[Morita therapy in cultural context].

Seishin Shinkeigaku Zasshi

Center for Psychotherapy, Department of Psychiatry, Saint Marianna University School of Medicine, Aomori Prefectural Mental Health and Welfare Center.

Published: October 2003

East is characterized by concepts of transcendence of ego structure, equality of mind to body and psychic structure of emptiness or nothingness. West is on the other hand characterized by concepts of ego strength, superiority of mind to body and psychic structure of fullness. Namely in the East ego is not strengthened but dispersed into relationships of a person with other persons, animated and in-animated others. There is no differentiation between mind and body. Also there is a traditional way of reaching a psychic state of emptiness or nothingness which is found in Zen-Buddhism. However in the West nothingness or emptiness has only negative meaning. West has also linear way of thinking that one lives by developing oneself towards God as progress whereas East has circular way of thinking like Nietzches word, "Eternal repeat of the sameness". Such traditional concepts of Eastern culture are reflected on our Japanese language. For example we would like to omit subject and object and propose to go to drink something, tea or coffee. We would like to keep the ambiguity in our expression so that we could avoid harming the others who actually wanted to go with us. Morita Therapy is based on the Eastern culture and has such cultural backgrounds. Indicated are the patients who have a tendency to be hypochondriacal and called "shinkeishitu". These patients have namely strong fear of death and also at the same time strong wish to live a full life. However the fear of death predominate and suppress the desire to live a full life which produces several neurotic symptoms like simple phobia, panic disorder, obsessive compulsive disorder, etc. For such patients we do absolute bed rest in order to let the patients discern the natural process of their inner self through paradoxical setting of lying down for 7 days that is usually unnatural. Patients are prescribed to lie down in bed except eating, face-washing and keeping hygiene. The bed rest induces at first boredom which would bring about paradoxically desire to live a full life. Also in the following work therapy period patients would not fixate their attention inwards, namely to their symptoms but learn to pay attention towards outwards even though they have still symptoms. In the body action we could acknowledge changes of our inner perception that is also possessed by other persons, other animated creatures and in-animated creatures as a form of "Inter-perceptivity". We do not only perceive the atmosphere established between us and others but also between us and outer nature. Patients learn that anxiety is not to be eliminated but to be accepted as it is. So we just accept and do "nothing" to eliminate anxiety. We address that Morita Therapy is not only indicated for "shinkeishitu" personality but also for other anxiety based disorders, such as cancer patients, traumatized patients, etc.

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