A Japanese Jungian perspective on mental health and culture: wandering madness

I must confess I find it very difficult to give a summary and provide a whole picture of this book. Its style is not academic but tricky. There seems no logical connection or consistency between each chapter. One biggest question the author asks is, ‘What is madness?,’ to which question the diagnostic system of western psychiatry cannot provide any answer. The author writes he once witnessed a woman whose diagnosis was schizophrenia, screaming, ‘I am going mad. I am on the brink of madness!’ (preface, p. xix). This episode indicates that the Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnosed schizophrenia, yet she was not mad (or at least she thought not). Psychiatry cannot properly incorporate madness itself into its system. So, according to the author, madness has been wandering. Therefore, the author argues, a new perspective is demanded to ‘to access the sense of awe at the core of the human psyche’ (preface, p. xxi). ‘Psycheology’ is the word he coined for a ‘new wineskin’ to contain madness.

The rhetoric in the original Japanese text is so unique that it could be called twisted and strange, while the translator modestly called its style ‘poetic’ (introduction, p. xi). Many words used in the original Japanese text cannot be found in dictionaries. Key terms such as ‘kyō-bi 狂美’ (translated as ‘mad beauty, Notes’ p. 9), ‘syō-bi 傷美’ (translated as ‘wounded beauty,’ Notes p. 9), ‘hagyō 破形’ (translated as ‘disfigured,’ p. xxv) are coined by the author, as well as terms like ‘psycheology 精神学’ or ‘cause of existence 存在因,’ the definition for which is not provided and left to the readers’ intuitive understanding.

Methodological background or the context into which this book should be located is not clear. The author is a psychiatrist and Jungian analyst, and yet this book has something different from the taste of books by Jungian authors we are familiar with. That is, classical Jungians are ready to dive into the ancient mythological text while discussing the symptom of their clients’ illness, and then go on to reduce it to the Jungian concepts like ‘shadow,’ ‘archetype,’ ‘individuation process.’ The author doesn’t necessarily resort to the Jungian terms, nor refers to ancient text of myth. Instead, he makes a great many references to modern novelists like Ryūnosuke Akutagawa or Edgar Allan Poe, to Japanese traditional popular entertainment like kabuki or rakugo, and even to contemporary TV drama series or manga. There should be few, if any, readers who are familiar with all those figures appearing in these stories, so it is quite difficult to read through without getting lost. Probably this range of scope is an expression of the broad knowledge of an intellectual who was born in the mid-Showa era (in the 1950s). Black Jack, for example, is a well-known hero in the eponymous manga by Osamu Tezuka, whose works have been very popular among Japanese people in their 40s or above. But when the author steps over out of the Showa era and jumps to twenty-first century movies or TV drama series, readers in former generations must feel disoriented. Thus, this book requires a complicated literacy: a vocabulary of psychology and psychiatry as well as wide knowledge in classical literature and even pop culture in Japan are necessary.

In ‘Introduction: Madness embraced,’ the author describes his childhood memories, which were to be ‘a formative experience’ to make him a psychiatrist. He was brought up in the countryside and met with a mad woman, who would have been considered to have schizophrenia, dancing with shadow or woundedness. But odd people like this were ‘a part of the world’ (p. 3). The author suggests there was ‘a true religion.’

In Chapter 1 ‘On the question of why,’ the author mentions Little Prince by Saint-Exupéry, as well as Spider Man and Japanese TV dramas. He criticizes the natural science orientation of psychiatry, which has attempted to understand symptoms of mental disorders by dividing their causes into endogenous and exogenous cause. The author supposes there is ‘The Cause of Existence’ behind them, which is the very thing Little Prince attempts to express in his drawings, or the mad woman in her dancing. What psychiatry fails to grasp is the constellation of whole things and ‘The Cause of Existence’ behind them.

In Chapter 2 ‘What is madness?,’ cases are mentioned where patients ‘cross the first line’ and are overtaken by madness. Since they couldn’t ‘remain grounded,’ the Queen in Snow-white went as far as to eat the lung and liver of her daughter, and the man in Black Cat by Poe to kill the cat and his wife. The author argues that what they should have done to ‘remain grounded’ is to ‘dance to connect her (his) madness with her ego’ (p. 44). To remain grounded, it is necessary ‘to remain aware of our own hideous wounds.’ It is this hideous side that Sonya in Crime and Punishment by Dostoevsky has, like therapists do, in assisting Raskolnikov, who couldn’t remain grounded and murdered an old woman (p. 52).

In Chapter 3 ‘The impossibility of objectivity,’ Yabu no naka by Ryūnosuke Akutagawa is taken up to warn against placing too much trust in objectivity. As depicted in Yabu no naka, subjective views are overlapped with each other; therefore, madness wanders on the level of psychic reality. So, it is necessary to keep in mind that the view of madness in psychiatry is a mere reflection of one subjectivity.

In Chapter 4 ‘The departure from godhood,’ the author discusses personality disorders (disordered personhood), especially borderline cases. According to the author, personality disorder is the state in which patients seek for godhood unsuccessfully and suffer from a resultant disturbance of personhood. And the definition of borderline cases is ‘people not at the psychotic level … who act out’ (p. 80). So the aim of the treatment would be to construct the levee against acting out. This chapter was written as a prescription for disordered personhood (p. xxii). So readers who are familiar with literature in clinical contexts would find these pages easier to assimilate.

In Chapter 5 ‘For those who wander in mazes,’ the author points out the difference between Japanese mazes or labyrinths and those of Europe. The former is not composed to lock up people, that is, there is always a way out. This is a reflection of Japanese cultural tradition. The ‘slight presence’ of the therapist is also characteristic of Japanese psychotherapies, where shadow and ego coexist without conflicting with each other; therefore, people are allowed to live their woundedness. The tradition of ‘the idea of two heroes standing abreast’ (p. 94) has enabled this. Black Jack is one character that embodies this idea. Black Jack, a young doctor with an ugly scar on his face, suffered his mother’s murder and was himself seriously injured as a boy, but abandoned his decision to revenge himself upon the enemies. He instead chose to follow a career as a doctor who saves the weak with his miraculous skill in surgery. The author calls figures like him a ‘disfigured hero.’

In the Conclusion ‘From mental health to psycheology,’ the author summarizes the points he has raised in the book and presents some ideas about possible future directions for his theory of madness. The diagnostic system of psychiatry has attempted to enclose madness or even the whole human spirit in its objective and universal scale and has failed so far. The author’s solution to this problem is to provide the proper room for madness in the arts (p. 114). In the Japanese original text, this is stated in the vocative case, ‘Madness, your place is in the arts.’

What kind of readers is this book targeted at? There has been a book genre in Japan written by psychiatrists or psychologists for general readers. Among such authors, one of the best known is Freudian psychiatrist Takeo Doi (1920–2009), who wrote The Anatomy of Dependence (甘えの構造, Amae no Kōzō) in 1971. Keigo Okonogi (1930–2003) is also a well-known author who produced many books from a Freudian perspective, discussing ‘the age of moratorium personality,’ or ‘narcissistic personality’ in Japanese society. Hayao Kawai (1928–2007), a pioneer of Jungian psychology in Japan, is counted as one of the most popular and productive authors, who discussed the pathology of Japan as a maternal society, or pointed out the ‘center-empty structure’ in Japanese myths and culture. Books by these authors, using newly imported psychoanalytic terms, have discussed various problems about the Japanese psyche and society and have been welcomed as a kind of Nihonjinron日本人論, which focuses upon Japanese cultural identity as something unique and superior. This volume by Akita could also be regarded as one among the psychological Nihonjinron texts in that it points out the uniqueness of Japanese psyche and culture.

Another trend in psychological literature in Japan that should be pointed out is that a substantial number of titles discussing borderline cases or personality disorder in general have come out every year since the 1990s. Many of them are, of course, for the interest of clinical experts, but personality disorder has been a remarkably hot topic for the wider population.

So there might be readers in Japan who are ready to understand what Akita argues in this book. But, as I stated above, the unique style of writing by this author makes this book rather tough for general readers. Of course psychological experts with similar clinical experience as Akita’s will find it easier to follow the logic and appreciate his message. But such experts must be limited in number and they do not necessarily share cultural interests with him. Probably readers who can have the deepest sympathy with the author will be those who are forced to live awkwardly in this society, embracing disordered personhood. They may feel empowered by or even find salvation in this book, as the author helps them find a proper place for madness, instead of suppressing it.

My comments here in some parts should have been given to the original Japanese text. Then how should the English edition be read? The irregular style of the original publication was seemingly rendered straightforward in the English translation. The translator must have taken great pains to do this, but this book is all the same tough to read through without broad knowledge of Japanese culture. Definitions of the terms are not clear enough. For example, although the author many times mentions ‘godhood,’ which is allegedly the state that people with disordered personhood seek for, its definition is not given. Is god in this case the Christian god, or a god in Japanese myths? It’s all left to readers’ imagination. This is also the case with ‘true religion.’ But this is his style and his purpose is to present pieces of ideas and to inspire the readers.

One important message of the author is that disordered personhood is a symbolic symptom, behind which is the pathology of Japanese society. This is partly the result of the spread of western psychiatric views of human psyche, which expelled madness away from our lives. If English readers of this book agree with the author on this point, they can grasp fruitful implications in it and apply them to their own society. The author chose to search for a key to break through this in Japanese cultural tradition and also in pop culture. This is an attempt to point out unique advantages of Japanese consciousness, so I call it one variation of psychological Nihonjinron.

I stated above that this book has something different from those by classical Jungians. But I also find it very Jungian when I hear echoes of James Hillman’s work here and there in the volume. James Hillman (1926–2011) is one of the representative Jungian psychologists in the U.S., known as the founder of ‘Archetypal Psychology.’ Apart from his provocative and tricky writing style, Akita’s argument seems to have much in common with Hillman’s. Akita writes that he incorporates into his work the ‘perspective of soul’ (p. 67), which phrase Hillman uses in his Archetypal Psychology (1981), where Hillman advocates a psychology of soul and emphasizes the importance of image, metaphor or rhetoric. Akita argues that Albert Einstein was able to ‘remain grounded’ to leave unbeatable accomplishments, thanks to the ongoing dance of his maddish thoughts with his ego (p. 43). This reminds me of Hillman’s Soul’s Code (1996), where Hillman mentioned, in describing lives of geniuses, difficulty of ‘growing down’ or ‘redressing the balance between the psyche’s weakness and the daimon’s potential’ (Hillman, 1996, p. 242).

Apart from these points, we can hear some Jungian resonances in this book, especially when Akita pays attention to unconscious factors like madness and tries to give it symbolical and ritualistic expression. Jung would have expected religion to play that role. We can properly locate Akita’s work along the line of Jungian literature. In fact, the title of the original Japanese edition didn’t have the word ‘Jungian’ in it; however, now we are assured that the translator’s choice of words in naming the English edition A Japanese Jungian Perspective was quite reasonable.