MENTAL HEALTH CHALLENGES FACING CONTEMPORARY JAPANESE SOCIETY the “LONELY PEOPLE” by Yuko Kawanishi

2831_FM.qxp 6/4/09 1:26 PM Page i

1 2 3 MENTAL HEALTH CHALLENGES 4 FACING CONTEMPORARY JAPANESE SOCIETY 5 THE “LONELY PEOPLE” 6 7 8 9 1 1 2 3 4 5 6 7 8 9 2 1 2 3 4 5 6 7 8 9 3 1 2 3 4 5 3 3 3 3 4 4 4 2831_FM.qxp 6/4/09 1:26 PM Page ii

6 7 8 9 0 1 2 2831_FM.qxp 6/4/09 1:26 PM Page iii

1 2 3 4 Mental Health Challenges 5 6 Facing Contemporary 7 8 Japanese Society 9 THE “LONELY PEOPLE” 1 1 2 3 4 5 6 by 7 8 Yuko Kawanishi 9 2 1 2 3 4 5 6 7 8 9 3 1 2 3 4 5 3 3 3 3 4 4 4 2831_FM.qxp 6/4/09 1:26 PM Page iv

x MENTAL HEALTH CHALLENGES FACING CONTEMPORARY JAPANESE SOCIETY THE “LONELY PEOPLE” by Yuko Kawanishi

First published 2009 by GLOBAL ORIENTAL LTD PO Box 219 0 Folkestone Kent CT20 2WP UK

www.globaloriental.co.uk

ISBN 978-1-906876-00-5

All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any 0 electronic, mechanical or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without prior permission in writing from the publishers.

British Library Cataloguing in Publication Data A CIP catalogue entry for this book is available from the British Library

6 7 8 9 Set in Garamond 11 on 12.5pt by IDSUK (DataConnection) Ltd 0 Printed and bound in England by Antony Rowe Ltd., Chippenham, Wilts 1 2 2831_FM.qxp 6/5/09 3:11 AM Page v

1 2 3 4 5 Contents 6 7 8 9 1 1 Preface vii 2 Acknowledgements x 3 Introduction xii 4 5 1 The “National Character” 1 6 I The National Psyche, Revisited 1 7 I Defining Deviance 6 8 I The Same, But Not the Same 7 9 I Habits of the Heart 14 2 I Different Times and Different Evaluations. 1 Confrontation and Denial? 16 2 3 2 Mental Health at Work 24 4 I What Are the Signs? 24 5 I The Way Japan Was 26 6 I Changes Happening Now 29 7 I Suicide and the Japanese 33 8 I The Men Who Cannot Say “No” 36 9 I Karoshi: Still a Form of Suicide 38 3 I Factors Specific to the Japanese Workplace 44 1 I Factors Specific to Japanese Society 47 2 I Factors Specific to Japanese Psychology 51 3 I Japan’s Response as a Society 55 4 5 3 The Japanese Family Today 61 3 I Skeletons Out in the Open? 61 3 I The Japanese Family and Its Cultural Traditions 65 3 I The Contemporary Family: An Efficient 3 Arrangement for Great Economic Growth 68 4 4 v 4 2831_FM.qxp 6/4/09 1:26 PM Page vi

Contents x I Unteaching the Ie System 73 I The Matriarchal Tradition 75 I Costs and Consequences: Too Much Love Can Kill You 77 I Mystery Dads: Strangers at Home 81 I What Do Sexless Marriages Tell Us About Men and Women in Japan? 82 I Why Not Divorce? 88 0 I Is Japanese Marriage at a Crossroads? 92

4 Youth 98 I Disturbing Signs 100 I The Over-afﬂuent Society 104 I School Environment 106 I Home Environment 107 I School Refusal: Psychologically-based Absenteeism 110 I Domestic Violence: A Japanese Case 113 I Hikikomori: The Hermit Children of Japan 115 0 I Parasite Singles. Who Are They? 123 I Social Structural Changes Japan Is Going Through. What Do They Mean to the Next Generation? 128

5 Japan’s “Lonely People” 137 I Have We Reached a Tipping Point? 140 I Approaching Mental Health from a Professional Perspective 146 I Stigma and Shame: Barriers to Better Treatment 152 I What Individuals Need to Do 157

0 Bibliography 162 Index 170

6 7 8 9 0 1 2 vi 2831_FM.qxp 6/4/09 1:26 PM Page vii

1 2 3 4 5 Preface 6 7 8 9 1 1 This book sets out to provide an analytical, critical, account of the men- 2 tal health of the Japanese today. It attempts to elucidate what is happen- 3 ing to the Japanese psyche, and the causes. It aims to go into greater 4 depth about the phenomenon than everyday journalistic description has 5 been capable of hitherto. Therefore, I begin by describing the mental 6 health challenges facing contemporary Japanese society, focusing on 7 three areas: work relations, family relations, and Japan’s youth. 8 Secondly, in each chapter, I endeavor to analyze the social, psychologi- 9 cal, and cultural background of the problems existing in these areas, and 2 to see how effectively (or ineffectively) Japan as a society is dealing with 1 them. Thirdly, I offer some suggestions as to what Japan can do to 2 survive and overcome these issues. 3 4 However, this is not to suggest that Japan is the only society with these 5 problems. Non-Japanese readers may feel that similar problems exist in 6 their own countries. It is always easy to trivialize social issues as something 7 unique to a particular country, a tendency we all have at times. My objec- 8 tive here is to deﬁne certain social and psychological problems facing 9 human beings in a society where both traditional and new cultures, ide- 3 ologies, and ways of thinking have had to ﬁnd room for each other in 1 order to coexist in a relatively short time. The sources I have drawn on 2 include existing literature on the issues, newspapers, TV, magazines, gov- 3 ernment publications, and discussions in the classroom with students 4 from all over the world, personal friends from Japan and abroad, particu- 5 larly those who work in the frontline of clinical support, and my own 3 experiences as someone who has lived across cultures for several decades 3 (mainly the United States and Japan). The approach of these inves- 3 tigations is basically eclectic, and is not bound by any one particular 3 theoretical perspective. The analyses are sociological and/or psychological, 4 4 vii 4 2831_FM.qxp 6/4/09 1:26 PM Page viii

Preface x sometimes historical and there are occasions when I borrow some psychiatric viewpoints. Whatever framework considered useful has been applied, and whatever lens that enables us to accurately observe the events has been used.

In social scientific inquiries, analysis of phenomena has often been based on two conflicting perspectives. One attributes causes primarily to social 0 structural factors; the other attributes causes to historical and cultural factors. A social structural explanation implicitly suggests political, economic, institutional, and physical environments that are transferred to a different setting can be expected to produce the same phenomena as that in the original milieu. A cultural explanation emphasizes the irreplaceable, deep-rooted influence of religious beliefs, thoughts, socialization patterns, and members’ innate outlooks on life. The cultural explanation suggests these elements are more instrumental in creating the situation under examination. If one adopts a social structural perspective, critics counter that cultural elements are ignored. If one emphasizes the impor- 0 tance of culture, one is “guilty of cultural determinism.” The fact of the matter, however, is that both perspectives are equally important in comprehending the background of the phenomena. After all, most social institutions are brought about and sustained by cultural conditions, and a newly-constructed social institution can create new cultural beliefs and traditions. Culture and social structure are not mutually exclusive. Instead, they are cyclical in nature, one creating the other, which then returns the compliment. What is important is not to claim one is more powerful than the other, but to keep a sense of balance. Stereotyping instantly earns social scientists a bad name. All social 0 scientists are extremely sensitive to being accused of making stereotypical observations, especially about people of different cultures. However, stereotyping is rarely in itself total falsification, though it is often tainted with various forms of prejudice. The oversimplification and exaggeration of an existing trait should be avoided, but social scientists also should not forget where the central idea originated. Any description of the traits of 6 a certain group is based on an implicit comparison with another group. 7 Just as we learn or say something about ourselves only when we have a 8 chance to examine others, whatever we perceive is intrinsically compara- 9 tive. The question is: what is or who is being compared? 0 Cultural analysts nowadays are caught in a Catch 22 situation: if one 1 2 viii 2831_FM.qxp 6/4/09 1:26 PM Page ix

Preface 1 2 makes a generalization, one is immediately criticized for missing another 3 contrasting theoretical dimension, or resorting to the cultural stereotypes 4 that characterized early Nihonjinron literature. If one avoids that criti- 5 cism, one might be cited for resorting to an essentialist approach. And of 6 course, the more sensitive one is to these charges, the more one ﬁnds it 7 utterly impossible to express any observations. 8 In this book I am not imposing a theoretical framework, nor am I 9 interested in creating a new formula that can explain what is going on 1 in Japan. Social reality is far too complex, multidimensional and illusive 1 to be framed in sets of theories. As a Japanese social psychologist who 2 has lived in two societies, I am simply trying to allow a “native point of 3 view” to emerge by presenting things the way they are, and hope the 4 reader will develop a deeper understanding of what is going on in the 5 Japanese psyche today. 6 As a researcher of mental health, I have always been interested in how 7 people cope with stress and how culture and society play their parts in 8 this process. Tolstoy wrote at the beginning of Anna Karenina, “Happy 9 families are all alike; every unhappy family is unhappy in its own way.” 2 If I may borrow this expression, may I say “Happy societies are more or 1 less alike, but unhappy societies are unhappy in their own unique ways 2 because their responses to unhappiness are conditioned by their culture, 3 history, and social structures”? 4 5 Yuko Kawanishi 6 New York 7 March 2009 8 9 3 1 2 3 4 5 3 3 3 3 4 4 ix 4 2831_FM.qxp 6/4/09 1:26 PM Page x

Acknowledgments 0

In this increasingly globalized world, being bicultural or multicultural may be considered to be a great advantage. But there is a price. While you may be competent in both cultures, deep down you no longer feel completely at peace in either culture. When one of the cultures you cherish is misunderstood or criticized, you feel an urge to correct mis- understandings, but this effort may be deemed defensive at times if you try too hard. Even when good explanations are given from an objective standpoint, you also feel a little frustrated unless the true insider’s view- 0 point is included. A growing number of people today who feel liberated from one society’s constraints because of their cosmopolitan background may also develop a feeling of not solidly belonging to one place, but rather being stuck between different cultures, and end up not thoroughly knowing any culture. Rigorous intellectual inquiries can sometimes resolve such an ambiguous position. I have been one of the fortunate few to have had the chance to face and to be required to articulate various views about Japanese society. In this regard I am indebted to hundreds of students from all over the world who have come to Japan to study at Tokyo Gakugei University. 0 Although I was in the position of “teaching” them, I learned so much from them as well through our discussions in and outside the classroom. A number of scholars and journalists from abroad, some of whom have become close friends since the mid-1990s, have also helped me shape and elaborate my views on Japan both as an outsider and an insider. I am extremely grateful to Mr. Paul Norbury, publisher at Global 6 Oriental, who has found this book worth making available to interna- 7 tional readers and observers of Japan. My sincere gratitude also goes to the 8 staff at Global Oriental, including Mr. David Blakeley, who helped edit 9 the book into its ﬁnal shape. 0 Help from James Hardy, my wonderful editor, proofreader, and 1 2 x 2831_FM.qxp 6/4/09 1:26 PM Page xi

Acknowledgments 1 2 English teacher, was priceless. I do not know how much I learned from 3 his corrections and style, but I wish to remember all he taught me. 4 Walter Hatch, a very good friend for many years, helped me formulate 5 the structure for this book and has constantly encouraged me. 6 Writing a book is a solitary task, but I knew I had friends I could turn 7 to. John Clammer has given me great moral support and has been a good 8 advisor over many years, including the times when I became discouraged 9 with the publishing process. John McNeil’s great guidance and Per Jögi’s 1 immense support often cheered me up and gave me strength to continue. 1 And lastly, without the precious friendship of Mari Shiobara, 2 Masahiro Togo, and Azusa Naito, all of whom are bicultural, I would 3 not have been able to develop many ideas in this book. Our endless con- 4 versations and discussions about work, family, human relationships, and 5 life in Japan have been a great source of inspiration that enabled me to 6 complete this book. 7 8 9 2 1 2 3 4 5 6 7 8 9 3 1 2 3 4 5 3 3 3 3 4 4 xi 4 2831_FM.qxp 6/4/09 1:26 PM Page xii

Introduction 0

Over the years, I have been asked both personally and professionally by people from North America and Europe to explain various contemporary social phenomena in Japan, as well as Japanese patterns of behavior and psychological characteristics, which are sometimes difficult for foreigners to comprehend. Whenever we encounter an alien culture, we are bound to ask one of the most fundamental questions in social science: “Why do the people of this culture behave the way they do?” As the faculty member of an international program at a university in Tokyo, I 0 teach students who come to Japan from the United States, Europe, Asia, Latin America, Russia, and other former Soviet states, and am faced every day with genuine interest and intellectual curiosity concerning these issues. Soon after arriving in Japan, it is not unusual for these students to become intrigued with “what the Japanese are really like” – behind the apparently gentle and polite surface shown to strangers and visitors from abroad. Furthermore, a number of pathological traits reportedly exhibited by some Japanese today are puzzling to them, to say the least, and sometimes totally incomprehensible. Whether they have come to Japan for aca- 0 demic or professional reasons, many ‘new arrivals’ are impressed – despite the language barrier – by how smoothly things run. In general, Japanese people seem friendly and courteous, often much more so than their countrymen back home. Things are clean and rules are generally respected. In fact, not a few visitors from abroad fall in love with Japan at first glance, and feel it is a place where East and West meet in a congenial manner. 6 Some foreign visitors become fascinated by Japanese traditional cul- 7 ture after experiencing Japan at an “introductory level.” At the same 8 time, both Westerners and Asians develop the impression that on the 9 surface, Japan is quite Westernized, especially at the level of everyday 0 practicalities. After all, Japan is the first and only country outside the 1 2 xii 2831_FM.qxp 6/4/09 1:26 PM Page xiii

Introduction 1 2 Western cultural sphere to establish itself as a major industrialized 3 nation. One naturally expects that most social institutional norms and 4 rules in Japan will show strong similarities to those in highly industrial- 5 ized Western nations. 6 7 Consciously or not, some of these observers may believe that any highly 8 industrialized nation that takes on Western technology and its ways of 9 thinking will eventually look and act the same too. This perspective is in 1 line with the so-called convergence theory, which claims that all indus- 1 trial societies end up sharing similar structures and values based on the 2 assumption that “the logic of industrialism entails a common batch of 3 functional imperatives.” (p.18)1,2 Foreigners living in Japan may come 4 across objects from Japan’s history and witness culturally unique behav- 5 iors and manners in the native population, despite its members’ Western 6 appearance and lifestyles. At the same time, they will also recognize 7 post-industrial trends common in many highly developed Western 8 nations. It is clear that the developmental stages Japan is following are 9 those already trodden by Western nations. One obvious example is pop- 2 ulation aging coupled with the start of population decline. Nothing is 1 more fundamental or has more significant ramifications for society than 2 changes to population size and structure. Its impact on the direction 3 Japan will take has become increasingly evident in recent years. 4 After passing an “introductory level” of experiencing Japan, some 5 “intermediate level” students may begin to recognize a number of chal- 6 lenges that Japan faces. Again, just as in many Western societies, ties that 7 previously created a strong social bonding system, such as family, kin- 8 ship, workplace, community, and religious groups, are all rapidly losing 9 their roles as the basis for society’s social integration, and as a protective 3 network in times of personal crisis. A sense of commitment to these tra- 1 ditional institutions, particularly family, kinship, and workplace, was 2 once regarded as the bedrock of Japan’s great economic success. Today, 3 these institutions are of less significance to people. Instead of placing 4 importance on the group goal, people appear to act more in pursuit of 5 their own interests, and are becoming more individualistic. The idea of 3 marriage based on mutual responsibility and family obligation is seen 3 as outdated. Now the main purpose of nuptials is the personal pursuit 3 of happiness. The current young generation is growing up in an era of 3 affluence not experienced by their parents. As a result, they are often 4 4 xiii 4 2831_FM.qxp 6/4/09 1:26 PM Page xiv

Introduction x criticized for lacking discipline by the older generations who survived World War II and the post-war deprivation. Again, this phenomenon is not exclusive to Japan, and can be observed in many highly industrial societies. Particularly during the last ten years, it has become increasingly evident that younger Japanese are rejecting the old system based on corporate values and ethics, and are creating a lifestyle with a totally different emphasis. This has drawn a frosty response from older 0 Japanese, who consider their new lifestyle a potential threat to the future of the country. As time goes by, students of Japan will feel they have further deep- ened their understanding of the country’s culture and people. They will start to gain conﬁdence in their ability to live or work there on a more intimate level. But with this conﬁdence, often comes a frustration at things they do not understand about Japanese modes of thinking and behavior. They begin to realize that in spite of similarities with Western post-industrial societies on the institutional surface, the inner opera- tional mechanism of these institutions and the psychological structure 0 of individual Japanese can be quite different from what they initially imagined. Japan may begin to look like a country of many mysteries, just as it was to the Westerners who arrived after the Meiji Restoration. The people who they thought were the citizens of a very Western, industrialized society may turn out to be not so Western after all. While basic human emotions and distress must be universal, students of Japan realize that the way different problems are responded to, handled, and coped with can depend on the culture. This kind of culture shock tends not to impact immediately after arrival, but rather later in the newcomer’s association with Japan and can 0 result in several possible states of mind. Some may see it as a challenge and try harder to better understand Japan, learning the language, reading books and making more Japanese friends. Out of the frustration of not being able to understand, others choose to reevaluate their view of Japan, and end up dismissing the country as “inscrutable after all.” The mature and sensible way to overcome this cultural puzzlement would be 6 not to jump to generalizations or turn to stereotyping, but to acknowl- 7 edge the variations and diversity of individuals. Just like any country 8 in the world, there are all kinds of people in Japan. Many Western resi- 9 dents – as well as anyone from abroad who has a long-time association 0 with Japan – confess to having experienced yo-yoing between a love-hate 1 2 xiv 2831_FM.qxp 6/4/09 1:26 PM Page xv

Introduction 1 2 relationship with the country they have chosen to stay in or remain 3 deeply connected with. Although the extremity of the feeling depends on 4 the individual, Japan is like a sea with a Western surface but hiding a 5 mysterious and to the student – foreign – abyss. 6 7 The views of professional Japan-watchers toward Japanese society and 8 their analytical tone also have shown pendulum-like swings over the 9 past few decades. During and immediately after World War II, the dom- 1 inant image of Japan was, unsurprisingly, negative. Through the 1950s, 1 Japan was seen not only as a former aggressor to its neighbors but also 2 as a country completely defeated. According to Ruth Benedict’s classic 3 analysis, Japanese people were filled with contradictory qualities that 4 were fundamentally alien to Westerners. Based on the psychoanalytic 5 perspective and Western model of human development, the Japanese 6 were a peculiar nationality brought up in a peculiar way.3 In the eyes of 7 many Westerners of this era, Japan was a backward country with a child- 8 ish and immature people. At a time when the nation was mourning the 9 loss of the war and living in penitence, Japanese scholars also held crit- 2 ical, if not always negative, views of the mentality of their own people.4 1 But as soon as Japan appeared to have recovered from the devastation of 2 the war and began to show rapid economic growth, the world started to 3 pay renewed, special attention to a country that seemed to be on the 4 road to true modernization. Seen as the most promising country to be 5 successfully Westernized and democratized, at the same time, however, 6 a number of studies were published that attempted to describe the 7 uniqueness of Japanese culture, psychology, and interpersonal relations 8 (such as Doi’s amae as a central psychic element of the Japanese, or 9 Nakane’s vertical society thesis). This development reflected regained 3 confidence in Japanese culture both by the Japanese themselves and 1 Western writers.5, 6 2 3 Furthermore, Japan’s miraculous economic growth in the 1960s produced 4 a clamor of “learn-from-Japan” voices in the 1970s which culminated in 5 Vogel’s Japan as Number One.7 Unbelievable as it sounded to Japanese at 3 the time, the book’s title certainly boosted their pride, and admiration 3 for the Japanese economic model, corporate management style, and 3 other social institutions continued up to the mid-1980s. Japan’s national 3 ego peaked in the heyday of the late-1980s bubble economy, but as it did, 4 4 xv 4 2831_FM.qxp 6/4/09 1:26 PM Page xvi

Introduction x critical and negative views toward Japan returned. These were spear- headed by revisionists who claimed Japanese capitalism was fundamentally different to the Western model, and the Japanese society Westerners had believed was a protégé with regard to social development was in fact alien from the root up.8 The revisionists suggested that strategies were needed to contain Japanese influence internationally by forcing Japan to change its social system to fit the “global standard.” Without reform, 0 Japan would be a threat to the international community. The size of the economic and financial boom in Japan at the time allowed Japanese com- mentators to dismiss this criticism as “Japan bashing,” and attitudes to other countries to harden. As a result, it was only with the final burst of the bubble in the early- 1990s that Japan’s positive self-image finally disintegrated. The media converged, as they often do, on the story of a once confident nation slip- ping into terminal decline. Japanese society was portrayed as suffering from what seemed, at the beginning, to be a temporary, conquerable recession. It turned out to be a slough of despond, from which the coun- 0 try struggled to escape for more than a decade. The prosperity that seemed everlasting was gone, shattering the glorious image of a successful society, in more than one sense. There was no more proud “Japanese model” to follow or learn from. Within a couple of decades, the image of Japan had been transformed from one of unquenchable admiration to one of deep pessimism at its ability to recover. What were once regarded as unique characteristics that were the basis for economic success (such as loyalty to the group, consensus-based decision-making, and other management styles loaded with Japanese cultural values) were now seen as the very reasons for stagnation, preventing Japan from recovering from 0 the long recession and becoming more internationally competitive.

However, while interest in Japan’s economic power has waned, Japanese culture, particularly pop culture, has drawn dramatic international attention. Manga, anime, gaming, and other creative arts have taken a new role in boosting national pride and identity in the global market. 6 Today, Japanese youth fashion and lifestyles are not only the subject of 7 keen interest among businesses, but also of serious investigation by cul- 8 tural anthropologists and social scientists.9 A new generation of 9 Japanophiles is attracted to the image of “cool Japan.”10, 11 Japan’s 0 unique fashion, design, pop music, and youth culture attract foreigners, 1 2 xvi 2831_FM.qxp 6/4/09 1:26 PM Page xvii

Introduction 1 2 who ﬁnd them unconventional and edgily cool when compared with 3 their equivalents in the West. Many international students in Japan are 4 inspired to come here by exposure to or interest in at least one facet of 5 Japanese pop culture, which leads to a desire to deepen their interest in, 6 and knowledge of, the nation that spawned it. 7 Perspectives in social sciences when examining a society often go 8 through fads, alternately looking at the society through the lens of the 9 current age, political situation, its status in the international power 1 structure, and other factors. The study of Japan is no exception. When 1 it was rising as an economic power, the main focus of investigations 2 into Japan was through the lens of economic interest. There has always 3 been interest in Japanese traditional culture, but in the post-war 4 era, Japan was seen mostly as a country of major economic accom- 5 plishments and Japanese society as a successful case study of industrial 6 development. 7 Whenever a society is studied, naïve observers tend to look at it as a 8 monolithic entity. As their knowledge and experience deepens, their 9 analysis becomes more sophisticated and reﬁned. They look at the soci- 2 ety as a larger organism containing various sub-groups within its culture. 1 And it is between corresponding cultural groups in different countries, 2 rather than between whole countries, that any serious comparisons 3 should be made. Japan is, after all, like any other country in the world, 4 divided by various social criteria: class, education, gender, geography, and 5 others. This path has been followed by an increasing number of serious 6 Japan scholars, who have been investigating different dimensions of its 7 society over decades, shedding light on areas previously unseen – a devel- 8 opment that clearly indicates a maturing of Japan studies. 9 Where scholars have trod, journalists have followed. Especially since 3 the burst of the bubble economy, the focus has been on social incidents 1 and phenomena that cast a negative light on Japan. This has gradually 2 changed the overwhelmingly simplistic image of Japan as a post-war 3 success story and offered alternatives to the image of a hard-working 4 people unanimously devoted to their company. This shift in the tone 5 of coverage is welcome in the sense that it provides a more balanced 3 picture of the country. Contrary to the popular image that even the 3 Japanese clung to, Japan has never been a total success story. Even 3 “Japanese-style management” that typically comprises lifetime employ- 3 ment, a seniority-based wage system, and the philosophy of company as 4 4 xvii 4 2831_FM.qxp 6/4/09 1:26 PM Page xviii

Introduction x family, in fact benefited less than half the entire workforce during the rapid growth period.12 The darker aspects of society, such as unstable employment, layoffs, the underclass economy, and discrimination of all kinds, which afflict all societies but were previously ignored in journalistic discussions of Japan, have come to the fore. Spurred on by the 1995 Great Hanshin earthquake and the Aum Shinrikyo cult’s 1995 sarin gas attacks on the Tokyo subway, the media 0 have reported the impact of the recession, increasing homelessness, rising crime rate, suicide, educational problems, and changes to youth culture and values that reject the very foundation of the country’s post-war success. These social changes also have led foreign media to examine various phenomena in Japan that were previously ignored. Reports on people suffering in the shadows of a failing society have begun to appear frequently in the press. However, the innate limitation of journalism is that it can only give a brief account of incidents and provide explanations with limited depth, if not entirely superficially. A proper investigation into questions such as why and how cannot be carried out given 0 the limited space and time in which journalism itself is defined. There also is a danger in that far from enlightening, coverage and episodic treatment of the darker and more unusual events and aspects of Japanese society will only help reinforce an image of Japan as a troubling and still incomprehensible country.

Particularly mysterious to many observers from abroad is the way Japanese people opt for one response or solution over others. This mystery is compounded by a lack of explanation for the reasons behind their choice. Any foreigner staying in Japan, regardless of how long, recog- 0 nizes that the Japanese are – to put it mildly – not the most expressive people in the world. Hidden behind material abundance and organized manners and behavior are the traumas experienced everywhere, but they are seldom expressed openly. Like the characters in Ozu Yasushiro’s classic film, Tokyo Story, made more than fifty years ago, the Japanese still appear to accept and quietly resign themselves to a number of small 6 daily conflicts and stressful circumstances that people from other cul- 7 tures would be likely to face up to. The Japanese are taught from child- 8 hood to avoid openly making a fuss about life’s small conflicts and 9 inconveniences, despite also being brought up to be extremely sensitive 0 to the potential conflicts arising from interpersonal relationships. The 1 2 xviii 2831_FM.qxp 6/4/09 1:26 PM Page xix

Introduction 1 2 sensitivities must be nurtured but yet, can only be subtly expressed. A 3 mature individual in Japanese society is someone who has the ability to 4 keep his or her frustrations and negative feelings to him or herself. Easily 5 expressing them means disrupting apparently harmonious relationships, 6 a cardinal sin in Japanese daily life. 7 When it becomes impossible to contain these frustrations, they are 8 let out, but sometimes in a way that appears bizarre as well as painful 9 to Western observers. It seems there are abundant examples of such 1 difficult-to-comprehend modes of expression of distress. Domestic and 1 overseas media have reported on karoshi (death from overwork) and 2 work-related suicide, cases of which are on the rise. For years, I have 3 been asked by foreign observers to answer questions such as, “Why do 4 the Japanese work until they die?” Hikikomori, a form of pathological 5 social withdrawal that is reported to affect at least 1.6 million young 6 Japanese, inspires questions such as: “Why do frustrated young Japanese 7 shut themselves up and completely withdraw from society?” “How can 8 they go on like this for years?” 9 Ironically, overseas curiosity about Japan’s otaku culture has legit- 2 imized the behavior of individuals who do not care about interacting 1 with reality. When Time magazine writes feature stories about young 2 men living out their obsessions, be it miniature dolls or dressing as 3 comic book heroes, it does not seem so outlandish. Otaku culture has 4 gone mainstream: maid cafés, where waitresses dressed in pseudo French 5 maid outfits play-act the role of a “cute” comic character with cus- 6 tomers, are another new and popular addition to Japan’s idiosyncratic 7 cultural scene. 8 In spite of, or perhaps because of, this popularity, questions remain. 9 “Why do so many young men obsess over female comic characters and 3 prefer to have a fantasy relationship with them, rather than with a real 1 woman?” Another not unrelated question asked by those who live with 2 and marry Japanese is: “Why do so many unhappy Japanese couples 3 remain married?” 4 Karel Van Wolferen13 calls the Japanese “a poor people in a rich 5 nation.” (p.25) He claims that a surprisingly large number of Japanese 3 feel there is something wrong with their lives, regardless of their social 3 class or generation, largely because Japanese life is filled with ambigu- 3 ous anxieties and frustrations caused by the systematic arrangement of 3 society. 4 4 xix 4 2831_FM.qxp 6/4/09 1:26 PM Page xx

Introduction x He asks, “Why are there manga that make fun of the salary man’s life and the frustrations of middle-class Japanese men? Why do so many children hate school? Why are there so many university students who look depressed, bored, and vacant? Why are Japanese women marrying later than any other women in the world? Why are so many of them determined not to marry at all? And why do so many young married women decide not to have any children?” Wolferen says these things are 0 rare outside Japan and attributes their existence not to Japanese people’s individual circumstances, but to Japanese society itself, which is so highly controlled it forces its people to give up the possibility of choice and makes it impossible for them to be happy as individuals. Is Japan as repressive a society for the individual as Wolferen suggests? Is there such a sense of despair haunting this nation? On the other hand, it is a cliché among the Japanese that this is a nation where “The Country is rich but people are not.” Foreign students at my university have repeatedly told me they do not understand what the Japanese are really thinking, but feel that the Japanese, especially men, are under 0 great stress. Hard work is one reason, they think. But what makes it worse is that Japanese men do not seem to be able to express their feelings honestly and openly, even to their closest friends, a fact that sur- prises not only Western students, but also students from other East Asian countries such as Korea and China. Many Japanese, they say, are lonely and not as happy as they look. Japan has been free of war, riot, and chaos for over sixty years. Despite the fact that the economy peaked more than a decade ago, Japanese people still seem to be enjoying afﬂu- ence, peace, and thanks to the post-war Constitution, an enormous degree of freedom of faith and expression. Compared to other countries, 0 there are few social inhibitors to freedom of expression. But people are faced with more anxiety and a greater sense of uneasiness about the future than ever before. Many feel that in the future Japan will not be as comfortable a place as now or that their quality of life will not improve. There exists a sense that a quiet and slow revolution may be around the corner, and it may radically change what Japanese people have taken for 6 granted. Change is an inevitable part of life but it is always accompanied 7 by stress. The Japanese are now struggling to deal with this process, a 8 struggle which is often challenging their mental health. In fact, Japan 9 seems to be in the midst of a psychological crisis never experienced 0 before. 1 2 xx 2831_FM.qxp 6/4/09 1:26 PM Page xxi

Introduction 1 2 NOTES 3 1 Sugimoto, Y., 2003, An Introduction to Japanese Society (2nd ed.). Cambridge: 4 Cambridge University Press, p.18 5 2 Dore, R., 1973, British Factory-Japanese Factory: The Origins of National Diversity in 6 Industrial Relationship. Berkeley: University of California Press. 7 3 Benedict, R., 1954, The Chrysanthemum and the Sword: Patterns of Japanese Culture. Tokyo: Tuttle. 8 4 Minami, H., 1996, . Iwanami Shoten, pp.187–212. 9 5 Doi, T., 1994, Anatomy of dependence. Kodansha International. 1 6 Nakane, C., 1972, Japanese Society. Berkeley: University of California Press. 1 7 Vogel, E., 1979, Japan as Number 1: Lessons for America. Tokyo: Tuttle. 8 Horvat, A., 2000, “Revisionism Revisited–The Era of Bilateral Acrimony.” Japan 2 Quarterly, July–September, pp.33–44. 3 9 Kinsella, S., 2000, Adult Manga: Culture and Power in Contemporary Japanese 4 Society. Honolulu: University of Hawaii Press. 5 10 Time Magazine 2003, “Japan Rules OK: a special report on Asia’s pop culture superpower.” August 11, vol. 162, no.5, pp.23–44. 6 11 McGray, D., 2002, “Japan’s Gross National Cool,” Foreign Policy May/June, 7 http://www.douglasmcgray.com/grossnationalcool.html accessed April 16, 2008. 8 12 Kawashima, Y., 1995, “Female Workers: An Overview of Past and Current Trends” 9 in Japanese Women: New Feminist Perspectives on the Past, Present, and Future. K. Fujimura-Fanselow and A. Kameda (eds.). New York: The Feminist Press, 2 pp.271–93. 1 13 Wolferen, K. V., 2000, (System 2 called Japan which does not make people happy): The False Realities of Politicized 3 Society. Shinchosha, p.25. 4 5 6 7 8 9 3 1 2 3 4 5 3 3 3 3 4 4 xxi 4 2831_FM.qxp 6/4/09 1:26 PM Page xxii

6 7 8 9 0 1 2 2831_CH01.qxp 6/4/09 1:08 PM Page 1

1 2 3 1 4 5 The “National Character” 6 7 8 9 1 1 “Every age develops its own peculiar forms of pathology, which express in 2 exaggerated form its underlying character structure.” (p.41) 3 CHRISTOPHER LASCH1 4 5 6 THE NATIONAL PSYCHE, REVISITED 7 “Character structure” or so-called “national character” is a vague yet 8 powerful concept that began to be investigated by academics more than 9 sixty years ago. In the wrong hands, definitions can slip into careless 2 stereotyping of a nation’s people. But we often find ourselves in a posi- 1 tion in which it is difficult to completely discard such stereotypes, and 2 feel there is some truth in them from time to time. Serious academic 3 inquiry into the relationship between culture and personality began 4 before World War II, when the United States was anticipating conflict 5 with Japan, and decided to investigate the nature of its potential adver- 6 sary. Unlike the Japanese government of the time, which completely 7 forbade study of enemy countries’ language and culture, the United 8 States considered knowledge of one’s enemy to be the best strategy to 9 destroy his morale. Out of this peculiar historical context came Ruth 3 Benedict’s classic study, The Chrysanthemum and the Sword, which was 1 soon joined by many studies of the national character of other countries, 2 drawing on the expertise of psychologists, psychiatrists, anthropologists, 3 and sociologists.2 Further significant developments in the field of Japan 4 studies unfolded after WWII, but to this day, The Chrysanthemum and 5 the Sword occupies a monumental position in the study of Japanese 3 psychology and continues to inspire Japanophiles to pursue their own 3 research. 3 While the assumption of these studies was that basic characteristics 3 endure through time, other theories stressed the changing nature of 4 4 1 4 2831_CH01.qxp 6/4/09 1:08 PM Page 2

Mental Health Challenges x national character as a result of modernization, such as industrialization. Alex Inkeles has examined how modernization impacts on a nation’s personality and its ways of thinking and how it transforms the people in developing countries into “modern men.” He emphasizes the theme of convergence through industrialization both in institutional structures and in popular attitudes and values.3 In his view, national characteristics or elements of personality that are shared by the majority of a country’s 0 people are not only steady and persistent because of their deep historical and cultural roots, but also can potentially change due to social and historical forces. In the middle of the twentieth century, David Riesman proposed a model of social transformation and national personality change in three stages of society and character.4 As a society moves toward high industrialization, it demographically goes through a high growth period (high birth and death rates) first, and then a transitional growth period (potential high population growth), and further, a stage of incipient population decline. In each stage, the society’s typical members display certain arche- 0 types when making important decisions: the “tradition-directed type,” the “inner-directed type,” and the “other-directed type.” For example, a traditional-directed type believes in stability and conformity to the group to which he belongs. An inner-directed type tries to keep his balance between external demands and his inner goal, and to hold his course with a psychological mechanism resembling a gyroscope. An other-directed type is keen to seek directions from contemporaries and depends on them for approval. Although these typologies may not be deemed methodologically sound or are seen as too simplistic by some contemporary social scien- 0 tists, Riesman’s insights struck a chord with general readers, as his book’s success illustrates. Besides his characterization of three historical types, he also developed a characterization that illuminates how human beings relate to the society they live in. Riesman maintains that within any of these periods, a certain degree of character diversity exists, depending on how socio-psychologically fitted a person feels toward his own society. 6 People can be “adjusted,” “anomic,” and “autonomous” vis-à-vis what the 7 mainstream spirit of the period demands of its members. The “adjusted” 8 are typically tradition-directed, inner-directed, or other-directed people 9 whose character structure is mostly in tune or psychologically fits the 0 demands of their society. Their thoughts and behavior are reflections of 1 2 2 2831_CH01.qxp 6/4/09 1:08 PM Page 3

The “National Character” 1 2 their society and these people can adjust themselves to society’s norms 3 without too much effort or inner conflict. Therefore, their thoughts and 4 attitudes do not fundamentally deviate from their society’s expectations. 5 In contrast, anomic people are “maladjusted” (though Riesman avoids 6 any evaluative connotations). “Autonomous” people conform to the 7 behavioral norms of their society like the “adjusted,” but they are aware 8 that they can possess and exercise free will in choosing to conform or not. 9 As Riesman says, “In determining adjustment, the test is not whether an 1 individual’s overt behavior obeys social norms but whether his character 1 structure does.” (pp.240–2) 2 If we borrow Reisman’s typology of human beings in society accord- 3 ing to their psychological comfort level, a significant increase in the num- 4 ber of maladjusted individuals seems to take place when society is forced 5 to go through extremely rapid transformations in a very short period of 6 time. There are bound to be more people who cannot keep up with the 7 pace and are likely to be left behind, some of them exhibiting various 8 symptoms of maladjustment. On the other hand, if the mood of the 9 entire society is upbeat, providing its members with a clear, positive out- 2 look for the future, the society as a whole will not take the “maladjusted” 1 minority seriously. If the entire society is moving forward with great force 2 and the majority of its members are preoccupied with pursuing a specific 3 reward, the discomfort experienced by the maladjusted is likely to be 4 pushed aside. A society in this state – with enormous faith in one goal – 5 has little room for real diversity. The priority for this kind of society can 6 be a social dogma that does not allow its members to experience or 7 express true individual feelings. Much of the attention and energy is 8 expected to stay focused, not on inner conflicts or existential issues, but 9 on external issues, such as striving to achieve a material goal. Those who 3 do not share these goals, therefore, can be dismissed by the majority as 1 anomalies, or insignificant failures. Even maladjusted individuals them- 2 selves may write off their own distress as not worth attending to. 3 Sociologist Masahiro Yamada says post-war Japan established an 4 extremely stable, prosperous society based on unusually strong assump- 5 tions about the gender-based division of labor. Despite the reality that 3 the majority of Japanese workers were not beneficiaries of Japanese-style 3 management or lifetime employment, the effectively manipulated 3 image of the secure position of full-time housewife that the Japanese 3 today take for granted is the direct product of post-war economic 4 4 3 4 2831_CH01.qxp 6/4/09 1:08 PM Page 4

Mental Health Challenges x growth. The new ideology inculcated the idea that while the husband completely dedicated himself to work, or his corporation, thus acting as midwife to the nation’s economic miracle, someone had to take care of the home and children. Though many of Japan’s pre-war families were not economically stable, and the divorce rate was relatively high, this post-war work-home arrangement created a peculiar sense of security with regard to marriage 0 and family life. Nevertheless, it deeply grounded itself in both sexes’ perception of a better future. In particular, it was believed that as one worked hard, income rose steadily and the whole family benefited. Equally, most Japanese women, denied equal opportunities in education and employment, saw it as a good deal to marry, become a housewife and conform to their expected role. The private-level or familial dissatisfactions that inevitably arose were subsumed in the forward-looking and positive atmosphere that filled Japan in those days. Almost everyone was able to achieve a certain level of material reward if he/she worked diligently within his/her predeter- 0 mined role. This “salaried man/full-time housewife model” also implied a family structure that minimized risks to home life such as divorce or unemployment. Moreover, the expectation of a brighter future acted as a controlling effect on other sources of discontent, both psychological and personal.5 But what happens when the euphoria fades and society faces the morning after? As the sense of optimism begins to wane, the force that once focused everyone’s attention in one direction slackens. At the same time, social institutions (work, family, community, etc.) that have played the role of controlling their members’ behavior start losing their 0 efficacy. The voices of the maladjusted and their feelings of dissatisfaction that have always existed but have somehow been repressed begin bubbling to the surface. Once the outwardly-directed goals have been achieved, society finds it has no option but to start taking more serious notice of the quality of its achievements in other areas, such as an individual sense of well-being. Unless it can create another collective, tangi- 6 ble goal that can harness the collective energy of its members, it may 7 even have to start listening to its members’ inner voices. As the voices of 8 the maladjusted grow increasingly louder, it will also become difficult 9 for society to continue ignoring them. Eventually, a time comes when it 0 is forced to face them head on. 1 2 4 2831_CH01.qxp 6/4/09 1:08 PM Page 5

The “National Character” 1 2 Under Riesman’s definition of “maladjustment” – how a person psy- 3 chologically fits their society – most people still conform outwardly or 4 do not explicitly violate social norms. It is true that most Japanese are 5 law-abiding, a fact that keeps the country’s crime rate relatively low 6 among highly-industrialized nations. Things appear to be run efficiently 7 and work ethics appear dependable, all of which still impress foreign vis- 8 itors to Japan. Without any signs of a drastic event like a revolution or 9 a war for more than six decades, Japan appears on the outside to be one 1 of the most stable places in the world, where people harmoniously con- 1 form to norms and social expectations. 2 In this kind of society, the maladjusted are allowed to maintain their 3 maladjusted feelings, but only if they contain them and never act them 4 out. The problem occurs when the expression of feelings of maladjust- 5 ment and accompanying pathological behavior leak out, as has hap- 6 pened in Japan in the recent past. Some pent-up emotions can become 7 increasingly intense and may pass a certain critical point when the 8 simple state of “not fitting in” develops into overt behavior such as crim- 9 inal acts, rebellion, or mental illness. Those who have felt uncomfort- 2 able or something is wrong are now unable to control these feelings. 1 Consciously or subconsciously, not fitting in will express itself one way 2 or another, and this I feel, is what is happening in Japan today. The more 3 shocking crimes that are reported nowadays are particularly disturbing 4 because one cannot find a logical explanation for the perpetrator’s 5 behavior. Those committing brutal crimes are likely to be those least 6 expected to do so. For example, we are shocked to hear that an exem- 7 plary primary school student suddenly kills her classmate, or a “nice and 8 quiet” person turns into a murderer. 9 A family that the community believed to be very close and loving 3 turns into a victim of interfamilial bloodshed. These incidents may not 1 be uncommon in other post-industrial societies. But for Japan, these 2 tragedies have been a terrible blow to the nation’s self-image as a society 3 where a basic sense of trust remains intact. 4 Expressions of distress can be directed onto oneself, too. The rapid 5 rise of clinical depression in Japan suggests an increasing number of peo- 3 ple feel they do not fit into the social patterns and rapidly changing sit- 3 uation they find themselves in and can no longer keep their feelings at 3 a manageable level. An increase in the number of people who commit 3 suicide or who cannot functionally interact with others is clearly a 4 4 5 4 2831_CH01.qxp 6/4/09 1:08 PM Page 6

Mental Health Challenges x serious warning sign for society. These patterns of behavior are considered deviant from the norms that are needed to keep society going. Naturally, increasing deviance is a potential threat to society.

DEFINING DEVIANCE Deviance is a word with judgmental connotations. From a sociological 0 perspective, the term “deviance” refers to a violation of norms on a behavioral level. As norms vary from culture to culture, the nature of deviance can somewhat differ. But as Howard S. Becker says, “it is not the act itself, but the reactions to the act, that make something deviant.” (p.194).6 Therefore, not only the nature of the deviance but its social context is extremely important. Mental pathology/illness is usually considered a part of “deviant behavior” but should be differentiated from other kinds of deviance, in a sense that most people do not consciously choose to become mentally ill. These people’s inner state can range from fitting the category of being 0 “maladjusted,” or discomfort that remains unexpressed on the behavioral level, all the way to a clear category of “deviance” or “abnormal psychology,” an obvious pathology which can be determined externally. However, the criteria for what constitutes a healthy mental state also varies depending on the culture.7,8 The American Psychiatric Association’s Diagnostic Statistical Manual now pays attention to “culture-bound syndromes.” Like social norms, it is not an absolute. For example, in a society where independence/autonomy is emphasized as the backbone of the value system, more strict criteria are applied toward how self-reliant a person is. If harmonious relationships in a group are 0 more important, highly individualistic people are more likely to be considered deviant. Furthermore, what mental pathology means to society may also differ. Some societies are more or less tolerant of mental abnormality in members. Inquiring about how a society defines “abnormal psychology” and how it deals with it reveal a lot about the society itself. Sociologist Robert Merton sees deviance as a phenomenon arising 6 from a certain kind of “anomie (norm-less-ness or lack of regulations)” 7 which creates a gap or discontinuity between cultural goals and the 8 socially-approved means for achieving those goals. He says that much 9 deviance can be understood in terms of people’s responses to these frus- 0 trating gaps. According to Merton, there are five kinds of response, 1 2 6 2831_CH01.qxp 6/4/09 1:08 PM Page 7

The “National Character” 1 2 though these are not exclusive of other possibilities: conformity, inno- 3 vation, ritualism, retreatism, and rebellion. Most people manage to take 4 the “conformist” position by accepting socially-approved goals and 5 socially-approved means for achieving them. Some may take the “ritu- 6 alist” position by accepting the means but not necessarily striving for the 7 goals for themselves. But others may choose to take a completely differ- 8 ent position, such as “retreatist” – rejecting both the goals and the 9 means, and resorting to deviant behavior. People called “innovators” are 1 those who accept the goal but reject the socially-approved means, while 1 “rebels” are those who reject both socially-approved goals, means, and 2 even their substitution.8,9 The last three have a high likelihood of devel- 3 oping patterns of behavior that are considered “deviant.” 4 Which of these reactions will prevail also depends on the culture, 5 social structure, and the basic characteristics of the people. It seems to 6 me that Japanese people who are dissatisﬁed with life tend to resort to 7 the “retreatist” option. Some with strong drives and motives to change 8 things become “innovators” or “rebels,” but I feel these are a rarer species 9 than the former. 2 The increase in psychopathological and deviant behavior is a sign 1 that individuals perceive the gap between their desired goal and the 2 means to achieve it to be unbridgeable. It also suggests that society is 3 failing to meet the needs of its members and to deal with its own inad- 4 equacy by adjusting itself to changing circumstances. In other words, 5 society is unable to provide its members with opportunities for self- 6 actualization and unable to provide adequate care or remedies for the 7 lack of these opportunities. An increase in abnormal/deviant behavior 8 represents the failure of society as a whole to cope effectively with grow- 9 ing expressions of distress. Distress emanating from the growing gap 3 between rapid social change and outdated ways of coping, or the mis- 1 match between conventional coping methods and what reality requires 2 is rampant in modern Japan. It not only tells us that something is seri- 3 ously wrong with society but also that conventional methods to resolve 4 distress are not working any more. 5 3 THE SAME, BUT NOT THE SAME 3 3 I believe human emotions are basically the same everywhere, but the 3 psychological characteristics of a society create variations in the kinds of 4 4 7 4 2831_CH01.qxp 6/4/09 1:08 PM Page 8

Mental Health Challenges x pathology that surface as expressions of human distress. If this is the case, what are the defining features of the Japanese psyche? These should prepare us to better understand the nature of psychopathologies the Japanese display today. There have been a number of descriptions of Japanese national character, which again, inevitably help to form a certain stereotypical image. Sociologist Yoshio Sugimoto summarizes three different patterns/ 0 frameworks that have been used to explain Japanese social structure or character. The first pattern describes a personality lacking independent ego or self and individuality. One’s loyalty to the group is deemed more valuable than satisfying individual needs. The second describes society in the context of intra-group dynamics, particularly Japanese people’s group orientation and keen awareness of hierarchical, vertical classifica- tions. The third focuses on Japanese people’s willingness to emphasize harmony, consensus, and stability among different groups to create social cohesion. Sugimoto also points to the excessive self-consciousness of the Japanese with regard to these descriptions, and writes, “While 0 every society is unique in some way, Japan is particularly unusual in having so many people who believe that their country is unique.”10 Despite paying scant attention to social structural factors, psychologists and psychiatrists have also made numerous attempts to analyze the deeper dimensions of the Japanese personality. No matter what social and political transformations Japan goes through, the psychological traits described by these scholars are still observed or seem to pop up, especially in interactions with different cultures: a situation best suited to discovering “who you are.” It may also take fresh eyes or extreme cases, such as psychological pathologies, to delineate these qualities. A 0 survey of these studies suggests that Japanese ways of relating to others, which are of course rooted in Japanese history and culture, are crucial factors in understanding the potential for pathological behavior. First of all, no one has produced a more influential perspective on the psychological mechanisms of Japanese interpersonal relationships than Dr. Takeo Doi. His concept of “amae” has its prototype in the sweet, 6 intimate feelings or sense of oneness typically found between mother 7 and infant. But in Japanese society, this is permitted to survive into 8 many adult intimate relationships. The starting point of this concept as 9 particularly Japanese is that Doi realized he was unable to find a corre- 0 sponding English word when he encountered it in a clinical context. 1 2 8 2831_CH01.qxp 6/4/09 1:08 PM Page 9

The “National Character” 1 2 Therefore, amae, has been explained to non-Japanese people in combi- 3 nations of several words such as “to depend and presume upon another’s 4 benevolence” (Doi’s definition), “indulgence,” “passive love,” “wish to 5 be loved,” or “primary love.”11 While this is in no way a uniquely 6 Japanese feeling, Japanese social and cultural background creates a 7 unique environment in which it is more readily accessible to individu- 8 als when they need it. In fact, it is believed that experiencing amae dur- 9 ing the formative years of socialization fosters a healthy development of 1 the self as an individual. Obviously amae is grounded in one’s need for 1 dependency, love, and understanding. But it has to be provided without 2 conditions such as verbalizing, requesting or explaining – following the 3 prototype that the mother exactly knows what the baby wants. As long 4 as it is within an acceptable range in a defined relationship, not only one 5 is allowed to have amae, but the other half of the relationship is expected 6 to willingly provide it through perceiving, sensing, and intuitively 7 understanding one’s needs. In such an interaction, the boundary 8 between the provider and the recipient of amae merges and the two par- 9 ties achieve, though temporarily, a sense of oneness. The Japanese often 2 seem to strive for and enjoy this type of oneness in significant interper- 1 sonal relationships (“nihonteki ittaikan”). Being able to engage in recip- 2 rocal amae is an expression of ultimate trust for the Japanese. 3 In Nihonteki jiga (The Japanese Self) (1983), Hiroshi Minami ana- 4 lyzed the social character of the Japanese from the perspective of struc- 5 tural features of the self – a self that he argues is likely to be plagued 6 by a sense of uncertainty (“jiga fukakujitsu kan”). According to Minami, 7 the self consists of two major dimensions. First is an active part of self 8 (“shutaiteki jiga”) (“I”), or the self as a source of action; second is the self 9 as an object (“kyakutai, taishoo to shite no jiga”), such as being aware 3 that others see one or do something to one. The second dimension is 1 further divided into two components: the first is called “inner object- 2 self,” which is the self as an object seen by oneself. Self introspection, 3 self-criticism, self-hate, and self-admiration are all mental activities of 4 this type, and help form one’s self image. The second component is 5 called “outer object-self,” which is formed by guessing what others are 3 thinking of one. Formation of the self image is also based on this 3 process. 3 Minami says the second component is especially strong among the 3 Japanese. By constantly asking oneself “what do others think of me?” 4 4 9 4 2831_CH01.qxp 6/4/09 1:08 PM Page 10

Mental Health Challenges x “How would they criticize my behavior?” or “Do they like me?” the Japanese tend to become highly other-directed and situation-dependent. By being too conscious of oneself as seen by others, the outer object-self grows disproportionately and affects other parts of the self structure. This heightened self-consciousness oppresses inner object-self, which results in a negative sense of oneself. At the same time, this negative sense of self prevents the active part of the self from mobilizing its full poten- 0 tial, and makes it difficult to develop a positive sense of oneself. This leads to too much anticipatory anxiety, weak will, timidity, and indeci- siveness. Thus, other-directedness and a sense of uncertainty about oneself are the fundamental characteristics of the Japanese. Minami further asks how this sense of uncertainty about self and subsequent anxiety can be mitigated. The Japanese propensity for depending on the group is one way to resolve uneasiness. Giving up one’s individual responsibility and depending on collective decision-making will also make one feel at ease. Fatalism is another way to reconcile a sense of uncertainty. Instead of taking responsibility for their life, Japanese often try to 0 avoid it by attributing their problems to fate or luck. The sense of uncertainty becomes most intense, says Minami, when an individual is unsure of his ranking relative to another. A lack of clear ranking or hierarchical criteria makes the Japanese so insecure they care about it intensely. One way to ease this type of discomfort is to follow fixed forms or patterns, sometimes to an obsessive degree. The obsessive pursuit of perfection or surface formality is only one manifestation of this tendency.12 More recently, Takie Lebra has described three dimensions of Japanese self structure: (1) the interactional self, where one is aware of the self 0 as a precarious being that is defined, sustained, enhanced, or blemished through social interaction; (2) the inner self as a fixed core of self-identity and subjectivity, which also becomes the potential basis for autonomy; and (3) the boundless self, which disengages the person from the social and physical world and aspires to eliminate object-subject differen- tiation, or achieve the Buddhist sense of transcendentalism. Though these 6 three dimensions form the Japanese self, Lebra admits that the interac- 7 tional self is what occupies most Japanese most of the time.13 8 Connecting social and historical factors and the culture of the 9 Japanese household, Hayao Kawai, a Jungian psychotherapist and 0 scholar, has analyzed relationships between Japan’s post-war social 1 2 10 2831_CH01.qxp 6/4/09 1:08 PM Page 11

The “National Character” 1 2 changes and pathology found in Japanese family relations. Kawai was 3 also a leading expert on counseling Japanese children who have become 4 violent toward their parents, a peculiar but not uncommon phenome- 5 non in distressed Japanese families. It is through his clinical experiences 6 that he has formed a thesis on Japanese culture, especially in compari- 7 son with Western culture. 8 Just like Doi, Kawai points to the strong Japanese emphasis on the 9 sense of oneness typically found between a mother and a small child. 1 While he accepts its lifelong influence, his conceptualization is some- 1 what different. Kawai says it constitutes the core of Japanese relation- 2 ships: to examine Japanese family relationships is to question the nature 3 of Japanese relationships in general and ultimately the existential char- 4 acteristics of the Japanese people. 5 According to Kawai, the fundamental human relationship is that 6 between a mother and a baby. In it, the baby is not even aware of the 7 mother as a separate being and is totally dependent on the mother, who 8 also feels and embraces the baby as a part of her own self. A third per- 9 son, usually a father-like figure, breaks this comfortable union. Through 2 this intervention by the father, the child understands the existence of 1 another human being or “the other.” But in order to get along with this 2 “other,” the child has to learn basic rules of the world outside his pri- 3 mary union with the mother. Without knowledge of these rules, the 4 child may be punished. Therefore, for the child, the father is the embod- 5 iment of various social rules and norms, as well as someone who teaches 6 the child the skills and know-how needed to survive in real life. 7 If we abstract these two approaches to a baby, two different prototypes 8 of human existence and ways of relating to the world emerge. One is to 9 embrace everything one encounters, making it a part of oneself. The 3 other is to separate oneself from the object/person, differentiating and 1 classifying according to the object/other’s abilities and characteristics. 2 Kawai calls the first concept the “maternal principle” and the latter 3 the “paternal principle.” The essential functions of these two principles 4 are “to contain” and “to cut,” respectively. The first permits, tolerates, 5 forgives or even accommodates unforgivable behavior (or acts “mater- 3 nally”). The second strictly judges and punishes if there is disturbing 3 conduct (in other words, “acts paternally”). 3 They should not be literally interpreted as principles always acted on 3 by a mother or a father, although it is often the case that the maternal 4 4 11 4 2831_CH01.qxp 6/4/09 1:08 PM Page 12

Mental Health Challenges x principle is exercised by the mother and the paternal by the father. It also should not be overlooked that these two attitudes exist in all cultures, but simply with differing degrees of emphasis. It is a matter of rel- ativity. Kawai says Western cultures are based on the paternal principle, which instills in the child a distinctive sense of individuality. By contrast, Japanese culture is based on the maternal principle, in which individuals are not urged to seek out one-to-one relationships based on their 0 individuality. Instead they are permitted to indulge in the sense of oneness that comes from a mother-child relationship, or more broadly, being part of a closed circle of insiders. When examining the value standards of what is good and bad, he says, maternal principle-based Japanese are sometimes criticized by Westerners for being too tolerant of “evil,” while Japanese often feel that Westerners’ approach is too “cold.” In parenting, children judged through the criteria of the maternal principle are forgiven everything as long as they maintain their status as children and never abandon the mother ﬁgure. In contrast, the paternal principle applies criteria to chil- 0 dren that judge them based on universal concepts of good and bad, and is based on discipline. Any Japanese relationship, familial or otherwise, which becomes extremely intimate, ends up functioning based on the maternal principle. Before World War II, the absolute authority of father in the Japanese household was legally sanctioned by the ie system, originally a samurai class Confucian-based ideology that was used to integrate the nation at the beginning of the Meiji period (1868–1912). However, the majority of Japanese had traditionally lived in an environment where the maternal principle was dominant. In fact, the family was a group without a strong 0 central power, at least psychologically, instead maintaining a vague yet harmonious balance among each member of the household. Therefore, Kawai contends, pre-war Japanese households had a tatemae-honne structure: a patriarchal front presented to society and a very different approach to one another when it came to relationships in the home. No matter how prevalent the patriarchal social structure appeared, it was the maternal 6 principle that dominated the national psyche. Through its patriarchal and 7 feudal ideology, the ie system maintained a certain balance in the family 8 structure, a place where the maternal principle was likely to predominate. 9 This was demonstrated by the abolition of the ie system after World 0 War II, which was meant to bring the true spirit of democracy into the 1 2 12 2831_CH01.qxp 6/4/09 1:08 PM Page 13

The “National Character” 1 2 household by following the American social model. However, this was 3 not able to fundamentally change family nature. Instead, Kawai argues 4 that removing ideological support for the father’s supremacy resulted in 5 the drastic weakening of the paternal principle – and with it, the ability 6 to tell right from wrong. This imbalance goes some way to explaining 7 why Japanese society has lost the ability to raise the young based on a 8 clear standard of right and wrong. Being surrounded by the maternal 9 principle may be a comfortable way to live up to a certain point, but it 1 is a double-edged sword that can suffocate the child’s individuality and 1 cause him problems as an adult. As Kawai says: 2 3 “For the Japanese today who still live in a traditional society, achieving self- 4 dependence is not an easy matter. Japanese-style self-dependence is estab- 5 lished through the delicate balance of not denying the maternal principle 6 but at the same time avoiding being buried by that principle . . .”14, 15 7 8 Kawai’s thesis is extremely useful in making sense of pathological 9 Japanese relationships. I will return to him later when examining 2 family problems. 1 Further on the maternal influence in Japanese culture, psychoanalyst 2 Keigo Okonogi finds much to recommend the theory articulated by 3 Kosawa Heisaku, a founder of Japanese psychoanalysis, who instead of 4 the Freudian Oedipus complex, maintained that from the psychody- 5 namic point of view, the development of Japanese boys into men can be 6 better understood by what he called the “Ajase complex.” Unlike the 7 psycho-developmental process of a child in Western cultures, Asian 8 cultures overwhelmingly emphasize maternal influence when it comes to 9 the development of manhood. The Ajase complex is based on the 3 Buddhist myth of the Indian Prince Ajase, who is so disillusioned by 1 the imperfection of his mother he initially idealized, that he tries to retal- 2 iate by killing her. His resentment is termed mishoon, or “prenatal rancor” 3 directed at his origin. Despite his crime, Ajase is eventually saved, cared 4 for by his mother, and pardoned by Buddha. The whole experience leads 5 him to feel remorse and helps him develop into an enlightened king. 3 The Ajase-complex model proposes the central role of forgiveness 3 and acceptance in overcoming the tensions of the close and intimate 3 mother-son relationship, rather than the Freudian model, which is based 3 on overcoming hostility toward the father, who allegedly stands in the 4 4 13 4 2831_CH01.qxp 6/4/09 1:08 PM Page 14

Mental Health Challenges x way of intimacy between the son and the mother. In the Ajase complex, the father’s role is unimportant to the point that it is nowhere to be found. Okonogi suggests this model is better if one wants to understand mother-child relationships in Japan. Furthermore, the ending of the Ajase story is in stark contrast to the Oedipus legend, in which Oedipus condemns himself to blindness and to live with the burden of his crime 0 for ever. As in the Ajase myth, rather than facing up to one’s mistakes and accepting punishment for them, a Japanese person only realizes the seriousness of his own sin and feels penitence when he is forgiven by the generosity and love of the victim. This type of mutual pardon is a very important theme in Japanese human relationships.16 Empirical- oriented social scientists often criticize psychoanalytic theories as being untenable. However, this Japanese alternative to the Oedipus complex has provided much insight into the cross-cultural diversity of human psychology. In particular, I believe that the story’s conclusion says a lot about Japanese coping behavior in the face of severe distress. 0 HABITS OF THE HEART While Doi and others explore the interpsychic dynamics of the Japanese individual, Japanese habits of the heart are the preserve of Hajime Nakamura.17 Unlike most Japan analysts whose comparative framework is Japan vis-à-vis American or European cultures, Nakamura compares Japan with other Asian nations such as India, China, and Tibet. In this context, the Japanese have outstanding features among these major Asian cultures. One of the deﬁning characteristics of the Japanese way of think- 0 ing is its emphasis on concrete events, rather than upon universals, and consequently, on the immediate social nexus rather than on the individual. Nakamura argues that Shinto, Japan’s indigenous religion, which is a form of animism based on the belief that spirits and gods exist in everything in the world, is one factor that has led the Japanese to accept the world itself as something of absolute signiﬁcance. Importantly, it also 6 rejects the recognition of anything existing beyond it (p.350). 7 Conceptualizing sacredness this way means it is to be applied to any 8 object that exists in reality. Following on logically from this, therefore, 9 is the absence in Shinto of the inclination to see this world as impure or 0 sinful, a belief that plays a major role in many religions of the world. 1 2 14 2831_CH01.qxp 6/4/09 1:08 PM Page 15

The “National Character” 1 2 Japanese thinking patterns are dominated by an almost excessive 3 stress on valuing social relationships over the individual as an independ- 4 ent entity. Although the value of individuality is recognized, it has to be 5 with a clear awareness of the individual’s social position and context 6 within the community. Or individuality is respected as far as its place in 7 the social framework is not forgotten, which often seems more impor- 8 tant to the Japanese mind. These heavily-weighted social relationships 9 are rather speciﬁc, narrow, or lie in a limited social network that has 1 only immediate bearings on one’s life. Again, the idea of transcending 1 a limited human relationship in search of something universal, as 2 many world religions advocate, does not thrive in Japan. Furthermore, 3 Japanese faith in immediate, concrete, and small surroundings (such as 4 groups they belong to) is often unconditional and has forced many indi- 5 viduals to make personal sacriﬁces throughout Japanese history. 6 In fact, Nakamura argues that historically, the Japanese have had a 7 weak awareness of religious values, and so have always Japanized foreign- 8 originated universal religions such as Buddhism. The Japanese standard 9 of evaluating and judging matters is always anchored in a particular 2 human nexus such as “ancestors, parents, lords, the state, and the 1 Emperor, to whom religion was subjected and made to serve (p.523).” 2 Nakamura points out the Japanese emphasis on secularity: 3 4 “The weakness of Japanese religious consciousness seems to have molded 5 many Japanese into philistine materialists. They are, generally speaking, 6 lacking in the desire for profound confession and severe compunction. 7 Religion, in the true sense of the word, never deeply took root on Japanese 8 soil. From this fact arises the weakness of religious order.” (p.530) 9 3 While positioning Japan within a group of other Asian countries is 1 very appropriate, and probably should be emphasized more often, the 2 reality is that a Japan-versus-West comparative paradigm remains pre- 3 dominant. After all, Japan’s comparative framework is within those 4 highly industrialized/post-industrialized societies, even though, cultur- 5 ally, Japan was for a long time the only non-Western country within this 3 group. Therefore, Japan has often suffered from a kind of identity con- 3 fusion when seeking appropriate comparative criteria: it has a number 3 of cultural similarities with Asian neighbors, but closer correspondence 3 with Western nations when it comes to social development. In most of 4 4 15 4 2831_CH01.qxp 6/4/09 1:08 PM Page 16

Mental Health Challenges x its modern history, Japan has looked toward the West, trying to catch up with and emulate it. Other Asian cultures and people have been neglected as sources of learning or comparison, with Western societies and cultures the preferred models. Only recently has Japan begun to take its own Asian afﬁnity seriously. Dramatically increased media coverage of Asian culture, celebrities, and cuisine has familiarized the Japanese public with the continent, and made it a presence in their 0 daily lives. This was largely out of economic necessity to expand its market and industrial base, but it also came out of a certain nostalgia for something Japan used to have but lost somewhere along the road to rapid industrialization. In the framework of Japan-versus-West, the contrast is clear to everyone. But when Japan compares itself with Asia, especially with East Asia, it is happily surprised to ﬁnd so much in common. Qualities such as “the importance of the group’s goal” and “no explicit demonstration of individuality” are not necessarily Japan’s monopoly. The fanatical popularity of schmaltzy Korean dramas that surfaced in 2004 seems to 0 be somewhat based on Japan’s nostalgic feelings for what it had lost: close family ties and more affectionate and intimate human relationships on all levels.

DIFFERENT TIMES AND DIFFERENT EVALUATIONS. CONFRONTATION AND DENIAL? But whatever Japan thinks it has lost, the reason why it was able to successfully modernize and industrialize earlier than any other Asian country remains an intriguing question to many visitors and students 0 of Japan. At the heart of this conundrum are the Japanese characteristics, personalities, and attitudes described by many writers, which must have worked both as strengths and weaknesses in the push for modernization. As we have seen, the same qualities that are likely to be regarded as strengths in a period of optimism will be seen as weaknesses in 6 different times. 7 For example, as one historian says, one of Japan’s cultural strengths is 8 its innate openness to and willingness to absorb ideas and practices from 9 foreign cultures. Even compared with other Asian societies, this feature 0 seems particularly distinctive to Japan. However, Japan always creates a 1 2 16 2831_CH01.qxp 6/4/09 1:08 PM Page 17

The “National Character” 1 2 hybrid of the foreign culture it adopts, reinterpreting it until it eventually 3 creates something uniquely Japanese.18 The history of Japan is a testament 4 to this cultural transformation and selective adoption, as is a modern 5 “Western-style wedding,” with its costume changes, “candle service,” and 6 carefully scripted tearful farewell. 7 Taichi Sakaiya, a social critic, emphasizes that this process was first 8 adopted as a national policy by Prince Sho–toku, who was responsible for 9 creating an ideological and spiritual foundation for Japan in the seventh 1 century. At a time when Buddhism – a new foreign religion – was fac- 1 ing off against Shinto the indigenous Japanese belief system – Prince 2 Sho–toku boldly made it possible for Japanese to follow both without 3 spiritual dislocation. From that point on, picking what was useful and 4 convenient and discarding the rest even if it was a core part of a foreign 5 belief or practice became a characteristic of the Japanese way of dealing 6 with foreign cultures. Aggressive and sometimes even shameless copying 7 from a developed nation (first China and later Western nations) with- 8 out suffering from too many conflicts with their own culture has 9 occurred at several critical points in Japanese history. 2 This attitude was particularly helpful at the beginning of the Meiji 1 era, when Japan urgently needed to learn from the West to maintain its 2 territorial independence and catch up technologically. The Meiji gov- 3 ernment’s dispatching of the Iwakura delegation to the United States 4 and Europe to seek the technological and political know-how that it 5 then used to build the new Japan was the most obvious example of 6 this.19 But while cultural absorption was widespread, it did not neces- 7 sarily have to be coherent. The Japanese skillfully ignored contradictions 8 that existed between the adopted and domestic cultures. High tolerance 9 toward contradictions, lack of judgemental positions toward universal 3 concepts of good and evil, and high flexibility and adaptability to new 1 cultural influences all made it easy for Japan to take whatever came from 2 over the seas, and to make use of them to her own advantage in a way 3 that worked at the time. The structure of human relationships in Japan 4 has also been considered instrumental to its modern development. 5 Within a defined circle of people, members can be easily united, thanks 3 to a relatively homogenous racial and ethnic composition. Culturally 3 and psychologically, a sense of self boundary more easily permeates to 3 create a sense of ittaikan, or oneness in the group, which is considered 3 more desirable than maintaining an individual, autonomous self. 4 4 17 4 2831_CH01.qxp 6/4/09 1:08 PM Page 18

Mental Health Challenges x These qualities also lead to a propensity for strong identification with and loyalty to the group. The Confucianism-rooted sense of hierarchy also reinforces inferiority toward those older or more experienced. Today this is constantly enforced through the education system and occupational training that new company employees are forced to under- take. Japan’s legendary economic growth, as well as the nickname “Japan Inc.” may be partially derived from the tendency to foster a sense of 0 unity on all levels of society. All this worked well enough until the Japanese economy began spi- ralling toward recession. The bursting of the bubble economy at the beginning of the 1990s made people feel the things they had been fran- tically pursuing might have been a mere mirage. Ferocious economic expansion, which for decades occupied the Japanese mind, was transformed into something much smaller and milder. Economic expansion became progress, then standstill, then shrinkage and finally, decline. After recovering from the devastation of World War II and achieving the highest material goal ever realized in its history, now many Japanese not 0 only lost a sense of purpose but did not know what to aim for in the coming decades. So, Japanese qualities that were once regarded as strengths are now seen as weaknesses or hindrances. What Nakamura termed the “social nexus,” which provided a backbone for social cohesiveness, weakened greatly in what became known as the lost decade. Groups and organizations, such as corporations, which were seen as safe and protective, lost their aura of inviolability. Growing fear and a realistically high possibility they could lose the perks and protection that traditionally came with salaryman status made Japanese workers realize it was not worth spend- 0 ing energy in establishing long-term, committed relationships with employers and colleagues. A feeling emerged that, deep down, too much investment in traditional values would not pay off. A number of surveys conducted by public and private organizations confirm that a sense of anxiety about the future is intensifying. Since the late 1990s, those in their twenties to their forties have expressed a growing sense of insecu- 6 rity about their occupational and financial future.20 In the words of Yuji 7 Genda, “a nagging insecurity” or “vague, amorphous uneasiness” over 8 growing economic disparities is plaguing young Japanese.21 9 This very real change in the relationship between employees and 0 their companies means that values such as strong group identification 1 2 18 2831_CH01.qxp 6/4/09 1:08 PM Page 19

The “National Character” 1 2 and loyalty are no longer regarded with the devotion they used to 3 receive. In fact, if one continues to worship these qualities, one may be 4 brutally betrayed, thrown out into the wild world of non-company 5 employment, with no idea how to survive. These formerly-admired 6 qualities are now seen as obstacles to surviving in a rapidly changing and 7 increasingly uncertain career environment. 8 Rapid social transformation caused by an upward economic swing 9 followed by a vicious downward trend and the changing values and 1 emphasis in life these bring are undoubtedly stressful for the people 1 going through the process. There is always a substantial time-lag 2 between changes in the social and physical environment and changes in 3 people’s values and beliefs. Of course, there are also times when changes 4 in values and beliefs precede changes in the physical environment. In 5 that case, even though people feel the social system is outdated, they 6 somehow continue to operate within it until the system is ready to be 7 revised or transformed. Though these two categories of variables (social 8 structures and what people believe in) are interactive, the latter is more 9 likely to catch up with the former, or even to resist change. In any case, 2 the gap between social structures and people’s mentality is a source of 1 serious stress. 2 In the meantime, people feel puzzled, uncertain, and try to under- 3 stand what is happening and what will happen in future, at the same 4 time hoping that they do not have to make too many big adjustments 5 or lose too much of what they have embraced for a long time. Change 6 is a scary thing. So is unpredictability. Eventually, however, they will 7 realize they must change. Even then, they will hope that they can min- 8 imize the pain and loss in the adjustment. In the worst case, they may 9 continue to hold on to old ways and convictions, which only conﬁne 3 them, ultimately, to self-destructive denial. 1 In going through this stressful transition, our response to distress or 2 any unpleasant events varies greatly, depending on our disposition, 3 socialization history, social position, and the available resources. When 4 one feels something is going wrong, one naturally tries to do something 5 about it. One may look straight at the problem and try to deal with it 3 head on. Or one can look at the problem, but be unable to deal with it 3 and live with a sense of helplessness. Or one may look at the problem 3 only superﬁcially, but fail to admit the gravity of the problem, because 3 one feels incapable of doing anything about it. So one pretends it is not 4 4 19 4 2831_CH01.qxp 6/4/09 1:08 PM Page 20

Mental Health Challenges x so serious and or even that no problem exists. All these different coping techniques to avoid feeling threatened, fearful or anxious can take place in individuals, families, or societies as a whole. Again, the coping technique chosen depends on the psychological characteristics of the individual, as well as the socioeconomic, institutional characteristics of a group the individual belongs to, and finally of the entire culture/society. After all, any behavior is a cultural product as 0 well as the result of our basic biological needs. Therefore, what people believe to be a good or correct coping strategy is very much a product of their sociocultural conditioning. For example, a relatively large-scale survey22 on people’s coping strategies for everyday stress suggested the issue of differential willingness to confront problems depends on cultural background. Japanese and Anglo-American participants showed two clearly contrasting coping patterns. Typical Anglo-American respondents would go directly to the problem itself to try to find its cause. And once what they thought “the cause” was defined, they would immediately try to take some type 0 of action to eliminate it or to change the situation. They also believed that confrontation and open communication in any relationship were essential to improving the situation. In contrast, a typical Japanese respondent would try first to bear the situation as long as he or she could. He or she did not immediately believe in open confrontation or overt action. Instead, he or she would think it was best to wait until things solved themselves and if no solution came, resign him or herself to the situation. Although the respondent would not neglect his or her duties, it seemed preferable to accept the whole situation rather than to analyze it to find “a cause” of the 0 problem. Japanese subjects would also prefer to shift their attention from the problem itself by doing something else or forgetting, rather than going directly to the “cause” of the problem. They seemed to think that focusing too much attention on the problem and being preoccupied with it were problematic. An act of gracefully resigning oneself to the situation, or “akirameru,” was in fact considered a courageous and 6 mature thing to do. 7 Japan has also been described as a culture in which non-confrontational 8 approaches to human relationships and many other communication 9 issues are seen as favorable. Though not explicitly discussed in terms of 0 patterns of coping, there are theories that imply Japan has a culture of 1 2 20 2831_CH01.qxp 6/4/09 1:08 PM Page 21

The “National Character” 1 2 non-confrontation, in which people avoid directly facing each other, not 3 only literally but with regard to psychological contact.23 4 Doi’s thesis on Japanese ultimate longing for ittaikan, or the wish to 5 eliminate boundaries between oneself and others through amae feelings, 6 Okonogi’s view that Japanese psychodynamics are designed for accept- 7 ance and forgiveness instead of facing up to one’s sins, and furthermore, 8 Kawai’s analysis of Japanese culture’s fundamentally more accepting 9 attitude toward evil, all suggest that the Japanese – both logically and 1 emotionally – are far more reluctant than someone brought up in a 1 Western culture to separate themselves from the source of a problem or 2 situation and view it as an object to be dealt with. 3 It is also true there is a long tradition of respecting indirect, subtle 4 involvement with a situation, issue, or problem, and indeed, such 5 behavior is considered to be a style of wisdom and beauty inherent in 6 Japanese culture. This has been largely reinforced by social structures, 7 including socialization and education processes. As a result, emphases 8 on harmony and sometimes excessive sensitivity toward not hurting 9 another’s feelings have been regarded as great virtues in Japan. 2 These cultural attitudes toward life and human relationships natu- 1 rally determine types of problem-dealing strategies, both positively and 2 negatively. A non-confrontational posture, both on behavioral and psy- 3 chological levels, creates the tendency not to look at things in strict 4 duality of black and white, or good or bad, and prevents one from being 5 narrow minded. It does not hold a judgemental, moralistic outlook 6 on many human problems, either. It makes it easier to understand the 7 situation as a whole, and so bring some gentleness into a relationship. 8 On the other hand, this outlook can slip to the denial of critical issues 9 that need to be dealt with, and allows people to remain unaware of the 3 seriousness of a situation, and even deny or ignore issues that are clearly 1 present. Instead of taking proactive measures, they may prolong a situ- 2 ation as long as possible, simply wishing that the problem will be some- 3 how taken care of. The culture of non-confrontation or even of denial 4 can ultimately backﬁre. It may have been partly responsible for the 5 sharp increase of clinical depression and various forms of social pathol- 3 ogy in recent years. Lasch’s statement, with which this chapter opened, 3 that “Every age develops its own peculiar forms of pathology, which 3 express in exaggerated form its underlying character structure” (p.41)24 3 highlights an interesting paradox in the question of deviance versus 4 4 21 4 2831_CH01.qxp 6/4/09 1:08 PM Page 22

Mental Health Challenges x normalcy. It implies that “deviance” is not really deviant, but is constrained by and in fact created by the culture itself. The Japanese today appear to be confused by many myths about work, home and human relationships that are no longer valid. These persistent but ultimately inaccurate beliefs about how the Japanese should be are preventing people from being true to themselves. Many are still ﬁxated by old ways, especially when it comes to close relationships that 0 exist in occupational and familial settings. Conventional ways of coping with distress also are being made obsolete as a drastically changed environment develops, in which traditional support networks have disappeared. Even though these coping styles are not working anymore, they are clung to, as a form of denial and suppression, as the participants in the problem hope it will go away, or turn to sources that are no longer helpful. In the next few chapters, we will examine how these situations manifest themselves, and what they are doing to the Japanese mind.

NOTES 0 1 Lasch, C., 1979, The Culture of Narcissism: American Life in an Age of Diminishing Expectations. W.W. Norton & Company (reprinted by Norton 1991), p.41. 2 Benedict, R., 1954, The Chrysanthemum and the Sword: Patterns of Japanese Culture. Tokyo: Tuttle. 3 Inkeles, A., 1998, One World Emerging? Convergence and Divergence in Industrial Societies. Boulder: Westview Press. 4 Reisman, D., 1961, The Lonely Crowd. New Haven: Yale University Press. 5 Yamada, M., 2004, . (Hope disparity society). Chikuma Shobo, pp.81–2. 6 Becker, H. S., 1966, Outsiders: Studies in the Sociology of Deviance. New York: Free Press. Quoted in Sociology: A Down to Earth Approach (2nd ed.), J. M. Henslin 1996, Boston: Allyn and Bacon, p.194. 0 7 Sue, D., Sue, D. and Sue, S., 1990, Understanding Abnormal Behavior, (3rd ed.). Boston: Houghton Mifﬂin Company, p.7. 8 Wallace, R. A, and Wolf, A., 1995, Contemporary Sociological Theory: Continuing the Classical Tradition. New Jersey: Prentice Hall, pp.54–66. 9 Lauer, R. and Lauer, J.C., 1998, Sociology: Contours of Society. Los Angeles: Roxbury Publishing Company, pp.189–91. 10 Sugimoto, Y., 2003, An Introduction to Japanese Society (2nd ed.), Cambridge: 6 Cambridge University Press, pp.2–3. 11 Doi, T., 1973, Anatomy of Dependence. Tokyo: Kodansha International. 7 12 Minami, H., 1983, . Iwanami Shoten. 8 13 Lebra, T., 1992, “Self in Japanese Culture” in Japanese Sense of Self. N. R. 9 Rosenberger (ed.). Cambridge: Cambridge University Press, Chapter 6, 0 pp.105–20. 1 2 22 2831_CH01.qxp 6/4/09 1:08 PM Page 23

The “National Character” 1 2 14 Kawai, H., 1981, “Violence in the Home: Conﬂict between Two principles— 3 Maternal and Paternal.” In Japanese Culture and Behavior. T.S. Lebra and W.P. 4 Lebra (eds.). Honolulu: University of Hawaii Press, 1986, pp.297–306 15 Kawai, H., 2002, . (Thinking about family relations). 5 Kodansha Gendai Shinsho. 6 16 Okonogi, K., 2005, “The Ajase Complex and Its Implications” in Asian Culture and 7 Psychotherapy: Implications for East and West. W. S. Tseng, S. C. Chang, and M. 8 Nishizono (eds.). Honolulu: University of Hawaii Press, pp.57–75. 17 Nakamura, H., 1985, Ways of Thinking of Eastern Peoples: India-China-Tibet- 9 Japan. Honolulu: University of Hawaii Press. 1 18 Morton, W. S., 1984, Japan: Its history and Culture. New York: McGraw Hill. 1 19 Sakaiya, T., 2003, The Twelve Men Who Made Japan. Kodansha International, 2 pp.30–45. 20 15 . (Whitepaper on national character 2003) 3 http://www.5.cao.go.jp/seikatsu/whitepaper/h15/honbun/html/15140230.html 4 accessed December 30, 2007. 5 21 Genda, Y., 2005, A Nagging Sense of Job Insecurity: The New Reality Facing Japanese 6 Youth. Tokyo: International House of Japan Inc. 22 Kawanishi, Y., 1993, A Cross-Cultural Analysis of Stress Appraisal and Coping. Ph.D. 7 Dissertation, University of California Los Angeles, Michigan: University Microﬁlm. 8 23 Hendry, J., 1995, Wrapping Culture. London: Oxford University Press. 9 24 Lasch, C., ibid. 2 1 2 3 4 5 6 7 8 9 3 1 2 3 4 5 3 3 3 3 4 4 23 4 2831_CH02.qxp 6/4/09 1:09 PM Page 24

x 2 Mental Health at Work 0

“Man’s characteristic privilege is that the bond he accepts is not physical but moral: that is, social. He is governed not by a material environment brutally imposed on him, but by a conscience superior to his own, the superiority of which he feels. Because the greater, better part of his existence transcends the body, he escapes the body’s yoke, but is subject to that of society. But when society is disturbed by some painful crisis or by beneficent but abrupt transitions, it is momentarily incapable of exercising this influence; thence come the sudden rises in the curve of suicides . . .” (p.252) DURKHEIM.1 0 WHAT ARE THE SIGNS? Since the beginning of the century, there has been no shortage of disheartening evidence that a sense of well-being among the Japanese has been destroyed. 2008 was the eleventh consecutive year in which more than thirty thousand Japanese committed suicide. About half of the suicides are apparently due to economic and financial difficulties caused by unemployment, debt, business failure, and bankruptcy. More than half of the people who committed suicide in 2007 were 0 unemployed.2, 3 It is now estimated that approximately a hundred people kill themselves every day in Japan. A suicide hotline in Tokyo receives a record number of calls from distressed people.4 Applications for worker’s compensation due to mental illness also have shown consecutive record growth, year on year.5, 6 In 2003, a Health, Welfare and Labor Ministry survey revealed that an estimated 470,000 workers 6 were taking long-term leave due to mental problems, missing out on 7 a combined 1 trillion yen in annual wages.7 The growing perception 8 of gloominess among workers in Japanese workplaces has led to an 9 increasing number of studies and surveys measuring how serious 0 the situation really is. In 2002, for example, another health ministry 1 2 24 2831_CH02.qxp 6/4/09 1:09 PM Page 25

Mental Health at Work 1 2 survey found that 62% of workers suffered some kind of stress with 3 regard to their work environment, including human relationships, 4 quantity and quality of work, as well as anxiety over their company’s 5 future.8 6 The proliferation of mental fatigue is not only limited to “some 7 kind of stress;” more serious cases needing clinical intervention are 8 also on the increase. One survey showed that more than half of the 9 276 companies contacted reported an increase over three years in the 1 number of employees who submitted medical certificates for depres- 1 sion, neurosis, psychosomatic disorders, and personality disorders. 2 Among companies with more than 1000 employees, 70% reported an 3 increase.9, 10 Moreover, the first survey by the Health Ministry in 2006 4 also reported that 82% of companies employing more than 1000 work- 5 ers had staff who took sick leave of more than one month due to mental 6 disorders.11 7 One of the few comprehensive studies describing how stress is affect- 8 ing corporate workers confirmed the trend. Of the listed companies 9 surveyed, 60% reported an increase in mental illness among employees, 2 particularly depression or mood disorders over a three-year period. 1 Workers in their thirties had the highest likelihood of having mental 2 problems. Compared with similar studies conducted ten years earlier, 3 it is obvious that workers in their thirties are the most stressed 4 employees today. Respondents blamed their high stress levels on work- 5 load, work evaluation, and anxiety about the future. The report also 6 found that work-related pressure was caused not so much by an increase 7 in the workload, but respondents’ feelings about their job situation. 8 The sense of burden was rooted more in their perception than the real- 9 ity, a finding that implies psychological stress is being caused by the 3 manner of work, human relationships, and other dimensions in the 1 workplace. Particularly noticeable is that workers in their thirties have 2 expressed a high level of discontent about their employer’s evaluation 3 system. They also expressed a sense of hopelessness at the direction 4 of their future career, including opportunities for promotion and 5 increases in salary, and even their prospects after retirement.12 On 3 one level, these findings are nothing new – many Japanese workers have 3 felt this way for some time. But what is new is that their feelings are 3 being more clearly substantiated and validated by these studies and 3 surveys. 4 4 25 4 2831_CH02.qxp 6/4/09 1:09 PM Page 26

Mental Health Challenges x THE WAY JAPAN WAS In 1945, Japan had lost everything. All it had achieved since the Meiji modernization in the mid-nineteenth century appeared to have been destroyed. Defeat in World War II reduced nearly all the major cities to rubble and ashes. Stripped of most of its infrastructure and lacking any major natural resources, at the time no one imagined Japan would become a country of any importance. However, international circumstances, par- 0 alleled with a U.S. occupation that implemented radical democratization and de-militarization, gradually enabled Japan to recover. Its rebirth was made possible by concentrating on industrial and economic restoration. Various outside forces and events helped Japan to achieve this recovery. The Korean War, for example, while a terrible tragedy for the neigh- boring country, was a boost and lifesaver for Japan’s post-war economy. The escalation of the Cold War automatically brought Japan under the protective umbrella of the Western bloc, particularly under the security guardianship of the United States. Japan’s geographical position in East Asia was also considered to be strategically indispensable to the 0 United States. With a security treaty with the U.S. and its new pacifist constitution, Japan was able to concentrate on strengthening its economic power without spending or worrying much about the costs of defending itself. In time, Japan’s recovery and economic growth were viewed by the world as nothing short of miraculous. Dramatic economic expansion and new democratization policies naturally brought transformations in culture and social structure to the nation at an unprecedented speed. By the mid-1960s, Japan appeared to have put the traumatic experiences of World War II completely behind it. The nation was looking forward to 0 a brighter future, at least financially and materialistically. Fervor for the future was such that the Japanese seemed to have forgotten everything about the painful past of loss and defeat. At the same time, the traditional virtue of hard work and the beauty of selfless devotion to the group’s goal were welcomed with open arms by the corporate world. The dominant image of a Japanese society centered on large corpo- 6 rations employing workers who were guaranteed “jobs for life” and a 7 seniority-based wage system is true of only a small minority. The major- 8 ity of Japanese businesses are chu–sho– kigyo–, small or medium-sized 9 companies that employ fewer than three hundred workers, while more 0 1 2 26 2831_CH02.qxp 6/4/09 1:09 PM Page 27

Mental Health at Work 1 2 than half of private-sector workers are employed by companies with less 3 than thirty workers.13 4 However, the ideological impact of the big corporation and its asso- 5 ciated structure and benefits on Japanese life and aspirations was so great 6 that the image of the nation as a big-business society is still accepted 7 by both domestic and overseas observers. As the economy expanded, 8 companies exploited the metaphor of the extended family to secure 9 the loyalty of their workers – and their families. Benefits provided by 1 employers made workers see their workplace as the center of their exis- 1 tence, making their lives and their futures begin to appear as almost 2 hostage to their employers’ whim. This was also true of blue-collar 3 workers. Before World War II, only white-collar workers were forced to 4 accept long-distance transfers. But as the economic miracle took hold, 5 blue-collar workers also had no choice but to accept transfers with no 6 regard to personal circumstances.14 7 Furthermore, though lifetime employment and company benefits 8 may not have been equally enjoyed throughout all sectors of the popu- 9 lation, everyone did enjoy a rising standard of living from the 1960s 2 onward. The clear distinctions that existed between blue-collar and 1 white-collar workers weakened as their lifestyles and pastimes standard- 2 ized. Regardless of their occupation, the size of their firm or where they 3 lived, Japanese began to have similar lifestyles, consumption patterns, 4 and leisure activities. Wives of blue-collar workers got the same service 5 and same level of respect as their white-collar counterparts – working 6 class women got used to being called okusan (Madam), too. Inequalities 7 in income were not as great as in Western industrialized nations.15 So 8 a new kind of relationship between employers and workers emerged, a 9 pattern that permeated the entire occupational sphere. The clearest 3 change through this period of rapid economic growth was the complete 1 separation of home and work for employees, and the clear division of 2 labor based on gender in the home. It is ironic that at the same time as 3 gender equality became a clearly stipulated right according to the post- 4 war Constitution and civil code, many women saw their place in soci- 5 ety almost totally restricted to the home. This was a new social norm. 3 In industry, women were seen as short-term employees (usually up to 3 marriage) or as a temporary workforce that could be disposed of if 3 the company needed to cut back. When women continued to work or 3 returned to work, it was mostly as part-time workers in small 4 4 27 4 2831_CH02.qxp 6/4/09 1:09 PM Page 28

Mental Health Challenges x and medium-sized companies, roles that could in no way contribute substantially to household income. A sense of status came to be attached to this, regardless of social class. Wives who did not work, or worked part-time, symbolized the economic capability of their husbands. Like any institutionalized division of labor, this was believed to be an efficient system for post-war Japan; after all, someone had to take responsibility for the home while the husband devoted himself entirely 0 to work. In spite of sacrifice or dissatisfaction at a private level, the vast majority of Japanese who embraced this model based their choice on an absolute faith in an economically bright future. Political ideology and accompanying social policy toward the family reinforced expectations that good Japanese would fulfill these separate, gender-based roles. A further discussion of this can be found in the following chapter. By the early-1970s, ever more accelerated urbanization and rising standards of living led more than 90% of the Japanese to describe themselves as middle class. Regardless of the reality, the perception that “we are all middle class” helped to create a sense of solidarity and it was a 0 powerful force in achieving collective goals. Higher education was fast spreading to all corners of Japan. By the mid-70s, more than 90% of junior high school graduates – the last level of compulsory education in Japan – went on to senior high school. The number continuing to university also continued to rise. The “Japanese dream” in this period was based on the idea that no matter how poor a person’s family was, he or she could achieve a higher socioeconomic status by graduating from one of the top universities. Of course, the reality is more complex. Educational achievement was never completely separated from the socioeconomic status of students’ parents. Nevertheless, most people 0 believed that education, or rather a degree from a prestigious university, would offset class differences or origin. Upward mobility was possible and seemed accessible to everyone if they had a top-level education and worked hard. Besides, the Japanese economy and its share of the global pie continued to expand in a way unparalleled in world history. Scholars, business people, and journalists from around the world came 6 to Japan to discover the secret of this miracle. 7 Sociologist Masahiro Yamada says that although the period of high 8 economic growth from 1955 to 1973 brought freedom in many areas, 9 it did not bring individuals or society as a whole into contact with risk, 0 a concept that is normally associated with freedom. In a positive sense, 1 2 28 2831_CH02.qxp 6/4/09 1:09 PM Page 29

Mental Health at Work 1 2 the future was predictable to the Japanese; most eligible male university 3 graduates were able to obtain a full-time position in a company, and 4 their salaries went up steadily with time, in line with their companies’ 5 supposed growth. This sense of predictability and reliability enabled 6 workers to safely make plans for the future. They were allowed to antic- 7 ipate someday taking higher positions and salaries in the company, even 8 though they were not there at the moment. It was also a time when two 9 contradictory phenomena were seen: huge economic growth that went 1 hand in hand with the perception of a narrowing gap between the rich 1 and the poor. These two do not normally happen together.16 2 The division between men and women in the labor market actually 3 grew wider in the mid-1980s to the 1990s, when the number of regular 4 female employees decreased, strengthening the notion that a married 5 woman’s primary responsibility was for household tasks and childrear- 6 ing.17 One reason was the decision by many companies to downsize 7 their domestic operations in favor of expansion into cheaper overseas 8 labor markets. Meanwhile, under the cover of diversification, women 9 were increasingly hired on part-time or temporary contracts. The flip 2 side of this reality was that husbands were increasingly expected to 1 dedicate their lives to their jobs. 2 3 CHANGES HAPPENING NOW 4 5 Despite the temporary setback during the 1970s due to the oil crisis and 6 the “Nixon Shock” – the Japanese term for Richard Nixon’s decision in 7 1970 to discontinue gold convertibility for the dollar and thus imple- 8 ment a floating exchange rate – the Japanese economy continued to 9 grow. Japan reached the zenith of her affluence in the late 1980s, and 3 the whole nation appeared to be heading toward a twenty-four-hour 1 state of uncontrollable euphoria. However, it was rather short-lived. 2 With the burst of the bubble at the beginning of the 1990s, the opti- 3 mism that had filled Japan for decades became a thing of the past. 4 People realized that the sense of affluence they had enjoyed was built on 5 fragile assumptions based on land market speculation. When this period 3 ended, it was the beginning of long downturn in the Japanese economy. 3 With the gigantic debt the Japanese government allowed many financial 3 institutions to create, it was clear the Japanese economy was no longer 3 on the up. In 2001, the number of company bankruptcies reached over 4 4 29 4 2831_CH02.qxp 6/4/09 1:09 PM Page 30

Mental Health Challenges x 19,000, the second highest level since the survey started in 1952, with the size of debt totaling over 16.5 trillion yen.18 Japanese-style management which was a costly system to maintain, and could continue to function only as long as the economy was growing, was losing its base. In the 1990s, its fundamental mechanism turned out to be a source of vulnerability in a no-growth economy. The post-bubble period was repeatedly described as the worst economic crisis since the end of 0 World War II. The failure of corporations that once represented Japan’s economic power fast spread fear and anxiety. Corporate downsizing was one way for many companies to keep afloat. Cuts to wages, if not layoffs, were something Japanese workers in major companies had not had to worry about for decades, but now these were a very realistic possibility. Of course, numerous analyses of the situation and recommendations to remedy it have been made, and in fact, various measures have been taken to help Japan get out of this long, gloomy dark tunnel. For a few years from 2006, Japan’s economy had been recovering as evidenced by the large profits made by many large corporations. However, 0 this economic “recovery” was not sensed or firmly perceived at an individual level. The problem is that much of these profits were generated overseas, not by workers in Japan. In contrast to a very small number of “winners,” the majority of the population feels left out. It is clear that the economic force and sense of glory that once filled the country has disappeared. In fact, after several sporadic positive signs in the economy, the Teikoku Databank, Japan’s largest credit research company, reported another highest figure of bankruptcies since 2001. The number in 2007 was 11,333, an 18.4% increase from the previous year, resulting in more than 5.53 trillion yen debt.19 The worldwide economic recession in 2008 0 has certainly swallowed Japan and has presented a dimmer outlook. The unemployment rate in Japan, remaining at 4–5% during the period 2001–2007, may still be relatively low compared with other highly industrialized Western nations. However, for the country where the unemployment rate had been kept around 2% until the beginning of 1990s, the rapid rise has had a profound impact on the people’s 6 psychology.20 The widening separation of regular workers and tempo- 7 rary contracted workers has also added to the sense of uncertainty about 8 their jobs among the latter group of workers. 9 Furthermore, the number of personal bankruptcies also increased 0 greatly from the end of 1990s and reached the record high of almost 1 2 30 2831_CH02.qxp 6/4/09 1:09 PM Page 31

Mental Health at Work 1 2 250,000 cases in 2003. The number of households on welfare in 3 2004 was over 1 million for the first time and is estimated to continue 4 to increase.21 5 Now Japan is struggling to find new ways to maintain what it still 6 has – not as a young dynamic society, but as a mature past-prime society. 7 The turning points are not only economic; the ramifications are far 8 more profound, and have been felt in every corner of society in recent 9 years. The changes taking place are wrecking the fundamental assump- 1 tions on which Japanese society has been built since the end of World 1 War II. Visitors from abroad who see the Japanese carrying on as if 2 nothing has changed, buying up expensive foreign brand-name goods 3 and the latest in home electronics, may think nothing is wrong with 4 the Japanese economy. But the apparent material prosperity hides the 5 true picture. 6 Yamada says Japan is seeing a widening gap between the rich and the 7 poor. A 2004 Yomiuri Shimbun survey for 3,000 randomly chosen sub- 8 jects nationwide also confirmed that more than half (55%) the public 9 believe the economic disparity is increasing.22 More importantly, the 2 gap is being created not only in socioeconomic terms, but in people’s 1 hopes for the future. The post-war decades were characterized by a sense 2 of optimism and freedom from risk. But life as it is perceived by the 3 Japanese today is full of risks, which make it difficult to plan for the 4 future. The steady polarization of Japanese society implies there are two 5 groups of people: one group of people who believe that hard work will 6 pay off and who, therefore, are hopeful about the future, and another 7 group who are unsure about the future, and, therefore, do not try to 8 improve their lot.23 9 So in what ways are these economic and social changes affecting the 3 working environment? 1 First of all, workers can no longer count on job security. What has 2 happened to the Japanese economy in the last fifteen years has brought 3 fear, anxiety, and confusion to those who still have a job, and a sense of 4 betrayal to those who have been made redundant. The enormous stress 5 people feel today is ironically coming from their workplace, the very insti- 3 tution and community that used to protect them from the harsh realities 3 of life. Competition within companies has grown fiercer as those still work- 3 ing try to gain more of a smaller pie. The result can be seen in the Health 3 Ministry’s nationwide survey reports of 16,000 workers in ten major 4 4 31 4 2831_CH02.qxp 6/4/09 1:09 PM Page 32

Mental Health Challenges x industries from primary to tertiary industry. These show that 62% of workers suffer from high stress and anxiety at work, particularly in human relationships (35%), amount of work (32%), the content of work (30%), and future or their company (29%).24 One of the ways companies have adapted to the changing milieu has been to remove the seniority-based wage system, and instead, to introduce performance-based pay. The introduction of performance-based evaluations was intended not only to reduce 0 personnel costs but also to stimulate and motivate individual employees. Since the late 1990s, an increasing number of blue-chip companies have begun to operate a strict employee-evaluation system. According to the Japan Management Association, 83.3% of major corporations responding to a 2004 survey say they have introduced personnel systems that primarily use performance-based evaluation.25 Many companies have tried to modify the system to better ﬁt the reality of the existing corporate culture. However, hasty implementa- tion of evaluation systems has resulted in longer working hours, and left workers experiencing intense pressure to perform better. Trust has 0 disappeared from the employer-employee relationship, and the new systems have caused so much discontent and anxiety, there have been repeated calls for the traditional management style to be brought back.26 Thus, even if one escapes the tragedy of being laid off, one may still be exposed to another tragedy at work: excessive stress due to excessive expectations. This no-win situation partly accounts for the fact that mental illness, mainly depression or other stress-related disorders, was cited in a record number of worker’s compensation cases in 2006. The majority of cases involved workers in their twenties to ﬁfties, some of whom committed 0 suicide. The long working hours now required to make up for the dismissed workers have also resulted in an increase in the number of workers receiving compensation for heart disease and strokes.27 Furthermore, a 2003 survey by the health ministry covering 2,100 man- ufacturers nationwide revealed that an estimated 470,000 workers were taking long-term leave due to mental problems, missing out on a com- 6 bined 1 trillion yen in annual wages.28 What is happening to these 7 workers? Whether it is of a private or professional nature, if the mental 8 pressure they experience is not outwardly expressed to others and an 9 actual change in their environment brought about, one of the most 0 acute and destructive responses to these stressful situations is suicide. 1 2 32 2831_CH02.qxp 6/4/09 1:09 PM Page 33

Mental Health at Work 1 2 SUICIDE AND THE JAPANESE 3 4 One of the most serious public-health issues in Japan today is the acute 5 increase of suicide. As we have already seen, in 2008, the number of sui- 6 cides continued the trend throughout the decade, hitting a record high 7 and exceeding thirty thousand for the eleventh consecutive year. More 8 than half of these cases were caused by financial difficulties such as debt 9 and unemployment, factors that had hit many men in their prime.29, 30 1 One of the worst results of this suicide epidemic is the compassion- 1 fatigue that it has caused. It is not unusual for commuters to be notified 2 that their train will be late or held up due to “an accident involving a 3 human being.” Jumping in front of a train is one of the more popular 4 methods of suicide in Japan. Train company personnel are amazingly 5 well trained to handle these situations, including notifying passengers, 6 rescheduling the trains, and cleaning up. Suicide on the tracks has sim- 7 ply become an annoying part of their daily work. When commuters 8 hear an announcement of an “accident,” most do not seem terribly 9 shocked or concerned about the tragedy of the unknown individual. 2 Almost simultaneously, however, they call their friends, colleagues, or 1 families on their cell phones, as they ARE concerned they will be late. 2 When I encountered this situation for the first time a few years ago on 3 the busiest train line in Tokyo, I was shocked by the aloofness of the 4 other passengers. The reaction suggested annoyance, as if it was “Oh, 5 another one. What a nuisance!” Indifference to others is not uncommon 6 in urban settings. However, it does not seem to occur to the Japanese 7 that there is something abnormal about developing immunity to the 8 news that another person has taken his or her life, and in a particularly 9 violent and painful way. Of course, no one looks happy about it, but no 3 one looks too cut up, either. What is incredible is the kind of hardness 1 in the air that suggests this is nothing to be surprised about. 2 The idea that the Japanese have a proclivity for suicide is not new, 3 and is almost a cliché. Western observers of Japan have expressed intel- 4 lectual curiosity about the Japanese obsession with and fanaticism about 5 death, and even connected it with a certain aesthetic unique to Japanese 3 culture. It is true that suicide as a laudable act has a special position in 3 Japanese history. During the feudal period, seppuku, or ritual suicide by 3 samurai, was considered an honorable deed. Double suicide by lovers 3 who were unable to be together in this life and hoped to see their love 4 4 33 4 2831_CH02.qxp 6/4/09 1:09 PM Page 34

Mental Health Challenges x realized in heaven or the next life, was seen not only as tragic, but also as an expression of ultimate romanticism. A parent taking a child’s life at the same time as killing him or herself was seen not as a purely deplorable incident, but with some sympathy and understanding for the parent’s decision, and was even interpreted as the expression of parental love and responsibility toward the child. Most famously, the kamikaze attacks on U.S. battleships at the end of World War II, which were seen 0 as an act of insanity in the eyes of Westerners and most contemporary Japanese, were beautified and idealized as the ultimate sacrifice for the homeland. Even today, there are occasionally cases of interfamily joint suicides, and there is still a widespread perception of suicide as the ultimate form of apology for what is considered an irretrievable mistake, illustrated in the Japanese idiom, “to apologize by dying.” Killing oneself to show true remorse supposedly cancels out mistakes and shame. All these factors point to a certain cultural tradition in Japan that tolerates or even supports suicide as a final method of problem resolu- tion. Additionally, because Japan does not have a culture based on Judeo- 0 Christian principles, it has never attached a particular sense of shame or guilt to the act of suicide. But do cultural peculiarities answer all the questions raised by Japan’s possession of the highest suicide rate of highly industrialized nations, a bloc in which all other countries fundamentally share similar religious beliefs? Is culture a good enough explanation? Despite public perceptions, however, Japan does not have the most suicidal people. Top of the list of countries with the highest suicide rate per capita is Lithuania, followed by Russia, Belarus, Ukraine, and other countries that used to be part of the Soviet bloc. These societies have suicide rates of around 40 per 100,000 people. Understandably, the Baltic states 0 and others in the vicinity underwent enormous social confusion and upheaval following the collapse of the USSR. Even after becoming independent, they still struggle to survive as nations, a situation that has put great strain on their citizens’ well-being. Japan ranks tenth after these countries with a rate of 24.1 per 100,000 people.31 However, the preced- ing nine countries and Japan are not quite comparable in terms of their 6 social development. It is clear that Japan’s suicide rate is unusually high 7 when compared with highly industrial or postindustrial nations. That of 8 the United States is 10.4, Germany 13.5, Sweden 13.4, France 17.5, and 9 the United Kingdom 7.5. Of particular note is that while Japan’s suicide 0 rate was not much higher than Western European nations through the 1 2 34 2831_CH02.qxp 6/4/09 1:09 PM Page 35

Mental Health at Work 1 2 1990s, at the turn of the century it showed a massive increase to its pres- 3 ent level.32 It coincided with after-effects of the bursting of the economic 4 bubble, effects that by this time had spread across the country. 5 Furthermore, the Japanese most likely to take their own lives are 6 middle-aged or older men. In the 1950s, those most likely to kill them- 7 selves in Japan were young adults, a pattern common in developing 8 societies around the world. But by the early 1990s, middle-aged and 9 older men, a group of people supposedly in the prime of their profes- 1 sional lives and with greater resources than any other age group, were at 1 the highest risk of killing themselves. As suicide rates for middle-aged 2 men in Western countries have remained unchanged or are even on the 3 decline, this phenomenon is indeed peculiar to Japan.33 Various social 4 factors are to blame. In a society like Japan, in which each generation 5 has survived a rapid transformation in values, beliefs, and norms, factors 6 unique to each group can sometimes be the decisive elements in their 7 patterns of behavior. The gradual rise in the number of middle-aged 8 men committing suicide has been pointed out since the early 1990s. 9 All these men belong to a generation that spent its childhood and 2 adolescence in a period during which the dominant ideology was one 1 that stressed the importance of diligence and self-sacriﬁce for the sake 2 of their company or the group to which they belonged. Hard work 3 was supposed to bring a better life and happiness. As Japan’s post-war 4 history proved, a belief in the “the more, the better” allowed the 5 economy – and citizens’ lives – to thrive in a small island nation with 6 few signiﬁcant natural resources. It was this belief that lifted Japan 7 from complete devastation to being the world’s second largest economy. 8 The belief was so widely shared during the decades of expanding pros- 9 perity that it became an unassailable principle. However, the sense of 3 prosperity was blown out of proportion, as the bubble economy of the 1 late 1980s showed. The burst of the bubble in the early 1990s made 2 this generation realize that everlasting growth was an impossible dream. 3 Slowly, Japan began to reach a turning point. The generation that had 4 built the expanding economy was tough and energetic at work, but 5 when links with work failed, showed surprising vulnerability. 3 As we have seen, in the late 1950s, the group with the highest suicide 3 rate was young adults. Interestingly, it is the men of this same generation 3 who, decades later, have the highest suicide rate by the 1990s.34 Though 3 this generation has shown impressive perseverance in pursuing a certain 4 4 35 4 2831_CH02.qxp 6/4/09 1:09 PM Page 36

Mental Health Challenges x goal, it also has witnessed an extraordinarily turbulent period. These people spent their formative years experiencing war and its aftermath. As they grew up, the ideologies, beliefs, and values that once seemed solid and secure were repeatedly replaced by new perspectives. However, surviving such a rapid transformation in their environment implies they had to make many adjustments in a hasty way, probably giving up many ideas and priorities that were once precious and dear. While they 0 also achieved great material wealth, it is possible they experienced a deep sense of spiritual loss for more intangible things. Such an unexpressed sense of profound loss may have created a fragile spot in the psychic structure of this particular generation.35 This sense of loss may also have come from the real experience of losing someone precious through death or separation. However, as the ideology of the time emphasized self- sacrifice for the greater good, they were not allowed to have enough time to grieve, and so buried the pain of loss inside as an unresolved trauma. The kind of fragility that characterizes this post-war generation may also reflect the vulnerability of contemporary Japan as a society. The 0 unquestioned belief that hard work will always pay off is a double-edged sword. When it does not, it is an irrecoverable blow. Thus, the characteristics of this generation’s men may be described this way and be held, in part, responsible for the high suicide rate. But from a mental-health standpoint, the majority of middle-aged men who committed suicide are, as in any society, suspected of having been suffering from clinical depression. Many Japanese psychiatrists and researchers have found that this generation of Japanese men has a special propensity for developing clinical depression in times of intense conflict. In addition to being hardworking and loyal to their companies and workplaces, these men tend 0 to be extremely punctual, want everything to be well-organized, and are willing to avoid confrontation. The way they do this is not by openly discussing a problem with others, but instead by forcing themselves to concede. This type of personality is believed to be particularly vulnerable to depression, according to the description of melancholy-prone types by German psychiatrist Hubertus Tellenbach.36 6 7 THE MEN WHO CANNOT SAY “NO” 8 9 This generation’s personality has also been described as predominately 0 “A-type.” A-type people are generally described as having a strong sense 1 2 36 2831_CH02.qxp 6/4/09 1:09 PM Page 37

Mental Health at Work 1 2 of competitiveness, impatience, and an aggressive interest in figures. 3 A-type people are believed to always energetically pursue individual suc- 4 cess. They can be very aggressive and even hostile to others. However, 5 the characteristics of Japanese male A-types are somewhat different from 6 the A-type personality in the United States. A-type men in Japan tend 7 to control their feelings to an extreme level, and are very careful not 8 to come into conflict with others at work. A strong sense of duty and 9 obligation – especially in human relationships – is the most distinctive 1 characteristic of Japanese A-type men. Willingness to self-sacrifice for 1 the sake of achieving positive evaluations from others is another char- 2 acteristic. When asked by colleagues to do something, it is difficult for 3 these men to say no. Furthermore, they are prone to feel guilty if they 4 do not work overtime, or if they take a break when others are still at 5 work. The more typical “Japanese” A-type they are, the more they will 6 try their hardest to live up to others’ expectations, often at the cost of 7 their own frustrations, anxiety, and anger.37 8 Since open expression of one’s feelings is not an accepted norm in 9 Japanese culture, not to mention in Japanese workplaces, workers, when 2 frustrated, often turn to methods of temporary and substitute release, 1 such as drinking, smoking, and eating. Not surprisingly, these habits lead 2 to chronic physical ailments. Drinking is seldom seen as a serious psy- 3 chological problem among Japanese white-collar workers. Alcohol addic- 4 tion exists in the same way in Japan as everywhere in the world, but to 5 see it as an illness needing intervention and treatment is uncommon, as 6 long as the person can conduct himself/herself reasonably well at work. 7 Making mistakes or losing control of oneself under the influence is gen- 8 erously tolerated. The general public does not have an accurate under- 9 standing of alcoholism, and families and friends of alcoholics will often 3 describe it as a funny characteristic or describe the pathological depend- 1 ency on alcohol simply as a troublesome or annoying habit. However, the 2 first nationwide survey on drinking and related problems by the Health, 3 Labor, and Welfare Ministry reported that 820,000 people are estimated 4 to be addicted to alcohol and about 30.4 million people have suffered 5 from incidents related to alcohol abuse.38 3 Psychiatrist Satoru Saito has analyzed the social psychological mech- 3 anism that traps salarymen into alcohol dependency. Loyal, selfless 3 corporate soldiers have been the well-(or even overly) adjusted type in 3 Japanese society. But thanks to the fact that society seems to function 4 4 37 4 2831_CH02.qxp 6/4/09 1:09 PM Page 38

Mental Health Challenges x with their interests in mind, Saito says they gradually develop an extremely self-centered, narcissistic and almost childish view about the world surrounding them; they are the ones who run the company and they are irreplaceably precious workers. They are also exempted from any other responsibilities such as being a good husband or a good father. The liquor and bar industries depend on these patrons for their survival. Drinking socially as part of their job acts not only as a continuation of 0 business, but also further boosts their self-centered belief and narcissistic world view. The role of hostesses in the countless “snack bars” and clubs that serve these corporate warriors is to act like mothers to these men rather than be someone who embodies mature and sexy feminin- ity. What these women are expected to do is to mollycoddle these men and nurture their otherwise fragile egos.39 Up to a point, all the characteristics of this generation’s men were highly suitable for and functioned well within the context of a growing economy. While the economy was expanding and material wealth continued to grow, the negative sides to these characteristics were ignored, 0 and in fact did not surface enough to deserve serious scrutiny. The underlying vulnerability that Saito shows exists beneath the tough corporate façade means it is easy to understand why these totally work-committed men plunge into depression when they are stripped of their corporate identity. But they are not the only victims of serious depression and subsequent suicide – it can also affect those who not only keep their jobs, but also become too deeply involved in work. In recent years another cliché has joined that of the Japanese male as someone ﬁlled with irrational suicidal urges – that of the salaryman who literally works himself to death. These are the victims of the notorious 0 “karoshi.”

KAROSHI: STILL A FORM OF SUICIDE Karoshi, literally translated as “death from overwork,” is a phenomenon in which workers suddenly die because accumulated stress induces 6 physical conditions such as heart attacks and strokes. Typically, karoshi 7 affects workers in their forties and ﬁfties. Though health problems 8 resulting from overwork have long existed, karoshi began to be recog- 9 nized as a social issue in the late 1980s, when the media started to report 0 on bereaved families who ﬁled lawsuits against the employers of the 1 2 38 2831_CH02.qxp 6/4/09 1:09 PM Page 39

Mental Health at Work 1 2 deceased for failing in their managerial responsibility. Karoshi came to 3 be seen as a complex legal, psychological, and sociological issue repre- 4 senting a certain aspect of Japanese work culture. As bereaved families 5 gradually spoke up in public, the Japanese began to question whether 6 there was something seriously wrong with their attitude to work. And 7 when overseas media started to cover these incidents, karoshi joined the 8 list of peculiar Japanese attitudes toward death. Just as the propensity 9 for suicide is at times perceived to be a pathetic trait of the Japanese 1 character, epitomizing the “corporate warriors” who gave up their lives 1 for the company, karoshi was another boost to the image of the “incom- 2 prehensible” Japanese in the eyes of overseas observers.40, 41, 42 The num- 3 ber of cases of karoshi that have resulted in worker’s compensation has 4 dramatically increased since the late 1990s, as has the number of unre- 5 solved applications. For example, out of 705 cases submitted in 2003, 6 312 deaths were recognized as caused by work-induced strokes or heart 7 failures. This is more than double the number of cases in 2001 and 8 almost four times the number of cases in 1999.43 In 2005, the figures 9 reached 330 recognized cases out of 869 applications, a 12.2% increase 2 from the previous year.44 However, since not all families apply for 1 compensation, these figures (both applications and resolved cases) are 2 believed to be the tip of the iceberg. Some families are dissuaded from 3 resorting to legal action, while others may settle with employers out 4 of court. 5 “Why does a racehorse gallop so enthusiastically, pushing itself to the 6 limit to win?” asks one woman who lost her twenty-six-year-old son to 7 karoshi in the early 1990s. “Thoroughbreds are gentle, docile, and beau- 8 tiful. But if they are injured in a race, they are destined to be mercilessly 9 disposed of. I think Japanese businessmen are no different from these 3 horses.” Her son worked as a computer engineer for a major Tokyo- 1 based insurance company. She recollects he was always a very healthy 2 child, but once a salaryman, was constantly deprived of sleep because he 3 was on call around-the-clock. He eventually died from heart failure, and 4 was not the only employee of the firm to die abruptly.45 A woman whose 5 forty-six-year-old husband died in 1994 after he had a stroke says his 3 promotion to section chief was a passport to karoshi. Her husband 3 worked for an agricultural machine sales company, a job that involved 3 traveling across a large geographical area, long distance journeys and 3 frequent business trips. After he was promoted, his responsibilities and 4 4 39 4 2831_CH02.qxp 6/4/09 1:09 PM Page 40

Mental Health Challenges x workload increased to a level that led him to say “even if I work 365 days a year, I still have more work to do.” In the last month before his death, he worked 331 hours: twice the hours stipulated in the company’s rules of employment.46 The cause of karoshi is not limited to physical ailments. Of all the karoshi phenomena, the most difficult to determine is karo-jisatsu (suicide by overwork) induced by extraordinarily stressful working 0 conditions. While it is always difficult to exactly point out the reasons for a person’s decision to commit suicide, it is particularly difficult to prove a causal link between the person’s motivation to take his life and an unbearable work schedule and environment. However, the record high 81 cases were officially recognized as karo-jisatsu and compensated in 2007, doubling the number of cases in 2003.47 When Junichi Watanabe, a forty-one-year-old middle manager of a major steel manufacturing corporation, jumped from the top floor of his company headquarters, he had had no more than two days off during the previous six months. In order to meet the demands for increased 0 production as well as to train junior staff, he would get home at midnight almost every day and also went to work in the holidays. He was not a workaholic by nature. He was a friendly person who enjoyed his social life and was also a respected supervisor at work. His peers regarded him as a mentally-balanced person with a high sense of personal integrity. However, three months before killing himself, he often became irritable and angry, and said, “I cannot speed up the work. I feel like dying. Am I a horse tied to a carriage?”48 Like karoshi, karo-jisatsu is found in all types of workplace – both public and private sectors – and among all corporate ranks, from clerical staff, middle management, to 0 executives. With this in mind, it is unsurprising to see that karo-jisatsu also is not limited to a particular demographic, and affects workers from their twenties to their sixties. However, it is predominantly a male problem, partly because of the lower ratio of female full-time workers in the Japanese labor market. Those committing karo-jisatsu are typically exposed in the six 6 months to one year prior to their death to extremely long working 7 hours, a poor working environment, and a heavy workload. Many had 8 not taken vacations or had weekends off and were burdened with enor- 9 mous responsibility, both physically and mentally, or were under 0 extraordinary pressure to achieve a very difficult goal.49 The economic 1 2 40 2831_CH02.qxp 6/4/09 1:09 PM Page 41

Mental Health at Work 1 2 downturn in the early 1990s only aggravated victims’ sense of burden in 3 the workplace. It is believed that instead of dying from heart disease or 4 strokes, these people developed depression, which led them to take their 5 own lives. It is not uncommon for people who died from physical 6 ailments caused by unreasonably hard work to also be depressed, but 7 it is reasonable to suggest that their physical deterioration killed them 8 before their mental state could lead them to suicide. 9 One of the particular characteristics of karo-jisatsu is that those com- 1 mitting suicide often blame themselves for not being able to fulfill their 1 tasks. Suicide notes left by these people are often filled with words of 2 apology and remorse for causing their family and company “a lot of 3 trouble.” Conspicuous by their absence are words of blame or anger 4 targeted at their company’s management, who are in fact responsible for 5 driving these people to self-destruction. 6 On the other hand, the anger and frustration of the bereaved fami- 7 lies is extremely intense, because they know how hard and devoted their 8 family members were before they committed suicide. 9 “Why did the company make my father work until he died?” asks a 2 twenty-one-year-old woman. She watched her father, an engineer at a 1 major shipbuilder, work day, night, and weekends. It was clear he was 2 growing completely exhausted by such a work schedule. His “recorded” 3 amount of overtime reached eighty hours a month, and she believes he 4 was working many more hours in reality. “While he was working so 5 hard, he must have developed depression. Why did the company con- 6 tinue to make him work, knowing that he was overburdened?” she 7 asks bitterly. 8 When the physical exhaustion of one woman’s twenty-four-year-old 9 son was too obvious to ignore, she decided to take him to hospital. 3 Unfortunately, it was too late – he had killed himself at his workplace, a 1 sauce factory. He was one of the firm’s most conscientious and hardworking 2 employees, and took his job very seriously. When his mother repeatedly told 3 him to take a day off, he said that without him, the staff at the factory could 4 not do their job. “I learned later that he had been telling his boss ‘I am tired,’ 5 ‘I may quit,’ ‘I may have a nervous breakdown,’ ” the woman says. “If the 3 company had taken his situation more seriously and responded to my son’s 3 claims more sincerely, he wouldn’t have killed himself.”50 3 The nineteenth-century French sociologist Emile Durkheim was the 3 first person to discuss the significance of factors such as region, gender, 4 4 41 4 2831_CH02.qxp 6/4/09 1:09 PM Page 42

Mental Health Challenges x or place of residence in defining the likelihood of an individual to commit suicide. His thesis is a classic discussion of the causes of suicide, and much of it holds true today. While there is no denying that suicide, a very personal choice, is conditioned by an individual’s psychological disposition, contrasting suicide rates among different countries imply that there are some social factors that foster a predisposition toward suicide. Durkheim identified three types of suicide. 0 First, “egoistic suicide” comes from an excessive state of individuation. This type of suicide is committed by those whose ties with the groups to which they belong become so weak and their concern so limited to their own selves that they depend on and care only about their own rules and interests. Second, “altruistic suicide” is committed by those who are so strongly integrated into society that they come to believe suicide is an act that will lead to the restitution of honor. In contrast to “egoistic suicide,” it comes from insufficient individuation and happens when the values and norms of a closely-tied group or organization take full control of an individual’s life. Samurai who committed 0 seppuku or the suicide of Imperial Japanese Army officers are examples of this kind of loss of individuation. The third type is “anomic suicide.” Anomie is a state in which norms are lost and the normlessness controls an individual’s life. This kind of suicide is committed by those who suffer from sudden loss of regularity, common values, and morality in the wake of a crisis, such as industrial and financial disasters or other events that destroy social order.51 People who have lost social status through unemployment are thrown into a kind of normless state. When they are unable to adjust to their new reality, or cannot bear the sense of confusion joblessness brings, they may 0 end up taking their own lives. Therefore, anomie suicide may play a part in karoshi. Today, even people who still have jobs and social status are faced with the constant fear of losing them. Hiroshi Kawahito, a lawyer specializing in cases of karoshi, says that in Japan, the negative psychological impact of hearing that unemployment is increasing can be greater than that caused by simply learning actual unemployment figures. The 6 fear that the same can happen to oneself is so great that this antici- 7 patory anxiety drives people, as ironic as it may seem, to work to death. 8 However, their anxiety may well be justified, based as it is on the dire 9 financial situation the unemployed face in Japan. The stigma against 0 the jobless also is strong in Japan, which is unsurprising, when one 1 2 42 2831_CH02.qxp 6/4/09 1:09 PM Page 43

Mental Health at Work 1 2 examines how strongly employment is tied to self-worth. The lack 3 of an adequate safety net in Japan is another reason for this fear. 4 Unemployment means one will have, after a while, the real possibility of 5 going bankrupt and losing everything.52 Thus, people who drive them- 6 selves into the corner of karoshi may be facing anticipatory anomie: if 7 they lost their jobs, their lives would be completely chaotic, so they keep 8 working until they have destroyed themselves. 9 But karo-jisatsu is slightly different. According to Durkheim’s crite- 1 ria, it can be considered mainly as a form of “altruistic suicide.” The fact 1 that many men who committed karo-jisatsu also blame themselves for 2 not being able to fulﬁll the goals they were expected to achieve at work 3 suggests their suicide was in part a face-saving act. Even so, it can be 4 seen as “altruistic suicide” more in the sense that the individual’s criteria 5 of desirable behavior resided not within himself but externally. The 6 individual is totally submissive to the standard set by external values 7 and acts as if his individuality has been completely subsumed to some- 8 thing external. In Kawahito’s view, this form of suicide can be called 9 “kaishaism suicide,” or corporate-caused suicide. 2 The complexity of karo-jisatsu is that the person’s overburdened cir- 1 cumstances are not simply imposed by outside forces. That is, the indi- 2 vidual is not explicitly coerced into working to the point of suicide. In 3 fact, many cases show that people who committed suicide after over- 4 work had voluntarily taken on so much of the work that eventually led 5 them to lose their mental balance. They were exemplary workers known 6 for their diligence, dependability, and particularly strong sense of duty 7 and responsibility. They obviously worked excessively, but also willingly 8 continued to do so. Therefore, the forces that led them to suicide came 9 from within as much as from without. To understand this voluntary 3 aspect of workers’ motivation is vital to understanding karo-jisatsu. 1 Before reaching the point of killing themselves, many individuals were 2 well aware they were working too much. As they reduced their sleep and 3 time off, they developed chronic ailments. Their family and friends may 4 have warned them, or even begged them, to stop and take a break. But 5 these workers kept working. 3 Here, the big question a non-Japanese person often asks is “Why? 3 What makes these people choose to keep working at the expense of their 3 mental and physical health?” There is no simple answer – each suicide 3 after all has its own unique and personal reasons. However, both karoshi 4 4 43 4 2831_CH02.qxp 6/4/09 1:09 PM Page 44

Mental Health Challenges x and karo-jisatsu do offer insights into certain patterns and behavioral traits unique to Japanese society. They grow out of the intricate dance between an individual’s willingness and society’s compulsion. It also represents a growing mismatch between traditional values and the reality.53

FACTORS SPECIFIC TO THE JAPANESE WORKPLACE 0 – Masakazu Ono, a specialist in karoshi and karo-jisatsu, points out the overwhelming importance of human relationships and personality factors in the typical Japanese workplace, which may not be easily applied to Western working environments. There are of course universally applicable principles of efficiency, rationalization, division of labor, and so on. But in Japan, other additional factors such as workers’ personality and attitude, or ways of thinking that are not easily measurable and are often considered too personal and private in Western workplaces, are seen as crucially important. These personality factors relate to whether 0 the person has a “good cooperative attitude,” how considerate to others he is, and how willing and sincere he is in trying to work and assist others in the workplace. One way to express this “desirable attitude” to others is to show a willingness to take on more work than is strictly defined or one is expected to do. The more the diligent worker expands the boundaries of his tasks, especially in helping others, the higher he is evaluated.54 None of this is written down or explicitly explained to workers at the time of hiring, but there is a tacit agreement that these qualities are strongly sought in Japanese workplaces. Therefore, in an extreme example, a person who is not necessarily very productive can be 0 highly evaluated as far as he exhibits all these “desirable personality qualities,” such as willingness and eagerness to be a part of a team. A person who is good at getting things done and who shows real results is not necessarily evaluated higher unless he or she shows these human qualities, and in fact can be evaluated lower if he or she behaves in a self-centered, uncooperative way. For example, if he or she always leaves the office at 6 the official end of working hours, or as soon as his or her job is done, 7 that person may be deemed not a very good worker. Job descriptions 8 tend to be rather vague, if they exist at all. This implicit but well under- 9 stood aspect of evaluation criteria makes such job descriptions and 0 job boundaries even more blurred, creating the possibility that one’s 1 2 44 2831_CH02.qxp 6/4/09 1:09 PM Page 45

Mental Health at Work 1 2 position can be extended to encompass more and more work to almost 3 an indefinite scope. 4 Karoshi and karo-jisatsu can be easily associated with long working 5 hours. Japanese workers are, like those in any highly industrialized nation, 6 supposedly protected by labor laws that stipulate a basic forty-hour work- 7 ing week and additional pay for any overtime. Though recent surveys 8 seem to suggest the United States has surpassed Japan with regard to the 9 total number of hours worked a week, in reality the Japanese workplace 1 requires workers to stay at work for longer than other countries. The rea- 1 son is that in Japan, a great number of hours of overtime are not included 2 in official statistics. This hidden work, called “service” overtime – using 3 the katakana word “service,” meaning free, is simply overtime without 4 pay and is not officially recorded by employers. It is widely believed that 5 this type of illegal overtime is rampant in Japan, and is one of the most 6 obvious examples of the implicit agreement that exists in many Japanese 7 workplaces. 8 A woman whose son killed himself after overwork says that no mat- 9 ter how long he worked, his payroll would only record that he left work 2 at 9 p.m. Even when he was called to come in to do extra work after 1 midnight, it was seen as unpaid overtime. Another woman whose son 2 committed suicide at his company says that most of his long working 3 hours were “service overtime,” including work at home after hours and 4 on weekends.55 5 The recent introduction of performance-based pay has meant this has 6 become a common experience for nearly all white-collar employees.56, 57 7 In fact, demand for unpaid overtime in recent years because of down- 8 sizing and cost-cutting has become so common that many workers 9 see nothing but a gloomy – and badly paid – future. These fears have 3 been voiced in expressions such as “the age of zero overtime pay” or 1 “disappearing overtime pay.”58, 59 2 The rationale on the employer’s side is that paying workers based on the 3 hours they work implies rewarding slow, inefficient workers. Therefore, 4 many employers consider a performance-based evaluation system to be 5 a more efficient and accurate method of evaluating employees’ ability, 3 thus encouraging the proliferation of “service overtime” in Japanese 3 workplaces.60 3 However, attributing work-related suicide to long working hours 3 alone is too simplistic. Long working hours are one factor, but more 4 4 45 4 2831_CH02.qxp 6/4/09 1:09 PM Page 46

Mental Health Challenges x serious are the various kinds of stress brought about by recent changes in the Japanese workplace.61 At the heart of these changes is the introduction of performance-based evaluation. Its basic principle is the complete converse of the traditional seniority-based salary system. When Suwa Tatsutoku, aged thirty-four, committed suicide, he had been working more than a hundred hours of overtime every month. When he started working, not having gone to university meant he had worried about 0 being left behind his more educated colleagues with regard to promotion. But when a performance-based evaluation was introduced to his company, his hard work meant he was able to move up through the ranks and prove his ability to his employer.62 The performance evaluation system causes workers to experience strong pressure to produce tangible results. To achieve these, they often end up working longer hours. Generally, it is assumed that lower-level workers are given less autonomy and decision-making power, and therefore are expected to experience a lot of stress from trying to fulﬁll the high demands of management, as well as put in long working hours. It 0 is also assumed that stress will decrease as the worker is allowed to have more autonomy and freedom at work. However, karo-jisatsu happens not only to lower-level workers with less freedom, but also to middle- ranked managers who are supposed to have high levels of discretionary power. These people, who are given a lot of discretionary powers and freedom, also end up working long hours at their own discretion. The irony of Japanese workplace dynamics is that decision-making power does not necessarily lead to less stress, but rather puts workers under pressure to willingly accept more work. A position seemingly accompanied by more freedom and autonomy in fact means more constraints – 0 and less capacity to control workload. Ono maintains that for this reason, it is inadequate to understand death by overwork in Japan only through examining ofﬁcial records of working hours and the rank of workers who die.63 Another irony of karo-jisatsu is that the people who commit suicide often possess the very personality characteristics that Japanese corpora- 6 tions have always rated as most desirable. Employers in Japan have long 7 sought employees who are friendly, kind, considerate to others, punc- 8 tual, and responsible. But today, the more of these qualities the person 9 has, the more likely it is he will be given greater responsibility and 0 will end up in circumstances that are dangerously conducive to causing 1 2 46 2831_CH02.qxp 6/4/09 1:09 PM Page 47

Mental Health at Work 1 2 karo-jisatsu.64 It is as if an essential part of Japanese corporate culture has 3 somehow backfired and ceased to function. Or is a better metaphor an 4 auto-immune disease, which has started to consume our own immune 5 system? 6 7 Clearly, Japan’s post-war prosperity depended on people who worked 8 hard and who also exemplified corporate virtues. Their hard work was 9 properly appreciated and rewarded at their workplace, as these virtues 1 were unanimously accepted and expected of every worker. There was 1 no mismatch between what was considered desirable and how it was 2 accepted in reality. However, since the 1980s and, more specifically, 3 since the collapse of the bubble economy, the Japanese workplace has 4 undergone fundamental changes. Workers’ consciousness and attitudes 5 have polarized. A gap has emerged between types of workers, one repre- 6 senting those who have lived and will continue to live by the old corpo- 7 rate values and the belief that hard work always pays off, and another 8 type that no longer believe in these values. The gap in different work- 9 loads and responsibilities has widened between those who continue to 2 abide by the old rules and therefore are willing to take on a lot of work, 1 and those who do not. This has resulted in unfair distribution of work, 2 overburdening the former with extra expectations and pressure. These 3 people, however, are exactly the type of workers who cannot turn down 4 requests, but are willing to work harder to fulfill any expectations placed 5 on them. The harder they work, the more they feel obliged to take on 6 new responsibilities, and eventually they find themselves stuck in a 7 vicious cycle. Karo-jisatsu may be symbolic of such newly-emerging 8 contradictions in Japanese workplaces.65 9 3 1 FACTORS SPECIFIC TO JAPANESE SOCIETY 2 Behind the situation Japanese workers are facing today is a deep-rooted 3 philosophy about work itself. It is often said that post-war Japan is a 4 corporate-centered society in which the values and priorities of the cor- 5 poration consume workers’ lives. But more fundamental and important 3 are Japanese cultural perspectives on how work (rather than corporate 3 organizations) is viewed, and the meaning attached to labor, which 3 orients and directs most people’s lifestyles. Karo-jisatsu is not only 3 committed by company employees. Other professionals such as civil 4 4 47 4 2831_CH02.qxp 6/4/09 1:09 PM Page 48

Mental Health Challenges x servants, teachers, lawyers and doctors and nurses are also victims. To understand the mystery of karoshi in Japan requires an examination – of more than just the workplace situation of the victim. Ono argues that Japan is, rather than a corporate-centered society, a work-centered society.66 In fact, noncorporate workers such as teachers and doctors are – sometimes at greater risk of karo-jisatsu, Ono says, because they are not 0 expected to work for personal profit, but hold positions that are seen as being based on more altruistic motives. The basis for these professions is devotion to others. The view that one must work not for oneself but for others to become happier or healthier is a sometimes over- idealized and beautified, but deeply-rooted and traditional, belief in Japan. Therefore, one’s relationships with others such as clients, students, and colleagues are crucial in these professions’ daily work. Evaluations are also heavily dependent on other’s opinions. For those very conscious of the nature of their occupation, it is very difficult to decline requests from others even if they are too taxing. It is common for these people to feel 0 guilty about taking holidays, even though they deserve a break, because covering their absence may cause their colleagues extra work. They regard the act of getting away from work as almost equivalent to betraying the trust of their colleagues. And if one betrays this trust, the sanc- tion may be alienation and ostracism. In a workplace where human relationships matter most, nothing is scarier than being isolated or ostra- cized. In order to avoid falling prey to this, it is safer to take on more work, take no holidays and show gaman (persevence). Thus, while devotion to work and attempts to live up to one’s colleagues’ high expectations have been seen as traditional virtues, these 0 also have been the way to secure one’s position and further one’s career. Today, this attitude toward work is becoming obsolete, but it remains strong among some people. Those who commit karo-jisatsu are those who still choose to be loyal to such a traditional work ethic. The tragedy is that when these people work with colleagues who have made a conscious choice to not care about the traditional work ethic/ideology, or 6 who prefer to work in a more individualistic manner, they feel they have 7 to work even harder to make up for these individuals.67 8 In a sense, neither these traditionally-minded workers nor the man- 9 agement system they work under is making the appropriate adjustment 0 to the rapid changes taking place in a larger social context. It seems old 1 2 48 2831_CH02.qxp 6/4/09 1:09 PM Page 49

Mental Health at Work 1 2 and new attitudes toward work exist side by side in a rather chaotic 3 manner, one putting pressure on the other. The widening gap between 4 the two perspectives ends up putting the old-type workers under greater 5 stress, and ironically, the management system they trust in has no way 6 of protecting them from this buildup of stress. The tragedy of karo- 7 jisatsu may represent the failure of an old system adjusting to new 8 demands. 9 A further question that can be put is why colleagues’ opinions have to 1 be so important in the traditional Japanese workplace, other than the 1 – fact that positive evaluations depend on them. Ono contends that these 2 traditionalists tend to view their company not as an organized place 3 with rules and regulations in which they earn their living, but more 4 as a place to develop precious human relationships. It is these human 5 relationships that they believe ultimately produce results. In their 6 view, human relationships come first, and results second. For them, col- 7 leagues are not simply people who happen to be working in the same 8 place; they have almost inseparable existences and give one’s job mean- 9 ing. In other words, the kaisha (company) is not an independent entity, 2 but is the embodiment of the most important relationships in one’s life. 1 The loss of these human relationships and the trust that comes with 2 them is sometimes the most difficult aspect of quitting or even reducing 3 work.68 Such a highly other-directed perspective toward work and the 4 workplace confirms the basic secularized mentality of the Japanese peo- 5 ple. The other side of believing that their evaluation and happiness are 6 so dependent on others’ approval is that there is no absolute standard 7 for their conduct and existence to turn to, regardless of work or non- 8 work context. The absolute standard is not something visible or tangi- 9 ble, but something that is internalized in one’s value system. If one 3 has this kind of external standard, one is not at the mercy of others.69 1 In the Semitic faiths, the final absolute evaluation criterion is God. 2 Theoretically, a similar concept to God is missing in Japan. The idea 3 of one absolute moral authority on which to base one’s conduct does 4 not exist in Japanese culture. Instead, the Japanese traditionally have 5 believed in many gods or spirits, which they fear and respect. These 3 gods and spirits are ubiquitous and do not represent a single moral and 3 ethical system and the absence of one absolute sacred being in their con- 3 sciousness naturally directs the Japanese to seek an anchor elsewhere, 3 more often than not in their own living reality. 4 4 49 4 2831_CH02.qxp 6/4/09 1:09 PM Page 50

Mental Health Challenges x Taichi Sakaiya, a noted social critic and writer, also writes that since World War II, Japan has become a work-focused society in which the workplace exerts an extraordinary unifying and cohesive force. According to Sakaiya, one of the reasons for this change is that Japan does not have an organized religion big or established enough to have the kind of communities and networks that compete with occupational networks for inﬂuence over a Japanese individual’s life. Before the war, a strong cen- 0 tripetal force existed in one’s blood relationships and the surrounding community. However, since these traditional forces have greatly weakened thanks to post-war urbanization and industrialization, work networks have almost entirely taken over individual life. Sakaiya points out that the origin of this Japanese secular nature can be traced back to the time of Prince Sho– toku, the ideological and spiritual father of Japan as a nation-state, who lived in the sixth and seventh century. One of the surprising things to Western observers of Japan is that Japanese culture is built on foundations full of contradictory beliefs, faiths and religious practices, coexisting without any 0 philosophical clashes. The Japanese are well known for celebrating the New Year in the Shinto way and following Buddhist rituals at the time of death. Christmas exists almost solely as an occasion for com- mercial activities, but many Japanese also visit churches nowadays during the Christmas season, as well as to hold Christian-style wedding ceremonies. There is no shame among the Japanese to enjoy different religious customs on a pick’n’mix basis. From a monotheistic cultural standpoint, this attitude toward different religions is to some, puzzling, and others, laughable. But according to Sakaiya, rather than being an innate characteristic, it was a strategic decision that grew out of 0 the political situation at the time. Seeing that Japan was under threat of splitting up and to unify the country under Imperial rule, Prince Sho– toku made it possible for the Japanese to embrace Buddhism, a foreign religion, and Shinto, the indigenous religion, without developing internal contradictions or conﬂicts. It was a very courageous and creative interpretation of the role religion could play in everyday life. 6 Thus a “thought-merging mentality” or the idea of “taking the 7 good bits and forgetting the bad,” which Sakaiya also calls “the world’s 8 one-and-only blended philosophy” developed, and proved remark- 9 ably useful when Japan later tried to learn from foreign cultures and 0 technologies. It also has become an important part of the Japanese 1 2 50 2831_CH02.qxp 6/4/09 1:09 PM Page 51

Mental Health at Work 1 2 people’s mindset about many personal aspects of life. This is the origin 3 of the work-focused society (or “business-focused mindset of present- 4 day Japanese”), as a strong religious feeling, which in other societies can 5 sometimes interfere with the occupational sphere, never developed as a 6 major part of Japanese life. Furthermore, unlike people from monothe- 7 istic cultures, who ultimately fear the judgement of God alone, the 8 Japanese people did not develop this kind of absolute standard for 9 their conduct. Sakaiya says, “What is important in Japan are the 1 human relationships that bind one.” Thus, after the traditional blood 1 tie or community tie was lost, “The only sense of belonging, of com- 2 munity, left to the Japanese is belonging to the workplace – the 3 company.”70 4 5 FACTORS SPECIFIC TO JAPANESE PSYCHOLOGY 6 7 These are the cultural and historical factors that have contributed to the 8 development of the karo-jisatsu phenomenon. Then what goes on in 9 the minds of those who commit suicide because of overwork? In what 2 kind of mental state are these people before committing the ultimate self- 1 destruction? The most signiﬁcant psychological problem that affects their 2 state of mind seems to be a loss of self-boundary and a pathologically 3 acute sensitivity to debt and indebtedness. 4 – Masakatsu Ono further details the psychology of karoshi and karo- 5 jisatsu. As mentioned earlier, people who commit karo-jisatsu are not 6 necessarily forced to work long hours against their will. They voluntar- 7 ily take up a heavier workload and responsibilities out of concern and 8 consideration for the people they work with. The harder they try and 9 the more they prove they are capable of handling the work, the more 3 expectations are placed on them by the company. It is impossible for 1 these people to decline requests or take a vacation, because it means 2 betraying the people who trust their ability to accomplish something. 3 Nothing is more powerful than this sense of trust from others in driv- 4 – ing them to incessant work, according to Ono. However, their work- 5 ing pattern looks like unrequited devotion – instead of being a fair or 3 balanced exchange, it seems like self-imposed enslavement. 3 When bogged down in this situation, the only sensible thing would 3 seem to be to stop and detach oneself from the situation for a moment 3 and correct the disproportionate involvement with one’s work. The 4 4 51 4 2831_CH02.qxp 6/4/09 1:09 PM Page 52

Mental Health Challenges x simple question is “why couldn’t they stop working before they killed themselves?” For those who commit suicide, the sense of self and the immediate exterior world – which is work – are so tightly and closely enmeshed it is utterly impossible to separate one’s existence from the work environment. For these people, the work is a consequence of their precious relationship with others. Since maintaining these relationships is of the utmost importance, jeopardizing what they hold most dear is 0 an impossible thought. When overburdened with work, they cannot ask for help either because the fact that they are being so depended upon at work implies they are irreplaceable, exceptional workers who stand out from the rest of the workers at the company. It means that they also have lonely and often isolated existences because of their outstanding conscientiousness and diligence. Having been placed in a position with no way out, they feel they have lost the power to control their exterior world, and their entire existence has been swallowed up by some gigantic force. In other words, they may feel the boundary that separates themselves from their exterior work environment has disappeared. 0 Instead, the work environment, including its important relationships, becomes an extension of their own selves. And thus, there is no way to escape. Loss of self boundary is also evident in their tendency to carry out other worker’s responsibilities as if they were their own. If someone at work does not fulﬁll his duties, those prone to karoshi and karo-jisatsu feel they have to compensate, based on the presumption that “If I don’t, who will?” And if they do not take care of it, they blame themselves and feel guilty. To prove that they can do extra work is a way of proving their own existence to themselves and others. As their sense of self continues 0 to encompass others and the whole work environment, they no longer think of themselves as a distinct existence with a limit or boundary. Soon they fail to distinguish what is their responsibility and what is others’. – Ono continues to say that what drives these workers to this pattern of thinking is their sense of indebtedness to others and their whole 6 environment. Suicide notes left by karo-jisatsu victims are often full of 7 apology to their families, colleagues, and companies because they think 8 they disappointed them. In most cases, no words or expressions of anger 9 are found toward the people who overworked them to death. Instead, 0 they only feel guilt at what they see as failure to give enough. Not 1 2 52 2831_CH02.qxp 6/4/09 1:09 PM Page 53

Mental Health at Work 1 2 fulfilling others’ expectations is seen as a serious ethical misdeed. 3 However, it sounds strange that they feel this way because they seem to 4 – be the ones who were constantly giving to others. Ono describes the vic- 5 tims as if they are burdened with indefinite amounts of indebtedness 6 (“on”). If they get help from others to complete their assigned tasks, 7 then it means they will create more on in return. Being so sensitive to 8 indebtedness means they try to take care of everything by themselves.71 9 – Ono’s account of this mentality and his reference to on interestingly 1 corresponds to Ruth Benedict’s classic analysis of Japanese human rela- 1 tionships. Despite the nature of her research as a part of the United 2 States’ war effort and despite the fact it was published more than sixty 3 years ago, the state of mind of those who have cornered themselves to 4 the point of karo-jisatsu displays characteristics that support Benedict’s 5 findings. 6 Benedict argued that in Japanese human relationships, recognizing 7 one’s place in the great network of mutual indebtedness was the basis 8 of morality in a way not found in Western cultures. On – a person’s 9 sense of indebtedness to others – is perceived as something that can 2 never be fully repaid. But while it can never be fully repaid, in the same 1 way that a Catholic can never be fully free of original sin, there is virtue 2 in trying. While older generations have deplored the weakening of this 3 sense of on and its replacement with the pursuit of self-interest, those 4 who have committed suicide are often those who not only rigidly and 5 loyally retain this traditional moral compass, but unfortunately have lost 6 themselves within it. 7 Benedict also pointed out that while this sense of indebtedness did 8 exist in China, the great mother and teacher of ancient Japan, the 9 Chinese sense of indebtedness did not require the individual to repay 3 unconditionally or indefinitely. By the same token, loyalty to the state 1 and filial piety, traditions Japan acquired and adopted from China, were 2 not originally meant to be held unconditionally. Japan reinterpreted 3 this crucial virtue and made it something to be observed no matter 4 what, even if it meant condoning vice and injustice, or expressing devo- 5 tion even if one’s parents or lord were undeserving of such emotion. As 3 a result, this intense devotion means that the Japanese tend to attach 3 absolute significance to the human relationships in their immediate 3 circle. What is ultimately important is a living and tangible network 3 that has an immediate effect on their well-being. Their loyalty is often 4 4 53 4 2831_CH02.qxp 6/4/09 1:09 PM Page 54

Mental Health Challenges x limited to people or entities-concrete relationships often embodied in the flesh that are concerned with the here and now. This also corresponds to Hajime’s Nakamura’s thesis that the Japanese place most importance on a limited human nexus. – Ono says the psychological mechanism that controls those who put themselves in karo-jistsu situations is based on this sense of on. It is not only directed toward a specific person, but also toward something much 0 larger; maybe the entire work environment or even the society that has generated work itself. Obviously, these people have deeply internalized this quintessential Japanese value to the point where there is no limit between themselves and ultimate breakdown. Interestingly, Tellenbach also describes these psychological characteristics as dimensions of a “melancholy type,” examples of which have been identified primarily in Germany and Japan. For this type, it is extremely difficult to receive something from others, as the incurred sense of indebtedness creates a feeling of ever greater obligation.72, 73 All these factors suggest social situations and personality structures 0 that give the Japanese a propensity for suicide. Having said all this, however, it is assumed that at the point of committing suicide, the individual is in a state of mind that has lost the ability to make a sensible judgement. He or she is most likely to be in the midst of deep depression. As research on karo-jisatsu indicates, and bereaved families often state later, those who committed suicide were suspected of having been suffering from depression. That said, few were receiving or even seeking proper treatment. The Ministry of Health, Welfare, and Labor also reports that three-quarters of those suffering from depression are not receiving any treatment.74 Kawahito asks why these individuals did 0 not visit a psychiatrist or a mental health professional before they killed themselves.75 The answer is not difficult to find, and centers around the stigma, misunderstanding, or ignorance about mental illness that remains prevalent in Japan. It is obvious that society’s attitude prevents workers and families in need of care from seeking appropriate help in a timely manner. Especially when it comes to work, many psychological 6 problems are regarded as personality defects such as lack of discipline, 7 immaturity, and laziness. A man heard his son say he was exhausted 8 from working and wanted to take some days off. Not knowing anything 9 about mental illness, he told his son he should try harder. In fact, his son 0 was on the verge of karo-jisatsu. Today, this father regrets not listening 1 2 54 2831_CH02.qxp 6/4/09 1:09 PM Page 55

Mental Health at Work 1 2 to his son more carefully. A woman who refused to admit her exhausted 3 son was in need of psychological counseling and opposed his attempts 4 to seek help now blames herself for not having known more about 5 mental illness.76 6 7 JAPAN’S RESPONSE AS A SOCIETY 8 9 Is Japan doing anything about the ever rising suicide rate? A better under- 1 standing of karo-jisatsu is slowly but steadily increasing. There is growing 1 recognition that it exists in Japan, thanks in main to successful lawsuits 2 bought by bereaved families, which previously had found it almost impos- 3 sible to win compensation from ﬁrms if their claims involved suicide. 4 Companies or employers usually refuse to admit responsibility in the 5 suicide of a worker, which is probably the case in many industrialized 6 societies.77 7 Furthermore, since 2004, public announcements have been aired on 8 TV to raise awareness of clinical depression as a preventable and treat- 9 able disease. Various TV programs have also educated viewers about the 2 issue, along with available treatment. Other types of mass media such as 1 magazines and newspapers are covering the issue a lot more than a few 2 years ago and providing information about mental illness in general. 3 A Web search for the word “utsubyoo (depression)” shows over two 4 million hits, which are playing an important role in spreading knowl- 5 edge as well as making the public realize it is not unusual. However, 6 stigma against mental illness in Japan is still so deep and persistent that 7 90% of doctors admit they have written euphemistic descriptions such 8 as “mental fatigue” or “depressed state” in diagnosis reports to be sub- 9 mitted to patients’ employers, even when “clinical depression” is the 3 correct term. They said that this was out of concern that a “depression” 1 diagnosis might make it more difﬁcult for the patient to return to work. 2 However, behavior like this can only perpetuate fear about the illness in 3 the long run.78 4 As for the government, in 2006 it started to adopt a bill to coordinate 5 suicide-prevention efforts involving ministries, public agencies, schools, 3 and hospitals, with a target of reducing suicides to 22,000 or less by 3 2010. The plan includes setting up suicide-prevention centers, providing 3 education, training specialists, and establishing local networks to respond 3 to emergencies.79, 80, 81 Building barriers on station platforms is also 4 4 55 4 2831_CH02.qxp 6/4/09 1:09 PM Page 56

Mental Health Challenges x planned to prevent people from jumping in front of trains, and making available free filtering software that limits access to Web sites that promote suicide. From 2008 there will be a large-scale survey on mental health to understand the state of stress and depression of the population.82 Furthermore, more private corporations are introducing Employee Assistance Programs (EPA) for the mental health of their employees. On the other hand, it is also a fact that there are few middle aged men 0 who call “Inochi no Denwa (The Telephone of Life),” a counseling line established in Japan since 1971 despite its strict anonymity and confidentiality.83 Of course, all these new measures are welcome – though much overdue. However, more fundamental changes to the social structure surrounding Japanese workers are needed to prevent work-related suicides. As mentioned earlier, the thought of losing employment alone often drives workers to panic, and then to work themselves to death. Their intense fear of being fired is not an overreaction, but, in fact, based on the reality of Japan’s job market. If the individual is middle-aged, he or 0 she will face a dire employment situation unless he or she has highly sought after-skills or special connections. Ageism is a harsh reality in the Japanese employment system. Most positions vacant set an age limit for applicants. Even if the laid-off look for a new job, they can usually do this without much worry and desperation only before turning thirty- five, or forty at the very latest. Most are not even given a chance to apply for a job in companies if they are over forty. In October 2007, a new law finally came into effect that prohibits stating an age limit in job advertising. A welcome change, but it will probably take a while until it becomes a commonly enforced practice. 0 There is an old Japanese saying that emphasizes the importance of being resilient: one should keep going even though falling seven times, by picking oneself up eight times. In reality, it is much harder to have a second chance in Japan if you lose your job. It is almost absurd to high- light the fact that such age discrimination dominates the job market in the country with the world’s highest life expectancy. 6 It is also true that Japan’s seniority-based corporate structure, as well 7 as the accompanying secure and paternalistic employment system, was 8 a source of strength for decades. But if Japan was a society that allowed 9 more job mobility, giving second, third, or more chances to indi- 0 viduals, and if Japan was a society in which individuals were evaluated 1 2 56 2831_CH02.qxp 6/4/09 1:09 PM Page 57

Mental Health at Work 1 2 on their own merits, not according to age, or selﬂess obedience to an 3 employer, and furthermore, if Japan was a society where people could 4 realize endurance had its limits and individuality could be defended, 5 words such as karoshi or karo-jisatsu may not have been created. Japan’s 6 high suicide rate is a sad product of the systematic failure of society 7 to provide people with appropriate support in times of crisis, and the 8 opportunity for self-realization. 9 1 NOTES 1 2 1 Durkheim, E., 1997, Suicide. Free Press. 3 2 Nishinippon Shimbun Online 11 3 (The number of suicide exceeds 30,000 for 11 consecutive years). http://www.nishinippon.co.jp/word- 4 box/display/6412/, accessed, March 11, 2009. 5 3 The Japan Times Online 2008, “Suicides up 2.9% in 07, passing 33,000,” June 20 6 http://search.japantimes.co.jp/nn20080620a8.html, accessed June 20, 2008. 7 4 Mainichi Shimbun 2004, 1 100 (Layoff, anxiety for the old age. 100 people kill themselves a day”). July 23. 8 5 Yomiuri Online 2008, 3 07 258 9 (Mental illness certiﬁed for workers compensation increased by 30%. 258 cases in 2 2007), http://www.yomiuri.co.jp/national/news/20080523-OYT100659.htm 1 accessed May 24, 2008. 6 Mainichi Shimbun 2006, 15 12% (15 work- 2 ers compensation cases approved. Karoshi, karo-disease increased by 12%). June 1. 3 7 Kyodo News Online 2004, “Estimated 470,000 workers on leave due to mental prob- 4 lems.” http://www.kyodo.co.jp/ accessed July 4, 2004. 5 8 Mainichi shimbun 2004, 62% (“62% of workers suffer from stress and anxiety”). June 2. 6 9 Mainishi Shimbun 2005, 3 7 (Employees’ mental illness increasing. Half of 8 responding companies report increases of depression for the last three years). 9 April 16. 10 Asahi.com 2005, (A half of the 3 companies say mentally ill employees increased). www.asahi.com/health/news 1 accessed April 15, 2005. 2 11 Mainichi Shimbun 2006, 82% (82% of 3 large companies have employees on leave of absence due to mental illness). September 30. 4 12 (Mental Health 5 Research Institute, Social Economic Productivity Foundation Headquarter) 3 (An industrial mental health whitepaper) issued on 3 August 22, 2004. 13 Sugimoto, Y., 2003, An Introduction to Japanese Society. Cambridge: Cambridge 3 University Press, pp.86–114. 3 4 4 57 4 2831_CH02.qxp 6/4/09 1:09 PM Page 58

Mental Health Challenges x 14 Meguro, Y. and H. Watanabe (eds.), 1999, 2 . (Sociology Course 2 Family). Tokyo University Press, p.73. 15 Tipton, E. K., 2002, Modern Japan: A social and political history. London and New York: Routledge, pp.182–228. 16 Yamada, M., 2004, . (Hope disparity society). Chikuma Shobo, pp.72–4. 17 Tipton, E. K., ibid., p.215. 18 2002. (The white paper on middle and small sized corporations 2002) http://www.meti.go.jp/hakusho/chusyo/H14/ 01-01-06-01.html accessed 0 April 19, 2008. 19 Nihon Keizai Shimbun 2008, 2007 (Company bankruptcy highest in 2007). April 19. 20 Honkawa Date Tribune, http://www2.ttcn.ne.jp/~honkawa/3080.html accessed April 19, 2008. 21 Oyama, N., 2008, vs . (Public assistance vs working poor). PHP Shinsho. 22 Yomiuri Shimbun 2007, “Public sees wealth gap widening.” http://www.yomiuri.co.jp/ newse/20041201wo31.htm accessed December 20, 2007. 23 Yamada, M., ibid. 24 Mainichi Shimbun 2004, 62% (62% of workers suffer from stress and anxiety”). June 2. 0 25 Mainichi Shimbun 2005, 3 (Performance evaluation in vain. Karo suicide. Promotion by three ranks led to sharp increase of overtime). June 7. 26 Asahi Shimbun Weekly AERA 2005, (On performance evaluation. Drifting personnel management of Japanese corporations and wage system). June 13, pp.12–17. 27 Mainichi Shimbun 2007, 57% 06 66 (Karo-suicide increased by 57% in 2006 to 66, the highest in the record), May 17. 28 Kyodo News Online 2004, “Estimated 470,000 workers on leave due to mental Problems,” http://www.japantoday.com/e/?content=news&id=304342 accessed July 4, 2004. 29 Nishinippon Shimbun Online, ibid. 0 30 The Japan Times Online 2008, ibid. 31 Mainichi Shimbun 2004, WHO 10 (International comparison of suicide rates by WHO. The number of suicide per 100,000). October 2. 32 Takahashi, Y., 2003, . (Suicide by the middle aged and the old). Chikuma Shinsho Publishing, pp.66–9. 33 Sato, T., 1991, (Personality of the con- 6 temporary middle age generation) in Kokoro no Kagaku(Human Mind) no.39, 7 September 1991 pp.31–5. 34 Yoshimatsu, K., 1991, (The middle age today as 8 a suicide generation) in Kokoro no Kagaku(Human Mind). no.39, September 1991, 9 pp.22–5. 0 1 2 58 2831_CH02.qxp 6/4/09 1:09 PM Page 59

Mental Health at Work 1 2 35 Ibid. 3 36 Sato, T., ibid. 4 37 Munakata, T., 1991, A (Karoshi of corporate worriers and type A behaviors”) in Kokoro no Kagaku(Human Mind) no.39, 5 September 1991, pp.48–54. 6 38 Kyodo News Online 2004 “No of alcoholics in Japan estimated at 820,000”. 7 http://www.kyodo.co.jp/ accessed June 20, 2004, 8 39 Saito, S., 1991, (Men, work, and alcoholism) in Kokoro no Kagaku(Human Mind) no.39, September 1991, pp.55–8. 9 40 Yates, R. E., 1988, “Japanese Live .... and Die . . . for their Work,” Chicago 1 Tribune, November 13. 1 41 Makihara, K., 1989, “Coming to Grips with Karoshi,” Time, January 30, p.50. 2 42 Sanger, D., 1990, “Tokyo Tries to Find Out if ‘Salarymen’ Are Working Themselves to Death.” The New York Times, March 19. 3 43 Ministry of Health and Labor website, http://wwwhakusyo.mhlw.go.jp/wpdocs/ 4 hpax200401/bIndex.html accessed February 20, 2006. 5 44 Mainichi Shimbun 2006, 15 12% (15 work- 6 ers compensation cases approved. Karoshi, karo-disease increased by 12%), June 1. 45 (National Family Association on Karoshi) 1997, 7 . (What job is worth dying for?). Kyoikushi 8 Publishing. 9 46 Ibid. 2 47 Yomiuri Online 2008, ibid. 48 Stress Disease Workmen’s Compensation Association and Lawyers National 1 Contact Conference on Karoshi, 2000, (Rapidly rising karo- 2 jisatsu). Koseisha Publishing, pp.67–9. 3 49 Kawahito, H., 1998, . Iwanami Shinsho, p.53. 4 50 (National Family Association on Karoshi). Ibid. 5 51 Durkheim, E., ibid. 6 52 Kawahito, H., ibid. 7 53 Takahara, M. (ed.), 2004, . (Sick relations – 8 pathology of micro society”). Gakubunsha, p.131. – 54 Ono, M., 2003, . (Psychology and workplace 9 of karoshi and karo-jisatsu). Seikyuusha. 3 55 . (National Family Association on Karoshi). 1 Ibid – 2 56 Ono, M., ibid. 57 Kawahito, H., ibid. p.53. 3 58 Shuukan Economist (Weekly Economist) September 19, 2005, A Special issue 4 (Disappearing overtime pay). 5 59 Yomiuri Weekly 2006, (The age of zero overtime pay). 3 November 5, p.12–19. 60 Kawahito, H., ibid. 3 – 61 Ono, M., ibid 3 62 Mainichi Shimbun 2005, ibid. – 3 63 Ono, M., ibid. p.50. 4 4 59 4 2831_CH02.qxp 6/4/09 1:09 PM Page 60

Mental Health Challenges x 64 Ibid. 65 Ibid. 66 Ibid. p.14. 67 Ibid. p.14. 68 Ibid. p.72. 69 Ibid. p.14. 70 Sakaiya, T., 2003, “Thought-Merging Mentality of the Japanese” in The Twelve Men Who Made Japan. Tokyo: Kodansha International. – 71 Ono, M., ibid. 0 72 Ibid. 73 Utsu /Depression http://www.geocities.jp/utuutu122/uyokuutu/uutuseikaku.html accessed April 19, 2008. 74 Mainichi Shimbun 2004, 1 100 (Layoff, anxiety for the old age. 100 people kill themselves a day). July 23. 75 Kawahito, H., ibid. 76 Ibid. 77 Ibid. 78 Asahi.com 2005, 9 (90% of doctors use euphemistic expressions for depression diagnosis). http://www.asahi.com /life accessed May 18, 79 Seii, S., 2005, “More moves to cut high suicide rate,” Asahi.com. http://www.asahi.com 0 /life accessed July 18, 2005 80 Asahi.com 2005, 20 % (Health and Labor Ministry aims at 20% reduction of suicide by depression). http//www/asahi.com/health/news “accessed June 11, 2005. 81 Mainichi Shimbun 2006, (Society eliminating the taboo. Suicide prevention law to be created). June 15. 82 Reuters news 2005, “Japan compiles plan to curb high suicide rate” http://jp.reuters.com/ accessed December 27, 2005. 83 Takahashi, Y., 2000, . (The middle age and mental crisis). Japan Broadcasting Publishing Association, p.250.

6 7 8 9 0 1 2 60 2831_CH03.qxp 6/4/09 1:10 PM Page 61

1 2 3 3 4 5 The Japanese Family Today 6 7 8 9 1 1 “The modern family lives in a greater state of tension precisely because it is the 2 great burden carrier of the social order. In a society of rapid social change, prob- 3 lems outnumber solutions, and the resulting uncertainties are absorbed by the 4 members of society, who are for the most part also members of families. Because 5 the family is the bottleneck through which all troubles pass, no other association so reflects the strains and stresses of life . . .” (p.178) 6 REUBEN HILL1 7 8 9 SKELETONS OUT IN THE OPEN? 2 In recent years, the intimate details of family relationships have become 1 the subject of widespread reporting and public discussion. For most of 2 our history, the home and the family were taken for granted; for most 3 people, they were not seen as worthy of serious, analytical investigation. 4 After all, most embraced the unquestioned assumption that the home 5 was ultimately a harmonious place and the family should be treated as 6 one unit. We all knew domestic conflicts existed, but these were basically 7 seen as problems to be resolved within the household. Furthermore, 8 private matters such as a husband-wife relationship were considered 9 irrelevant to public discussions or policymaking. These topics were too 3 personal, and should be confined to a counseling room or a closed circle 1 of private friends. But today, the home as a topic for discussion is unsur- 2 prising to most Japanese, a change that suggests the pretence of familial 3 peace may be finally beginning to dissolve. With this new liberalism, 4 the media and academics have coined phrases for phenomena such as 5 “sekkusu-resu (sexless) marriage,” “kateinai (in-house) divorce,” “jukunen 3 (middle-age) divorce,” and “husband-presence stress syndrome,” to name 3 but a few. 3 Divorce in Japan is increasing at an unprecedented rate, and has been 3 on the rise since the mid-1990s. In 1970, approximately 10 % of all 4 4 61 4 2831_CH03.qxp 6/4/09 1:10 PM Page 62

Mental Health Challenges x marriages ended in divorce. In 2000, this had risen to one in three marriages. The number of divorces in 2003 totalled 283,906 – that’s one marriage ending every 1 minute 51 seconds. (In the same year, one couple got married every 43 seconds.) Japan’s divorce rate today is higher than that in France and Italy, and almost comparable to the level of Germany, though it is still much lower than that of the United States.2 It is not surprising to see that relatively young couples who have 0 been married for only a few years are more likely to divorce. Not only are they less constrained by the traditional view of divorce as shame and failure, but they have not, comparatively speaking, invested a lot of time, resources, and energy in their marriages. But what is unusual about Japan today is the emergence of another group of divorce seekers – those who have been married for more than twenty years and have finished raising their children. These couples are approaching or have reached retirement age and are supposed to be at the point in their lives where they can start reaping the benefits of all their hard work. Below is a typical situation, a composite scenario containing all 0 the essential elements of a so-called jukunen divorce. A man who has been a loyal corporate soldier for decades has finally retired from his job. He returns home on his last day, wondering how he will spend his post-retirement years. He may dream of doing what he always wanted to do but never had time to, such as pursuing his hob- bies, or traveling abroad. He may even fancy going on a trip with his wife, like a second honeymoon. But disaster lurks in the genkan. When he arrives home, his wife of thirty years is waiting, not to greet him with kind and affectionate words of appreciation for his years of hard work, but with a grim look on her face and divorce papers in her hand. She 0 says that all these years, she led the life of a servant. He was always working and never at home, leaving everything, including raising and educating their children and even the care of his invalid mother, to her alone. No matter how much she needed his help, or how much she tried to communicate with her husband, he was never there for her. She has long repressed her resentment to prevent the breakup of their home for 6 the sake of their children and his career, but she feels now that she and 7 her husband have nothing in common. That is why she wants a divorce, 8 before it is too late for her to build a new life. She demands half of his 9 handsome retirement settlement and the family assets, which she is enti- 0 tled to. The husband is totally shocked and devastated. For all these 1 2 62 2831_CH03.qxp 6/4/09 1:10 PM Page 63

The Japanese Family Today 1 2 years, he had not even the slightest idea about his wife’s feelings. It had 3 never even occurred to him. 4 If the wife is not so determined or has no choice but to stick it out, 5 the stale marriage will damage her mental and physical health. She 6 develops stomach ulcers, polyps in her throat, and rashes around her 7 eyes. Her reaction is not uncommon. In 1991, Dr. Nobuo Kurokawa 8 gave it a name: “retired husband syndrome” (RHS). For many Japanese 9 wives of this generation, having the husband at home can be a serious 1 source of stress and a burden, as she has to take care of him all the time. 1 It is as if she has another child.3 2 But stress does not just affect older couples. Younger wives also 3 suffer from the same ailment due to simply being with their husbands. 4 A woman whose husband’s presence at home makes her nervous and 5 tense begins drinking heavily and now worries if she is becoming an 6 alcoholic. A wife whose husband has started working from home 7 ends up developing heart disease.4, 5 Otto zaitaku sho¯ko¯gun, “husband at 8 home syndrome,” has been widely reported and drawn attention. A 9 number of sympathetic studies confirm it is a widespread problem that 2 creates varying degrees of discomfort. 1 Even more revealing are reports on “sekkusu-resu (sexless)” marriages 2 that began to appear in the late-1990s. Japanese people may be more 3 likely than the previous generation to talk openly about sex in general, 4 and therefore, it is always possible to attribute the apparent increase 5 of sexless couples to an increasing willingness or openness in intimate 6 matters. However, even when this reporting bias is discounted, there 7 seems to have been a substantial increase in sexless relationships among 8 married couples in recent years. Books and articles written about the 9 topic have included episodes and case studies of individuals, but most 3 were not with substantiated data indicating how widespread the phe- 1 nomenon actually was. The medical definition presented by Dr. Teruo 2 Abe for the first time at the Japan Sexologist Conference in 1991 refers 3 to the condition as when a couple does not have any sexual contact, 4 including body touching, for more than one month and this state is 5 expected to continue longer.6 However, a survey of the issue conducted 3 by the Ministry of Health, Labor, and Welfare, jointly with the Japan 3 Family Planning Association in 2005, which targeted 3,000 men and 3 women aged sixteen to forty-nine, finally confirmed that 32 % of cou- 3 ples are in sexless marriages, with a further nearly 20 % reporting they 4 4 63 4 2831_CH03.qxp 6/4/09 1:10 PM Page 64

Mental Health Challenges x have had no sexual contact for one year. Of those describing themselves as sexless, 44 % admitted they weary of getting involved with the opposite sex, while 31 % of non-sexless people gave the same reply.7 The same survey two years later showed a 3% increase in sexless marriages, as well as finding that 46% of married people over forty-five years old defined themselves as in a sexless relationship.8 A much talked about international survey in 2005 by condom manufacturer Durex, found 0 that of forty-one countries, Japan ranked bottom in terms of the frequency people on average had intercourse in a year (twenty-four) as well as the level of interest in their own sex life. Respondents in Greece showed the highest number of 138.9 The number of sexless cases dealt with by members of the Japan Sexologist Association has also increased from 10 % in the late 1980s to nearly 40 % in recent years. Many are men in their thirties to forties who reportedly are unable to have sex with their wives, though they can with other women, a situation that leaves many wives feeling miserable and humiliated.10 0 For sure, this is all very sad for the individuals involved, but why should Japan as a nation care? The reason why the most private and intimate affairs of an individual’s life have become the target of government surveys is their relevance to one of Japan’s most critical national-level issues: the declining birthrate. Japan’s fertility rate has been on the decline for thirty-five years. When the total fertility rate per woman (the average number of children born to a woman aged between fifteen and forty-nine) hit 1.5 in the early 1990s, it was considered to herald the beginning of serious population decline. But at the time, who knew it was just the beginning of a continuous and more drastic fall? While the 0 decline of the birthrate is a common phenomenon in many highly- industrialized societies, Japan’s fertility rate has dropped since the early 1990s to the lowest level (along with South Korea) among developed nations. What is more fundamental and profound, when it comes to the future of a nation, than the size of its population? The causes for Japan’s inability to produce enough children are mul- 6 tiple and complex. The most obvious reason is that people are marrying 7 later in life. Though Japan is still a country where most people will even- 8 tually marry by the age of forty, suggesting marriage and family as social 9 institutions have not lost their validity, why are people increasingly put- 0 ting off tying the knot? Even when the marriage threshold has been 1 2 64 2831_CH03.qxp 6/4/09 1:10 PM Page 65

The Japanese Family Today 1 2 crossed, there seem to be a number of material and mental obstacles that 3 prevent couples from having children. Previously, sexlessness was not 4 considered a major reason for a couple to have no children or fewer chil- 5 dren, but it has begun to show up on the radar, a fact that led to the 6 health ministry’s groundbreaking survey. Renewed attention to such 7 private matters in recent years may also imply society has started to take 8 the quality of individual life more seriously. 9 We want to believe that, regardless of cultural differences, there 1 are fundamental universals about life, and that we are all basically the 1 same. Family intimacy is one thing we want to believe is invariant 2 across borders and cultures. But not a few foreigners visiting Japan are 3 perplexed to witness Japanese husband-wife relationships and parent- 4 child relationships. These people tend to hold a certain image of 5 Japanese families as sharing an Asian cultural background, which 6 emphasizes order and harmony and respect for parental authority and 7 the elderly. Often, this kind of naïve view can be the source of disap- 8 pointment and puzzlement. The reality of Japanese family life is, prob- 9 ably like that of any highly-industrialized society, a strange and curious 2 mixture of basic, universal human needs, its own pattern of moderniza- 1 tion and social transformations, and something unique based on its 2 history and culture. 3 One avenue to understanding why it has turned out to be the way it 4 has would be to trace back to where the characteristics originated. Let 5 us look at the background to Japanese family development. 6 7 THE JAPANESE FAMILY AND ITS CULTURAL TRADITIONS 8 9 Despite the image of Japan as a male-dominated society, a look at early 3 Japanese society offers a pleasant surprise with the realization that men 1 and women originally had equal rights in every aspect of their relation- 2 ship, such as marriage proposal, inheritance, management of assets, 3 parental rights, and divorce. Not only did women originally have all these 4 rights, which were eventually taken away during the social changes from 5 the middle- to pre-modern period, but early Japanese society clearly had 3 a matriarchal culture, where home emphasized the matrilineal link rather 3 than patriarchal heritage. Marriage usually meant a duolocal arrange- 3 ment: a husband and a wife had a separate residence and that a husband 3 visited the wife’s house when needed. A child born to the couple stayed 4 4 65 4 2831_CH03.qxp 6/4/09 1:10 PM Page 66

Mental Health Challenges x and grew up at the wife’s home, the child belonged to the wife’s family, and in the child’s life, father was much less important than the mother. This matriarchal family culture was gradually replaced by a more patriarchal family structure as Japan moved from the early to the feudal period, in which the military class gained virtual control of society and therefore greatly inﬂuenced the mainstream cultural orientation of the country. As this change occurred, Japanese women’s human rights began 0 to diminish. Society increasingly reduced women to a subordinate role at home and at large. For the ruling warrior class, securing a male heir became the dominant issue, and, therefore, women became regarded as a tool to produce that heir. During the middle ages to the Edo period, when society grew more stable and hierarchically organized, marriage ceased to be a matter of mutual attraction and compatibility, but became a matter of family strategy to strengthen alliances among powerful families and to continue patriarchal linkage, at least for the warrior class. Ie (household) became crucially important in preserving and continuing the line, no matter what, and without doubt at the cost 0 of individual happiness. In an era of absolute peace and isolation from the rest of the world, there was no way for a samurai to live by the sword, proving himself in the battleﬁeld and expanding his territory. Instead, the samurai became the bureaucrats of the Tokugawa regime. Deprived of the possibility of dramatic upward mobility, it became critical for all members of society to know their exact social positions, and to maintain them for the sake of the continuity of their ie. Neo-Confucianism was the underlying ideology of all Edo society, but also it was very much a family ideology. One way to continue ie without fail was that a husband had a concubine or mistress, with whom he could increase the 0 possibility of producing an heir. Some women in the wealthy merchant class were able to enjoy substantial freedoms, independence, and some chances for self-actualization. But for women of the samurai class, it became an extremely important quality to be able to control their jealousy if their husbands had a concubine. It was also up to parents to raise daughters who would be women able to suppress their jealousy for the 6 sake of the security of the family into which they married. How they 7 should behave at home was laid down by the Confucian scholar, Kaibara 8 Ekken, in Onna Daigaku (A Greater Learning for Women).11 9 At the time of the Meiji Restoration, Japan once more became a tightly 0 united nation devoted to the goal of modernization and militarization. 1 2 66 2831_CH03.qxp 6/4/09 1:10 PM Page 67

The Japanese Family Today 1 2 It was determined to accomplish these tasks quicker than any other 3 country. “Modernization” was synonymous with “Westernization.” To 4 achieve this, Japan shamelessly copied and imitated Western cultures and 5 technologies so she would not look like a backward nation in the eyes of 6 guests from these counties. However, in order to achieve these goals as 7 fast as possible, Japan needed to create a clever social structure through 8 which all citizens could be effectively monitored and controlled, and thus 9 would be united under the centralized government, and more impor- 1 tantly, under the absolute power of the Emperor. The government used 1 the ie system to do this, and it was so successful it lasted until the end of 2 World War II. Despite the efforts and enthusiasm of those who wanted 3 to transform Japan into a Western nation, at least on the surface, Japan, 4 at the beginning of the Meiji Restoration, ended up creating a civil code 5 using a family-based system that almost retrogressed to the feudal era. 6 Gustave-Emile Boissanade, a French legal scholar invited to Japan by 7 the Meiji government together with many other Western consultants, 8 proposed a concept of family based on the nuclear model, with the hus- 9 band-wife unit at the core. This was completely rejected by the new gov- 2 ernment as something that was entirely contrary to “Japanese traditional 1 culture.” Besides, it would not be in the government’s best interest, if 2 under a Western-style family code, Japanese citizens began to develop 3 self-awareness as independent individuals. For tax and conscription sys- 4 tems to be thoroughly implemented, it was also more efficient to desig- 5 nate the basic unit of these responsibilities to be a household, not an 6 individual. Thus, a collective and patriarchal family system was created, 7 which defined the male head of the family as the source of absolute 8 authority within the household. The male head – the husband or the 9 oldest son – was the only heir to the family name and assets, and at the 3 same time given duties to supervise every other member of his house- 1 hold. Ideally, this role was to be handed down to his eldest son. If there 2 was no male heir, adopting the son-in-law or adopting from relatives or 3 even outside kin was not infrequent. In any case, men had all the rights, 4 and women had none. Legally, everyone was subordinate to the head of 5 the household. Marriage usually meant that a woman married into her 3 husband’s family. She would not have any financial or parental rights, nor 3 inheritance rights from her parents or husband. Since all Japanese lived 3 under the framework of ie, all Japanese women lost their human rights – 3 and in a greater way than at any other period in Japan’s history.12 The ie 4 4 67 4 2831_CH03.qxp 6/4/09 1:10 PM Page 68

Mental Health Challenges x system not only defined the nature of marriage in Japan, but more importantly, defined the smallest unit of society not as an individual, but as a household. There was no room for Japanese people to develop a true sense of individuality vis-à-vis society. It is ironic that ie ideology, which was originally an ideology adopted by a ruling warrior elite, was now codified and thoroughly spread and enforced in every sector of the Japanese population. 0 THE CONTEMPORARY FAMILY: AN EFFICIENT ARRANGEMENT FOR GREAT ECONOMIC GROWTH However, the end of World War II changed all that. The U.S. occupation brought drastic reforms to every corner of Japan. This time, in contrast to the national slogans of the Meiji period, “democratization” and “demilitarization” were the new goals to be achieved. The new constitution was quickly written up, swiftly issued, and implemented, and then came a new set of civil code and family laws. The undemocratic and 0 male-centered ie system was dismantled and replaced by a family structure based on a conjugal unit of a consenting man and woman with equal legal rights. Rapid urbanization and economic growth led young people to move from their birthplaces to cities, leaving the traditional family lifestyle behind, and creating nuclear families away from home- towns. After a brief baby boom, family sizes started to shrink and many children began growing up without living in an extended family that included grandparents and a large number of siblings. People increasingly favored Western-style courtship and dating before marriage. Most marriages now started out with the nuclear family as a model and stayed 0 this way for as long as possible. Today, more than fifty years after the new family law was enacted, marriage-related norms appear no different from those in any industrialized Western nation. As Japan’s recovery and economic growth in the 1960s left the world agape in admiration, a structural transformation was taking place in the Japanese economy, as it changed from a mainly agricultural economy to 6 one based on manufacturing and service industries. At the same time, as 7 discussed in the previous chapter, a new pattern for family life had 8 started to emerge: a husband employed by a corporation and a wife 9 assigned to take full responsibility for all domestic matters, including 0 child-rearing and management of the daily family budget. It also 1 2 68 2831_CH03.qxp 6/4/09 1:10 PM Page 69

The Japanese Family Today 1 2 resulted in a very clear separation of home and work. Some Japanese 3 husbands today who “boast” that they never bring work home and wives 4 who say they don’t “interfere” with their husband’s work have obviously 5 been inculcated with this idea. As the corporate-centered or work- 6 centered principle penetrated peoples’ lives and became the dominant 7 ideology of the middle class, the husband/father was expected to dedi- 8 cate himself to his company in exchange for job security or a financially 9 brighter future, a tradeoff that was the cornerstone of the post-war 1 kaisha (corporation) system. 1 This arrangement was further legitimized by public policy toward 2 families. Some scholars point out that despite democratization efforts 3 immediately after the war, Japan’s post-war family policy was subsumed 4 within a greater national goal: economic recovery and development, 5 which relied on a traditional view of gender roles. In 1961, for example, 6 a zero-tax system was established for a married individual who earned 7 less than 1.03 million yen a year. Later this system was expanded to 8 exempt spouses (in reality, wives) from paying basic national social secu- 9 rity premiums, but still enabled them to receive future benefits. This 2 became a great deterrent to wives seeking to work longer and earn more. 1 The curriculum designed by the Ministry of Education for public jun- 2 ior and senior high schools reinforced gender separation: girls took 3 home economics and boys did crafts and industrial arts. A special cate- 4 gory for tax deduction was also created in 1987 for workers whose 5 spouse earned less than 380,000 yen a year. A marriage in which the 6 husband was breadwinner and wife the housekeeper was not only a 7 socio-culturally encouraged combination, but also became a legally 8 institutionalized unit. The family was organized to support national 9 economic growth. 3 Thus, the percentage of married women who could be described as 1 wives of salaried workers – a minority before the war – greatly increased 2 from the mid-1950s to the 1980s, on a parallel with a decline in the 3 number of women working in primary industry and non-paid workers 4 in family-owned businesses. At the same time, the number of female 5 part-time employees drastically increased, eventually becoming practi- 3 cally synonymous with a married women’s typical working situation.13 3 Working part-time, or paato, does not only mean earning less 3 because of fewer hours on the job. It also means a lower rate of pay and 3 unstable work with no fringe benefits or potential for promotion. As 4 4 69 4 2831_CH03.qxp 6/4/09 1:10 PM Page 70

Mental Health Challenges x discussed in the previous chapter, employers saw women’s part-time labor as a convenient adjustable valve against recession, a way to reduce the cost of their workforce in times of hardship. Since the 1960s, Japanese women’s labor participation has been graphically rendered as an M-shaped curve, where the vertical axis is labor participation ratio and the horizontal axis is age. The line goes up to the mid-twenties, falls in the early to mid-thirties (typically child- 0 rearing years) and swings upward to the late-forties before dropping sharply around the retirement age. In 2004, women constituted 41% of the entire workforce, and of that, about 40% were in part-time work.14 The vast majority of working women in their forties and over are in part-time employment, in general simply supplementing their household income (in fact, less than a quarter of the total family income). In contrast, working women in Euro-American and other Asian societies continue to participate in waged labor without interruption.15 This puts Japanese women’s life choices into further perspective. The national political, economic, and corporate agenda have successfully 0 deﬁned home to be predominantly women’s territory, and the workplace to be a man’s world. Consequently, husbands spend less and less time at home with their wives and children. Their contribution to household chores is notori- ously low. An international survey found that Japanese men spent, on average, only four hours a week cooking, cleaning, and doing other housework, signiﬁcantly less than men in the U.S., Canada, Russia, Finland, Hungary, and Sweden. Men in the U.S. were found to spend sixteen hours a week on such tasks.16 Home became a place for many Japanese husbands, simply to rest 0 before going back to work again the next morning. However, before we are critical of or feel sorry for them, it is important to remember it was the best possible choice both men and women personally could make. Many newly-married couples of this period were raised by parents who worked in traditional industries such as agriculture, or ran their own businesses, and who had struggled to take care of their farm or business and 6 their children at the same time. For their daughters, being able to become 7 a full-time housewife was a luxury and as such was an improvement in 8 lifestyle. Their sons, too, saw it as a very desirable and comfortable 9 arrangement if their wives could take care of everything at home, includ- 0 ing child-raising. This way, they were able to concentrate on work.17 1 2 70 2831_CH03.qxp 6/4/09 1:10 PM Page 71

The Japanese Family Today 1 2 The continual absence of father or husband meant home naturally 3 became a place centered on the mother-and-child relationship, not the 4 husband-wife relationship, which is supposed to be the core of the mod- 5 ern Western household, at least conceptually. In the marital relation- 6 ship, as time went by, functional and parental obligations came to take 7 precedence over emotional ties between husband and wife. Sociologist 8 Masahiro Yamada says a kind of “for-the-children’s-sake” ideology 9 emerged within the Japanese family after World War II, in part as a reac- 1 tion to the pre-war and wartime ideology of “for the sake of the coun- 1 try.” This ideology even “became the core of social consciousness in 2 post-war Japan, and familial love meant parental love rather than con- 3 jugal love . . . The objective of families at this time was to raise living 4 standards for their children and send them to the best schools.” Yamada 5 continues, “Thus parents were called upon to exert themselves to 6 the utmost for the sake of their children, even at the cost of sacrificing 7 their own quality of life and of abandoning their own leisure time – and 8 parents answered the call willingly.”18 However, the reality is that many 9 children who grew up in urban areas hardly ever saw their fathers and 2 came to regard them simply as breadwinners or someone who came 1 home to sleep. 2 This might not have been what the Japanese truly wanted. From the 3 standpoint of individual happiness, this arrangement forced substantial 4 personal sacrifices. But with a promising future – at least materialisti- 5 cally speaking – and in the midst of an ever-growing economy, the 6 Japanese obviously gave priority to gaining tangible rewards, or may 7 have been simply swamped in the storm of optimism and euphoria 8 of the time. This separation of work and family, combined with a 9 husband’s loyalty to his employer over his private life, has created the 3 prototype for the modern Japanese family, which is often characterized 1 as mother-child centered, having an absent father/husband, and weak 2 emotional bonds and companionship between husband and wife. A 3 famous saying still cherished by many Japanese housewives goes, “Teishu 4 genki de rusu ga yoi (A good husband is healthy and stays away from 5 home),” and succinctly expresses their mentality; a husband is necessary 3 for financial stability, therefore he must be healthy. But home life goes 3 smoothly even without him (or even more smoothly) as far as his wife 3 is concerned. This saying not only points out the physical absence of the 3 husband from the Japanese home, but also points to a kind of emotional 4 4 71 4 2831_CH03.qxp 6/4/09 1:10 PM Page 72

Mental Health Challenges x independence of wives from their husbands. Despite a wife’s dependence on her husband’s economic ability and social status, emotional independence is also strong; a wife does not need her husband’s presence and affection to feel happiness or maintain high self-esteem. Instead, the wives discover joy in their close emotional relationships with their children or close friendships with other women in the same situation. Since the first priority for families is the children, when a husband 0 and wife are together, their concern and common interest are focused on their children’s affairs. For better or worse, Japanese parents’ willingness to do things “for the sake of the children” has changed the priority and purpose of marriage itself. They work hard to provide for their children’s education and often tolerate bad marriages. Making the child the center of the family may keep parents and children closer together, but it also forces children to play a bonding role. Rather than saying Japanese families are mother-child relationship centered, it may be more accurate to say they are simply child-centered. Psychoanalyst Keigo Okonogi is a severe critic of contemporary 0 Japan, which he sees as a society where young people are pampered and encouraged to remain in a “moratorium” stage forever, so they become unwilling to commit to anything as mature, responsible adults. Okonogi defines this “moratorium” stage as characterized by having no occupational role, seeing all social involvement as temporary, feeling free from any value or ideology and postponing major decision-making in life. Though this “moratorium” stage is an important part of healthy development, which should be eventually passed on the way to the next stage, as theorized by Erik Erickson, Okonogi says that in today’s Japan, even grownups are stuck in the “moratorium” stage and have no idea 0 how to act as parents or teachers to the younger generation. Since these “moratorium people” are too preoccupied with keeping up with the progress and changes in society, they therefore are incapable of establishing a true, honest, and solid identity. When they have children, they project their unfulfilled dreams and ambitions on them. In the name of “love for their children,” they lack the awareness that it is in fact noth- 6 ing but self-love. Naturally, children depend on parents, but parents 7 have also come to psychologically depend on and seek meaning for their 8 lives in their children.19 Though Okonogi’s rather harsh view on youth 9 disregards economic structural changes against them that Japan has 0 been experiencing in recent years, his view on parents’ attitudes toward 1 2 72 2831_CH03.qxp 6/4/09 1:10 PM Page 73

The Japanese Family Today 1 2 their children suggests potential risks for highly dysfunctional family 3 patterns. That is why, in Japan, when a child leaves home, the family 4 often loses its validity. In fact, my personal feeling is that many Japanese 5 parents are subconsciously reluctant to see their children grow into fully 6 independent adults, for fear the husband and wife will have to face each 7 other and realize the emptiness of their relationship. Married couples are 8 not unaware of this, and often continue to have a mutually dependent 9 relationship with their own parents even after they marry and start their 1 own family. 1 Thus, although it appears to be quite Western on the surface, the 2 underlying structure of Japanese families is quite different from that of 3 Western societies. The significance of intergenerational relationships 4 over conjugal relationships cannot be overstated enough when under- 5 standing behavioral patterns in so many family circumstances. However, 6 interactions unique to contemporary Japanese reality are not simply 7 attributable to the rapid social changes since World War II. 8 9 UNTEACHING THE IE SYSTEM 2 1 One of the major factors in contemporary family patterns in Japan 2 seems to come from the persistent influence of the ie system, even sixty 3 years after its abolition – a fact that makes one realize the Meiji govern- 4 ment did an extremely thorough job in spreading this ideology. Though 5 post-war efforts democratized the Japanese household, it has been 6 difficult to sweep away the indelible stamp of the ie system on family 7 culture. 8 Yes, the ie system is gone, but its ghost is felt in many aspects of fam- 9 ily life, haunting the Japanese when it comes to decisions regarding inti- 3 mate relationships. The Japanese still have a tendency to see marriage as 1 a contract between two families, rather than a matter strictly between 2 two individuals. Marriage, for many women, still implies marrying into 3 the husband’s family and becoming a yome, or bride of his family. The 4 eldest or only son is under great pressure to care for his aging parents and 5 to carry on the family business or name, although all the privileges that 3 used to be his alone under the ie system have disappeared, and now 3 inheritance is divided equally among children. No wonder that eldest 3 sons are unpopular choices for marriage among young women today. 3 Young Japanese women know very well what they are getting into if they 4 4 73 4 2831_CH03.qxp 6/4/09 1:10 PM Page 74

Mental Health Challenges x marry an eldest son: various incidental burdens as a bride to the family, and above all, a meddlesome mother-in-law who is controlling and yet psychologically dependent on her first son. The new wife will also have to care for her parents-in-law, rather than this responsibility falling to her husband or his siblings. And if there is no son, other concerns are raised. Who will succeed to the name and take care of the family tomb? This may not be an issue in 0 highly urbanized areas, but is a pressing worry in the regions. A daughter who is also the only child often grows up feeling multiple burdens, subconsciously or consciously, no matter how freely she has been raised. Eventually, she may be pressured to consider that rather than marrying out like most young woman, she needs to find a husband who will agree to become an adopted son-in-law and take her name. For this reason, an eldest son will be the last on her list of potential husbands. She will also have to think about her parents’ future and even their present, as she knows their happiness depends on her living nearby. The same is true for a son who is the only child. He is pressured to find a wife who is will- 0 ing to live with his elderly parents, or at least one of them, if the other has died. Thus, parent-child interdependence is a critical element in forming Japanese family life, and when it comes to making major life decisions. It has a greater influence than the husband-wife relationship on the overall well-being of the family. In an age of free love and unchaperoned dating, we like to think we can marry anyone we choose. In reality, we bind ourselves by many social factors such as class and educational background. Unsurprisingly, Japanese mate selection is constrained by these social factors. Additionally, residuals from ie ideology still sneak into young people’s 0 consciousness and affect their ideas about the future; they are not entirely free to choose their own lives. These features of the contemporary Japanese family can be further examined within a broader cultural context: the thousands of years of Confucian heritage common to many East Asian countries. From the Confucian perspective, the family unit was more important than any indi- 6 vidual member and was defined more in terms of obligations, especially 7 toward the senior generation, rather than conjugal affection. This meant 8 the individual sacrificed emotions for the family, and formality, order, 9 and stability were emphasized. Although this pattern varied from family 0 to family, generally the focus was not on the relationship between the 1 2 74 2831_CH03.qxp 6/4/09 1:10 PM Page 75

The Japanese Family Today 1 2 spouses but on the parent–child relationship.20 That is why, for many 3 Japanese, being inherently Confucian in their social relationships, mar- 4 riages that start in an apparently Western style can easily slip back into the 5 traditional pattern. After all, it is quite hard to overcome thousands of 6 years of psycho-cultural tradition. Of course, the absence of fathers due to 7 work is not a phenomenon limited to Japan, but rather is a universal and 8 inevitable result of industrialization that took place in Western societies 9 throughout the nineteenth and twentieth centuries. But the deeper 1 level orientation originating from the fundamental psycho-cultural back- 1 ground has made the Japanese more likely to follow the pattern as 2 described. 3 4 5 THE MATRIARCHAL TRADITION 6 The counterargument to the inﬂuence of the patriarchal Confucian tra- 7 dition has been elucidated, as mentioned above, by Hayao Kawai, the 8 renowned Jungian psychologist mentioned in Chapter 1. Kawai says 9 that the most fundamental of all Japanese familial relationships is based 2 not on the patriarchal Confucian tradition, but a matriarchal tradition 1 that is more deeply rooted in Japanese culture. As noted in Chapter 1, 2 Kawai has deﬁned the two most basic approaches to a relationship with 3 another human as the “maternal” principle and the “paternal” principle. 4 The maternal principle is not judgemental, but forges tolerant, uncon- 5 ditional acceptance of others. The paternal principle is based on rules 6 and discipline, maintaining the possibility of punishment or ending the 7 relationship. Both principles are necessary and complementary in any 8 culture, but each society imposes different degrees of emphasis. Kawai 9 sees that Christian-based Western cultures emphasize the paternal prin- 3 ciple more. But in Japanese human relationships, Kawai says, the sense 1 of oneness between the mother and the child can be preserved and cher- 2 ished through lifetime and is considered to be the ideal to follow in any 3 kind of relationship.21 The analysis reminds us of Takeo Doi’s famous 4 thesis on amae. Amae, too, is rooted in the deep desire to merge with 5 another person. Kawai developed his theories on the psychology of 3 Japanese interpersonal relationships from the viewpoint of the con- 3 frontation between two opposing principles. 3 In a culture dominated by the maternal principle, not only is a 3 mother’s benevolence a form of absolute power, but individuals tend 4 4 75 4 2831_CH03.qxp 6/4/09 1:10 PM Page 76

Mental Health Challenges x to value and appreciate fatalistic and inseparable approaches to issues, seeing them as beyond human control, rather than adopting an approach based on rational and contractually-based decisions. Therefore, a conjugal relationship, based on choice and a legal contract, is considered less strong and less important than a parent-child relationship, which is bound by blood/biological ties. Unlike the Western principle of human relationships, which is based on the understanding of ties through a rel- 0 atively clear boundary between individuals, Japanese relationships instinctively and intuitively follow the maternal principle of unconditionally encompassing one another’s existence. Ultimately, what is important for the Japanese is to share as close as possible a feeling of bor- derless identiﬁcation with another person, an arrangement that allows them to feel bound by a vague sense of fate or karma. It is not a sense of individuality that sets the limit of acceptance of another’s existence. This shows, Kawai says, that no matter how strong Confucian tradition appears to be in Japan, the culture is ultimately based on the mother- child ideal. Since Japan “Westernized” herself earlier than other Asian 0 countries, she may be perceived by other countries to favor Westernized or paternal principle-based human relationships. But the reality is far different. In a society that has always had the potential to be easily swayed by the maternal principle, Kawai says the patriarchal ie system played an important role in deliberately limiting the inﬂuence of the maternal principle by force of law, and ironically brought about a balance. The father’s position was legally protected as one that could exercise authority and power, and this had the effect of offsetting otherwise over-powerful maternal cultural orientation. However, as post-war reforms invalidated the legal power of the ie system, nothing has stood in the way of the 0 maternal principle taking control of society.22 It will come as no shock to realize that the overwhelming importance of maternal principle-based relationships affect the nature of spousal relationships as well. The ideal model of Japanese husband–wife relationship resembles that of a mother and child. The wife is expected to take a motherly role, care for her husband and bring him up to be a suc- 6 cessful man. She is expected to be patient and accepting of whatever he 7 does. She is expected to have a big heart, and as the expression “Teishu 8 o te no hira de korogasu” (literally “rolling the husband in her palm”) 9 shows, should be big-hearted and mature enough to control and manip- 0 ulate the little creature her husband is. 1 2 76 2831_CH03.qxp 6/4/09 1:10 PM Page 77

The Japanese Family Today 1 2 And he, like a little boy, is supposed to be psychologically dependent 3 on her, because she is supposed to be infinitely generous and forgiving. 4 She is not dependent on the husband emotionally, as her emotional 5 needs are more readily satisfied in her relationship with her children. 6 Therefore, in a typical Japanese home, there is no tradition of seeing 7 each member ultimately as an independent person. Parent and child see 8 each other as innately sharing identity and fate. The same is more or less 9 true in a spousal relationship. Marriage is best seen not as a union of two 1 individuals with different wishes and wants, but something taken com- 1 pletely for granted, like a quasi-mother-child relationship. An implicit 2 but strong assumption exists in the Japanese home that family relation- 3 ships require no scrutiny nor special maintenance, because they should, 4 after all, be based on something like the primary feelings that exist 5 between a mother and her child. 6 Thus, the psychological tendencies of the Japanese family have been 7 shaped not only by post-war social changes, but are rooted in centuries 8 of historical and cultural tradition. The system worked fine for a long 9 time. At least, its health did not become a serious public issue. But now, 2 for the first time, the Japanese are looking at the home as the potential 1 source of many problems facing society. After believing for many 2 decades that family unity and peace were the basis for Japanese eco- 3 nomic prosperity, the Japanese are looking with new eyes on the home 4 and its rules. 5 6 7 COSTS AND CONSEQUENCES: TOO MUCH LOVE 8 CAN KILL YOU 9 There is basically nothing wrong with a close mother-child relationship, 3 especially when the child is small. A close bond with its primary care- 1 taker gives the child a sense of security and protection, a crucial element 2 in the early development of a human being. However, the mother-child 3 bond can develop into a double-edged sword. If the relationship is too 4 tight and exclusive, in the worst cases it can psychologically torment the 5 child into adulthood. With the husband often a weak and peripheral 3 figure, the risk of a mother-child bond becoming too close is rather 3 high. If the mother is also a full-time housewife, a social category that 3 includes many middle-aged women in Japan, the possibility for this 3 grows even greater. 4 4 77 4 2831_CH03.qxp 6/4/09 1:10 PM Page 78

Mental Health Challenges x Even though Japanese women have accepted a family structure based on division of labor and lifestyle on gender lines, it does not mean they have been completely happy with it. The saying, “Teishu genki de rusu ga ii ” may be a fair comment on Japanese family culture, but this attitude is possible only when the wife has significant relationships in her immediate surroundings that support her in the absence of her husband, such as extended family, friends, and the neighborhood community. As 0 urbanization has rapidly progressed, the support network for married women has substantially diminished, leaving housewives alone at home and responsible for everything themselves. Naturally, they get distressed at times and seek emotional solace in their children. If they have a healthy awareness of their position as a parent and a clear sense of boundaries, they will understand the child is incapable of handling grownup issues. But a wife who feels quite isolated and lonely may turn her child into her best friend, confidant and ally, complaining about her husband and talking about how unhappy she is. Discontent and anger that should be communicated directly to her husband is displaced onto 0 her child. Then a strange thing can happen to their relationship. Called “incongruent hierarchy,” this occurs when the child starts to emotionally care for the parent rather than vice versa.23 Under this circumstance, the child grows up with an enormous psychological burden, and is extremely sensitive to his or her mother’s mood. It is difficult to develop as a healthy person independent from the mother. Dr. Satoru Saito, a psychiatrist and family therapist, calls this relationship the “mother–child capsule” and says it is one of the biggest factors in the psychopathology of Japanese children. He observes that because many mothers are lonely and dependent on their offspring, 0 their children grow up to be particularly sensitive to their mother’s feelings. They want to please their mothers when they are unhappy and do their best to please them, until this enormous burden begins to suffocate them.24 This capsule relationship can also result in a mother’s over- identification with her child’s life, especially if the woman has a high level of education. Because women still do not have equal career oppor- 6 tunities to men, and because of the persistence of the “For the child’s 7 sake” ideology, once a child arrives, many Japanese women give up their 8 careers to be full-time mothers, at least until the child finishes basic 9 schooling. This is clearly reflected in their M-shaped labor market par- 0 ticipation pattern. As they follow the wishes of society, so they start to 1 2 78 2831_CH03.qxp 6/4/09 1:10 PM Page 79

The Japanese Family Today 1 2 see child-raising as a way for their own self-actualization, and over iden- 3 tify with their children’s achievements. This mentality was aggravated by 4 the education ideology that was a product of post-war affluence, which 5 replaced the undemocratic idea of class with a kind of blind faith in 6 meritocracy. This was embodied in the rapid spread of mass education 7 and heated competition to get into the best schools and universities. 8 The generation born after the war grew up without any traces of the 9 war’s devastation, and by the 1970s, more than 90 % of teenagers grad- 1 uated from senior high school, even though it was not compulsory, 1 while university entrance rates rose as well. This meant that going to 2 senior high school became the norm, regardless of a child’s aptitude for 3 further academic education. 4 Those now in their thirties were educated in a period when new 5 criteria, called hensachi, became the absolute standard for evaluating 6 academic performance and the prerequisite for success in entering uni- 7 versity. Hensachi means “deviation value,” and is a quantifying method 8 that determines one’s relative rank, not actual ability. Hensachi status, 9 however, painfully suggests to many students that they are inferior to 2 others. Its impact on them and on their attitude to life is so strong that 1 it often lingers throughout their lifetime. Because their self-esteem is 2 firmly based on comparisons with others, they can never accept them- 3 selves as they are or develop self-confidence, which eventually affects 4 their relationships with others. Many of the first hensachi generation 5 grew up with this inferiority complex and, without resolving it, married 6 and became parents.25 Therefore, today’s mothers, who are from the 7 hensachi generation, are very conscious of the ranking system and want 8 to do everything in their power to ensure their children succeed as if 9 they are running a three-legged race with their children. And for them, 3 success has to be evaluated in a measurable way, that is, by academic per- 1 formance. Anything that does not contribute to high grades is consid- 2 ered unnecessary. In the mother-child centered family, many mothers 3 find their greatest joy in educating their children. But they interfere in 4 their children’s lives and often deprive them of the chance to be on 5 their own. Deep down, it becomes a frightening idea that their children 3 grow up to be independent, because it means their raison d’être will be 3 taken away. 3 These factors combined with an absent and unavailable husband or 3 father may make sensitive and vulnerable Japanese children end up 4 4 79 4 2831_CH03.qxp 6/4/09 1:10 PM Page 80

Mental Health Challenges x developing deviant and abnormal characteristics. Of course, a clear causal relationship between family interaction and pathological behavior can never be proved for sure. After all, a lot is based on speculations or observed in clinical settings. Nevertheless, we cannot help but seek clues in the family domain, because we all know how our relationship with our parents in our childhood makes a lasting impression on our lives. Kimiko Tanaka is a harsh critic of Japanese mothers and their 0 attitude toward child-raising. She says these are the source of many problems seen in children and young people today. Tanaka, a writer, a publisher, and a civil activist, runs the “New Mothering System” (NMS) group, which provides consultation and guidance for many distressed mothers. She deplores the fact that in the richest era of its history, the quality of child-raising in Japan has deteriorated. At no time in Japanese history have mothers had more time to immerse themselves in raising their children. The Japanese historically knew how to raise children in poverty, and then, mothers were too busy to be with them. But, Tanaka says, in a time of affluence, and when mothers have all the time and 0 resources they need, the Japanese have no idea about how to bring up their offspring. Compared with mothers in other countries, Japanese mothers spend enormous amounts of time looking after their babies. From lulling them to sleep, lying down next to their baby, or taking care of their every need whenever called on, mothers have been led to believe that such “skinship,” or physical contact and maternal presence is crucial to the infant’s healthy development.26 Interestingly, a study exploring the lives of farmers’ wives in 1950 showed that many of the household tasks, such as managing the family budget, cooking, cleaning, and childrearing, that are considered to be the wife’s role today, 0 were not then seen as distinctively her responsibility. Her most important role was to be engaged in agricultural labor. It was the mother- in-law who was in charge of these household-related duties.27 The mother’s increasing involvement in child-raising is, of course, partly a result of the post-war transformation of the Japanese family structure, but at the same time, it further weakens existing conjugal ties. 6 A kind of vicious cycle has become a fixed pattern at home, pushing the 7 husband and wife further and further apart. Many of these mothers, 8 filled with a strong cultural illusion of noble and supreme maternal love, 9 can be extremely selfish, because ultimately, they are only concerned 0 with the welfare and interest of their own children. Furthermore, 1 2 80 2831_CH03.qxp 6/4/09 1:10 PM Page 81

The Japanese Family Today 1 2 because of her extreme identification with children, the mother begins 3 to see the child as her possession and to feel, at least subconsciously, that 4 she does not want the child to leave the nest. In fact, Tanaka feels that 5 many Japanese mothers prefer to keep their children under their protec- 6 tion and control, preventing him or her from becoming an independ- 7 ent adult who does not need the mother any more. 8 9 MYSTERY DADS: STRANGERS AT HOME 1 1 Tanaka also says Japanese fathers are not only worn out from work and 2 have little time for their families, but also have no idea as to what kind of 3 father they should be. Many Japanese husbands/fathers find there is no 4 place for them in a home that is controlled by their wives. Furthermore, 5 as the image of the father as the strong head of the household disap- 6 peared with the abolition of the ie system, they have trouble assuming a 7 new role as a father to their children. Since they lost a model to follow, 8 the type they follow is that of a father-like figure who is at best a gentle 9 and understanding friend. The problem is that this type of parent is not 2 so different from the role many mothers are expected to play in chil- 1 dren’s lives. Thus many Japanese children are brought up by two protec- 2 tive and gentle parents, without someone who brings a strong 3 disciplinary approach. Tanaka indicates these gentle fathers are not nec- 4 essarily concerned with their wives. Many of them are disinterested in 5 their wives’ lives, and as long as they keep their families financially com- 6 fortable, they seem to believe that they are doing a good job. The truth 7 of the matter is that many of these fathers have no energy left, and do 8 not understand that being a “good father” is only possible if one is also 9 a “good husband,” Tanaka says.28 Not only is their presence at home 3 weak, but Japanese fathers are often the object of contempt to their chil- 1 dren and wife. For a while now, it has been a popular truism that hus- 2 bands who stay at home longer than they are wanted are considered 3 good for nothings or “bulky trash” (sodai gomi). Many daughters think 4 their fathers are dirty and smelly, while many children of white-collar 5 families see them as Mr. Paycheck and someone who occasionally gives 3 them pocket money. It is uncommon for children to go to their fathers 3 for life advice. 3 Particularly in this age of economic uncertainty, the status of the father 3 has become progressively shakier. Yoshihiko Morotomi, a therapist and a 4 4 81 4 2831_CH03.qxp 6/4/09 1:10 PM Page 82

Mental Health Challenges x scholar, says that today’s middle-aged Japanese men are terribly lonely and feel lost as professionals, husbands, and fathers. He describes the reaction of a typical Japanese middle-aged man to his life. “I can stand being scolded by my younger boss and having my pride shattered,” the man says. “But what’s unbearable is my family. Going home exhausted, I can’t find a place for me. Not being a father-like figure is blamed for my son’s refusal to go to school. I can’t feel relaxed at work or home.”29 The other 0 side of these men’s apparent gentleness is often simply disinterest or a desire to avoid facing another person, namely their spouses and children. Why does this happen? Probably they do not want to stir up what lies beneath the surface by creating a confrontation. Confrontation inevitably makes one look straight at and deeper into an issue. It may force unwanted change to a situation one is used to, even if one is unhappy at present circumstances. At the least, it is not a comfortable situation to be in. Being confronted by a strong figure who does not necessarily agree with you and eventually trying to resolve the situation is an important step in achieving maturity. But a combination of a protective and sneakingly- 0 controlling mother and an absent but understanding father creates a family environment in which the silent rule for the child is to play the role given and avoid looking deeper than the orderly surface. Avoidance exists not only in parent-child relationships. The epitome of how husbands and wives are avoiding interaction is the sexless state of many marriages, a situation that has only recently drawn much attention in Japan.

WHAT DO SEXLESS MARRIAGES TELL US ABOUT MEN AND WOMEN IN JAPAN? 0 “Before we got married two years ago, we used to have sex at least four times a month. But we don’t anymore. Soon after we began to live together, we became sexless,” a twenty-nine-year old woman with a husband in his thirties confesses. She tried to have intimate physical contact with her husband by kissing and hugging and made efforts to make 6 him interested, but in vain. She even cried and exploded in front of him, 7 only to hear him say a humiliating word, “You are a nymphomaniac. 8 You can do it with other men.” However, she feels, except for the sex life, 9 she and her husband get along with each other just ﬁne. Her relation- 0 ship with his mother-in-law is good, too. She is tired of trying anymore, 1 2 82 2831_CH03.qxp 6/4/09 1:10 PM Page 83

The Japanese Family Today 1 2 and instead is trying to change her way of thinking. “Now I try to tell 3 myself that we are a family, so we don’t have to have sex,” she says.30 This 4 is a typical situation so-called sexless couples face today. 5 Couples in sexless relationships exist in many countries and cultures. 6 But when the government takes it seriously enough to investigate and 7 even conducts a survey on the problem, the issue is elevated to a new 8 level of social concern. Although its ultimate concern is the declining 9 birthrate, the Ministry of Heath, Labor, and Welfare’s first survey on the 1 most private aspect of people’s lives revealed that 32 % of married cou- 1 ples could be defined as not having any sexual contact. Furthermore, 2 nearly 20 % did not have intercourse for a year.31 Confirming this phe- 3 nomenon are reports from Okamoto, Japan’s largest condom manufac- 4 turer, which says shipments of condoms have declined by 20 % in the 5 last five years. Condoms remain the most popular method of family 6 planning in Japan, despite the belated general introduction of the con- 7 traceptive pill in 1998. The decline in sex has forced Okamoto to work 8 on developing products other than condoms to ensure its survival.32 9 The decline of a person’s libido can be caused by various physical as 2 well as psychological factors. Of psychological factors, some originate 1 from stress and accumulated negative affects such as anxiety and anger. 2 Others come from deeper, subconscious reasons derived from socializa- 3 tion, such as the fear of intimacy.33 As mentioned earlier, a medical def- 4 inition given by Dr. Teruo Abe in 1991 states that sexlessness is when, 5 without special circumstantial reasons, a couple has no sexual contact, 6 including intimate body contact such as touching, for more than one 7 month, and this situation is expected to last longer. So-called “sexless 8 couples” are divided into two groups: those who are incapable of per- 9 forming sexual intercourse despite the desire, and those who do not 3 want to have anything to do with sex. (p.33) 1 Dr. Abe says that the causes for sexlessness vary from case to case, but 2 he points out that its increase among the relatively young is a phenom- 3 enon unique to Japan. An increase in the number of young men or those 4 in the prime of their lives who show strong abhorrence toward sexual 5 intercourse itself is unheard of in Western countries. Although erectile 3 dysfunction (ED) in middle-aged or older men has drawn public atten- 3 tion because of the introduction of Viagra, a doctor who treats ED 3 patients in Tokyo says the biggest demographic group suffering from 3 sexual dysfunction due to psychological factors is men in their twenties 4 4 83 4 2831_CH03.qxp 6/4/09 1:10 PM Page 84

Mental Health Challenges x and thirties. In fact, of an estimated 1 million psychologically triggered ED patients in Japan, most of them are in their twenties.34 Abhorrence of sex is not the same as loss of libido. Until the mid-1990s, Abe believed it to be a problem almost unique to women. Between 1984 and 1996, only two men came to his office for this problem, in contrast to thirty-eight women. But today, an increasing number of Japanese men are rejecting sexual contact, or even the thought of sexual contact, with 0 their partners. With some fluctuations, the number of men suffering from sex abhorrence visiting Abe increased from eighteen in 1999 to thirty-four in 2004, compared to twenty-three female patients in 2004. Sex is undoubtedly a private act that reduces the distance from another human being to a minimum. Although the causes for sexlessness in Japanese couples are not yet fully known, as Dr. Abe suggests, a profound transformation may be taking place in something very basic to human relationships in Japan. He asks what kind of cultural and social elements are creating contemporary Japanese men with these problems.35 0 Interestingly, few of Dr. Abe’s male patients have problems with experiencing sexual arousal itself. They simply have difficulty when it comes to sexual intercourse with their wives or partners (in general, women are more likely to develop the problem of asexuality, or the lack of sexual interest itself). Therefore the sexual problem facing these men is considered mainly situational. Furthermore, another interesting point is that many of these men do not necessarily think they have a bad relationship with their partners. According to Dr. Abe, various situations can trigger a decline in a man’s sexual interest in his partner. Some do not have regular sex because they anticipate that being married means it 0 is easy to have sex anytime they want. But once the appropriate timing becomes scarce, it gradually becomes awkward to mention sex as a topic of conversation. Others feel under too much pressure to satisfy their wives. Some cannot overcome embarrassing experiences in which they were unable to sexually perform. Others have married women who resemble their 6 mothers since, for these men, no women are better than their mothers – 7 and thus soon develop sexual disinterest in their wives. Often, the wives 8 of these men are also willing to play the motherly role in the marriage, 9 but their husbands begin to develop an incestuous image of intercourse 0 and are inevitably turned off. Instead of seeing their partners as an 1 2 84 2831_CH03.qxp 6/4/09 1:10 PM Page 85

The Japanese Family Today 1 2 object of sexual desire, they end up seeing them as a mother, sister, close 3 friend, or cute pet. And of course, there are some who cannot have sex 4 because they have lost affection for their partners. 5 Another type of sexual abhorrence expressed by Dr. Abe’s male 6 patients is found in those who wish to have sexual contact with the part- 7 ners, but cannot because of low self-esteem, timidity, intense fear of 8 rejection or criticism, and embarrassment. They are unable to take 9 action unless they are absolutely sure of being accepted by their poten- 1 tial partners. Some of these men’s characters, he says, show signs of 1 avoidant personality disorder, a psychiatric condition. 2 Furthermore, Dr. Abe has found that these men share a certain socio- 3 cultural background. They are likely to be an only child, or they may 4 have a sister who is much older. When they were children, they were 5 brought up with a rigid schedule of artificial nutrients that strictly fol- 6 lowed instructions from a child-care manual. They have also grown up 7 in an emotionally aloof home environment. Their mothers tended to be 8 controlling of, and over-interfering in, their lives, telling them how to 9 study, which friends to choose, and which university to go to. These 2 men are also likely to become highly-educated professionals, and many 1 have found wives through an arranged marriage, instead of finding a 2 partner themselves. (p.65) 3 Dr. Abe says that the association between an interfering mother and 4 her son’s sexual dysfunction is well established and a term to describe it, 5 “mother fixation,” was coined by Dr. Yasushi Narabayashi, a pioneer in 6 marriage and sex counselling in Japan. Many of these men have been 7 brought up by mothers who are frustrated with their absent husbands, 8 and so focus their entire energy on their children and make it difficult 9 for them to overcome the Oedipus complex. Thus, the children end up 3 becoming adults who are unable to develop the necessary skills to relate 1 intimately with others. (p.67) Many young people who have fallen into 2 the sexless state also reportedly are hypersensitive to failed attempts 3 in the past at initiating sexual contact and have developed such anxiety 4 that they cannot try again.36 Morotomi says the problem facing 5 Japanese men is not just their inability to have sexual relationships, but 3 any relationship with a woman. “Men are creatures of pride. That is the 3 essence of a man,” he states. As their societal role as breadwinner dimin- 3 ishes in value, their sense of self has become increasingly vulnerable and 3 sensitive to how their wives and/or children treat them. When faced 4 4 85 4 2831_CH03.qxp 6/4/09 1:10 PM Page 86

Mental Health Challenges x with anxiety and the fear of criticism, these men’s already shaky sense of self can collapse. To make it worse, Japanese men’s communication skills are hopelessly poor, Morotomi says. He supports this contention with statistics from a survey on the communication style of married couples in urban areas that found that “silence” was the most common form of “communication” at 36.4 %, followed by “only the wife talks” (32.4 %), and “dialogue” (22.7 %). In 8.5 % of couples, only the husband did the 0 talking. As he admits, this exception to the rule is almost bizarre and spooky when one imagines the typical scene where a Japanese husband and wife are together. Morotomi says poor communicator husbands are divided into two types: one is cold and unemotional, the other childish, dependent, and seeking a motherly figure in his wife. The first type of husband only wants to see his wife as a domestic caretaker. He tends to be authoritative and lacks sympathy for his family. The second type of husband is like a little boy needing to be taken care of, and becomes a burden to his wife as he does not do anything to help her with daily chores. Morotomi 0 also indicates that this “dependent” type of husband sometimes “wears the disguise of understanding husband” to hide his fear of an honest confrontation with his wife.37 For some men, the only way they know how to relate to their children is to play the role of a gentle and understanding father. In the same way, these husbands just do not know how to relate to their wives, except to be dependent on or be pampered by them. They cannot even imagine coming face to face with their wives as an equal and individual partner. In fact, that is what they fear more than anything else – a sexual relationship is, after all, like any intimate relationship a matter of communication. In essence, it is the act of exchang- 0 ing and sharing emotions, feelings, different egos and physicality. Of course, it is not just men who are responsible for sexless marriages. It takes two to tango, or not tango. Although, on one hand, more Japanese women are sexually open today than several decades ago, a type of individual who rejects and abhors any sexual behavior is becoming more common, according to Dr. Abe. But when studying women, it is 6 more difficult to generalize on patterns of sex abhorrence. These women 7 start avoiding sexual contact because they have lost affection for their 8 partners or have been traumatized by their partners for some reason.38 9 It is also reported that more young women are finding intercourse 0 painful. According to a Tokyo gynecologist, many of these women diet 1 2 86 2831_CH03.qxp 6/4/09 1:10 PM Page 87

The Japanese Family Today 1 2 excessively or have stressful lives that can disturb their hormonal bal- 3 ance. The 2001 survey conducted by condom manufacturer Okamoto 4 revealed that about 70 % of women in their twenties and thirties had 5 reported experiencing pain during intercourse. An increasing number of 6 women worry that they have an unpleasant odour, and have become 7 afraid of engaging in any sexual act. Others are over-conscious of their 8 appearances and feel inferior or unattractive, which also makes them 9 reluctant to have sex. There are still others who cannot overcome the 1 notion that sex is disgusting, while others have developed depression out 1 of various stresses in life and have lost their libido.39 2 What is most bizarre about sexless couples is that many say they do 3 not mind this situation, as otherwise they get along with their spouses 4 perfectly. They say that although they can no longer see each other as sex- 5 ual partners, they deeply trust each other as family members and there- 6 fore the absence of sex does not disturb or jeopardize their marriage. One 7 wife says she thinks her husband is having an affair, and she has also 8 started to have an affair, but wants to remain married since she and her 9 husband are very close, except for not having sex.40 A detailed survey on 2 the motives and circumstances of sexless couples in their twenties to 1 forties reports that more than 22.5 % of husbands and 50 % of wives 2 believe they were responsible for initially refusing to have sex, while 3 about 35 % are unsure exactly who initiated the abstinence. Nearly 90 % 4 of husbands do not see being in a sexless marriage as a special problem, 5 and almost 70 % of men who have avoided sex with their wives (rather 6 than the wives avoided sex with them) do not particularly want to do 7 anything about it. In fact, the majority feel that their love for and com- 8 munication with their wives have not changed since they stopped having 9 sex. More than 80 % of women who stopped having sexual relationships 3 with their husbands also say they do not want to do anything special to 1 improve the situation.41, 42 In other words, a majority of couples in this 2 state do not think the absence of sex is a serious threat to their marriage. 3 However, this apparently blasé attitude about the lack of sexual con- 4 tact in their married life may only hide a fundamental inability to face 5 the problem, because it would touch profound and yet unsettled issues 3 in their relationship. One Japanese therapist says that sexless husbands 3 and wives who say they get along with each other just ﬁne are basically 3 not communicating well, and sexlessness can be an expression of resent- 3 ment that they are not even fully aware of. It can be a subtle form of 4 4 87 4 2831_CH03.qxp 6/4/09 1:10 PM Page 88

Mental Health Challenges x aggression and hostility toward the other person. They pretend to be loving toward their spouses, but at the same time are afraid of being hurt by the other. One sure way to escape from any possibility of getting hurt is to remain psychologically uninvolved in the relationship. When they feel resentment toward the spouse, they try to ignore their own feelings and force themselves to believe they are not upset. They even tell themselves that sexlessness is not so bad, or “it is just one way of living.” This 0 way, they will not hurt each other’s feelings since they leave deeper issues untouched and buried.43

WHY NOT DIVORCE? As mentioned earlier, when a wife’s anger and dissatisfaction toward her husband is repressed over decades, some begin to suffer from retired husband syndrome (RHS), or husband presence stress syndrome. The husband’s presence at home changes and disturbs the order and routine the wife has established. Both RHS and husband presence stress syn- 0 drome manifest themselves psychosomatically. It is expected that an increasing number of courageous wives, or ones with resources, will turn to the ultimate last resort – divorce. However, many women are suspected of being stuck in marriages they want to end, but cannot. These feelings could become endemic from 2007 to 2009, when a record number of men of the so-called baby-boom generation born after World War II are scheduled to retire. Wives who are fed up and disgusted with being a mother and a maid to their husbands, rather than an equal partner, are horriﬁed by the prospect of sharing life with these men for another thirty years, not an unreasonable estimate of life expectancy in 0 the longest-living nation in the world. A survey by advertising agency Hakuhodo showed that while 85 % of husbands were looking forward to retirement, 40 % of their wives are “depressed” just thinking about it.44 But to be fair, it is not only women who are distressed by the presence of their spouse. According to Morotomi, an increasing number of men are also afraid of returning home because they feel they will not be 6 accepted by their wives and children and have developed something he 7 calls kitaku kyohi sho¯ko¯gun, “refuse to go home syndrome.”45 Of course, 8 these not-so-uplifting aspects of relationships between Japanese couples 9 did not just appear yesterday. They are the result of years or even decades 0 of serious failure to communicate. The reader may wonder, however, 1 2 88 2831_CH03.qxp 6/4/09 1:10 PM Page 89

The Japanese Family Today 1 2 why these couples did not do anything about their marriage before it 3 reached this dreadfully stale or even painful stage. Sometimes, simple 4 inertia is to blame. But was the reason there were other things they 5 thought far more important than psychological satisfaction? 6 As noted in Chapter 2, sociologist Masahiro Yamada believes Japan 7 is now in the process of breaking into two demographic groups, one 8 which can afford to be hopeful for the future and still believes in upward 9 mobility, and another that cannot and instead can only try to maintain 1 its current standard of life, at best, if not attempt to prevent a decline. 1 Especially for the latter group, the future is filled with unknown risks. 2 The widening gap in society lies not in material possessions, but rather 3 in outlook regarding the future, an outlook that is conditioned by edu- 4 cation, income, and parents’ socioeconomic status. Life in Japan used to 5 be fairly predictable. Salarymen could expect their wages to steadily rise, 6 an expectation that brought a strong sense of security to many house- 7 holds. As the economy grew, most young people were able to safely 8 expect to marry and have families before reaching a certain age. After 9 getting married, it was easy to ignore psychological dissatisfaction 2 between husbands and wives as it was a minor problem when compared 1 with the prospect of a solid financial future together. Consequently, 2 families were also prevented from drastic breakdown.46 Japan’s low 3 divorce rate after World War II did not necessarily mean, as discussed 4 above, that its marriages produced happier husbands and wives than in 5 other countries. It is just that the social expectations of marriage, espe- 6 cially once a child arrived, were different from those in cultures where 7 family life centered on the conjugal relationship. It also implies that 8 alternative life choices for women, and sometimes men, after divorce 9 were so limited that many unhappily married women felt they had no 3 choice but to stay. The importance of the perception of alternative life 1 situations cannot be overstated enough. What we think is out there if 2 we leave the status quo is what determines our decision to change things. 3 Assessing the potential cost or benefit of making a change ultimately 4 determines our decision to stay or go. 5 Divorce in Japan can be easily achieved by both parties. So-called 3 “conciliatory divorces” make up the majority of cases filed, although if 3 one party refuses to divorce, the process can be quite complicated, time 3 consuming, and painful. Despite the absence of religious restrictions, 3 such as sin or guilt, in breaking up holy matrimony and the legal 4 4 89 4 2831_CH03.qxp 6/4/09 1:10 PM Page 90

Mental Health Challenges x simplicity of the Japanese system, divorce remains an uncommon method of resolving marital problems, and is often seen as causing more harm than good. It is also true that society does not provide spouses with images of better alternatives to staying married. That is why most couples in general do not or cannot afford to choose such an overt way of coping with marital unhappiness. It is extremely difficult for the wives over forty who have not actively devel- 0 oped a career up to that point to find a full-time job to support their post-divorce life. When thinking about the economic instability and lowering of living standards they will be forced to experience, the rational choice for those women is to stay married, at least legally. Not surprisingly, some may develop the husband-related stress syndromes mentioned earlier. Even in these cases, many couples still choose katei nai rikon or “domestic divorce,” a marital condition that has been frequently mentioned in the last ten years, whereby a couple lives separate lives yet inhabit the same house for the sake of appearances.47 Separating affection and the social obligations of marriage is common throughout 0 Japanese history. Or rather, the idea that marriage and true affection lie in separate spheres of life is not uncommon. This double standard in marriage, based less on affection than formality, was exemplified in a 1997 survey by Asahi Shimbun in conjunction with Louis Harris & Associates in which only 48 % of Japanese people polled said they would not condone extramarital sexual relations under any circumstances, compared to 76 % of Americans who expressed the same view. Husbands’ extramarital affairs, in particular, are tolerated in Japan as long as they do not destroy family life.48 Many young people distinguish between the formal and emotional aspects of marriage. When I once 0 asked my Japanese students whether love is absolutely the most important element of their future marriage, most – especially women – believed not. Other things, they say, such as economic potential and family support, are more important. When I ask American students, almost all firmly agree that love is the most important element. They believe, as the cliché goes, that love can overcome all obstacles. 6 On the other hand, certain “traditional” images and characteristics of 7 Japanese family we take for granted today, such as intact family life, low 8 divorce rate and clear gender-based division of labor, are obviously 9 products of Japan’s post-war social arrangements, devised for the pur- 0 pose of securing economic growth. For example, in pre-war Japan, not 1 2 90 2831_CH03.qxp 6/4/09 1:10 PM Page 91

The Japanese Family Today 1 2 everyone could afford to marry, and even after marriage, family life 3 was not necessarily stable. The divorce rate and premature death rate 4 were also high, thus creating many widows and widowers, as well as 5 orphans.49 But ironically, these post-war characteristics are nostalgically 6 associated with the idea of traditional family life. The idea of women 7 quitting the labor market to become full-time homemakers is not at all 8 “traditional.” Throughout history, women have continued to work for 9 most of their lives, in farms or family businesses. Even the practice of 1 automatically adopting the husband’s surname after marriage is only 1 150 years old, part of the ie system enforced by the Meiji government. 2 It is sobering to realize how deeply we are made to believe and accept 3 these creations of society, as if they were something innate and natural 4 to Japan. Furthermore, lifestyles filled with uncertainty and risk inside 5 and outside the home are not especially new to many highly-industrial- 6 ized Western societies. In many post-industrial nations, in exchange for 7 diversity of choices and lifestyles, uncertainty in life has also increased, 8 a fact that has forced individuals to be aware and better prepared for the 9 unpredictability of life. 2 Having admitted these facts, it is also true for most Japanese men and 1 women living today, that the changes occurring right now are posing 2 challenges they have never experienced before. It no longer appears that 3 life is as certain as they were allowed to believe it was for many decades. 4 As in pre-war Japan, from now on, not all young adults will be able to 5 expect to marry and have families. On the contrary, as social expectations 6 on marriage change, emphasizing hard-to-define concepts such as per- 7 sonality compatibility and personal happiness rather than the social obli- 8 gation to procreate, it will become far more difficult to find the right 9 person. There is even the possibility they will never find Mr. or Miss. 3 Right. And even if they do, they may not be able to afford to get married. 1 But if they can find the right person, and they can afford it, after they 2 marry, Japanese society holds many risks and dangers for their conjugal 3 happiness, such as financial instability and the new availability of alter- 4 native lifestyles other than “traditional” family life. Therefore, the con- 5 cept of the family, which was supposed to protect people from risks 3 caused by economic and social uncertainty, is now becoming a source of 3 risk itself, Yamada says. Salarymen’s wives will no longer be able to count 3 on their husband as sole provider for the family. Once a man loses his 3 job and financial base, he may also lose his entire family.50 4 4 91 4 2831_CH03.qxp 6/4/09 1:10 PM Page 92

Mental Health Challenges x IS JAPANESE MARRIAGE AT A CROSSROADS? With mounting stress at home too hard to ignore, the Japanese are facing a critical question as to how they and their families can cope with this social change and remain a happy and healthy unit. When there seems to be no way to improve home life, and when they believe that they may be able to do better by not staying married, more husbands and wives are getting out. Their children are choosing not to have a family at all. 0 Either way, Japanese society is experiencing a fundamental structural transformation. It is undeniable today that divorce in Japan is part of this new phase. Divorce is radically on the rise. It surpasses the level of some European nations, such as France and Italy, and looks like catching up with the rates of Germany, the United Kingdom, and Sweden, countries that have high but stable divorce rates.51 The number of divorces in Japan in 2004 was 270,000, the highest ever but following a steady rising trend that started in the early 1990s. Women under thirty are particularly likely to get divorced, and it is estimated that one out of two women 0 who marry in their early twenties will eventually divorce. But as noted above, what is most unusual is the rapid increase in divorce by those married for more than twenty years. The number of jukunen rikon (mature-age divorces) quadrupled from 1980 to 2000. Another point of great interest is the parallel fluctuation of divorce and unemployment rates, which suggests the primary importance of economic factors in Japanese marriages. A law promulgated in 2007 has started to enable wives to receive up to half of the husband’s pension accumulated during his working life. This legal reform is expected to eventually produce a huge surge in the number of older women seeking 0 divorce. Those women who had given up on the idea of divorce because of future financial difficulties may finally start to take more radical action to change their lives. Depending on the economic conditions in Japan at the time, as many as 400,000 couples were estimated to be potential divorcees, which would give Japan the highest divorce rate after the United States.52 However, many married women who had 6 planned to divorce as soon as the law came into effect are beginning to 7 realize that even with a bigger slice of the pension, it will be extremely 8 difficult to have a comfortable post-divorce life. From this viewpoint, 9 the status quo looks less unattractive. 0 1 2 92 2831_CH03.qxp 6/4/09 1:10 PM Page 93

The Japanese Family Today 1 2 Although we do not yet know if this outbreak of divorce will happen 3 in reality, and how it will change the idea of marriage in Japan, it is clear 4 that more and more people are starting to feel that divorce is a legitimate 5 choice for dealing with an unhappy marriage. However, it also seems 6 that many families in Japan avoid doing anything to change the situa- 7 tion, even if the stress felt in the home has risen to a pathological level. 8 They may continue to maintain the status quo, at least on the surface. 9 But how long can they stay in denial of reality at the cost of their 1 psychological and physical well being? 1 One major source of problems in family relations stems from the 2 growing gap between reality and the persistent ie ideology, which still 3 haunts many Japanese people’s consciousness. Despite enormous social 4 changes in the past decades, the Japanese still somewhere in their heart 5 cherish the traditional view of family, in which each member is united 6 around the idea of ie, the family name and its continuity are more impor- 7 tant than individual happiness, and marriage is a matter of intergenera- 8 tional negotiation. Although it is rapidly becoming a myth, people like 9 myths because they are reassuring. Keeping up social appearances and 2 order, for the sake of maintaining the image of being a decent family, 1 often take precedence over meeting the personal satisfaction of each 2 member. Most Japanese today cling to the idea that family structure 3 should not be disturbed on the surface, regardless of what goes on in 4 the home. Mother-child centered, or intergenerational, bonds continue 5 to be more important than conjugal ties. Marital frustrations are less 6 likely to be solved within the marriage, but instead are displaced onto 7 other relationships, such as that between the parent and child, or some 8 other intimate relationship outside the home. Obsession with the super- 9 ficiality and order of the traditional family structure stands in the way of 3 dealing with problems with courage and honesty. 1 Therefore, many of the problems Japanese families face today come 2 from a strange mixture of warped post-war political and economic 3 development, the haunting influence of Confucian-based ie ideology on 4 the surface, and a deeper cultural, psychological orientation. 5 Hayao Kawai alludes to the intrinsic vulnerability of Japanese fami- 3 lies in distress. The dominance of the matriarchal principle in Japanese 3 family culture may make it difficult for the Japanese to relate to others 3 in highly-intimate relationships as equals and independent individuals. 3 He points out that a Christian view of human relationships is based on 4 4 93 4 2831_CH03.qxp 6/4/09 1:10 PM Page 94

Mental Health Challenges x the view that anyone who believes in the same God is a brother, sister, or parent. This denial of biological links under the same faith or contract, or the denial of an overwhelming matriarchal existence, is very important in Western culture and what makes human beings independent entities with clear boundaries that separate them from others. Kawai says this clear delineation is quite difficult for the Japanese to imagine.53 Kawai also argues that the strictly patriarchal ie ideology once helped to 0 balance the Japanese family’s predominantly matriarchal culture. When post-war reforms eliminated legal support for the ie system, the authoritarian, paternal figure was removed with the hope that the new Japanese family would be centered on a husband-and-wife unit with equal human rights. But what grew out of the post-war environment was not an individual-focused philosophy that would have been the base for healthy conjugal relationships. Instead, persistent concern with peripheral aspects of the ie outlook linger. The Japanese have continued to emphasize the importance of the roles they have to play, maintained their obsession with superficial order (not substantial order and princi- 0 ples at home), and have made mother-and-child interdependence the core of family life. With the patriarchal figurehead gone, the Japanese family system has reverted to its original matriarchal orientation. Even if the divorce rate exceeds today’s high levels, and people realize that marriage does not necessarily guarantee security, Japan will not see the creation of the couple-centered family model that exists in Western countries. Such social change will take a long long time to occur, and will require the Japanese to digest a new concept of marriage. Instead of building meaningful conjugal relationships, people will choose to divorce and maintain highly interdependent relationships with their parents and chil- 0 dren. In their post-divorce lives, these will remain the main source of social support. Although the contemporary ideal of marriage and family is that of a man and a woman developing a conjugal relationship as equals, somewhere deep in the Japanese psyche, there lies a yearning for the sense of oneness with a maternal figure that unconditionally allows and accepts anything one does. The fundamental desire for a boundless fusion of one- 6 self and another is not uniquely Japanese, but Japan does possess a cultural 7 and psychological tradition that has enabled this mentality to survive and 8 flourish. This may make it particularly difficult for the Japanese to con- 9 front critical issues at home, as this attempt at oneness goes completely 0 against the idea of individual choice and decision-making. 1 2 94 2831_CH03.qxp 6/4/09 1:10 PM Page 95

The Japanese Family Today 1 2 But how does the psycho-cultural environment of the Japanese fam- 3 ily affect children’s socialization processes? How do factors facing fami- 4 lies inﬂuence young people’s ability to cope with life’s problems? The 5 next chapter will take an in-depth look at these questions. 6 7 8 NOTES 9 1 Hill, R., 1958, “Generic Features of Families Under Stress.” in Family Stress. P. Boss 1 (ed.), 2003, Thousand Oaks: Sage Publications. 1 2 Japan Almanac 2005, Asahi Shimbunsha, p.20. 2 3 Faiola, A., 2005, “Sick of Their Husbands in Graying Japan.” Washington Post, 3 October 17. 4 . (Husband presence stress syndromes). 4 (http://www.kyosai-cc.or.jp/health/mental/SP_1/5c_pages/c5_26.html accessed 5 April 19, 2008. 6 5 . (Husband presence stress syndromes). 7 (http://www.jili.or.jp/lifeplan/event_type/lifeevent/marriage/10.html) accessed April 19, 2008. 8 6 Abe T., 2004, . (Psychiatry of the sexless). Chikuma 9 Shobo Publishing. 2 7 Go, M., 2005, 32% (32% of the married sexless), 1 Mainichi Shimbun, April 26. 8 Asahi Shimbun 2007, 3 2 (One third of couples sexless. Found by the Ministry of Health and Labor research 3 section). http://www/people.ne.jp/2—7/03.18/jp20070318_68918 html accessed 4 March 19, 2007 5 9 Honkawa Data Tribune 2005, Sex (The frequency of sex and degree of satisfaction in different countries) 6 http://www2.tten.ne.jp/~honkawa/2318.html accessed April 19, 2008. 7 10 Yomiuri Weekly 2004, 8 (Increasing sexless: reasons why a husband and wife cannot do it). October 31. 9 11 Yoshimi, S. (ed.), 1988, . (Women and ie). Doseisha. 12 Ibid. 3 13 Meguro, Y. and H. Shibata, 1999, (Corporatism and family)” 1 in Meguro, Y. and H. Watanabe (eds.) 2 (Sociology Course 2 2 Family). Tokyo University Press, pp.59–88. 3 14 Ministry of Health, Labor, and Welfare, 2004, 16 (Reality of working women 2004). http://wwwhakusyo.mhlw.go.jp/wpdocs/ 4 hpwj200401/ body.html accessed April 19, 2008. 5 15 Sugimoto, Y., 2003, An Introduction to Japanese Society. Cambridge: Cambridge 3 University Press, pp.146–81. 3 16 Reuters News 2002 “Japanese men shirk housework, study shows” in Japan Today. http://www.japantoday.com/e/?cpmtemt=news&id=205793 accessed March 13, 3 2002. 3 4 4 95 4 2831_CH03.qxp 6/4/09 1:10 PM Page 96

Mental Health Challenges x 17 Yamada, M., 1998, “The Japanese Family in Transition.” About Japan Series, No.19, Foreign Press Center, p.21. 18 Ibid. pp.16–17. 19 Okonogi, K., 1998, . (Crisis of moratorium nation Japan). Shodensha, pp.158–62. 20 Slote, W., 1998, “Psycho-cultural Dynamics within the Confucian Family” In Confucianism and the Family. W. Slote and G. De Vos (eds.), State University of New York Press, pp.37–51. 21 Kawai, H., 1981, “Violence in the Home: Conflict between Two principles— 0 Maternal and Paternal.” In Japanese Culture and Behavior. T.S. Lebra and W.P. Lebra (eds.). Honolulu: University of Hawaii Press, 1986, pp.297–306 22 Kawai, H., 2002, . (Thinking about family relations). Kodansha Gendai Shinsho, originally published in 1980. 23 Nichols, M. and R. Schwartz, 2001, Family Therapy. Boston: Allyn and Bacon, p.125. 24 Saito, S., 1999, . (Family addiction). Shincho Bunko. 25 Ogi N., 2001, . (How should we see the crisis of children?). Iwanami Shinsho, pp.135–7. 26 Tanaka, K., 2004, . (Mother-child adhesion and child-raising difficulties). Kodansha. 27 Watanabe, H., 1999, (Parent-child relationship in post 0 war Japan) in Meguro, Y. and H. Watanabe (eds.) ibid. Chapter 4, pp.89–117. 28 Tanaka, K., ibid. 29 Morotomi, Y., 2002, . (Lonely men). Chikuma Shinsho. 30 . (Bedroom situation next door and mine) http://www.suzune.net/sodan/archives/2008/02/post_64.html accessed April 6, 2008. 31 Go, M., ibid. 32 Asahi Shimbun Weekly AERA 2004, Sex (Don’t hate sex, young people!). May 3, pp.16–19. 33 Abe, T., ibid. 34 Asahi Shimbun Weekly AERA. Ibid., 35 Abe T., ibid. pp.22–39. 36 Asahi Shimbun Weekly AER. Ibid. 0 37 Morotomi, Y., ibid. 38 Abe, T., ibid. 39 Asahi Shimbun Weekly AERA. Ibid. 40 Asahi Shimbun Weekly AERA 2004, (Though sexless, we are a close couple), August 2. 41 Asahi Shimbun Weekly AERA 2005, (Sexless: men’s honest opinions). October 31, pp.34–8, 6 42 Asahi Shimbun Weekly AERA 2005, (Sexless: women fight back), November 7, pp.37–40. 7 43 Asahi Shimbun Weekly AERA 2004, 8 (Though sexless, we are a close couple), August 2. 9 44 Faiola, A., ibid. 0 45 Morotomi, Y., ibid. 1 2 96 2831_CH03.qxp 6/4/09 1:10 PM Page 97

The Japanese Family Today 1 2 46 Yamada M., 2004, . (Hope disparity society). Chikuma shobo. 3 47 Kawanishi, Y., 1998, “Breaking up Still Hard to Do,” Japan Quarterly, July- 4 September, pp.84–9. 5 48 Asahi Shimbun 1998, (Lower hurdle against extramarital affairs or divorce). January 1. 6 49 Yamada, M., 2004, ibid. 7 50 Ibid. 8 51 The Economist 2005, 2007 40 (Divorce in 2007 estimated to be 9 400,000 cases), November 22, pp.18–31. 52 Ibid. 1 53 Kawai, H., 2002, ibid. 1 2 3 4 5 6 7 8 9 2 1 2 3 4 5 6 7 8 9 3 1 2 3 4 5 3 3 3 3 4 4 97 4 2831_CH04.qxp 6/4/09 1:11 PM Page 98

x 4 Youth 0

“Only the individual himself can develop his given potentialities. But, like any other living organism, the human individuum needs favorable conditions for his growth ‘from acorn into oak tree’; he needs an atmosphere of warmth to give him both a feeling of inner security and the inner freedom enabling him to have his own feelings and thoughts and to express himself. He needs the good will of others, not only to help him in his many needs but to guide and encourage him to become a mature and fulﬁlled individual. He also needs healthy friction with the wishes and wills of others. If he can thus grow with others, in love and in friction, he will also grow in accordance with his real self.” (p.18) 0 KAREN HORNEY1

In any place and at any time in history, the young have always been the object of criticism, whether it is how different, ignorant, immature, or inadequate they are compared with the adults doing the criticizing. It seems that lamenting the failures of “young people nowadays” is a part of human nature. Admittedly, it seems today’s young Japanese, and even children, are causing more uneasiness and restlessness among their seniors than ever before. At no time in Japanese history has the state of the young mind and heart been seen as a more serious threat to the 0 country’s future. But it may be also true that the ubiquitous media drive us to pay attention to Japan’s “youth problems” far too much. Just a look at the striking fashions and apparently hedonistic lifestyle of the teenagers and young adults who congregate in the Shibuya, Shinjuku, and Harajuku districts of Tokyo is enough to leave the older generation perplexed, if not completely aghast. Their cultures, artifacts, 6 and ever-multiplying sub-cultural sets defy grown-ups’ comprehension. 7 These kids, born during the most afﬂuent period in Japanese history, 8 not only seem to know how to enjoy themselves without guilt, but they 9 also appear to like making powerful statements about their identity that 0 may even cause jealousy among the older. Many are turning their backs 1 2 98 2831_CH04.qxp 6/4/09 1:11 PM Page 99

Youth 1 2 on the rigid, career-driven lives of their fathers and opting for a more 3 flexible way of life. They have become so-called “freeters,” living off a 4 series of temporary, low-wage, part-time jobs while following their 5 interests at will or simply having fun. And worse of all for the old, they 6 make no apologies for trying to enjoy the present, or for not worrying 7 about the future. 8 Choosing a lifestyle that emphatically rejects that of their fathers’, 9 which was spent crawling up the corporate career ladder, sounds rebel- 1 lious and youthful. However, the other side of this daring or carefree 1 façade is the reality that many of them are far from assertive or sure 2 about themselves. One youth-related problem that has arisen in the past 3 few years concerns the so-called “NEETs,” people who are “Not in 4 Education, Employment, or Training.” It is estimated that, in 2006, 5 620,000 Japanese aged fifteen to thirty-four are in this state of limbo, 6 approximately 2% of the population of this age bracket. The term was 7 originally a British Government classification for those aged sixteen to 8 eighteen not participating in society and beyond the scope of labor wel- 9 fare.2 But more generally in Japan, NEETs are perceived as lazy and 2 pampered cowards who are wasting their lives away. When freeters first 1 appeared in the mid-1990s, they were considered potential rebels. But 2 they had jobs at least, even if they did move from one kind to another 3 with unusual alacrity, and in the beginning, were seen as a group with 4 the potential for creativity. But unlike freeters, NEETs do not have even 5 vaguely-defined social status and have no involvement with society’s 6 activities or future production. As a result, they have begun to be recog- 7 nized as a growing social problem requiring policy intervention. If more 8 and more young people are living lives with no future possibilities, one 9 may naturally wonder what is wrong with society. In a way, NEETs may 3 be only symptomatic of Japan’s numerous social pathologies, which they 1 have inherited from their former generations. How has Japan come to 2 produce so many individuals who seem to live such apathetic, meaning- 3 less lives? What are their biggest worries and concerns? Of course, the 4 majority of young people do not go terribly astray from what is expected 5 of them by society. But the ones who appear to exist in a “normal” range 3 of behavior, but in reality feel uncomfortable with themselves and their 3 environment also are increasing. What is the dark side which creeps up 3 and secretly torments them? There have been some disturbing signs in 3 both public and private that cannot but cause concern. And I myself 4 4 99 4 2831_CH04.qxp 6/4/09 1:11 PM Page 100

Mental Health Challenges x cannot help but sense more fragility and low self-esteem in Japanese young people than ever before.

DISTURBING SIGNS In the early 2000s at a university at which I was working, I was talking to Fumiko, one of my Japanese students, about the attitudes of the 0 young generation. Being a few years older than the average college student, Fumiko found it surprising to observe just how sensitive some of her classmates could be to the reactions of others. She said they never seemed to be able to relax and be themselves, because life for them was like wearing a mask. For example, when one of her friends was sick, she did not want to tell her mother for fear of worrying her. One of my former colleagues, a professor of English, also expressed the opinion that students today showed an unusual mix of childishness, ungratefulness, and self-centeredness but, ironically, were extremely anxious not to hurt others’ feelings. He said that while more students blamed teachers and 0 schools for their academic incompetence, when it came to relationships with their peers, they were extremely careful not to offend others. They desperately wanted to please, because they were so afraid of being dis- liked by their “friends.” One of my friends, Azusa who is in her mid- forties, works at a company where most employees are in their twenties and early thirties. To her, the way her younger colleagues communicate with each other is hard to comprehend. Even after years of working together, they stick to their expected roles, always mask their feelings, and are very careful never to reveal their true selves. She has a younger friend who feels she was severely traumatized by something her mother 0 said to her years ago, but does not dare to confront her mother because “it may hurt my mother’s feelings.” Peer pressure may signiﬁcantly affect the self-esteem of young people everywhere, but the degree to which Japanese youths and young adults desire to conform is puzzling as well as disturbing. They often worry excessively about not being liked or accepted by others. Taijin kyofu, a 6 phobia of interpersonal relations that includes a phobia of eye-to-eye 7 confrontation or blushing in front of others, was once considered a 8 psychopathology peculiar to Japan. It attracted the attention of scholars 9 who saw it as the manifestation of a deep fear of hurting others, some- 0 thing they saw as culturally unique to Japan.3 These individuals were 1 2 100 2831_CH04.qxp 6/4/09 1:11 PM Page 101

Youth 1 2 seen as extreme cases and clearly pathological. Is it possible that milder 3 versions of this phobia are more widespread today, especially among the 4 young? 5 Yuko Sakagami, who is an instructor at a Japanese university, writes 6 that the biggest source of worry for students is taijin kankei, or their rela- 7 tions with others. In one psychology class, more than half of her students 8 said they felt they were not good at making friends, were extremely shy 9 of strangers, always worried about how others evaluate them and were 1 almost neurotically tense about relationships. They showed special inter- 1 est in studying personality disorders and criminal psychology, because 2 they felt they themselves had different personalities depending on with 3 whom they interacted. “It’s the only way to live,” one of her students 4 says. “Otherwise, we cannot have relationships.” Sakagami believes many 5 students do not show their real selves even to their own families.4 6 Sometime in the mid-1990s, the word yasashisa, a word used daily 7 that means gentleness or kindness, gained special popularity and was 8 thought to best represent the mood of Japanese youth. This was partly 9 due to a best-selling book by psychiatrist Ken Ohira, Yasashisa no 2 Seishinbyo–ri.5 In his book, Ohira goes into great detail explaining 1 what young people nowadays consider the essential elements of rela- 2 tionships. Through his experience as a counselor, Ohira realized that 3 more and more of his young patients said they behaved toward others 4 in a certain way out of yasashisa. In fact, these patients seemed to be 5 obsessed with building a relationship based on yasashisa. What particu- 6 larly surprised Ohira was that even a patient who exhibited schizo- 7 phrenic symptoms asked Ohira not to mention his illness to his family 8 because he cared about behaving with yasashisa toward them by not 9 making them worry. This kind of consideration is not usually seen in 3 psychotic patients. One patient talked about marrying his girlfriend, 1 even though he did not particularly like her, because he felt he should 2 do it out of yasashisa. Another did not offer a seat to the elderly on trains 3 or buses because doing so would make the older person feel old. In this 4 patient’s view, the most yasashisa thing to do in this situation was to 5 ignore the elderly person’s presence. Another young female patient 3 pretended to be happy when her parents gave her an allowance, even 3 though she knew they could not afford to give her money. She believed 3 it was true yasashisa not to hurt her parents’ pride by declining the 3 allowance. 4 4 101 4 2831_CH04.qxp 6/4/09 1:11 PM Page 102

Mental Health Challenges x Yasashisa originally meant to understand and empathize with another person’s feelings. When one knows that someone understands one’s feelings and has taken them as his or her own, a warm sense of oneness is created between the two people. Then, a genuine concern is expressed verbally or non-verbally, and an act of kindness expressed to the other person. However, yasashisa as used by the young today has very little to do 0 with empathy or a sense of oneness. Even an attempt to share another person’s feelings seems to be missing from their interactions. What matters more here is their arbitrary perception of the situation and the other person’s feelings, Ohira says. Of course, their motivation is genuine. They simply want to be “nice” to others. But their interpretation of what is good for the other person is based on a very self-centered interpretation of the world. And despite their best intentions, their yasashisa is the central source of conflict in their relationships.6 The more yasashisa they wish to show toward a person they care about, the more they try NOT to express their own personal feelings such as complaints, 0 sorrow, anger, or other negative emotions, because these personal emotions, they believe, can only embarrass the other person. Crying in front of a friend would be the worst thing to do to him or her. For them, yasashisa means to prevent the person they care for from being exposed to their raw, intense emotions. To avoid potentially embarrassing moments or even topics, many young people in Japan seem to secretly struggle, and even become exhausted by their own efforts. They strongly assume that yasashii (gentle) people, the kind of people they associate with, are very vulnerable to others’ pain. Just like themselves, their “friends” are quite easily hurt by others. They tell themselves that emo- 0 tional pain is contagious, and nothing is more unbearable than their own pain and tears influencing another’s mental state. Ohira observes that in order to avoid any possibility of offending others, these young people restrict themselves to very superficial interactions, such as simply hanging out together and listening to music, playing video games, or reading comics, but with no verbal communication.7 6 Yoshihiko Morotomi, a psychologist, says young Japanese, particularly 7 men, are living lives full of distress, anxiety, and hopelessness. An increas- 8 ing number of young people say they do not like themselves.8 Morotomi’s 9 descriptions even make us wonder if there are any “youthful” youths in 0 Japan. It is difficult to find in his descriptions of young Japanese men the 1 2 102 2831_CH04.qxp 6/4/09 1:11 PM Page 103

Youth 1 2 kind of spirited energy we associate with the word “youth.” On one hand, 3 Morotomi says, young men today are conservative, wishing to pursue lives 4 that promise future security and stability. On the other hand, they are 5 scared of failing to meet the traditional demands and expectations of their 6 parents’ generation, such as holding a steady job, having a successful 7 career, having a family and providing sufficiently for it. They are often 8 overwhelmed by what is expected of them. For their parents’ and grand- 9 parents’ generations, poverty and material depravation were the source of 1 all strength and energy. And for these generations, life was predictable and 1 simple hard work was worthwhile. The harder one worked, the more one 2 was rewarded with tangible success. Even when barriers and obstacles 3 stopped them from attaining material goals, previous generations could 4 believe harder work would eventually benefit them. 5 Today’s young generation grew up with everything they wanted, and 6 so do not know how to set clear physical goals. Without something spe- 7 cific to direct their energy toward, they feel at a loss. Morotomi says 8 many young people appear to have already given up any hopes for the 9 future. However, traditional social expectations remain firm, a situation 2 that is not making it any easier to make that vital first step in adulthood. 1 This explains why they try to postpone becoming an adult as long as 2 they can, depend on their parents and avoid getting a job. This kind of 3 life tends to be focused solely on the present, and based on the need for 4 instant or transient gratification. According to Morotomi, one of the 5 biggest differences between the stress facing today’s young and that 6 which faced previous generations is that the former are faced with 7 unspecific, vague anxiety – they are unable to pinpoint the actual source 8 of distress. They do feel something is wrong, and it may be perceived as 9 somatic, but are unable to articulate what it is, and often seem to be 3 lacking the ability or skills to face their problems. 1 It is this kind of ambiguous distress that is eating up their spirit, par- 2 alyzing them and eroding their sense of hope for the future. Here again, 3 the worst thing for them is to get hurt. The greatest anxiety is not the 4 work itself but human relationships (taijin kankei) at work or school. In 5 the eyes of older generations, the young are unbelievably sensitive to 3 criticism. In fact, senior workers at companies or teachers at school are 3 perplexed by the reactions of their juniors or students when they are 3 criticized or have mistakes and weaknesses pointed out. It is not uncom- 3 mon for newly-hired employees to no-show after being scolded. 4 4 103 4 2831_CH04.qxp 6/4/09 1:11 PM Page 104

Mental Health Challenges x However, the dilemma for managers is that not only are the young unable to work well with others but they also are incapable of working without being told what to do. These observations, or rather, cries of distress from the business sector, grew so strong that a special study group was created by the Ministry of Economy, Trade, and Industry. Consisting of academics, the personnel directors of Toyota and Sony, and other human resource specialists, it investigated what qualities were 0 essential for young people to become a shakai-jin, a fully responsible member of society. Three major qualities were highlighted: a willingness to take charge and step forward, the ability to think through an issue and its solution, and the ability to work with different types of people in a team. The young employees of today were found to lack all three.9 In one case, a young ofﬁce worker was so embarrassed by the fact that she was eating her lunch alone, and was so worried about how she must have been perceived by others, that she ended up quitting. School teachers also must be extra careful in not hurting students’ feelings when cor- recting mistakes. Even if one becomes friends with someone, e-mail is 0 the best way to correct mistakes, because it maintains a distance that prevents hurt feelings.10, 11 Young people have developed a certain style of dealing with other human beings that emphasizes the prevention of hurt feelings. The way they do this is by always pretending to play the expected role in a relationship, and never touching others’ inner feelings. That, they believe, is yasashisa, or the recipe for being considerate to others.12 This tendency is often seen in their choice of language and register. Young Japanese prefer to avoid an afﬁrmative or assertive tone, and instead use vague endings to sentences or distant, respectful language, even when talking to close friends. 0 So far, the key concepts that can help us understand the mind and heart of today’s Japanese youth are “masking their own feelings,” “fear of hurting and getting hurt” and “fear of developing intimate human relationships.” But WHY have young Japanese become such fragile and vulnerable creatures? Why are they so scared of interacting with others in a meaningful and intimate way? 6 7 THE OVER-AFFLUENT SOCIETY? 8 9 Extended childhood and longer adolescence are phenomena common to 0 many post-industrialized societies. The development of a formalized 1 2 104 2831_CH04.qxp 6/4/09 1:11 PM Page 105

Youth 1 2 education system allows children to postpone facing up to the harsh real- 3 ities of life. At the same time, children in post-industrial societies tend to 4 grow up rather slowly. Although their physical development has sped up, 5 mental maturation is slower and more delayed than a few generations 6 ago. It takes a child much longer today to become a functioning adult 7 who participates in society. Setting the age of majority at twenty, as it is 8 in Japan, is hardly realistic any more, considering the immaturity of 9 young people. In recent years, criticisms have been expressed at the man- 1 ners and attitudes of those attending city-sponsored “Coming of Age” 1 ceremonies every January. According to the critics, many of those becom- 2 ing adults look and behave like high-school students. Unlike adults, these 3 early-twenty-somethings are not committed to a job or a particular way 4 of life, and are exempt from many of the responsibilities a member of 5 society is supposed to shoulder. 6 Psychoanalyst Keigo Okonogi is a noted critic of how post-war Japan 7 has spoiled its young generation. He calls its negative psychological con- 8 sequence a “moratorium” mentality, a phrase that has been in vogue 9 since the late 1970s.13 Looking back on the changes in social trends in 2 the post-war era, Ohira suggests the meaning of the word yasashisa 1 changed around 1970, when Japan’s radical student movement ended in 2 failure. In those days, yasashisa meant sharing pain with comrades. 3 Those who felt the student movement had failed, recognized and admit- 4 ted their failure, but did not hesitate to be open about their psycholog- 5 ical scars and consoled their fellow activists. In the aftermath of this 6 turbulent period, in which people had striven to live for an ideological 7 cause, Japan rapidly became an affluent, materialistic and consumption- 8 oriented society in which everything was disposable. A tiny blemish on 9 a manufactured product was reason to discard it entirely, and people 3 became over-sensitive to and fearful of minor defects. Ohira suggests 1 this mentality for superficial perfection was extended to human beings, 2 and affected the psychology of all human relationships. It became more 3 important than anything else to protect a person from being hurt to 4 maintain a smooth relationship on the surface. This is how the new 5 version of yasashisa, Ohira argues, became the underlying principle for 3 relating to other human beings.14 Of course, there is another side to the 3 coin. When one is struggling to survive on a material and physical level, 3 or working toward some specific goal – as most Japanese were until the 3 1980s – one usually has to develop some kind of mental toughness. 4 4 105 4 2831_CH04.qxp 6/4/09 1:11 PM Page 106

Mental Health Challenges x Vulnerability to emotional injury is a quality that everyone possesses, but extra-sensitivity to it may be a sign that people ﬁnally have the luxury, and time, to care about other areas of life, such as feelings and emotions.

SCHOOL ENVIRONMENT 0 Or, as the doomsayers warn, it may be the result of the school culture that developed during the country’s rapid economic growth. Japan’s post-war education system was seen as instrumental to economic success, especially up to the 1970s, for its ability to mass-produce good- quality workers, who shared uniform and basic knowledge. Of course, the emphasis on compulsory education dates back to the modernization efforts of the Meiji period. The secondary and higher education system also created an efficient system to find and educate the brightest students from a wide socioeconomic background, students who would join the elite and become future leaders. Japan, like other industrialized soci- 0 eties, has become a “credential society,” in which social prestige is con- ferred by academic qualifications. However, unlike higher education in the United States, for example, prestigious national universities did not charge high tuition fees, a policy that was supposed to enable any student, regardless of their family background, to take advantage of their academic prowess to move up in society. But like everything, there is another side. Around the mid-1970s, when nearly all students began staying on until senior high school (rather than leaving education after junior high school at fifteen), the education system started to draw criticism, a situation that only intensified in the following decades. Today, 0 few Japanese feel the school system is functioning well or providing a good education. The most common criticism is the over-emphasis on examinations in what is an already severe competition for places at prestigious schools. Particularly, Japan’s examination culture encourages one to quantify one’s value in figures. As explained in the previous chapter, hensachi, a 6 score indicator that positions individuals in the hierarchical ranking, 7 became the most highly-weighted evaluation criteria. Its impact on 8 individuals’ self-esteem continues after they have left school. The cur- 9 riculum has been under attack, too. Highly centralized, it is controlled 0 by the Ministry of Education. Meticulous uniform rules and supervised 1 2 106 2831_CH04.qxp 6/4/09 1:11 PM Page 107

Youth 1 2 teachers’ guidelines also leave little room for regional differences, indi- 3 vidual creativity, and talent. The relationship between schools and stu- 4 dents also has become problematic. As part of “personality formation,” 5 schools have imposed quasi-militaristic ethics that stress certain behav- 6 ioral patterns and senpai-kohai hierarchy. These also emphasize group 7 work, which also was believed to promote psychological uniformity and 8 cohesion. Throughout the 1970s and 1980s, schools increased their 9 control of and became more rigid about rules for students to suppress 1 potential deviance and standardize educational outcomes.15 1 Such an educational environment may produce students who, in 2 appearance, are good at conforming to rules, regulations and social 3 expectations, but who are poor at expressing themselves naturally, or 4 even recognizing their true needs as they are conditioned to suppress 5 them for the sake of classroom harmony. Furthermore, parents’ and 6 teachers’ obsession with school performance as a sole standard for eval- 7 uating the child’s worth and hensachi only plant in children’s minds an 8 over-sensitivity to rank relative to others. It may consequently deprive 9 them of a fundamental sense of unconditional self-acceptance. The 2 children today are the second generation to grow up with this school 1 evaluation system. If they grow up without a chance to overcome their 2 over-sensitivity, they may develop various defense mechanisms to cope 3 with problems in future life. 4 One of the responses to their inferiority complex is to clearly distin- 5 guish outward self and true inner self. The greater the gap between the 6 two selves, the more unstable the whole self structure can be, just as a 7 building with a weak frame cannot survive an earthquake. To develop 8 inflated pride and to falsely imagine oneself as someone with enormous 9 importance and ability is another defense against a sense of worthless- 3 ness. However, such a great distance between reality and fantasy makes 1 healthy integration of self impossible.16 2 3 HOME ENVIRONMENT 4 5 Exploring the question from the perspective of generational effects and 3 larger social transformation is no doubt justifiable. However, nothing 3 seems to be more crucial to this than the family socialization processes 3 today’s young have undergone. Family is, after all, the most direct and pri- 3 mary influence on one’s life, at least while one is young. The experiences 4 4 107 4 2831_CH04.qxp 6/4/09 1:11 PM Page 108

Mental Health Challenges x a person has through family interactions are the crucial factor in the development of mental reality. The home we are born into and raised in gives us a chance to acquire a basic sense of security, safety, acceptance, and, consequently, self-worth. Furthermore, the most basic ways we cope with various life distresses are shaped by our primary experiences at home. So what has changed? First, the fact that the number of children per family has dramatically declined in the last thirty years means that each 0 child is raised with much greater care and attention. In post-industrialized societies, parents also spend more time and money in protecting their offspring from injuries and mistakes. Naturally, children kept at home and school for a longer period, instead of striking out on their own or going out to work, are more likely to grow up without having experienced serious failure. This lack of experience stops children from knowing how to deal with hardship in later life. Furthermore, as discussed in the previous chapter, the family structure prevalent in Japan, centered on the mother and child with an absent father, encourages a peculiar interaction pattern between mother 0 and child. There is no problem if the mother has been given a chance to achieve self-actualization herself and is finding her life fulfilling as an individual. However, many lonely, frustrated wives and mothers, deprived of the chance for professional development, focus all their energy on the small number of children they have, often over-identifying themselves with the lives of their children. Here, what psychiatrist and family therapist Dr. Satoru Saito calls a “mother-child capsule” is created. This closed tie often excludes important external figures, such as the father, friends, and other significant people, even though their influences are needed for the healthy development of the child’s self. 0 From the child’s perspective, the mother becomes the only absolute needed for survival. At the same time, the child develops great sensitivity to its mother’s mood, making sure that it can console her whenever she is unhappy. To harm the mother’s feelings will jeopardize the child’s own safety, and thus is avoided at all costs. Even when the child experiences hostility and resentment toward its mother, the child will try 6 to subconsciously suppress such negative emotions and, instead, will 7 blame itself for even feeling such emotions. As this process continues 8 and becomes a fixed pattern, the child will grow up to be a guilt-ridden, 9 self-reproaching human being.17, 18 It will be difficult for the child to 0 learn how to assert its rights and feelings in intimate relationships, or 1 2 108 2831_CH04.qxp 6/4/09 1:11 PM Page 109

Youth 1 2 any relationship at all. When the time comes for the child to break free 3 from parental protection to explore the world of peers and larger soci- 4 ety, the mother’s presence sits deep in its psyche, controlling the child’s 5 sense of freedom as an independent being. The awareness that future life 6 choices cannot be made entirely freely intervenes at a number of turn- 7 ing points in the adult child’s life, such as marriage, career, choice of 8 place to live, and so on. 9 Today, it is common to see particularly close relationships between 1 mothers and daughters. Even if a mother and her son develop a close rela- 1 tionship, puberty and sexual differences can work as an ultimate barrier 2 to the relationship becoming too intimate. However, when it comes to 3 the mother and the daughter, there is no limit to how close they can be, 4 to the point where the phrase ichirannsei oyako (identical twin parent- 5 child) has been coined. They often go out together and are proud of 6 their relationship as best friends. In this type of relationship, the mother 7 can hardly act as a figure supposed to have more life experience – and, 8 therefore, cannot offer guidance to her daughter. In the same way, the 9 daughter does not have a childlike respect for her mother as her senior. 2 Sometimes, the daughter is more experienced and knowledgeable about 1 life situations, and the mother is more dependent on her. But what is 2 important is that these two women are confidants, and exclude the father 3 in nearly everything. 4 However, not a few young women suffering from low self-esteem, self- 5 negation, and self-hate experience serious, unresolved conflicts with 6 their mothers. They have grown up trying to live up to their mothers’ 7 expectations, and trying to make their mothers happy. They have 8 always played the role of the “good daughter.” Even if their mother’s 9 expectations are unreasonable and utterly unrealistic, it doesn’t make 3 a difference to these daughters. They cannot assert themselves, even 1 though they know it is their mother who should give up imposing such 2 a dream on them. But nothing is more difficult in life for these young 3 women than confronting their mothers. Instead, they blame themselves, 4 believing they are bad for not being able to live up to their mothers’ 5 expectations.19 3 Under these circumstances, the child carries an enormous psycholog- 3 ical burden, although he or she is unaware of it. Many sons and daugh- 3 ters learn very early in life to be extremely sensitive to their mother’s 3 mood because the mother is often a very unhappy and lonely wife. There 4 4 109 4 2831_CH04.qxp 6/4/09 1:11 PM Page 110

Mental Health Challenges x is little room left for them to develop a healthy sense of independence. And when the children in this mother-child capsule begin to feel their relationship is too suffocating and they can no longer suppress their true feelings, they begin to show pathological behavioral patterns. Japan has seen an increase in such cases in the past few decades, and Dr. Saito says the mother-child capsule is one of the biggest factors in the psychopathology of Japanese children.20 Their frustration can be directed 0 both outward and inward, but in either case, takes a painfully destructive form. For these children, home is not only where they learn the funda- mentals of human relationships, but also where they are given the ﬁrst life challenges to overcome.

SCHOOL REFUSAL: PSYCHOLOGICALLY-BASED ABSENTEEISM Since the 1970s, a symptom of social distress has drawn attention in schools. Called to¯ko¯ kyohi (school refusal) or futo¯ko¯ (non-attendance), these are defined as absence from school for more than thirty days a year, 0 but are different from simple truancy; the problem has psychological roots and is often accompanied by somatic symptoms. For various reasons, students develop phobic reactions to attending school. They may find the academic requirements too demanding – the severe competition of the Japanese education system is sometimes stressful enough to scare students from going to school every day. They may have been exposed to ijime (bullying), another serious problem in Japan. Intense psychological and physical abuse often leads to a victim’s refusing to go to school and, in some extreme cases, to suicide. In any case, this is different from playing hookey because although 0 most to¯ko¯ kyohi students understand they should be in school, they just cannot do it, leaving them feeling extremely frustrated and ashamed. These feelings are shared by their parents, who also agonize over a situation in which they cannot find good reasons why their children are incapable of going to school. They, particularly the mothers, often blame themselves for their children’s problems. 6 There have been some positive attempts to remedy the situation. As 7 this problem began to spread across Japan, parents got together and 8 tried hard to understand their children’s state of mind. These parents’ 9 groups then tried to de-stigmatize refusal to go to school and to argue 0 that under the current education system in Japan, which emphasizes 1 2 110 2831_CH04.qxp 6/4/09 1:11 PM Page 111

Youth 1 2 uniformity and provides few alternative choices, any student could 3 develop this type of problem. Consequently, the official phrase to¯ko¯ 4 kyohi was changed to futo¯ko¯, or “school non-attendance,” which appears 5 less stigmatized and pathological naming. This view has been officially 6 adopted by the Ministry of Education and Science. However, no matter 7 what you call it, the Japanese know that children who stop going to 8 school have serious problems. 9 In 2006, about 122,000 students in elementary and junior high 1 schools suffered from this malaise: one out of 317 children in elemen- 1 tary schools and one out of every thirty-six junior high school students. 2 While the rate for elementary school children remained the same as the 3 previous year, that of junior high school students showed an increase of 4 0.02%.21 A study investigating the causes of futo¯ko¯ in the United States 5 and Japan showed interesting cross-cultural differences (though it is 6 doubtful that the same, socially recognized label for this problem exists 7 in the United States). The possible reasons for voluntary absence from 8 school were divided into five sources of stress: social pressure, school 9 work, peers, family, and personal problems. They were also roughly 2 grouped into two sources: pressure coming from one’s private environ- 1 ment (family and self) and from outside (society, school, friends). 2 Japanese futo¯ko¯ students were significantly more likely to feel external 3 pressure, what in Japanese is called “manazashi ” or the “public gaze,” in 4 particular what they perceived as other people’s view of themselves. 5 They were also more likely to put themselves under pressure by inter- 6 nalized academic expectations. This suggests they are suffering from 7 intense pressure, internally and externally.22 8 And although the Japanese education system has come in for some 9 more than justified criticism, it is also true that a growing number of 3 children today have problems in developing skills needed for healthy 1 human relationships. A counselor for these children reports they typi- 2 cally lack autonomy, endurance, and self-motivation. These deficiencies 3 often persist for years and when they become adults, they are still 4 incapable of looking after themselves or facing up to even trivial prob- 5 lems. In fact, one school counselor observed that these truant children 3 feel pressure from teachers and parents to socialize, even if they have no 3 problem studying. “I don’t know how [to make friends],” says one 3 student. “I just want them to leave me alone.” Another student says 3 that school social life makes him tired. “I am always afraid they do not 4 4 111 4 2831_CH04.qxp 6/4/09 1:11 PM Page 112

Mental Health Challenges x like me. So I always try to agree with others, which makes me tired...”23 Teachers have also remarked on the negative qualities of these children – spoilt, immature, and ungrateful – and note that they also tend to be easily hurt and to fear socializing. They are so egocentric and self-centered that if they are thwarted or their pride hurt, they then feel completely incompetent and depressed. If they are disappointed 0 and frustrated in their relationships, they may choose to completely withdraw, for example, by refusing to go to school. There is no consensus over the reasons for extreme bullying among Japanese children. Again, some blame the rigid school system, which lacks diversity and tolerance for individuality and drives students to find an outlet for their hostility. On the other hand, some children perceive even innocuous remarks as extremely hurtful and react to them hyper- sensitively: another sign of the inability to maintain a healthy balance of patience and assertiveness. It has been pointed out that the weakening of traditional social 0 norms and authoritarian forces that had worked as a restraining factor on individual self-consciousness and behavior leads to “ego inflation,” a situation which makes one believe that one is far more important and competent than reality. This weakening also allows the increase of narcissistic personalities.24 When a child is brought up with excessive care, protection, and adoration from parents, the child does not have a chance to make appropriate and timely adjustments of its self-image to reality through the various experiences and interactions with others that would normally serve for this purpose. One important maturation process occurs when our primary, infantile sense of omnipotence is 0 gradually replaced by the realistic assessment of the self and the world around one. With the support of its mother, the over-protected child continues to have an omnipotent self-image and tries to hold on to it when difficult reality sets in. However, this sense of omnipotence is only the other side of a paper-thin self-confidence that can be easily shattered by reality. Once a child like this has a small taste of reality, it makes it 6 realize its own fragility. Avoidance behavior in human relationships, 7 such as to¯ko¯ kyohi, are expressions of anxiety and fear of having the self 8 hurt. The reluctance to express the true self to others and to keep the 9 relationship as superficial as possible, may also be a way to prevent the 0 inflated self from being scared. 1 2 112 2831_CH04.qxp 6/4/09 1:11 PM Page 113

Youth 1 2 DOMESTIC VIOLENCE: A JAPANESE CASE 3 4 A seventeen-year-old high school student started to hit his younger 5 brother and parents three years ago. His father, a graduate of a presti- 6 gious university working for a famous corporation, and mother spent 7 much effort and money to provide a good education for him making the 8 arrangements for him to attend an expensive juku (preparatory school 9 for entrance examinations) located far away from home. Since the start 1 of senior high school, he became reluctant to go to school and his vio- 1 lence intensified. Not only breaking things at home, he would hit his 2 mother’s face until it bled and threatened his father all night to force 3 him to buy something he wanted. There were times when his parents 4 rushed to the police department for help. This boy was also suffering 5 from various physical pains, depression, acute anxiety and irritability, 6 and uncontrollable fits of anger. Despite the chaos at home, the family 7 stayed together and the boy was brought to a mental clinic.25 8 This is the typical example of acute distress expressed by such a child 9 outwardly but strictly within the home called kateinai bo¯ryoku, or intra- 2 family violence, a form of pathology perhaps unimaginable in Western 1 countries. Usually when people hear of “violence in the home” in the 2 West, they think of spousal abuse or child abuse. However, when a 3 Japanese person hears the word kateinai bo¯ryoku, it always means one 4 thing: a child beating up a parent. (In recent years, domestic violence, 5 or spousal violence as usually understood in Western nations, has finally 6 gained official recognition as a legitimate problem in Japan as well. It is 7 known as “D.V.” and is distinguished from kateinai bo¯ryoku.) The once- 8 sweet, obedient child becomes an enormous menace to the family. In 9 many cases, the first sign is the child’s refusal to attend school. After a 3 while, these children may start attacking their mother at home, throw- 1 ing things at her, beating her, and probably swearing as well. It is obvi- 2 ous these children are extremely frustrated about something they cannot 3 articulate, and also very sensitive to what other family members say to 4 them. Physical and verbal abuse toward parents can escalate to such a 5 degree that at times, the only reasonable thing to do seems to be to call 3 the police and have the child arrested or separated from home, which 3 however seldom happens in Japan. Violent children may also make 3 unreasonable demands of their parents, such as forcing them to apolo- 3 gize repeatedly. The parents are shocked by the transformation in their 4 4 113 4 2831_CH04.qxp 6/4/09 1:11 PM Page 114

Mental Health Challenges x child and try to understand and communicate with them. Eventually all efforts fail, and the whole family lives in constant fear of violence at home. The irony of this abnormality is that the parents continue to live with the child in such circumstances and to endure violence and abuse for years. (It is possible in some cases that the behavior is caused by a psychiatric condition. In that case, it is very important to detect it and immediately request medical treatment. However, kateinai bo¯ryoku is 0 generally considered and handled as a psychological problem closely connected with the family environment.) By the time the father – who typically has been uninvolved in domestic matters – realizes the seriousness of the situation and tries to help his wife, it is usually too late. Both parents gradually lose authority and control over their child. With the fear of violence and the constant worry of anyone outside the family ﬁnding out about it, they eventually become totally subservient to the child. In one 1996 case, a father who endured years of abuse at the hands of his violent son ended up killing him. It is hard to imagine that the violence between the parent and the child esca- 0 lates to this degree in a Western country. American parents would call the police at a much earlier stage and stay away from the child, or the child, if so resentful of the parents, would simply leave home. However, violent Japanese children know they cannot leave home nor have a life on their own. No matter how their relationship is destroyed, Japanese parents and children faced with these situations seldom realize their separation is the most important thing to do, unless they are advised by doctors and counselors. Of course, children are sometimes over-protected, spoilt, and rebel- lious all over the world, and angst-ridden adolescents hating their par- 0 ents is nothing new. The pain of growing up is a topic we all can relate to. However, what is pathological in Japanese cases is the way parents deal with a child’s emotional outbursts by trying to endure anything out of “parental love” or a sense of shame. But why do these children become so violent and hateful toward their parents in the ﬁrst place? Hayao Kawai, as a leading Jungian psychotherapist, has dealt with a 6 number of cases involving kateinai bo¯ryoku. Kawai, as I have noted in 7 previous chapters, sees the “maternal principle” overwhelmingly domi- 8 nating the “paternal principle” in contemporary Japanese family rela- 9 tions. In his view, this sense of unconditional oneness created between 0 mother and child is culturally supported throughout one’s lifetime. 1 2 114 2831_CH04.qxp 6/4/09 1:11 PM Page 115

Youth 1 2 Under this family culture, the child’s natural desire to separate from the 3 mother as it grows up is sometimes extremely difficult to accomplish. 4 The predominant Japanese family structure established after World 5 War II is no help to the child, either, in making it realize it is a separate 6 being from the mother and entitled to pursue its own life. In fact, there 7 is a persistent assumption in Japan that, no matter what happens, the 8 mother-child bond is something absolute and supreme. In Western 9 societies, where the paternal principle is stronger, this separation process 1 takes place with less pain and conflict at home. Kawai says Christianity 1 denies the supremacy of blood ties in favor of universal brotherhood. In 2 this type of culture, the denial of mother’s position in one’s conscious- 3 ness is accepted as more natural and so there is no need for children to 4 experience violent separation from their mothers. 5 Of course, most Japanese children grow up without ever hitting their 6 parents. But some, during their struggle to become independent human 7 beings, start to feel utterly suffocated by the intense mother-child cap- 8 sule, and may begin to show various symptoms considered disruptive 9 and severely pathological. They perceive the presence of their mother, 2 who believes with not even the slightest doubt in the goodness of her 1 own motherly love, as an unbearable weight. For these children, their 2 mother can be a monster that will swallow them or an enemy who is 3 plotting their psychological death by trapping them in the capsule. It is 4 these kinds of psychological relationships in which some children 5 express their desperation and desire to get away from their mother, in 6 the form of violence against their parents.26 However, as mentioned 7 earlier, what is uniquely Japanese is the method they use to cope with 8 the situation. Despite chaos and violence at home, parents continue to 9 willingly support the child’s physical and financial needs, and as for the 3 child, it continues to depend on its parents for food and shelter. It 1 hardly occurs to either party that they should be physically separated 2 to start with, not only to avoid the immediate problem of violence, 3 but also ultimately to solve the fundamental problems of their highly 4 codependent relationships. 5 3 HIKIKOMORI: THE HERMIT CHILDREN OF JAPAN 3 3 When a child becomes unable to go to school and is violent toward its 3 parents, it may further develop hikikomori (social withdrawal), a kind of 4 4 115 4 2831_CH04.qxp 6/4/09 1:11 PM Page 116

Mental Health Challenges x social phobia that involves a complete withdrawal from the outside world. A twenty-year-old woman who has been staying home for some time expresses strong anxiety about her future. “I want to go out, work, and be ﬁnancially independent someday, but the thought of leaving home, going to school, getting a job overwhelms me...... I panic in a room with many people. So I won’t be able to attend school. I cannot get 0 along with others because I worry so much about the feelings of others and I get exhausted.....” A thirty-six-year-old man who has been in the hikikomori state for ten years also is distressed about his own inability to have a human relationship. He says, “The reason why I have been in hikikomori for a long time is because I am exhausted with relationships with parents, classmates, and others. I am trying to go out and attend a few daycare facilities. But I cannot get along with others. I cannot make friends. I don’t have the courage to take action.....” A mother of a twenty-six-year-old man worries about her son. “After graduating from university, my son has been staying home without 0 getting a job. He is alone and only reads books or goes on the internet. He has no contact with others except for his family. Is he going to be like this forever? My husband even told him that he had given up hope.”27 These cases are just a few of the numerous cries for help and despair brought to one mental health clinic in Tokyo. Most young people affected by hikikomori do not leave their homes or even their bedrooms, their only communication being with their family or people through the internet. They live a purposeless existence and often stay awake at night and sleep throughout the day. Many are 0 also depressed, have irrational fears and develop paranoia, believing that others stare at them or think them ugly. This lifestyle can go on for months, years and sometimes even decades if there is no proper intervention. The reality and causes of hikikomori are still not fully understood or well-examined, a situation that leaves everyone concerned only puzzled and sometimes feeling hopeless. 6 Ascertaining the number of hikikomori sufferers is elusive at best, 7 ranging from the commonly quoted estimate of 1 million or 1.6 million 8 to a more conservative estimate of 410,000 by Ministry of Health and 9 Labor as the number of households with a hikikomori family member.28 0 Another cautious estimate is one in one thousand of the population.29 1 2 116 2831_CH04.qxp 6/4/09 1:11 PM Page 117

Youth 1 2 However, the matter of fact is that it is not uncommon for an average 3 Japanese person today to hear about someone they know, or know of, is 4 in some kind of hikikomori state. It is almost the consensus of mental 5 health professionals in Japan that cases fitting the general descriptions of 6 hikikomori have increased dramatically in recent years. 7 Due to the efforts of parents’ support groups in calling public atten- 8 tion to the situation, the existence of hikikomori has come to be regarded 9 as a social, not simply an individual, issue that has serious implications 1 for the country. Now, there is a small industry of support services for 1 hikikomori sufferers and their families, providing information, halfway 2 programs, and counselling.30 3 According to a widely accepted definition of hikikomori by Dr. 4 Tamaki Saito, a leading expert in the field,31 the problem must surface 5 by the end of the victim’s twenties and involve continuous withdrawal 6 at home without participation in any social activities for more than six 7 months. However, no specific psychiatric disorder can be considered a 8 primary reason for the condition. (p.25) The Ministry of Health, Labor, 9 and Welfare and the Tokyo Metropolitan government have issued pam- 2 phlets and guidelines for the understanding of hikikomori. For example, 1 the ministry of health’s literature on the topic starts out by pointing out 2 that hikikomori “is a vague concept referring to a certain condition, but 3 not a clear psychiatric diagnosis.” It at least agrees on the minimum 4 length of withdrawn life to be six months, but also emphasizes that 5 hikikomori patterns are quite diverse, and therefore, could be triggered 6 by various reasons. 7 “This is not a special phenomenon,” it says. “It happens that for 8 some reasons one develops hikikomori when one cannot adapt to the 9 surrounding environment.” It also states it is an issue related to mental 3 health, caused by a combination of biological, psychological and socio- 1 logical factors.32 Many experts admit hikikomori is a loosely-defined 2 label given to multiple conditions, a fact that has left a lot of room for 3 various interpretations. This allows the concerned people to opt for an 4 explanation that is easy for them to accept, even if it is wrong. 5 As well as the lack of preciseness regarding this problem, even within 3 the expert community, the public’s view of hikikomori is confused. 3 The first time the Japanese mainstream media reported hikikomori 3 was in the context of shocking criminal acts, such as the hijacking of a 3 bus in 2000 by a seventeen-year-old hikikomori sufferer who then killed 4 4 117 4 2831_CH04.qxp 6/4/09 1:11 PM Page 118

Mental Health Challenges x a passenger. Another man living in a hikikomori state was discovered to have confined a girl he had kidnapped to his bedroom for nine years. Naturally, these incidents caused public unease. As with the emergence of the otaku tag in the late 1980s, the word hikikomori initially took on a pejorative air due to the bizarre criminal acts perpetrated by those labelled so. Since then, the public has begun to understand that hikikomori is a much more widespread problem. 0 In fact, the government raised the issue back in 1989, when a white paper on youth warned of the increase in various behavioral problems. These were divided mainly into two types: overtly deviant behavior violating laws and social norms, and the other more introvert/inner- directed behavior such as hikikomori, school refusal, and suicide. In the early 1990s, Asahi Shimbun started to carry several articles on hikikomori families. These articles mainly announced lectures and support groups for parents of hikikomori, or that pamphlets on these social issues were being published.33 They also referred to other issues, such as school refusal and shu¯shoku refusal, or the refusal to find work. 0 Hikikomori as it is perceived in Japan today began to appear more frequently in the media from 1997. For example, a series of articles carried in Asahi Shimbun in February 1997 vividly described the lifestyle of a hikikomori sufferer, and how his mother and father suffered from their child’s state of being. These articles were among the first to introduce emotional and dramatic episodes experienced at home to the general public. Over the last few years, hikikomori has also drawn foreign media attention.34, 35, 36 Between 2001 and 2003 in particular, the Western media often covered these peculiar, incomprehensible, and mysterious young 0 Japanese. However, there is only limited solid research and analytical literature on the issue produced in English or other Western languages. Instead, these articles drew on the image of Japan as a declining economic superpower, and almost without fail saw the various symptoms of hikikomori to be a certain metaphor for Japanese society itself. This interpretation of the hikikomori phenomenon seemed to resonate with 6 Western (and also Japanese) images and views of what Japanese people 7 and culture are “really” like. In fact, there almost appears to be an attempt 8 to make another “Nihonjinron” out of hikikomori. 9 In a Newsweek article by George Wehrfritz (August 20, 2001), titled 0 “Tune Out, Stay In; An epidemic of young Japanese pulling back from 1 2 118 2831_CH04.qxp 6/4/09 1:11 PM Page 119

Youth 1 2 the world has deep roots,” Wehrfritz writes. “Hikikomori is a baffling 3 public-health problem, one that has grown to epidemic proportions in 4 Japan.” It says that hikikomori is “a uniquely Japanese malady” which 5 afflicts 1.2 million young people in Japan through agoraphobia, para- 6 noia, and various anxiety symptoms.37 A BBC report by Phil Rees 7 (October 20, 2002) titled “Japan: The Missing Million” opened with 8 the statement: “Teenage boys in Japan’s cities are turning into modern 9 hermits – never leaving their rooms.” Pressure from schools and an 1 inability to talk to their families are suggested causes. And the report 1 also stresses that it has spread to an “epidemic” proportion among 2 young Japanese people. As noted, other articles more specifically 3 attempted to describe hikikomori as a metaphor for Japanese society 4 itself, saying hikikomori is a “symptom of Japan’s decline” or that Japan 5 is becoming “isolated, apprehensive, and unable to interact with the 6 outside world” just like a hikikomori sufferer,38 or “inward-looking and 7 very cold to outsiders.”39, 40 Just as in arguments on school refusal, 8 experts are quoted criticizing the inflexible, rigid education system and 9 Japan’s conformity-focused value system as responsible for producing 2 these withdrawn young people.41 1 In general, the underlining tone of these accounts of hikikomori sug- 2 gests it is reaching “epidemic proportions” or “increasing to a serious 3 degree” and that it is caused by Japan’s social and cultural situation – a 4 uniquely Japanese phenomenon. The Japanese are acutely self-conscious 5 of how others see them, and their tendency to be influenced by foreign 6 views about themselves seems to have had some impact on public 7 discussions of hikikomori. What is clearly suggested here is that there is 8 something wrong with Japan and these hikikomori youth are simply 9 responding to a pathological society. However, to see it as a “Japanese 3 society disease” or sociogenic disease is of course too simple and inaccu- 1 rate. And it does not help hikikomori sufferers and their distressed 2 families, either. 3 As noted, hikikomori is not a legitimate medical or psychopathologi- 4 cal diagnostic label. It refers to a certain cluster of psychological and 5 behavioral idiosyncrasies. What started as a phobia, a sense of conflict, or 3 anxiety at something specific, may or may not develop into hikikomori- 3 type social withdrawal. It largely depends on the person’s disposition, 3 living circumstances, support available, and many other variables. What 3 is problematic in Japan is that many people regard hikikomori as a 4 4 119 4 2831_CH04.qxp 6/4/09 1:11 PM Page 120

Mental Health Challenges x label of its own. The word hikikomori has always existed in Japanese to indicate those unwilling to mingle with others and who adopt a reclu- sive or hermit-like existence. Originally, it was not necessarily a word associated with abnormality. Monks or people on spiritual and philosophical pursuits could be labelled hikikomori. However, in modern parlance, it refers to the many young people who are stuck with psychological hang-ups. With the original and newly-created meaning coexist- 0 ing, the word has an elusive quality, and it is not clear whether it is normal or not normal at all. The public has been reluctant to see hikikomori as a form of mental illness, and the tone of the widely-accepted definition de-emphasizes that possibility, (though does not deny it entirely). However, it is very important to understand the phenomenon from a psychiatric standpoint as well. Various hikikomori symptoms resemble those, or in fact can be found in the American Psychiatric Association’s Diagnostic Statistical Manual, which instead of giving loose definitions, records a number of specific diagnoses such as “avoidance personality dis- 0 order,” “social phobia,” “obsessive compulsive disorder”, and “depression.” In fact, cases the Japanese would simply call hikikomori exist in Western countries, but there is greater acceptance of psychiatric labelling in those societies. Hikikomori as we know it in Japan could very likely be a behavioral response to various afflictions of a psychiatric nature. Hikikomori must be further examined from other perspectives, especially from the point of view of Japanese family interaction. Let me repeat: what influences young minds more powerfully than their home environment? While some teenagers have been suffering from this condition for years, until recently, most families managed to cover it up. In 0 some cases, children live in seclusion well into middle age. In these cases, parents feel they must continue to care for them, because they see it as their responsibility. They cannot imagine their child being able to survive without them. Although treatment for hikikomori or the best intervention method is still being explored, psychologists believe that a certain distinctive 6 familial pattern has emerged from homes with hikikomori children. As 7 psychiatrist Dr. Tamaki Saito reports, young hikikomori sufferers tend to 8 be eldest sons with middle- or upper-middle-class backgrounds whose 9 parents are both highly educated. Their fathers are workaholics and dis- 0 tant from their children and their mothers tend to worry and interfere 1 2 120 2831_CH04.qxp 6/4/09 1:11 PM Page 121

Youth 1 2 too much in their children’s lives. This description sounds exactly 3 like the prototypical post-war middle-class Japanese family. Dr Saito 4 observes that hikikomori does not usually occur in overtly dysfunctional 5 families, where divorce or abuse has occurred.42 In fact, many hikiko- 6 mori youths are previously well-behaved children who made their par- 7 ents proud. Of course, it is not that this kind of family background 8 causes hikikomorii; far from it. However, for certain psychological or 9 psychiatric discomfort to develop in a person who eventually may 1 show hikikomori symptoms, we should examine the family’s structure, 1 interaction patterns and household culture. 2 Whether hikikomori is a uniquely Japanese phenomenon or not 3 remains to be more thoroughly investigated through international com- 4 parisons of clinical data. My guess is that the problems experienced by 5 hikikomori sufferers are not uniquely Japanese, but social and familial 6 responses to them exhibit very “Japanese” characteristics. In a society 7 where mental illness and psychiatric-related matters are highly stigma- 8 tized, direct reference to a psychiatric label is avoided at any cost. The 9 low visibility of authentic mental health services only makes the core of 2 the problem more elusive to affected families. In Japan, a loosely- 1 defined label like hikikomori is simply much more acceptable, as the 2 general public still feels quite uncomfortable when it comes to facing up 3 to psychological or behavioral pathology. Certainly, the word hikiko- 4 mori sounds more benign and more like a temporary condition than 5 “personality disorder,” and suggests the nobility of the lifestyle of 6 ancient Japanese hermits or monks, who withdrew from the secular 7 world for spiritual training. The sufferer and his or her family, unedu- 8 cated and misinformed about the intricate nature of human behavior 9 and thus completely puzzled by the condition, will find it much easier 3 to accept this label without facing the problem and examining what has 1 caused it, which, in fact, is the one thing they need to do. If they say a 2 person has hikikomori, it somehow sounds like no further explanation 3 or investigation is necessary. They tend to forget that hikikomori is just 4 a name given to a collection of specific symptoms, which happen to 5 result in withdrawal from social contact. 3 More importantly, however, what enables the person to continue 3 living in a hikikomori state is the fact that he or she has somewhere to 3 withdraw into and there are other people, namely parents, who care 3 for his or her minimum needs such as food, shelter, and safety. Most 4 4 121 4 2831_CH04.qxp 6/4/09 1:11 PM Page 122

Mental Health Challenges x hikikomori sufferers live in the center of a support system provided by their parents, who continue to provide logistical support despite occasional violence or verbal abuse targeting against them. Some of these parents may end up becoming slaves to their children, constantly worrying about their mood swings. Of course, parents and other family members are often as distressed as the hikikomori sufferers themselves. They worry about the future of the sufferer and feel at a loss about what 0 to do to change the situation. They also feel it is their fault their children have fallen into a hikikomori state, and therefore it is their responsibility to keep taking care of their children, because otherwise they would be out on the street. It seldom occurs to them that the best thing they could do would be to stop caring for their grown-up children so they are forced to deal with the real world. It may be that they do not know where to seek help in taking the first step to unmasking a years-old family secret. When a certain familial pattern is fixed, it is extremely difficult to break it. Thus, even with enormous anxiety and confusion inside the home, years can pass until one 0 day, the parents are horrified by the fact that their child has now become middle aged, but has never really grown up. A sense of shame and embarrassment also overwhelms parents and may prevent them from seeing what is right and most important for their child. As one hikikomori expert says, “Japanese parents tell their children to fly while holding firmly to their ankles.”43 Parents’ complete loss of authority and control over their children’s behavior is matched by their strong, hidden dependency on their offspring. As pathological and distressing as it may appear, subconsciously, many parents need to keep their children with them. Continuously 0 being able to take care of their children gives them a reason to go on. If the child became too independent, the parents would feel lost at home and would not know what to do as their life has been established with their child as the core. The psychological interdependency between parents and children, which, as mentioned in earlier chapters, is much stronger than the con- 6 jugal tie in Japanese family culture, makes it difficult for both sides to 7 recognize the right time to draw boundaries between their lives. It eas- 8 ily becomes the basis for psychological codependence. Since the sense 9 of balance between the “maternal” and “paternal” principles was lost, or 0 simply since the traditional sense of respect for the older generation has 1 2 122 2831_CH04.qxp 6/4/09 1:11 PM Page 123

Youth 1 2 disappeared, there has seemed to be no solid axis around which to build 3 family relationships. Missing nowadays are the generational clashes that 4 used to break out at home as children were confronted with their par- 5 ents’ ideas and plans and responded with criticism. Parents used to be 6 stubborn and unyielding, and for many children, the biggest hurdle to 7 overcome in making decisions. However, struggling to overcome them 8 was also an important growing up process, for parents were able to show 9 their children how to stand firm with their own principles. When this 1 sense of order and balance is lost, an instinctive desire for interdepend- 1 ency has no limit in expressing itself in family relationships. 2 3 PARASITE SINGLES. WHO ARE THEY? 4 5 The term “parasite single” has been bandied about since the late 1990s, 6 and refers to young single adults who continue to live with their parents 7 even after they graduate from school or university and get a job.44 While 8 living at home is not uncommon in Japanese society, these young adults 9 are different in that they continue to live like children. Even though they 2 are earning, they usually do not contribute to the family economy, and 1 enjoy substantial financial freedom. Logistically, they do not have to worry 2 about their basic needs such as meals and shelter, because many of their 3 mothers still cook for them, clean their rooms, and do their laundry. They 4 have the best of both worlds: the freedom of an adult and the protection 5 and care afforded to a child. The term “parasite single” is not seriously stig- 6 matized, compared to the clearly pathological hikikomori or intra-family 7 violence, it refers to a widespread social phenomenon that includes 8 millions of young adults. However, as the word “parasite” rarely has a good 9 connotation, it is not regarded as anything to be proud of, either. 3 The general perception is that it is synonymous with spoilt children 1 who have never fully grown up. It is undeniable that these individuals 2 postpone marrying or committing to a career because the status quo is 3 comfortable and difficult to give up. However, their decision makes a lot 4 more sense if one considers the changing economic structure and high 5 unemployment rate among the young, which have made it more diffi- 3 cult than ever for young adults to find a job with an income that enables 3 them to have financial independence from their parents. 3 Furthermore, I suspect that not a few “parasite singles,” consciously 3 or subconsciously, feel their presence at home is needed by their parents. 4 4 123 4 2831_CH04.qxp 6/4/09 1:11 PM Page 124

Mental Health Challenges x They may not want to stay at home, but are aware that by remaining as a child, they are providing their parents, especially their mothers, with a purpose in life. It is not an exaggeration to say that middle-aged or older Japanese couples do not know what to do once their children leave home. Without parental obligations, many couples have little to talk about. As for the children, the sensitive ones feel they cannot leave home for the sake of the parents. It is not surprising to hear from some chil- 0 dren, “I feel kawaiso¯ for my mother,” that is “I sympathize with my mother’s unhappiness.” These children are bound to mask their emotions even at home, to feel they must be considerate to parents who claim they live for the sake of their children. Doing so is at the cost of their own identity and healthy boundaries between family members. In fact, surveys of young Japanese have revealed an overwhelmingly pessimistic attitude to the future. In a 2001 survey, to the question “Should one eventually marry?” only 20% of Japanese students said yes compared with 80% in the United States and 50% in South Korea. The survey also posed the question: “Are you hopeful about the state of 0 twenty-first century society?” Only 34% of students in Japan said yes, compared with 86% in the U.S., 71% in South Korea and 64% in France.45 Furthermore, in another survey, Japanese high school students’ pessimism was contrasted with the optimism of their American and Chinese counterparts, who had much brighter and forward-looking views of their future.46 A 2003 survey by Yomiuri Shimbun of 5000 children over the age of thirteen reported that 75% felt Japan’s future was not bright or that their efforts would not necessarily lead to success. However, 82% said they ought to take care of their parents when they get old.47 Does it suggest 0 that traditional filial piety is strong in the new generation? When the Japanese say “taking care of old parents” it usually means living with them or taking care of their daily physical needs when they become infirm. Beside inadequate public facilities for elderly care in Japan, another way to look at these responses is to argue that relationships based on individual autonomy within the home are not part of Japanese culture, and chil- 6 dren’s consciousness of their parents remains quite conservative and 7 traditional even six decades after the ie system was abolished (and long 8 after the nuclear family pattern became a well-established norm). 9 It is true that in Japan, unlike in Western societies, grown-up chil- 0 dren are not automatically expected to leave home. Moving out is not 1 2 124 2831_CH04.qxp 6/4/09 1:11 PM Page 125

Youth 1 2 necessarily a condition for being an independent adult, though many 3 children do so as a result of their work. But if unmarried children work 4 in the same city as their parents’ home, having their own apartment and 5 living alone is rather rare. Strong interdependence between the two gen- 6 erations, a state rooted in Japanese family culture, makes it even harder 7 for children, first physically and second psychologically, to separate 8 themselves from their parents. When deep conflicts arise between fam- 9 ily members and remain unresolved, the forces that break them apart 1 may turn inward and become imprisoning fetters. It comes down to the 1 fact that in Japan, many children are not allowed to put themselves first 2 when they make their life choices, but are instead expected to incorpo- 3 rate or at least consider the wishes of their parents. While in the United 4 States and many other Western cultures, grown-up children are encour- 5 aged to think of what is important in their lives first and then try to 6 make their parents happy, the priority in Japan is often the opposite if 7 not the reverse. This is epitomized in cases in which middle-aged or 8 older couples are faced with the responsibility of taking care of their 9 infirm parents. This situation often seriously challenges the middle-aged 2 couple, as the choice of somehow logistically and physically accommo- 1 dating the infirm parents may cause so much strain it breaks up the 2 marriage itself. 3 According to Dr. Satoru Saito, in families where parents are psycho- 4 logically dependent on their children for their reason to live, the parents 5 have basically ceased to function as adults. Instead, the children support 6 their parents and keep them together, even by sacrificing their futures. 7 They do not know how to rebel against their parents or how to assert 8 their own identity. Therefore, in this environment, they may even grad- 9 ually lose their own interests, desires and passion. When they do react, 3 the symptoms these children show – school refusal, violence, eating dis- 1 orders – are the only ways they can cope with the sickness in their 2 family. Paradoxically, these manifestations, in Dr. Saito’s words, may be 3 “a healthy response” or “therapeutic behavior.”48 Another psychiatrist, 4 Tamaki Saito, observes that young people today are divided into two 5 types: those who are poor at communicating and socializing with oth- 3 ers and prefer to be alone in their own world, and those who are very 3 active in communicating with others and constantly seeking new 3 friends, but become extremely anxious if alone or if not in touch with 3 someone.49 The first type at its most extreme and pathological obviously 4 4 125 4 2831_CH04.qxp 6/4/09 1:11 PM Page 126

Mental Health Challenges x falls into hikikomori, and so is harder to see its entire picture in society. The latter type is easier to spot as they can be seen in the fashionable districts of big cities. This type seems to be of less concern as they apparently are cheerful and have busy, hectic lives. However, Dr. Tamaki Saito and many other psychologists specializing in counseling adolescents know this type is likely to develop insecurity about their self-image and finds it hard to maintain stable relationships. It is not unusual for these 0 teenagers to have as many as a hundred “friends” they can contact through their mobile phone, or via the internet, but not one person they can call a true friend. Some of the most extreme cases of insecurity and inner emptiness lead to self-mutilation in the form of wrist-slashing, drug overdoses, and suicide attempts, all of which are reportedly on the increase. Repeated wrist-slashing is especially increasing among women in their twenties. These acts of self-destructive behavior are not necessarily suicide attempts, but are seen as a way to release tension or to feel alive through experiencing pain. Their sense of inner emptiness is so intense that they can be diagnosed as having a borderline personality 0 disorder, “which is characterized by extreme insecurity and the tendency to see the world in a way that is all or nothing, good or bad.”50 Just as the hikikomori phenomenon is seen as a serious social and individual problem in modern Japan, this latter issue has also been attracting attention in clinical settings for some time. According to the first survey of the phenomenon by the National Psychiatry and Nerve Center conducted in 2004, almost 20% of high school girls surveyed admitted to injuring themselves with sharp objects such as knives. Nearly 10% of junior high school girls and 8% of junior high school boys said they had cut themselves with edged tools, and 27.7% of both 0 high school and junior high school boys and 12.2% of girls said they had hit their heads or fists against walls. The reasons for these acts of self-injury were varied, but included indescribable loneliness, anxiety, and anger. At one public junior high school in Tokyo, the number of third-year students slashing their wrists was more than 20 out of 200. The spread of self-mutilation among students is tormenting education 6 professionals, who feel they do not have the time or the expertise to deal 7 with these epidemics.51 8 Self-mutilation is a phenomenon caused by psychiatric, psychologi- 9 cal, and social factors. There is no right answer as to why such conduct 0 is increasing among young people. However, in many cases, it is based 1 2 126 2831_CH04.qxp 6/4/09 1:11 PM Page 127

Youth 1 2 on an inner fragility and a sense of anxiety about human relationships. 3 If their behavior is a form of communication with the outside world, it 4 is a reflection of their inability to express themselves in other ways, such 5 as articulating verbally or using creative methods as an emotional outlet. 6 Each pathological act, whether it is domestic violence, hikikomori, or 7 less severe anti-social behavior, seems unique in its own way. However, 8 it is often backed by psychological interdependency between parent 9 and child, which is so deeply rooted in Japanese family interactions 1 and directs life in such an insidious way. Thus, a home situation 1 in which parents and children continue to meet each other’s psycholog- 2 ical needs appears to be good and loving but is, in fact, corrosive. 3 And often, behind the interdependency is an unhappy conjugal rela- 4 tionship. In the name of love, parents continue to “protect” their chil- 5 dren from experiencing the real world and real human relationships. Of 6 course, these life experiences may be frightening at times and may even 7 turn out to be disappointing to the children. However, by not allowing 8 them to learn to take responsibility for being an independent human 9 being, parents are subconsciously preventing their children from 2 growing up. 1 As long as these children are under the care of their parents, they may 2 be all right. They live under the protective umbrella provided by their 3 parents’ financial resources. Even if they have serious problems socializ- 4 ing and are unable to take care of themselves, they can still live the 5 middle-class lifestyle their parents have worked so hard to create. 6 Unlike highly-industrialized Western societies, these freeters are 7 saved from becoming completely destitute or homeless. They can pur- 8 sue their dreams and continue to choose their lifestyles even with a very 9 small income from part-time, temporary jobs, because they live at 3 home. In other words, they continue to reap the harvest sown by the 1 generation who worked through the decades of economic growth after 2 World War II. These children’s “dream” may be to find the perfect job 3 with a good income, or a job that matches their education level or in 4 which they do not have to make too many compromises. For women, it 5 may be to find the perfect husband who can provide a life which is at 3 least as good as, or even better, than the one they experience with their 3 parents. As a result, these individuals postpone committing to a career 3 or marriage until the perfect job or possibilities arrive. This pursuit of 3 perfection is often supported by their parents, who have invested a lot 4 4 127 4 2831_CH04.qxp 6/4/09 1:11 PM Page 128

Mental Health Challenges x of energy and money in bringing up their children so that their children could achieve what their parents always wanted for themselves but could not. These parents sent their children to cram schools and sometimes schools abroad, hoping they would eventually find a job to justify their investment. The same is true for their children’s potential spouses. In their view, the children they raised with all that care and resources must marry well to justify their investment. As Yamada says, they are not only 0 supporting their children’s dreams, but “they are also ‘dreaming’ with their children.” (p.219)52 Here again, parents are subconsciously identifying their life goals with those of their children. In the not-so-distant future, Japanese society may end up having millions of adults who are being financially supported by aging parents. But what will happen after their parents, now in their fifties to seventies, are gone? What if the parents’ assets are depleted? Then it will become more apparent which adult children can maintain a certain standard of life. Some of these grown-up children will have only known a life of financial dependence, because, frankly, 0 their inability to communicate effectively and relate to others has prevented them from leaving home and striking out on their own. Their standard of life and level of income will directly depend on their own ability to fend for themselves and build their own life. Already, growing concerns have been raised that Japan’s cohesive middle class is breaking apart and is starting to show a widening gap between the haves and have-nots. When the parents of today’s young die, it is suspected the difference will be all too clear.

SOCIAL STRUCTURAL CHANGES JAPAN IS GOING THROUGH. 0 WHAT DO THEY MEAN TO THE NEXT GENERATION? A society that used to emphasize the image of a cohesive middle class is now experiencing forces that are dividing people simply into kachigumi “winners” and makegumi “losers.” Increasingly, this perspective is believed to be a reliable predictor of the future Japan. No matter what 6 slightly optimistic reports the media sporadically send, unlike the 1960s 7 to 1980s, the majority of the Japanese do not share this optimism. 8 Rather, they feel the good news is happening somewhere else, and affect- 9 ing other people. A perception exists that their lives are not improving, 0 despite positive reports in the media, and success is increasingly 1 2 128 2831_CH04.qxp 6/4/09 1:11 PM Page 129

Youth 1 2 concentrated on a small group of people, leaving the majority with few 3 chances to enjoy the benefits of the economic upswing. 4 This is critically different from the results of economic booms Japan 5 experienced in the past. Many are concerned at this “deplorable” new 6 trend toward inequality, but also unwillingly accept it as a fact of the 7 new Japan, The changing economic structure is also more explicitly 8 polarizing society into a group of people in secure employment with 9 large corporations, and another group who are employed on a part-time 1 or temporary basis, have no job security, and who are an adjustable 1 safety valve according to the corporation’s financial fluctuations. If the 2 company is doing badly, the latter group are released. They are not given 3 a chance for promotion or career development, as most of their tasks are 4 routine and apparently have no requirement for professional skills. They 5 are considered convenient labor at the mercy of employers’ convenience. 6 When the word “freeter” arrived in Japan, it was seen to represent a lib- 7 erated choice for young people seeking their own lifestyle. Freeters lived 8 a dream – never committing themselves to full-time company employ- 9 ment and trading financial security for freedom. However, there are mil- 2 lions of young people today who are forced to be freeters because they 1 simply cannot secure a full-time position in a firm. It is becoming a mat- 2 ter, not of personal choice, but inevitability. In an economic slow down, 3 Japanese companies are still likely to protect existing employees at the 4 cost of young people looking for their first jobs. They do this by tend- 5 ing to keep new employees off the regular payroll, and instead employ- 6 ing them as temporary, disposable workers. It is estimated that there are 7 roughly 5 million young people in this state today.53 8 Another current catchphrase is karyu¯ shakai, or lower-class society, a 9 term coined by Atsushi Miura. He points out that the top 25% of the 3 population possesses 75% of the nation’s entire wealth and there is a 1 growing underclass of young people. He says that not only is people’s 2 perception of their standard of life widening, but the number of those 3 who say they belong to the lower-middle or lower class has gradually but 4 steadily increased since 1996. A society whose members used to believe 5 they were middle class is changing into one more clearly stratified and 3 even skewed toward the lower end. Only a small proportion of the 3 upper-middle or upper class will be able to retain their positions, and 3 the perception of the remaining population is that they are on a path to 3 downward mobility. National wealth is already distributed unevenly, 4 4 129 4 2831_CH04.qxp 6/4/09 1:11 PM Page 130

Mental Health Challenges x but Miura predicts that this trend will accelerate, and become most evident in the next generation, those children of the baby-boom generation.54 The direst example of an emerging lower class are “net café refugees,” the majority of whom support themselves through day labor, and spend their nights at “internet cafes” – in which a cubicle with a PC can be rented for as little as 100 yen an hour – because they cannot afford to rent an apartment. A 2007 survey by the Ministry of Health 0 and Labor – the first of its kind – put their number at 5,400, a quarter of whom were in their twenties.55 With an unstable income, this generation will further delay the decision and the timing of their marriage, if they marry at all. The situation will also further perpetuate the parent-child dependency cycle and once these freeters reach middle age, the possibility of finding regular secure employment will be reduced even further. As we have seen, the age ceil- ing against hiring is extremely strict, which makes middle-aged jobseekers nearly unemployable in Japan. Besides, having led a freeter lifestyle, these new middle-aged freeters will never have acquired professional skills and 0 experiences. The potential demographic nightmare is that of millions of middle-aged and even older ex-freeters, who have used up their parents’ resources and whose survival depends on unstable finances. But of particular worry is Yamada’s prediction that real polarization will occur between those who can have hope for the future and those whose opportunities are so limited that they have already given up and stop even trying.56 A society that has a widening gap between haves and have-nots is a society with a widening gap in psychological outlooks. What is hope? It is the feeling that even if one is in difficulty, perseverance will eventually bring something good. It is a crucial source of 0 strength for enduring hardship and something that enables a person to delay instant gratification and to look to the future. However, young people are strongly sensing that unlike their parents’ era, a time in which their efforts could eventually lead to a stable, solid life, there is no guarantee that their current insecure state will improve. People who have lost hope will no longer be able to find meaning in overcoming obstacles, 6 because, most likely, doing one’s best will not pay off. Some of these 7 people will despair, or become antisocial, turn to crime, seek refuge in 8 cults, develop addiction, or withdraw from society. 9 Since many see no value in preparing for the future, a growing sense 0 of escapism will produce young people who simply rely on luck for 1 2 130 2831_CH04.qxp 6/4/09 1:11 PM Page 131

Youth 1 2 success in life. Instead of trying to avoid risk, they will pursue dreams 3 that may depend on extreme good fortune. Increasingly, a concept of 4 rational planning will be considered a waste of time and life will become 5 a series of gambles.57 6 This kind of gambling can be seen in those who, with the protection 7 of their parents, are following their dreams and do not commit them- 8 selves to a career. In a way, they are gambling on life itself by procrasti- 9 nating over important decisions or not doing anything concrete to 1 prepare for the future. They are living in denial: someday they may have 1 to face the consequences of their current lifestyle, but when the time 2 comes, they will be quite vulnerable as they have never experienced real 3 adversity. 4 But strangely and interestingly, as Miura points out, young people 5 who see themselves as belonging to the lower-middle class, and continue 6 to live a life of risks, are more likely to report a sense of self-confidence 7 and pride at being “true to themselves” (jibun-rashisa) than those who 8 do not see themselves as belonging to this social strata.58 Miura intro- 9 duces a revealing study which analyzed the self-esteem of high-school 2 students. To the question of whether they thought they had better qual- 1 ities than others, a survey conducted in 1970 showed a correspondence 2 between students’ levels of confidence and their parents’ educational 3 level, as well as the number of hours they spent studying at home. In 4 other words, the higher socioeconomic status they were from, the more 5 confidence they had and the more they studied. These students also 6 expressed a desire to pursue higher education themselves. However, 7 when the same study was conducted in 1997, not only had the correla- 8 tion among these variables disappeared, but students from the lower 9 than middle socioeconomic status were more likely to report higher self- 3 confidence and were even more likely to deny the importance of hard 1 work. They were more likely to say that pursuing a life “true to them- 2 selves” was more important.59 3 Miura suggests their high self-esteem does not necessarily reflect their 4 actual abilities to realize their dreams, or even reflect their efforts to 5 make them happen. These young people tend to be unmarried, have no 3 children, or stable employment. Emphasizing the importance of being 3 “true to themselves,” this is a lifestyle that often implies a tendency to 3 avoid commitment and responsibility. Furthermore, they are not good 3 at communicating with others, a character type that has appeared 4 4 131 4 2831_CH04.qxp 6/4/09 1:11 PM Page 132

Mental Health Challenges x repeatedly in this book. They often tend to be introverted and have difficulty making connections with others, which is why they cannot find a good job, cannot escape the freeter lifestyle or find a girlfriend or boyfriend. Miura concludes that ultimately, communication ability will determine their potential for success.60 In a way they are also quite self- centered as they have no ability to understand others well. So-called NEETs (Not in Education, Employment, or Training) have 0 also started to attract attention from policymakers, due to their potential negative impact on the economy. These people are stuck in an even more withdrawn and unproductive state than freeters who, though irregularly, at least work. NEETs are seen as the ultimate parasites in society. The loss of tax revenues and economic vitality caused by NEETs is naturally a serious concern for the future of society, and these apparently lazy young people are frowned upon as a growing burden. NEETs may not be such an uncommon phenomenon in affluent post-industrialized societies. However, in a quintessentially work- focused society like Japan, where diligence is the greatest virtue, their 0 existence is a fundamental threat to society. Is it these young people’s fault or are they victims of circumstance? Are they to blame, or is it the fault of the previous generation? Genda and Maganuma strongly defend NEETs, freeters and “parasite singles,” saying they are victims of the recession and structural changes in the economy. Genda says the priority that society put on keeping middle-aged or older workers on the payroll meant fewer jobs for the young, and that bashing youth for having idle and luxurious lifestyles misses the point. It is not the young who feed off the older generation; it is rather the old generation who are feeding off society.61, 62 0 While it is absolutely important to be reminded of the large structural barriers, their psychology and motives are still worthy of study, and are the main focus of this book; and Genda himself admits the importance of their mental attitude. Although more than one third of NEETs asked said they had no motivation to do something about their life, Genda says this is because they have given up even the hope of a job after 6 repeated trials, failures, and rejections. In fact, 60% of NEETs asked say 7 they are frustrated with their situation. But they still appear to be 8 inactive and do not appear to try to change their life. Why? 9 Genda and Maganuma further argue that the biggest reason they 0 cannot find work is a basic lack of confidence in being able to handle 1 2 132 2831_CH04.qxp 6/4/09 1:11 PM Page 133

Youth 1 2 the human relationships they will encounter at work. It is not because 3 they do not know how to look for a job.63 The core reason for NEETs 4 as a social phenomenon is their deep-rooted phobia of human relation- 5 ships. They are so worried about handling the stress and pressure of 6 getting along with people that they feel it is impossible to even try. This 7 is the most fundamental problem facing young people in Japan, as 8 repeatedly noted. 9 We do not know when this phobia became such a problem, but it 1 expresses itself by making victims worry excessively about being 1 accepted by others and showing hypersensitivity to the social demand to 2 conform. If the pressure is too much to take, it is not surprising that 3 they seem to be doing everything to avoid situations that involve long- 4 term, committed interactions with others, such as those in the work- 5 place. They prefer to have no involvement with others or even ignore 6 them at times out of yasashisa. At the same time, they have built a 7 defense mechanism based on believing they are capable of many great 8 things if the right time and opportunity arrives, and that they are not at 9 fault for their situation. Of course, this sense of omnipotence is only 2 symptomatic of the inner fragility of their self structure, which is main- 1 tained by the protection of their parents and their own avoidant coping 2 styles. It can be easily shattered by coming face to face with reality. 3 It is quite ironic that, in an era of globalization in which communica- 4 tion with different kinds of people is crucial to the future and survival of 5 Japan, many young Japanese suffer from an inability to relate to other 6 human beings. But they are hardly aware of what is wrong with them- 7 selves. In the meantime, their energy is encroached by various ambiguous 8 distresses which they cannot put their fingers on. 9 Japan’s accomplishments in the last sixty-four years are no doubt 3 remarkable. Its people worked hard, first to recover from the devastation 1 of war, and then to become a global economic power. These goals were 2 achieved fanatically, as if they were an attempt to put the trauma of war 3 behind them as quickly as possible, even though the Japanese might 4 have needed a little more time to recover. The obsessive pursuit of mate- 5 rial gains meant sacrificing many things, personal and private. The gen- 3 eration that became grown-ups right after the war still vividly 3 remembered its harsh deprivations, and these were the most powerful 3 driving force for them. Their children’s generation, growing up in the 3 1950s and 1960s, was not so affluent, but knew a life of expanding 4 4 133 4 2831_CH04.qxp 6/4/09 1:11 PM Page 134

Mental Health Challenges x social and economic opportunities. They, too, often pushed aside personal happiness for the sake of tangible achievement. Now these people’s children seem to have all they need materially but have a void in their souls. It has taken three generations for the psychological consequences of rapid social change to ﬁnally surface.

0 NOTES 1 Horney, K., 1950, Neurosis and Human Growth: The Struggle Toward Self- Realization. New York: W.W. Norton & Company. 2 Wikipedia http://en.wikipedia.org/wki/NEET accessed April 18, 2008. 3 Kasahara, Y., 1986, “Fear of Eye-to-Eye Confrontation among Neurotic Patients in Japan” in Japanese Culture and Behavior. T. Sugiyama Lebra and W. Lebra (eds.), Honolulu: Hawaii University Press, pp.379–87. 4 Sakagami, Y., 1999, (Youth and family: being an educator and a clinician). Kokoro no Kagaku (Human Mind), vol.85. no.34, p.35. 5 Ohira, K., 1995, . (Psychopathology of gentleness). 0 Iwanami Shinsho. 6 Ibid. 7 Ibid. 8 Morotomi, Y., 2005, . (It is painful to live: psychology of the era of nationwide depression). Heibonsha Shinsho. 9 Sakai, T., 2006, (Bureau of Economy and Industry deals with difﬁcult young employees). Mainichi Shimbun, February 9. 10 Nemoto, K., 2005, . (Afraid to get hurt). Bunshunshinsho. 11 Morotomi, Y., ibid. 12 Nemoto, K., ibid. 13 Okonogi, K., 1998, . (Crisis of moratorium 0 nation Japan). Shodensha. 14 Ohira, K., ibid. p.167. 15 Sugimoto, Y., 2003, An Introduction to Japanese Society. Cambridge: Cambridge University Press, pp.115–45. 16 Nemoto, K., ibid. 17 Ibid. p.54. 18 Saito, S., 1999, . (Family addiction). Shincho Bunko. 6 19 Morotomi, Y., ibid. p.61. 20 Saito, S., ibid. 7 21 The Yomiuri Shimbun 2006, (Junior high school 8 nonattendance increased). August 11. 9 22 Kuramoto, H., 2007, . (The youth meeting with a setback). 0 Nihon Hyoronsha Publishing, pp.4–5. 1 2 134 2831_CH04.qxp 6/4/09 1:11 PM Page 135

Youth 1 2 23 Fukuda, N., 1999, 3 (Understanding school maladjustment. From the standpoint of a 4 school counselor) in Kokoro no Kagaku (Human Mind ), vol.87, pp.32–6 5 24 Mori, S., 1995, . (Between the normal and the abnormal: psychopathology of the borderline). Kodansha Gendaishinsho. 6 25 Kuramoto, H., ibid. 7 26 Kawai, H., 2002, . (Thinking about family relations). 8 Kodansha Gendaishinsho. 9 27 Kuramoto H., ibid. pp.111–30 28 NHK . (NHK hikikomori information) http://www.nhk.or.jp/ 1 fnet/hikikomori/index.html. accessed April 11, 2008. 1 29 Kuramoto, H., ibid. p.100. 2 30 Jones, M., 2006, “Shutting Themselves In.” The New York Times Magazine, 3 January 15. 31 Saito, T., 1998, . (Social withdrawal: 4 endless adolescence). PHP Shinsho. 5 32 Ministry of Health, Labor, and Welfare, 2003, 6 (Hikikomori guideline. Research on intervention in community mental health 7 activities) http://www.mhlw.go.jp/topics/2003/07/tp0728-1.html accessed December 28, 2004. 8 33 Asahi Shimbun 1993, Q&A 46 9 (Q&A on 46 cases of hikikomori published by a private counselor in Chiba). 2 May 14. 1 34 Zeilenziger, M., 2003, “More Japanese are imitating a nation that closes itself off. Shut-ins increasing among young adults.” The Detroit Free Press, January 3, 2003. 2 35 Watts, J., 2002, “Japan’s teen hermits spread fear : Film lifts the lid on the hell of 3 child recluses.” The Observer, November 17. 4 36 Ryall, J., 2004, “Japan’s Secret Epidemic.” a feature report by Al-Jazeera, May 31, 5 2004. 37 Wehrfritz, G., 2001, “Tune Out, Stay In: An epidemic of young Japanese pulling 6 back from the world has deep roots.” Newsweek, August 20. 7 38 Zeilenziger, M., ibid. 8 39 Watts, J., ibid. 9 40 Jones, M., ibid. 41 Wehrfritz, G., ibid. 3 42 Saito, T., ibid. 1 43 Jones, M., ibid. 2 44 Yamada, M., 1999, . (The age of parasite singles). 3 Chikuma Shinsho. 45 Mainichi Shimbun 2001, (Premonition for pain? 4 Pessimistic future outlook). August 1. 5 46 Yomiuri Shimbun 2005, 3 (Survey on opinions of junior and senior high school students in the 3 U.S. and Japan). March 16. 47 Saito, T., 2003, “ SOS. “(SOS of the young mind). NHK Ningen 3 Kooza. NHK Publishing Association, August–September 2003 3 48 Saito, S., ibid. 4 4 135 4 2831_CH04.qxp 6/4/09 1:11 PM Page 136

Mental Health Challenges x 49 Saito, T., 2003, ibid. 50 Ibid. 51 Okuni, A., 2006, (Schools in distress with students’ self- mutilation). Mainichi Shimbun, February 6. 52 Yamada, M., 2004, . (Hope disparity society). Chikuma Shobo. 53 Ibid. pp.116–20. 54 Miura, A., 2005, . (Lower class society). Kobunsha Shinsho. 55 Asashi Shimbun 2007, 5400 4 120 (Net Café Refugees 5400. One Fourth are in their twenties). August 28. 0 56 Yamada, M., ibid. 57 Ibid. 58 Miura, A., ibid. 59 Ibid. 60 Ibid. 61 Genda, Y. and M. Maganuma, 2004, . (NEET: neither freeter or unemployed). Gentosha. 62 Genda, Y., 2005, A Nagging Sense of Job Insecurity: The New Reality Facing Japanese Youth. Tokyo: International House of Japan Inc. 63 Genda, Y. and M. Maganuma, ibid.

6 7 8 9 0 1 2 136 2831_CH05.qxp 6/4/09 1:12 PM Page 137

1 2 3 5 4 5 Japan’s “Lonely People” 6 7 8 9 1 1 “The only way to maintain any semblance of equilibrium during the super- 2 industrial revolution will be to meet invention with invention – to design new 3 personal and social change-regulators. Thus we need neither blind acceptance nor 4 blind resistance, but an array of creative strategies for shaping, deflecting, acceler- 5 ating, or decelerating change selectively. The individual needs new principles for pacing and planning his life along with a dramatically new kind of education. He 6 may also need specific new technological aids to increase his adaptivity. The 7 society, meanwhile, needs new institutions and organizational forms, new buffers 8 and balance wheels.” (p.373) 9 ALVIN TOFFLER1 2 1 In his discussion of the contemporary forces that cause different societies 2 to share common institutional and attitudinal patterns, Alex Inkeles also 3 examines forces of resistance to such convergence. These forces are 4 found in the entire population or in subgroups within a nation, and are 5 sometimes very influential in their efforts to maintain “original” cultural 6 traditions.2 In the occupational field, despite the full adoption of the 7 basic principles of capitalism and modern bureaucracy, many Japanese 8 workers are not able to see, or are not allowed to see, work simply as the 9 result of contractual agreements that can be broken at will. A traditional 3 sense of human connectedness seems to run their lives so powerfully that 1 it sometimes suffocates them. In the family arena, even though love or 2 marriages after courtship and the nuclear family have been established 3 patterns for several decades, the Confucian emphasis on intergenera- 4 tional rather than the conjugal ties seems to occupy the greatest part of 5 the Japanese heart. However, relationships at home have been strained by 3 the growing gap between the traditional ideal, family expectations, and 3 reality. As Inkeles notes, the idea of filial piety is still very strong in many 3 Pacific Rim countries. But even though there is a strong motive for keep- 3 ing the spirit of filial piety, the way it is expressed among the younger 4 4 137 4 2831_CH05.qxp 6/4/09 1:12 PM Page 138

Mental Health Challenges x generation is more complex and in some cases distorted into a source of paralysis. If there is such a thing as “healthy” filial piety, there seems to be much confusion about it in Japan. Young people in all highly- industrialized nations do not know the deprivation of the post-war era, and are criticized to greater or lesser degrees by the older generation for being spoilt and self-indulgent. However, young Japanese appear to present distinctive patterns of behavior in coping with their distress if the 0 confusion becomes too much to handle – pathological expressions that have something to do with Japanese family culture. Wherever the strains surface and in whatever form, the bottom line seems to be that the Japanese are increasingly having difficulties in establishing comfortable relationships with one another. It is as if they can no longer enjoy or even tolerate the types of Japanese relationship that long sustained them and acted as an ultimate safety net. Traditional Japanese relationships emphasized the value of ittaikan (a sense of oneness) and the unconditional acceptance of the other, without verbally explaining the wish for it or reinforcing it. There was an assumption that 0 everyone shared the same modes of thinking and priorities. But as we have seen, this type of relationship can be binding and extremely stressful. It is backed up by a sense of indebtedness, implicit but heavy obligation, and exclusiveness, all of which are never explicitly stated, but that all “good” and “decent” Japanese people are supposed to be fully aware of. These things are so deeply embedded in the Japanese psyche that if they have to be clearly explained, they lose their effectiveness. The positives and negatives, or the rewards and costs of human relationships, have somehow maintained a fine balance, and the Japanese have been able to center their lives on them. However, this sense of balance is 0 gradually disappearing. What torments the Japanese about their traditional form of relationship is “shigarami.” If death and taxes are the inevitables of life the world over, the Japanese also have shigarami to contend with. This word originally means “weir,” but has lost its original meaning to all but a few people – only fishermen, perhaps. Instead, shigarami refers to the restric- 6 tive, binding fetters on one’s psychology that prevent one from acting 7 freely. Googling the word brings up more than 500,000 references to it, 8 many of which contemplate its significant impact on life. Shigarami 9 reminds the Japanese person of the obligation, responsibility and sense 0 of loyalty required by the groups they belong to. Although this 1 2 138 2831_CH05.qxp 6/4/09 1:12 PM Page 139

Japan’s “Lonely People” 1 2 shigarami has protected Japanese individuals from having a completely 3 solitary existence based on self-reliance, the word unsurprisingly has 4 connotations of heavy and unbearable weight to anyone who thinks 5 about it. It is taken for granted with the usual fatalistic attitude of 6 “shigakata ga nai (It can’t be helped; I must resign myself to it).” Many 7 Japanese who have lived in the United States and other Western nations 8 readily appreciate the incredible convenience, efﬁciency, and safety of 9 Japanese society when they return. However, they have difﬁculties in 1 adjusting to Japanese life when they start to feel the sense of shigarami, 1 which is such an elusive but heavy psychological burden. Especially after 2 experiencing individualistic cultures such as that which exists in the 3 United States, they have become particularly sensitive to elements that 4 restrict their sense of freedom. 5 Even if the person has no overseas experience, many Japanese 6 nowadays appear to be overwhelmed by the power of shigarami and 7 sometimes feel crushed by it. In fact, shigarami is never easy for the 8 Japanese to deal with, as contrary to appearances, it is not innate. It 9 takes a Japanese person a number of years of social training and life 2 experiences to fully understand, accept and manage it as a part of their 1 lives. At work and home, a dragging sense of shigarami seems to be pre- 2 venting the Japanese from being true to themselves and sometimes from 3 facing up to the most important issues in their lives. Young people are 4 also surprisingly tormented by a sense of shigarami in their relationships 5 with parents, to the point where they feel paralyzed by it. 6 What makes this situation worse is a serious lack of communication 7 skills among many Japanese people; both verbal and non-verbal expres- 8 sion of their honest feelings and emotions. Yes, Japanese culture is rich 9 with subtle non-verbal ways of communicating one’s emotions and con- 3 sideration for others, a style of communication that has been cherished 1 and appreciated as a valuable Japanese quality. Non-verbal and intuitive 2 understanding of another is considered the best form of human interac- 3 tion in Japan. But in an era of rapid value transformations, such a tradi- 4 tional approach to mutual understanding is losing its effectiveness, or is 5 not necessarily shared by all. Even though the Japanese still share the 3 same language, how it is expressed and used varies more greatly than 3 before depending on generation and background. Communication dys- 3 function or the lack of communication is becoming a major source of 3 distress. Perhaps the most serious problem of all is that many Japanese 4 4 139 4 2831_CH05.qxp 6/4/09 1:12 PM Page 140

Mental Health Challenges x do not even realize communication is actually important in significant human relationships. The assumption is that if it is considered a “significant relationship,” open and honest communication is not really needed. In their eyes, because the relationship is already seen as “significant” through its status or closeness thanks to blood ties, the assumption is that no more effort to communicate is needed. That is why many Japanese do not seem to even try to reach out for each other. Or proba- 0 bly, they do not know how to reach out or express their feelings even though they would like to. They just go on feeling frustrated but powerless. And so, they are left feeling terribly lonely. An almost universal observation of the foreign students I teach is that Japanese people, especially men, show amazing signs of stress. Many of their observations are based on the part-time jobs they have in offices, shops, restaurants, or izakaya. European and American students also wonder why Japanese do not express more affection with their inti- mates. The cliché is that Japanese are shy, but they are often puzzled by the seeming lack of strong emotions even within the family. Chinese 0 and Korean students say their countrymen also work very hard, but are far more open, honest, and expressive about their feelings. The problem with the Japanese, they say, is that they are poor at expressing their feelings even when they want someone to listen to them. Discussions of the ubiquitous sex-related and bar industries in Japan are interesting because so many non-sexual elements play an important part in these services, such as conversation with hostesses and playfulness. These businesses appear to cater to men who not only need to drink away their stress, but also need to be listened to and pampered without making an effort to communicate. By venting the problems of life in these places, 0 these men share even less with their family. The Japanese are lonely people, my foreign students say.

HAVE WE REACHED A TIPPING POINT? It is clear from day-to-day personal impressions, as well as from surveys and 6 clinical reports, that more and more Japanese are suffering from various 7 psychological ailments. When social norms and value systems start to 8 falter and change into something more diverse and relative, unless they can 9 quickly reestablish their mental compass, people become anxious at the 0 absence of a clear direction. Not knowing what to believe is just like setting 1 2 140 2831_CH05.qxp 6/4/09 1:12 PM Page 141

Japan’s “Lonely People” 1 2 sail on a voyage without a map. Human beings can only live in a world 3 that gives meanings and makes cognitive sense to them. While they strug- 4 gle to recreate a world in which their heart and mind can be at peace, they 5 are bound to be exposed to the risk of losing their psychological balance. 6 According to clinical reports, not only are the number of psychopatho- 7 logical cases on the increase, a situation that has led some mental health 8 professionals to say the Japanese are living in an “era of depression,”3 but 9 the most prominent disorders suffered have also changed. Surveys of 1 outpatients at psychiatric institutions taken in the late 1990s showed diag- 1 noses for schizophrenia at 26.7%, mood disorders at 21.3%, neuroses 2 at 24.3%, dementia at 4.9%, alcohol-related problems at 4.7%, other 3 mental or behavioral disorders at 3.4% and epilepsy, which is customarily 4 treated by psychiatrists in Japan, at 12.8%.4 On the decline were serious 5 types of schizophrenia and manic-depressiveness, considered the two 6 major psychiatric disorders and the most debilitating illnesses as they 7 forced many patients to be in treatment for life. This is due to remarkable 8 progress in psychopharmacology and the availability of more information 9 on mental illnesses through public health education. Comprehensive 2 epidemiological data on psychopathologies has not been available in 1 Japan because a political campaign against a national mental health 2 policy made it difﬁcult to carry out community-based psychiatric surveys. 3 However, Nishizono reports that these two major disorders have been on 4 the decline as modernization and urbanization progressed in the decades 5 that spanned World War II, and since the mid-1970s psychiatrists have 6 observed a rapid increase in clinical depression accompanied by various 7 neurotic anxieties and conﬂicts or depression with mainly psychosomatic 8 symptoms (called “masked depression” in Japan).5 Clearly, depression 9 is on the rise, but the majority of these cases are not classical mental 3 disorders with psychotic symptoms. They are often most appropriately 1 positioned in the gray area between the normal and the abnormal, or 2 categorized between non-disease and disease. The line between these two 3 areas used to be very clear. However, it is becoming increasingly blurred 4 in contemporary Japan.6 Eating disorders among young women, social 5 withdrawal, various types of obsessive-compulsive disorders, and alcohol 3 addiction are also increasing.7 3 While many of these cases are accompanied by depression, they are also 3 seen as a part of a broader category of personality disorders. A number of 3 mental health professionals in Japan have reported a gradual increase of 4 4 141 4 2831_CH05.qxp 6/4/09 1:12 PM Page 142

Mental Health Challenges x various types of personality disorder in recent years.8, 9, 10 Personality disorders are a separate category from psychotic illnesses and have different subtypes, including antisocial personality disorder, borderline personality disorder, narcissistic personality disorder, dependent personality disorder, avoidant personality disorder, and many others. People with personality disorders can have more than one type of disorder. In any case, the symptoms of personality disorders are enduring pat- 0 terns of inner experience (such as thoughts and emotions) and behavior (such as interpersonal functioning and impulse control) that sharply deviate from cultural and social norms. The symptoms cause so many difficulties that various aspects of the sufferer’s life are severely impaired. Many factors are believed to be contributing to the development of the symptoms, but signs of personality disorders are usually found during adolescence or young adulthood.11, 12 No doubt, they are “disorders” and make ordinary life difficult. But there is much confusion as to whether they should be regarded as diseases. They also are very difficult to diagnose as many of the sufferers do 0 not seek help. The symptoms often contain things many of us can relate to, such as passivity, perfectionism, indecision, stubbornness, suspicion, hypersensitivity, mood swings, anxiety, fear, and so on. While psychotic patients’ experiences are considered unreal from our standpoint, those suffering from a personality disorder and “normal” people basically share the same reality. How they differ is that those with personality disorders tend to express common emotions in various exaggerated and extreme ways to a degree that is considered abnormal. For example, people with antisocial personality disorder disregard others’ rights, feelings, concerns, or society’s norms and expectations. Their antisocial 0 behavior often results in arrest or legal involvement. They lack remorse for their wrongdoings and often attempt to trick others for personal profit.13 Major symptoms of borderline personality disorder include poor sense of self, unstable self-image, inconsistent mood, significant impul- sivity, and intense fear of abandonment, all of which negatively affect the 6 quality of relationships, or make it extremely difficult to sustain them. 7 Extreme fear of abandonment often acts as a self-fulfilling prophecy as 8 they cling to others too much and in trying to avoid rejection, eventu- 9 ally push others out of their life. Self-harming, destructive behavior 0 such as suicide attempts, gestures and threats, and self-mutilation and 1 2 142 2831_CH05.qxp 6/4/09 1:12 PM Page 143

Japan’s “Lonely People” 1 2 sudden anger are all symptoms. They also suffer from chronic feelings 3 of emptiness.14, 15 4 Narcissism in its primary version is a crucial defense mechanism for 5 infants, which protects them from physical injury. But secondary nar- 6 cissism or pathological narcissism is maladaptive, and can develop into 7 a personality disorder. Narcissistic personality disorder shows a pattern 8 of grandiosity, self-importance, need for praise and admiration, and a 9 twisted sense of entitlement. These feelings of superiority are in fact 1 based on a sense of inferiority and overcompensation.16 1 Mental health professionals have noted an acute increase in patients 2 with borderline personality disorder and narcissistic personality disorder 3 coming to emergency psychiatric departments. But why are these types 4 of disorder increasing in Japan? 5 Personality disorders increase as urbanization progresses, and can 6 be triggered, again, by rapid changes in value and norm systems. Old 7 values and norms have been dismantled and instead, more individual- 8 oriented, diverse, choices for life have become available. If one clings to 9 the old values and norms in this changing environment, one is likely to 2 develop depression as one feels overwhelmed by a sense of impotence 1 and helplessness. The dismantling of the old system also removes or 2 weakens oppressive forces in hierarchical human relationships, namely 3 the power of higher-ranked people such as parents, teachers, and pro- 4 fessional superiors. The disappearance of these authoritative symbols 5 enables the young, who used to be relegated to a lower position in 6 society, to believe they are much greater and more capable than they 7 really are. This “ego inflation” produces people with narcissistic tenden- 8 cies. If their ego becomes too inflated, they will start to do anything to 9 protect it from getting hurt, in particular in situations of conflict. 3 Another defense mechanism is to blame others for everything that 1 does not go as one wishes and to never admit responsibility for one’s 2 problems.17 3 Another possible consequence of dismantling this value system is 4 that people become so uncomfortable and insecure that they behave in 5 totally irrational ways. Unable to stand their own sense of uncertainty, 3 these people resolve it by searching for extraordinary physical stimulus. 3 It has been persuasively argued that many self-mutilating acts and 3 sexual addiction among the young occur out of a desperate need to feel 3 “alive.”18 4 4 143 4 2831_CH05.qxp 6/4/09 1:12 PM Page 144

Mental Health Challenges x However, the rise of borderline and narcissistic cases is not only occurring in Japan; in fact, it has also been highlighted in the United States for several decades. Naturally, the psychology and psychopathology of the individual is considered symptomatic of the times we live in. Psychiatrist Alexander Lowen says that in forty years of practice in the United States, there has been a change in the type of problems he has been asked to treat. Classical neuroses ridden with guilt and anxiety 0 have been replaced by more cases of depression, lack of inner feelings, emptiness, frustration, and a lack of fulﬁllment, even if the patients are quite successful. Lowen says these patients experience “a split between the way they perform in the world and what goes on inside.”19 In The Culture of Narcissism, Christopher Lasch famously criticized the direction that 1970s’ American life was taking in terms of the national psyche. With the weakening of tradition, family, community, and other institutions, a narcissistic personality type emerged that, out of its own deep insecurity, depended on others for validation, self- esteem and desperately sought admiration to maintain the fantasy of 0 a “grandiose self.” This new type was in sharp contrast to the image of the rugged individualist who was willing to create and change the world to his own design. (p.8) But although not romantic, it was a natural or adaptive process for the human being who had to survive the rapid changes of our times. As Lasch wrote, “Narcissism appears realistically to represent the best way of coping with the tensions and anxieties of modern life, and the prevailing social conditions therefore tend to bring out narcissistic traits that are present, in varying degrees, in everyone.” (p.50) Although Lasch was criticizing the narcissistic tendency that had 0 appeared among ordinary people due to changing cultural and social phenomena in the United States, he also referred to the changes in clinical literature and pointed to the increase of personality disorder patients in the 1940s and 1950s. These patients lacked phobias or repressed sexual energy, but suffered severely from vague, diffuse dissatisfaction with life. They found their existence to be futile, purposeless, and empty, but 6 somehow protected themselves by impulsively acting out conﬂicts or 7 developing only shallow emotional relationships. They avoided seri- 8 ously mourning or developing emotional involvement so that intense 9 rage would not destroy them.20 It is as if a defense mechanism has 0 become the most important part of their character. 1 2 144 2831_CH05.qxp 6/4/09 1:12 PM Page 145

Japan’s “Lonely People” 1 2 If urbanization and industrialization bring the same social conse- 3 quences to many highly-industrialized and post-industrialized societies, 4 it may not be surprising that these countries also share similar transfor- 5 mations in their people’s characters. Not only can the general national 6 character change, or rather a new tendency can emerge and be added to 7 the existing character, but types of dominant psychopathology, which 8 also mirror the sociocultural reality of the time, move in a similar direc- 9 tion. However, some countries may be more vulnerable to these changes 1 than others because of their core character structure, as well as the 1 adaptability and willingness of society to cope with the consequences of 2 an increase in certain psychopathologies. 3 In Japan’s case, the potential consequences for individuals and soci- 4 ety seem grave. It is not possible to say that Japan has a greater number 5 of problems than other countries, but it is possible to say that Japan can 6 have no fewer. 7 Developing awareness of one’s self within the context of a relation- 8 ship with others and within intimate groups has been particularly 9 important in Japanese society. If you will forgive the repetition of a 2 cliché, the Japanese have tended to put priority on collective goals rather 1 than individual goals if forced to make a choice. A culture that empha- 2 sizes the collective is a culture that emphasizes the observance of stan- 3 dards, values, and norms by its members. The process of establishing 4 and maturing as a Japanese individual has always occurred in such a 5 context. Generally speaking, social values and norms seem to be more 6 deeply and ﬁrmly internalized in Japanese individuals than in Western 7 countries, where individualistic values are ultimately respected above 8 anything else. The more strictly a person observes social standards and 9 expectations, the more likely the person has been regarded as a good 3 Japanese. Therefore, the dismantling of this value and norm system 1 has the potential to cause more devastation to Japanese individuals than 2 their Western counterparts. Those who have been socialized to believe 3 that living with a close sense of mutual dependency within a group is 4 desirable are thrown into greater chaos when they realize those outside 5 sources of support are no longer dependable. Minami, a social psychol- 3 ogist, has described the sense of uncertainty held by the Japanese self 3 and the strong tendency for other-directedness based on the fact that 3 evaluation by others is so important.21 Those showing these character- 3 istics are likely to suffer from an even more serious sense of uncertainty 4 4 145 4 2831_CH05.qxp 6/4/09 1:12 PM Page 146

Mental Health Challenges x if rapid social transformation occurs. The people of a culture in which their ultimate support is not built on a strong sense of individual reli- giosity, but rather on the situation-speciﬁc limited human nexus, as Nakamura, a philosopher, described,22 are potentially exposed to more psychological risks when traditional beliefs lose their power to convince. For these people, the ground on which they base their existence easily becomes unstable. Some of them might be too scared and crushed by 0 this instability, while others likely will develop various pathological defense mechanisms to ensure their mental survival. Furthermore, people in a culture that has never emphasized the articulate communication of feelings, because it is assumed that understanding will occur without such effort, will be lost when such communication fails. They will not know how to effectively seek help, either. I cannot help but feel that this is what is happening in many corners of modern Japan.

APPROACHING MENTAL HEALTH FROM A PROFESSIONAL PERSPECTIVE 0 The fundamental mechanisms of human distress may be universal, but there also exist culture-speciﬁc dimensions in the ways human distress is expressed, responded to, and coped with. Then what should Japan do to deal with its own psychological crisis, which may only escalate in the years to come? To ﬁll the vacuum left by discredited traditional cultural support systems, Japan must come up with some other methods to help, salvage, and heal its people. Japan as a society as well as each individual has to do something. This issue cannot be successfully dealt with unless efforts are made on both levels. 0 Japan has long depended on traditional institutions such as family and community when it comes to resolving personal and psychological problems. This was believed to be the Japanese way, and ergo, the best way. However, because of such a belief, professionalization of social work and, subsequently, mental health treatment, has been seriously undeveloped when compared with other highly-industrialized societies. This is also 6 partly the result of government social policy in the 1970s and 1980s, 7 which was intended to dissuade citizens from developing dependency on 8 publicly-run support systems similar to those in existence in European 9 nations. Instead, in times of crisis, the Japanese were subtly encouraged to 0 turn to family, community, and companies as the major agents of social 1 2 146 2831_CH05.qxp 6/4/09 1:12 PM Page 147

Japan’s “Lonely People” 1 2 welfare. Turning to these institutions was considered to better fit the style 3 of Japanese society, whose citizens were supposed to be equipped with a 4 strong national character and solid family ties. This style was also consid- 5 ered to reflect traditional Japanese values stemming from the country’s 6 “unique” history and “natural” division of labor based on gender. 7 Furthermore, stigma was implicitly attached to receiving welfare from 8 sources other than oneself, family, communal solidarity, or the workplace. 9 This ideology was called the “Japanese-style welfare society,” and of course, 1 women were defined as the primary agent of welfare service delivery inside 1 the home.23, 24 However, how much can the Japanese rely on family, com- 2 munity, and companies today? As has been discussed, institutions that were 3 considered the major agents of social welfare have weakened and started 4 to falter. 5 It is clear that more aggressive professional intervention is needed in 6 many areas of human distress. It is also important to present and support 7 a framework that enables the people to make use of these services when 8 they are available. In order for this to happen, it is essential that patho- 9 logical behavior be understood and interpreted in a way that makes 2 people more willing to accept (or be open to) professional assistance and 1 intervention. 2 There are different ways for people to interpret mentally-rooted 3 deviant behavior. Haslam presents four major social-cognitive models of 4 lay people’s attitudes toward mental disorder: pathologizing, moraliz- 5 ing, medicalizing, and psychologizing. Pathologizing is to judge certain 6 behavior simply to be abnormal or deviant and points to the presence of 7 cause of the abnormality within the person, though it does not explain 8 what actually caused the symptoms. It produces psychiatric classifica- 9 tion and social categorization. Moralizing is to judge and blame the per- 3 son for being morally accountable for his abnormality and his deviant 1 behavior. It assumes that the deviant behavior is voluntary and derives 2 from intentions, reasons, and desires. Therefore, unintentional or less 3 intentional behavior due to uncontrollable factors such as sickness is not 4 blamed. On the other hand, medicalizing, a mainstream explanatory 5 framework in highly-advanced Western societies, judges the abnormal- 3 ity as based on somatic or physiological causes outside the person’s con- 3 trol. As biomedical understanding of mental disorders is increasingly 3 becoming the dominant perspective in psychiatry today, the medicaliz- 3 ing perspective assumes that the deviance exists as a specific bodily 4 4 147 4 2831_CH05.qxp 6/4/09 1:12 PM Page 148

Mental Health Challenges x aberration like a natural phenomenon, discrete from the personhood. Psychologizing uses mentalist explanations for deviant behavior without moralizing, but re-describes them with psychological or intrapsychic concepts. It also refers to causal connections the person is not aware of. Different cultures and societies adopt these frameworks with different emphases, depending on the level of Western influence and the degree to which the society has retained traditional attitudes.25 0 All these perspectives are found among Japanese lay people. Normally, more than two perspectives are combined to understand a disorder, even though they may contradict each other. For example, when the families of mentally-ill patients try to understand why their loved ones became mentally ill, they are never absolutely confident about the explanations they have reached themselves. They often waver between different explanatory models, such as the patient’s dysfunctional family environment, parenting practices and later life traumas, as well as seeking genetic causes – a more medicalized perspective – as the reason for the emergence of the mental disorder. Furthermore, spiritualization of mental disorder is not uncom- 0 mon among Japanese families: some karmic cause such as wrongdoing in a past life can be blamed for introducing a mental disorder to the family’s present life. It is unsurprising that families seek and eventually cling to explanations that are easy for them to accept and offer some hope, even if they are not correct. However, the lack of information and visibility of mental health professionals in most Japanese communities, and the less medicalized perspective in Japanese society in general, means it is difficult for sufferers and their families to find a psychiatric link to abnormal or deviant behavior. Therefore, in Japan it takes longer for sufferers to get the medical care they need, and families and patients are likely to feel 0 extremely isolated. This only intensifies their distress and leaves them trapped in a vicious circle.26 There still seems to be a strong propensity in Japan to see deviant behavior caused by mental afflictions to be a moral problem affecting the individual, at least when problems first arise. Not only does moralizing often miss the core of the problem, but it gives no solution or help 6 to the individual or those closely associated with him or her. Those 7 who show deviant behavior triggered by alcohol or drug dependency 8 are blamed for their “weak” character and told to toughen up. Their 9 determination to change is important, but what is needed to help 0 them is a therapeutic and medical approach. However, the associated 1 2 148 2831_CH05.qxp 6/4/09 1:12 PM Page 149

Japan’s “Lonely People” 1 2 shame also prevents individuals and their families from seeking the 3 appropriate support from outside sources in a timely manner. Complex 4 problems, such as mental disorders as well as psychologically-based 5 deviant behaviors, can never be comprehended by moralizing, which is 6 a dominant reaction in traditional societies where medical knowledge 7 is lacking. In Japan, it seems to me that perspectives based on more 8 psychologization and medicalization are needed to cope with the sharp 9 rise in mental disorders. Both of these perspectives are inherent in the 1 professionalization of mental care. 1 For example, discussions of hikikomori have taken place from differ- 2 ent interpretative perspectives. Information from the most reliable and 3 widely accepted sources all cautiously avoids sounding deterministic 4 about what causes hikikomori. Guidelines issued by the Ministry of 5 Health, Labor, and Welfare start by pointing out that hikikomori is a 6 vague concept referring to a certain condition, not a clear psychiatric 7 diagnosis, and emphasizes that hikikomori patterns are quite diverse and 8 varied, and therefore, hikikomori can be triggered by various reasons. It 9 also says that hikikomori itself is not one peculiar phenomenon and 2 occurs when for some reason one “cannot adapt to the surrounding 1 environment.” It concludes that hikikomori is an issue related to men- 2 tal health caused by a combination of biological, psychological, and 3 sociological factors. 4 A pamphlet published by Tokyo Metropolitan government titled 5 “Futo–ko– (School avoidance) and hikikomori during adolescence and 6 young adulthood: how to understand and deal with it” first introduces 7 the concept by referring to the developmental phases of human beings. 8 It says that adolescence and early adulthood are the most sensitive and 9 confusing periods of one’s life, and tend to make everyone somewhat 3 unstable. Another easily accessible source, NHK’s hikikomori web site, 1 also emphasizes that hikikomori is not a specific disease or disorder, but 2 a certain “condition,” which is caused by various factors. It also says 3 there are cases in which no specific reasons have been detected, and it 4 can happen to anyone. The tone reminds us of the official viewpoint 5 presented by the Ministry of Education in 1992 that futo–ko– could 3 happen to any child. These public information sources have touched on 3 the possibility of disease. Many in fact at least mention that some types 3 of hikikomori can be psychiatric illnesses, including schizophrenia, 3 depression, compulsive obsessive disorder, various types of phobia, and 4 4 149 4 2831_CH05.qxp 6/4/09 1:12 PM Page 150

Mental Health Challenges x personality disorders. But the lack of one clear definition, the presenta- tion of multiple reasons as a possibility, and the mixing of messages that it can be disease or it can happen to anyone or that it is not a psychiatric disease, are the source of great confusion to most lay people, who are not well educated in mental health issues. These contradictory messages of course reflect the level of understanding of hikikomori even among professionals. 0 The most striking example of this is the web site of Hikikomori KHJ Oya no Kai (Hikikomori Sufferers’ Parents’ Group) which was established in 1999 by Masahisa Okuyama, the father of a long-time hikikomori sufferer. This group’s clearly stated purposes include “exchange of information on treatment,” “access to psychiatric drugs through parents’ meeting with doctors” and “assistance in applying for disability pension as a mentally-handicapped person.” The website’s homepage has the organization’s slogan: “A wake-up call from hikikomori sufferers. Any child or young man can develop neurosis!” As you can see, it goes straight to the issue of mental disorder. In fact, 0 KHJ stands for kyo–haku shinkeisho– (obsessive compulsive disorder) higaimôsô (paranoiac delusion), and jinkaku sho–gai (personality disorders). In their explanations of what hikikomori is, a whole range of psychiatric illnesses are presented, which even includes the possibility of chronic fatigue syndrome, an ailment not yet well known in Japan. The group’s attitude appears first to view hikikomori precisely from a psychiatric standpoint, arguing it needs medical intervention. However, it also presents a contradictory message by asserting that it can happen to anyone. And along with a number of support sources for hikikomori sufferers and their families, a famous Buddhist temple in Ko–yasan, 0 the spiritual headquarters of a Shingon Buddhism sect that offers seminars and rehabilitation programs, is introduced as a supporter of this group. The problem is that hikikomori is not yet clearly positioned within a medical or psychiatric framework in Japanese society. The question of “should it be treated as a disease or not?” has often been raised 6 among professionals and families of hikikomori sufferers. Of course, the 7 development of many illnesses can be influenced by non-biological or 8 non-physiological factors, such as social and psychological factors. But 9 in public discussions of hikikomori, even if the medical perspective is 0 included as a part of the explanations, it is constantly presented quietly, 1 2 150 2831_CH05.qxp 6/4/09 1:12 PM Page 151

Japan’s “Lonely People” 1 2 and unlike other diseases, non-medical factors are offered as equally 3 significant causal factors. 4 This is how the phenomenon is currently grasped in Japan. It may be 5 very “Japanese” to prefer a non-medicalized explanatory model of this 6 deviant behavior. It is possible the same phenomenon would be divided 7 into different symptoms and given medical labels and specific treatment 8 in Western countries, where such a vague social label as hikikomori 9 would not be created or popularized. The fact that many Japanese 1 people still use training programs to “fix” or “correct” deviant behavior 1 implies that a moral approach to psychological disorders is more accept- 2 able and favored. Of course, the problem is that there is not yet reliable 3 data on the percentage of hikikomori sufferers who have psychiatric 4 disorders. In fact, to come up with an accurate figure seems impossible 5 since there are still too many gray areas with regard to this phenomenon. 6 The same is true with violence by children in the home. There is a 7 possibility that child-authored violence is an early symptom of some 8 psychiatric disorder, or those concerned could be suffering from serious 9 psychological problems needing professional help. In any case, it is 2 wishful thinking to see violence toward family members as a “phase” 1 that adolescents go through or that will pass in time. Similarly, it is not 2 an issue of family environment alone, and in fact is a crisis that needs 3 the immediate intervention of specialists or even the police. 4 On the other hand, within a medical or psychiatric framework, 5 clearer definitions of these conditions are available and gray areas disap- 6 pear. From a psychiatric point of view, hikikomori is not uncommon. 7 For example, Zenkaren (The National Federation of the Family of the 8 Mentally Ill) publishes periodicals promoting understanding of hikiko- 9 mori’s psychiatric symptoms and treatment options. One issue pub- 3 lished in 1998 (before the word hikikomori was known to the general 1 public) focused solely on hikikomori. The article clearly discussed it as a 2 condition that could develop after the acute phase of developing a psy- 3 chotic illness. In the case of schizophrenia, for example, after the acute 4 stage was treated by medical professionals and the most disruptive 5 symptoms subsided, many families did not dare to struggle to further 3 improve the life of the patients, who then withdrew from social contact. 3 Of 1,570,000 people with mental disorders as of 1994, a cautious 3 estimate was that tens of thousands of patients were in a state of hikiko- 3 mori.27 As we can see, a huge gap exists between a medical professional’s 4 4 151 4 2831_CH05.qxp 6/4/09 1:12 PM Page 152

Mental Health Challenges x view of hikikomori and the explanation preferred by lay people. The greater the gap is, the longer it takes to bring a solution to the situation. What creates this gap and why is it so difﬁcult to narrow it?

STIGMA AND SHAME: BARRIERS TO BETTER TREATMENT A persistent stigma toward mental illness and the accompanying fear 0 and shame of developing it form a great barrier against accepting that deviant behavior is the result of mental illness. Of course, stigma and prejudice toward mental illness exists across the world, but ignorance and fear are particularly strong in Japan. Most people do not know the difference between a psychiatrist and a psychologist. In their view, both treat mental problems in “crazy” people, and should be left to their own devices. These simplistic and grossly inaccurate views of the professions and the mechanism of human mind predominate in Japan, leading most people to shun any involvement with the ﬁeld. A cross-cultural 0 study on the adjustment of families to psychiatric patients’ illness has revealed that Japanese parents are hit with two particular forms of stress: they blame themselves for their child’s condition, and worry about the implications of the illness on the marriage prospects of their healthy children, thanks to the strong fear of hereditary illness that exists in Japan.28 This prejudice is a major hurdle to the spread of the highly medicalized perspective that is widely accepted both in the United States and Japan among mental health professionals and those well educated in mental health issues. This view, which sees the cause of serious mental 0 illnesses, especially psychotic illnesses, as located in the area of brain chemistry and other physiological afﬂictions that are beyond one’s control, has been instrumental in both countries in reducing parents’ sense of guilt and the social stigma attached to sufferers. It also has made moralizing almost impossible, because linking mental illness to a “brain disorder” removes any suggestion of choice on the part of the sufferer 6 by placing it on the same level as other bodily diseases such as cancer 7 and strokes. 8 But problems remain. The Japanese obsession with, or hypersensi- 9 tivity to, genetic background and the belief that one member’s mental 0 illness could impact on the entire family’s future means that accepting 1 2 152 2831_CH05.qxp 6/4/09 1:12 PM Page 153

Japan’s “Lonely People” 1 2 a perspective based on medicalization, or a biogenic explanation 3 model, remains far off. In a culture where intergenerational links 4 are regarded as important not only psychologically but also biologically, 5 it requires a delicate balancing act to medically understand the mental 6 disorder and at the same time work around the associated social 7 stigma.29 8 Despite their great knowledge of the problem, medical professionals 9 in Japan have been guilty of astounding tactlessness, and need to be 1 aware of how sensitive families are to, and fearful of, social stigma. A 1 family with a daughter suffering from hikikomori (who was twenty years 2 old at the time and clearly suffering from schizophrenia) refused her 3 treatment for ten years because when they visited a psychiatrist soon 4 after their daughter had become withdrawn, the doctor told them 5 she probably had schizophrenia and would never be able to marry. The 6 parents were so distraught by the doctor’s insensitivity they never 7 returned.30 8 A social environment that triggers intense fear and painful emotions 9 when it comes to mental disorders naturally makes it extremely difficult 2 for people to seek help. A number of people who worked themselves to 1 death by karoshi or karojisatsu might have been saved if they had had a 2 more medicalized perspective of their depressed state and no hang-ups 3 about going to a mental health professional for help. It is difficult but 4 crucial to come up with ways to educate the public on mental health in 5 a way that encourages people to seek appropriate care before it is too 6 late. This, in my view, is the responsibility of society; it needs to spread 7 a more medicalized perspective of mental health that reduces stigma 8 and fear. 9 Medicalization as an approach to mental illness has not been free of 3 criticism, and such positions have attracted some vociferous support 1 in some highly-industrialized Western societies. The first major critic of 2 the medicalization of human suffering was Thomas Szas, whose theory 3 of nonschizophrenia or antipsychiatry became popular in some circles 4 in the 1970s. Szas cast radical skepticism into the whole concept of 5 modern psychiatry. Comparing modern psychiatry to witchcraft and 3 demonology, he claimed “mental illnesses” could not be proven objec- 3 tively, and in fact psychiatry was a field that simply dealt with various 3 human “problems of living,” or deviations from psychosocial, ethical, 3 and legal standards. According to Szas, it was absurd and wrong to seek 4 4 153 4 2831_CH05.qxp 6/4/09 1:12 PM Page 154

Mental Health Challenges x solutions for these non-medical problems in a medical or even therapeutic framework, as it misleadingly disguised the real human struggles of life. Therefore, he declared there was no such a thing as mental illness, and the concept itself was a myth.31 But while Szas’s contention may appeal to a stereotypical view of “shrinks” feeding off the insignificant neuroses of pampered North Americans, impressive progress in the bio- medicine, pharmacology, and measurement technologies since he wrote 0 Ideology and Insanity have shown that some serious mental illnesses do have biological origins and clearly physiological causes. Medicalization is also under attack from social scientists, who are concerned it is emerging as a way to explain away deviance in contemporary society. Especially when the medicalization model is used in the field of criminal justice, it can create an argument that people who commit a criminal act should not be punished or accused because they are sick and not fully responsible for their behavior.32 Lasch, too, criticizes the spread of a psychotherapeutic perspective and the way it has become the dominant standard of judging personal 0 happiness. He argues that it has become a new religion and has contributed to the development of a narcissistic tendency across society. In this view, the traditional concept of love as being based on the idea of self-sacrifice is likely to be viewed as outdated and as an oppressive obstacle to one’s ultimate well-being, standing as it does in the way of one’s emotional needs, immediate gratification or impulses.33 Furthermore, critics in Japan see the introduction of a Western psychotherapeutic perspective as problematic because, in reviewing one’s life from childhood, a sense of being traumatized by family interactions is often uncovered. As might be imagined, going over one’s life and crit- 0 ically reexamining the dysfunctional family environment one grew up in does not play well in a society that puts strong emphasis on filial piety and indebtedness to everyone as the base of virtue and morality. In fact, going into the past to understand present problems and to develop one’s true sense of independence may appear to be blaming one’s parents, sev- ering emotional ties with them, and becoming ungrateful, even though 6 this is not the goal of psychotherapy. 7 Makiko Ozawa expresses strong concerns about the recent popular- 8 ity of psychotherapy among young people in Japan and the growing 9 psychologization of human problems. She has no time for the funda- 0 mental premise of psychotherapy, seeing it as an activity that leads one 1 2 154 2831_CH05.qxp 6/4/09 1:12 PM Page 155

Japan’s “Lonely People” 1 2 to develop dependency on a very artificial and skillfully manipulated 3 relationship with a therapist, which is far removed from real human 4 interactions. What is more important, she suggests, is to create social 5 and political solutions for these problems.34 6 It is undeniable that countries such as the United States have seen 7 many people turn to psychotherapy and signs of psychotherapeutic 8 culture, to the extent that an occasional critical check – such as that 9 performed by Szas – is necessary to remove overdependence on the 1 industry that has grown. However, Japan is far from needing this reality 1 check. It was only in the mid-1990s when the average Japanese person 2 started to hear about “kokoro no ke-a (mental or psychological care),” 3 in part thanks to the 1995 Great Hanshin earthquake and a series of 4 violent incidents at schools and in communities. Until then, the term 5 “Post Traumatic Stress Disorder” was unknown to the man on the street, 6 and mental health professionals such as psychiatrists and psychologists 7 were rarely asked to comment in the media. This has changed, and 8 there appears to be more awareness and information available now than 9 ever before. 2 But the reality is that a majority of people still do not connect their 1 problems to psychological causes, even when all the evidence points in 2 that direction. When the problem is of a psychiatric nature, they may 3 further try to ignore it, helped by the fact that information about and 4 access to reliable, qualified mental health specialists is not easily avail- 5 able. A licensing system for the profession was only established in 1988 6 by the Japanese Certification Board for Clinical Psychologists, and just 7 as the majority of Japanese remain ignorant and uneducated about most 8 psychiatric pathologies, they are also unaware this qualifying system 9 exists. However, even this certification is not a part of the state-licensing 3 system such as exists for medical doctors and lawyers. 1 Due to its relative obscurity, it is hard for people in Japan to see 2 psychopathology or psychiatry as a highly trained and established 3 profession. When a problem of a psychiatric nature occurs, they try to 4 solve it in their own way, often postponing contact with outside help, 5 hiding, and resorting to completely non-medical “cures,” whether they 3 are religious or disciplinary. Stigma and shame are strong enough to pre- 3 vent them from seeking necessary help when needed. Ironically, many 3 Japanese nowadays talk of how to reduce their stress at work and home, 3 and how to reduce their fatigue. An extensive “healing” industry has 4 4 155 4 2831_CH05.qxp 6/4/09 1:12 PM Page 156

Mental Health Challenges x emerged in recent years, which provides various services from health foods, aromatherapy, massage, fortune-telling to spiritual or psychic counseling – services that often confuse recipients who think they are paying for legitimate psychological counseling. Since these businesses use extensive advertising or other means to ensure they are highly visible, the average Japanese person is more likely to turn to them for a short-term ﬁx to his or her stress. 0 The bottom line is that Japan is far from the medicalized society that exists in Western nations when it comes to dealing with mental problems. Criticisms against the over-medicalization of society that may have some validity in the United States, for example, do not yet apply to Japan. In fact, I feel it is twenty years too early for Japan to worry about the negative impact of the medicalization of human distress. In Japan, it is very uncommon to hear the view that repeat sexual offend- ers or chronic shoplifters need therapy rather than, or at least together with, punishment. Most forms of substance addiction, including alcoholism and other addictive behavior such as gambling, cannot be treated 0 without professional, therapeutic intervention. All these problems are still regarded as a matter for individuals to conquer through strength of personality. Such a view is not only of no help to the individual, but also does nothing for society. It may be humbling to remind ourselves that until a couple of centuries ago, schizophrenia was widely believed to be a form of spiritual possession. Modern medical discoveries and technological advancements have made it possible to see it as a biologically- based ailment. Who can deny the possibility that people suffering from personality disorders may lack some impulse control mechanism in their brain that has not yet been discovered? Ideological discussions 0 on the pros and cons of psychologization and medicationalization of human distress are intellectually stimulating. However, when one looks at the reality facing Japanese society, in which people do not know where to go for help and every day, in hospitals across the country, doctors are dealing with sick people who should have been treated much earlier, such ideological jousting appears to be a luxurious waste of time. 6 What Japan needs to do is establish a proper and efﬁcient system so that 7 any individual can get the professional care he or she needs. To elimi- 8 nate social stigma, the public needs to be better educated so it under- 9 stands the relationship between psychological/psychiatric problems 0 and deviant behavior. 1 2 156 2831_CH05.qxp 6/4/09 1:12 PM Page 157

Japan’s “Lonely People” 1 2 WHAT INDIVIDUALS NEED TO DO 3 4 Even though these efforts should be made on a social level, Japanese 5 individuals must be willing to accept the changes made and also to 6 change their ways: how they relate to others at work, home, and in their 7 communities, and, more importantly, how they relate to themselves. It 8 seems that establishing a sense of individuality has been a theme repeat- 9 edly discussed and questioned among Japanese intellectuals since the 1 beginning of the Meiji era, when encroachment of Western people and 1 their ideas forced the Japanese to recognize different values and ethical 2 viewpoints. 3 Kawai, in asserting the predominance of the “maternal principle” – 4 under which individuals value and appreciate fatalistic and insepa- 5 rable approaches to issues and prefer unspoken ties of affection – says 6 the Japanese need to be aware of the importance of the “paternal 7 principle” – more logical and based on standards for good and bad, 8 and personal independence – in their relationships with others. Those 9 Japanese who actively try to escape the maternal principle often go too 2 far, however, and mistakenly believe that stressing one’s individuality 1 is best achieved by dissolving any intimate relationships one has and 2 leading a self-centered, isolated life.35 3 A genuinely independent person is someone who has a solid sense of 4 self and still can enjoy close relationships. It is still difficult for many 5 Japanese, as Kawai has stated over a number of years, to distinguish 6 between independence and isolation. The confusion occurs when the 7 individual is still very sensitive to the overwhelming power of interac- 8 tions based on the maternal principle. It is only regarded as the threat to 9 their individuality. In this situation, a person may leave a group domi- 3 nated by the maternal principle, but then find himself or herself recre- 1 ating a similar circle, based on similar principles, but with different 2 people. Of course, the Japanese have acquired the ability to critically 3 approach and analyze most situations that require a rational approach. 4 But when it comes to very personal and intimate relationships, they 5 easily slip back to the warm embrace of the maternal principle.36 An 3 inability to find the right balance between the maternal and paternal 3 principles is causing so much strain among the Japanese. Those who 3 avoid interactions with other people are also afraid of being sucked into 3 the pressure of shigarami they cannot handle. 4 4 157 4 2831_CH05.qxp 6/4/09 1:12 PM Page 158

Mental Health Challenges x It is also time for the Japanese to learn to confront and reexamine things they take for granted, such as family life. When we feel something is wrong, it takes great courage to face it head on, especially if it is something we are used to – for better or worse. Challenging inertia is a tough job. It may shake the foundations of something we want to embrace for ever. An overwhelming desire to keep up appearances as if everything is going well may be a profound part of ie culture and a 0 shame-sensitive society. Traditionally, the Japanese have preferred to take the situation as it really is and avoid focusing their attention too much on the problem or deliberately changing the source of the problem. Instead, to wait patiently until a different situation arises has generally been considered a desirable coping style. This is no longer viable. The social upheavals of the last fifteen years have meant that primary relationships in the home cannot afford to be smothered in denial – the risks of explosive anger and frustration are too great. Not least, such obfuscation and procrastination is seriously damaging to children’s mental welfare. When the impact on the next generation is 0 so potentially dangerous, the situation needs serious repair. For me, what it boils down to is the need for the Japanese to first realize they need to reestablish a healthy sense of boundary between the individual and others, and second, to learn how to do this. The whole self-boundary concept sounds as if it goes against core Japanese cultural definitions of idealized personhood, religion, and cosmology. These seem to emphasize the importance of eliminating self-consciousness, and stress a sense of oneness with nature or whatever the object of interaction is. Japanese personhood has been defined by a kind of permeable self into which significant others’ existences can be incorporated easily. 0 No doubt, this characteristic has been a great strength on numerous occasions throughout Japanese history. However, when a culturally weak sense of boundary results in negative consequences and creates much distress in the everyday social world, members of society must be reminded that, first and foremost, they are responsible for their own existence, separate from others. They need to relearn to be individuals, 6 whose destiny is their own responsibility. Problems such as working 7 oneself to death, of parents over-identifying their life goals with those of 8 their children, or children’s pathological outbursts of anger and frustra- 9 tion against their parents, might have been avoided if a clear boundary 0 between the self and others had been drawn. 1 2 158 2831_CH05.qxp 6/4/09 1:12 PM Page 159

Japan’s “Lonely People” 1 2 The Japanese need to realize what is most important in life, and to 3 grow into individuals who have the courage to follow through on these 4 beliefs. In an age of growing uncertainty, this seems to be the only way 5 for true survival. This individual may need to fulfill Reisman’s criteria 6 as the personality type best suited to deal with the coming era: the 7 autonomous type, which can conform to the expectations and norms 8 of the society but deep down is autonomous enough to be aware that 9 he or she can exercise free will in choosing the best action or course. 1 If the basis for the development of the independent and autonomous 1 Western self is Christianity, it has ultimately formed the foundation for the 2 Western outlook on life, social structure, and how human relationships are 3 conducted. Even though most highly industrialized Western societies have 4 grown secularized in the last century, individuals from these societies 5 cannot escape this spiritual tradition when critical life decisions need to 6 be made. Similarly, no matter how “modern” the Japanese are, they cannot 7 completely dispel from their consciousness Confucian ethics and the 8 maternal principle-based approach toward intimacy. For a Western indi- 9 vidual, it is the relationship with God (or God-like principles) that ulti- 2 mately matters. This is what gives him a sense of permanence, security, 1 and autonomy. Therefore, the criteria for his action is directed somewhere 2 on the vertical line between him and the one universal God positioned 3 far above himself. However, the Japanese have never lived in a world in 4 which the autonomous self is the first priority. Instead of turning to one 5 almighty God-like image for their salvation, the Japanese individual histor- 6 ically has acted in accordance with criteria directed horizontally between 7 himself and his immediate social circle. The tangible and concrete pres- 8 ence of other human beings and groups has allowed Japanese to nurture a 9 strong awareness of being collectively-minded and mutually dependent. 3 Morality has been traditionally grounded within this context. 1 I am not advocating that the Japanese acquire a Western sense of self or 2 convert to Christianity. The latter suggestion would anyhow, suffer the pit- 3 falls of all Japanese religious organizations, in that whatever they intend, 4 they inevitably develop an extremely hierarchically-conscious, Japanese- 5 group mentality that emasculates the original principles of the religion. 3 Instead of something new, they end up creating another small village filled 3 with shigarami, and faith is rapidly relegated to a minor diversion. 3 In this era of rapid change and as the presumptions on which the pre- 3 vious generations built society are repeatedly undermined, the Japanese 4 4 159 4 2831_CH05.qxp 6/4/09 1:12 PM Page 160

Mental Health Challenges x have to create a new sense of independence that can coexist alongside a traditional Japanese self. How can such a new Japanese self be created and sustained in a culture that has never held one absolute universal principle? It may be made possible by first learning to come face to face with one’s inner self, accepting and embracing one’s existence, and being unafraid to ask the most fundamental question: why are we here? Post-war materialism, in over emphasizing tangible and measurable 0 goals, has succeeded in pretty much destroying something the Japanese had cherished for most of their history: a kind of faith in the intangible. Even without a monotheistic tradition, Japanese life was guided by many internalized virtues and by a faith in something greater than human existence. It was a sense of personal spirituality that would allow each individual to find a space in the universe and give him or her an ultimate reason for living. One may be able to find it today in an established religion such as Christianity, Buddhism, through other sources such as philosophy and nature, or through one’s own experiences. It is up to the individual. But it may be increasingly important for each 0 Japanese to find his or her own spiritual core, something he or she can call an ei-en no do–hansha, an eternal companion, to borrow Kawai’s expression. Otherwise, the Japanese will continue to live a lonely and lightless existence.

NOTES 1 Tofﬂer, A., 1971, Future Shock. Bantam Books, p.373. 2 Inkeles, A., 1998, One World Emerging? Convergence and Divergence in Industrial Societies. Colorado: Westview Press Boulder. 3 Ohara, K., 1998, . (The era of depression). Kodansha Shinsho. 0 4 Nishizono, M., 2005, “Culture, Psychopathology and Psychotherapy: Changes Observed in Japan” in Asian Culture and Psychotherapy, Implications for East and West. W.S. Tseng, S. Chang, and M. Nishizono (eds.). Honolulu: University of Hawaii Press, pp.40–54. 5 Ibid. 6 Mori, S., 1995, . (Between the normal and the abnormal: Psychopathology of the borderline). Kodansha Gendai Shinsho. 6 7 Nishizono, M., ibid. 7 8 Mori, S., ibid. 8 9 Nishizono, M., ibid. 9 10 Isobe, U., 2003, . 0 (It may be a personality disorder. Why can’t I be normal?). Bunsha Shinsha. 1 2 160 2831_CH05.qxp 6/4/09 1:12 PM Page 161

Japan’s “Lonely People” 1 2 11 AllPsych Online http://allpsych.com/disorders/personality/index.html accessed on 3 April 18, 2008. 4 12 Diagnostic and Statistical Manual of Mental Disorders 4th ed. 2000, Washington: American Psychiatric Association, pp.685–729. 5 13 AllPsych Online http://allpsych.com/disorders/personality/antisocial.html accessed 6 on April 18, 2008. 7 14 AllPsych Online http://allpsych.com/disorders/personality/borderline.html accessed 8 on April 18, 2008. 15 Diagnostic and Statistical Manual of Mental Disorders 4th ed. ibid. 9 16 AllPsych Online http://allpsych.com/disorders/personality/narcissism.html accessed 1 on April 18, 2008. 1 17 Mori, S., ibid. 2 18 Isobe, U., ibid. p.150. 19 Lowen, A., 1997, Narcissism: Denial of the True Self. Touchstone Books, 3 Introduction, p.x. 4 20 Lasch, C., 1979, The Culture of Narcissism: American Life in An Age of Diminishing 5 Expectations. New York: W.W. Norton & Company, 1991, pp.36–7. 6 21 Minami, H., 1983, . (Japanese self). Iwanami Shoten. 22 Nakamura, H., 1985, Ways of Thinking of Eastern Peoples: India-China-Tibet-Japan. 7 Honolulu: University of Hawaii Press. 8 23 Goodman, R., 2000, Children of the Japanese State:The Changing Role of Child Protection 9 Institutions in Contemporary Japan. London: Oxford University Press, pp.24–7. 2 24 Meguro, Y. and H. Shibata, 1999, (Corporatism and family) in Meguro, Y. and H. Watanabe (eds.), 2 (Sociology course 2 1 Family). Tokyo University Press, pp.59–88. 2 25 Haslam N., 2005, “Dimensions of Falk Psychiatry,” Review of General Psychology, 3 Vol.9 No.1, 35–47. 4 26 Kawanishi, Y., 2006, Families Coping with Mental Illness: Stories from the US and Japan. New York: Routledge. 5 27 Komatsu, M., 1998, (On hikiko- 6 mori from the family perspective). Zenkaren Information Review Journal, published 7 by Zenkaren (National Association of the Families of the Mentally Ill). No.22, p.6. 8 28 Kawanishi, Y., ibid. 29 Ibid. 9 30 Kasuga, Takehiko, 1998, (Home visit of 3 hikikomori suffers), Zenkaren Information Review Journal, published by Zenkaren 1 (National Association of the Families of the Mentally Ill) No.22. pp.34–5. 2 31 Szas, T., 1970, Ideology and Insanity. Garden City NY: Anchor Books. 32 Lauer R.H., and J.C. Lauer, 1998, Sociology: Contours of Society. Roxbury 3 Publishing Company, p.202. 4 33 Lasch, C., ibid. p.13. 5 34 Ozawa, M., 2003, . (We don’t need mental health special- 3 ists). Yosensha. 35 Kawai, H., 2002, . (Thinking about family relations). 3 Kodansha Gendai Shinsho, p.160. 3 36 Kawai, H., ibid. 3 4 4 161 4 2831_bib.qxp 6/4/09 1:14 PM Page 162

Bibliography 0

NB. Japanese language books in the following list were all published in Tokyo, unless speciﬁed otherwise. Abe T., 2004, . (Psychiatry of the sexless). Chikuma Shobo Publishing. AllPsych Online http://allpsych.com/disorders/personality/index.html accessed on April 18, 2008. AllPsych Online http://allpsych.com/disorders/personality/antisocial.html accessed on April 18, 2008. AllPsych Online http://allpsych.com/disorders/personality/borderline.html accessed on April 18, 2008. 0 AllPsych Online http://allpsych.com/disorders/personality/narcissism.html accessed on April 18, 2008. American Psychiatric Association (2000), Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington DC. Asahi.com 2005, (A half of the companies say mentally ill employees increased) www.asahi.com/health/news accessed April 15, 2005. Asahi.com 2005, 9 (90% of doctors use euphemistic expressions for depression diagnosis) http://www.asahi.com/life accessed May 18, 2005. Asahi.com 2005, 20% (Health and Labor Ministry aims at 20% reduction of suicide by depression) http//www/ 0 asahi.com/health/news accessed June 11, 2005. Asahi Shimbun 1993, Q&A 46 (Q&A on 46 cases of hikikomori published by a private counselor in Chiba) May 14. —— 1998, (Lower hurdle against extramarital affairs or divorce), January 1. —— 2007, 3 (One third of couples sexless. Found by the Ministry of Health and Labor research section). http:// www/people.ne.jp/2–7/03.18/jp20070318_68918.html accessed March 18, 2007. 6 —— 2007, 5400 4 1 20 (Net Café Refugees 7 5400. One fourth in their twenties), August 28. 8 Asahi Shimbun Weekly AERA 2004, Sex (Don’t hate sex, young 9 people!). May 3, pp.16–19 —— 2004, (Though 0 sexless, we are a close couple). August 2, pp.18–19. 1 2 162 2831_bib.qxp 6/4/09 1:14 PM Page 163

Bibliography 1 2 —— 2005, . 3 (On performance evaluation. Drifting personnel management of 4 Japanese corporations and wage system), June 13, pp.12–17. 5 —— 2005, (Sexless: men’s honest opinions), October 31, pp.34–8. 6 —— 2005, (Sexless: women ﬁght back), 7 November 7, pp.37–40. 8 Becker, H. S., 1966, Outsiders: Studies in the Sociology of Deviance. New York: Free Press, 9 quoted in Sociology: A Down to Earth Approach 2nd ed. (1996) by J. M. Henslin. Boston: Allyn and Bacon. 1 Benedict, R., 1954, The Chrysanthemum and the Sword: Patterns of Japanese Culture. 1 Tokyo: Tuttle. 2 (The white paper on middle and small sized corporations) 2002, 3 http://www.meti.go.jp/hakusho/chusyo/H14/01-01-06-01.html accessed April 19, 2008. 4 Doi, T., 1973, Anatomy of Dependence. Tokyo: Kodansha International. 5 Dore, R., 1973, British Factory-Japanese Factory: The Origins of National Diversity in 6 Industrial Relationship. Berkeley: University of California Press. 7 Durkheim, E., 1997, Suicide. Glencoe: Free Press. Faiola, A., 2005, “Sick of Their Husbands in Graying Japan.” Washington Post, October 17. 8 Fukuda, N. 1999, 9 (Understanding School Maladjustment, from the standpoint of a school 2 counselor). Kokoro no Kagaku (Human Mind). vol. 87 Nihon Hyoron Sha, 1 pp.32–6. Genda, Y. and M. Maganuma, 2004, 2 (NEET: Neither freeter or unemployed). Gentosha. 3 Genda, Y., 2005, A Nagging Sense of Job Insecurity: The New Reality Facing Japanese 4 Youth. Tokyo: International House of Japan Inc. 5 Go, M., 2005, 32% (32% of the married sexless), Mainichi Shimbun, April 26. 6 Goodman, R., 2000, Children of the Japanese State: The Changing Role of Child 7 Protection Institutions in Contemporary Japan. London: Oxford University Press. 8 Haslam N., 2005, “Dimensions of Falk Psychiatry,” Review of General Psychology, vol.9, 9 no.1, 35–47. Hendry, J., 1995, Wrapping Culture. London: Oxford University Press. 3 Hill, R., 1958, “Generic Features of Families Under Stress” in P. Boss (ed.) Family Stress, 1 2003. Thousand Oaks: Sage Publications. 2 Honkawa Data Tribune 2005, Sex (The 3 Frequency of sex and degree of satisfaction in different countries) http://www 2.tten.ne.jp/~honkawa/2318.html accessed April 19, 2008. 4 —— http://www2.ttcn.ne.jp/~honkawa/3080.html) accessed April 19, 2008. 5 Horney, K., 1950, Neurosis and Human Growth: The Struggle Toward Self-Realization. 3 New York: W.W. Norton & Company. 3 Horvat, A., 2000, “Revisionism Revisited – The Era of Bilateral Acrimony.” Japan Quarterly, July–September, pp.33–44. 3 Inkeles, A., 1998, One World Emerging? Convergence and Divergence in Industrial 3 Societies. Boulder, Colorado: Westview Press. 4 4 163 4 2831_bib.qxp 6/4/09 1:15 PM Page 164

Bibliography x Isobe, U., 2003, . (It may be a personality disorder. Why can’t I be normal?). Bunsha Shinsha. Japan Almanac 2005, Asahi Shimbunsha Jones, M., 2006, “Shutting Themselves In”, The New York Times Magazine, January 15. Kasahara, Y., 1986, “Fear of Eye-to-Eye Confrontation among Neurotic Patients in Japan” in Lebra T. and W. Lebra (eds.), Japanese Culture and Behavior. Honolulu: Hawaii University Press, pp.379–87. Kasuga, T., 1998, (Home visit of hikikomori suffers), Zenkaren Information Review. Published by Zenkaren (National Association 0 of the Families of the Mentally Ill). no.22, pp.34–5. Kawahito, H. 1998, . Iwanami Shinsho Publishing. Kawai, H., 1981, “Violence in the Home: Conﬂict between Two principles – Maternal and Paternal.”. In Japanese Culture and Behavior. T.S. Lebra and W.P. Lebra (eds.) Honolulu: University of Hawaii Press, 1986, pp.297–306 ——, 2002, . (Thinking about family relations). Kodansha Gendai Shinsho. Kawanishi, Y., 1993, “A Cross-Cultural Analaysis of Stress Appraisal and Coping,” Ph.D. Dissertation, UCLA. Michigan: University Microﬁlm. —— 1998, “Breaking up Still Hard to Do,” Japan Quarterly, July–September, pp.84–9. —— 2006, Families Coping with Mental Illness: Stories from the U.S. and Japan. New York: Routledge. 0 Kawashima, Y., 1995, “Female Workers: An Overview of Past and Current Trends” in Fujimura-Fanselow K. and A Kameda (eds.), Japanese Women: New Feminist Perspectives on the Past, Present, and Future. New York: The Feminist Press New York. pp.271–93. Kinsella, S., 2000, Adult Manga: Culture and Power in Contemporary Japanese Society. Honolulu: University of Hawaii Press. Komatsu, M., 1998, (On hikikomori from the family perspective). Zenkaren Information Review Journal, published by Zenkaren (National Association of the Families of the Mentally Ill). no.22, p.6. Kuramoto, H., 2007, . (The youth meeting with a setback), Nihon Hyoron Sha Publishing. Kyodo News 2004, “No of alcoholic in Japan estimated at 820,000” http://www.kyodo. co.jp/ accessed June 20, 2004. 0 —— 2004, “Estimated 470,000 workers on leave due to mental problems” http:// www.kyodo.co.jp/ accessed July 4, 2004. Lasch, C., 1979, The Culture of Narcissism: American Life in An Age of Diminishing Expectations. New York: W.W. Norton & Company (reprinted in 1991). Lauer, R. H. and J. C. Lauer, 1998, Sociology: Contours of Society. Los Angeles: Roxbury Publishing Company. Lebra, T., 1992, “Self in Japanese Culture” in N. Rosenberger (ed.) Japanese Sense of Self. 6 Cambridge: Cambridge University Press, Chapter 6, pp.105–20. 7 Lowen, A., 1997, Narcissism: Denial of the True Self. Touchstone Book. Mainichi Shimbun 2001, (Premonition for pain? 8 Pessimistic future outlook), August 1. 9 —— 2004, 62% (62% of workers suffer from stress 0 and anxiety), June 2. 1 2 164 2831_bib.qxp 6/4/09 1:15 PM Page 165

Bibliography 1 2 —— 2004, 1 100 (Layoff, anxiety for 3 the old age. 100 people kill themselves a day). July 23. 4 —— 2004, WHO 10 5 (International comparison of suicide rates by WHO. The number of suicide per 100,000). October 2. 6 —— 2005, 3 7 (Employees’ mental illness increasing. Half of responding companies report 8 increases of depression for the last three years). April 16. 9 —— 2005, 3 (Performance evaluation in vain. Karo suicide. Promotion by three ranks led to 1 sharp increase of overtime). June 7. 1 —— 2006, 15 12% (15 Workers compensation 2 cases approved. Karoshi, karo-disease increased by 12%), June 1. 3 —— 2006, 82% (82% of large companies have employees on leave of absence due to mental illness). September 30. 4 —— 2006, (Society elimi- 5 nating the taboo. Suicide Prevention Law to be created). June 15. 6 —— 2007, 57% 06 66 (Karo-suicide 7 increased by 57% increase in 2006 to 66, the highest in the record). May 17. Makihara, K., 1989, “Coming to Grips with Karoshi,” Time, January 30, p.50. 8 McGray, D., 2002, “Japan’s Gross National Cool,” Foreign Policy May/June 9 http://www.douglasmcgray.com/grossnationalcool.html accessed April 16, 2008. 2 Meguro, Y. and H. Shibata, 1999, (Corporatism and family)” 1 in Meguro, Y. and H. Watanabe (eds.), 2 (Sociology course 2 Family). Tokyo University Press, pp.59–88. 2 Meguro, Y. and H. Watanabe (eds.), 1999, 2 (Sociology course 3 2 Family). Tokyo University Press. 4 Minami, H., 1983, . (Japanese self). Iwanami Shoten. 5 ——, 1996, . (Nihonjinron). Iwanami Shoten. Ministry of Health, Labor, and Welfare, 2003, (Hikikomori 6 Guideline. Research on intervention in community mental health activities) 7 http://www.mhlw.go.jp/topics/2003/07/tp0728-1.html accessed December 28, 2004. 8 Ministry of Health, Labor, and Welfare, 2004, 16 (Reality 9 of Working Women 2004) http://wwwhakusyo.mhlw.go.jp/wpdocs/hpwj200401/ body.html accessed April 19, 2008. 3 Ministry of Health, Labor, and Welfare website http://www.hakusyo.mhlw.go.jp/ 1 wpdocs/hpax200401/bIndex.html accessed February 20, 2006. 2 Miura, A., 2005, . (Lower class society). Kobunsha Shinsho. 3 Mori, S., 1995, . (Between the normal and the abnormal: Psychopathology of the borderline). Kodansha Gendaishinsho. 4 Morotomi, Y., 2002, . (Lonely Men). Chikuma Shinsho. 5 ——, 2005, . (It is painful to live: 3 psychology of the era of nationwide depression). Heibonsha Shinsho. 3 Morton, S.W., 1984, Japan: Its history and Culture. New York: McGraw-Hill. Munakata T., 1991, A (Karoshi of corporate 3 worriers and type A behaviors) in Kokoro no Kagaku (Human Mind), no.39, 3 September 1991, pp.48–54. 4 4 165 4 2831_bib.qxp 6/4/09 1:15 PM Page 166

Bibliography x Nakamura, H., 1985, Ways of Thinking of Eastern Peoples: India-China-Tibet-Japan. Honolulu: University of Hawaii Press. Nakane, C., 1972, Japanese Society. Berkeley: University of California Press. Nemoto, K., 2005, . (Afraid to get hurt). Bunshunshinsho. NHK . (NHK hikikomori information) http://www.nhk.or.jp/fnet/ hikikomori/index.html accessed April 11, 2008. Nichols, M. and R. Schwartz, 2001, Family Therapy. Boston: Allyn and Bacon. Nihon Keizai Shimbun 2008, 2007 (Company bankruptcy highest in 2007). April 19. 0 Nishinippon Shimbun Online 11 3 (The number of suicide exceeds 30,000 for 11 consecutive years). http://www.nishinippon.co.jp/wordbox/ display/6412/ accessed March 11, 2009. Nishizono, M., 2005, “Culture, Psychopathology and Psychotherapy: Changes Observed in Japan” in W.S. Tseng, S. Chang, and M. Nishizono (eds.) Asian Culture and Psychotherapy, Implications for East and West. Honolulu: University of Hawaii Press, Chapter 3, pp.40–54. Ogi, N., 2001, . (How should we see the crisis of children?). Iwanami Shinsho. Ohara, K., 1998, . (The era of depression). Kodansha Shinsho. Ohira, K., 1995, . (Psychopathology of gentleness). Iwanami Shinsho. 0 Okonogi K., 1998, . (Crisis of moratorium nation Japan). Shodensha. ——, 2005, “The Ajase Complex and Its Implications” in Tseng, W., S. C. Chang, and M. Nishizono (eds.) Asian Culture and Psychotherapy: Implications for East and West. Honolulu: University of Hawaii Press, pp.57–75. Okuni, A., 2006, (Schools in distress with students’ self- mutilation). Mainichi Shimbun, February 6. – Ono, M., 2003, . (Psychology and workplace of karoshi and karo-jisatsu). Seikyuusha. . (Husband presence stress syndromes) http://www.jili.or.jp/ lifeplan/event_type/lifeevent/marriage/10.html) accessed April 19, 2008. Oyama, N., 2008, v s . (Public assistance vs. working poor). PHP Shinsho. 0 Ozawa, M., 2003, . (We don’t need mental health specialists). Yosensha. Reisman, D., 1961, The Lonely Crowd. New Haven: Yale University Press. Reuters News 2002, “Japanese Men Shirk Housework, Study Shows” in Japan Today. http:// www.japantoday.com/e/?cpmtemt=news&id=205793 accessed March 13, 2002 —— 2005, “Japan compiles plan to curb high suicide rate” http://jp.reuters.com/ accessed December 27, 2005. 6 Ryall, J., 2004, “Japan’s Secret Epidemic” a feature report by Al-Jazeera, May 31, 2004. Saito S., 1991, (Men, work, and alcoholism) in 7 Kokoro no Kagaku (Human Mind), no.39, September pp.55–8. 8 ——, 1999, . (Family addiction). Shincho Bunko 9 Saito, T., 1998, . (Social withdrawal: endless 0 adolescence). PHP Shinsho. 1 2 166 2831_bib.qxp 6/4/09 1:15 PM Page 167

Bibliography 1 2 ——, 2003, “ SOS.” (SOS of the young mind). NHK Ningen Kooza. NHK 3 Publishing Association, August–September 2003 4 Sakagami, Y., 1999, (Youth and family: 5 being an educator and a clinician). in Kokoro no Kagaku (Human Mind). Nihon Hyoron Sha, no. 34, p.35. 6 Sakai, T., 2006, (Bureau of 7 Economy and Industry deals with difficult young employees). Mainichi Shimbun, 8 February 9. 9 Sakaiya, T., 2003, The Twelve Men who Made Japan. Tokyo: Kodansha International, pp.30–45. 1 Sanger, D., 1990, “Tokyo Tries to Find Out if ‘Salarymen’ Are Working Themselves to 1 Death.” The New York Times, March 19. 2 Sato, T., 1991, (Personality of the contem- 3 porary middle age generation) in Kokoro no Kagaku (Human Mind), no.39, September, pp.31–5. 4 Seii, S., 2005, “More moves to cut high suicide rate.” http://www. asahi.com/life 5 accessed July 18, 2005. 6 . (Husband presence stress syndromes). http://www.kyo- 7 saicc.or.jp/health/mental/SP_1/5c_pages/c5_26.html accessed April 19, 2008. Slote, W., 1998, “Psycho-Cultural Dynamics Within the Confucian Family” in 8 W. Slote, W. and G. De. Vos (eds.) Confucianism and the Family. State University of 9 New York Press. 2 Stress Disease Workmen’s Compensation Association and Lawyers National Contact 1 Conference on Karoshi, 2000, . (Rapidly rising karo jisatsu). Koseisha Publishing. 2 Sue, D., D. Sue, and S. Sue, 1990, Understanding Abnormal Behavior (3rd ed.). Boston: 3 Houghton Mifflin Company. 4 Sugimoto, Y., 2003, An Introduction to Japanese Society (2nd ed.). Cambridge: 5 Cambridge University Press. Szas, T., 1970, Ideology and Insanity. Garden City NY: Anchor Books. 6 Takahara, M. (ed.), 2004, . (Sick relations – 7 pathology of micro society). Gakubunsha. 8 Takahashi, Y., 2000, . (The middle age and mental crisis). Japan 9 Broadcasting Publishing Association. ——, 2003, . (Suicide by the middle aged and the old). Chikuma Shinsho 3 Publishing. 1 Tanaka, K., 2004, . (Mother-child adhesion and child-raising 2 difficulties). Kodansha. 3 The Economist 2005, 2007 40 (Divorce in 2007 estimated to be 400,000 cases). November 22, pp.18–31. 4 The Japan Times Online 2008, “Suicides up 2.9% in 07, passing 33,000.” June 20, 5 http://search.japantimes.co.jp/nn20080620a8.html accessed June 20, 2008. 3 Time Magazine 2003, “Japan Rules OK: a special report on Asia’s Pop culture super- 3 power.” August 11, vol.162, no.5, pp.23–44. Tipton, E. K., 2002, Modern Japan: A social and political history. London and New York: 3 Routledge. 3 Toffler, A., 1971, Future Shock. Bantam Books. 4 4 167 4 2831_bib.qxp 6/4/09 1:15 PM Page 168

Bibliography x . (Bedroom situation next door and mine). http://www.suzune.net/sodan/archives/2008/02/post_64.html accessed April 6, 2008. Utsu (Depression) http://www.geocities.jp/utuutu122/uyokuutu/uutuseikaku.html accessed April 19, 2008. Vogel, E., 1979, Japan as Number 1: Lessons for America. Tokyo:Tuttle. Wallace, R. A, and A. Wolf, 1995, Contemporary Sociological Theory: Continuing the Classical Tradition. New Jersey: Prentice Hall. Watanabe, H.,1999, (Parent-child relationship in post war 0 Japan) in Meguro, Y. and H. Watanabe (eds.) 2 (Sociology Course 2 Family). Tokyo University Press, Chapter 4, pp.89–117. Watts, J., 2002, “Japan’s teen hermits spread fear: Film lifts the lid on the hell of child Recluses.” The Observer, November 17. Weekly Economist 2005, A Special issue (Disappearing overtime pay). September 19. Wehrfritz, G., 2001, “Tune Out, Stay In; An epidemic of young Japanese pulling back from the world has deep roots.” Newsweek, August 20. Wikipedia http://en.wikipedia.org/wiki/NEET accessed April 18, 2008. Whitepaper on National character 2003, http://www.5.cao.go.jp/seikatsu/whitepaper/ h15/honbun/html/15140230.html accessed December 30, 2007. Wolferen, K. V., 2000, (System called 0 Japan which does not make people happy): The False Realities of Politicized Society. Shinchosha. Yamada, M., 1998, “The Japanese Family in Transition,” About Japan Series, No.19, Tokyo: Foreign Press Center. ——, 1999, . (The age of parasite singles). Chikuma Shinsho. ——, 2004, . (Hope disparity society). Chikuma Shobo. Yates, R. E., 1988, “Japanese Live . . . and Die . . . for their Work,” Chicago Tribune, November 13. Yomiuri Online 2008, 3 07 258 (Mental illness certiﬁed for workers compensation increased by 30%. 258 cases in 2007). http://www.yomiuri.co.jp/national/news/20080523-OYT100659.htm accessed May 24, 2008. 0 Yomiuri Shimbun 2005, (Survey on opinions of junior and senior high school students in the US and Japan). March 16. —— 2006, (Junior high school nonattendance increased), August 11. —— 2007, “Public sees wealth gap widening” http://www.yomiuri.co.jp/newse/ 20041201wo31.htm accessed December 20, 2007. 6 Yomiuri Weekly 2004, 7 (Increasing sexless: reasons why husband and wife cannot do it). October 31. —— 2006, (The age of zero overtime pay). November 5, 8 pp.12–19. 9 Yoshimatsu, K., 1991, (The middle age today as a sui- 0 cide generation) in Kokoro no Kagaku (Human Mind). no.39, September p.22–5. 1 2 168 2831_bib.qxp 6/4/09 1:15 PM Page 169

Bibliography 1 2 Yoshimi, S. (ed.), 1988, . (Women and ie). Doseisha. 3 (Mental health research 4 institute, social economic productivity foundation headquarters) 2004, 5 (An industrial mental health whitepaper) issued on August 22. 6 Zeilenziger, M., 2003, “More Japanese are imitating a nation that closes itself off. Shut- 7 ins increasing among young adults,” The Detroit Free Press, January 3, 2003. 8 (National family association on karoshi) 1997, 9 . (What job is worth dying for?). Kyoikushi Publishing. 1 1 2 3 4 5 6 7 8 9 2 1 2 3 4 5 6 7 8 9 3 1 2 3 4 5 3 3 3 3 4 4 169 4 2831_Index.qxp 6/5/09 3:09 AM Page 170

x Index 0

A-type men, 36–7 clinical depression, understanding as a Abe, Teruo, 63–4, 83–6 treatable disease increasing, 55 absenteeism, psychologically based, communication skills, lack of, 139–140 110–12 compensation cases and stress, 32 age discrimination, 56 condom sales decline, 83 Ajase-complex model, 13–14 conformists, 7 “adjusted people”, 2–3 convergence theory, x akirameru, 20 coping techniques, 19–20 alcoholism, 37, 156 credential society, 106 amae, xii, 8–9, 21, 75 cultural analysis perspective, xix 0 Anna Karenina, xx Culture of Narcissism, The, 144 “anomic people”, 3 culture-bound syndromes, 6 anomie, 6 antipsychiatry, 153–4 deviance Aum Shinrikyo cult, xv constrained by culture, 22 “autonomous people”, 3, 159 deﬁnitions, 6–7 avoidant personality disorder, 85 mental illness, 152 divorce, 88–91 bankruptcies conciliatory, 89–90 corporate, 29–30 “domestic”, 90 personal, 30–1 jukunen, 62–3 Becker, Howard S., 6 mature age, 92 Benedict, Ruth, xii, 1, 53 rapid increase, 92 0 bibliography, 163–70 rates, 61–2 birthrate, 64–5 unemployment links, 92–3 decline, 68 Doi, Takeo, xii, 8–9, 21, 75 Boissanade, Gustave-Emile, 67 Durkheim, Emile, 24, 41–2 Buddhism, 15, 17, 50 Ekken, Kaibara, 66 bullying among children, 110, 112 eldest son’s position, 73–4 Erickson, Erik, 72 6 change, fear of, 19–22 examinations, over-emphasis, 106–107 children’s sensitivity to mother’s feelings, extramarital affairs, 90 7 78–79 8 Chrysanthemum and the Sword, The, 1 family life 9 chu–sho– kigyo–, 26 contemporary, 68–73 0 1 2 170 2831_Index.qxp 6/5/09 3:09 AM Page 171

Index 1 2 cultural traditions, 65–8 Hikikomori Sufferers’ Parents’ Group, 3 eldest son’s position, 73–4 150 4 family relationships publicized, 61–5 Hill, Reuben, 61 “for the sake of the children”, 71–2 Horney, Karen, 98 5 head of household, 67 human relationships absolute 6 home and work separation, 68–9 importance, 53–4 7 ie system and reality gap 93 8 life goals identified with children, 128 ichirannsei oyako, 109 obsession with family structure, 93 “identical twin parent-child”, 109 9 pre-war and post-war, 12 Ideology and Insanity, 154 1 salaried man/full-time housewife ie system, 12–13, 66, 68, 73–7 1 model, 3–4 incongruent hierarchy, 78 2 source of many social problems, 77 indebtedness to others, 53 family life – husband independence and isolation, 157 3 home as place to rest, 70 Inkeles, Alex, 2, 137 4 husband at home syndrome, 63 innovators, 7 5 less time at home, 70 “Inochi no Denwa”, 56 6 no room for, 81–2 intergenerational relationships, 73 retired husband syndrome, 63 intra-family violence, 113–15 7 family life – wife isolation and independence, 157 8 matriarchal culture, 65–6, 75–6, 94 ittaikan, 17, 21, 138 9 mother-child relationship, 71 Iwakura delegation, 17 2 parent-child interdependency, 74–5, izakaya, 140 122–3, 127 1 retired husband syndrome, 88 Japan 2 filial piety, 138–9 aggressive copying, 17 3 freeters, 99, 129 appearance of stability, 5 4 futo–ko–, 110–12, 149 balanced picture, xiv–xv comparisons with West and with Asia, 5 gaps between goals and means for 15–16 6 achieving them, 6–7 “cool”, xiii–xiv 7 Genda, Yuji, 18, 132–3 culture and personality relationship, 1 8 graceful resignation to situation, 20 culture based on maternal principle, Great Hanshin earthquake, xv, 155 12 9 group identification, 18–19 development stages, x 3 “healing” industry, 155–6 1 Haslam, N., 147 ideas and practices absorbed from 2 hensachi status, 79, 106 foreign cultures, 16–17 hikikomori, xvi, 114–22 image of incomprehensible country, xv 3 disease or not?, 150–1 international attention to culture, xiii 4 home environment, 119–2 “jobs for life” in large corporations, 5 mental disorder, attitudes toward, 26–7 3 149–53 national personality change, 2 mental illness, 119–20 national psyche, 1–6 3 overview, 149–3 religious practices, 50 3 publicity, 117–19 social issues not unique, xviii 3 support for sufferers, 117–18, 121–2 social structural changes, 128–34 4 4 171 4 2831_Index.qxp 6/4/09 1:14 PM Page 172

Index x social structure, 8 Japanese Certification Board for Clinical value and norm system, 145 Psychologists, 155 well-being sense destroyed, 24 Japanese Self, The, 9–10 Western on surface, xii “Japanese-style management”, xiv–xv Japan – economy job security, 31–2 bubble collapse, 47 jobless stigma, 42–3 decline after expansion, 18–19 decline in early 1990s, xiii karo-jisatsu downturn, 35 apologies left for disappointing 0 economic change, 29–32 colleagues and families, 52–3 economic restoration, 26–9 management not adjusting to change, partial recovery, 30 49 pessimistic attitude to the future, 124 personality characteristics, 46–7 unemployment, 30 professionals’ devotion to work, 48 work-centered society, 48 suicide by overwork, 40–7 Japan as Number One, xii–xiii understanding slowly increasing, 55 Japanese karoshi belief that Japan is unique, 8 death from overwork, xvi, 38–44 clinical depression, 36 fear of unemployment, 42 communication skills, lack of, promotion as a passport to karoshi, 139–40 39–40 – 0 emphasis on concrete events, 14 karyu shakai, 129 “haves” and “have nots” gap, 128, 130 kateinai bo–ryoku, 113–15 hierarchical criteria, 10 Kawahito, Hiroshi, 42, 54 hopelessness of future careers, 25 Kawai, Hayao, 10–13, 21, 75, 93–4, independence, needed, 160 114–15, 157, 160 individuals – actions needed, 157–60 Kurokawa, Nobuo, 63 influenced by foreign views about themselves, 119 Lasch, Christopher, 1, 144, 154 men under stress, xvii Lebra, Takie, 10 mental health challenges, xviii Lowen, Alexander, 144 mutual pardon theme, 14 lower-class society, 129 national character, 7–14 loyalty to the group, 18 need to distinguish between 0 independence and isolation, 157 Maganuma, Mie, 132–3 not expressive, xv “maladjusted people”, 3, 5 “not fitting in”, 5 marriage psychological ailments, 140–6 concepts seen as outdated, x ranking system, 10 contract between two families, not religious values weak, 15 two people, 73, 77 sense of uncertainty, 145–6 dangers from within society, 91 6 sensitive to personal relationships, xv different expectations, 89, 90 social relationships highly valued, 15 eldest son’s position, 73–4 7 stress levels very high, 140 husband’s surname for children, 91 8 suicide, obsession with, 33–8 ideal based on mother-child 9 upward mobility, 28 relationship, 76 0 workplace as center of existence, 27 later in life, xvii, 64 1 2 172 2831_Index.qxp 6/4/09 1:14 PM Page 173

Index 1 2 no tradition of independent people, 77 mother ﬁxation, 85 3 problems, xvii mother-child relationship, 71, 108, 110, 4 sexless, 63–5, 82–8 114–15 unhappy couples remaining married, children grow to independence, 5 xvi 79–80 6 masked depression, 141 family life – wife, 71 7 maternal principle, 11–12, 75, 114, 157 marriage, 76 8 mental disorder, attitudes towards maternal love selﬁsh, 80–1 hikikomori, 149–52 too much love, 77–81 9 karmic cause, 148 1 medicalizing, 147–8 Nakamura, Hajime, 14–18, 54, 146 1 moral problem, 148–9 Nakane, C., xii 2 moralizing, 147 Narabayashi, Yasushi, 85 pathologizing, 147 National Federation of the Family of the 3 psychologizing, 148 Mentally Ill, 151 4 spiritualization, 148 NEETs, 99 5 mental health psychology and motives, 132 6 dominant psychopathology, 145 neo-Confucianism, 66 hereditary illness, fear of, 152–3 net (internet) café refugees, 130 7 masked depression, 141 New Mothering System group, 80 8 medicalization, 156 “Nixon Shock”, 29 9 personality disorders, 141–3 non-confrontational approach to 2 professional perspective, 146–52 relationships, 20–1 psychological ailments, 140–6 nonschizophrenia, 153–4 1 psychological causes not recognized, 2 155 obligation to groups, 138–9 3 specialists now recognized, 155 Ohira, Ken, 101–102 4 USA comparisons, 111, 144 Okamoto, 87 mental illness Okonogi, Keigo, 13–14, 21, 72, 105 5 antipsychiatry, 153–4 Okuyama, Masahisa, 150 6 deviant behaviour, 152 oneness 7 Employee Assistance Programs, 56 in group, 17 8 hikikomori, 119–20 interaction, 158 ignorance of, 54 mother and child, 8–9, 11 9 medicalization, 153–5 sense of, 138 3 – nonschizophrenia, 153–4 Ono, Masakazu, 44–7, 49, 51, 53 1 professional tactlessness, 153 otaku culture, xvi 2 psychotherapeutic perspective, 154–5 overtime, “service”, 45 schizophrenia, 153 Ozawa, Makiko, 154–5 3 stigma, 55, 121, 152–6 4 Merton, Robert, 6–7 parasite singles, 123–8 5 Minami, Hiroshi, 9–10, 145 parent-child interdependency 3 misho–n, 13 family life, 74–5, 122–3, 127 Miura, Atsushi, 129–30 paternal principle, 11–12, 75, 114, 157 3 moral authority, absolute, 49–50 performance-based pay, 32 3 Morotomi, Yoshihiko, 81–2, 85–6, 88, personality disorders, 141–3 3 102–103 pre-natal rancor, 13 4 4 173 4 2831_Index.qxp 6/4/09 1:14 PM Page 174

Index x problem handling, cultural influence, xi “social nexus”, 18 psychologists social structural perspective, xviii–xix Japanese Certification Board for society failure to support people in crisis, Clinical Psychologists, 155 57 stress, affect on corporate workers, 25 rebels, 7 substance addiction, 156 Rees, Phil, 119 Sugimoto, Yoshio, 8 religious belief, possible need in Japan, suicide 160 “altruistic”, 42, 43 0 retired husband syndrome, 63, 88 anger of the bereaved, 41 retreatists, 7 “anomic”, 42–3 Riesman, David, 2–3, 5, 159 apologies left for disappointing risk-free society, 28, 31 colleagues and families, 52–3 ritualists, 7 blame themselves for not fulfilling tasks, 41, 43 Saito, Satoru, 37–8, 78, 108, 110, 125 by overwork, 40–7 Saito, Tamaki, 117, 120–1, 125–6 compassion-fatigue, 33 Sakagami, Yuko, 101 corporate-caused, 43 Sakaiya, Taichi, 17, 50 death through overwork, 38–44 schizophrenia, 153 demonstration of remorse, 34 medicalization, 156 “egoistic”, 42 0 school avoidance, 110–12, 149 factors specific to Japanese psychology, sekkusu-resu marriages, 63–5 51–5 self factors specific to Japanese society, active part of, 9 47–51 as an object, 9 factors specific to Japanese workplace, boundless, 10 44–7 dependence on the group, 10 government prevention centers, 55 inner, 10 hotline, 24 inner object-, 9–10 jumping in front of train, 33, 56 inner, facing, 160 “kaishaism”, 43 inner, true, 107 kamikaze attacks, 34 interactional, 10 long working hours, 45–6 outer object-, 9–10 middle-aged or older men, 35–6 0 outward, 107 mismatch between values and reality, uncertainty and anxiety, 10 44 self-boundary concept, 51–2, 158 no blame for people who overworked self-mutilation, 126–7, 143 them, 53 sensitivity toward not hurting another’s numbers, 24 feelings, 21–2 obsession with, 33–8 seppuku, 33–4, 42 other countries, 34–5 6 sexual addiction, 143 performance-based evaluation, 45–6 sexual contact rejected, 85–6 ritual, 33–4 7 sexual dysfunction, 83–5 society’s response, 33, 55–7 8 shigarami, 138–9 stress cited, 32 9 Shinto, 14, 17, 50 too deeply involved in work, 38 – 0 Shotoku, Prince, 17, 50 Szas, Thomas, 153–5 1 2 174 2831_Index.qxp 6/4/09 1:14 PM Page 175

Index 1 2 taijin kyofu, 100–101 specific factors leading to suicide, 3 Tanaka, Kimiko, 80 44–7 4 Tasutoku, Suwa, 46 wrist slashing, 126 Teikoku Databank, 30 5 “Telephone of Life”, 56 Yamada, Masahiro, 3, 28, 31, 71, 89, 91, 6 Tellenbach, Hubertus, 36–8, 54 128, 130 7 thought-merging mentality, 50–1 yasashisa, 101–102, 104, 105 8 Toffler, Alvin, 137 Yasashisa no Seishinbyo–ri, 101 Tokyo Story, xv Yasushiro, Ozu, xv 9 Tolstoy, Leo, xx youth 1 to–ko– kyohi, 110–12 ambiguous distress, 102–103 1 domestic violence, 113–15 2 unpredictability, concern at, 19–22 fragile and vulnerable, 104 USA comparisons, mental health, 111, gambling on life, 131 3 144 home environment, 107–10 4 inability to relate to others, 133 5 violence towards parents, 11, 151–2 intra-family violence, 113–15 6 Vogel, E., xii low self-esteem, 99–100 media pressure, 98 7 Watanabe, Junichi, 40 mother-child relationship, 108, 110, 8 Wehrfritz, George, 118–19 114–15 9 Wolferen, K. V., xvii not automatically expected to leave 2 women home, 124–5 full-time housewife image, 3–4 others’ feelings, 100, 102, 104 1 part-time work, 69–70 over-affluent society, 104–106 2 restricted to home, 27–8, 29 over-sensitive to rank, 107 3 see also family life – wife, post-war deprivation unknown, 138 4 workplace school environment, 106–107 changes, 47 self-esteem of high-school students, 5 complete separation from home, 27 131–2 6 human relationships traditionally sensitivity to criticism, 103 7 come first, 49 social withdrawal, 115–23 8 management not adjusting to change, superficial perfection, 105 49 worries over being liked, 100–101 9 performance-based evaluation, 46 3 self-imposed enslavement, 51–2 Zenkaren, 151 1 2 3 4 5 3 3 3 3 4 4 175 4 2831_Index.qxp 6/4/09 1:14 PM Page 176

6 7 8 9 0 1 2