roots of even a healthy plant confined in a pot will rot if given too llUlch water" (Higuchi 1980:90).

Ambiguities are layered one upon another. Hard work, perseverance, am discipline are valued, but runni.n] a small hoose with the aid of II¥Jdern technology, where one's husbarx:l is absent most of the time, am where the two children are fully o=upied in the pursuit of an education, takes relatively little time. Nevertheless,~, who are said to be the pillar of the family, should devote themselves to the care of other family members (am apparently suffer fran guilt if they fall ill am are unable to fulfill these duties (DeVOS am Wagatsuma 1959; Lock 1982). It is agreed that housewives today, however, become lonely am bored am tend to use "o:t;gan" l~ to E!l!pJ:'eSS their dj scontent (as one specialist in internal IlBli.cine ~ it), (Lock 1987), but, with virtually no exceptions, ~ are required to discontinue enployment once they beccnre pregnant am, apart fran facto:ry enployees, are highly unlikely to be re-enployed once they have raised their families (Robins~ 1983).

On the other ham, it is said that women today cannot erxiure as their Jrothers did, that they are selfish am spoiled am no 10n:JE!r make gcxxl Jrothers. One ~ysician who has written a best seller on the subject of "illnesses caused by IrDther" (Bogenbyo, Kyiit:oku, 1979) states that Jrothers were formerly gcxxl at childrearirg but that in the past 20 years they have beoc:me very poor at it. Irxlustrialization has, he says, distorted the "natural childrearirx] instinct" into sanethin;J which satisfies the IlOther's "narcissistic ego" but does not produce a healthy child. Mothers are described as too bossy or too over-protective. 'lhe best lellialy for a sick child is "parentectomy"-the l'eI1XlVal of the child fran the I!Other's charge for exteOOed care in a hospital (Ikemi et al. 1980). In order to ocrnbat boredom, -7-

it is suggested that haJsewives take up m:>re hoIi:>ies; this will act as a preventive measure for both m:Jt:her and child against illnesses of psychosocial origin. Frequently these =ntraclictions are sununed up with a suggestion that haJsewives are thelrselves victims of modernization and, in particular, of the inevitable isolation which develops with the rise of the nuclear family (KyiIt:oku 1979).

Menopausal Syrrlrane

Fran at least the 10th century it awean; that special attention has been given by the medical profession to the problems thought to be associated with IreI1Struation and its cessation (Nishimura 1981). '!here was no special term, however, for the ern of IreI1Struation l.Ultil a =ncept kBnenki (often glossed as the c:han:1e of life) was created 1.II'der Gennan medical influence at the ern of the last century. Disorders associated with kOnenki were usually attr:ibuted in part to an unbalanced autonomic nervous system-a very pcpliar explanatory IOOdel in both Gennany and Japan which is still in regular use today. since the 1950s, in CCITIlIDll with COI'Itenp>rary Western medicine, the term ''Irenopausal syndrcane" has becane popular in medical circles (Lock 1986b). It is viewed as a "disease" which, rAM officially recognized, allows diagnosis and trea'bnent by PlYsicians who can receive reilnJ:m:'Sement 1.II'der the socialized health care system.

'!he interviews corrlucted with gynecologists, general practitioners, and practitioners of traditional medicine prcxlllced a variety of etiological explanations for menopausal syn:ircare. At the );ilysiological level same focllsed on an unbalanced autonomic nervous system caused by declining estrogen levels, while others si.qlly focused directly on lowered estrogen levels. All of the practitioners had, in addition, several ideas about why same women are nore vulnerable than others to menopausal syndrcane. '!he !lOst pcpliar explanations include: an excess of free time; no clear role; no self-discipline; selfishness, boredom, no hoIi:>ies and, in contrast, too !Illch control; a neurotic personality; over-protectiveness toward children; inward focus; loneliness. Additional explanations include sufferin;J fran unresolved guilt related to abortions, no sense of self, and, less frequently, family prcblems and the "enpty nest syndrcane." Housewives are thought to be especially vulnerable. sane practitioners recognized the =ntraclictory nature of their statements but justified themselves by sayin;J that wcmen are affected in a variety of ways deperrlln;J upon their basic personality types. Practitioners frequently added that women are victims of nodern social OIganization and discriminatory enplcyment practices and, therefore, should not be held responsible for their ''weak'' behavior. A few PlYsicians blamsd thoughtless husbarrls for menopausal problems, and the majority believe that the nuclear family, especially when it is situated in a small apartment, is not a healthy place for a wanan to sperrl !lOst of her time.

Despite their beliefs in the social and psychological origins of menopausal syndrcane, the majority of practitioners si.qlly prescribe medication: estrogen replacement therapy, tranquilizers, or heJ::bal medication. '!hey have neither the time nor the inclination to try to manip.llate anything other than the );ilysical bcx:1y. One recent developnent is, however, very striking. D.lrin;J the course of the 1980s an interest in coonselin;J has becane apparent. Rlysicians are allowed to advertise in Japan, and it is rAM not llIlOClTIll'OI1 to see gynecologists listin;J counselin;J anong their -8-

specialities, in a&:lition to :internal examinations ani surgery. TiJne is usually set aside two afternoons a week for counselin:J, at a fee of about $15 an hour. When asked what fom their therapy takes, gynecologists JOOSt usually replied that they suggest women go out m:>re often, take up another hoIX!y, go out to dinner, ani so on. One or two reccmnen;i the practice of Buddhist cererronies in cormection with guilt incurred Oller abortion.

'!he cross-sectional survey de!oonstrated that Japanese IrII:IIIeI'l report very few synptans, either samatic or psychological, at menopause (a statistically c:c:mparable canaclian sample l:epac ts synptans nearly three tiloos as often (IDck, Kaufert, ani Gilbert, ms), although they share the stereotype with their Fhysicians that lazy, bored, selfish, ani neurotic women are likely to suffer (IDck 198Gb). Like their Ffiysicians they ~ that ''menopausal syrDrare" is a recent prcblem, a by-product of IrCldernization ani the nuclear family, ani that modern women carmot practice eOOurance as did their m:>thers:

My m:>ther had seven children. She had no freedan, and in fact, she had no self (iiliun ga nai). She was always suppressin:J her feelin:Js ani not lettin:J anything shC7II' on the surface. I can't do that. I had depression at menopause ani that is because I am a spoiled type. Waren who work hard don't get any synptans. A Kobe housewife

A yourger wanan who runs a fam in Nagano sin:Jle-han:iedly (while her husbarxi works in a neamy town) does not anticipate menopausal prcblems; she says that it is a "tough tiJne," rut believes that with the right mental attitude that is, enotional control ani will power, one can 0IIercc:ane the unavoidable Fhysical chan;Jes. Like JOOSt other infonnants, this wanan, should she need assistance, would resort first to patent medicine or hertlal medicine bought at a FhannaCY before she would go for a consultation with a medical professional. .

'!he mass media, pcpllar articles by academics, and pcpllar medical literature, which is heavily influenced by Western medical views on menopause (see Okanura 1977), have awarentIy helped to create a stereotype of the sufferin:J menopausal woman. 'Ihis stereotype however, does not mesh with the actual experiences of JOOSt women, rut rather seJ::Ves to reinforce the idea in the mirrls of the Japanese p.lblic that the ananalous modern housewife who has tiJne on her hams does not have the ability to en:lure adversity as did her own "good ani wise" m:>ther. In one of her representations the menopausal housewife becanes, instead, a key actor in the current cultural debate, in which she is characterized as a materially oriented, leisured, weak, ani selfish character who is the epitcane of what sane pecple believe is wron::J with modern Japan. She embodies the results of slack Fhysical discipline ani represents what is fearful about Western values, especially extreme individualism. An alternative representation, equally cla!nninJ, has her portrayed as neurotic ani "Oller-socialized," the "good wife ani wise m:>ther" to excess, Oller-protective ani stiflin:J, unable to adapt to modern tiloos.

'!he attenpt. to medicalize menopause seems, on the part of the medical profession, to be a response to two principal factors: first, an influence fran American ani European professional literature in which menopause is portrayed as either a deficiency disease or a syrDrare, ani second, a reduction in gynecological business in Japan. Japanese gynecologists in -9-

private practice are usually also practicin;r obstetricians. 'lhey obtain IrOSt of their income fran three sources: obstetrics, abortions, and prescribin;r medication. 'IWo of these sources have declined recently: Japanese wanen TKM usually opt to have their babies in large hospitals with full technolcX]ical backin;r, and birth control is lOOre widely practiced through the use of contraception than by means of abortion, as was formerly the case (Coleman 1983). '!here is therefore considerable incentive for gynecologists in private practice to create new sources of income, and innovations are the pronotion of menopausal syndrane as an "official" disease, and camselin;r for distressed wanen. So far the Sllocess of the gynecologists is not overwhe1Inin1 since out of the sanple of 1,323 wanen only 11 percent had consulted a gynecologist in connection with menopausal problems (Lock 198Gb) •

Conclusions

'!he majority of housewives today pursue their lives in relative canfort and happiness, but a few suffer considerable distress. '!he plight of these few is packaged and broadcast arounj as a kind of ~lic warnin;J of the perils that are in store for Japan if traditional values cnnnble further. A hedonistic ent>race of individualism, loss of discipline, and the family with no core seem to be images which generate particular concern, and the "selfish housewife" has oane to be a symbolic representation of this concern. Medicalization of manopause draws upon and contributes to a reinforcement of the rtletoric. '!here is, hl:Mever, no neat fit between medicalization and the actual experience of menopause, or the explanations given for ''menopausal syndrane" by the mass media, by the majority of medical practitioners, or by the wanen themselves.

'!he cultural construction of menopause is a CCJlllaratiVely haFtlazard affair: refractions created fran snippets of idealized Japanese histoJ:y and the role and behavior of wanen in that histoJ:y, fran medical mythology created initially in the West, and fran current concerns over the future direction of Japanese society and econany and in particular its international image. Paradoxically, virtually none of this rhetoric is grounded in the biological transfonnations which take place in connection with mid-life and the natural process of agin:J, and it touches the lives of only a few Japanese wanen directly.

with some notable exceptions (Aoki 1982), very few Japanese wanen question their second-class citizenship. It may well be in part because there does not appear to be anything very invitin;r about participatin;r in the work routines and schedules that middle-class Japanese men errlure. It is surely also in part because of the efficiency with which the female body is still "disciplined" to accept its assigned place in Japanese society. '!here are, nevertheless, some signs of unrest. '!he divorce rate of middle-aged, middle­ class wanen is soarin;r (Madoka 1982), for exaIl'ple, and there is a small but active feminist lroVE!l'l'el1t (Buckley and Mackie 1986). It remains to be seen in the risin;r tide of conservatism in Japan, with its call for the "Japanese­ style welfare state" in which there will be a retum to traditional values including the full care by wanen of the }'CllIn3", the sick, and the elderly in the family, whether young Japanese wanen can or wish to l'OClbilize themselves for lOOre radical c:han;Je in the near future. Should a large scale c:han;Je in the traditional ideal role of dcm3Sticity for Japanese wanen eventually take place, it will be instructive to observe heM this is reflected in the rhetoric -10-

associated with the professional housewife, who would de facto became obsolete, but pertJaps not redumant, in the Cll'¥1OID;J cultural debate. -11-

Notes

1. In a questionnaire survey that I carried out in 1984 of 1,323 Japanese wanen 90 percent reported that they were reasonably or very happy with their present life.

2. nus information was obtained from 15 gynecologists, 15 general practitioners, anI 6 practitioners of traditional medicine whom I interviewe::l. in 1983-84, anI from popular literature anI articles written by medical paractitioners. -12-

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