Notes on Trends and Problems of Psychotherapy in Japan
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Psychologia. 1958. 1. 231-236. NOTES ON TRENDS AND PROBLEMS OF PSYCHOTHERAPY IN JAPAN T ADASHI TSUSHIMA Kyoto Prefectural Saikyo University INTRODUCTION As it was so in the West, there have been various kinds of pre-scientific ideas and techniques of psychotherapy in Japan since several hundred years ago. Some of the famous books written by Japanese old scholars and wise men such as Yojokun-" The dis ciplines for good health" by Ekiken Kaibara (1630-1714) who had a very rich back ground in Chinese philosophy and literature, and Yasenkanwa-" Free talking on a night boat" by Hakuin (1685-1786), a Zen-Buddhist monk who suffered from a kind of serious neurosis are considered to have very fruitful scientific implications even from the viewpoint of the contemporary psychosomatic medicine (3). These kinds of psychothera peutic or mental hygienic ideas are deeply rooted in Buddhism, Yoga, Chinese philo sophies, Bushido-training and some Japanese religions centered around Shinto-a kind of national religion in Japan before World War n. However, we may say that considerable scientific interest in psychotherapy started after Japan had been baptisized by the western medical and psychological sciences about half a century ago. In the present-day Japan, one might find there almost any schools or orientations of psychotherapy in the West. But generally speaking, most of them have not well matured yet because of the lack of training system and agencies as well as research works in this field. It may be legitimately said that the interest in counseling and psychotherapy both in the academic and civil worlds has greatly developed after World War n under the influence of the West, especially the United States of America. In fact, the U. S. Occupation educational policy was an impetus of the deep influence of the American academic trends upon our psychological field. Also the development of psychotherapy in Japan in the last decade could not be considered separately from the improvement of democracy and awareness of individuality in this country. Before World War n, roughly speaking, psychotherapy was not seriously taken into the acade mic fields of psychiatry and psychology mainly because of the strong influence of the German school in psychiatry and the social situat:o:lS. Most of the psychiatrists used to be engaged in psychopathology and neurology being interested in treating the severer mental disorders and they exclusively used drugs and shocks. On the other hand, only a small number of psychologists had been interested in clinical treatment of the emotion ally disturbed because of the academic trends which put too much emphasis on ex perimental psychology on perception and sensation, and the lack of job opportunities and the concerned agencies in clinical area. Now, there are some 2100 members in the Japanese Association of Psy~hiatry and Neurology, and only about two percent of them se::m to have serious interest in psycho therapy. Also, there are some 1600 members in the Japanese Psychological Association, and about half of them are ei ther teaching edllca tional or clinical psychology or engaged in 23 1 TSUSHIMA clinical practice,* so more than several hundreds of the Japanese may have, more or less~ honest academic interests in psychotherapy. We have had more than one hundred translations of American and European books of various schools in psychotherapy, but most of them were published after World War ll. We have also had some Japanese original books and papers on psychotherapy before and after the War, and among them, the most extensive and representative one may be that written by Tsunero lmura, professor of psychiatry at Nihon University, formerly the head of the Department of Psychology at the National Institute of Mental Health (3). In that book, one may get a fairly good view of the picture on psycho therapy till 1952 when it was published. It consisted of nine chapters: Chapter I-What is psychotherapy? Chapter II-Psychotherapeutic situation, Chapter Ill-Diagnosis, Chapter IV-Support, Chapter V-Expression, Chapter VI-Insight, Chapter Vll Training, Chapter VIII-Flexibility of psychotherapy, Chapter IX-Theories of psycho therapy. In the following sections, the writer draws a brief survey of the main trends and some problems in psychotherapy in Japan. MAIN TRENDS OF PSYCHOTHERAPY Though there mar be many ways to present notes on this topic, the writer will try it according to the following classification. A. Psychotherapy with adults I. Individual approaches lI. Group approaches B. Psycho:herapy with children I. Individual approaches lI. Group approaches A. Psychotherapy with adults I. Individual approaches. Among the individual approaches with adults, (a) Morita therapy, (b) Nondirective approach, and (c) Psychoanalytic approach are presented in the other papers of this issue, so the writer omits the explanations about these three approaches although he gives some comments about them in later section. Several other individual psychotherapeutic approaches should be noted here. (b) Hypnotherapy; Though various kinds of hypnotherapy have been found in many old books in one way or the other, the first academic one was published in 1906 by the late T. Fukurai, a psychologist. This was written as his dissertation for the doc toral degree (doctor of letters, or Litt.D.). Then late U. Nakamura published a well rounded book on this topic in 19 I 2. The next important publication in this field was done by late K. Nakamura, a psychiatrist and psychological writer, in 1938. It is interesting that though he mentioned in his book "Education is gradual hypnosis whereas hypnosis is quick education," he changed this opinion greatly a few years later, and wrote, "The therapeu tic effects are rather superficial and the applicable fields of hypnosis are very limited," and he came to take a viewpoint of Morita therapy largely. The newest academic book in this field is that written by T. Takeyama Hypnosis and suggestive therapy, which was published in 1950. It may be said that hypnosis or hynotherapy is not seriously considered both in * Forty-five prefectures (states) have more than one child guidance clinics each, about 30 universities or colleges have psychological clinics, and there are several public and private clinics for mental hygiene. Also. several universities have student counseling bureau which serve for therapeutic cOunaeIingwitb students. PSYCHOTHERAPY IN JAPAN medical and psychological fields at the present time in Japan, but the writer believes that we should have further explorations on it in terms of its applicability and therapeutic limitations especially in medical practices as well as in relation to secular folk religions which are prevailing here now. (d) Depthpsychological approaches: As psychoanalytic therapy is presented by K. Kake ta, the writer is to make a survey on the other kinds of depthpsychological approaches than that one, namely, the existential analysis etc. The existential analytic therapy: The academic interest in this approach started largely after World War n. The translations of three main books such as V.E. FlankIe's have been published in the last several years. Masashi Masaki, professor in educational psychology at Kyoto University, is one of the main figures who introduced nondirective approach and depthpsychological approaches into Japan (See Tomoda's paper in this issue). Though there seem to be some deep theoretical thoughts on psychotherapy in our -country, he may be one of the most distinguished scholars who could develop theoretical and philosophical elucidation on-the basis of psychotherapy and its relationship with human .education. But, in short, it could be said that this approach has not yet given broader influence than the psychoanalytic one has done in the fields of psychiatry and psychology in our country. Ernst Kretchmer's main books have been translated into Japanese by the several psychiatrists and psychologists such as M. Masaki, and they have given considerable influence, too. Besides these depthpsychological approaches, there have been some endeavors to find .new ways in psychotherapy in the oriental thoughts on depth of human mind. Ryo Kuroda published two volumes of books entitled, Studies on "Kan"-a sort of intuition, in 1923 and 1 9 28, in which he tried to clarify the quality of " Kan " in the light of the depth psycho logical thoughts both in the East and West. Tempu Nakamura, now a eighty-four years <lId man, has been trying to integrate Yoga training with contemporary medical sciences and there seems to have been considerable number of successful cases of psychosomatic patients. Koji Sato has been trying to make use of Zen implications of psychotherapy as readers find it in this issue. The writer thinks that there may be very good possibilities for establishing a kind of depth psychological therapy based on the oriental thoughts, especial ly the knowledge of human being in Buddhism. (e) Learning approa~h to counseling and psychotherapy: The interest in this approach sezms to have been, paradoxical enough, very weak in Japan. This may be mainly due to the fact that during the War we did not have enough integration of academic psycho logists for the practical purposes as it was done in the States. Only a few psychologists .seem to have earnest interest in it at present. Tadahiko Oguchi, Ochanomizu Uni versity, suggested the possibility of this approach in 1952 in his An introduction to learning psychology, which is one of the most stimulating books in psychology in our country. Morio Saji at the National Institute of Mental Hygiene and Hiroshi Azuma at Tokyo Uni versity have shown their concerns on this approach in some publications (I). Yoshinori Matsuyama, Doshisha University, showed a keen interest in it in his book, entitled Ab normal behayiors (5). The writer also has deep interest in this approach through the direct influence of O.H.