I visited Tokyo In November 2006 to lecture and teach at the invitation of the Japanese Psychoanalytic Society (JPS) and the Kodera Foundation for Psychoanalytic Study at Keio University. It was an extraordinary opportunity both professionally and personally. There is, of course, the personal growth and pleasure in getting to know people and places more closely, but, beyond that, I have always found engaging in dialogue with colleagues from another culture—particularly in trying to think more deliberately about one's own choice of words in the effort to be comprehensible—a powerful learning experience. Having to pause for translation pushes me to reflect more closely on the nuances in the words and on what I mean to convey. It fosters the recognition and clarification of ambiguity even in my own thinking. Since English was not my first language, there may be a lingering familiarity in this effort.
Let me first share a bit about how this invitation came about: I have, for many years, been in correspondence with Takeo Doi, a renowned Japanese psychiatrist and psychoanalyst, whom I first met when he presented a paper on his concept of amae at the IPA Congress in Montreal in 1987. I found Doi's ideas very meaningful and illuminating, and, as he too felt a resonance with my own ideas about how we listen, we have exchanged views and writings ever since. I was deeply honored by his suggesting this invitation. I remain most appreciative as well of the close care and hospitality I received from many colleagues and other co-workers and by their impressive clinical participation and dialogue, impeccably organized by Rikihachiro Kano, a training analyst of the JPS.
Takeo Doi's concept of amae, which he has written extensively about in English as well as Japanese, has become a widely accepted theory of human behavior in Japan. A Japanese word, for which there is no English equivalent, it speaks to what is seen as a universal psychology, referring to the feeling of “sweet” dependence of the infant towards its mother, which, taking place nonverbally, remains a lifelong part of human relatedness. Doi introduced this concept and related terms, to the English-language reader in his book charting the Japanese personality, The Anatomy of Dependence, published in 1971. A best seller in Japan, it has been translated into eight languages.
Noting the differences in cultural values of autonomy and independence in the U.S. and the “indulgent dependence” of personal relations in Japan, it occurred to Doi that the rich vocabulary of words related to amae expressed the nature of personal relations in Japan. Doi has written extensively about this concept since, and received the Sigourney Award for his contribution to psychoanalysis in 2006.
In a paper published in 1993 on Freud's paper on transference love, Doi wrote of the central relevance of amae for the understanding of transference. I was honored to learn that in illustrating his views, he drew upon clinical material from my own writings in which I try to illuminate the importance of “recognition,” a developmental concept, as central to therapeutic action. Commenting on a patient I described, he states, “She almost came to articulate her wish for amae. In the transference, she would become angry again and again at something Dr. S said or did not say. Dr. S tried to make sense of her experience after each such incident, but (though it was seemingly understood) to no avail, since it did not prevent her from creating angry scenes anew. One day an idea occurred to Dr. S, and I quote the passage describing it:
Then I realized there was an element I had not addressed. The patient's way of relating was to recount an experience she'd had without any hint apparent to me that she was seeking a particular response and to become furious with me afterwards when I failed to comment about the concern which she only then made explicit. I shared my observation of this sequence with her, asking her why she made her feelings clearer to me only afterwards. And she answered: “I want you to understand me without my having to spell it out. If you really care about me, you would know; if have to ask, it feels like begging. Even if you then understand, it is no longer the same.”
In the example, I go on to recount the ensuing elucidation and newly found remembrances of the lifelong nature of this wish and its childhood frustration, central to the complexities in her relationships about which she first came for treatment.
I find myself now thinking of Doi's words, “A Japanese would almost never ask a stranger unceremoniously if he was hungry, but would produce something to give him without asking.”
Evelyne Albrecht Schwaber, M.D., is a training and supervising analyst at the Psychoanalytic Institute of New England, East, a member of the faculty of the Boston Psychoanalytic Society and Institute, and a geographic rule supervising analyst at the Pittsburgh Psychoanalytic Society and Institute.
With my patient, I did not have to know her wish without her “spelling it out,” but it was of fundamental import that I could recognize and understand the basis of its power.
To draw upon Doi's comments on another example from my writings, “She understood that (Dr. S) understood what it was she really meant to convey. And that in itself was good enough, because what she was really hoping for was not (a clairvoyant response) itself, but to be understood in the depth of her mind” (words in parentheses added). I found this to be a deceptively simple statement, yet quite powerful and moving, in illuminating the expression of amae. And it drew me towards further appreciation of what we might learn in heeding the vocabulary of another culture.
Psychoanalysis was first introduced in Japan in the years after 1910, when some of Freud's writings began to be translated into Japanese, followed by the collected works between 1929 and 1933. During the '30s, some Japanese psychiatrists visited Freud in Vienna; one was Heisaku Kosawa, ultimately considered the father of Japanese psychoanalysis. Actively studying with Freud for analytic training, Kosawa had an analysis with Richard Sterba and supervision with Paul Federn. On return to Japan, he and a small circle of colleagues organized a branch of the IPA in Sendai and in Tokyo.
During the Second World War, Kosawa was under constant surveillance by the special police because of his pursuit of what was labeled this “Jewish system of thought.” Nonetheless, he maintained a private practice throughout those years. The end of the war brought an influx of learning and culture from the U.S., and with “individualization of self” becoming an ideal, interest in psychoanalysis began to bud throughout the country. Some psychiatrists sought training analysis and supervision from Kosawa. Takeo Doi was one of his trainees.
As interest in psychoanalysis continued to spread, Kosawa asked the IPA to include the Japan Psychoanalytic Society as a nationally organized entity. It was admitted in 1955. A number of psychoanalysts visited from other parts of the world, offering lectures, seminars, and other coordinated teaching activities. Thereafter, a separate body of psychoanalytically oriented clinicians was started, apart from the JPS and not based on the training criteria of the IPA, to further spread and develop psychoanalysis and dynamic psychiatry. This group is called the Japan Psychoanalytical Association (JPA), many of whose members belong to both organizations and which continues to function actively and in cooperation with the IPA. In 1991, a relatively small training Institute (approximating 20 members or a bit more—largely, though not exclusively, psychiatrists and perhaps 12-15 trainees) was established in accord with IPA criteria, while the much larger membership continues in a rather sophisticated and ambitious psychoanalytic psychotherapy program.
In commemoration of the 50th anniversary of the founding of the Japan Psychoanalytic Society, a remarkable collection of English-language papers by members of the society was published for the first time in 2004. (The cover illustration by Kiyoshi Yoshida, Mount Fuji Mirrored in a Lake, was a gift to Freud in 1932 by Kosawa.) These papers include an informative and fascinating grouping of multi-faceted articles by many of the leading figures of Japanese psychoanalysis. Their positions are eclectic in theoretical predilection and speak to the signal evolution and growth in the field locally, which, after all, has its origins in a Western cultural attitude. Masahisa Nishizono, president of the JPS, wrote in this issue: “Some 60 years after WWII, social changes in this country are remarkable. Individuals are now asked to form an ‘individualized self.’ And the conflict with the sense of value of the traditional family system is intensifying. Under such a psychic situation, various psychotherapies have increased and the need for psychoanalysis has spread.”
My visit to the psychoanalytic community of Japan was a compelling experience, deepening my awareness and appreciation of commonality accessible through difference. I cannot say I fully knew what the translators did with my words in our discussions, or, for that matter, whether I truly understood theirs as reported back to me. But it was a challenge stretching the intellect and imagination, in some ways as poetry—perhaps as haiku—might, and hopefully enlarging my capacity towards recognition, my amae for the depth and creativity of psychic experience.
A longer version of this article appeared in the Summer 2007 issue of the Psychoanalytic Institute of New England, East Newsletter.