Are the Japanese crazy like us? (And by “us”, I mean “Americans”)

Ethan Watters is the author of “Crazy Like Us: The Globalization of the American Psyche,” and recently appeared for a six minute interview on the US comedy show The Daily Show. Curiously, much of what he talked about focused on Japan:

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The author raises this question: Is the American focus and treatment on understanding mental health (depression, schizophrenia) a “cultural” export? His answer is yes, and describes how, in treating symptoms that are believed in American culture to be “mental sickness,” we replace some symptoms that are in fact cultural characteristics in other societies. He ends up spending much of his six minutes on the Daily Show interview talking about Japan and criticizing the American “export” of mental health treatment to Japan. He says:

“Japan is actually a very sad culture. They think of sadness… almost as a religious state, as a way to get moral guidance…”

I read more about Watters book, and found some of the numbers that he uses to back his book. One is that GlaxoSmithKline and other drug makers funded favorable medical studies to sell treatments for depression in the Japanese market, with huge success — GlaxoSmithKline’s sales in Paxil went from nothing in 2000 to topping $1 billion in 2008. 27 books were published on depression from 1990 to 1995, but 177 were published from 2000 to 2005. Meanwhile, the Crown Princess is reported to be suffering from depression. So “depression” as a disease and syndrome, as opposed to a result of Japanese cultural characteristics, is now widely recognized in Japan, although I would argue that there is still much more stigma attached to it than in America.

Yet he goes on to say that Japan is perhaps the biggest copier of the American model. This seems to be absolute lunacy to me. Yes, Japan is a sad culture. The Japanese people are much more pessimistic and cynical about their future and their country’s future than any other Western developed nation. (I’ve seen stats to this effect but nothing that I can link to — feel free to weigh in on this point.) But first of all, they are still no where close to institutionalizing mental health on the educational, social, corporate, and government level. And second of all, is this the “Americanization” or “modernization” of mental health? While I think there is an excessive and too broad a focus on mental health in the United States, where everything is deemed to be an issue of mental health, I think that Japanese culture and society still has far too little emphasis on psychology, counseling and mental health.

21 thoughts on “Are the Japanese crazy like us? (And by “us”, I mean “Americans”)”

  1. Your general points, I feel, are spot on. I think that Japan is being trotted out here because most audiences are unaware of how American-style (or “modern” or “postmodern”….) clinical culture of depression has not been entrenched in Japan.

    From the point of view of “culture”, this is as silly as the most banal Nihonjinron produced domestically – “Japan is actually a very sad culture. They think of sadness… almost as a religious state, as a way to get moral guidance…” This is true of a segment of Japan’s “high culture” tradition (Buddhist melancholy, mono no aware, samurai death meditation) but had nothing to do with the pragmatic day to day or world view of 99% of the population throughout history. If we want to go high culture fishing, we can seize on “Byronic unhappiness”, Stoicism, the more morose trends of early modern Protestantism, early Christian self mortification, etc. It’s all there in the West too, but dragging it out as a meaningful explanation obscures way more than it illuminates.

    “(I’ve seen stats to this effect but nothing that I can link to—feel free to weigh in on this point.)”

    True to a degree.

    However, there have been some interesting things written about “comparative sad-ology” and a lot of it has to do with cultural norms, not emotional states.

    Example – Japanese mom, when told that her child is brilliant immediately plops her hand on the top of her head, starts bowing, and says “ie, ie, ie”. American mom told the same thing at best says “thank you!” and at worst starts listing progressively more exaggerated examples about their baby Einstein. Both of them probably think that their child is the bee’s knees. Maybe the Japanese mom more.

    In a similar respect, scholars have seen in Japanese a tendency to attempt to appear no more happy than their neighbors and in Americans a tendency to feel like a failure unless you are happy (causing, ironically, a state of perpetual anxiety about happiness that causes unhappiness!) and to exaggerate quantitative measures of happiness as a result. This isn’t the last word on this question, but I think that it complicates the discussion nicely.

    In the end, Japanese poll hugely pessimistic about their country’s future but are among the highest in the world on “were you glad to be born in (your country)?” questions while Americans (perhaps wrongly) famous for parochialism poll very low (this could be because of large numbers of dissatisfied new citizens) in international comparison.

  2. I think the relatively high level of suicide in Japan would seem to logically state that mental health and psychology are not pervasive enough in Japan. Also, the Japanese version of the Tokyo English Life Line is monumentally busy and overburdened. There are a lot of people who need and want assistance, but may be too ashamed to seek it officially so they call an anonymous line.

    I think self-proclaimed experts love to trot out Japan as an example and they like to use the U.S. as a reference point because one isn’t known well enough to dispute and the other is a rich market for certain types of books. Japan is constantly treated as a blank slate for foreigners to write their theories on because of the underlying notion that the culture is strange and exotic. I agree with you wholeheartedly that this is more about modern living than Americanization.

    Nothing gets into Japan until the Japanese government wants it to have an impact on their culture. The very late introduction of birth control pills and rapid entry of medication for erectile dysfunction prove that. Personally, I find the underlying notion that the Japanese are so incapable of making their own decisions or keeping their own cultural priorities intact and force fed American culture offensive. If it is here, it’s because the Japanese want it, not because it’s being forced on them. Maybe they don’t want to be a culture steeped in sadness as the people residing in rich, developed countries prefer to be happy, and they made choices to allow in mental health services and pharmaceuticals to further that end.

  3. It’s already mentioned above but I’ll mention it again. Japan’s extremely high suicide rate is a symptom of some problem or issue related to the mental health of a large portion of the Japanese population. That certainly is not an American export.

  4. The Japanese suicide rate is twice that of the United States but the suicide rate of the United States is twice that of Mexico. The suicide rate of African Americans is half that of whites. Across the US population, white males kill themselves at 10 times the rate of black females. There are certainly more things going on here than mental health awareness.

    In Japan, a disproportionately high percentage of suicides are terminally ill people – government statistics reveal that over 40% of Japanese suicides are due to terminal or chronic illness.

    The suicide rate for the 15-24 group, a unit that you would think is benefiting from the US mental health infrastructure, is actually slightly higher for the United States. In addition, across the board the US does not include murder suicide or the not-as-uncommon-as-you-would-hope suicide by cop in the conventional suicide statistics.

    Drug overdose (hugely relevant if we are talking about self-destructive violence) is also not included. If you add suicides and drug overdoes together, the rate of self-inflicted death is higher for the United States than Japan.

  5. I don’t hear Watters saying that Japan gets its culture of sadness, but rather that the possible solutions to these mental health problems are including pharmaceuticals and other methods that have been pushed into Japan by the West. In the end, he hopes that it isn’t forced upon other cultures with insensitivity, but that “the knowledge can flow both ways”.

    Forgetting pharma for a moment (because Japanese have been importing pharma from China for far longer), I’m amazed that products like antiperspirant or even Starbucks brownies are selling as much as they are. These types of products are indications of a change in lifestyle, however slight, and usually take a long time to have penetrate the Japanese market.

    And they remind me of the GHQ scheme to introduce school lunches, which were to include bread baked from a surplus of US wheat, all with the long-term aim of getting the J-kids hooked on bread, or at least indifferent between bread and their beloved rice. While we can talk about introducing pharma into Japan as “exporting the American psyche” I think it parallels the school lunch scheme, or P&G’s introduction of paper diapers in the 1970’s as an attempt at market penetration.

  6. Quite interesting. Some good points made by all.

    I do respectfully disagree with your dismissal of religion contributing to any meaningful explanation, M-Bone. Whether or not religion or religious rites have historically been a part of daily life for most of the population (and I would say in some countries like America, religion is a bigger part of daily life than say in Japan), religion does play a big role in shaping a culture. I’m not asserting that religion IS a big part of the equation here, but I would be interested to see some studies aimed at determining if it does in fact play an appreciable role.

  7. Today’s English Yomiuri:

    “To cope with a growing number of people suffering from depression and other mental problems due to stress at workplaces, the government plans to revise an ordinance so that mental disorders can be discovered at an early stage through medical checkups, according to sources. The government also plans to more than double the number of training hours for central government officials who specialize in giving instructions on mental health care to private companies and elsewhere. It intends to increase the time for lectures on mental health from 4-1/2 hours a year to 10-1/2 hours a year, the sources said.

    “The measures are expected to be incorporated into a proposal to be compiled by the end of this month by the Health, Labor and Welfare Ministry’s project team working on measures to prevent suicide and depression. The government aims to implement this program starting in fiscal 2011 as part of comprehensive measures to prevent suicide.”

  8. “Japan is constantly treated as a blank slate for foreigners to write their theories on because of the underlying notion that the culture is strange and exotic.”

    Yes, but I would add that this is largely an American tendency. On a hell of a lot of indicators that are seen as uniquely Japanese in America, Japan often matches up with Western European nations.

  9. “religion does play a big role in shaping a culture.”

    Sure. You are totally right. It is, however, the religion that people actually practice and experience that shapes life views, etc. Contemporary American religion, I think, has way more to do with love of Jesus than the pulverizing, total fear of Satan that was more the norm in some historical periods. These things are subject to historical change, and you can’t read “City of God” and hope to crack the puzzle of present US views of self in society.

    Is it possible to find periods of aesthetic-religio-meditation in the life path’s of ordinary Japanese? I would argue that this would be tangential at best. Sadness is intimately socially constructed and there are many things for Japanese – from mass mediated aspirations to social pressures to modernist work culture – that seem much more crucial here than the author’s attempt to play “It’s in the Tale of Genji, therefore….” That tiny world was never typical of the cultural and religious experience of more than a handful of Japanese. If anything, the social norms of Confucianism have been more widely influential than the reflective melancholy of Japanese Buddhism.

    How’s this for a poll – Daiichi Seimei, 2006, 1000 adults 40-74, 81% respond that religion is not needed for a happy life. Of the balance, some of whom no doubt responded “do not know”, I strongly suspect that you will find Christians, new religion members, etc. For many contemporary Japanese, religion is more about cultural identification – which ties to the earlier numbers I alluded to about “proud to be born in”. Those polls also reveal “traditional culture” – the religious part of which seems to have a lot more to do with family and positive cultural identification – as a mark of pride.

  10. Suicide in Japan is mostly due to the
    pattern of お金の切れ目が縁の切れ目

  11. @M-Bone

    While I do agree with your position that the vast majority of Japanese did not and do not personally spend a lot of time contemplating sadness, it does not change that the cultural narrative of sadness and depression can be influenced by the Buddhist and courtly ideals to make depression be less stigmatising than read through the narrative of personality disorder and mental illness, which is how I read Watters point in bringing it up.

  12. Like the author says, depression drugs are a billion dollar industry in Japan. Many many people are diagnosed and treated for depression. Sure, severe depression is a very real issue, but it seems like doctors are all too ready to prescribe drugs, including for depression. Adding fuel to the fire are relentless media reports of the supposedly terrible depression problem.

    This is the first time I have heard the phrase “culture of sadness” used about Japan. I am not sure what exactly he is referring to, but it’s true that tragic stories are very common in pop culture (see my post on “The Toilet God”) and unlike America it’s expected that people try not to appear overly well-off and happy.

  13. Rune – I don’t want to dismiss the possibility entirely, but why take the Buddhist and courtly ideas over Ningen Shikakku or other ideas rooted in Japanese modernity? Like the “zen influenced otaku” debate –

    these kinds of directions of arguments tend to reduce a complex network of influences to “it is tradition” which always simplifies and often legitimizes some pretty sketchy stuff.

    As for mental illness, etc. there is a considerable body of anthropological writing on folk ways of explaining this – fox spirits, possession, etc. Now that’s illness. I don’t read the contemplative melancholy of Genji Monogatari or Tsureduregusa or whatever as illness or disorder at all – it can easily be read as a performative way of asserting one’s moral worth or depth in a society in which aesthetic sadness is associated with cultural quality. Bypassing ways of dealing with mental illness in folk culture to read the Japanese tradition through select high culture products is not a good approach on Watters’ part.

  14. I think the easiest way to persuade foreginers to abandon this “the-culture-of-sadness-is-uniquely-Japanese”meme is to ask either Fujiwara Masahiko or Ishihara Shintaro to pen a Nihonjinron essay on the subject and translate that into English.Me think.

  15. @M-Bone About suicide rates: in the US, men commit suicide four times as often as women. A bit over 24,000 US men committed suicide in 2001 compared to a bit under 6,000 US women.

    However, statistically US women attempt suicide at three times the rate of US men. Men have about a 13% “success rate”, women have about a 1% “success rate”. The old explanation I heard was “men use guns or jump off tall buildings, women take sleeping pills or slash their wrists – women aim for sympathy, men aim for results”.

    Now as to all this mumbo-jumbo about a “culture of sadness” (particularly if this is being somehow connected to suicide rates), if that is what Japan has then what on earth does that say about the culture of Baltic States, Russia and other former Soviet Republics? Some of those places make Japan look bush league.

  16. “Fujiwara Masahiko or Ishihara Shintaro to pen a Nihonjinron essay on the subject and translate that into English.Me think.”

    100% right.

    How would we react if the same argument was being made by a Japanese?

    We had perfectly good cultural ways of dealing with mental illness in Japanese tradition (ignores brutal ostracism of “fox possessed” in favor of quotation of something that sounds way better like “Record of my Ten Square Foot Hut”). Stop imposing your American norms on us. That is cultural imperialism!

    Nihonjinron stinks, no matter who is doing it. One of the main reasons is that it is rooted in EXACTLY what Watters is up in arms about – modernist projects that iron out local/regional/ethnic differences in favor of strands of high culture that serve the interests of elites (bushido during the war, lifetime employment and the Japanese work ethic after).

    Going after big pharma is not always a bad thing and I’m always up for alternatives, but Watters seems to be on the borderline of using the Tale of Genji to negate the type of initiative that Mulboyne raised above.

    LB – those statistics are correct and paint an unpleasant picture.

  17. As an aside, I remember a few years back the idea of 心の風 (kokoro no kaze) being used in Japan by US pharmaceutical companies to market anti-depressants. The fact that they needed to do this suggests they had to work to create demand for something that wasn’t on the radar of the Japanese.

  18. @Fat Tony”Yes, but I would add that this is largely an American tendency. On a hell of a lot of indicators that are seen as uniquely Japanese in America, Japan often matches up with Western European nations.”

    Sorry, but I must beg to differ. I have seen just as much cultural projection on the part of Europeans (via blogs and conversations with coworkers from various cultures) as that of Americans. Frankly, I’ve found that Europeans are also more vocally ethnocentric than Americans about Japanese culture (perhaps because America pushes people to be so PC).

    That being said, I think that American media is more pervasive (both because there are more outlets and because it is an English-language resource) so one can certainly find more American-based nonsense to point at than that from other countries. They certainly appear to be more frequently off-base in their assertions if you look at the sheer volume of theories, but they by no means have the market cornered on misinformation and distortion of Japanese culture.

  19. Possibly related:
    I was just watching a couple of segments on NHK’s News Watch 9, literally a few minutes ago. The first was live from the expo in Shanghai, talking to Chinese kids who were all optimistic about what they would do in their future (building robots, designing mass transit systems, etc. etc.). The second was about a middle school in Tokyo where they were teaching kids career skills. The teacher told the class, in effect, “The population of this country is going down and the economy is not going to grow any more. This is your future. You have to decide how you will deal with it.”

    Definitely related:
    I went to a fascinating talk recently given by Etsuro Totsuka, a Japanese lawyer who was involved with legal and lobbying efforts to reform mental health care in Japan. Until the late Showa/early Heisei years, it was possible for people to check family members into mental hospitals with little more than the opinion of the doctor who was getting paid to admit the patient. The patient was not free to leave and had very little recourse if they did not want to be there, as the hospitals basically cut off all of their communication with the outside world. Even now, the only way to get treatment for many non-dangerous mental illnesses is to be checked into a high-security facility alongside people who want to hang themselves so the bunnies will leave them alone. Of course, the status quo is relentlessly fought for by the doctors, to whom policy-makers like to defer because, well, they’re doctors and they should know, right?

  20. Japanese sadness – more melancholy really. I’ve heard it explained thusly: the appreciation of the fleeting nature of living things. Being able to experience joy when taking in the beauty of sakura in bloom, while also being aware that it will all be gone in a few days. Blah blah blah.

    Anyone wonder if Americans are unrealistically, manically positive?

  21. I was in Japanese mental health care system for a short time, under coordination of a 産業医 at my company.
    It was drug-based, and there was no opportunity for psychotherapy.
    The caretakers’ attitude that depression is a biological issue was reassuring, because I did not feel that I was a bad person, only sick. But at the same time, I think the psychiatrist and his assistants did not believe that non-biological factors are present, or that there was validity of my feelings of sadness. I was given several medicines including one sedative, and they told me basically to take the medicine and when I had enough sleep I will feel better. I could not return to work without the approval of 産業医. I could not get better with this. In the end, I go to a private psychiatrist who cannot accept National Health Insurance, but receive better care.
    So, I think that drug companies’ push to sell anti-depressants in Japan has had some good, some bad effects on culture surrounding mental health.

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