Redefining mental illness: medicalization, mental healthcare, and Morita Therapy, 1868-1938

In 1919, Morita Shōma first published his theories on the nature of a disorder he called shinkeishitsu. While it was often translated as “neurasthenia” after the definition of George Miller Beard (1869), Morita himself maintained that it was a nervous disorder with symptoms that included a range of ailments. Anything from physical and mental fatigue, headaches, heart palpitations, insomnia, nausea, or even dizziness could be a symptom of shinkeishitsu. The treatment that Morita recommended for this disorder was a combination of what is now considered behavior modification therapy, self-assessment, and meditation. After his death, this treatment came to be known as Morita Therapy, and it has persisted as a form of therapy for a variety of nervous disorders to the present day.

In this thesis, I will demonstrate how Morita, through his education and connection with western psychiatrics, adapted Western mental health concepts to the Japanese context. At the same time, however, Morita attempted to extend concepts of mental illness that he considered to be Japanese culture-bound syndromes--specifically shinkeishitsu, which in addition to symptoms of neurasthenia caused patients to exhibit signs of obsessive-compulsive or perfectionist tendencies and a social phobia known as taijin kyōfushō. Morita Therapy exemplifies the general trends of psychiatric healthcare in the prewar period; the medicalization of nervous disorders and his interaction with the larger psychiatric community demonstrates how Japanese psychiatrists attempted to take part in the international discourse on mental health and wellness.