Getting Help In Japan
Homesickness, helplessness, and doubt can turn into depression, anxiety, and panic. Our cultures collide. Everyone around you seems to know exactly what to do and how to act. You become an outlier, a pariah, an unpredictable and unstable outsider. Being so far outside the norm in your thoughts and actions, you become, in a sense, insane.
Week after week, I am battling loneliness (I barely know anyone here.), boredom (I don’t know what there is to do here.), and frustration (I can’t seem to figure anything out here.). At night I feel desolate and fearful. Work keeps me up early in the morning and insomnia keeps me up late at night. I have been here over two months and it doesn’t feel like anything is getting easier or better. Two months of this will wear you down. Last week, I decided to do what any educated American with means would do; I decided to get professional help.
But how to do it? I am an English-teaching ALT working through a private placement company. My company offered to help me find English speaking doctors but did not mention anything about English speaking psychologists. I didn’t exactly want to alert them to the fact that I was about to lose my marbles, anyway. A Japanese-speaking friend said there was an English-speaking psychologist recommended by the JET program working in nearby Isesaki. She called for me to make an appointment. The woman only worked one weekday in the morning. I would have to miss work, so I mustered up all my courage to call my company and tell them. The Western staff were quite understanding, but there were rumblings of deep consternation within the Japanese staff. In my culture, counseling is considered common preventative medicine, at least for anyone that could afford it. I would soon learn that, in this culture, psychological treatment is reserved only for sincere emergencies and obvious mental illness.
My trip to see the psychologist was a disaster. I prefer to keep my medical concerns private, but in Japan I need help with everything. My company assigned a Japanese staff member to accompany me, and this was absolutely necessary. We arrived one time for my appointment The place turned out to be a hospital. This was my first warning that things were not going to go as smoothly as in my own country. This was not a private office like I had expected. I was handed many forms to fill out, all in Japanese. My assistant translated as best she could and then translated my answers as much as possible. It was embarrassing to reveal all the details of my health and mental condition to someone from my work. After the forms were turned in, we waited an hour. A woman then told us that the doctor was not ready and to come back in another hour. An hour and ten minutes after that, I was lead into a private room and told that the doctor would not see me. She only sees inpatients and it was just not possible. There was no promise to see me, my friend must have misunderstood. I personally trust my friend a lot more than I trust the Japanese bureaucracy to communicate clearly.
If I were in my own country I would have fumed furious demanding things in English. All sorts of irate “Now you see heres” and “Let me tell you somethings.” I had long ago decided that if someone "Sumimasen. Chottoed" me one more time in this country I was going to start shooting pencils and pens like poison darts and throwing staplers and tape dispensers like grenades. Why couldn't I see the doctor? Why couldn’t they have told me all this when I first came in? Or even an hour later when they told me to wait longer? Why does the only English-speaking psychologist in the area only see patients in a mental hospital? It’s not like they have a lot of institutionalized English speakers. Or maybe they do because no one can get any help here. Why did I waste my sleep time, my work time, and over two hours of my stressed out, unhappy life for nothing? I was broiling to throw one good American fit. Instead, I was suddenly overwhelmed with the full weight of my defeat. It was hopeless. I had tried to be proactive and do something to help my ever-growing and debilitating problem and it had backfired on me. Japan had just irreparably reinforced all my reserved horrors. I broke down and sobbed, in front of the hospital staff, in front of the assistant from my company. As I left the private room, all the hospital patients would see a red, puffy-faced gaijinJapanese word meaning "outsider" commonly used to describe foreigners. Considered somewhat impolite. , choking back tears, being lead away by a shocked Japanese woman. In a reserved and formal country, my hysterical display had ensured my place in a realm outside the sane and normal.
My assistant made some phone calls. She found an English-speaking male counselor in Takasaki who worked one day a week in the early afternoon. My trip to Isesaki had been such an emotionally damaging disaster that I felt the stresses of taking off more work and doing more rushed traveling might hurt more than it might help. Then she found a female psychiatrist near me in Maebashi who spoke a little English and was willing to see a foreigner. She didn’t do counseling but she was willing to do what she could for me. I disapprove of medication without additional counseling, but I am running out of options. Off we went to another hospital. This was a much better experience. Even though the staff did not speak fluent English, they were kind and interested. The treatment was very expensive, however, and I don’t think my private insurance company, InterGlobal, covers mental health expenses.
The hours I spent waiting gave me a lot of time to think. I had assumed that mental health services were a normal part of any developed country’s schema of care. In my country it has the paradox of carrying both stigmatization and socio-economic status. If you have to go to counseling, there’s something wrong with you. You can’t hack it on your own. At the same time, counseling is an expensive luxury and popular with the sophisticated as being helpful and healthy. If you have a toothache, go to the dentist. If you’re feeling stressed, go to the psychologist. Here there is only stigmatization. It is the last, desperate resort. The end of the Wacky Shinkansen with the terminal in Gone Off The Deep End.
So what’s with the lack of mental health care in this country? Do they not have mental illness? Or is it just so private and shameful that no one deals with it? Studies have shown that people with some mental illnesses, such as schizophrenia, have a greater rate of recovery and progress in community-based societies. Does the strength and harmony of the Japanese family and society prevent insanity without the need of mental health services? Somehow I don’t think it’s that simple. There may be disturbing undercurrents in this culture that I just can’t understand.
Clinical psychologists are rare in this country and English-speaking ones are barely a rumor. People do sometimes receive treatment in the form of medication from their doctor, but seeking a specialist is cause for alarm. If you live in Tokyo or another major city, there are some services available and the attitude towards mental health care is more progressive. If you’re out in rural GunmaOne of Japan's 47 prefectures. It forms the Northwest corner of the Kanto area. like me, your resources are scant and very difficult to find.
Here is the website for the Tokyo English Lifeline (http://www.telljp.com). They are based in Tokyo and offer face-to-face counseling there. But they also do free over the phone counseling and you can call them from anywhere in Japan.
I also found this website for the International Mental Health Professionals Japan (http://www.imhpj.org). I cannot seem to use it to find an English-speaking counselor in my area, but maybe you can have more luck with it.
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