INDEX (Volume 4 Num 1) 2009

Advancing Collaboration of the East and West: Special Issues for the JSTP, WPATPS, and WACP Joint Meeting in Kamakura, April 2007 - Editorial T. Akiyama 1 - 2

Globalization and the meaning of psychiatry - Special Article M. Nishizono 3 - 11

It is said that the people of the 20th century have left two assets to the people of the next century: respect for human rights and the benefits brought about by progress in science and technology. With these ideas as the background, globalization has been advancing rapidly on a global scale. There are two sides to everything, one bright and the other, dark. At home, globalization is bringing about not only changes in the environment such as changes in industrial structures and urbanization, but also changes in people’s sets of values, such as what form families and married couples should take. In terms of external relationships, globalization has resulted in encounters between different cultures. These rapid changes are believed to have triggered the frequent incidence of numerous types of mental health disorders. Today’s psychiatry can cope with globalization only if it has universality common to the entire world—in other words, so-called evidence-based psychiatry, as seen in DSM-III or IV, or in ICD-10—as well as cultural uniqueness, or, in other words, narrative-based psychiatry. For these reasons, I believe the development and spread of cultural psychiatry to be essential.

Hwabyung in Korea: Culture and dynamic analysis - Original Paper S. Min 12 - 21

Hwabyung, which means anger (fire) disease, is a culture-related anger syndrome in Korea. The symptoms include a subjective feeling of anger with anger-related bodily and behavioral symptoms. The symptoms seem to symbolize the nature of fire (anger) and its suppression and/or release. According to the patients' explanation, reactive anger, resulting from being a victim of an unfair situation, must be suppressed so as not to jeopardize harmonious family or social relationships. However, if the unfair situations continue, the suppressed anger "accumulates and becomes dense”, and finally causes a disease. Defense mechanisms related to hwabyung were found to be suppression, inhibition, withdrawal, somatization, and oral consumption. The concept of hwabyung seems to have been shaped by Korean people's socio-cultural experiences throughout history. Such historical experiences have developed a unique, collective emotional reaction called ‘haan’, which is a chronic suppressed anger resulting not only from the tragic collective national history, but also from a traumatic personal life. Accordingly, hwabyung shares many components with haan and seems to be a pathologic form of haan. Additionally, hwabyung and haan are commonly related to other Korean cultural heritages including shamanism, traditional medicine, the culture of the relationship (“jeong”) and collectivism, and the traditional philosophy of the ‘han’ in Korea. Finally, a suggestion was made regarding the conceptualization of an “anger disorder” based on the studies of this anger syndrome.

“Distorted medicalization” of senile dementia: The Japanese case - Original Paper M. Ikeda, M. Roemer 22 - 27

This study uses historical and anthropological perspectives to analyze the dynamic nature of cultural interpretations of senile dementia among modern Japanese. In our discussion of “distorted medicalization”, we point out discrepancies between the biomedical practices of doctors and what most Japanese conceptualize as the preventable and curable nature of senile dementia.

Family and group suicide in Japan: Cultural analysis - Short Paper S. Katsuragawa 28 - 32

Suicide is generally thought to be a personal behavior, however many suicide clusters have been seen all over the world. We have quite a unique behavior of suicide pact, which is called a ‘Shinjyu’, in Japanese society. There is a variety of shinjyu. The latest word is ‘Net-shinjyu’, which means a group suicide where members are gathering through the internet. It became a social issue as the numbers of those completing suicide especially among the young generations have increased since 2003. Net-shinjyu is completely different from other ‘shinjyus’ (the traditional suicide pact) where people had a close relationship between themselves. Some authors point out that there is a correlation between the changing of group suicide and the rapid structural change of society, which involves cultural change.

Naikan therapy in Japan: Introspection as a way of healing introduction to Naikan Therapy - Short Paper T. Maeshiro 33 - 38

It is the author’s great pleasure and privilege to have a chance to introduce Naikan method here. The author is a clinical psychotherapist. After twenty-four years of working at a hospital as a clinical Naikan therapist, the author took his current position as the third director of the Yamato Naikan Institute in Nara, where the founder of the Naikan method, Ishin Yoshimoto had spent his time guiding many people through this method. The Naikan method had been considered as the ascetic training to attain enlightenment. It is the author’s lifework, however, to practice and study Naikan as one of the psychotherapeutic methods.

Role of Attitude in Multicultural Counselling Competency - Short Paper M. Minami 39 - 46

Multicultural Social Work in Japan The Need for Development - Short Paper K. Ishikawa 47 - 52

The number of foreigners in Japan has been rapidly increasing in the last two decades. The noteworthy trend is that the majority of these foreigners are no longer short time visitors and they stay in Japan long term as residents. Since the population of Japan has predominantly consisted of Japanese nationals until recently, social welfare and social service systems have been targeting primarily Japanese nationals. Social work with culturally diverse clients is underdeveloped. In this paper the need for development of multicultural social work in Japan is discussed. Three major areas are presented. The first area is an illustration of the characteristics and problems of diverse foreign population groups in Japan. The second area consists of some key components of micro-level social work skills necessary for intervention with those culturally diverse clients. The third area is represented by a macro-level social work practice, which needs to develop a more adequate service system and a more culturally sensitive community.

Current Status of Occupational Mental Health in Japan: A Comparison of the Administrative Guidelines Published in 2000 and 2006 - Original Paper L. Kurabayashi 53 - 59

A country’s working styles are based on its respective culture. Until the beginning of the 1990s, the Japanese economy was showing robust development. Stable employment was enjoyed by the majority of the population, and employees enjoyed a high level of life-style satisfaction. Lifetime employment and the seniority system were regarded as the secrets of the strong growth within the Japanese economy. However, in recent years, Japanese employees have been under a significant amount of physical and mental stress. Sleep deprivation caused by extended working hours is common, and the number of people suffering from work-related stress has been increasing annually. Concurrently, the suicide rate of company employees has also risen considerably. As a result, karo-jisatsu (suicide from overwork) has become an object of public concern. The increase of stressful working conditions in Japan occurred as follows. Soon after the economic bubble burst in the early 1990s, drastic changes in working conditions took place. There was a noticeable decline in the number of people in lifetime employment and the seniority system began to be replaced by the introduction of a meritocratic system. Information technology began to be introduced into the workplace. Restructuring, downsizing and lay-offs also took place in most Japanese companies, resulting in an increasing workload for each individual employee. In order to improve working conditions and promote employee mental health, administrative guidelines for occupational mental health were issued by the Ministry of Labour in 2000 and 2006. At present, these two mental health guidelines do not appear to have been particularly effective in reducing working hours or the suicide rate. Therefore, to definitively assess the effects of these guidelines, long-term observation is necessary. Japan is currently in a transitional period regarding improvement to the workplace environment. Thus, it is an ideal time to construct a working culture based on the positive aspects of the traditional Japanese working style, such as cooperation among employees, health care staff, and employers. As in any culture, a new working culture that incorporated the old would be more readily accepted.

Cross-Cultural Factors on Workers’ Mental Health – From the Experience of the EAP Service - Short Paper Y. Murakami 60 - 64

There are various stress factors on employees who work in a different culture and such cross-cultural factors cannot be ignored. Occupational mental health is now an issue discussed by the Government, but information from the Human Resources Department of companies indicates that the support system for workers who work out of Japan is not yet well-developed. Meanwhile, cases from an Employee Assistance Program (EAP) service show the reality of Japanese workers’ situation in different cultures and how they cope with stress with the assistance of the EAP. This paper indicates that not only is support needed for each individual case, but also a support system for companies including consulting, sharing information and networking is required. This is a challenge for mental health specialists.

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