Index

AA (Alcoholics Anonymous), 45, 107
The Ability to Worry: The People of Bethel (Saito), 204, 227n.4
abortion, 223–24n.32.
See also birth control; eugenics
Acorn Society (
Donguri no Kai), 102–3, 104, 157, 187
Ainu people
and Bethel House origins, 104
Christianity among, 98–99
colonization of, 91, 95–96, 98, 99
cultural pride, 99
ethnic background, 89
Hidaka settlements, 94
and Hokkaido landscape, 3
imu, 96–98, 226n.8
and Urakawa Red Cross Hospital, 136
Akao, Etsuko, 122, 123
Alcoholics Anonymous (AA), 45, 107
alcoholism treatment, 45, 107, 110–11, 134, 153
Allied occupation (1945-1952), 89, 223n.31
anathocytosis, 199
anime, 38, 222n.4
Anshinshite Zetsubō Dekiru Jinsei (How to live a worry-free life without hope) (Mukaiyachi), 111
anthropological/ethnographic approaches, 16, 17–19, 20–22, 25, 115, 221n.6
antipsychiatry movement, 36, 133, 224n.34
antipsychotics.
See pharmaceuticals
arugamama (how things are), 45
Asahiyama Hospital (Sapporo), 134
Asylums (Goffman), 56
auditory hallucinations.
See Gencho-sans

Batchelor, John, 98–99
Before the Dawn (Shimazaki), 40–41, 222n.5
Bethel
accommodation flexibility, 148–49, 210–11
author's experiences, 1, 2–3, 4–6, 10–11, 163–65, 228–29nn.1,3
daily life, 74–76, 163–65, 167–68, 226nn.5,6
expansion of, 106, 144–48, 204
facilities, 6–7, 14–16, 71–72, 145, 148–49
founding of, 1, 104–5
future of, 217–19
as intentional community, 207–9, 210–12, 213
isolation of, 186, 211
organizational management, 205–6
origins of, 101–4, 227n.2
recent changes in, 203–7
repeatability of, 185–86
staff, 7, 76–77, 85, 206–7
transportation to, 2–3
unique qualities of, 21
as utopia, 213–14
Bethel: Community and Schizophrenia in Northern Japan (film) (Nakamura)
and anthropological/ethnographic approaches, 18, 19
on Bethel isolation, 186
Bethel member band in, 229n.1
conflict in, 108, 190–91
on doctor's self-deprecating role, 153
financial management support in, 31
Kiyoshi Hayasaka in, 25, 30, 32–33
Kohei Yamane in, 114–15
peer supporters in, 228n.4
psychiatric consultations in, 228n.7
Rika Shimizu in, 76
self-directed research in, 229n.7
social skills training in, 170–71
Bethel Festival, 1, 9, 148, 186, 187–88, 189. See also Hallucinations and Delusions Grand Prix
Bethel House group home, 30, 103, 104–5, 106, 160–61
Bethel House's Self-Directed Research (Mukaiyachi), 172
Bethel members
driving access, 164
medical diagnoses, 17, 27, 188, 203, 204, 222n.4
non-schizophrenia diagnoses, 17, 188, 203, 204
number of, 221n.4
parenthood, 83, 149–52, 226n.9
and promotion activities, 1–2, 16, 23, 154, 185, 188–89, 201
romantic relationships, 30, 83–85
smoking, 166–67
as staff, 76–77, 206–7
Bethel principles, 106–11, 227n.4
ability to worry (nayamu chikara), 108–9, 153, 204
acceptance of Gencho-san hallucinations, 81–82, 83, 109
acceptance of problems, 108–10, 191
and alcoholism treatment, 45, 110–11, 134, 153
and Christianity, 11, 45, 107
cooperative management (
zen'in keiei), 107
development of, 106–7
doctor's self-deprecating role, 139, 152–53, 155, 228n.13
gaizaika (externalization), 82
and independent living, 106
Kohei Yamane's experience, 120–21, 122–24
life of descent, 110–11, 154
and meetings, 11, 107–8, 123
and Morita therapy, 45
non-support philosophy (
Hienjo Ron), 154–55, 212
organic development of, 208
past, 24–25
and pharmaceuticals, 83, 109, 110
recovery (
kaifuku), 153–54
right to struggle (
kurō), 153, 155, 167
sono mama ga iimitai, 45
soredejunchō, 45
See also social support
Bethel programs
Bethel Festival, 1, 9, 148, 186, 187–88, 189
birth control promotion, 84–85
group therapy, 169–70
Hallucinations and Delusions Grand Prix, 1, 82, 114, 115, 126, 130–31, 148, 187
meetings, 7, 11, 107–8, 123, 165, 190–91, 210, 229n.2
personal conferences, 12–13
schedule, 168
social skills training, 11–12, 83, 169, 170–72
study abroad (
ryūgaku), 176, 182–83
Women's Anonymous (WA)/Schizophrenics Anonymous (SA), 72–74, 80, 169, 225–26nn.2-4
See also self-directed research; Urakawa Red Cross Hospital
Bethel promotion activities
and Dr. Kawamura, 152
and expansion, 204
and Gencho-san hallucinations, 12, 13
and Gen'ichi Nakayama, 16, 188–89, 200
and Ikuyoshi Mukaiyachi, 112, 153, 182–83, 187
and Kiyoshi Hayasaka, 23
member lectures, 1–2, 16, 154, 185, 188–89
and self-directed research, 172, 182–83
success of, 201
videos, 8–9
Bethel Self-Directed Research Workbook, 174, 182
Bethel work programs
and Bethel expansion, 106
and Bethel Festival, 188
cooperative management (
zen'in keiei), 107
and Kiyoshi Hayasaka, 28, 29
and meetings, 7
origins of, 105
and promotion activities, 2
recent bureaucratization, 209
therapeutic value of, 169
wages, 31, 222n.6
biopsychosocial perspective, 35–36
birth control, 84–85
The Birth of the Clinic (Foucault), 66
books, 9
Bouvard, Marguerite Guzman, 207
Buddhism
and Ainu colonization, 91
and conflict within Bethel, 190–91
and Gen'ichi Nakayama's funeral, 195, 196
and premodern psychiatric treatment, 38, 39, 41
and talk therapy, 67
byōki (illness), xiii

CBT. See cognitive-behavioral therapy
Chidaka, Nozomi, 75, 83, 85
chlorpromazine (Thorazine), 49.
See also first-generation antipsychotics
Christianity, 87–100
author's background, 225n.1, 226n.5
and Bethel principles, 11, 45, 107
Bible study, 10
and history of Hokkaido, 89–95, 98–99
Japanese history of, 87–89, 226nn.1,2,4
and Kiyoshi Hayasaka, 28, 29, 70–71
Moto-Urakawa Church, 93, 94–95, 99
and Schizophrenics Anonymous, 225–26n.4
and Soka Gakkai, 190–91
and talk therapy, 66, 67, 225n.52
Urakawa Church, 4, 70–71, 99–100, 102, 103–4, 226n.1
Civil Rights Protection program (Kenri Yōgo), 31, 160
Clark, David.
See Clark Report
Clark, William S., 91
Clark Report, 53–55, 68
cognitive-behavioral therapy (CBT), 170.
See also self-directed research; social skills training
colonialism, 3, 91, 95–96, 98, 99
community.
See intentional communities; social support
community-based mental health programs, 68–69.
See also independent living
Condom-Sha (
Kondo-umusha ), 84–85
confession, 66, 67, 225n.52
Confinement Act (Law for the Confinement and Protection of the Mentally Ill) (1900), 43–44, 223nn.10,11
Connecting Hearts (NHK TV), 216
consciousness raising, 229n.6
conversion disorder, 222n.4
cooperative management (
zen'in keiei), 107
Corin, E., 173
Cornell, John B., 94
cultural diagnosis issues, 17, 37, 98

Daiunji Temple, 38, 39
Deaf in Japan (Nakamura), 16
deinstitutionalization
and first-generation antipsychotics, 49, 56
and peer supporters, 158–60, 189, 228n.4
and second-generation antipsychotics, 60
United States, 56, 63, 65, 224n.48
and Urakawa Red Cross Hospital, 143–44, 156
Yuzuru Yokoyama, 156–62, 228n.5
See also independent living
delusions
Kohei Yamane's UFO experience, 114–15, 125–26, 129–30
mass, 129–31
and self-directed research, 172
See also Gencho-sans; Hallucinations and Delusions Grand Prix
descent, life of, 110–11, 154
Diagnostic and Statistical Manual (DSM), 37
disability activism, 3–4, 221n.1
disability studies, 36
Dower, John, 46
Dubreuil, Chisato O., 94

Eguchi, Shigeyuki, 222n.4
electroshock therapy, 42–43
epilepsy, 62, 224n.39
ethical issues, 20–21
ethnographic approaches.
See anthropological/ethnographic approaches
ethnographic film, 18–19, 25, 115, 221n.6
Eugenic Protection Law (1948), 52–53, 223n.31
eugenics, 51–53, 223nn.28-32
Eugenics Law for National Citizens (1940), 52, 223n.29
Europe, 222n.6
externalization (
gaizaika), 82
Ezo.
See Hokkaido

Fanon, Frantz, 99
financial management support, 31, 160
financing for psychiatric programs
Clark Report on, 54
group homes, 145
as incentive for institutionalization, 37, 50–51, 54, 55–56
and Mental Hospital Law, 44
Mental Hygiene Law, 46–47, 223nn.18,21
1960s private hospital growth, 50–51, 223n.24
and talk therapy, 67
first-generation antipsychotics, 36–37, 49–50, 51, 56
Fitzhugh, w. w., 94
folie à deux, 130
folie à plusieurs, 130–31
forced institutionalization, 47, 50, 223nn.19,20
Foucault, Michel, 66–67, 225n.52
Fukushima earthquake (2011), 212, 216, 227n.3
Fundamental Law for People with Disabilities (1970), 61

gaizaika (externalization), 82
Gencho-sans (auditory hallucinations)
acceptance of, 81–82, 83, 109
and Bethel promotion activities, 12, 13
personal stories, 76–77, 78, 119, 122
and self-directed research, 176, 178, 179, 181, 183–84
and social skills training, 83, 171
and social support, 128
in videos, 8
gender
and institutionalization, 142
and Schizophrenics Anonymous, 72
and shamanism, 97, 226n.8
Gen'ichi. See Nakayama, Gen'ichi
German medical tradition, 41–42
Glaze, Lauren E., 224n.48
Goffman, Erving, 56, 140, 212
group homes, 14–15, 30, 103, 104–5, 106, 144, 145, 160–61

hallucinations. See Gencho-sans; Hallucinations and Delusions Grand Prix
Hallucinations and Delusions Grand Prix, 1, 82, 114, 115, 126, 130–31, 148, 187
Halperidol, 49.
See also first-generation antipsychotics
Hamada, Yuzo, 4–6, 10–11
Harrison, John A., 91, 95
Hayasaka, Kiyoshi, 23–33
autobiography, 26–29
Bethel Festival recognition, 187
and Bethel origins, 104, 105, 204
budget, 31–32, 222nn.6,7
and Christianity, 28, 29, 70–71
and Dr. Kawamura, 28, 30, 134, 152
and Gencho-san hallucinations, 13
and Gen'ichi Nakayama, 194, 195, 200
hospitalizations, 27–28, 30, 105, 149
and Kohei Yamane, 121, 128
new roles of, 208
and organizational management, 206
on psychiatric disabilities, 32–33
self-directed research, 110
and self-disclosure, 23–26
smoking, 166–67
and Yuzuru Yokoyama, 159, 160, 161
Hienjo Ron (non-support philosophy), 154–55, 212
higai mōsō (feelings of persecution), 77, 226n.7
hikikomori, 79
Hiratsuka, Raicho, 51
Hisomu, Nagai, 51
The History of Sexuality (Foucault), 66
Hitchcock, Romeyn, 94, 95
Hokkaido, 3, 89–95, 98–99, 227n.2
Hokkaido Former Aborigines Protection Act (1899), 95
Hokuto, Iboshi, 99
home confinement, 36, 38–41
Confinement Act, 43–44, 223nn.10,11
Europe, 222n.6
Honda, Mikio, 216
hospitalization.
See institutionalization; Urakawa Red Cross Hospital
hospitals.
See institutionalization; Urakawa Red Cross Hospital
Howell, David L., 96

Illness and Healing Among the Sakhalin Ainu (Ohnuki-Tierney), 96–97
imu, 96–98, 226n.8
independent living, 36, 37, 60–62, 68–69, 106.
See also deinstitutionalization
Independent Living Support Act (2005), 69
institutionalization, 17
Clark Report, 53–55, 68
and control, 140–41, 228n.10
current private hospital predominance, 63, 224n.40
current status, 62–63
early twentieth century, 44, 223n.13
financing as incentive for, 37, 50–51, 54, 55–56
and first-generation antipsychotics, 36–37, 49–50, 51
forced, 47, 50, 223nn.19,20
length of stay, 63–65, 140, 142, 157, 224nn.42,45
Mental Hygiene Law, 46–48, 59, 223nn.16-21
1960s private hospital growth, 50–51, 223nn.24,26
Okuma report, 50, 57–58, 59
postwar private hospital growth, 36–37, 48–49
shakaiteki nyūin (hospital admission for social reasons), 64–65
Utsunomiya Hospital incident, 58–60, 61, 224n.37
See also deinstitutionalization
insulin shock therapy, 42–43
intentional communities, 207–9, 213, 230n.5
International Classification of Diseases (ICD), 37
International Court of Justice, 61
Ishikawa, Bunnoshin, 58, 59
isolation, 81
Ito, Hiroto, 50, 57, 64–65
Itoh, Eriko, 150, 203, 226n.9
Itoh, Noriyuki, 174, 175, 176, 177, 178, 229n.8
Itoh, Yu, 161–62
Itoh Emi, 170
Iwakura Mental Hospital, 38
Iwata, Megumi, 72, 82–83, 192

James, Doris J., 224n.48
Japanese culture
adulthood, 81
bedding, 221n.2
death, 192, 229n.3
decentralization, 38, 40
divorce, 222n.2
education, 222n.5
funeral services, 194
games, 222n.3
modes of address, xiii, 221n.3
and recession, 111
and social support, 210
A Japanese Funeral (film) (Nakamura), 18, 20, 192
Japanese Private Mental Hospital Association, 61, 63
Japanese psychiatry, 35–69
absence of talk therapy, 66–67
antipsychiatry movement, 224n.34
Clark Report, 53–55, 68
community-based mental health programs, 68–69
Confinement Act, 43–44, 223nn.10,11
current status, 62–66
and deinstitutionalization movement, 55–57, 63, 65
diagnosis, 17, 37
early twentieth century, 44, 223n.13
eugenics, 51–53, 223nn.29-32
home confinement, 36, 38–41, 43–44, 223nn.10,11
independent living, 36, 37, 60–62, 68–69
Medical Affairs Bureau, 42, 222n.7
Mental Hospital Law, 44
Mental Hygiene Law, 46–48, 59, 61, 69, 223nn.16-21
and modernity, 41–42
native psychotherapies, 45–46
new changes, 186, 209
1960s private hospital growth, 50–51, 223nn.24,26
Okuma report, 50, 57–58, 59
perspectives on, 35–36, 222n.1
postwar private hospital growth, 36–37, 48–49
Reischauer incident, 53
and romanticization of the past, 36
sick role, 67–68
temple-based treatment, 38, 39
Utsunomiya Hospital incident, 58–60, 61, 224n.37
and Western psychiatry, 37
See also institutionalization
Japanese Red Cross Society, 135, 227n.3
Japan Railways Corporation, 118, 227n.2
Jilek, Wolfgang G., 42
Jōmon people, 89

kaifuku (recovery), 153–54
kango (nursing/confinement), 43, 223n.10
Kanter, Rosabeth Moss, 207
karōshi (death from overwork), 119
Katogi, Shoko, 100
Kawamura, Toshiaki (chief of psychiatry)
on acceptance of Gencho-san hallucinations, 82, 83
on acceptance of problems, 109
background, 133–34
and Bethel accommodation flexibility, 149
and Bethel origins, 134, 204
and Bethel promotion activities, 152
and deinstitutionalization, 143, 144, 158
on future of Bethel, 218
and Gen'ichi Nakayama, 193, 200
and German language, 41–42
importance of, 113
and inpatient ward management, 140–41
and Kiyoshi Hayasaka, 28, 30, 134, 152
and Kohei Yamane, 122, 125–26, 127
on life of descent, 110
new roles of, 216–17, 230n.6
on non-support, 154, 155
on pharmaceuticals, 83, 109
psychiatric consultations, 138–39, 169, 200, 228nn.7,8, 229n.4
Red Cross Hospital role, 137, 138
on restraint, 143
on right to struggle, 153, 167
and Rika Shimizu, 80
self-deprecating role of, 139, 152–53, 155, 228n.13
on self-directed research, 182
and support meetings, 149, 150, 228n.13
and Yuzuru Yokoyama, 158, 160, 161, 162
Kawasaki, Hiroshi, 173
Kennedy, John F., 56
Kennedy, Robert, 56
Kenri Yōgo (Civil Rights Protection program), 31
Kerouac, Jack, 203
Kesey, Ken, 56
Kimura, Akiko, 149, 149–52
Kimura Rihito, 52, 223n.31
Kindaichi, Kyosuke, 96
Kirmayer, Lawrence, 98, 172, 173
Kitanaka Junko, 17, 43, 138, 172–73, 228n.8
Kitayama Hospital, 38
Kiyoshi.
See Hayasaka, Kiyoshi
Kleinman, Arthur, 17
Kohei.
See Yamane, Kohei
kokoro no gomibako (trash can of the soul), 24
Kraepelin, Emil, 42, 44
Kudo, Yu, 191–92
Kure, Shuzo, 44
kurō (right to struggle), 153, 155, 167
Kyoto Prefectural Asylum for the Epileptics and the Insane, 42

language, xiii, 16–17, 221n.1
Law for the Confinement and Protection of the Mentally Ill (Confinement Act) (1900), 43–44, 223nn.10,11
Leamer, Laurence, 56
lectures.
See Bethel promotion activities
legal definitions, 16, 38, 62, 222n.8, 224n.39
length of stay, 63–65, 140, 142, 157, 224nn.42,45
Let's Do Self-Directed Research (Mukaiyachi), 172, 183–85
leucotomy, 42
Lewis, G., 222n.1
Liberman, Robert, 170
lobotomy, 42

Maeda, Kei, 170
Mamiya, Ikuko, 68
Mandiberg, James M., 38, 44, 61, 213
manga, 222n.4
Matsubara, Asami, 8–9, 15, 51
Matsuzawa Hospital, 52
McGrath, John, 222n.1
Medical Affairs Bureau, 42, 222n.7
Medical Care Facilities Finance Corporation, 50, 223n.24
medications.
See pharmaceuticals
meetings
and Bethel principles, 11, 107–8, 123–24
boring nature of, 7, 165
conflict in, 108, 190–91, 229n.2
and transactive memory, 108, 210
Meiji Restoration, 40, 41–42, 91
mental health consultation offices (
seishin eisei sōdanjo), 46, 223n.17
Mental Hospital Law (1919), 44
Mental Hygiene Law (1950), 46–48, 59, 223nn.16-21
revisions (1987), 61, 69
mental illness (seishinbyō), 43
Mental Retardation Facilities and Community Mental Health Centers Construction Act (United States) (1963), 56
Metzl, Jonathan, 42
Minas, Harry, 98
Mitsubishi Motors, 116–19, 128–29
Miyajima, Michiko, 28, 30, 71, 103, 104, 105
Miyajima, Toshimitsu, 11, 29, 103, 104
Miyanishi, Katsuko, 176–82, 183–85
Miyazaki, Hayao, 222n.4
Mizuki, Shigeru, 222n.4
modernity, 35, 40, 41–42, 91, 222n.1
mononoke, 38
Morita, Shoma, 45
Morita therapy, 45
Moto-Urakawa Church, 93, 94–95, 99
Mukaiyachi, Etsuko
and author's visits, 15
family of, 14
and Gen'ichi Nakayama's funeral, 192
marriage, 104
and organizational management, 207
and personal conferences, 12–13
and social skills training, 170, 171
and Urakawa Church, 100
Mukaiyachi, Ikuyoshi
and author's visits, 28
and Bethel expansion, 145–46
and Bethel origins, 101–2, 103–4, 204, 227n.2
and Bethel principles, 106, 108, 111, 218
and Bethel promotion activities, 112, 152, 182–83, 187
as counselor, 169
and deinstitutionalization, 143, 156, 158, 162
on fight scene, 229n.2
and Gen'ichi Nakayama, 189
importance of, 111–13
new roles of, 208–9
on organizational management, 206
and Rika Shimizu, 80
and self-directed research, 110, 172, 173–75, 179, 180–81
and social skills training, 170
and Urakawa Church, 100
Mukaiyachi, Mana, 216

Naff, William, 222n.5
Nagaoka, Yasushi, 50–51, 60
Naikan therapy, 45–46
Nakamura, Karen, 16, 21–22
Nakanishi, Shoji, 229n.5
Nakatani, Yoji, 43
Nakayama, Chika, 189, 196, 198, 199–200
Nakayama, Gen'ichi, 15
background, 196–99
Bethel arrival, 199–201
and Bethel expansion, 204
and Bethel Festival, 189, 190
and Bethel promotion activities, 16, 188–89, 201
death of, 191–96, 211–12
peer supporter role, 158–59, 189
on self-directed research, 174–75
Nakayama, Yoshihiko, 189, 197, 201
narrative, 23–24, 172–73
nayamu chikara (ability to worry), 108–9, 153, 204
Nazi Germany, 52
negative self-thoughts, 12
non-support philosophy (
Hienjo Ron), 154–55, 212

Ohnuki-Tierney, Emiko, 96–97, 226n.8
Okamoto, Katsu, 148
Okuma, Kazuo, 50, 57–58, 59
Okyaku-sans (negative self-thoughts), 12
Omata, Waichiro, 38, 41
One Flew Over the Cuckoo's Nest (Kesey), 56
Oriteiku Ikikata (How to live in descent) (film), 111
Osawa Sakae, 49

Papipupepo, 210
Parsons, Talcott, 67
patient's rights, 36, 61
peer supporters, 158–60, 189, 228n.4
The People of Bethel (Mukaiyachi), 182–83
personal conferences, 12–13
Pettee, James H., 94
pharmaceuticals
and Bethel principles, 83, 109, 110
current status, 63
and deinstitutionalization, 49, 56, 60
dosages, 66, 224–25nn.49,50
first-generation antipsychotics, 36–37, 49–50, 51, 56
polypharmacy, 65–66, 225n.49
rates of use, 17
second-generation antipsychotics, 37, 60, 83
side effects, 30, 49–50, 65
and Western psychiatry, 37
Plath, David W., 207
polypharmacy, 65–66, 225n.49
possession beliefs, 38, 222n.4
Princess Mononoke, 38
problems, acceptance of, 108–10, 191
protective custody.
See forced institutionalization
psychiatric disability
accommodations for, 18
author's background, 21–22, 225n.2
Bethel member diagnoses, 17, 27, 188, 203, 204, 222n.4
as disability, 18, 61, 68
and disability activism, 3–4, 229n.1
Hayasaka on, 32–33
as identity, 226n.8
legal definitions, 16, 38, 62, 222n.8, 224n.39
modernity as cause of, 35, 222n.1
as
seishin shōgai, 16–17, 46, 61
statistics, 61–62
stereotypes of, 19
psychosurgery, 42–43
psychotourists, 1, 9, 146, 154, 186
public assistance, 32
Punch n' Glove, 188, 229n.1

Rainbow House, 71–72. See also Sunshine House
recovery (
kaifuku), 153–54
Red Cross Hospital (Urakawa).
See Urakawa Red Cross Hospital
reeducation training (
nikkin kyōiku), 118, 227n.2
Regulation for the Education of Former Aborigines' Children (1901), 95
Reischauer, Edwin, 53
religion.
See Buddhism; Christianity; Shinto
Report—Psychiatric Hospitals (Okuma), 57
Research on East Asia Psychotropic Prescription (REAP), 66
restraint, 143
Rika.
See Shimizu, Rika
Rika House, 14–15, 144
Risperdal, 83
ritsuryō legal system, 38
Robertson, Jennifer, 51–52
romantic relationships, 30, 83–85
Rosenhan experiment, 229n.3
Russell, John Gordon, 43, 52, 138
ryūgaku (study abroad), 176, 182–83

Saito, Michio, 119, 120, 204, 227n.4
Saito, Yoichi, 59–60
Sakai, Noboru, 158, 159, 228n.4
Sakaki, Hajime, 42
Sapporo, 91
Sasaki, Minoru, 28, 100, 102, 104, 106, 161, 187, 204
SA (Schizophrenics Anonymous), 72–74, 80, 169, 225–26nn.2-4
satorare, 77, 79, 81
schizophrenia
Bethel members' diagnoses, 17, 27
modernity as cause of, 35, 222n.1
statistics, 62
See also psychiatric disability; specific people
Schizophrenics Anonymous (SA), 72–74, 80, 169, 225–26nn.2-4
Scott, J., 224n.48
seaweed industry, 105, 209, 227n.3.
See also Bethel work programs
second-generation antipsychotics, 37, 60, 83
Sederer, Lloyd I., 50, 57, 64–65
seikatsu hogo (social welfare), 32
seishinbyō (mental illness), 43
seishin shōgai (psychiatric disability), 16–17, 46, 61
Sekishin-sha, 93–94
self-diagnosis, 25, 174, 176, 183
self-directed research (
tōjisha kenkyū), 77, 154, 169, 172–85
and Bethel Festival, 188
and Bethel promotion activities, 172, 182–83
directions for, 174, 175
presentation examples, 175–82, 229nn.9,10
report examples, 77, 183–85, 226n.7
translation, 173, 229nn.5,6
self-disclosure, 21–22
self-narration, 23–24
shakaiteki nyūin (hospital admission for social reasons), 64–65
shamanism, 96–98, 226n.8
shame, 17, 21, 22, 43, 44, 157, 228n.2
sheltered workshops, 107.
See also Bethel work programs
Shigenori, Ikeda, 51
Shimazaki, Tōson, 40–41, 222n.5
Shimizu, Rika, 76–81
and author's visits, 8
Bethel arrival, 79–81
and Bethel expansion, 204
and Bethel promotion activities, 9
caretaking role, 75–76, 85
and
Connecting Hearts, 216
drinking, 167
driving access, 164
and Gen'ichi Nakayama's funeral, 192
psychiatric symptoms, 77–79, 81
and romantic relationships, 83–84, 85
self-directed research, 77, 226n.7
and social support, 81, 82
staff roles, 76–77
and Sunshine House, 72
Shimono, Tsutomu, 82, 164, 188, 189, 215, 216
Shinfuku, Naotaka, 224n.49
Shinichirō, Takakura, 91, 95
shinkei suijaku (neurasthenia), 46
Shinto, 38, 67
Shorter, Edward, 222n.6
shūyō (detention), 47. See also institutionalization
sick role, 67–68, 109, 153, 167
Sim, Kang, 224n.49
smoking, 166–67
social skills training (SST), 11–12, 83, 169, 170–72
social support, 107
and hallucinations/delusions, 81–83
and Japanese culture, 210
and Kohei Yamane, 124, 126, 128–29, 131
life of descent, 154
as power of place (
ba), 227n.4
social welfare (seikatsu hogo), 32, 223n.18
Soka Gakkai, 190–91
sono mama ga iimitai (things are good as they are), 45
soredejunchō (right on schedule), 45
SST (social skills training), 11–12, 83, 169, 170–72
Station House, 189
stereotypes, 19
sterilization.
See eugenics
struggle, right to (
kurō), 153, 155, 167
study abroad (
ryūgaku), 176, 182–83
Sugamo Hospital, 223n.13
Sugimoto Akira, 43
Sulpiride, 49.
See also first-generation antipsychotics
Sunshine House, 72, 74–76, 85
support meetings (
ōen mītingu), 149–52, 228nn.12,14
Suzuki, Mai, 176, 180

Takei, Nori, 65
Takemi, Taro, 51
Takemura, Nobuyoshi, 58–59, 60
talk therapy, 66–67
Tan, Chay-Hoon, 224n.49
Tanaka, Tasuke, 94
therapeutic affirmation, 139, 228n.8
Thorazine (chlorpromazine), 49.
See also first-generation antipsychotics
time, 24–25
tōjisha kenkyū. See self-directed research
tōjisha (people with disabilities or families thereof), 173, 174, 229n.5
Tōjisha Shuken (The Sovereignty of Tōjisha) (Nakanishi & Ueno), 229n.5
Tokugawa Ieyasu, 88
Tokyo University Medical School, 59–60
Tomita Mikio, 50
tōno Monogatari (Yanagita), 222n.4
Totsuka, Etsuro, 41, 44, 60
town relations with Bethel, 9, 146–48, 228n.11
support meetings, 149–52, 228nn.12,14
Toyotomi Hideyoshi, 88
training, 54–55, 58
transactive memory, 108, 210
Tranulis, Constantin, 173
Tsuchiya, Takashi, 53

Ueno, Chizuko, 229n.5
Ukigaya, Sachiyo, 136, 142, 143
United Church of Christ in Japan, 89, 100, 226n.5.
See also Urakawa Church
United Nations Sub-Commission on Prevention of Discrimination and Protection of Minorities, 61
United States
deinstitutionalization, 56, 63, 65, 224n.48
Schizophrenics Anonymous, 225nn.3,4
talk therapy, 67
See also Western psychiatry
Urakawa
economy, 9–10, 144, 146, 148, 227n.3
isolation of, 186, 211
map of, 14
See also town relations with Bethel
Urakawa Church, 4, 70–71, 99–100, 102, 103–4, 226n.1
Urakawa Red Cross Hospital, 135–44
author's first visit, 15–16
and Bethel origins, 101–2, 104, 105, 134
current staffing, 137
and deinstitutionalization, 143–44, 156
Department of Psychiatry and Neurology, 138–40, 227n.5
flexibility, 148–49
future of, 216
and Gen'ichi Nakayama, 201
history of, 135–37
and Kiyoshi Hayasaka, 27–28, 30, 105, 149
and Kohei Yamane, 125–28
non-schizophrenia diagnoses, 142
nursing school, 15
psychiatric consultations, 138–39, 169, 200, 228nn.7,8, 229n.4, 229n.6
psychiatric day care, 15, 139–40, 165–66
psychiatric inpatient ward, 140–44
and Rika Shimizu, 80, 85
social skills training, 170
social workers, 156, 169, 228nn.1,12
specialists, 227n.6
support meetings, 149–52, 228nn.12,14
and Urakawa economy, 10
See also Kawamura, Toshiaki
Utsunomiya Hospital incident (1983), 58–60, 61, 224n.37

Vickery, George Kendall, 17
videos.
See Bethel promotion activities

WA (Women's Anonymous), 72–74, 169, 225–26nn.2-4
"Welcome to Bethel," 7–8, 219
Welfare Law for the Mentally Retarded (1960), 61
Welfare Law for the Physically Disabled (1949), 61
Western psychiatry, 42–43
and cultural diagnosis issues, 17, 37, 98
deinstitutionalization, 49, 56, 63, 65, 224n.48
and epilepsy, 224n.39
and eugenics, 223n.28
Japanese identification with, 37
length of stay, 63–64
Schizophrenics Anonymous, 225n.3
Wolf, Margery, 97–98
"The Woman Who Didn't Become a Shaman" (Wolf), 97–98
Women's Anonymous (WA), 72–74, 169, 225–26nn.2-4
work.
See Bethel work programs
World Health Organization, 53–54, 66
World War II, 46, 52, 226n.5
worry, ability to (
nayamu chikara), 108–9, 153, 204

Xavier, St. Francis, 87

Yadokari no Sato, 68, 69, 211
Yamagishi Association, 230n.5
Yamamoto, Kayo, 188
Yamamoto, Koichi, 100, 195
Yamane, Kohei, 114–31
and anthropological/ethnographic approaches, 20
background, 115–16
and Bethel expansion, 204
hospitalizations, 125–28
introduction to Bethel, 119–24
Mitsubishi experience, 116–19, 128–29
return to Bethel, 212
and social support, 124, 126, 128–29, 131
UFO experience, 114–15, 125–26, 129–30
Yamato people, 89
Yanagita, Kunio, 222n.4
Yanaka, Teruo, 68
Yokoyama, Yuzuru, 156–62, 187, 228n.5
Yoshimoto, Ishin, 45
Yoshino, Masako, 71, 178–79, 190, 216

zen'in keiei (cooperative management), 107