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Koichi Togashi trained as a psychoanalyst in New York (in English, his second language) and then returned in 2006 to his native Japan, where he has endeavored to integrate self psychological and intersubjective perspectives with the cultural and clinical experiences that he encountered at home. In order to fully engage his patients, he discovered he needed to go beyond the “understanding and explaining” that has traditionally characterized Kohut’s (1981) Self Psychology and enter into a distinctly Japanese realm characterized by such concepts as emptiness, makoto (sincerity) and mono-no-aware (appreciative acceptance of transience).
“The Psychoanalytic Zero” offers the fruit of that integration and a window into how our theories are shaped by their cultural context and how they must stretch when translated into new ones.
Togashi’s treatment of a young woman, Miyuki, whose face was disfigured by a fire when she was four years old offers a beautiful example how his clinical acumen is shaped by his analytic training in conjunction with the Japanese moral ideal of makoto, which can be translated as “sincerity” but conveys something profounder than that English equivalent suggests. Makoto, says Togashi, implies a “pure and selfless mind,” one “open to the cosmic tide of the psychoanalytic process” in which each participant is both aware of, but transcends, “their personal, professional and societal roles” in order engage at a level of radical sincerity or authenticity. In Miyuki’s case, social convention required everyone, herself included, to minimize or ignore her prominent facial scars. For a long time, she affected a cheerful nonchalance about her appearance, though she entered treatment complaining that her family treated her differently than her siblings, never arguing with her, always treating her with great delicacy, leading ultimately to a profound sense of unreality and non-recognition. For a long time, the subject of her appearance remained off limits in therapy