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Research in Analytical Psychology and Jungian Studies
Series Advisor: Andrew Samuels
Professor of Analytical Psychology, Essex University, UK

The Research in Analytical Psychology and Jungian Studies series features

research-focused volumes involving qualitative and quantitative research,
historical/archival research, theoretical developments, heuristic research,
grounded theory, narrative approaches, collaborative research, practitioner-
led research, and self-study. The series also includes focused works by clinical
practitioners, and provides new research informed explorations of the work
of C. G Jung that will appeal to researchers, academics, and scholars alike.

Books in this series:

Jung and Levinas

An Ethics of Mediation
Frances Gray

Symptom, Symbol, and the Other of Language

A Jungian Interpretation of the Linguistic Turn
Bret Alderman

Post-Jungian Psychology and the Short Stories of Ray Bradbury and

Kurt Vonnegut
Golden Apples of the Monkey House
Steve Gronert Ellerhoff

Eros and Economy

Jung, Deleuze, Sexual Difference
Barbara Jenkins

Towards a Jungian Theory of the Ego

Karen Evers-Fahey

A Japanese Jungian Perspective on Mental Health and Culture

Wandering Madness
Iwao Akita
Translated by Waka Shibata and Kittredge Stephenson
A Japanese Jungian
Perspective on Mental
Health and Culture

Wandering Madness

Iwao Akita
Translated by Waka Shibata
and Kittredge Stephenson
First published 2017
by Routledge
2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN
and by Routledge
711 Third Avenue, New York, NY 10017
Routledge is an imprint of the Taylor & Francis Group, an informa business
© 2017 Iwao Akita
The right of Iwao Akita to be identified as author of this work has
been asserted by him in accordance with sections 77 and 78 of the
Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this book may be reprinted or
reproduced or utilised in any form or by any electronic, mechanical,
or other means, now known or hereafter invented, including
photocopying and recording, or in any information storage or
retrieval system, without permission in writing from the publishers.
Trademark notice : Product or corporate names may be trademarks
or registered trademarks, and are used only for identification and
explanation without intent to infringe.
British Library Cataloguing-in-Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging-in-Publication Data
Names: Akita, Iwao, 1957– author.
Title: A Japanese jungian perspective on mental health and culture :
wandering madness / Iwao Akita ; translated by Waka Shibata and
Kittredge Stephenson.
Description: Milton Park, Abingdon, Oxon ; New York, NY : Routledge,
2017.
Identifiers: LCCN 2016040778 | ISBN 9781138805699 (hardcover) |
ISBN 9781315752105 (electronic)
Subjects: LCSH: Japanese—Mental health. | Mental illness—Japan. |
Cultural psychiatry.
Classification: LCC RC339.J3 A35 2017 | DDC 616.8900952—dc23
LC record available at https://lccn.loc.gov/2016040778
ISBN: 978-1-138-80569-9 (hbk)
ISBN: 978-1-315-75210-5 (ebk)

Typeset in Sabon
by Apex CoVantage, LLC
Contents

Foreword x
Translators’ introduction xi
Acknowledgements xvi
Preface, Japanese edition xix
Preface, English edition xxiv

Introduction: Madness embraced 1

1 On the question of why 10

2 What is madness? 29

3 The impossibility of objectivity 54

4 The departure from godhood: Everyone is

borderline and at the borderline 66

5 For those who wander in mazes: Escaping the

fly bottle 93

Conclusion: From mental health to psycheology 106

Postscript 117
Index 118
Foreword

It’s a pleasure to write a foreword for such an important work. Dr. Iwao
Akita has a similar history as I do, being a psychiatrist and a Jungian ana-
lyst. His cases are holistic, and combine his interest in psychiatric medicine
as well as analytical psychology. I endorse his approach in using the bio-
psychosocial model and his addition of a spiritual dimension. Dr. Akita’s
approach makes sure that finding meaning in madness is an essential aspect
of treating our patients. I’m always humbled by William James’ philosophy
and understanding of how religion and illness intersect. Perhaps Dr. Akita
is following the lead of this pioneer by understanding the import of how
religion, and its influence on culture, shape our care of patients.
David H. Rosen, M.D.
Eugene, Oregon, U.S.A.
Translators’ introduction

The translation of this work is relatively unusual in that it is a collaborative

product. At the most basic level, Waka Shibata translated the Japanese
text into English, while Kittredge Stephenson refined the language of that
translation. However, this description belies the extensive dialogue that was
involved to ensure an appropriate balance of accuracy and flow. To speak to
the process, then, Waka provided the initial, literal translation of the text. A
series of conversations followed with Kittredge to ensure he understood the
meaning of the text. An initial polished translation followed that focused
on rendering the meaning of Waka’s original translation accurately, while
making it consistently comprehensible for an English reader with some
background in psychology and Japanese culture. Another set of conversa-
tions followed to ensure that this level of refinement continued to reflect the
original Japanese text accurately. Subsequently, a second polished transla-
tion focused on rendering the text into fluid English, with the intention that
it read smoothly for native English speakers, as well as capture some of the
poetic nuances of Dr. Akita’s original work. This polished translation was
then reviewed once again by Waka, as well as by native English speakers
who varied with respect to professional background and familiarity with
psychology and Japanese culture. We would like to thank these individu-
als for their thoughtful reflections: Sean Fitzpatrick, Bunmi Ogunleye, Ruth
Stephenson Strom, and Rodney Waters. At Routledge, Heidi Lowther and
Andrew Samuels also contributed valuable feedback. The final translation
incorporated these reviews and represents the culmination of these develop-
mental stages.
It is also worth noting that this translation process is itself in parallel
with the book’s subject. Central to Wandering Madness1 is an appreciation
of how Japan and the West each have valuable contributions to make to
mental health and our understanding of the human condition. Dr. Akita
argues that pooling these different culturally informed insights provides
us with an opportunity for a synergetic whole. It is perhaps not surpris-
ing that Dr. Akita himself embodies this bridging of understandings, both
with respect to Japanese and Western cultures, as well as mental health. As
xii Translators’ introduction

his author description and the book itself make apparent, Dr. Akita’s life
and experiences are testaments to the insights he shares here. What may be
less apparent is that the translation process, and the translators themselves,
also manifest this dynamic. The extensive conversations required to accu-
rately translate the work were apposite reflections of this intention to bring
Japanese and Western cultures and mental health perspectives into dialogue.
This dialogue, in turn, was made possible by Waka and Kittredge’s respec-
tive explorations and experiences – East and West, cultural and psycho-
logical. Thus, the translation of this work has been not only dynamic, but
embodied.
Having reviewed the translation process, we would like to discuss a num-
ber of points regarding the translation itself. The first is primarily a cultural
distinction that is reflected in the respective languages. The Japanese have a
distinctive aesthetic and corresponding affinity for images. By way of exam-
ple, Hayao Kawai was the first Japanese to become a Jungian analyst, and
he was eager to share this perspective in Japan. At the same time, he knew
the introduction needed to be made with care if it were to be adopted. So
he began by introducing sandplay therapy, which provided an opportunity
for the Japanese to gain an appreciation for the dynamism of the scenes –
images – depicted in this therapeutic mode. As this experiential sense for the
psychological power of images was adopted, Dr. Kawai introduced Jungian
psychology, which complemented sandplay therapy and provided additional
scope and insight through its interpretations of symbolic images. In keeping
with Dr. Akita’s argument in this text, one might say that the Japanese have
an intuitive grasp for the dynamism of symbolic images. In contrast, Western
cultures tend to emphasize intellectual comprehension in keeping with Des-
cartes’ philosophy.
This cultural difference is reflected in language used to describe the assim-
ilative process. For example, Dr. Akita sometimes uses words that describe
an image or the process of viewing something, whereas the rendering in
English might use recollection, recognition, or the like. In English, too, one
can “see” what someone is saying, but this usage differs from the more direct
assimilation of the images themselves that is reflected in Japanese usage. The
implication is that the Japanese come into relationship with something more
through the process of engaging with images of it, whereas native Western
speakers of English place more of an emphasis on cognitive modes of assimi-
lation. In this translation, we have retained language that reflects assimila-
tion through vision and images where possible, but have made use of more
cognitively oriented language at times to render a smoother translation or
reflect the primary meaning in context.
A second point is to note that the original Japanese text is quite poetic.
To read it is to have something of the experience Dr. Akita attributes to the
Japanese generally, i.e., that they are able to dance with both conscious and
unconscious elements. One example would be his discussion of The Little
 Translators’ introduction xiii

Prince in Chapter 2. Dr. Akita weaves quotes from The Little Prince in with
paraphrase and interpretive comments to form a coherent whole. All of this
is made more immediate by his decision not to refer to the protagonist of
the work in any way other than the first-person pronouns used in the book
itself. The resultant effect is to make the reader feel quite close to both the
protagonist of the work and to Dr. Akita as he develops his interpretation of
it. He is similarly deft in molding his audience into different roles through-
out the text. Wandering Madness leaves open the possibility, implicitly, that
the readers have within themselves the capacity to be mad, to be therapists,
and to be clients. In other words, he writes in a manner that invites readers
to reflect on the various roles they play in the dynamics he is discussing. Our
translation inevitably falls short of capturing such a fluid and poetic style –
and indeed, such a perception of life itself.
A third issue that affects the work as a whole is the development of the
Diagnostic and Statistical Manual of Mental Disorders (DSM). When the
original Japanese version of Wandering Madness was published in January
of 2012, DSM-IV-TR was still current. DSM-5 was released in May of 2013
and did away with the multiaxial assessment system that placed personal-
ity disorders on a separate axis than other diagnoses. Dr. Akita discusses
this role of personality disorders and their position in the DSM at length in
Chapter 4. Given that the discussion of personality disorders runs through-
out the text, however, it was decided simply to translate the work as it is,
since any attempt to update it so as to reflect the developments of DSM-5
would involve significant changes to the work as a whole.
On a related note, a fourth set of points concerns the terminology associ-
ated with clinical practice. As a psychiatrist, a clinical psychologist, and a
Jungian analyst, Dr. Akita has an unusually broad perspective on clinical
work and the various professions that compose it. Sometimes, the distinc-
tions between the professions are straightforward. In the original Japanese
text, Dr. Akita refers most often to psychiatrists/psychiatric medicine, cli-
nicians/clinical psychology, and psychotherapists/psychotherapy. Given his
training in multiple clinical disciplines, however, the boundaries between
these are not always clear when he shares about his professional experience.
In an attempt to capture the inclusive quality with which Dr. Akita discusses
clinical work, while also honoring the specificity of the various disciplines,
we have chosen to refer to these clinical domains under the general term
“mental health” when possible. The terms used for the practitioners them-
selves have been left more varied. We have generally reserved specific terms
like “psychiatric medicine” for those times when Dr. Akita is describing
elements specific to that discipline, e.g., the prescribing of medications, or
situating it within the history and fields of medicine. Also, while Dr. Akita
makes reference to both “clients” and “patients,” we have chosen to trans-
late references to individuals seeking mental health treatment consistently
as “clients.” Finally, there are times when Dr. Akita refers to individuals
xiv Translators’ introduction

suffering from mental illnesses in a manner that identifies them with their
diagnosis, e.g., a schizophrenic or alcoholic. In keeping with the growing
awareness of the potentially stigmatizing nature of such reifying language in
English, we have in most cases translated the intended meaning in a manner
that also acknowledges the distinction between the individual and his or her
diagnosis.
Fifth, it is worth noting that the Japanese language is more contextu-
ally driven than English, which involves both practical implications for the
translation and reflects a broader cultural dynamic. Practically, pronouns
and stated subjects of sentences are often simply implied via context in Japa-
nese, whereas English generally requires them. This issue is further com-
plicated by the necessity in English to acknowledge the gender of those to
whom reference is being made. The net result is that, in order to make the
translation sufficiently smooth for English readers, we have often had to add
specific subjects and referents that are not stated directly in the Japanese.
And in an attempt to reflect the gender neutrality of the original work with-
out repeated reference to “him or her,” we have often made use of plural
forms. Nevertheless, this approach does not fully capture how Dr. Akita
balances talking about the individuality of a given client, for example, while
situating him or her within the general experience of the human condition.
This issue of context also affects how certain terms have been translated,
particularly those referring to evil and the divine. Regarding the former,
mara can be translated as “evil,” “devil,” “demon,” or “fiend” (from Poe’s
“The Black Cat,” as referenced in Chapter 2). This has been translated pri-
marily as either “evil” or “devil.” Our intention was to limit the English
words used for a single Japanese term (though variations of “demon” and
“fiend” still make occasional appearances), while retaining sufficient speci-
ficity to capture differences concerning how mara can manifest in a more
animated form (devil) or refer to a general force (evil). With respect to the
latter, kami can be translated as “God,” “gods,” or “god,” depending on
the context. Thus, a single term makes reference to the divine as it is rep-
resented in the Judeo-Christian tradition, in Shinto, and as a more general
reference to the divine, respectively. In addition to being marked by context,
the particular Japanese alphabet (of three) in which the term is written also
clarifies its intended use. In this translation, we have rendered the term in
these different forms as best fits the context.
With respect to style and formatting conventions, Dr. Akita makes use
of quotation marks extensively in the original Japanese text. As a point of
style, for example, he uses direct quotations of his own work, both within
the current text and when he cites his previous publications. In English,
however, it is common to paraphrase material being referenced in this way.
While we retained the direct quotations in certain instances, we often tran-
sitioned to paraphrase in order to better capture the flow of the original text
for an English-speaking audience. Dr. Akita also uses quotation marks to
 Translators’ introduction xv

highlight certain key terms, some of them throughout the text, e.g., “cause
of existence,” “wound,” and “psycheology.” In English, however, the con-
vention is to use quotation marks when the term one intends to emphasize
first appears, but not subsequently. We handled this differently depending
on the term. For the most important terms, such as “cause of existence,”
“disfigured hero” and “psycheology,” we used italics throughout. For other
terms where Dr. Akita uses quotation marks, we employed the English-
language convention of using quotation marks around only the first use of
the term, though this is sometimes repeated for the first instance of the same
term in a new section or chapter. Also, we used italics for most Japanese
words in the text. Some Japanese terms are sufficiently familiar that they are
not typically italicized in English, such as haiku or manga, but we italicized
these for consistency.
Finally, there is the issue of providing Western readers with sufficient cul-
tural context to follow the many references made to Japanese culture, past
and present. In rare instances, this additional contextual clarity is added
in the text itself and marked with brackets, when the implied meaning is
very clear and succinct. The great majority of this information, however, is
provided via endnotes. Our purpose is to supply sufficient context to allow
readers largely unfamiliar with Japanese culture to read through the text
with perhaps only occasional cultural hiccups. At the same time, we have
generally refrained from interpretive commentary, trusting Dr. Akita’s work
to speak for itself, whatever the language.
Kittredge Stephenson
Houston, Texas, U.S.A.

Waka Shibata
Kyoto, Japan
Acknowledgements

Japanese edition
I want to express my warmest thanks to Mr. Toshiyuki Tsuda and Ms. Akemi
Watanabe from Sougensha2 for their support and guidance. Mr. Tsuda was
the one who set up this project, and both believed in my potential and
worked patiently with me over the course of the book’s development. This
book would not exist without Mr. Tsuda. He was always encouraging and
supportive. He provided me with freedom of thought and expression, which
may have seemed rather eccentric at times. He did not hesitate in allowing
me to develop my theory. I lack words to describe my appreciation.

I also want to touch upon the cover art.

When I was in Switzerland, I had a dream in which I am looking at a
famous Japanese writer, who is writing a novel in a stylish atelier. I had no
clue why I had such a dream at the time. Sixteen years later, on Novem-
ber 15, 2011, I visited Mr. Tsutomu Nishioka’s studio to discuss the cover
art with my editors, Mr. Toshiyuki Tsuda and Ms. Yumiko Miyazaki. (I was
meeting Yumiko for the first time, but she contributed greatly to the publica-
tion of this book behind the scenes.) As we stepped in, I was confronted with
the scene from the dream. That was it! Tsutomu Nishioka and I had several
subsequent exchanges through Toshiyuki Tsuda. As someone who appreci-
ates deep questions about the world, I learned a great deal in the course of
my communications with Nishioka. When talented individuals get together
and work collaboratively, a masterpiece can be produced. Perhaps I should
not praise my own book so highly, but when I received the proof for the
cover, I felt embraced by the cosmos. I thought, “Finally, this is complete.”
Many thanks to Mr. Nishioka, Mr. Tsuda, and Ms. Miyazaki.
I would also like to thank Ms. Natsu Higami and Mr. Hiroshi Sato, who
helped me in getting copyright permissions in Japan.

This book was published with the aid of a Kyoto Bunkyo University pub-
lishing grant. I want to express my appreciation once again for this wonder-
ful academic research environment.
 Acknowledgements xvii

Acknowledgement of translators
The original Japanese edition of Wandering Madness was written in a poetic
style with carefully selected language, if I do say so myself. It contains many
esoteric Japanese words, rarely used in everyday life. Accordingly, it was
a great burden on the translators. Ms. Waka Shibata, who did the initial
Japanese-English translation of this book, put enormous energy into clear-
ing this hurdle. The original edition and the translated edition are not abso-
lutely identical as a matter of course, because the nuance of each word is
different. Therefore, the original edition and the translated edition of Wan-
dering Madness are effectively different works, though Waka’s efforts have
reduced the gap as much as possible.
It is fortunate that I, as the author of this book, could address Waka’s
questions directly. I believe this has provided readers of the English edi-
tion with a more precise grasp on what the original book attempts to
explain.
In addition, I was fortunate to have this initial draft of the English edition
developed by Dr. Kittredge Stephenson, who is an outstanding psychologist,
as well as a native speaker of English. When the project of translating Wan-
dering Madness had just been launched, Kittredge was attending the Gradu-
ate School of Kyoto Bunkyo University, where I work and Waka attends. To
top it all off, his research topic was haiku!
Kittredge is himself an American, but came to Japan to grasp the spirit
of this country. The three of us met at such a juncture. Therefore, one
cannot hope for a better translation than this. Such an opportunity has
been a great blessing for me as the author. I simply thank God for it, as
such things are not granted simply through wishing them to be so. Again,
I would like to extend great appreciation to Waka Shibata and Kittredge
Stephenson.

Copyright permissions
Excerpts from the following authors and titles are published with the fol-
lowing permissions:

Japanese language

Introduction
Nihonteki-kanse, by K. Sasaki, 2010, Tokyo, Japan: Chukoshinsho.
Reprinted with permission.

Igyō-ni-sareta-hitotachi [People who were portrayed as divergent] (2nd ed.),

by S. Shiomi, 2009, Tokyo, Japan: Kawade Shobo Shinsha. Reprinted with
permission.
xviii Acknowledgements

Chapter 1
Jung shinrigaku nyūmon [Introduction to Jungian psychology], H. Kawai,
1967, Tokyo, Japan: Baifukan. Reprinted with permission.

Chapter 2
Sky-High, T. Takahashi, 2001, Tokyo, Japan: Shueisha. Reprinted with
permission.

Chapter 4
Personality-shōgai [Personality disorders], N. Hayashi, 2005, Tokyo, Japan:
Shinko Igaku Shuppan. Reprinted with permission.

Chapter 5
Unexploded bomb (Episode 115). Black Jack (Vol. 7, pp. 103–127), O. Tezuka,
1987, Tokyo, Japan: Akita shoten. Reprinted with permission.

The second person (Episode 195). Black Jack (Vol. 12, pp. 133–153),
O. Tezuka, 1988, Tokyo, Japan: Akita shoten. Reprinted with permission.

English language

Introduction
The Letters, by V. van Gogh, 2009, retrieved from http://www.vangoghletters.
org. Copyright 2009 by Van Gogh Museum Enterprises B. V. Reprinted
with permission.

Chapter 1
The Little Prince, by A. de Saint-Exupéry (T. V. F. Cuffe, Trans.)., 2000,
London, England: Penguin Books Ltd. English-language copyright 2000 by
Penguin Books Ltd. Reprinted with permission.

Chapter 2
Memories, Dreams, Reflections, by C. G. Jung (A. Jaffe, Ed., R. Winston &
C. Winston, Trans.), 1989, New York, NY: Vintage Books. Translation copy-
right renewed 1991 by Random House LLC. Reprinted with permission.

Takasebune, O. Mori. (M. Brase, Trans.), 2006, Tokyo, Japan: IBC Publish-
ing. Reprinted with permission.