The concept of neurasthenia and its treatment in Japan

The term neurasthenia, which had been widely used in Japan before the Second World War, came to be replaced by the term neurosis thereafter. With this change in terminology, there seems to have been a shift in the popular ideas of minor psychiatric disorders towards a more psychological view. Unlike in the West where psychoanalysis was a major contributing factor, in Japan it was Shoma Morita who contributed to this change by questioning the somatic basis of conditions then diagnosed as neurasthenia and by developing the concept shinkeishitsu in the early 1920's, rejecting the concept of neurasthenia. In his theory, the development of shinkeishitsu symptoms is explained in terms of certain psychic dispositions and as a vicious cycle of sensation and attention; he formulated a psychological treatment, Morita therapy, which has been very effective for that condition. With the advent of modernization in this country, doubts have been raised whether this form of psychotherapy will continue to be acceptable to modern Japanese. However, in reality many neurotic patients are still being treated with Morita therapy, although analytically oriented psychotherapy is coming to be practiced more and more in recent years. The indigenous psychotherapies represented by Morita therapy and Naikan therapy have deep-seated roots in Buddhist tradition: its values and ideas have been redefined and reformulated into forms of therapy acceptable to modern Japanese.