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Notes
Miéko Macé, Médecins et médecine dans l’histoire du Japon [Doctors and Medicine in Japanese History] (Paris: Les Belles Lettres, 2013), 191–95.
Serizawa Kazuya 芹沢一也, “Hō” kara kaihō sareru kenryoku: hanzai, kyōki, hinkon, soshite Taishō demokurashii 〈法〉から解放される権力-犯罪、狂気、貧困、そして大正デモクラシー [Power Liberated from “Law” – crime, insanity, poverty and Taishō democracy] (Tokyo: Shin’yōsha 新陽社, 2001), 85–98.
Genshiro Hiruta, “Japanese Psychiatry in the Edo Period (1600–1868)”, History of Psychiatry, vol. 13, no. 50 (2002): 131–151.
See the distinction made by Ian Hacking between the classifications of objects produced by the natural sciences (where objects are “indifferent” to the classifications applied to them) and those produced by the social sciences, which deal with human beings and thus produce “interactive” classifications in the sense that they modify the behaviour and self-perceptions of the very people they designate. Ian Hacking, The Social Construction of What? (Cambridge, MA: Harvard University Press, 1999).
See, for example, Jan Goldstein’s discussion of the “boundary disputes” pitting French psychiatrists against lawyers and clerics: Jan Goldstein, Console and Classify: The French Psychiatric Profession in the Nineteenth Century (Cambridge: Cambridge University Press, 1987).
Junko Kitanaka, Depression in Japan: Psychiatric Cures for a Society in Distress (Princeton: Princeton University Press, 2012), 44–46; Eric J. Engstrom, Clinical Psychiatry in Imperial Germany: A History of Psychiatric Practice (Ithaca: Cornell University Press, 2003), 196–97.
Suzuki Akihito has examined the history of psychiatry in Japan from the angle of the social history of medicine, Kitanaka Junko from the angle of medical anthropology, Serizawa Kazuya using a Foucauldian analysis of discourse, and Satō Masahiro from the angle of historical sociology (see this paper’s bibliography for references).
Aside from some rather hagiographical works on Morita, the only studies to place his theories in their historical context are those by Shimazono Susumu and Wu Yu-Chuan.
The dissemination, through “Dutch learning”, of Western medical theories prior to the opening up of Japan falls outside the scope of this paper; however, note that in the late 18th century some Japanese doctors began to incorporate elements of European medicine (in particular the idea that the brain was the main site of mental activity) into the Sino-Japanese conception of madness. For more on the subject, see: Hiruta, “Japanese Psychiatry in the Edo Period”.
Okada Yasuo 岡田靖雄, Nihon seishinka iryōshi 日本精神科医療史 [The History of Japanese Psychiatry] (Tokyo: Igaku shoin, 2002), 122–29.
The Japanese Society of Psychiatry and Neurology continues to be the main professional organisation for Japanese psychiatrists and publishes the most prestigious Japanese journal in the field.
Okada, Nihon seishinka, 186; Serizawa, “Hō” kara kaihō, 104–06.
Okada, Nihon seishinka, 168–69.
Okada Yasuo, “Meiji-ki no seishinka iryō — sono shoki jijō” 明治期の精神科医療—その初期事情 [Psychiatric Care in Meiji Japan] in Seishin iryō no rekishi 精神医療の歴史 [The History of Psychiatric Care], ed. Matsushita Masaaki 松下正明 and Hiruta Genshirō 昼田源四郎 (Tokyo: Nakayama shoten 中山書店, 1999), 258–60. Okada, Nihon seishinka, 159–60, 168. Although he is best known for his controversial Psychopathia Sexualis, Krafft-Ebing also wrote two textbooks that were widely read in the 1870s, one on general psychiatry and one on forensic psychiatry.
Kure spent part of his study trip (1897–1901) in Heidelberg, studying under Kraepelin. A leading figure in German-language psychiatry in the 1890s to 1920s, Kraepelin wrote a psychiatry textbook whose successive republications (in particular those published during Kure’s time in Germany) radically changed the classification of mental illnesses by basing it on clinical observation. Okada, Nihon seishinka, 168; Engstrom, Clinical Psychiatry in Imperial Germany, 121–46.
Engstrom, Clinical Psychiatry in Imperial Germany, 174–77, 194–98.
With the Kyoto asylum having closed in 1882, all that remained was Sugamo Hospital 東京府立巣鴨病院 (formerly the Tokyo asylum), which since 1887 had been under the medical direction of the psychiatry chair at Tokyo Imperial University. It was there that students did their clinical practice and where psychiatry classes were taught until 1919.
The Custody Law for the Mentally Ill (Seishinbyōsha kango-hō 精神病者監護法), adopted in 1900, was designed to ensure the secure custody of mentally ill patients posing a threat to public order and prevent wrongful confinement. The aim was to regulate a centuries-old practice rather than to promote the expansion of psychiatric care. Akihito Suzuki, “The State, the Family, and the Insane in Japan, 1900-1945” in The Confinement of the Insane: International Perspectives, 1800-1965, ed. Roy Porter and David Wright (Cambridge: Cambridge University Press, 2003), 199–201. In 1905 the Ministry for Health reported a total of 12,000 patients confined to their homes, compared to 5,500 patients interned in hospitals. Akihito Suzuki, “A Brain Hospital in Tokyo and its Private and Public Patients, 1926–45”, History of Psychiatry, vol. 14, no. 3 (2003): 340.
Suzuki, “The State, The Family”, 199–201.
Satō Masahiro 佐藤雅浩, Seishin shikkan gensetsu no rekishi shakaigaku: “kokoro no yamai” wa naze ryūkō suru no ka? 精神疾患言説の歴史社会学 「心の病」はなぜ流行するのか [Historical Sociology of Discourses on Mental Illness: Why have “Disorders of the Mind” Become Prevalent?] (Tokyo: Shin’yōsha, 2013), 220–22.
Published in the Tokyo Journal of Medical Science under the title “Actual Conditions of Home Confinement and Statistical Observations of the Mentally Ill”, this lengthy report presented the results of a painstakingly in-depth national survey conducted between 1910 and 1916 on more than 350 confinement cells as well as on “popular” treatments for mental illness. Kure Shūzō 呉秀三, Kishida Gorō 樫田五郎, Seishinbyōsha shitaku kanchi no jikkyō: gendaigo yaku 精神病者私宅監置の実況 現代語訳 [Home Confinement Conditions of the Mentally Ill (modern translation)], trans. Kanekawa Hideo 金川英雄 (Tokyo: Igaku shoin 医学書院, 2012).
Okada, Nihon seishinka, 174–75.
Suzuki, “The State, the Family”, 202–03, 213.
Ibid. 217.
Satō, Seishin shikkan gensetsu, 200–30.
Beard’s first paper on neurasthenia was published in 1869, but the two books that popularised the concept overseas were A Practical Treatise on Nervous Exhaustion (Neurasthenia). Its Symptoms, Nature, Sequences, Treatment (1880) and American Nervousness: Its Causes and Consequences (1881).
Marijke Gijswift-Hofstra, “Cultures of Neurasthenia, from Beard to the First World War” in Cultures of Neurasthenia from Beard to the First World War, ed. Marijke Gijswijt-Hofstra and Roy Porter (Amsterdam and New York: Rodopi Bv Editions, 2001), 2; Edward Shorter, A History of Psychiatry: From the Era of the Asylum to the Age of Prozac, (Hoboken: John Wiley & Sons, Inc., 1997), 129–30.
In his 1880 publication, Beard lists more than 70 symptoms, including: dilated pupils, headaches, mental irritability, morbid fears, frequent blushing, insomnia, localised muscle spasms, sensitivity to climate, a feeling of exhaustion, dry skin, tooth decay and impotence, etc. George M. Beard, A Practical Treatise on Nervous Exhaustion (Neurasthenia). Its Symptoms, Nature, Sequences, Treatment (New York: Rockwell, 1889), 36–117.
A modern civilisation characterised, according to Beard – in an oft-quoted phrase – by the following five elements: “wireless telegraphy, science, steam power, newspapers and the education of women” (quoted by Simon Wessely, “Neurasthenia and Fatigue Syndromes – Clinical Section” in The History of Mental Symptoms: Descriptive Psychopathology since the Nineteenth century, ed. German E. Berrios (London: Athlone, 1996), 512.
Brad Campbell, “The Making of ‘American’: Race and Nation in Neurasthenic Discourse”, History of Psychiatry, vol. 18, no. 2 (2007): 157–78.
The contributed volume by Marijke Gijswijt-Hofstra and Roy Porter (Cultures of Neurasthenia) clearly illustrates the differences between American, British, German, French and Dutch neurasthenia.
Tom Lutz, “Neurasthenia and Fatigue Syndromes – Social Section” in The History of Mental Symptoms, ed. German E. Berrios (London: Athlone, 1996), 533–45; Shorter, A History of Psychiatry, 119–28.
Shorter, A History of Psychiatry, 132; Volker Roelcke, “Electrified Nerves, Degenerated Bodies: Medical Discourses on Neurasthenia in Germany, circa 1880–1914” in Cultures of Neurasthenia, ed. Marijke Gijswijt-Hofstra and Roy Porter, 177–80.
Campbell, “The Making of ‘American’”, 165–68; Wessely, “Neurasthenia and Fatigue Syndromes”, 512–19. On the emergence of Freudian and Janetian concepts from the matrix of neurasthenia, see, in French, chapters V and VI of Pierre-Henri Castel, Âmes scrupuleuses, vies d’angoisse, tristes obsédés. Volume 1, Obsessions et contrainte intérieure de l’Antiquité à Freud [Scrupulous Souls, Anguished Lives, Sad Obsessed. Volume I, Obsessions and Internal Constraint from Antiquity to Freud] (Paris: Ithaque, 2011), 319–453.
Sexual neurasthenia was mentioned in an 1879 paper on “Nervous Illnesses Linked to the Male Reproductive Organs”, published in Tōkyō iji shinshi 東京医事新誌 [Tokyo New Medical Journal] one year before the publication of Beard’s Practical Treatise on Nervous Exhaustion. The term neurasthenia was translated in that paper as shinkei kyosui 神経虚衰. The first appearance of the term shinkei suijaku 神経衰弱 dates from 1884. Watarai Yoshiichi 度会好一, Meiji no seishin isetsu: shinkeibyō, shinkei suijaku, kamigakari 明治の精神異説:神経病・神経衰弱・神がかり [Diverse Theories on the Mind from the Meiji Period: neurosis, neurasthenia, possession] (Tokyo: Iwanami shoten 岩波書店, 2003), 159.
Chikamori Takaaki 近森高明, “Futatsu no ‘jidaibyō’ – shinkei suijaku to noirōze no hayari ni miru ningenkan no hen’yō” 二つの「時代病」—神経衰弱とノイローゼの流行にみる人間観の変容 [“Two ‘Illnesses of an Era’: the changes in human perspective visible in the prevalence of neurasthenia and neurosis”], Kyōto shakaigaku nenpō 京都社会学年報 [Kyoto Journal of Sociology], no. 7 (1999): 199; Satō, Seishin shikkan gensetsu, 161.
See in particular Volker Roelcke, “Biologizing Social Facts: An Early 20th Century Debate on Kraepelin’s Concepts of Culture, Neurasthenia, and Degeneration”, Culture, Medicine and Psychiatry, vol. 21, no. 4 (1997): 383–403. Degeneration theory, developed by Bénédict Augustin Morel (1809–1873) in 1857, was the first comprehensive theory of the cause of madness and occupied a prominent place in European psychiatric theory in the second half of the 19th century. Degeneration was conceived as a pathological transformation that predisposed individuals to madness. Morel believed that degeneration was inherited and had a cumulative effect, with each generation accumulating the defects of its predecessors until the extinction of the race. This process thus posed a threat to society and had to be tackled via social prophylaxis (measures to combat alcoholism, eugenic policies, etc.). Degeneration theory was highly influential in the European cultural sphere in the 1890s, where it fit in perfectly with the fin-de-siècle pessimism of the era and social Darwinism. Jean-Christophe Coffin, La Transmission de la folie 1850–1914 [The Transmission of Madness] (Paris: L’Harmattan, 2003), 21–64; Jacques Postel, Dictionnaire de la psychiatrie et de psychopathologie clinique [Dictionary of Psychiatry and Clinical Psychopathology] (Paris: Larousse, 2006), 120–22; Shorter, A History of Psychiatry, 93–99; Paul Weindling, Health, Race, and German Politics between National Unification and Nazism, 1870–1945 (Cambridge: Cambridge University Press, 1989), 80–89.
Ishida Noboru 石田昇, Shinsen seishinbyō-gaku 新選精神病学 [New Anthology of Psychiatry], revised 4th ed. (Tokyo: Nankōdō 南江堂, 1909), 237.
So-called acquired neurasthenia was also known as “chronic nervous exhaustion” (mansei shinkeisei hihai 慢性神経性疲憊, in German nervöse erschöpfung), while constitutional neurasthenia was also called “congenital neurasthenia” (shōraisei shinkei suijaku 生来性神経衰弱) or “physical neurasthenia” (taishitsusei shinkei suijaku 体質性神経衰弱).
Ishida, Shinsen seishinbyō-gaku, 261–62; Miyake Kōichi 三宅鑛一, Seishinbyō shindan oyobi chiryōgaku 精神病診断及治療学 [Diagnosis and Treatment of Mental Illness], vol. 1 (Tokyo: Nankōdō 南江堂, 1910), 594.
As was the case in Germany (see Engstrom, Clinical Psychiatry, 194–98). Serizawa Kazuya and Hyōdō Akiko have stressed that the Japanese concept of intermediate states reflects an attempt by psychiatrists to expand their professional jurisdiction from their established realm of insanity to a new area of competence – and responsibility – with regards behaviours previously seen as social or personal problems. They did this by highlighting the purported underlying medical issue. Serizawa, “Hō” kara kaihō, 138; Hyōdō Akiko 兵頭晶子, Seishinbyō no Nihon kindai: tsuku shinshin kara yamu shinshin e 精神病の日本近代 憑く心身から病む心身へ [Japanese Modernity and Mental Illness: from a possessed mind and body to a sick mind and body] (Tokyo: Seikyūsha青弓社, 2008), 136–37, 176–77.
Matsubara Saburō 松原三郎 (1877–1936), for example, one of Kure’s students who spent time in the United States (rather than Germany or Austria as was the norm at that time), saw neurasthenia as an illness of overwork suffered by people at the frontline of the process of civilisation. Kitanaka Junko 北中淳子, “’Shinkei suijaku’ seisuishi – ‘karō no yamai’ wa ika ni ‘jinkaku no yamai’ e sutigumaka saretaka” 「神経衰弱」盛衰史-「過労の病」はいかに「人格の病」へとスティグマ化されたか [The Rise and Fall of Neurasthenia: how it went from a “disease of overwork” to a “disease of personality”], Yuriika ユリイカ, vol. 36, no. 5 (2004): 156; Izumi Takateru 泉孝英 (ed.), Nihon kingendai igaku jinmei jiten 1868–2011 日本近現代医学人名事典 1868–2011 [A Biographical Dictionary of Modern and Contemporary Japanese Doctors 1868–2011] (Tokyo: Igaku shoin, 2012), 570.
Summaries of the presentations were published in Shinkeigaku zasshi, vol. 12, no. 6 (1913): 305–11.
Miyake Kōichi 三宅鑛一, “Shinkei suijaku to shinkeishitsu no kata” 神経衰弱と神経質の型 [Forms of Neurasthenia and Nervosity], Shinkeigaku zasshi 神経学雑誌, vol. 28, no. 1 (1927): 75–86.
Satō, Seishin shikkan gensetsu, 308–09.
In several of his novels, Natsume Sōseki, an eminent neurasthenic himself, depicted characters considered by friends and family to be neurasthenic (I Am a Cat, Kusamakura). Takahashi Masao 高橋正雄, “Sōseki bungaku ni okeru iyashi: ‘Shinkei suijaku’ sha no rikai to kyūsai” 漱石文学における癒し 「神経衰弱」者の理解と救済 [Healing in the Work of Sōseki – understanding and relieving “neurasthenics”], Nihon byōsekigaku zasshi 日本病跡学雑誌, no. 52 (1996): 30–36.
Kitanaka, Depression in Japan, 55–58; Satō, Seishin shikkan gensetsu, 166–84.
Watarai, Meiji no seishin isetsu, 186–94.
Satō, Seishin shikkan gensetsu, 144-59.
The golden age of neurasthenia, in terms of discourse, spanned the four decades from 1900 to 1940. Satō Masahiro has identified more than 550 articles on neurasthenia published between 1905 and 1939 in the Asahi alone, and 110 books on the subject published between 1906 and 1939 held at the National Diet Library (Satō, Seishin shikkan gensetsu, 148, 164.)
Kanō Kengo 狩野謙吾, for example, director of the Kanō Hospital in Tokyo and inventor of a “visceral cure” for neurasthenia, was just one of these “media psychiatrists”. He wrote a series of around 50 articles for the Asahi in 1905–1906, later published collectively in his book Shinkei suijaku yobōhō 神経衰弱予防法 [Preventative Methods for Neurasthenia], republished immediately upon its release (1906). Satō, Seishin shikkan gensetsu, 166–84.
The Darwinian metaphor of the “struggle for existence”, first used in the context of war (as a “struggle for existence” against the United States and the cause of neurasthenia among Russian soldiers) and later identified as the cause of the neurasthenia consuming society, is said by Satō to have helped establish an analogy between the military, political and economic “struggles” of Japan internationally, and the violence of the everyday “struggle for existence” experienced by individuals during times of peace. Satō, Seishin shikkan gensetsu, 158–59.
Satō, Seishin shikkan gensetsu, 169, 172.
Sabine Frühstück has examined the sexual dimension of neurasthenic discourse, in particular the debates over masturbation as a cause of neurasthenia and the promotion of sex education by the fledgling field of sexology. Sabine Frühstück, “Male Anxieties: Nerve Force, Nation, and the Power of Sexual Knowledge” in Building a Modern Japan: Science, Technology, and Medicine in the Meiji Era and Beyond, ed. Morris Low (New York: Palgrave Macmillan, 2005), 37–59.
Satō, Seishin shikkan gensetsu, 230–39.
Natsume Sōseki, “Gendai Nihon no kaika 1911”. Translation taken from “The Civilization of Modern-day Japan”, trans. Jay Rubin, in The Columbia Anthology of Modern Japanese Literature, ed. J. Thomas Rimer and Van C. Gessel (New York: Columbia University Press, 2011), 160. Note that although the translation uses the term “nervous breakdown”, the Japanese term employed by Sōseki was actually shinkei suijaku (neurasthenia). Bracketed elements added by the present author.
Chikamori, “Futatsu no ‘jidaibyō’”, 200–01; Wu Yu-Chuan, “A Disorder of Ki: Alternative Treatments for Neurasthenia in Japan, 1890–1945” (PhD thesis, University College London, 2012), 38. Available at http://discovery.ucl.ac.uk/1344102/1/1344102.pdf (accessed September 2018).
For example, Nakamura Yuzuru 中村譲, a psychiatrist trained at the University of Tokyo, published in 1912 a book aimed at the general public in which he ridiculed those who “took pride in suffering from modern civilisation and who, no sooner have they noticed one or two symptoms [of neurasthenia] in themselves, then they announce it to anyone who will listen, boasting that they embody civilisation” (quoted in Watarai, Meiji no seishin isetsu, 180).
Satō, Seishin shikkan gensetsu, 238; Frühstück, “Male Anxieties”, 43, 47–48.
Satō, Seishin shikkan gensetsu, 310–12.
Kitanaka, Depression in Japan, 57–59.
For example, the disorders known in the late 19th century as ki-utsu 気鬱 (melancholia, sadness, anxiety) and shaku 癪 (irritability), seen as resulting from an accumulation or stagnation of ki, were replaced during the Meiji period by the notion of nervous exhaustion. For more information, see : Shigehisa Kuriyama, “Translation and the History of Japanese Irritability” in Traduire, transposer, naturaliser: la formation d’une langue scientifique moderne hors des frontières de l’Europe au xixe siècle, ed. Pascal Crozet & Annick Horiuchi (Paris: L’Harmattan, 2004), 27–41; see also the chapter “Reading Emotions in the Body: the Premodern Language of Depression” in Kitanaka, Depression in Japan, 23–39; and Keiko Daidoji, “Treating Emotion-Related Disorders in Japanese Traditional Medicine: Language, Patients and Doctors”, Culture, Medicine and Psychiatry, no. 37 (2013): 59–80.
This change of focus to the brain was particularly visible in the names chosen for private psychiatric hospitals, which from 1899 ceased calling themselves tenkyōin 癲狂院 (in reference to traditional Japanese categories for madness) and instead became “brain clinics” (nōbyōin 脳病院), and in the frequent publication of detailed guides on how to maintain a “healthy brain” (kennō 健脳). Watarai, Meiji no seishin isetsu, 20–24; Okada, Nihon seishinka iryōshi, 156–58; Chikamori, “Futatsu no ‘jidaibyō’”, 201.
Wu, A Disorder of Ki, 46.
Satō, Seishin shikkan gensetsu, 200–30.
Erwin Baelz taught medicine at Tokyo Imperial University as a guest lecturer from 1876 to 1902.
Watarai, Meiji no seishin isetsu, 160.
Okada Yasuo, Shisetsu Matsuzawa byōin-shi 私説松沢病院史 1879-1980 [A Personal History of Matsuzawa Hospital (1879-1980)] (Tokyo: Iwasaki gakujutsu shuppansha 岩崎学術出版社, 1981), 284, 291, 324, 374 and 400.
Tōkyō daigaku seishin igaku kyōshitsu hyakunijūnen henshūiinkai 東京大学精神医学教室120年編集委員会 (ed.), Tōkyō daigaku seishin igaku kyōshitsu hyakunijūnen 東京大学精神医学教室120年 [120 Years of the Psychiatry Department at the University of Tokyo] (Tokyo: Shinkō igaku shuppansha 新興医学出版社, 2007), 261, 286.
Note that in contrast to contemporary representations of neurasthenics, a significant proportion of Gotō’s patients were shopkeepers and farmers. Quoted by Watarai, Meiji no seishin isetsu, 163–64.
This treatment, reported by Morita as having been administered by his colleague Ishida Noboru (1875–1941) (Morita Shōma 森田正馬, “Shinkeishitsu oyobi shinkei suijaku-shō no ryōhō” 神経質及神経衰弱症の療法 [The Treatment of Nervosity and Neurasthenia] in Morita Shōma zenshū 森田正馬全集 [Collected Works of Morita Shōma], vol. 1 [Tokyo: Hakuyōsha 白揚社, 1974], 346) , is typical in that it aimed to both calm the nerves and strengthen the body (see Janet Oppenheim, Shattered Nerves: Doctors, Patients, and Depression in Victorian England (Oxford: Oxford University Press, 1991), 110–40); combining rest and abundant nutrition was the trademark of the highly popular “rest cure” devised by American physician Silas Weir Mitchell.
Miyake, Seishinbyō shindan, 597; Kure Shūzō, Seishinbyō-gaku shūyō 精神病學集要 [Compendium of Psychiatry], vol. 2 (Tokyo: Tohōdō 吐鳳堂, 1916), 90; Ishida Noboru 石田昇, Shinsen seishinbyō-gaku 新選精神病学 [New Anthology of Psychiatry] (Tokyo: Nankōdō 南江堂, 1922), 450.
Kure Shūzō, “Bunmei to shinkei suijaku” 文明と神経衰弱 [Civilisation and Neurasthenia], Yomiuri Shimbun 読売新聞, 20 May 1913, 5.
Satō, Seishin shikkan gensetsu, 183.
Presented by Kanō Kengo as a world first, this treatment consisted of injecting or orally administering a blend of mysterious animal-derived “products” which he claimed were good for the body and effective not only for treating neurasthenia but also ophthalmological and pulmonary diseases, genital disorders and anaemia. Kanō Kengo 狩野謙吾, “Shinkei suijakubyō no hanashi” 神経衰弱病の話 [Conversation on Neurasthenia], Asahi Shimbun 朝日新聞, 30 June 1903, 7.
Tamura Kasaburō 田村化三郎 (a former army doctor converted to private practice), for example, claimed that he injected patients with an “excellent fortifying medicine […] which acts on the brain and nerves to strengthen the brain and increase overall physical strength, thus completely relieving neurasthenia”. Quoted by Watarai, Meiji no seishin isetsu, 185.
Kitanaka, “‘Shinkei suijaku’”, 160.
This intellectual movement was linked to the defence of a Sino-Japanese medicine deprived of institutional legitimacy since 1874 – though still widely supported by the public – and of forbidden native Japanese therapeutic practices (religious and secular). It was also linked to a revival of Buddhism during the Meiji period and a “boom” in hypnosis and scientific spiritualism. Lastly, it reflected a certain hostility towards psychiatry, which worked hand-in-hand with the state to destroy these practices. Satō, Seishin shikkan gensetsu, 262–68.
Wu, A Disorder of Ki”, 31.
Mark Nichter, “Idioms of Distress: Alternatives in the Expression of Psychosocial Distress: A Case Study from South India”, Culture, Medicine and Psychiatry, vol. 5, no. 4 (1981): 379–408.
Morita’s given name can be read either as Shōma or as Masatake. “Shōma” is the reading known to Morita’s contemporaries, for example his student and successor Kōra Takehisa, who presented Morita by the name Shōma in foreign journals. “Masatake” is thought to be the true reading of Morita’s given name, as Morita himself was heard to confirm on one occasion. Although “Masatake” is becoming popular in contemporary academic literature (it was chosen by the Encyclopaedia of Psychiatry for example [Seishin igaku jiten 精神医学事典, Tokyo: Kyōbundō, 1993]), both readings coexist, as indicated in the Dictionary of Modern and Contemporary Japanese Physicians (Nihon kingendai igaku jinmei jiten 日本近現代医学人名事典, Tokyo: Igaku shoin, 2012). I have decided to retain the usual reading of “Shōma”.
Hentai shinri 変態心理 [Abnormal Psychology] was a journal founded in 1917 by Nakamura Kokyō 中村古峡 (1881-1952), a literary graduate from the Imperial University, and other intellectuals. It criticised the materialism of modern psychiatry, advocated the scientific study of all “abnormal” psychic phenomena (including psychopathology, hypnosis and psychotherapies, deviance and supernatural phenomena) and published papers in a range of fields, for example psychology, literature, sociology, medicine, education, anthropology, criminology and sexology. Kanno Satomi 菅野聡美, “Hentai” no jidai 〈変態〉の時代 [The Age of “Abnormality”] (Tokyo: Kōdansha 講談社, 2005), 16–20.
Morita Shōma, “Shinkeishitsu no ryōhō” 神経質の療法 [Nervosity Treatment], Seiikai zasshi 成医会雑誌, no. 453 (1919): 315–27; Morita Shōma, “Shinkeishitsu no hanashi” 神経質の話 [Talking about Nervosity], Hentai shinri 変態心理, vol. 3, no. 6 (1919): 510-26; Morita Shōma, “Shinkei suijaku no tokushu ryōhō” 神経衰弱の特殊療法 [Special Treatment for Neurasthenia], Hentai shinri 変態心理, vol. 7, no. 4 (1919): 420; Morita Shōma, “Shinkei suijaku no hontai, shinkeishitsu no ryōhō” 神経衰弱の本態・神経質の療法 [The True Nature of Neurasthenia: Treating Nervosity], Shinkeigaku zasshi 神経学雑誌, vol. 20, no. 7 (1921): 361–67.
In contrast to many other works on the history of Morita therapy, which retain the transcription shinkeishitsu, in this paper the term has been translated as “nervosity”. As we saw earlier, the term shinkeishitsu was adopted by Japanese psychiatrists in the early twentieth century as a translation of the Western terms Nervosität and nervosity/nervousness. Retaining the Japanese word in Western texts gives this concept an artificially exotic feel, when it was actually derived from a shared intellectual context. Although later connotations of the term (post-World War II) may justify such a decision, when talking about Morita himself, it seems anachronistic.
The first, Shinkeishitsu oyobi shinkei suijaku-shō no ryōhō 神経質及神経衰弱の療法 [The Treatment of Nervosity and Neurasthenia], published in 1921, was republished annually; Shinkei suijaku oyobi kyōhaku kannen no konjihō 神経衰弱及強迫観念の根治法 [Completely Curing Neurasthenia and Obsessive Thoughts], published in 1926, was republished no less than thirty times in ten years; finally, Shinkeishitsu no hontai oyobi ryōhō 神経質の本態及療法 [The True Nature and Treatment of Nervosity] was published in 1928.
Morita Shōma 森田正馬, “Shinkei suijaku oyobi kyōhaku kannen no konjihō” 神経衰弱及強迫観念の根治法 [Completely Curing Neurasthenia and Obsessive Thoughts], in Morita Shōma zenshū森田正馬全集 [Collected Works of Morita Shōma], vol. 2 (Tokyo: Hakuyōsha 白揚社, 1974), 73.
Morita, “Shinkei suijaku oyobi kyōhaku”, 72.
Morita, “Shinkeishitsu oyobi shinkei suijaku-shō”, 347.
Wu, A Disorder of Ki, 128–39.
Nomura Akichika 野村章恒, Morita Shōma hyōden 森田正馬評伝 [Critical Biography of Morita Shōma] (Tokyo: Hakuyōsha 白揚社, 1974), 158. Morita belonged to the first cohort of Kure’s students.
However, he was not the only person to take an interest in psychotherapy. One of his classmates at university, Ishikawa Teikichi 石川貞吉 (1869–1940), published a fairly comprehensive review of psychotherapies in 1910: Seishinryōhō-gaku 精神療法学 [Psychotherapy].
This knowledge was derived from books. Morita never studied overseas.
Morita, “Shinkeishitsu no hontai oyobi ryōhō”, 395–406.
Despite initially writing almost exclusively in medical publications, in the 1910s Morita wrote most frequently for the general public (Hentai shinri, women’s magazines and medical journals aimed at the layman).
Morita was not the first Japanese psychiatrist to explore the psychological causes of nervosity. One of his university classmates, Nakamura Yuzuru 中村譲 (b. 1877, death unknown), wrote a book for the general public in 1912 in which he argued that neurasthenic symptoms were caused by the mind (Shinkeishitsu to sono ryōhō 神経質とその療法 [Nervosity and its Treatment]).
“Neurasthenia is said to increase with culture, as if it resulted from physical and nervous exhaustion caused by the struggle for existence. But the struggle for existence is above all about getting enough food to live. Are there many neurasthenics among those who struggle to feed themselves? No. Neurasthenia is actually more frequent among the affluent.” Morita, “Shinkei suijaku oyobi kyōhaku”, 71.
Morita, “Shinkeishitsu oyobi shinkei suijaku”, 333.
Morita, “Shinkei suijaku oyobi kyōhaku”, 81.
“Nervosity is a constitution characterised by an excessively sensitive and weak physical and mental stamina; in other words, it is not a disease. For the sake of convenience, since its symptoms can be significant and disabling in everyday life, I will refer to it as if it were a disease. However, just like the feeble-minded and degenerates, nervous individuals represent an intermediate state with regards mental illness.” Morita, “Shinkeishitsu oyobi shinkei suijaku”, 252.
Ibid. 241.
According to Morita, this hypochondriacal tendency was fuelled by the hygienist discourse of the day and it was only in this sense that neurasthenia could be considered a “disease of civilisation”.
Morita, “Shinkeishitsu oyobi shinkei suijaku-shō”, 240–41.
Ibid. 326–27; Morita Shōma, “Shinkeishitsu no hontai oyobi ryōhō” 神経質の本態及療法 [The True Nature of Nervosity and its Cure], in Morita Shōma zenshū 森田正馬全集, vol. 2 (Tokyo: Hakuyōsha 白揚社, 1974), 281–442.
Morita, “Shinkeishitsu oyobi shinkei suijaku-shō”, 244.
Ibid. 248.
Ibid. 244.
Morita Shōma 森田正馬, “Henshitsusha no bunrui ni tsuite” 変質者の分類について [Classifying Degenerates], Shinkeigaku zasshi 神経学雑誌, vol. 27, no. 9 (1927): 556–62.
Morita, “Shinkeishitsu oyobi shinkei suijaku-shō”, 253; Morita, “Shinkeishitsu no hontai oyobi ryōhō”, 315–16.
Morita, “Shinkeishitsu oyobi shinkei suijaku-shō”, 253, 334–340.
According to Morita, nervosity was a pathological by-product of an essentially positive trait he called the “desire for life” (sei no yokubō 生の欲望), which he contrasted with the “fear of death” (shi no kyōfu 死の恐怖). Since these two characteristics were directly proportional, intense anxiety was seen as signalling an equally strong desire for life.
Irie Hideo 入江英雄 speaking in Kōra Takehisa 高良武久 (ed.), Keigai sensei genkōroku – Morita Shōma no Omoide 形外先生言行録-森田正馬の思い出 [The Words and Deeds of Professor Keigai — Recollections of Morita Shōma] (Tokyo: Morita Shōma Seitanhyakunen kinen jigyōkai 森田正馬生誕百年記念事業会, 1975), 85. Comments like this abound in the accounts given by Morita’s patients.
Sociologically speaking, to a certain extent Morita’s clientele reflected the stereotypes on neurasthenia: the overwhelming majority were men and a third were students; however, there were also many shopkeepers, office workers, farmers, bureaucrats, soldiers and teachers. Morita refuted the cliché of the overworked neurasthenic student, which he saw as a statistical bias caused by the fact that nervosity usually appeared at an age when people were still in education (which by then had been extended to the general public). Morita Shōma, “Shinkeishitsu ni taisuru yo no tokushu ryōhō seiseki” 神経質に対する余の特殊療法成績 [The Results of my Special Treatment for Nervosity] in Morita Shōma zenshū 森田正馬全集 [Collected Works of Morita Shōma], vol. 2 (Tokyo: Hakuyōsha 白揚社, 1974), 34–43; Morita, “Shinkei suijaku oyobi kyōhaku”, 116–17.
Based on Morita’s description of his therapy in his 1928 book (see the 1974 republication in Morita, “Shinkeishitsu no hontai oyobi ryōhō”). He had been administering it for around ten years at the time of writing and it had acquired a more or less stable form.
In reality Morita also treated many sufferers as outpatients and by correspondence.
Morita, “Shinkeishitsu no hontai oyobi ryōhō”, 412–13.
Morita claimed to have hospitalised “more than 260 patients” between 1919 and 1928. Given that he treated 86 in 1925, this puts the average yearly number at between 14 and 28. Morita, “Shinkeishitsu no hontai oyobi ryōhō”, 361.
Ibid. 348–52.
Ibid. 353–56.
Similarly, reading should not be either contemplative or forced in order to encourage the patient to let go of their perfectionistic and inhibiting desire to read efficiently (a phobia of reading was common among student neurasthenics). Ibid. 358–60.
Morita, “Shinkeishitsu no ryōhō”, 318.
Morita, “Shinkeishitsu no hontai oyobi ryōhō”, 348, 365–66.
Ibid. 325.
Ibid. 347.
For example, Morita abandoned hypnosis after practicing it for many years, discovered almost by accident the benefits of occupational therapy on psychotic patients at Sugamo Hospital, and relaxed the method of regulated living developed by Swiss psychiatrist Otto Binswanger (1852–1929) after deciding that too much structuration impeded the spontaneous activity of patients and was only effective during hospitalisation. Morita, “Shinkeishitsu no hontai oyobi ryōhō”, 348 and 408.
The famous Swiss neurologist and psychotherapist Paul Dubois developed a psychotherapy for nervous disorders that aimed to “make the patient master of himself” through “the education of the will, or, more exactly, of the reason.” Dubois, The Psychic Treatment of Nervous Disorders: The Psychoneuroses and Their Moral Treatment, trans. Smith Ely Jelliffe and William A. White (New York: Cornell University Library, 2009), 35. The original text was translated into several languages and abundantly republished.
This contradiction of ideas refers to the conflict between “objective” reality and the way it is perceived or desired to be. Such a conflict can be resolved by adopting an existential attitude of “obedience to nature” (shizen fukujū 自然服従) and by accepting things “as they are” (arugamama あるがまま). Morita, “Shinkeishitsu no hontai oyobi ryōhō”, 326.
Ibid. 348.
The paper Morita sought to publish was translated into German by Shimoda Mitsuzō and refused on several occasions in Germany. It was finally rewritten by one of Shimoda’s students and published in 1940, under the title “Der Begriff der Nervosität”, in the journal Zentralblatt für Psychotherapie und ihre Grenzgebiete.
Matsubara Saburō 松原三郎 et al., “‘Shinkeishitsu oyobi shinkei suijaku-shō no ryōhō’ ni taisuru gakkai no hankyō” 「神経質及神経衰弱症の療法」に対する学界の反響 [Reactions of the Academic World to the Treatment of Nervosity and Neurasthenia], Hentai shinri 変態心理, vol. 8, no. 6 (1921): 650–58.
Ishikawa Teikichi 石川貞吉, Jitsuyō seishin ryōhō 実用精神療法 [Practical Psychotherapy] (Kyoto: Jinbun shoin, 1928), 169; Wu, A Disorder of Ki, 188.
Ishikawa, Jitsuyō seishin ryōhō, 169.
Shimoda Mitsuzō 下田光造 and Sugita Naoki 杉田直樹, Saishin seishinbyō-gaku 最新精神病學 [New Psychiatry] (Tokyo: Kokuseidō 克誠堂, 1930), 2. Shimoda was an unfailing supporter of Morita’s and notably presented Morita’s therapy in his own psychiatry textbook; he was also one of the few academics practising it at the time (based on Wu, A Disorder of Ki, 237).
These images regularly feature in accounts by Morita’s former patients, as reported in Kōra, Keigai sensei genkōroku, 71–72, 92, 106.
“Many people place too much emphasis on my conception of Zen Buddhism. Although I have practised sitting meditation (zazen) and carried out Zen training – for study purposes and out of curiosity – I did not even manage to resolve the kōan …. My knowledge of nervosity does not come from Zen. I simply use interesting Zen expressions to explain things.” Morita, “Shinkeishitsu no hontai oyobi ryōhō”, 231.
An extreme version of this idea can be found in the work of Naka Shūzō 中修三 (1900-1988), a student of Shimoda’s, who saw Morita’s nervosity as an exact portrait of the Japanese psyche and applied it to colonists in Taiwan (where he worked from 1934 to 1945) as the Japanese version of the “tropical neurasthenia” afflicting Westerners (Wu, A Disorder of Ki, 233–42).
See Shimazono Susumu 島園進, “Iyasu chi” no keifu: kagaku to shūkyō no hazama <癒す知>の系譜 科学と宗教のはざま [The Genealogy of “Healing Knowledge”: between science and religion] (Tokyo: Yoshikawa kōbunkan 吉川弘文館, 2003), 110–78.
See Wu, A Disorder of Ki, 205–21, 228–33.
Ibid. 191, 205.
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