Food for Diagnosis

posted in: Uncategorized | 7

It’s been a strange day today.

First, in the midst of reading what for me as a diabetic is an important book (important because so few books that I’ve read on diabetes have spoken soberly and without the sickening “Oh, poor widdle babykins, let Daddy kiss the booboo and make it all bedder” attitude that I can’t stand, and actually goes into depth about the origins and workings of diabetes, with examples and explanations that closely follow my own experience with the disease), “The Mind-Body Diabetes Revolution“, by Richard S. Surwit, and taking the clinical tests within to determine my levels of risk in stress, depression, and hostility, I discovered that in both stress and depression I carry the highest possible risk factors (what a relief to know that hostility-wise I am a lamb!), and that technically I have severe clinical depression, and need professional help.

I guess I’ve more or less known this all along, but it seems so artificial. It’s hard to describe. I grew up and live in a culture, Japan’s, where I don’t know a single person who goes to any type of therapy (as opposed to America and Europe where it seems half my friends see a shrink), and have very rarely met anyone who even remotely seems to need it. Yes, I meet people who are down occasionally and who have anger issues and such, but it never seems to get that much in the way of their lives. In the 14 years that I’ve been teaching English I’ve asked countless students about their memories and experiences of high school, if they harbored any resentment or exceptionally bad memories. Almost without exception each student, men and women, have told me they enjoyed high school and would be very happy to do it all again. Only about three or four admitted to any kind of bullying. When I ask these students about their present lives, a few will tell me of dissatisfaction, or disappointment, but in general, very few people tell me out and out that they are really unhappy. You walk the streets and, compared to what I have seen in the States and Europe, only rarely do you come across individuals who seem out of whack with reality and their surroundings.

Now I know that some of this comes as a result of the Japanese tendency to keep embarrassing family secrets out of the public eye, but it is more than that, too. There is a whole alternative expectation out of life here that, I think, puts less pressure on individuals and in many, many ways is much more realistic about life. There is none of the tunnel-vision of organized religion pervading the society in any way (and Westerners who come here seeking such a social construct often tend to give more weight to such things as the Buddhist temples and the shrines than actually exists… Japanese are simply not a religious people, though they do carry their own form of spirituality). Marriage is often seen much more as a pact between two people for raising a family, than as a field for solely nurturing the couple’s romantic feelings (though that is a big benefit when it happens). I have talked to many married people, men and women, equally, who, without the slightest sense of guilt or moral wrongdoing (though not all, course), feel that there is nothing wrong with their spouses having extra-marital affairs, as long as they don’t find out about it (in their transliterated words: “As long as the affair doesn’t intrude in the family circle”). People here expect life to be hard and full of sadness. The whole concept of “mono-no-aware”, a perception of pathos, in which the whole world is seen through the glass of impermanence and passing, and everything is filled with the sadness and beauty of things that only last a moment, is something that every Japanese intuitively understands. Say the words “moon”, “rain”, “frog”, “blossom”, “pebble”… and each one will conjure up a flurry of colors, movement, sounds, and feeling that pertains to things not lasting. People see themselves and their possessions as just as fleeting… one reason why so few artifacts from the past, especially buildings, remain.

I could go on, but the point is that I’m not sure how to interpret the criteria that the diabetes books lays out for determining the ill health of my mind and spirit. I grew up non-Japanese and spent a little less than half my life in the States, so there is the influence of western culturedrawing me one way, but there is also this Japanese sense of how things are and should be. I don’t see my state-of-mind as being all that unusual or off-kilter. The questions in the book felt so American, in that they assume a MacDonald’s smile for a state-of-mind that they consider healthy:

1. Do you feel sad most of the time?
2. Do you often feel as if there’s little to look forward to?
3. Do you see your life as being one failure after another?
4. Do you feel as if you no longer enjoy any activities these days?…

to name just a few.

Part of me nods in sage understanding, knowing that it must be necessary to keep up that sense of glittering cheerfulness that pervades American culture, where if you aren’t smiling something must be seriously wrong with you. Smile at the camera!

But the other part of me sees no reason to smile at the camera when I just don’t feel the least bit perky. It doesn’t mean I am not full of mirth or quiet contentment; it just means that the camera is no reason to put on a show.

Why weren’t the questions framed thus:

1. Do you love what is around you and grieve the letting go?
2. Do you often feel a responsibility toward people around you and just don’t have the time or means to do what you would really like?
3. Do you see your life as being a learning experience and that there are bound to be more failures than successes?
4. Do you feel that you are changing as you get older and your tastes have moved on?

So now I must determine my state of affairs and go either East or West. Decide to prance about or skulk in the corner… Take your pick.

After putting aside the book I met a blogging friend, whom I hadn’t seen in over six months, for lunch. He brought his young son along this time and we three men sat in Starbucks, basically being ordered around by my friend’s son, he telling us to help him complete his sketchbook doodles. The boy was a great little kid, full of fresh vivacity and laughter, and I found myself, as I watched him, suddenly filled with a great sadness that most likely my wife and I will never have a child together. I have no idea where this suddenly came from. Children are not something I have much thought about or strongly desired, and yet there I was, jealous of my friend and wondering how I could have missed something so fundamental. When the two of them said good-bye, I headed toward my evening job with a kind of slack-jawed surprise. Me, a father?!? I promptly dashed off a message on my cell phone to my wife: “I really miss you today.”

And finally, on my way home, I decided to take the extra long walk from one station before my own, a quiet saunter through an upper-income neighborhood where quite a few gardens and trees reminded me that soil still existed in this world. I love going home this way and have taken to doing it almost every evening these days, as part of my steps toward changing my life toward those things that mean most to me. As I descended a particularly charming set of steep stairs lined with zelkova trees and ivy-covered walls, I spied a break between some of the houses and saw straight into someone’s bedroom, where the lights were full glare. Staring right back at me from the wall of the bedroom was a huge Nazi flag, the red and black blazoned in the darkness. “Damn!”, I thought. “What’s that person up to?” What exactly did they like about that flag? But this was Japan, of course, and, like almost everything, it was mostly likely something just for aesthetic affectation. But you never know. There be blond, Aryan-Asian dragons even here.

7 Responses

  1. I recently read an article (perhaps a review in the New Yorker of a new history of happiness) that talked about the etymology of happiness. Apparently, the root is the same as an ancient word for luck, which also gives us words like happenstance or hapless. If good things happened to a person, they were called happy or lucky. For some reason, this knowledge releases me from the burden of happiness, from seeing happiness as a burden, and I hope it does for you as well.

    I haven’t read it carefully in a long time, but there is also a thoughtful essay by Jonathon Delacour (http://weblog.delacour.net/archives/2003/09/life_liberty_and_the_pursuit_of_sadness.php) in which he thinks about the relationship of mono no aware and happiness that you might find interesting.

  2. Thanks, Andru. I read the article last night and spent quite some time absorbing what was discussed. It was a bit strange reading it, because such pathos as aware and such are the complete opposite of intellectual discourse… you can only “understand” them by “feeling” them and by completely immersing yourself in presence. So when people dissect the concepts the whole point of this “presence” evaporates in the very nature of the discourse. It is not possible to explain aware to another person; you need another person experiencing it, speaking from within it, and surrounded by the world that creates it to come into the understanding. It is like someone telling you that this particular slice of lasagne is sensational… there is no way you can know that yourself unless 1) you’ve had other lasagne to compare it to and 2) you’ve had a taste of this particular slice of lasagne and 3) the other person has made you aware of the existence of this particular slice of lasagne and then proceeds to remove that slice from existence. In other words, it is the dynamic relationship of all living things that conjures up aware. It cannot exist in an intellectual vacuum.

    I don’t believe the western concept of “happiness” is the true state of the world, or that it is even a desireable state of being. I believe that what we ought to be consciously aiming to achieve is a state of “grace”, a much different kind of sacrament. Perhaps the Navajo concept of “hozjo”, “walking in beauty” is more what our society should be after. It is a sustainable state of being, one that does not require the acquisition of anything. I imagine it as a stillness within a whorl, but not a detachment. Within this exists the perception of aware, which, through its value of sadness (perhaps melancholy in the European sense might be a more appropriate word…) rising out of the love of life, in its very nature instills a wholeness to one’s presence in the world. If I think about it the people I’ve known who are most tranquil within themselves, and most accepting of their lives are the ones who clearly perceive the impermanece of everything, including themselves. As I see it, it is not the brightness of children… it is a maturing of presence that a child cannot achieve and the very nature of a growing awareness of impending death that makes all the difference. Which makes me think that the English word “suffering” used to describe Buddhist reasoning misses the mark. The Japanese would use the word “kurou-suru” which is more like “being called upon to endure hardship” and carries within it a great sense of sadness, impermanence, and responsibllity towards others. But in no way does it carry the implication of imposition to oneself that the word suffering does, as if an individual “deserves” better. The whole idea is that one must soften oneself in the fabric of world, not the other way around. It implies that the world is more important than you are and that your passing is of little significance. Seen in this way, acheiving a state of grace would fully immerse one in the world.

  3. I’m not so sure that defining depression is a matter of culture, and that Japanese people accept sadness as a fact of life, as opposed to Westerners, who tend to experience “unmet expectations” as an “artificial” construct, depression.

    First of all, this isn’t meant to be a flame on your post, it’s an attempt at dialogue, so if I get some of what you’re saying wrong, point me in the right direction so we can continue the conversation. Second, I suffer from mild depression. I’ve always been moody and angry, but after losing a treasured job about 18 months ago, and then again, after getting laid off from a different job last summer, I found the following questions pretty darn useful:

    1. Do you feel sad most of the time?
    2. Do you often feel as if there’s little to look forward to?
    3. Do you see your life as being one failure after another?
    4. Do you feel as if you no longer enjoy any activities these days?…

    The answer was yes to all of them, and these feelings or whatever manifested themselves rather suddenly, and were quite physical in nature. The condition was accutely physical, like a kind of sickness. Rather than feeling irritable or unhappy, I was in the throes of something much, much darker.

    1. Do you feel sad most of the time?
    I did. I felt guilty about laughing. There was nothing to be cheerful about.

    2. Do you often feel as if there’s little to look forward to?
    I felt as though life were over (and remember, I hadn’t always felt that way; happily, the feeling left me, although it did come back again, and it probably will in the future)

    3. Do you see your life as being one failure after another
    Oh, yes

    4. Do you feel as if you no longer enjoy any activities these days?…
    I could not read a book, I could not listen to music, I could not play with my son, I could not talk with other people, I could not drink coffee…

    I also was unable to sleep for more than three or four hours, I awoke with feelings of dread and anxiety – all the classic symptoms of depression.

    My point is this: it’s not cultural, it’s psychological, or even psychiatric, although I don’t need to take drugs to manage my condition, and instead rely on cognitive therapy – going to a shrink.

    To be sure, Japanese culture plays an important role in people’s mental health there. For one thing, parents (well, mothers, mostly) practice “attachment parenting.” Children are breastfed and sleep with their mothers until early childhood. Until recently, children were carried around in a backpack or sling. Grandparents and the extended family all play an important role in nurturing children. All of this helps promote mental health in later life.

    And you’re right – marriage is more family-centric. My wife is Japanese. I lived in rural Japan for ten years. Our son was born at a traditional midwifery in Japan. So I think I can talk about how the Japanese family operates. In Japan, it’s all about the family. Here in Canada, husbands and wives are expected to maintain an identity outside of being a parent: “Oh, you must want some spend some free time away from your kids so you can get to know each other better, and have fun.” I totally disagree.

    School is the same in Japan: students are part of a community. Elementary school bonds are strong. Everyone has a place. The teacher looks out for the student, and, for better or for worse, plays an active role in the development of the child, even outside school.

    And there’s also Buddhism: Japanese people are Buddhists, and there’s not getting away from it. Buddhism is not just another religion, it’s a way of life, of looking at the world. Ever tried to find a Buddhist “bible” in Japan, outside of the little black books they leave in business hotels? You don’t need to study the precepts, Buddhism is part of the culture. And what do we learn from Buddhism? Acceptance. Death is contemplated and acknowledged.

    I got into Buddhism when I was in Japan. I have one of those books I took from a hotel room. I’m reading it here in Canada, and I’ve just started cognitive therapy.

    And you know what? The stuff that’s in the Buddhist book is almost the same as the messages and techniques I discuss with my counsellor – be kind in everything you do, and that includes being kind to yourself. It’s kind of the same thing.

    “The most important thing you must do in this life is to get in touch with your Self, who you truly are.”

    But are people in Japan more emotionally healthy than people in the West? Suicide rates are high in Japan (Finland, Japan, Canada).

    I would argue that there is less knowledge in Japan about emotional and mental health. There is little psychiatric care in Japan outside of institutionalization, for example. There is almost no understanding of learning disabilities in the classroom.

    At this point I’m fizzling out…

  4. OFF TOPIC

    I found a photo of a beautiful image of a blue iris on your website (it’s one of the first results on Google Images for “blue iris”) and I would like to know if I could use this photo. Please let me know.

  5. Sorry to take so long to reply. I was away since last Thursday and haven’t had a chance to get to the computer.

    Andru, thanks for asking about the photo. Please, you’re welcome to use it. When my new page is up I will most likely be selling larger versions of my photos, but for the smaller ones, as long as people ask, I’m more than happy to share.

    Thanks CNT for taking the time to express your thoughts. Please never feel that you are not welcome to leave whatever opinions you have, whether or not they agree with mine. I write here, in public because I love open discussion and always feel I have a lot to learn from others. The only time I will intervene is when someone is abusing another person here and showing no respect.

    I agree with almost everything you wrote, including your assessment of Buddhism (it’s a methodology, not a religion… and I would even propose that having Buddhism as an everyday part of the culture and people’s personal lives substitutes the need for the kind of therapy that is needed in the West), the examples of how a family stays together and shows “skinship”, and even in how my initial reaction to the questions in the book affected me (I answered yes to nearly all 30 questions for stress and depression… about as bad as bad can be).

    But I don’t think it is right to separate an individual’s mental state from the culture that they live in. It’s all one and the same, I think, though at different levels of involvement. I’ve lived in Japan since I was a young boy, over 25 years, spanning over 35 years, I’m married to a Japanese, and have always identified best with Japanese and Asians. The other half of me, namely German and American, also fits in there in an awkward alliance, and the conflicting expectations and logic often cause me a lot of mishaps in both Japan and in America, since at times I feel quite different from the people around me and can’t bring together what I feel with what the people around me would expect. My mental state has changed according to the culture that I live in, mainly because the people around me have so many similar expectations. I think anyone who lives outside their own culture for long enough (and since I have never identified with any one culture I would probably say that I have lived outside of any culture all my life) can give one glance at someone walking on the street and by their gait, their clothing, their mannerisms, the intonation in their voices, even the way they look at you, and basically tell where they come from. Just like individuals, whole societies have personalities, too and they very much weigh on the psychological state of the individual.

    I wonder if suicide rates in Japan are any higher than in other places. I think the reason you hear so much about it is because on the whole any of that kind of tragedu and violence is very rare and so when it does happen it is shocking and immediately becomes national news. It is true that psychiatric care is dismal compared to that of the States or Europe, but I also feel that Japanese (and Asians in general) are much more (certainly more than I am) resilient when it comes to dealing with the blows of life, simply because they expect things to be hard in that way.

    I would argue that there is less knowledge in Japan about emotional and mental health.

    I would agree to a point on this. But if you sit in with the daily conversations of most people you hear them daily practicing the emotional and mental health support among themselves, as part of being “nakama” (“within the circle”). Even if you watch the TV animations for children almost all the conversations between characters are deep, psychological discussions that you rarely, if ever, see in Western animations. Even the lega system is based upon reconciliation rather than litigation, as in the West (most Asian systems are). People here are aware of details and emotional comprehension that, I feel, is quite a lot more focused on the mental health of group members (after all if harmony is the focus of your world view then understanding emotional needs is paramount) than what you see in the West. It’s as if everyone here is brought up to be a psychotherapist. It’s partly why people here spend so much time listening to each other (and why so many Westerners that I know get so bored at Japanese parties).

  6. I guess what I would argue is that our interior lives aren’t that much different, even if we’re from different cultures. Haruki Murakami reads the same in both Japanese and English.

    Having lived in Japan for 10 years, I really got to hate the idea that we are different because of race, or the idea that you can be “pure-blooded” or “mixed-blood.” I’m from the West Coast of Canada, and the fact that my wife is Japanese and I am “white”, and our son is somewhere in between is not even an issue. In Vancouver, soon 50% of the population will be made up of “visible minorities.”

    I don’t think the idea of seperate races is uniquely Japanese – it’s also American. So there’s this dialogue about race that I don’t want to participate in because I think it’s pointless.

    Mind you, I would probably think differently if I was a Carribean immigrant living in the bleak northern suburbs of Toronto. Or if I was one of the unlucky left to fend for myself in New Orleans.

    But my point is this: culture is syncretic, an accumulation of bits and pieces from all over the place. And surely people are the same, with each one of us representing a multiplicity of viewpoints.

    But in today’s consumer society, I don’t think anyone is truly at home within the culture – not unless you have money. What’s it called? Cognitive dissonance, the way *they* generate anxiety to get people to buy things or go to war. It’s common to all cultures.

    You spoke of not really fitting in anywhere – hey, I feel the same. But, after several months of cognitive therapy, I’m beginning to think that it’s all internal, and that self-image is the most important thing.

    Of course, in Japan, people are going to look at a “foreigner” (how can I be foreign if I speak the language, observe my father-in-law’s yearly memorial service, and pray to Yakushi-nyorai for the safe recovery of my son from sepsis?) and make assumptions. And I’ll never be able to hold public office. However, unlike my friend, a Todai graduate who, as an investment banker, once headed the investment arm of a major bank’s East Asia operations from Tokyo, I don’t have any desire to become an MP. He left Japan and a near 7 figure yearly salary to pursue his dream of holding public office.

    So there are some realities about being a foreigner. There are some differences. But on a personal scale, are there really any differences?

    Kind of a pedantic reply, I guess. Maybe it is all culture. Maybe there’s too much choice in North American society. Maybe it would be better to exist as a small part of a greater overall structure oriented toward preserving harmony.

    But I still think the high suicide rates in Japan point towards some sort of problem.

  7. I too have felt that stab of regret at times when seeing parents with young children. thanks for a thought-provioking post. Sorry I haven’t stopped by more often, but for some reason the feed stopped working a while back, or Bloglines stopped reading it – it doesn’t update. (Might it have something to do with these pop-ups you’ve attracted?)

Leave a Reply