Morita therapy

Morita therapy is a purpose-centered, response oriented therapy from Japan, created in the 1930s by Dr. Shoma Morita.

Morita therapy has been described as cognate to Albert Ellis's rational-emotive therapy.^[1] It also has commonalities with cognitive behavioral therapy.^[2] Morita Therapy is effective in treating neurosis, particularly OCD. This has been recognised by the academic circle and a large amount of patients. According to statistics, the recovery rate is between 70% and 75%.

A brief introduction

To be simple, Morita Therapy is ‘let nature take its course’ and ‘do what you should do’. ‘Let nature take its course’ means that, we have to respect and adapt to the law of nature. In face of obsessive thoughts, we should neither control nor reason them out. This will only intensify and become even more sensitive to the obsessive thoughts. To correctly understand ‘let nature take its course’, we have to know what the ‘nature’ is. We know that there are days with full and crescent moon, and sunny and cloudy days. This is nature. Before we human beings exist on earth, the earth is already present. This fact cannot be changed with willpower, we can only respect and accept the fact so that we can be at ease. If not, we are asking for trouble.

‘Do what you should do’ is to withstand pain in doing what we should do, not to be stopped by obsessive thoughts and wasting a whole day in thinking about them. Or else, we will forever fall into the quagmire of obsessions, not being able to save ourselves. It is very wrong trying to get rid of symptoms. The process of ‘recovery’ is not to get rid of symptoms ourselves, but to allow the recovery to happen spontaneously. It is impossible to recover if we actively try to get rid of symptoms. If ‘let nature take its course’ and ‘do what you should do’ are successfully done, symptoms will gradually disappear naturally.

Background

Dr Shoma Morita (1874-1938) was a psychiatrist and department chair at Jikei University School of Medicine in Tokyo. Morita's personal training in Zen Buddhism influenced his teachings, yet Morita therapy is not a Zen practice.

Morita formulated his psychotherapeutic principles in Japan as a program for the treatment of neurotic tendencies at the same time that attention in Europe was given to Dr. Sigmund Freud's discovery of the unconscious and Carl Jung's development of archetypes.^[3]

Underlying philosophy

Morita Therapy directs one's attention receptively to what reality brings in each moment - a focus on the present, avoiding intellectualising.^[4] Simple acceptance of what is, allows for active responding to what needs doing. Most therapies strive to reduce symptoms. Morita therapy, however, aims at building character to enable one to take action responsively in life regardless of symptoms, natural fears, and wishes.^[5] Character is determined by behavior, by what one does. Dogmatic patterns of collapse are replaced with the flexibility to call upon courage and empowerment. Decisions become grounded in purpose rather than influenced by the fluid flow of feelings.

In Morita Therapy, character is developed by cultivating mindfulness, knowing what is controllable and what is not controllable, and seeing what is so without attachment to expectations. Knowing what one is doing, knowing what the situation is requiring, and knowing the relationship between the two are quintessential to self-validation, effective living, and personal fulfillment. Character is developed as one moves from being feeling-centered to being purpose-centered. A feeling-centered person attends to feelings to such an extent that the concern for self-protection reigns over decisions and perceptions. Given the human condition, change, pain, and pleasure are natural experiences. Indeed, emotions are a rich type of experience and a valuable source of information. Feelings are acknowledged even when what is to be done requires not acting on them. Constructive action is no longer put on hold in order to process or cope with symptoms or feelings.^[6] The individual can focus on the full scope of the present moment as the guide for determining what needs to be done.

Trying to control the emotional self willfully by manipulative attempts is like trying to choose a number on a thrown die or to push back the water of the Kamo River upstream. Certainly, they end up aggravating their agony and feeling unbearable pain because of their failure in manipulating the emotions.
— Shoma Morita, M.D.^{[citation needed]}

Ultimately, the successful student of Morita therapy learns to accept the internal fluctuations of thoughts and feelings and ground his behavior in reality and the purpose of the moment. Cure is not defined by the alleviation of discomfort or the attainment of some ideal feeling state (which the philosophy of this approach opposes), but by taking constructive action in one’s life which helps one to live a full and meaningful existence and not be ruled by one’s emotional state.^[7]

Morita's four stages

Morita therapy was developed to deal with what Dr. Morita defined as Shinkeishitsu - “anxiety-based disorders” involving a high degree of perfectionism.^[8]

Morita offered a four-stage process of therapy involving:

Isolation and rest
Occupational therapy (light)
Occupational therapy (heavy)
Complex activities.^[9]

Morita therapy may be seen as a form of re-socialisation, involving a social influence process.^[10]

Morita Therapy Methods (Western)

Shoma Morita's groundbreaking work was first published in Japan in 1928, so that pure Morita Therapy had its greatest applications to a Japanese culture almost one hundred years ago. Morita Therapy Methods (MTM) brought Morita’s original thinking to the west, and has sought to adapt it to modern western minds and culture.^[11]

Thus, for example, the original Morita treatment process has the patient spend their first week of treatment isolated in a room without any outside stimulation—no books, no television, no therapy other than being alone with their own thoughts. Modern-day benefits providers are unlikely to see the ancient wisdom of paying for people who are attempting to learn to better face the challenges of life to spend a week alone sitting in a hospital bed; and the practice has been modified, the MTM approach seeking nonetheless to remain consistent with the underlying principles.

The shinkeishitsu concept has also been broadened to consider not just anxiety, but life situations in which modern westerners may find themselves, involving stress, pain (physical, psychological, or both) and the aftermath of trauma (physical, psychological or both).^[12] While no cure-all, and requiring personal commitment and action, MTM is an amalgamation of Eastern treatment methods applied to the Western mind, and claims to help patients find, and use, a well of inner strength deep within themselves that enables them to make powerful changes in their life, though further research to clarify its effectiveness in Western settings is still [2011] required.^[13]

As with Morita therapy proper, MTM is roughly divided into four basic areas of treatment.

The four areas of treatment

Phase one is the “rest phase”. It is a period of learning to separate ourselves from the minute-by-minute barrage of the constant assault on our senses and thought processes by a loud and intrusive world. We learn to turn off the television, close the door temporarily to demanding work, well-meaning friends, and yes, even family. We use the solitude to meditate with simple, non-religious based meditation. Through this simple meditation we learn to re-familiarize ourselves with the warm and healing peace that has been beaten out of us by work stress, the media, psychological and physical pain. Yes, you can have profound meditation even if experiencing profound pain.

Phase two introduces us to “light and monotonous work that is conducted in silence”. One of the keystones of this stage of self-treatment is journal writing. Our thoughts and feelings come to us in indistinguishable waves and flood our minds. Writing in our personal journals helps us learn to separate our thoughts from our feelings and define their different effects on our lives. In this phase we also go outside… outside of ourselves and out of the house and begin a reconnection with nature. We leave the solitude of Phase one and go out of doors. We breathe the fresh air and feel the sun on our faces. We walk. We walk and breathe. We walk, breathe and reconnect with the world of nature that has been shut out of our lives by pain and stagnation for weeks, months, even years. We move from darkness to light in both figurative and literal ways.

Phase three is one of more strenuous work. Dr. Morita had his patients engage in hard physical work outdoors. This is what we call the “chopping wood” phase. For people with physical injuries, it is the phase where you move from passive treatment given to you by others (i.e. chiropractic, massage and pain medicine) to learning to begin healing yourself though a stretch and strength oriented physical therapy program. MTM incorporates moving from being treated to learning self-treatment in both the physical and psychological realms. It is hard, it hurts, and it will be a challenge to persevere in the beginning, but if you are ever going to move from being the treated victim to being the recovering survivor this step must occur.

Depending upon the depth and nature of injury (of spirit, mind or body), Phase three can be short or long. For some it becomes a part of daily life, forever. Some pain resolves, some pain needs to be managed. The beneficial aspect of this phase of treatment is that it also encourages the engagement of what we now understand is the right side of the brain. The recovering survivor is encouraged to spend time in creating art—writing, painting, wood carving—whatever puts them into contact with the creative aspects of their humanity.

Phase four is when Morita would send patients outside the hospital setting. They would apply what they had learned in the first three phases and use it to help them with the challenge of reintegration into the non-treatment world. This is the phase where the patient learns to integrate a new lifestyle of meditation, physical activity, clearer thinking, more ordered living, and a renewed relationship with the natural world. They are not returning to their former lifestyle. Instead, they will integrate their “new self” into the imposed set of changes brought about by their trauma, pain and limitations. As re-integration into the world outside of treatment brings with it some unanticipated challenges, the survivor returns to the materials they studied and perhaps even the counsel of their teacher to find coping skills that will allow them to progress further and further on the journey of recovery.

References

^ Morita therapy
^ U. P. Gielen et al, Handbook of Culture, Therapy and Healing (2004) p. 289
^ Morita therapy: Japanese therapy for Neurosis
^ Gielen, p. 285
^ David K. Reynolds, The Quiet Therapies (1982) p. 34
^ David K. Reynolds, Playing Ball on Running Water (1984) p. 173
^ Reynolds, Quiet p. 35-41
^ Gielen, p. 285
^ Gielen, p. 285
^ Gielen, p. 289 and p. 278
^ Robert K. Conyne, The Oxford Handbook of Group Counselling (2011) p. 477
^ Conyne, p. 477
^ Conyne, p. 478