The cultural practices and cultural meaning of health care in urban Japan.

This is one of the first attempts to explore the effects of social, political, and cultural variables on the interpretation of ideas about health, illness, and medical care in a technologically rich society. In this collection of essays, five anthropologists and one political scientist demonstrate that modern medical care in Japan is not a uniform, value-free scientific endeavor, but rather a culturally shaped part of a complex pluralistic medical system that is, itself, the product of a specific historical and social tradition. The comparative study of health, illness, and medical care provides a rich source of cross-fertilization of ideas among the social sciences. This collection of essays offers new insights on and raises new questions about contemporary Japanese society, biomedicine as a cultural product, and the transformation that occurs when medical knowledge and techniques are used in a different cultural milieu.

"This is a terrific book―moving, clear, and compassionate. It not only illustrates the way psychiatric illness is shaped by culture, but also suggests that social environments can be used to improve the course and outcome of the illness. Well worth reading." — T. M. Luhrmann, author of Of Two Minds: An Anthropologist looks at American Psychiatry Bethel House, located in a small fishing village in northern Japan, was founded in 1984 as an intentional community for people with schizophrenia and other psychiatric disorders. Using a unique, community approach to psychosocial recovery, Bethel House focuses as much on social integration as on therapeutic work. As a centerpiece of this approach, Bethel House started its own businesses in order to create employment and socialization opportunities for its residents and to change public attitudes toward the mentally ill, but also quite unintentionally provided a significant boost to the distressed local economy. Through its work programs, communal living, and close relationship between hospital and town, Bethel has been remarkably successful in carefully reintegrating its members into Japanese society. It has become known as a model alternative to long-term institutionalization. In A Disability of the Soul, Karen Nakamura explores how the members of this unique community struggle with their lives, their illnesses, and the meaning of community. Told through engaging historical narrative, insightful ethnographic vignettes, and compelling life stories, her account of Bethel House depicts its achievements and setbacks, its promises and limitations. A Disability of the Soul is a sensitive and multidimensional portrait of what it means to live with mental illness in contemporary Japan.

Over the last twenty years, type 2 diabetes skyrocketed to the forefront of global public health concern. In this book, Mari Armstrong-Hough examines the rise in and response to the disease in two societies: the United States and Japan. Both societies have faced rising rates of diabetes, but their social and biomedical responses to its ascendance have diverged. To explain the emergence of these distinctive strategies, Armstrong-Hough argues that physicians act not only on increasingly globalized professional standards but also on local knowledge, explanatory models, and cultural toolkits. As a result, strategies for clinical management diverge sharply from one country to another. Armstrong-Hough demonstrates how distinctive practices endure in the midst of intensifying biomedicalization, both on the part of patients and on the part of physicians, and how these differences grow from broader cultural narratives about diabetes in each setting.

This collection brings together fifteen chapters written by scholars specializing in disciplines ranging from anthropology and sociology to literature, film, and performance studies. These scholars analyze complex questions about how the body is lived and imagined as a locus of meaning-making in contemporary Japan. Exploring such topics as mind-body dualism, aging and illness, spirit possession, beauty, performance, and gender, this collection addresses the wide array of socio-cultural and literary contexts in which the body is interpreted in Japanese culture and thought.

Karatani Kojin is one of Japan's leading critics. In his work as a theoretician, he has described Modernity as have few others; he has re-evaluated the literature of the entire Meiji period and beyond. As one critic has said, Karatani's thought "has had a profound effect on the way we formulate the questions we ask about modern literature and culture ... [his] argument is compelling, moving even, and in the end the reader comes away with a different understanding not only of modern Japanese literature but of modern Japan itself." Among the many authors discussed are Soseki Natsume, Doppo Kunikida, Katai Tayama, and Shoyo Tsubouchi.

This book examines the phenomenon of social withdrawal in Japan, which ranges from school non-attendance to extreme forms of isolation and confinement, known as hikikomori. Based on extensive original research including interview research with a range of practitioners involved in dealing with the phenomenon, the book outlines how hikikomori expresses itself, how it is treated and dealt with and how it has been perceived and regarded in Japan over time. The author, a clinical psychologist with extensive experience of practice, argues that the phenomenon although socially unacceptable is not homogenous, and can be viewed not as a mental disorder, but as an idiom of distress, a passive and effective way of resisting the many great pressures of Japanese schooling and of Japanese society more widely. The Open Access version of this book, available at http://www.taylorfrancis.com/books/e/9781351260800, has been made available under a Creative Commons Attribution-Non Commercial-No Derivatives (CCBY-NC-ND) licence.

This book addresses the profound question of mental malaise in its many forms in contemporary Japanese society, focusing on three main areas: work, family and youth. The purpose is to provide an analytical, critical account of the social psychological state of the Japanese today, as well as to present possible measures that could contribute to positive outcomes. Following the boom and bust years of the Japanese economy in the 1980s and 1990s, Japanese society was faced with the burden of rapid change and adjustment resulting in a significant increase in psychological and personality disorders at a level unknown in the past. These include karo-jisatsu (suicide by overwork), sekkusu-resu (sexless marriage), kateinairikon (in house divorce) and hikikomori (complete social withdrawal). This study will be widely welcomed by sociologists, psychologists and mental health professionals interested in the interconnectedness of culture and social structure, personality and psychopathology, and the historical development of these issues. It also offers valuable insight into questions relating to cross-cultural understanding.

The recent manifestation of exclusionism in Japan has emerged at a time of intensified neoliberal economic policies, increased cross-border migration brought on by globalization, the elevated threat of global terrorism, heightened tensions between East Asian states over historical and territorial conflicts, and a backlash by Japanese conservatives over perceived historical apologism. The social and political environment for minorities in Japan has shifted drastically since the 1990s, yet many studies of Japan still tend to view Japan through the dominant discourses of “ethnic homogeneity (tanitsu minzoku shakai)” and “middle-class society (so ̄churyu ̄-shakai)” which positions the exclusion of minorities as an exceptional phenomenon. While exclusionism has been recognized as a serious threat to minority groups, it has not often been considered a representative issue for the whole of Japanese society. This tendency will persist until the discourses of tanitsu minzoku shakai and so ̄churyu ̄-shakai are systematically debunked and Japan is widely recognized as both multiethnic and socio-economically stratified. Today, as with most advanced capitalist countries, serious social divides occasioned by the impacts of globalization and neoliberalism have destabilized Japanese society. This book explores not only how Japanese society is diversified and unequal, but also how diversity and inequality have caused people to divide into separate realities from which conflict and violence have emerged. It empirically examines the current situation while considering the historical development of exclusionism from the interdisciplinary viewpoints of history, policy studies, cultural studies, sociology and cultural anthropology. In addition to analyzing the realities of division and exclusionism, the authors propose theoretical alternatives to overcome such cultural and social divides.