A Disorder of Ki: Alternative Treatments for Neurasthenia In

A DISORDER OF KI ALTERNATIVE TREATMENTS FOR NEURASTHENIA IN JAPAN, 1890-1945 Yu-Chuan Wu University College London PhD 1 I, bk~ Wu , confirm that the work presented in this thesis is my own. Where information has been derived from other sources, I confirm that this has been indicated in the thesis. 2 Abstract This thesis studies some of the most popular alternative treatments for neurasthenia in Japan in the period of 1890 to 1945, including breathing exercise, quiet-sitting, hypnotism-derived mental therapy and Morita therapy. Neurasthenia, with its supposed relation to modern civilization, was a widely used and preferred disease label in Japan. As the official Western medicine failed to provide satisfactory solutions to this obstinate and debilitating disease, a variety of alternative treatments were invented or reinvented and some of them became very popular. Concerning the popularity and effectiveness of these treatments, this thesis argues that they provided contemporary Japanese, who had been experiencing rapid and dramatic change to lifestyle, culture and society, with models by which they could perceive, conceive and strengthen their neurological, circulatory and psychological systems by their analogy to ki. Known as a nervous disorder, neurasthenia was also perceived and understood as a disorder of ki, with insufficiency, stagnation, obstruction and turbulence still thought to be the major faults. Through undergoing and practicing these treatments, Japanese neurasthenic patients could control and invigorate the flow of nervous currents, blood and ideas as they previously cultivated ki. This thesis also investigates these treatments in the context of Japanese nationalism. Their advocates often claimed that they were embedded in traditional Japanese culture and hence particularly effective for Japanese patients. Returning to traditional lifestyle and culture was regarded by them as a cure for neurasthenia, which they thought was a disease of ‘de-Japanization’. Furthermore, they founded a large number of groups and organizations for the practice and promotion of these treatments, which were in many ways like traditional extended families and provided patients with a much-needed sense of security and belonging. These treatments were endowed with social and cultural significance, which was also crucial to their therapeutic effectiveness for neurasthenia. 3 Contents Introduction The Effectiveness of Psychotherapy 7 Neurasthenia: A Nervous Disorder 10 Neurasthenia: A Psychological Disorder 20 Neurasthenia in Japan 26 1. The Abdominal Heart Neurasthenia and its Recovery 38 Neurasthenia: a Disease of Top-heaviness 46 Modern Lifestyle: A Lifestyle of Top-heaviness 56 Abdominal Heart: Futaki’s ‘Abdominal Breathing’ 65 Fujita’s ‘Belly-centred Medicine’ and Okadaian Quiet-Sitting 74 ‘Modernization’ of Breathing exercise and Quiet-sitting 83 2. A Civilization of the Belly Two Different Kinds of Bodies 86 Breathing Exercise, Ki and Yōjō Medicine 88 Modern Forms of Ki 93 Nostalgia, De-Japanization and the ‘Japanese’ Belly 101 ‘Teacher!’ 114 Modern Forms of Breathing Exercise 120 ‘Modern’ or ‘Traditional’? 125 3. Mental Therapy Mental Therapy and Mental Therapists 128 Hypnotism in Japan: 1880 – 1913 133 No Idea, No Thought, No Self and No Mind 140 Neurasthenia: the Stagnant flow of Ideas and Obsessions 150 Body and Mind: the Flow of Ki and the Flow of Attention 158 College, Family and Nation 171 Body, Mind and Spirit 183 4 4. Morita Therapy Morita Therapy: A Modern Form of Psychotherapy? 187 What is Morita Therapy? 191 Shinkeishitsu 198 Renunciation of the Ego 205 The Flow of the Mind and Attention 211 A Family of Shinkeishitsu 221 A Nation of Shinkeishitsu 233 Epilogue Is the Ki still Flowing? 244 Bibliography References to works in Japanese 249 References to works in English 292 5 A note on translations: All translations, including book titles, from the Japanese are by the author, except where otherwise indicated. 6 Introduction The Effectiveness of Psychotherapy What underlies the effectiveness of psychotherapy? This question lies at the foundation of clinical psychology. Although the psychotherapeutic profession insists that modern psychotherapy is soundly based on psychological knowledge, it has often been the case that the development of a form of psychotherapy comes well before that of the theory upon which it is allegedly based. From hypnotism and moral persuasion to catharsis and free association, the effectiveness or ineffectiveness of treatments has been the key subject of speculation and research for psychiatrists and clinical psychologists. The efforts made to solve the puzzle have resulted in a host of theories about the mind and its disorders, which not only constitute the theoretical basis of this discipline but also profoundly influence how people understand themselves. However, the effectiveness of psychotherapy has been precarious and elusive. Often, a form of therapy effective in a particular historical, social and cultural context loses its healing effect when carried out in other environments. Even in a particular time and place, the effectiveness can vary widely among individual clients who come from various walks of life and have different life stories. In the history of psychological medicine, there have been several forms of psychotherapy, such as hypnotism, whose acknowledged efficacy varied across era, society and culture and whose popularity rose and fell again and again. To explain the effectiveness, psychiatrists and psychologists continually invent new psychological or somatic theories, which are sometimes consistent with, sometimes parallel to, or, not infrequently, completely contradictory to one another. Nonetheless, they form the theoretical foundation of modern psychotherapeutics. Psychiatrists, psychologists and psychotherapists seem to have agreed on the varying effectiveness of psychotherapy and the diversity and inconsistency of its theories. An eclectic approach seems inevitable for a discipline and profession that has been built upon something as precarious as the effectiveness of psychotherapy; the technology and knowledge of psychological medicine have hence often been subjected to doubt and criticism, 7 as well as modification. But the contingency and elusiveness of the effectiveness of psychotherapy should not be surprising, since psychotherapy is meant to treat mental diseases, particularly non-psychotic mental diseases, that have been equally, if not more, changeable and elusive. Take a look at the diseases that gave rise to the birth of modern psychotherapy in the late nineteenth and early twentieth centuries. Modern psychotherapy came into being to treat diseases from hysteria and neurasthenia to fugue and multiple personality, and their supposed underlying psychopathological mechanisms were assumed to be the targets of psychotherapy. These diseases, once prevalent in particular places and with particular people, have all but vanished into history and are rarely seen by today’s psychiatrists and psychotherapists. Only the various forms of psychotherapy originally invented to treat them continue to exist and develop to deal with new mental diseases that have taken their place. The objects of psychotherapy have changed remarkably over time, so it is understandable that there is no sound or durable explanation of its efficacy in the past or today Perhaps the effectiveness of psychotherapy needs to be explored from a different perspective, just as those diseases that once were its primary objects do. Although no longer a concern for today’s psychiatrists and psychotherapists, these diseases, central to the foundation of modern psychiatry and clinical psychology, have become interesting to historians of psychiatry and psychology. With hindsight, historians are able to focus their study on the historical nature of these elusive diseases, as well as that of the various theories invented to explain them. By investigating these diseases and theories in a wider context, historical studies have made it clear that not only did contemporary intellectual, social, cultural and political situations, such as intellectual traditions and trends, gender and class issues and ongoing social and political conflicts, greatly influence how doctors, patients and the public viewed, understood and responded to these diseases, but their occurrence, presentation, distribution and disappearance can also be better understood in context than by any somatic, psychological or social causes alone.1 Holding different views on their biological and 1 Ian Hacking, Mad Travelers: Reflections on the Reality of Transient Mental Illnesses (London, 1998); Mark S. Micale, Approaching Hysteria: Disease and its Interpretations (Princeton, N.J., 8 psychological reality, historians explored these diseases as historical realities to see how they evolved in history. They have provided valuable insights into a wide range of questions related to these diseases, including those that had always been the focus of psychiatric and psychological study, such as why they were epidemic and presented with certain symptoms in certain times and places, and why certain genders, classes and groups of people were overrepresented in the patient populations. Whether or not they have biological or psychological basis, the features presented by these diseases are, to a great extent, historical ones and have to be understood in history. A wide range of factors, not just psychological ones, gave rise to, sustained and eventually led to the disappearance

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