In many ways I feel I learned as much from the Japanese as they learned from me during my 5 days of sharing experiences with consumer/survivors and mental health professionals. During the period from November 17-21, 2005, I found that NEC’s message of recovery resonated deeply with the several hundred Japanese people I met with. Across language and culture there are universal aspects of the principles of recovery that ring as true in Japan as they do in the United States.
I had been invited to Japan to speak in Osaka and in Tokyo on the topic of recovery. My wife and I were hosted by Professor Hiro Matsuda during our journey to these modern cities. Hiro made the whole trip possible and productive. I had met with him and Makiko, a consumer leader from Tokyo, in Massachusetts in March of this year. Hiro heads a self-help clearinghouse in Osaka. He was a terrific host and made my talks productive and our visit a delight. He took me to the main consumer-run social club in town, the Bochi Bochi Club (Step by Step Club) on the first day. It was really an important visit. I got to bond with the members and to learn of their concerns. I also started to realize the challenge of communicating my ideas about recovery across cultures. I found they were amazed that I became a psychiatrist after I was diagnosed with schizophrenia. The stigma of mental illness is apparently even worse in Japan than in the United States. They told me that by law people labeled with mental illness in Japan are not allowed to become psychiatrists, barbers, and a variety of other positions. One member told a very touching story of his brother’s wedding. His parents told him he could attend the wedding, but they did not want the bride’s family to know that he was mentally ill. He was unable to sleep the night before the wedding. He had bags under his eyes. His family was distressed that the bride’s family would find out about his problems. So they forced him to apply makeup under his eyes. He felt humiliated, but complied. They also told me they run a warmline, which they call sharing over the phone.
Discussing Recovery in Osaka
The next night, November 18th, Hiro arranged a dinner with the members of Bochi Bochi and several other consumer leaders and advocates. One member of the club said there was a move in Japan to normalize people with mental illness. He wanted no part of it. To him recovery meant becoming comfortable with himself. It did not mean that he needed to become a new or different person. It just meant becoming who he really was. This message resonated very deeply with me. It deepened my own understanding of recovery. Another member of the club said that recovery to him meant believing in yourself as he was starting to do. He said he still feels he needs to read more before he can be a successful advocate. I pointed out that he may be holding himself back by believing that he needs to be primarily guided by knowledge gained through books and coming from above and outside himself, instead of through his own understanding of the world gained through his own experiences. I was also very moved by a nurse who traveled some distance from Okinawa. She has a masters degree in nursing and teaches at a nursing school. She articulated very clearly the plight of professionals who have not been labeled but want to change their practice to recovery. She said she had to get over the belief that people never recover, because she realizes the extreme importance of the attitude of the practitioner. She knows that if she could deeply feel that people can recover that she would be much more effective. She also said she can see there is a deep bond between the consumer/survivors. “They have a passion for their work, and a bond with each other which is very profound and which I envy.” I told her I was moved by her insights and understanding.
On November 19th I was scheduled to give my first talk. I was worried that my audience was new to the concept of recovery and would not understand what NEC means by the term. I had lunch with Hiro before the talk, and we discussed the concept of recovery. He said that the Japanese word coming closest in meaning was kaifuku. He said it means going back to a preexisting condition. It was like getting over a cold. I said the meaning of recovery from mental illness was much deeper. That people usually report that they learn something new about themselves. People who have recovered often report, like the gentleman the night before, that they gain a greater acceptance of who they truly are. He immediately grasped this deeper meaning and said it is a more existential term. He said it would be best to stick with the word recovery but to spell it out with Japanese letters. We then met with the translator and she agreed to do so. About 130 people from all stakeholder groups attended my talk. I focused a great deal on the concept of recovery. I started by sharing a good deal of my own experience with recovery. They especially appreciated my sharing of my own experience with mental illness and recovery because that is so rare in Japan. There was a very active dialogue at the end of my formal talk.
On November 20th I gave two talks in Tokyo, each of three hours duration. There was again very active dialogue after each formal portion of the talk. A parent said the talk was very helpful because it helped her to understand why her son wanted to live more independently. A consumer said that the hierarchical nature of Japanese culture made recovery difficult. Another said he was glad to hear me say that expression of feelings was important, as that was not encouraged in Japan.
On November 21st I attended the consumer-run social club in Tokyo, Choral Taito. Hiro, my wife and I shared lunch with Makiko, the director of the social club, and three other staff. Their concern focused on how a small number of people with meager resources can make a big difference in changing a very traditional system. I emphasized the need to believe in their group and to resonate with the truth inside each person. The idea that deep down each person knows the system is not working and that each of us who have experienced severe distress has important knowledge that can guide the system, was very appealing. I told them they are part of a worldwide movement toward recovery.
As we were departing, Hiro said that NEC’s message resonated with him. I told him the feeling was