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Junko Kitanaka - Depression in Japan: Psychiatric Cures for a Society in Distress

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Since the 1990s, suicide in recession-plagued Japan has soared, and rates of depression have both increased and received greater public attention. In a nation that has traditionally been uncomfortable addressing mental illness, what factors have allowed for the rising medicalization of depression and suicide? Investigating these profound changes from historical, clinical, and sociolegal perspectives, Depression in Japan explores how depression has become a national disease and entered the Japanese lexicon, how psychiatry has responded to the nations ailing social order, and how, in a remarkable transformation, psychiatry has overcome the longstanding resistance to its intrusion in Japanese life.
Questioning claims made by Japanese psychiatrists that depression hardly existed in premodern Japan, Junko Kitanaka shows that Japanese medicine did indeed have a language for talking about depression which was conceived of as an illness where psychological suffering was intimately connected to physiological and social distress. The author looks at how Japanese psychiatrists now use the discourse of depression to persuade patients that they are victims of biological and social forces beyond their control; analyzes how this language has been adopted in legal discourse surrounding overwork suicide; and considers how, in contrast to the West, this language curiously emphasizes the suffering of men rather than women. Examining patients narratives, Kitanaka demonstrates how psychiatry constructs a gendering of depression, one that is closely tied to local politics and questions of legitimate social suffering.
Drawing upon extensive research in psychiatric institutions in Tokyo and the surrounding region, Depression in Japan uncovers the emergence of psychiatry as a force for social transformation in Japan.

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DEPRESSION IN JAPAN DEPRESSION IN JAPAN Psychiatric Cures for a Society in - photo 1
DEPRESSION IN JAPAN
DEPRESSION IN JAPAN
Psychiatric Cures for a Society in Distress
Junko Kitanaka Copyright 2012 by Princeton University Press Published by - photo 2
Junko Kitanaka
Copyright 2012 by Princeton University Press Published by Princeton University - photo 3
Copyright 2012 by Princeton University Press
Published by Princeton University Press,
41 William Street, Princeton, New Jersey 08540
In the United Kingdom: Princeton University Press,
6 Oxford Street, Woodstock, Oxfordshire OX20 1TW
press.princeton.edu
All Rights Reserved
Library of Congress Cataloging-in-Publication Data
Kitanaka, Junko, 1970
Depression in Japan : psychiatric cures for a society in distress / Junko Kitanaka.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-0-691-14204-3 (hardcover :alk. paper) ISBN 978-0-691-14205-0 (pbk. : alk. paper) 1. Depression, MentalTreatmentJapan. 2. PsychotherapyJapan. I. Title.
[DNLM: 1. Japan. 2. Depressive Disorderpsychology. 3. Depressive Disordertherapy. 4. Patient Acceptance of Health Care. 5. Psychiatrytrends. 6. Suicidepsychology. 7. Workloadpsychology. WM 171]
RC537.K536 2012
616.85'2706510952dc23 2011012706
British Library Cataloging-in-Publication Data is available
This book has been composed in Sabon
Printed on acid-free paper.
Printed in the United States of America
10 9 8 7 6 5 4 3 2 1
To Chris and Rick Contents CHAPTER ONE Introduction CHAPTER TWO Reading - photo 4
To Chris and Rick
Contents
CHAPTER ONE
Introduction:
CHAPTER TWO
Reading Emotions in the Body:
CHAPTER THREE
The Expansion of Psychiatry into Everyday Life
CHAPTER FOUR
Pathology of Overwork or Personality Weakness?:
CHAPTER FIVE
Socializing the Biological in Depression:
CHAPTER SIX
Containing Reflexivity:
CHAPTER SEVEN
Diagnosing Suicides of Resolve
CHAPTER EIGHT
The Gendering of Depression and the Selective Recognition of Pain
CHAPTER NINE
Advancing a Social Cause through Psychiatry:
CHAPTER TEN
The Emergent Psychiatric Science of Work:
CHAPTER ELEVEN
The Future of Depression:
List of Illustrations
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Acknowledgments
THIS BOOK IS A PRODUCT of my engagement with three fieldsmedical anthropology, psychiatry, and medical historythat have profoundly shaped my thinking over the years Ive spent in Japan and in North America. Margaret Lock has been a constant source of inspiration. Her vision of medical anthropology was what drew me to this field in the first place, and her deep compassion and unfailing support have kept me going. I have learned much from years of enriching conversations with Allan Young, whose incredible depth of knowledge, underlying passion for social justice, and great sense of humor I so respect and admire. Ellens Corins brilliant insights and willingness to engage deeply with my own thinking have helped me give shape to the ideas that really mattered to me. And I can never fully thank Laurence Kirmayer for helping me navigate through fieldwork in both Canadian and Japanese psychiatries, and enabling me, through his incisive comments on my writing, to raise my work to a higher level.
Over the last decade, I have been fortunate to have met many superb psychiatrists, who have been open to far-ranging discussions with an anthropologist. In particular, Im deeply indebted to my Japanese mentor in medical anthropology, Dr. Eguchi Shigeyuki, without whose generous help this research would not have been possible. (Japanese names are written in the order of family name followed by given name.) Special thanks go to Dr. Kat Satoshi, who has exemplified the blending of critical intellectualism and passionate commitment to clinical practice. Dr. Noda Fumitaka introduced me to the fascinating world of cultural psychiatry. Doctors Kanba Shigenobu and Kuroki Toshihide have opened my eyes to historically informed, critical biological psychiatry. Ive enjoyed talking with such brilliant scholars-cum-clinicians as Doctors tsuka Kichiro, Noguchi Masayuki, Abe Takaaki, Tsujiuchi Takuya, Kobayashi Toshiyuki, and Okajima Yoshir. Im also grateful to Doctors Hayashi Akiko, Ogiwara Chikako, Maeda Keiko, Suzuki Kunifumi, Hayashi Naoki, Tajima Osamu, and mae Susumu. I have felt privileged to learn from depression and suicide experts such as Doctors Utsumi Ken, Takahashi Yoshitomo, and no Yutaka, as well as Morita specialists such as Doctors Nakamura Kei, Kitanishi Kenji, and Kond Kyichi. Ive also benefited from dialogue with psychologists Ichikawa Kyko, Yamashita Mayu, Tsuruta Nobuko, and Ehara Yumiko. Ive appreciated many conversations with Doctors Pierre-Henri Castel, David Healy, Sing Lee, and Dominic T. S. Lee. I want to thank numerous other doctors who so generously allowed me into their clinical practices and shared their time and thoughts in interviews.
Without the help of the brilliant historian Professor Suzuki Akihito, who invited me to participate in the research group on premodern senses of the body at the International Research Center for Japanese Studies (Nichibunken), I could not have delved as deeply into the historical aspects of depression. Professor Suzukis work on English and Japanese psychiatries sets a standard that I hope to achieve some day. Thanks also go to Professors Waltraud Ernst, Clark Lawlor, Elizabeth Lunbeck, Jonathan Metzl, Mark Micale, Thomas Mller, Christian Oberlaender, and David Wright, all of whom so generously shared their expertise with a nonhistorian. Im honored to have worked with Professor Kuriyama Shigehisa, who has showed me what it means to do medical history with an anthropological edge. Im also indebted to medical historians Doctors Hiruta Genshir, Sakai Shizu, Omata Waichir, and Okada Yasuo, as well as Professors Shirasugi Etsuo, Kitazawa Kazutoshi, and Kzai Toyoko.
Ive learned so much from years of engaging dialogues with my dear friend Dominique Bhague, whose work on Brazilian psychiatry continues to inspire me. I also thank Sean Brotherton, Steve Cohen, Stephanie Lloyd, Sadeq Rahime, Audra Simpson, and Christina Zarowsky for stimulating conversations and friendship. Professor Adriana Petryna has given me many insights and warm encouragement. Ive benefited greatly from my conversations with Professors Kal Applbaum, Alan Harwood, Bill Kelly, Lenore Manderson, Karen Nakamura, and Chikako Ozawa-de Silva. Professror Amy Borovoy has engaged deeply with my work and given me much support over the years. In Tokyo, Professors Ogawa Kichi, Takei Hideo and Miyaji Naoko, as well as Kobayashi Kayo and Hashimoto Yko gave me valuable comments. My colleagues at Keio University, particularly Professors Mitsui Hirotaka and the late Fujita Hiroo provided a wonderfully congenial environment in which to work. Special thanks go to Professor Miyasaka Keiz, whose creative anthropological reflections have encouraged me to think beyond conventional disciplinary borders. I am indebted to Adam Lock for his diligent editorial work and moral support as well as Teruyama Junko, from whose research assistance I benefited greatly. I also want to thank Fred Appel, senior editor at Princeton University Press, for his kindness and professionalism throughout the process of completing the book.
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