Random Thoughts - Emotional Irregulars

Early in my time back in the U.S., I had a discussion with a relative about mental illness in America as compared to that in Japan. This stemmed from a comment I'd made on Facebook about how I was seeing so many adults standing on streets and corners holding up signs asking for money in which I said that that was unlikely to happen in Japan. There are multiple reasons for this. One is that Japanese people would be ashamed to ask strangers for money. Another is that families are expected to and generally do look after their relatives with problems. This is not always the case, but it is more often the case than in the U.S.

The situation is complex, and I'm sure even talking about it in a format as limited as a blog post will generate some trouble with those who are intent on not taking any caveats about that fact to heart, but I will talk about it nonetheless. It was my impression that this relative felt that I was being inherently unfair to Americans and portraying them as heartless and selfish. While I don't believe Americans are heartless (far from it), I do believe that from the Japanese perspective on some issues, they are quite selfish, particularly when it comes to matters of their homes.

One of the things I realized about Japanese families, in general, but certainly not specifically, is that they feel a strong sense of obligation to look after one another. A good example of this is the case of adult children with hikikomori, a mental disorder in which one seeks social isolation. In most cases, the family accommodates  a member's disease by finding a way to financially support and house them. They do not issue ultimatums to "get better" or "get out". They do not insist on treatment or expulsion from the home. The parents or other family tend to accept the burden and live with it. 

One might ask how I know this or if I'm basing my conclusions on anecdotal experience. Because those who suffer from hikikomori are in social isolation, it's not like I was going to run across them or have the experience of teaching them. My information comes from a broader source. I met a woman in Japan who was doing her PhD and as part of her dissertation was visiting and interviewing a large number of these young men (it's almost always men). I also saw her actual dissertation and part of what she said was that insisting that your mentally ill relative do whatever was in his or her power to get better or face having to leave simply "was not done". 

By contrast, in the U.S., and I worked for two years in a halfway house for people who had been institutionalized or hospitalized after having had a psychotic break, so I have first-hand experience with this as well, American families tell the people with such problems to get their crap together or get out of their homes. If they are too ill to actually do that, their families find a way to off-load them onto a social service system in not a small number of cases. I was part of a system onto which such people were off-loaded and some of the things I discovered about the families of people who couldn't get rid of their mentally ill were, at times, horrifying. In one of the worst cases, the sister of one woman who found her way to our facility routinely locked her in a closet or beat her when she didn't want to deal with her. 

My point in this post is not to paint Americans as evil people who do not care about their families, but rather to point out how we handle mental illness in the family differently. While Japanese people are far more likely to hide or obfuscate such illnesses because it brings shame to them, Americans are likely to try and push people out of their lives and insist on treatment at any cost. As I may have mentioned in a post before, this is because Americans are tolerant on a macro level (society at large), but intolerant on a micro level (within their own homes) whereas the Japanese are the opposite.

This is all an introduction to my larger topic and that is about how the manner in which we are treated when we have an emotional or mental problem greatly influences how that problem will manifest. As part of my discussion with the aforementioned relative, she offered an anecdote about the boyfriend of an acquaintance of hers who was narcissistic, selfish, lazy, and refused to take any work that was "beneath" him and was therefore utterly dependent on his girlfriend for support. She asserted that the only thing to be done with a person with such a personality disorder was to expel him or he would forever be a leech on whoever he was with. She tasked me with explaining how a Japanese family would deal differently with such a person. To this, I said that, whatever personality disorder he was biologically inclined to have would very likely manifest differently in Japanese culture. 

The seeds are the same in all of us, but the plant that grows sprouts differently depending on the soil, water, sunlight, and care that it is given. This is a fundamental notion that people who have lived within the perspective of a single culture have difficulty understanding. A man who is at risk of such a personality disorder in the U.S., with its culture of entitlement, consumerism, and emphasis on material gain, might see his tendencies manifest with a tendency to be parasitic on those around him even when he has skills and potential. In Japan, such a man would be unlikely to do so because his culture would teach him that it would be shameful to do so. He may end up being a tyrannical boss who foists work that he feels beneath him onto his subordinates. It is hard to predict precisely, but there are more or less likely outcomes for people with similar biochemical vulnerabilities to various mental illnesses based on the shaping of ones culture.

I have been thinking about this as of late because, even after a little over a year back home, I remain shocked and often distressed by the manner in which Americans will act out emotionally, often with strangers. I deeply miss the emotional regulation that Japanese people often displayed and a culture in which it was believed that only children acted out in such a fashion because only they had not yet learned to control their emotional impulses. 

I once read a study, and wish I could find it to link to, but have not relocated it on the web, which said that Japanese people experience a limited range of emotions relative to Westerners. If the saddest we can feel is a "1" and the happiest a "10", most Western folks will experience that full range from time to time. Most Japanese people will tend to operate in the 3-7 range, unless they live abroad for awhile.

This all links to what I was saying about how culture shapes our mental life. If you are raised in a culture in which emotional expression tends to be suppressed, your brain chemistry is shaped such that you are less vigorously emotionally activated less often. Acculturation in Japan leads to better emotional regulation both because emotional outbursts are not only discouraged, but can result in social censure, and because such control is heavily role-modeled. In America, no such acculturation occurs and role modeling of outbursts, particularly those meant to "teach" people a lesson about bad behavior by venting openly at them, is the norm. This emotional dysregulation which is a part of American life is at the root of the ugly American image as well as the tendency to be openly and vociferously opinionated. We are not taught to be in control, so our minds do not develop like those of people who are taught to be in control. 

I have been reading a book about the brains and bodies of criminals and how the development of certain areas of the brain are critical to whether someone behaves aggressively. People who behave violently have certain characteristics which are highly correlated with aggressive and often criminal behavior, but such characteristics are not deterministic. The "right" environment will prevent someone with a biology that is oriented toward aggression to act on those impulses in a less destructive manner. The "wrong" environment will have them engage in risk-taking or aggressive behavior. One thing that is evident as I read through this excellent book is that the support of the family when people have such biochemical risk factors is enormously important and can make the difference between someone who acts out and someone whose destructive behaviors remain relatively contained or re-routed in more productive ways.

I'm not offering any of this as a condemnation of Americans or as an elevation of the Japanese. As is the case with all things, there is a yin and a yang. The emotional suppression that happens in Japan, as I have said before, carries a heavy price to the people who have to exercise it and I personally believe that the high rates of suicide are a part of that. It is also one thing to say that the families supporting their mentally ill is a better thing than finding a way to outsource their care or leaving them on street corners holding signs asking for money and another to live that life. Having a mentally ill person live with you is very hard on everyone, and in Japan the burden for care-giving of the disabled of any sort disproportionately falls on the women of the family. Additionally, I often felt that the Japanese were denied the heights of passion as a result of the limited emotional ranges they tended to display. Not experiencing the lowest of the lows sounds good, but not experiencing the highest of the highs is a far less pleasing notion.

My point in talking about this is two-fold. One is that I'm fully aware that one of the benefits I had as a foreigner living in Japan was that I lived among people who were well-regulated emotionally in a manner in which I personally did not have to be regulated. I had the benefits without having to pay the same price. That being said, after years of being in that culture, I actually gained far better regulation and have much better emotional control than the average American. This has been a very hard experience for me upon returning to the U.S. I often feel as if I'm living in a nation of mentally unstable people, but that is part of the reverse culture shock I have been experiencing. I don't know if I'll ever feel comfortable with what I perceive as a great deal of instability around me, but it has been overwhelming and made me socially cautious in a manner I did not anticipate.

My other point is to open up my readers minds to the idea of how the common biochemical seeds of illness or aggression can grow different plants based on acculturation. There's a reason we don't see hikikomori in the U.S. or high levels of suicide and the Japanese don't see dissociative identity disorder or nearly as much crime and they are based on what we teach and raise our children. No country or culture is immune to the genetic tendencies to have certain problems, but what we do with the people with such issues shapes how they act out in each society.