Rethinking the concept of kokoro no kea (care for mind) for disaster victims in Japan

ABSTRACT

The Japanese concept of kokoro no kea (care for mind) is a local notion based on the global concept of post-traumatic stress disorder (PTSD). This localized concept has contributed to raising awareness of the need for post-disaster psycho-social support and establishing a disaster mental health system. Despite its intention to reduce the mental health-related stigma by expressing that mind can be injured in the same way as body can, the reluctance to seek support still persists. This paper aims to explore the challenges underlying the notion of kokoro no kea in changing the help-seeking behaviour of disaster victims through examining Japanese cultural concepts and political history. The literature review suggests that the semantic ambiguity embedded in the concept does not fully reflect the double-natured structure of consciousness in Japan which is related to an interdependent self in a society where cohesiveness and social inclusion are emphasized. Nor is the concept able to adequately signify the way that societal power relations have produced the collective experience of suffering. This paper concludes by reiterating that the cultural configuration of the self, language use, and the socio-political aspect of collective trauma are crucial elements in addressing the mental health needs of disaster victims.

KEYWORDS:

• PTSD
• disaster
• trauma
• mental health system
• culture

Acknowledgements

The author greatly appreciates Dr Allan Young and Ms Nicole A. D’souza for their comments on an earlier version of this manuscript. An earlier version of this paper was presented as Charles Hughes Memorial Fellowship Lecture at the 37th Society for the Study of Psychiatry and Culture Annual Meeting held in Minneapolis in May 2016.

Disclosure statement

No potential conflict of interest was reported by the author.

Notes on contributor

Sakiko Yamaguchi is a PhD student in Social and Transcultural Psychiatry at McGill University. Her main research interests are long-term effects of violent conflicts on mental health and the mediating role of culture, which produces the multiple meanings of trauma experiences as well as individual and collective resilience in the post-conflict settings.