Dealing With Suicide In Japan With Andrew Grimes

• One of the most disturbing records that Japan holds is having one of the highest suicide records in the world. Some estimate the number of suicides reaches as high as 30,000 per year – an astonishing 82 suicides per day! There may be several historical, cultural, and financial reasons why the suicide rate is high. Many point to the Japanese concept of ‘wa’ or keeping harmony by not sharing personal issues with others as one of the culprits. This idea of harmony can be challenging for foreigners who are new to Japan and who count on friends or colleagues as a shoulder to cry on in difficult times.
• To find out what people can do when suffering from depression, Anthony invites Clinical Psychologist Andrew Grimes on the show to talk about the issue of suicide and how mental health is dealt with in Japan.

Hard Landings in Life

Hikosaemon recently wrote an excellent post on hard landings in Japan – the pressure he faced to succeed in a company plus a crumbling relationship that all led to a lot of stress. He was able to overcome it with the help of some Japanese friends and surfing. In the west, it is generally accepted to lend some emotional support but in Japan, feelings are often bottled up. People tend to look for an outlet through various activities such as karaoke and sports. Unfortunately, a few turn to suicide, a cause of concern among authorities and the government already dealing with the country’s declining population.

With this, Anthony talked to clinical psychologist Andrew Grimes on the issue of mental health in Japan. Andrew came to the country 25 years ago to see Post-War Modern Japan and founded Tokyo Counseling in 1999. Having minored in Oriental studies, he cited the seemingly general acceptance of suicide in Japan may be traced to the seppuku or ritual suicide which is a duty under the bushido code and was eventually outlawed during the Meiji period. But even this was done as order and as part of an honor system, not voluntary. Some may have unintentionally romanticized it in culture and literature.

The sense that vocation or service gives one identity is extremely strong in Japanese culture. The loss of it in one’s culture is a huge cause of depression and anxiety. People lose pride and self-respect. Those who were unemployed for a few weeks know how depressing it can be.

In Japan where lifetime employment is on the range, being part of a company is like being accepted into a large extended family. Some companies provide recreation centers, accommodations, and foster social circles among their employees. From that point of view, if the company files for bankruptcy, it has to let go of its people. People then lose not only homes but also their identity and position in society. This was the case in the 90s when many businesses closed. Many of those who are affected by the economic downturn and by depression are men in their 40-60s who may have run out of hope and options.

Other companies manage to recruit people but selected those in their mid-careers. Recent articles on depression and suicide thus focus on young people and recent graduates who couldn’t find jobs last year. Thus, healthcare professionals keep an eye on the unemployment rate. When it goes down, people have hope things are going better and that they can get new jobs. When it goes up, people lose hope and the suicide rate goes up too.

Probably for most people, they can count on friends for counseling and sympathy. In Japan though, expressing criticism is not encouraged because maintaining harmony is more important. Some would rather talk about something less troubling and keep conversations light-hearted. While this may annoy or offend others who have shared their troubles, Andrew stated that people may not always know what to say or feel in such situations. This is not to be dismissive and uncaring, but rather they opt to help forget troubles by offering casual words or fun activities. He then suggested some ways to respond better to friends in trouble. It can be by simply giving support through a few words of encouragement. Listening without speaking is already a deep mark of sympathy.

For those who experience clinical depression, extreme mood swings, or panic attacks, see a psychiatrist as soon as possible. Symptoms that may last for long periods include not sleeping well, feeling down, anxious, and tired all the time.

Unlike before, mental health counseling is gaining more acceptance as media has brought attention to important issues and pushed back its old image on hospital confinements. Many psychiatric community clinics have been established in big cities. Rehabilitation facilities are well-staffed with clinical psychologists, trained nurses, and doctors. While the national health insurance only covers the usual medical consultations and medicines, school counselors and family therapists are now in discussion with the Ministry of Health, Welfare, and Labor to provide sufficient psychological services not yet recognized by the health card.

Tokyo Counseling Service is one clinic that offers such services in English and Japanese. Andrew’s colleagues are a mix of Japanese and foreigners trained in various schools from all over the world. They are associated with Japan’s Clinical Society for Certified Psychologists. Some of them also speak other languages such as Portuguese, French, and others which makes it a good place for residents to seek help.