[On the "folkloric" psychotherapy to schizophrenic patients--based on phenomenological study]

Area of Science:

• Psychiatry and Psychotherapy
• Cultural Anthropology
• Phenomenology

Background:

• Psychotherapeutic treatment for schizophrenia is often difficult, complicated by patient-doctor conflict over delusions.
• Delusions are often rooted in patients' fundamental experiences and concepts, necessitating a deeper understanding beyond simple judgment.

Observation:

• Patients experiencing delusions often exhibit a conflicted mental state, indicating a collapse in adaptability to their social environment ("Seken").
• This conflict can lead to feelings of guilt and a sense of indebtedness or deserved punishment.
• Phenomenological analysis revealed that delusions stem from a patient's subjective reality and their perceived deviation from social norms ("Giri").

Findings:

• A novel psychotherapeutic approach was developed, focusing on the Japanese concept of "Seken" (society/world) and its cultural underpinnings.
• Utilizing folktales (e.g., "Torikuyou") and proverbs ("Kotowaza"), patients were guided to understand the reciprocal nature of experiences, such as stealing and being stolen.
• This method facilitated a collaborative reframing of delusions, moving from disputing their validity to fostering a positive understanding of the patient's primary experience.

Implications:

• The approach successfully reduced psychological conflict and distanced patients from delusions rooted in erroneous judgments.
• It offers a culturally sensitive framework for treating schizophrenia, particularly for individuals struggling with social adaptation and persecution delusions.
• This work highlights the potential of integrating cultural narratives and concepts into psychotherapeutic interventions for complex mental health conditions.