Yasunaga Komori, Japan

Many Japanese practitioners are using narrative ideas in new ways. In my own case, I worked in general psychiatric settings for more than 10 years. During this time, in a psycho-educational context, my colleagues and I made an externalising puppet show (Mr. Schizo) for Schizophrenics and their families. This drew on the long tradition Japan has of puppetry, and allowed us to talk about difficult issues. We also had some unpredictable adventures doing it, and it was a lot of fun.

The value of externalisation conversations has been generally emphasised in the psycho-social context, but is also beneficial in preventing misdiagnoses in more clinical and medical contexts. For example, the side-effects of different medications can be read as depression, anxiety, and so on. But if we focus on the problem in an externalised way, then we can deal with it for what it is, rather than an internalised description of some new pathology.

Working with narrative ideas in the Japanese context can be a challenge. For example, in Japanese grammar, we usually don’t use the subject in the sentence. When we say ‘I felt acute pain’, we say ‘kyuni itaku natta’ (acute painful). If one were to say, ‘I don’t feel well’, or ‘I’m depressed’; meaning in an internalising way, this would be ‘guai ga warui’(not so fine), or ‘utsuppoi’ (depressed) – without the subject ‘I’. So, with the subject not directly linked to the verb or object, although the intention might be an internalised account, the language we use is already ambiguous. Making something clearly externalised in this context can be a challenge!

In the future, I can see re-membering becoming more popular in palliative care here in Japan. We Japanese still hesitate to speak about death and the fear of it, but I think re-membering practices offer some ways to do this well.

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