Alternative Treatments for Neurasthenia in Japan


A review of A Disorder of Ki: Alternative Treatments for Neurasthenia in Japan, 1890-1945, by Yu-Chuan Wu.

Since the latter half of the 1990s, Japanese society has witnessed a sudden increase in patients suffering from depression (utsu byo うつ病). Although many psychiatrists and therapists have discussed the etiology of and healing approaches to this disease, the numbers of patients continued to rise in the 2000s, and some academic societies of psychiatrists eventually made a declarative statement that the disease had come to be a “national disease” of our times. However, this is not the first time the Japanese people have seen an “epidemic” of mental disorders in their history. From a historical angle, the most famous epidemic of mental disorders was probably that of “neurasthenia” (Shinkei suijaku 神経衰弱), which afflicted many Japanese intellectuals and lay people in the early twentieth century. It was also called the “national disease” of that age, like depression in our time. Yu-Chuan Wu’s doctoral dissertation, A Disorder of Ki: Alternative Treatments for Neurasthenia in Japan, 1890-1945, adds a new chapter to the historical inquiry of neurasthenia in modern Japan. When compared to previous studies on the neurasthenia epidemic in this country, Wu’s dissertation has enormous significance, and deserves praise for providing detailed analysis of multitudinous alternative treatments for this disease, including breathing exercise, quiet-sitting, and hypnotism-derived mental therapy, all of which enjoyed a great deal of popularity in the first half of the twentieth century.

Wu’s dissertation consists of four main chapters. In Chapter 1, entitled “The Abdominal Heart”, he shows how Japanese people of the age perceived and experienced neurasthenia, and how they sought to overcome it. According to Wu’s research, unlike people in Western societies, neurasthenia was perceived not as a disease of the nervous system in Japan but as a disease of the brain or head. Therefore, a feeling of “top-heaviness” was the main symptom of the disease, because, as a consequence of modernized lifestyle after the Meiji Restoration, people in the age thought that the traditional Japanese body position had been transformed and distorted. Thus patients and therapists tried to strengthen the lower belly by using breathing exercises or quiet-sitting in order to restore their “original”, innate body. The author introduces three famous methods — Futaki Kenzō’s 二木謙三 “abdominal breathing” (fukushiki kokyū 腹式呼吸), Fujita Reisai’s 藤田霊斎 “method of harmonizing the breath and the mind” (shūyō sokushin chōwahō 修養息心調和法) and Okada Torajirō’s 岡田虎二郎 “Okadaian quiet-sitting method”(Okada-shiki kokyū seiza 岡田式呼吸静坐) — in great detail in this chapter.

Chapter 2 mainly discusses the historical and cultural origins of these treatments, and their modernization process. The author points out that, although these methods were based on traditional Ki 気 theory and “Cultivating Life” (Yōjō 養生) medicine, they were actually a combination of modern and traditional medicines. In other words, they were “reinventions of traditional health methods but at the same time modern treatments with a scientific explanation” (p. 66). Wu demonstrates this fact by using some famous therapists’ theories and practices, and he also describes the process in which these therapies gradually became transformed and represented as distinctively Japanese methods in the context of the rise of nationalism after 1920. Chapter 3 deals with the theme of hypnotism-derived mental therapy. After reviewing the introductory process of hypnotism in Japan, the author inquires into how Japanese mental therapists understood the mechanisms of the human mind and the causes of neurasthenia. According to Wu, mental therapists thought that the stagnant flow of ideas, which was caused by distractions resulted from people’s countless encounters with Western novelties, was the main cause of neurasthenia. They therefore recommended that patients utilized hypnotic therapy in order to regain the original state of the Japanese mind: the profluent flow of Ki and the natural flow of attention.

The conceptualization of the “uniqueness” of the Japanese mind and the original therapeutic approaches for neurasthenia were similar to the view of Morita therapy, which was possibly the most famous psychotherapy invented in modern Japan. This therapy is the theme of the final chapter. In Wu’s view, Morita therapy was also “designed to treat neurasthenia based on an understanding of the disease that integrated Western psychological concepts with traditional perceptions and conceptions of the body and mind” (p. 191). Morita Shōma 森田正馬 and other therapists commonly acknowledged the existence of the special nature and superiority of the Japanese body and mind, and thus such “Oriental” (perhaps ethnocentric) thought was one reason for the popularity and effectiveness of the therapy in Japan. In this chapter, the author discusses Morita’s original conception of neurasthenic patients — shinkeishitsu 神経質 (literally “nervous disposition”) — and his original healing approaches to them in detail.

This dissertation is a truly evocative and well-researched study that opens up a new horizon for the study of the Japanese neurasthenia epidemic in the first half of twentieth century. Compared to previous studies about this phenomenon, this dissertation has a substantial advantage in focusing on the multitudinous local therapies peculiar to modern Japan and analyzing their historical origins, conceptual continuities and discontinuities through history, the modernization and scientization process, and the socio-political contexts in which these therapies attained nationwide popularity. In particular, I think it is a penetrating indication that Morita therapy and other Japanese local mental therapies were based on approximately the same preconceptions about the “Japanese mind” and its distortions. This analysis will recast, or encourage the reconsideration of, the conventional understanding of the theoretical background of Morita therapy. When the dissertation is published as a book monograph, it should make a substantial contribution to not only the historical study of neurasthenia in Japan but also to the broader research field on the history of both mental and physical therapies in modern societies.

Sato Masahiro
Research Fellow
Sociology Department
University of Tokyo

Primary Sources

Yoshinaga Shinichi 吉永進一 (ed.), Japanese Body, Mind and Spirit: An Anthology of Modern Folk Mental Therapies (日本人の身・心・霊: 近代民間精神療法叢書), Part I (8 vols.) and Part II (7 vols.)  (Tokyo: Kuresu Shyuppan, 2004).
Kōra Takehisa 高良武久 et. al. (eds.), The Complete Works of Morita Shōma (森田正馬全集), 7 vols (Tokyo: Hakuyo-shya, 1974).
Shinkeishitsu (神経質), Vols. 1-12 (Tokyo: Shinkeishitsu Kenkyu-kai,1930-1941).

Dissertation Information

University College London. 2012. 297pp. Primary Advisors: Sonu Shamdasani and Michael Neve.


Image:  Morita Shōma 森田正馬 (1874-1938), Web森田療法図書館.

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