Once-Stoic Japanese Find Little Shame In Asking for Help

A truck driver with a firm chin and graying hair, Hitoshi Yamada says he blew "at least" $100,000 at the game of mah-jongg, a Chinese diversion played with ivory tiles. He stayed in parlors for days at a time, skipping work and losing jobs.

His 17-year attraction to the game became so consuming that a counselor sent him to Alcoholics Anonymous (AA). "When I was listening to alcoholics trying to stop drinking, I began to think I could quit mah-jongg," says Mr. Yamada,who agreed to be interviewed only if his real name was not used.

"It was difficult at first to talk in terms of God or a higher power" - part of the AA approach - "but I thought I had to keep going and not worry about what I didn't understand," he adds. Now he is a convert of sorts - one of the growing number of Japanese who are turning to "self-help" groups and other imported forms of therapy.

Changes in the national character seem to underlie what Yamada and others are doing. A growing willingness to ask for help for a problem, some counselors say, is a sign that the oft-noted stoicism and endurance of the Japanese are waning, particularly among the young.

The Japanese are also known for maintaining barriers between insiders and outsiders and for keeping personal problems within the confines of the family. Now many people are crossing these boundaries and discussing their troubles with counselors and strangers.

Although no one has made a study, self-help is growing rapidly here. An organization founded in 1965, the All-Nippon Sobriety Association claims a membership of 50,000. The first AA groups were founded by Catholic missionaries in 1975, and now there are at least 600 meetings a week countrywide.

The elevator in Satoru Saito's Institute for Family Functioning in Tokyo is plastered with posters and flyers announcing meetings of one kind or another. The jargon on these would be familiar to anyone who has scanned the personal improvement section of an American bookstore: There are groups for "adult children," families engaged in "codependent" behavior, and people gripped by addictions ranging from shopping to work to sex.

Dr. Saito, a psychiatrist who is considered the dean of self-help and family therapy here, says Japan in the 1990s has been experiencing the same "recovery movement" that took place in the US in the 1980s. "People have begun to try to find other people who really understand what they're suffering from."

Young entrepreneurial therapists have imported and adapted techniques and approaches from abroad, mainly the US. These counselors are posing a challenge to the psychiatric community in Japan, where Saito says the focus remains on traditional definitions of mental illness and medical treatments.

The self-help boom is a reflection of several changes in this society. For one thing, there is rising concern about addictions of various kinds. A government survey put the number of alcoholics in Japan at 2.2 million in 1991 (out of 124 million people). Since then, the production of liquor has expanded more rapidly than the population. The use of drugs is rising, and the media are paying more attention to those who spend their free time playing pachinko, a pinball-type game that often involves gambling.

It's difficult to generalize about why people here are turning to vices in larger numbers, but it is clear that Japanese society is much less focused than it has been in recent decades. For much of the post-World War II era, the economy was "everything," says Tsukasa Mizusawa, director of a Tokyo-based counseling and publishing enterprise called Ask Human Care Inc.

More than a decade ago, it dawned on many people that prosperity had been achieved, and commentators began wondering how to fill the vacuum of national purpose. More recently, the economy has slowed down, notes Sayoko Nobuta, head of the Harajuku Counseling Center in Tokyo, so companies are no longer as demanding of their employees. The workplace is not as binding as it once was and she says the family and other types of community have also been "unraveling."

Weakening family ties

Mr. Mizusawa agrees that the modern family is a weak institution in Japan, with fathers accustomed to spending nearly all their waking hours working and mothers overly focused on the success of their children. Perhaps as a result of these developments - though the causal relationship is unclear - people may be turning to compulsive behaviors in larger numbers, even as the institutions that once helped prevent or resolve those problems are in transition.

Self-help groups seem to be meeting a need. "More and more people are coming out to explain what they're suffering from," says psychologist Riki Kato. "Counseling places are on the rise. They're crowded with patients."

One development that may be both a cause and an effect of Japan's recovery movement is that many Japanese are no longer simply putting up with difficult situations. This society has long lauded gaman, or stoical endurance, as an appropriate response to adversity, but these days many people speak of gaman in nostalgic tones.

"Gaman remains a strong idea among older and middle-aged people," says Mizusawa, "but among young people, there's no patience." Ms. Nobuta takes a sterner view: "I think many people have noticed that nothing good will come from gaman."

The decision of many of Japan's addicts, gamblers, and emotionally troubled people - and their families - to bypass gaman and seek the help of outsiders is an indication of the changes under way in the Japanese notion of identity. Nobuta says that addressing problems only within the group, such as the family or a company, is no longer seen as necessary.

Becoming 'un-Japanese'

"Our AA and Narcotics Anonymous people," adds Roy Assenheimer, a Roman Catholic missionary who has worked with addicts in Japan for decades, "become very un-Japanese in a sense. They can make decisions; they're not slaves to the system.... The more they recover, the freer they become."

"People tend to think about what people expect of them, rather than about their own feelings," observes Saito of the Institute for Family Functioning. But he and other counselors suggest that Japanese are becoming more concerned with finding their own happiness, even if it means abandoning some of the social conventions that have so far defined Japaneseness. "More and more Japanese are expressing more individuality," says Nobuta.

For Yamada, who has helped start Japanese branches of the US-based organization Gamblers Anonymous, all this social change has its limits. He hasn't played mah-jongg since 1989, but the thrill of the parlor is not forgotten. Sitting in a glaringly bright coffee shop, the truck driver takes another sip from his cup of warm milk. "I do have a slight fear that ... I might start gambling again."