Academic Abstracts
Reflections on Schizophrenia: Sources of the Social Stigma in Japan
(co-author Dr. Yutaka Ono) Psychiatric Networks, Volume 3, Number 2, 2000
In this paper we consider the sources of the social stigma associated with schizophrenia in Japan. We begin by arguing that any conception of schizophrenia is tied to a conception of self (something implicit in clinical conceptions of the disorder) and that this conception will have subtle cultural differences. We point out how the Japanese expression currently used to translate the Western diagnostic term contributes to the stigma associated with this disorder because of an implicit view of the self contained in the translation. Next, since delusions are central to schizophrenia, we offer a critique of the conventional clinical definition of delusion and argue that it is conceptually weak. We argue that what bothers most people about someone who is schizophrenic is not that he has false beliefs per se, but what he does while experiencing a delusional state. It is as agents in the world relating to others that schizophrenic patients present problems for themselves, their family members, state authorities and clinicians and why they have been so highly stigmatized socially. Since families in Japan have tended to play a major role in the care of family members with schizophrenia, a patient’s bizarre actions cause family members to experience shame and guilt and lead to manifold social problems for the patient. Finally, we discuss the increasingly important role biochemistry plays in the treatment of schizophrenics in Japan and argue that the wider use of neuroleptics, along with a greater understanding by family members of both the psychosocial and biochemical nature of schizophrenia, will probably lead to a lessening of the stigma associated with this disorder in Japan.
(co-author Dr. Yutaka Ono) Psychiatric Networks, Volume 3, Number 2, 2000
In this paper we consider the sources of the social stigma associated with schizophrenia in Japan. We begin by arguing that any conception of schizophrenia is tied to a conception of self (something implicit in clinical conceptions of the disorder) and that this conception will have subtle cultural differences. We point out how the Japanese expression currently used to translate the Western diagnostic term contributes to the stigma associated with this disorder because of an implicit view of the self contained in the translation. Next, since delusions are central to schizophrenia, we offer a critique of the conventional clinical definition of delusion and argue that it is conceptually weak. We argue that what bothers most people about someone who is schizophrenic is not that he has false beliefs per se, but what he does while experiencing a delusional state. It is as agents in the world relating to others that schizophrenic patients present problems for themselves, their family members, state authorities and clinicians and why they have been so highly stigmatized socially. Since families in Japan have tended to play a major role in the care of family members with schizophrenia, a patient’s bizarre actions cause family members to experience shame and guilt and lead to manifold social problems for the patient. Finally, we discuss the increasingly important role biochemistry plays in the treatment of schizophrenics in Japan and argue that the wider use of neuroleptics, along with a greater understanding by family members of both the psychosocial and biochemical nature of schizophrenia, will probably lead to a lessening of the stigma associated with this disorder in Japan.
Taijin Kyofusho in Japan: Social Phobia or Culture-Bound Syndrome?
(co-author Dr. Yutaka Ono) Psychiatric Networks, Volume 3, Number 1, 2000
This paper discusses Taijin Kyofusho (TKS) and presents socio-cultural, clinical, epidemiological, and biological evidence for why it is a culture-bound syndrome in Japan. Although TKS superficially resembles social phobia, we argue that the psychopathology of TKS is much broader in scope than social phobia and encompasses a greater variety of anxiety-related behaviors. Moreover, a careful consideration of the illness experience points to subtle, but significant, differences in the idioms of distress used to express the anxiety felt by patients suffering from these disorders. The manner in which the illness presents relates specifically to cultural factors in how illness is experienced and these factors influence what counts as a symptom. Even though we cannot offer conclusive proof that TKS is a culture-bound syndrome in Japan, we add clinical, epidemiological, and biological evidence to the debate, evidence that suggests that it is culturally bound.
(co-author Dr. Yutaka Ono) Psychiatric Networks, Volume 3, Number 1, 2000
This paper discusses Taijin Kyofusho (TKS) and presents socio-cultural, clinical, epidemiological, and biological evidence for why it is a culture-bound syndrome in Japan. Although TKS superficially resembles social phobia, we argue that the psychopathology of TKS is much broader in scope than social phobia and encompasses a greater variety of anxiety-related behaviors. Moreover, a careful consideration of the illness experience points to subtle, but significant, differences in the idioms of distress used to express the anxiety felt by patients suffering from these disorders. The manner in which the illness presents relates specifically to cultural factors in how illness is experienced and these factors influence what counts as a symptom. Even though we cannot offer conclusive proof that TKS is a culture-bound syndrome in Japan, we add clinical, epidemiological, and biological evidence to the debate, evidence that suggests that it is culturally bound.
Morals, Suicide, and Psychiatry: A View from Japan
Bioethics, Volume 16, Number 5, 2002
In this paper, I argue that within the Japanese social context, the act of suicide is a positive moral act because the values underpinning it are directly related to a socially pervasive moral belief that any act of self-sacrifice is a worthy pursuit. The philosophical basis for this view of the self and its relation to society goes back to the writings of Confucius who advocated a life of propriety in which being dutiful, obedient, and loyal to one’s group takes precedence over the desires of the individual selves that make up the group. I argue that this philosophical perspective poses formidable challenges to Japanese psychiatry (which accepts a contrary Western perspective) because, as Western psychiatry is based on the concept of autonomous individuality, the Japanese conceive of the self as socially embedded. Because suicide in Japan is viewed as a potentially honorable, virtuous, and even beautiful act of self-sacrifice expressing one’s duty to one’s group, the Western perspective is quite foreign to the Japanese self-conceptual framework. Therefore, since Japanese psychiatry and law have embraced the Western medical tradition of viewing suicide as a non-rational response to mental illness, which runs counter to the cultural view that suicide is a moral (and rational) act, I argue that Western explanations of suicide present significant cross-cultural problems for Japanese psychiatry.
Bioethics, Volume 16, Number 5, 2002
In this paper, I argue that within the Japanese social context, the act of suicide is a positive moral act because the values underpinning it are directly related to a socially pervasive moral belief that any act of self-sacrifice is a worthy pursuit. The philosophical basis for this view of the self and its relation to society goes back to the writings of Confucius who advocated a life of propriety in which being dutiful, obedient, and loyal to one’s group takes precedence over the desires of the individual selves that make up the group. I argue that this philosophical perspective poses formidable challenges to Japanese psychiatry (which accepts a contrary Western perspective) because, as Western psychiatry is based on the concept of autonomous individuality, the Japanese conceive of the self as socially embedded. Because suicide in Japan is viewed as a potentially honorable, virtuous, and even beautiful act of self-sacrifice expressing one’s duty to one’s group, the Western perspective is quite foreign to the Japanese self-conceptual framework. Therefore, since Japanese psychiatry and law have embraced the Western medical tradition of viewing suicide as a non-rational response to mental illness, which runs counter to the cultural view that suicide is a moral (and rational) act, I argue that Western explanations of suicide present significant cross-cultural problems for Japanese psychiatry.
Mind-Body Concepts and Mental Illness: A Study of Japanese Values
The Japanese Society of Psychiatry and Neurology, Volume 106, Number 8, 2003
This paper examines Japanese mind-body concepts and attempts to tease out some of the ways this philosophical orientation fluences the view of mental illness. An analysis of key Japanese words demonstrate that traditionally the Japanese have viewed the mind and body as inextricably intertwined and that this interconnectedness extends to the Japanese self-conceptualization. It is argued that this Japanese value orientation sheds light on the stigma associated with mental Illness and equally helps to explain the Japanese tendency to somatasize psychological distress. Because “mental illness” is perceived as a character weakness, “somatic talk”becomes a culturally coded idiom of distress providing the Japanese with a culturally acceptable way to influence the behavior of others while at the same time avoiding being labeled with a psychiatric disorder. Somatization in Japan, then, can be understood as an inherently ethical event that has nore to do with morals than medicine.
The Japanese Society of Psychiatry and Neurology, Volume 106, Number 8, 2003
This paper examines Japanese mind-body concepts and attempts to tease out some of the ways this philosophical orientation fluences the view of mental illness. An analysis of key Japanese words demonstrate that traditionally the Japanese have viewed the mind and body as inextricably intertwined and that this interconnectedness extends to the Japanese self-conceptualization. It is argued that this Japanese value orientation sheds light on the stigma associated with mental Illness and equally helps to explain the Japanese tendency to somatasize psychological distress. Because “mental illness” is perceived as a character weakness, “somatic talk”becomes a culturally coded idiom of distress providing the Japanese with a culturally acceptable way to influence the behavior of others while at the same time avoiding being labeled with a psychiatric disorder. Somatization in Japan, then, can be understood as an inherently ethical event that has nore to do with morals than medicine.
Using the Music of English Creatively in the ESL Classroom
Keio Research Center for Foreign Language Education, Volume 6, 2009
In this paper it is argued that the inherent musical nature of the English language lends itself to intriguing classroom activities which, when implemented, can help English as a Second Language learners acquire a sense of the natural intonation and rhythm of English. The underlying logic of a person’s first language can have a profound effect on how that person speaks English as a second language, especially when the two languages have dramatically different rhythmical logics, as Japanese and English do. English language education in Japan tends to emphasize grammar and translation, with the intention of helping students pass standardized written exams, and does little to help students learn to speak in English. This situation can be ameliorated, it is argued, by getting students actively and creatively involved in the music of English. During the autumn term of 2008, we conducted an experimental class at Keio University with the goal of getting students engaged in creative activities, some physical (singing), some cerebral (poetry writing), some a little of both (song writing), in order to strengthen their communicative sense of the natural rhythm of spoken English.
Keio Research Center for Foreign Language Education, Volume 6, 2009
In this paper it is argued that the inherent musical nature of the English language lends itself to intriguing classroom activities which, when implemented, can help English as a Second Language learners acquire a sense of the natural intonation and rhythm of English. The underlying logic of a person’s first language can have a profound effect on how that person speaks English as a second language, especially when the two languages have dramatically different rhythmical logics, as Japanese and English do. English language education in Japan tends to emphasize grammar and translation, with the intention of helping students pass standardized written exams, and does little to help students learn to speak in English. This situation can be ameliorated, it is argued, by getting students actively and creatively involved in the music of English. During the autumn term of 2008, we conducted an experimental class at Keio University with the goal of getting students engaged in creative activities, some physical (singing), some cerebral (poetry writing), some a little of both (song writing), in order to strengthen their communicative sense of the natural rhythm of spoken English.