Programa de Prevención y Mitigación

Naikan introspection should lead one to "discover" or "grasp" his true self (jibun) (Suwaki, Yokoyama, and Takezaki 1969) through recollections of his past. Unlike free association in psychoanalysis, the recollection of one's past in Naikan must not be free, arbitrary, or diffuse but guided by specific, predetermined codes.

First, there are two points of reference for conceptualization of self: temporal and social. The temporal reference locates the self in a sequence of specified periods in one's past. What periods those are depends upon the client's age, experiences, problem at hand, and other factors. They may range from remote to recent past, from preschool to school age to adulthood. The duration of a period, too, ranges from a few years to decades, which are further broken down, for sequential reflection, into smaller units of appropriate intervals: the interval varies from several years to a few months. For example, the client may be asked to start by reflecting on what he was when he was twenty to twenty-five years old, when he was in the first year of elementary school, or in January and February of a particular year. After he completes that reflection, he will be asked to move on to the next interval, namely, age twenty-six to thirty, the second year of elementary school, or March and April, and so on.

Coupled with the time reference is the social reference. The self is recalled in a specified period in relation to a series of significant others. The social reference, too, varies from case to case depending upon the client and upon the period selected. In one's childhood, the most significant other is likely to be one's parent, grandparent, other kin, or schoolteacher; significant others in adulthood will be one's spouse, in-law, child, colleague, employer, or employee. The client may be told to reflect upon his self in the relationship with his mother the year he entered high school. When this task is completed, he may be asked to reflect either upon the same relationship the next year or upon the same year in relation to another significant person, such as his father.

Table 1 depicts these variations in matrix form. The columns refer to a series of significant others from 1 to n, and the rows refer to intervals of a period, also ranging from 1 to n. The Naikan client begins reflection by locating his self in the cell of the first column (SO1, e.g., his mother) and the first row (T1, e.g., his first school year). His next step is to move horizontally or vertically. Horizontally, he moves along the arrow of H1 to place himself in the second column, that is, in relation to a second significant other, such as his grandmother, while remaining in the

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interval T1. When the first row is completed, technically, a similar sequence is followed along H2. Yoshimoto once called this procedure "horizontal Naikan." The other possibility is "vertical

Naikan" where the significant other is fixed while the time reference moves from T1 to T2 to T3 and so on, and then from V1 to V2.

Though this matrix gives an overview of all possible combinations of references for self- reflection, in actual cases only certain cells are chosen for the client. Furthermore, the counselor tends to have a bias for a certain period and a certain significant other, regardless of the client's individual age, experiences, and need. Yoshimoto has recently concluded that the most revealing period is one's elementary school years. That is because every person is more dependent on parental care at that time than in later years; the preschool period is too remote to recall unless the client is very young; and more recent experiences would involve too much self-interest to be amenable to objective recollection. As for the social reference,Yoshimoto singles out mother as the most crucial Alter. The standard beginning for Naikan, then, is to reflect upon how Ego related to his mother when he was in thefirst year of elementary school. The next step is to move to T2, namely, the second school year, with the mother fixed as the social reference. After that the client is encouraged to proceed to other temporal and social references that might be more relevant to his situation. I am inclined to label the mother/elementary school combination ''the primary reference." Needless to say, this general rule does not apply to a person whose mother died early, was remarried, or is otherwise impossible to recall. In that case father, grandmother, aunt, or other surrogate would replace mother as the primary reference.

Given these specific references, the client is further guided in the content of his reflection. This thematic reference consists of three questions the client should ask himself: (a) What care (sewa) have I received? (b) What have I done to repay (okaeshi)? (c) What troubles (meiwaku) or worries (shimpai) have I caused (the caretaker)? The client is asked to reflect upon what sewa he received from his mother, for example, when he was a schoolboy, what okaeshi he did for her, and what meiwaku he imposed upon her. Of the three points of the thematic reference, the last is stressed. Yoshimoto allocates reflection time for (a), (b), and (c) in the ratio of 2:2:6.

It is clear that Naikan is far from abstract speculation or meditation on universal, philosophical topics such as What is true? but is reflection guided by specific rules and oriented to concrete events and experiences (Takeda 1972:173–174).

Outcome

The ultimate objective of Naikan is for the client to transform himself through a radical reconceptualization of his past, recalled self. The reconceptualization is directed, as can be inferred from the Naikan method described above, toward an inculcation and reinforcement of some Japanese core values. First, one's past self is to be reconceptualized as totally dependent upon a series of persons, especially one's caretaker. If the client evinces any confidence that he is what he is because of his own capacity and character, this arrogance must be smashed. The counselor will ask, for example, how he would have been able to participate in special school-sponsored events without the support and cooperation of his family. The client may then remember how his mother took on extra work outside the house to earn money tobuy him a new outfit for the beginning-of-school ceremony, or to pay his travel expenses for a school study-tour. He would further recall how his mother packed an elaborate lunch with special candies for his school picnic so that he would not lose face in front of competitive classmates. Sometimes the client is asked to calculate how much money it cost the family to bring him up. He would recall that whenever he was sick, he was wholly dependent upon his mother's care around the clock. Along with these specific kindnesses, the depth and intensity of parental indulgence and love are recalled: the client might remember how pleased his father was with his report card and take this as evidence of fatherly indulgence. One client spoke on tape of his marrying into a family without a son and thus becoming its heir. His mother could well have

reproached him for having abdicated responsibility as the eldest son in his own family. Instead, she happily threw herself into wedding preparations, buying furniture for him to take to the bride's house, "as if he were a bride entering the husband's house." In recalling this, he could not hold back tears of gratitude. The client thus becomes aware of his absolute helplessness without others' indulgence and

acknowledges to the counselor that he has indeed benefited from abundant sewa from particular persons.

Awareness of one's dependency upon another's caretaking and indulgence is accompanied by a sense of on debt and concern for repayment (okaeshi). Although itemization of okaeshi deeds is on the Naikan agenda, the client is expected ultimately to arrive at the conviction that either he did nothing in okaeshi or what he did amounted to nothing in comparison with what he received. Indeed, he might recall, he played around when his help was needed, as when his mother was ill.

That is not all. The debtor not only failed in repayment, but he imposed inexcusable meiwaku and shimpai upon his benefactor due to his thoughtlessness and lack of omoiyari. A high school girl speaking on tape confessed in tears that she had shown no sympathy for her mother, who, while working to support the family, spent extra time and resources to provide for the children's comfort and safety, neglecting her own well-being. When she was in the second year of elementary school, her mother told her to come home from school before dark. One day, in disregard of that warning, she stayed at school until dark, and her motherlocked her out to teach her a lesson. Now she realizes that all this was because her mother worried about her, but at the time she was only resentful. A

successful thirty-one-year-old businessman recalled on tape how his mother protected him, when there was an air raid during the war, by spreading her body over his. He also remembered resenting and retaliating against his paternal grandmother for mistreating his mother, at the time not realizing that it doubled his mother's hardships by aggravating her relations with her mother-in-law. In his early twenties he left home for Tokyo to achieve success and provide a better life for his mother. He was determined not to tell his family his new address until he succeeded in his goal. Meanwhile, his father became bedridden, and his mother had to work to support the whole family. She finally fell ill and died, which the son did not know until it was too late. Empathizing with the shimpai and hardships he had caused his mother, he sobbingly repented and apologized for his stupid, heartless refusal to let her know where he was.

For a convict, delinquent, or other "problem" client, this feeling of having done harm to others tends to be overwhelming. An alcoholic or gambler is encouraged to calculate how much monetary loss he incurred for his family. He then realizes how many people—his wife, parents, children, friends, boss, and so on—have been victimized by his aberration, and how much meiwaku they have suffered because of him.

This last point—reflection on the injury inflicted upon others—constitutes the most important part of Naikan. As in other parts, the client is supposed to recall concrete incidents and experiences that definitely and irreversibly establish his guilt, however trivial they may sound.

Before Naikan, clients, particularly the deviant, the handicapped, victims of a broken family, and the mentally or physically ill, tend to be bitter and resentful of parents, more fortunate persons, and the world as a whole, and filled with self-pity. Through Naikan, this resentment and self-pity are expected to be replaced by the realization of one's egocentric social insensitivity, an insurmountable sense of debt and gratitude to others, and a deep empathetic guilt toward those who have suffered because of one's heartless, ungrateful conduct. Sumanai, the word in which gratitude is mingled with guilt, is the final word of confession expressive of all these feelings.

What can one possibly do to redeem this guilt? The client is encouraged to resolve or reform himself (e.g., to abstain from alcohol, gambling, stealing, lying), to repay his debt, and to dedicate himself, worthless though he is, to the welfare of his victims and other people. A former gambler, asked by Yoshimoto if he was ready to give up gambling even if someone threatened to kill him, answered yes without hesitation. Indeed, the fear of death is not supposed to hinder a new resolution.

This process of transformation is schematized in Table 2, based on a reciprocity matrix adapted from W. L. Wallace (1969:33).

The rows stand for what Alter (a significant other) has given to Ego, which is divided into benefit, nothing, and injury (abbreviated, respectively, +, o, and -). Alter has benefited, done nothing

for, or hurt Ego. The columns refer to what Ego has returned, similarly divided. Ego has repaid (+), done nothing (o), or hurt (-) Alter in return. Cells 1 and 9 represent symmetric reciprocity, where Ego has benefited Alter in return for Alter's beneficence (+/+) or Ego has injured Alter in retaliation against the latter's mistreatment (-/-). The central cell 5 (o/o) shows the absence of a reciprocal relationship. All the other cells represent asymmetric relationships, in which one party has overgiven or

overreceived benefit or harm from the other. Extreme asymmetry is shown in cells 3 and 7: in 3, Alter has benefited Ego whereas Ego has injured Alter in return; conversely, in 7, Ego has been overly forgiving and generous toward Alter despite the latter's malice.

Prior to treatment, the Naikan client may place his past self in the bottom row, seeing himself a victim of Alter's malevolence. If he had no chance to retaliate, as in cell 9, and instead had to endure the hostility, his resentment toward Alter in particular and toward the world in general for permitting such unfairness would be maximal. Let us suppose that the pre-Naikan client does place himself in cell 7. Through Naikan he will come to realize that Alter, far from having injured Ego, has actually indulged or enormously benefited Ego. Ego moves toward cell 1, as indicated by arrow (a). Furthermore, when he reflects upon what he has returned to Alter, he finds himself in debt, having returned nothing to speak of. He moves along arrow (b). When he starts to enumerate what harm he has inflicted upon Alter, he will be overwhelmed by the extreme imbalance between the sewa of beneficent Alter and the okaeshi of ungrateful Ego. He now places himself in cell 3, the exact opposite from the starting point, thus completing his self-reconceptualization. When this stage is reached, the client is advised to reorient himself along arrow (d) and resolve to do his best to repay.

This is a simplified schema of Naikan "brainwashing." In actuality the transformation process is far from smooth. In the first few days, the client seems totally confounded, unable to recall anything. In some cases, reflection only serves to reinforce resentment against Alter, inducing Ego to complain about the mistreatment he has received. This phase is called gaibatsu, "outer punishment," as against naibatsu, "inner punishment"; the counselor reminds the client that what he is doing is gaikan, ''outer examination," not naikan, ''inner examination." In other cases, the client may be carried away by what okaeshi he has done for others, and start to boast. Speaking on tape, a priest expressed gratitude to his wife but launched into a long discourse on how in return he had saved her from near death through his prayers. The counselor rebuked the priest, saying that it sounded more as if his wife had saved herself through her own spiritual enlightenment and that a true Naikan exercise would reveal the client's repentance.

During this initial period, when the client is still unable to respond as expected, he may be aided by listening to tapes of the best examples of "confession." He will also be urged by the counselor to take his task seriously, to think of the kind intention with which his parent, employer, or superior has recommended Naikan treatment to him. He is told that his stay will cost his boss a lot of money—room and board plus his salary without work. In short, the pressure of reciprocal obligation in present social relationships is mobilized to facilitate one's recollection of debts accumulated in past social relationships.

On the third day or so, the client usually begins to emerge out of confusion, becomes "awakened" to his "true" self, and finds himself able to "confess" in response to the counselor's question: ''What have you thought about in the last hour?'' When self-reconceptualization is

completed, or when cell 3 is reached, the client, now guilt-ridden and sensitized to his worthlessness, may have sunk into a state of depression. As Kitsuse has observed, he may be seized by a

temptation to commit suicide "as the only means of redemption." The counselor then reminds him that

as undeserving and miserable a person as he has realized himself to be, even so the society has fed, clothed, and housed him (ikashite morau). To commit suicide or to abandon hope would be the supreme act of ingratitude which would completely deprive his life of meaning. He is offered in its stead the opportunity to redeem himself by "living as though he were dead" (shinda tsumoride), i.e., without regard to one's own egotistic desires. In so living he might devote himself to the task of repaying others with a lifetime of selfless good works. (Kitsuse 1965:15)

Thus, depression is replaced by hope and joy, and emotional turmoil by tranquility. The phases of Naikan may be summarized as: initial confusion or resistance; "awakening";

self-repulsion and depression; hopefulness and tranquility.

If the "conversion" lasts, the deviant client becomes morally upright and the ill client may be cured. Yoshimoto frankly admits that physical cures occur only rarely, but taped confessions reveal successful cures of arthritis, cirrhosis of the liver, stomach disease, stuttering, and many symptoms of neurosis. Recognized as a unique method of psychotherapy, Naikan is widely studied and has been adapted for use by some psychiatrists (for example, R. Ishida 1969). During my interview with Yoshimoto, a new client showed up with a letter of introduction from a psychiatrist who apparently, after an unsuccessful attempt to cure the patient, had sent him to Yoshimoto. General therapeutic results have been noted by professional observers as well as by clients themselves: "One feels one's whole body vitalized and lightened; does not get tired; does not need as much time for sleeping; does not become ill; recovers soon if one gets ill; most chronic diseases are cured before long."

"Frustrations and anxiety diminish, while vital energy is heightened; interpersonal relations improve, the feeling of happiness increases, and self-control is strengthened" (Takeda 1972:227).