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My purpose in presenting this paper today is to share with you some of the difficulties facing psychotherapists in practice in Japan. I shall be looking specifically at several different areas of culturally patterned expectations which tend to lead Japanese patients in the direction of assuming a pathologically dependent role. I want to show how these dependency patterns relate to (1) the modern medical model of treatment, (2) the development and treatment of traditional folk healing, and (3) two indigenous types of psychotherapeutic treatment. I want to draw attention to culturally supported patterns of behavior in each case and point out the importance of being aware of them — particularly in areas where this has an impact on psychoanalytic work. I have outlined a summary of this in Table I.
In my experience as a psychoanalytic psychotherapist practicing in Japan, I have found that Japanese psychiatrists tend to overemphasize somatic manifestations of illness at the cost of largely disregarding psychological processes. It seems to me that this