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• A Qualitative Study on Views about Morita Therapy by Special Education Teachers and Students

  Noriaki Azuma

  According to Morita, “Morita therapy would be very useful if the therapy were applied to educational settings.” (As an historical note, with regard to education, Morita was interested in Maria Montessori's educational philosophy during his life time as they were contemporaries at the turn of the last century). This study was conducted as a first step to clarify the usefulness of Morita therapy in education systems. The purpose of this investigation was to analyse the views by professional teachers and student-teachers following a lecture series on Morita theory and practice. In the first phase of the pilot study, this author conducted a 4-day workshop on Morita therapy and Morita therapeutic counselling, with 40 teacher participants. At the end of the workshop descriptions of participants' views of Morita therapy were gathered. Analysis was made of the descriptions by the qualitative K-J method as originated in Japan. Three major concepts were clarified during that analysis: (1) the modes for application of Morita therapy to educational settings; (2) the present problems within the Japanese education system faced by teachers; and (3) the more personal problems teachers were willing to disclose. Following that successful pilot, I structured a lecture series that met once a week for 10 weeks (ten sessions) with 23 students who will be teachers after graduation. At present the author is analysing the data based on the outcomes from those ten lectures (around Morita therapeutic counseling and Morita therapy) that finished in December 2009. (It is noted that the group interaction with the author was part of the process of delivery of the lectures). Final data from descriptions of student's views of Morita therapy (via K-J method) will be presented at the Congress in Melbourne.
  
  

  Biography: Noriaki Azuma: I am a full professor of the Department of Special Needs Education, Faculty of Education, Iwate University in Japan. I am also the principal of the experimental school for special needs education of our university. I hold the posts of professor and principal concurrently. My specialty area is mental health in special needs education. I am studying the application of Morita therapy to education and Morita therapeutic counseling, and am especially interested in the application of Morita therapy to special needs education. I am a member of the Japanese Society for Morita Therapy and a member of the educational committee of the Society. I have conducted Morita therapy seminars for the past ten years in the north-eastern region of Japan.

• Training and Supervision in Morita Therapy in North American Universities: A Dialogue

  Theresa Benson

  A Morita Certificate Program has been created at Washburn University, which includes coursework in Eastern Therapies, Morita Methods, Morita Research Methods, Morita Intensive workshops, and a Morita field placement or internship. Students who complete the certificate program come from various colleges and academic disciplines, and apply the training to work within but not limited to the criminal justice system, victim advocacy, and counseling. At Washburn, Morita is taught as a life way, which emphasizes that life is now and life is attention. Life way can be defined as a common sense approach to everyday living. This presentation will discuss the training of Morita as a 'life way' that students receive at Washburn University from the perspective of the student and the instructor. (This author will explore briefly how Washburn's training is different from 'Constructive Living' as developed by David Reynolds, PhD from the ToDo Institute in the USA). Further, as a doctoral candidate in a USA counselling psychology, this presenter will give examples of the methods of supervision received during Morita training/practice, alongside her supervisor's perspective on training-supervision of Morita practice. In the form of a dialogue, the instructor and student will indicate the opportunities and challenges of this form of training and supervision from their individual perspectives in order to illuminate pathways by which training and supervision can evolve (while attending to the integrity of Morita's philosophical intention) for future Morita students in North America.

  Biography: Theresa Benson: I began working with the UIUC Counseling Center Paraprofessional program in 2007 as the Program Coordinator. I have a Masters degree in holistic health education from JFK University. Currently, I am finishing my dissertation for the completion of my doctoral degree in counseling psychology from The University of Akron. As a clinician, I practice a common factors approach influenced by an existential-constructivist perspective when developing case conceptualisations and treatment plans with my clients. As an instructor, I take an experiential learning approach with a holistic emphasis focusing on the development and integration of the cognitive, emotional, social, and spiritual aspects of the students. Clinical interests include Eastern therapies with an emphasis on Morita therapy; holistic health practices and interventions; self-care practices of caregivers; body-based psychotherapies; post-traumatic growth; and social justice issues.

• Psychosocial and Geographic Health Challenges in Cambodia's Post-Genocide Development

  Sotheara Chhim, MD

  
  It is evident that Cambodians who survived the Khmer Rouge continue to live with on-going trauma in ways that trickle into the next generation. Individual and community distress is associated with changing forms of violence, poverty and mental health problems, alongside a lack of resources, dependency on foreign health and education advisors and funding bodies -- as well as Western models of counselling and mental health that infiltrate Cambodia via foreign Non-Government Organisations. This author will discuss how a culturally responsive community-based model of mental health intervention as developed at TPO (Transcultural Psychosocial Organization) in Cambodia may benefit those who are trapped in the vicious cycle of violence, poverty and poor mental health in rural and remote regions of Cambodia. The author will also discuss these challenges while proposing some ways forward. For instance, this author proposes ways that research models can account for the diversity of indigenous ritual practices and health promotion systems for people who depend on and engage with their seasonal water and landscapes. And given that stages in Classical Morita therapy are designed to make use of the landscape and to facilitate human contact with Nature as a therapeutic process, there is resonance with indigenous models used in remote regions for mental health care in Cambodia for those suffering extreme trauma.
  
  

  Biography: Sotheara Chimm, MD (and PhD candidate, Monash) is the Director of the Transcultural Psychosocial Organisation in Phnom Penh, Cambodia. As a transcultural psychiatrist, he recently gave testimony at the ECCC (Khmer Rouge Tribunal) as an expert 'trauma' witness.

• What's Gone Missing? Maintaining a 'Holding Place' in Therapy

  David Chong

  Historically, the discipline of psychology and the psychoanalytic and humanistic schools of psychotherapy were committed to the art and craft of responsive therapy, while designing therapeutic environments that enhanced outcomes. In the last few decades, an era of endorsing therapies as "evidence-based" has emerged. Of course, this author is in agreement with collecting evidence so that our systems of treatment are reliable and dependable. However, there seems to be more emphasis on 'what' therapy does (such as measuring a decrease in symptoms post-treatment), with little accountability for the 'presence of therapist' and 'how' therapy progresses. Is our craft eroding in the face of instruction-based methods of treatment that are more easily researched from quantitative research over qualitative methods? This author aims to generate a dialogue on, "The Holding Place in Therapy". For instance, in psychoanalysis, 'the couch' and 'therapist's position in the room' might provide the holding ground. In Morita therapy, the first stage establishes the importance of 'safe place' for the patient, wherein the holding place is the physical container provided by the room, as well as the holding place in self, and the holding experience provided by the therapist's silent presence. This paper discusses the challenges of designing therapy that accounts for 'Holding' multidimentions of self and other that includes context, history, and socio economic status.

  Biography: David Chong is a psychologist and psychotherapist with 25 years experience. Educated in Brazil and of Chinese parentage, David has been a resident of Melbourne for the last 20 years. His training includes psychoanalysis, psychodrama, family therapy and Buddhism. David maintains a private practice in Melbourne. He is an organisational consultant, trainer and a clinical supervisor for several organisations, including the Victorian AIDS Council, Alfred Infectious Disease Unit and the Australian Centre for Grief Education. David is invested in the 'art and craft' of psychotherapy including how it is practiced and taught. He is the director of the newly created "Left Bank Institute" an institute that promotes dialogue on clinical and organisational practice.

• Responsive and informed capacity-building for refugee communities: Lessons from Morita

  Andrew Harris

  This is a joint session offered by an Australian psychologist (Andrew Harris) and African (Sierra Leone) refugee allied health professional (John Quee Nyagua) who has taken citizenship in Australia. This session provides the opportunity for those working with refugee communities to momentarily step away from approaches based on western-centric thinking and consider options that explicitly account for the cultural norms of the populations that are being serviced. The role of the environment in therapy will be discussed with some notes on how Morita theory can contribute to work with youth and adults who have come from village-based regions of the world, where the lived understanding of 'time' and 'place' and the 'ancestral realm' is not so linear. In particular, refugees often carry physical symptoms related to past and cumulative trauma. Forms of therapy, akin to Morita, offer ways to increase the ecological balance of the whole person in her and his communities, rather than over focusing on the intra-psychic and 'cognitive and emotional' aspects.

  Biography: Andrew is a Research Fellow at the University of Tasmania Department of Rural Health. He has been working with and researching refugee and migrant communities as a psychologist for the past six years, with a particular emphasis on the ways that African beliefs and counselling approaches conflict with western assumptions.
  
  John Quee Nyagua, a former refugee with roots in West Africa, is a nurse and counsellor and works with the refugee community in Tasmania as an advocate and so much more. He managed a program in health in Sierra Leone after gaining his masters degree in primary health education, with extensive experiences in remote health care. He currently works for the Migrant Resource Centre and the Red Cross in Launceston.

• The Development of Outpatient Morita Therapy Methods: Desire and Health Promoting Lifestyles

  Kazuyuki Hashimoto

  The current trend regarding the development of outpatient Morita therapy was reflected in 45 presentations delivered at the 27th Annual Meeting of the Japanese Society for Morita Therapy held in Osaka in October 2009. In this presentation, the author will describe some of the essential features of Morita therapy that can be used for outpatient treatment. In particular, (1) review life events or contexts that trigger symptoms from patients; (2) generate a new perspective wherein present symptoms are a result rather than cause of one'sanxiety; (3) assist the patient to notice how her/his attitude toward eradicating anxiety perpetuates a vicious cycle of symptoms; (4) assess the patient’s life style; and determine ways his/her lifestyle can be altered in five stages.
  
  The author will focus on actual examples for altering the patient’s lifestyle: 1) review the laws of emotions according to Morita; 2) review generalisations; 3) challenge unhealthy patterns/lifestyles; 4) maintain active modeling by the therapist; 5) provide support for challenges underlying the altering of lifestyle; 6) suggest a concrete and feasible behavioral goals; and 7) re-interpret anxiety as the reverse side of wholesome desire.
  

  Biography: Kazuyuki Hashimoto, MD (Chofu Hashimoto Clinic)
  1969: Wakayama Medical University Graduation.
  1975: The Degree of Doctor of Medicine from Kyushu University.
  1976: Senior Assistant on the Medical Staff of the Department of Psychosomatic Medicine of Kyushu University Faculty of Medicine.
  1998: Certificated Doctor of the Japanese Society for Morita Therapy.
  

• Present Status and Future of the Morita Therapy Ward in Japan、Report by Jikei University Center for Morita Therapy Report

  Junichiro Hinoguchi

  Initially, Morita therapy was developed as a residential therapy. As part of the treatment, patients with neurosis were encouraged to engage in work and cultivate attitudes not ruled by their emotional state. In recent years, however, aspects of Morita therapy are increasingly being used in outpatient clinics. Jikei Daisan Hospital maintains one of the few Morita therapy wards (originating in 1972 and renovated in 2007), which is known as the Center for Morita Therapy. This ward has 20 beds, with two rooms reserved for absolute rest. In recent years, patients' age range has spread to include youth with a third of the patients diagnosed with a mood disorder. This paper presents two cases that illustrate treatment in our Morita therapy residential center. One patient was diagnosed with Obsessive Compulsive Disorder which began during youth. Another patient was diagnosed with clinical depression, which began in middle-age. These authors would like to shed light on the role and meaning of inpatient Morita therapy amidst recent interest in outpatient approaches through two case studies.

  Biography: Junichiro Hinoguchi:
  2009~ The Jikei University Center for Morita Therapy, Head of the Inpatient Ward
  2001~ The Jikei University School of Medicine, Psychiatric Department, Daisan Hospital
  1994~ Graduated from The Jikei University School of Medicine.
  

• Psychotherapy for Survivors of Domestic Violence (DV) using Modified Morita therapy

  Ryoichi Hoshino

  Various cognitive-behavioral treatments (CBT) for those suffering from post-traumatic stress disorder (PTSD) have been described in the literature. Morita therapy (MT) accounts for changes in cognitions and behaviours akin to CBT outcomes, but with an orientation that does not focus on recovery from the anxiety symptoms as a central goal. This paper reviews the life history, relationship life, and treatment processes related to 8 survivors/victims of Domestic Violence (DV) treated by this author. Our Treatment program consists of psychosocial education, including an awareness building of one's vicious cycle of anxiety (toreware) caused by communication dysfunction, and cognitive-behavioral treatments to change the pattern of object relations and to facilitate a healthier life. Subjects were 8 female patients with a mean approximate age at start the treatment as 36 years (29-46). While 5 out of the 8 had an abbreviated treatment, 3 continued the full course of treatment. Mean treatment duration was 1.3±0.8 years (1-4). All showed improvement in their cognition and behaviors with regard to instability in self-concept, and difficulty in self-assertion. Such changes were related to minimising communication dysfunction related to the start and perpetuation of DV, with faulty patterns that had developed during their life history. In sum, we found that a Morita-oriented psychotherapy useful for DV victims with regard to shifts in life style, communication patterns and coping capacity.

  Biography: Ryoichi Hoshino: PhD in Psychology, Institute of Psychiatry, Tohou University, Tokyo, Japan; BA Sophia University, Tokyo.
  Oct 1980- July 2002: Psychological Testing and Psychotherapy for inpatient-outpatient units, Hamamatsu University School of Medicine, Teaching in Clinical Psychology and Psychotherapy at Institute of Medicine and Institute of Nursing in Hamamatsu University School of Medicine.
  Oct 2002-present: Psychological Testing and Psychotherapy for inpatient and outpatient units in Kanarekai Koujinn Hospital, Nagoya, Japan. Teaching at Hamamatsu University School of Medicine in the bedside care in psychiatry; supervise psychotherapy and Morita therapy in the Institute of Psychiatry, Hamamatsu University School of Medicine. Full Member of the Japanese Society for Morita Therapy.

• Activating the Philosophical Underpinnings of Morita Therapy for Treating Depression more Holistically

  Wataru Iseki

  The identification of people diagnosed with clinical depression is increasing at alarming rates and this phenomenon is world wide. There may be contextual factors that contribute to this trend alongside our clinical capacity to diagnose earlier and more efficiently. For example, prolonged economic recession and related distress and the fundamental complexities of cultural changes in modern Japanese society seem to be at play.
  As clinical and common sense informs our therapeutic practices, the combination of physical and mental rest (alongside strategic use of pharmacological therapy when indicated) may not be enough for some depressed patients who require a shift in 'quality of life' and protection from relapse. Given some of the less-than-holistic therapeutic systems for depression in Japan, we designed a specific facility to assist patients with depressive symptoms and patterns as a way of increasing their social and symptom coping skill capacity for the purpose of preventing relapse.
  We have drawn on Morita's therapeutic orientation illustrated by the well-known Morita proverb: "A well-organised outer shape sharpens the mind".
  These authors introduce several rehabilitation programs for depression and explains in detail how the essence of Morita therapy is utilised and developed in these programs.
  
  

  Biography: Wataru Iseki worked as a public servant after graduating from Obihiro University. He has been engaged in production of wine for 25 years. At the same time, he has been a facilitator of a Morita therapy self-help group. He currently works for Odori Koen Mental Clinic as a psychiatric social worker. He is a coordinator of the return-to-work program for patients with depression. He has made tremendous headway in making a Morita therapeutic approach available to the public sector.

• Use of the Morita Perspective in the Treatment of Halitosis and Aerophagia

  Satoshi Ishida

  This paper reviews ways Morita's theory and practice perspectives can effectively treat halitosis with aerophagia associated with social phobia. When patients with halitosis visit the dentist, they are rarely assessed for aerophagia. In Japan, it is considered that extreme worry about halitosis is related to taijin-kyofu-sho or social phobia. In this paper, we report significant findings from a case study that applied Morita therapy to a patient who had been suffering from halitosis and aerophagia for twenty years. The patient was a 34 year-old woman whose principal complaints were halitosis and gas. Because of these issues, she felt very nervous around others. Based on her appearance in the waiting room and her answers on the intake interview, we diagnosed her as having halitosis and aerophagia which culminated in anthropophobia; thus we decided to carry out Morita therapy to treat her anxiety, improve her everyday life, and promote cognitive remediation. Halitosis and aerophagia and associated anthropophobia and olfatophobia were understood from the perspective of “life desires,” psychical interaction, and psycho-somatisation which maintained a vicious cycle of symptoms. Treatment involved on-going support and psycho-education, with explanations of the psycho-emotional cycles that perpetuated her distress. She was able to experience how her serious and methodical character was actually likable, and with that focus and support, she gradually strengthened these aspects and gained an appreciation for her self and her relationship to others across time and place. We adjusted the treatment time to fit the patient’s schedule and carried treatment out at monthly intervals. Over the course of 18 months, the patient came to re-evaluate her perspective and her daily life improved, and her social interactions became more fulfilling. The treatment eliminated almost all of the physical ailments, and the patient who had been friendless before the Morita-based intervention, entered a romantic relationship with a co-worker that led to marriage. Treatment decreased her avoidance behaviour based on fear, and increased her realistic plans based on desire.

  Biography: Satoshi Ishida: Dentist (DDS, PhD), Oral and Maxillofacial Surgeons, Department of Dental Psychosomatic Medicine
  

• A Bending Willow Tree: Key Concepts and the Philosophical Orientation of Morita Therapy and Its Counselling Applications

  F. Ishu Ishiyama

  It has been more than 90 years since the inception of what we now call “Morita therapy.” It reflects Asian wisdom about human nature and change process. I will discuss selected key concepts of Morita therapy with illustrations of how such Moritian concepts and the underlying philosophical orientation are reflected in the practice of Morita therapy. The metaphor of “a bending willow tree” is used to reflect how we can learn to stay rooted in the reality of living and engage in constructive action while the tree flexibly bends and embraces strong winds without fighting nature. I will describe how clients learn to ride the waves of anxiety and other inconvenient feelings and situations. The following fundamental principles of Morita therapy will be the focal points of this presentation: (a) arugamama (observing and accepting self and the present reality as they are), (b) activation of one’s spontaneous healing capacity without intentional attempts to resist and change the affective symptoms, and (c) “the desire for life” (a positive motivational force enabling clients to withstand hardships and proceed to action for meaningful and constructive goals). Further, I will illustrate how these fundamental principles are put into practice in counselling sessions.

  Biography: Ishu Ishiyama, Ph.D. is an Associate Professor and the former Director of Training for the counselling psychology area in the Dept. of Educational and Counselling Psychology and Special Education, Faculty of Education, University of British Columbia, Canada. He is also an associate member of the Dept. of Psychiatry at the same university and an invited research fellow at the University of Tokyo. He is a certified psychotherapist and registered with the College of Psychologists of British Columbia. He teaches counseling psychology graduate courses, conducts research, and supervises masters and doctoral students in their research and clinical work. He specializes in multicultural and cross-cultural counselling, Morita therapy, anti-discrimination and prejudice-reduction methods, social anxiety treatment, and sociocultural competency training. He is currently on his sabbatical leave (2009-2010) and has been engaged in teaching and joint research at the University of Tokyo.

• Practising Morita-based “Active Counselling”: Implications to Clinical Training and Supervision in Canada

  F. Ishu Ishiyama

  Morita therapy has traditionally been practised either as a residential treatment program or as a directive, psychoeducational, and non-process-oriented outpatient approach for treating shinkeishitsu (nervous)-type clients, mostly in medical settings. In recent years, however, we have seen various modifications and innovations in the practices of outpatient Morita therapy, including Morita-based counselling, in both medical and non-medical settings. In this presentation, I will describe an integrative model of outpatient Morita therapy (Ishiyama, 1990, 2008), which is also called “Active Counselling” (Ishiyama & Azuma, 2004), incorporating flexibility, diversity, eclecticism, and process-sensitivity into its clinical practice. The three core phases of the model (i.e., Subjective, Objective, and Action Phases) are preceded by an initial client assessment and orientation phase (i.e., “Preparatory Phase”) and followed by an ending and termination phase (i.e., “Closing Phase”). I will describe how the principles of Morita therapy are applied to each of the core phases and how they are translated into concrete intervention techniques, case conceptualization, and clinical supervision of counsellors in Canada

  Biography: Ishu Ishiyama, Ph.D. is an Associate Professor and the former Director of Training for the counselling psychology area in the Dept. of Educational and Counselling Psychology and Special Education, Faculty of Education, University of British Columbia, Canada. He is also an associate member of the Dept. of Psychiatry at the same university and an invited research fellow at the University of Tokyo. He is a certified psychotherapist and registered with the College of Psychologists of British Columbia. He teaches counseling psychology graduate courses, conducts research, and supervises masters and doctoral students in their research and clinical work. He specializes in multicultural and cross-cultural counselling, Morita therapy, anti-discrimination and prejudice-reduction methods, social anxiety treatment, and sociocultural competency training. He is currently on his sabbatical leave (2009-2010) and has been engaged in teaching and joint research at the University of Tokyo.

• Case of a Cancer Patient and Morita-based Group Psychotherapy: Tensions between fear of death and desire to live fully

  Ronko Itamura

  Foundational principles of Morita therapy have been successfully applied to cancer patients who experience angst and anxiety. A self-help group program is known as ‘Meaningful Life Therapy’ and has been developed by Dr. Itami. At the clinic where this author practices, over 60% of patients have cancer. The objectives of our Morita-based Group Psychotherapy Program is to help cancer patients cope pragmatically and realistically with anxiety and fear associated with pain and death. This paper presents a case study of a 40 year-old woman who was
  diagnosed with breast cancer (stage IIIc) five months prior to group therapy. She appreciated having access to this group work as often as she could attend.
  In her first session, she talked about her shock at the diagnosis of cancer, but she described wanting to "find her own natural life". Over time, while she talked about her suffering, anxiety and fear of cancer, she found that listening and being heard while listening to other patients' experiences, gave her a better degree of interpersonal connection. After a while, she acknowledged the limiting aspects of her condition as an 'emotional spiral' from which she could direct her focus outwards, while recognising how she had an 'unnatural' life ethic of “having to do everything" by herself. As she explored concrete ways to gain more support and comfort in her life, she experienced her “desire to live fully.” And she actually started to do just that.
  By redirecting focus, her fear of death to desire to live fully became more naturally balanced. Through professional help and group support, we have found that our centre gives cancer patients a chance to acknowledge their illness for what it is, alongside the reality of the situation. Group dynamics direct them to notice a desire to live as fully as they can, despite of their underlying fear of death These processes help patients modify their way of life and find a more natural pathway when living with cancer.
  

  Biography: Itamura Ronko, MD, PhD: Director of Obitsu Sankei Seminary Clinic & Specialist in Psychosomatic Medicine.
  Board Member for the Society for Morita Therapy.
  
  I graduated from Kansai Medical University with a medical doctor degree and finished my PhD at Kyoto University in 1988. After working at the Department of Dermatology in the Jikei University Hospital, and Obitsu Sankei Hospital, I became Director of Obitsu Sankei Seminary Clinic as a specialist in homeopathic medicine (2003). I am a Registered Dermatologist and Board Member of Japanese Psychosomatic Medicine.
  Senior Director and Dean of the Japanese Physicians Society for Homeopathy (JPSH)
  This author translated “Homeopathy in Primary care” “Homeopathic practice”and co-translated “International Dictionary of Homeopathy”
  

• Paradoxical Dimensions in Morita Therapy: Biographical Notes from Morita's Presence and Practice

  Mari Iwata

  Paradoxical aspects of Morita Therapy and how they help clients with Shinkeishitsu-neurosis are reviewed. One of the characteristics of Morita's therapy is the paradoxical approach to overcoming psychosocial symptoms. In particular, the therapist does not directly engage the client about her or his symptoms. Rather, focus is on comprehending desire, with goals centered on this pathway towards realistic desire. Overtime symptoms recede and behaviours become less destructive. In addition to the basic principles of therapy, paradoxical approaches are noted in the practice by Dr Morita. Biographical notes on Morita are offered by this author. For example, Dr Morita used humour and allegories to change the clients’ perspective. The most important paradoxical teaching came directly from Morita’s presence and modeling. In early 20th century Japan, according to convention, a professor of medicine was an esteemed person. However, within Morita's inpatient home setting, he did not act like an unapproachable person in a high position. Sometimes he behaved contrary to conventional wisdom. In front of his patients, he allowed himself to be seen as he was. Shinkeishitsu patients have a tendency to be caught up in idealised standards of who they 'should' be. Morita influenced patients through his non-ego centred presence. Thus, his presence had the effect of a paradoxical intervention on his patients by his very pure nature that they could experience. Paradoxical approaches in Morita Therapy are powerful enough to break down the fixed, vicious cycle of symptoms (toreware), and rigid conventional ways of thinking-acting in his patients. This often facilitates patients' capacities to live according to Nature.

  Biography: Mari Iwata, MA (formerly Mari Kikuchi) is a Clinical Psychotherapist, (2006-present at Higa Mental Health Clinic). Worked at Seikatsu-no Hakkenkai (Study Group of Morita Theory) from 1976-2005. Other related experience: 1972-1976 with Hakuyosya, Pub,Co.Ltd. as Editor of “ The Complete Works of Morita Shoma; Editor of the monthly magazine for the organization; Chief Manager (1991-2005) while organising meetings on Morita's Principles of “Pure Mind"; Literary works include “Morita Shoma ga kataru Morita Ryoho (2002), Jun na kokoro de ikiru,” Hakuyosya, Pub.Co., Ltd as a biography of Morita Shoma (English title: “Morita Therapy as Spoken by Shoma Morita; Living with Pure Mind”)
  Education
  1968-1972 Seikei University, Tokyo
  Dept. of English literature
  2003-2006 Alliant International University/California School of Professional Psychology, Tokyo Campus,
  Department of Clinical Psychology, MA
  

• Integrating Inpatient and Outpatient Methods in Morita Therapy: Applications for Psychiatric Day Care Centres

  Mihoko Kobayashi

  There is a current state of dialogue about whether Morita therapy can survive without developing a quality out-patient approach. In particular, our traditional Morita therapy inpatient settings are decreasing from changes in our social and financial climates for both therapists and patients. And sadly, some of our famous private hospitals with special gardens have closed permanently due to the loss of our seasoned psychiatrists, such as the late Dr Takehisa Kora. And although several models of out-patient Morita therapy are currently being invented, it is a strategic time to evaluate what is 'best care' for 'better outcomes' when adapting our inpatient modalities into outpatient modes. These authors propose methods for use in psychiatric Day Care settings. This is kind of a middle-path setting for Morita therapy and is relatively convenient for participation by patients and their families. Additionally, it is favorable for the therapist to observe and intervene across many situations, particularly with regard to behaviors that have yet to be observed (in an outpatient setting).
  
  Nowadays, Japan's increase in serious social problems seems to coincide with our increase in patients with depression, as well as those at risk for suicide. By designing our rehabilitation facilities for depressive patients, and by calling on Morita's methods and unique aspects for increasing Desire for Life, day treatment seems feasible from the standpoint of medicine and administrative guidance and economics. These authors will discuss Morita therapeutic approaches in a psychiatric Day Care setting that increase better outcomes and long-term improvement -- and as a means to maintain the value derived from Morita inpatient care.
  

  Biography: Mihoko Kobayashi is a Clinical Psychologist who practices in a mental health clinic that facilitates several programs, including a return-to-work program for patients suffering from depression. While professionally trained as a counselor, the author is a splendid singer as well. She is also a counselor of a private company and clinical center in Sapporo Gakuin University. She graduated from Waseda University, Department of Politics and Economics.

• A Study on the Efficacy of Inpatient Morita Therapy at Jikei University Center for Morita Therapy

  Mikiko Kubota

  Given the efficacy-based outcomes from pharmacotherapy for anxiety disorders, it is imperative to demonstrate equally the sole and co-therapeutic effects by psychotherapy. In order to appreciate the therapeutic effects by Morita therapy as originally designed, however, it is useful to address the impact by treatment goals, while accounting for the primary principles of Morita therapy. What is addressed in Morita therapy is not anxiety or symptoms themselves, but the attitude of being preoccupied with symptoms; Morita therapy aims to modify this attitude. Therefore, it is suggested that research methods measure more than reduction in anxiety and symptomology; these authors suggest measuring changes in attitudes toward one's experienced anxiety, acceptance of symptoms and self 'as it is', and capacity for social adaptability. From this point of view, we have conducted collaborative research among multiple treatment facilities to evaluate the efficacy of Morita therapy. As concrete measures, the “Mini-International Neuropsychiatric Interview (M.I.N.I.)” and “Semi-Structured Interview for the Assessment of Mental State” were administered, and the “Global Assessment of Function (GAF)” was rated. In addition, self-administered questionnaires were used for comparative purposes, including the self-esteem scale developed by Rosenberg, SCL-90-R, and STAI. Results are presented as an interim report, and indicate significant changes in the scores of the scales following patient's treatment by Morita therapy as inpatients treated at the Jikei University Center for Morita Therapy.

  Biography: Kei Nakamura, MD is a Professor in the Department of Psychiatry at Jikei University, and the Director of the Jikei University Center for Morita Therapy.
  Mikiko Kubota, MA is an Associate Professor in the Faculty of Social Policy and Administration, Hosei University; she is also a clinical psychologist at the Jikei University Center for Morita Therapy.
  

• Morita Therapy and Perspectives on Social Anxiety: A Phenomenological View

  Nobuo Kurokawa, M.D.

  Social Anxiety Disorder, according to Morita, is a condition with symptoms that the person considers to be embarrassing, while needing to conceal evidence of anxiety to others, such as blushing, quivering hands, and feelings of being scrutinised by others. Underneath their social anxiety, however, such overly sensitive people have a desire to be liked and respected by others. This desire can be highlighted and accessed in therapy as a pathway towards accepting symptoms 'as they are' when in front of others as the first step toward recovery. Such acceptance, however, is rather difficult for youth and young adults. This paper offers a phenomenological view of Morita's staged therapy and discusses the perseverance required in shaping a symptom-rejection attitude towards a symptom-acceptance orientation (from youth to adulthood). Self reflection is offered from this author's experience of past suffering from "blushing sensitivity" wherein Morita therapy assisted me during my adolescence, at a stage in life when any imperfection is in the foreground of one's perception -- a time when accepting my symptoms was difficult. I did, however, persevere, despite my extreme nervousness felt during my work and academic presentations. I refer to this achievement (of engaging in purposeful activity even when suffering) as the 'First Goal'.
  
  After several years of persevering with my work, despite symptoms, and gaining recognition and respect, I became capable of candidly admitting my symptoms and experiences in front of others, which freed up the energy that had been expended by concealing my fears for use in more positive and constructive ways. This achievement is the 'Final Goal,' and it led to my being completely cured of my condition. I, therefore, consider perseverance and acceptance of the emotional facts as they are to be of paramount importance in curing Social Anxiety Disorder.

  Biography: Nubo Korokawa, MD [Kurokawa Internal Medicine Clinic (Kurokawa Psychological Laboratory)]
  1969: Wakayama Medical University Graduation. The Degree of Doctor of Medicine
  1976: Senior Assistant on the Medical Staff of the Department of Psychosomatic Medicine of Kyushu University Faculty of Medicine.
  1998: Certificated Doctor of the Japanese Society for Morita Therapy.
  

• Morita Values Influencing Cultural Sensitive Therapeutic Services in Inner City, UK

  Michael Lilley

  This paper offers a discussion about My Time CIC, which is a community-based social enterprise in Birmingham (UK) that provides culturally & faith-sensitive psychological & therapeutic services. Birmingham is the UK's second city and by 2020 will be totally intercultural with over 60 main countries of origin amongst its residents. My Time is situated in an area that is 70% Muslim (with 20% unemployment) which requires counsellors to account for over 10 faiths and 18 languages. My Time has developed a Community Family Psycho-Social Therapeutic Approach that draws from Western and Eastern psychologies, including Mindfulness CBT, Cognitive Humanistic Counselling, Morita Therapy, Buddhist Psychology, and Islamic and African-based therapies. In 2007, My Time was awarded the UK Prize for Innovation by the British Association of Counselling and Psychotherapy. We work alongside the NHS in Birmingham and deliver its services in Children Centres, through the Police, and GP surgeries. It is a principle component of the IAPT (Improving Access to Psychological Therapies) in Birmingham that has a population of 1.4 million. My Time CIC has developed a package of talking and non-talking therapies including horticultural and art activities in therapy. It has a therapeutic garden based in the city that particularly benefits refugees, asylum seekers, victims of violence and torture, and adult survivors of child abuse. My Time has undertaken a study on therapeutic engagement of BME (Black Minority Ethnic) men diagnosed with Post-Traumatic Stress Disorder. Results from this qualitative study show that men responded significantly more positively to horticultural therapy than talking CBT.

  Biography: Michael Lilley is Founder Director and Senior Psychologist of My Time CIC based in Birmingham, United Kingdom. Michael has worked in community and family development since 1978. He originally trained in community development and social work in Reading and London. Later he studied psychology & crimonology at Keele University, Staffordshire and Counselling Psychology at City University, London. He is a member of the British Psychological Society and Chair of West Midlands Branch for many years. He is also a member of the British Association of Counselling and Psycotherapy and been a BACP representative on BME psychology and culturally/faith sensitive counselling to the Department of Health in developing BME commisioning guidelines on IAPT (Improving Access to Psychological Therapies). Michael has always work in areas faced with poverty and refugee communities and become a specialist in Post-Traumatic Stress Disorder, adult survivors of child abuse, dysfunctional families, and social justice based approaches.

• A Phenomenological Investigation: Essence, Models and Methods Underlying Morita Therapy

  John Mercer

  Phenomenological and heuristic based methods inform this PhD study designed to qualify the intra-and-inter-subjective experience of Morita Therapy. Methods are selected based on their capacity to 'unravel' the essence of Morita Therapy, while teasing out Zen. The lived-experience of the researcher provides the raw qualitative data for the study. The main quest of the project is to distil the core impacting features (and the sequence of methods related to such) of Morita's perspective and method, by penetrating through the forms of the therapeutic tradition.
  
  The research rests on the foundation of a comparative theoretical analysis between contemporary 'Therapeutic Mindfulness' models which have emerged out of North America and Australia, and Morita Therapy, in which the structures of each therapeutic method are compared.
  
  The lived-experience of the qualitative phenomenological researcher ~ the personal practice dispositions and pre-learnings (Lifeworld), and the subjective-experience-in-context (Fieldwork) as a patient ~ will be introduced. The session provides an overview of 'research in progress', and focuses on the process of the study rather than a finished product. Initial themes emerging from the first active data collection component of the project ~ experience of Morita Therapy as an inpatient (‘Trainee’) in Sansei Private Hospital in Kyoto, under the direction of psychiatrist, Dr Shinichi Usa ~ will be introduced.
  
  The diverse emerging themes span across cultures and disciplines, and raise considerations for the transportability of Morita's traditional model & method from Japan to the West. The potential place of Zen and Do in Western therapeutic milieu and paradigm is also being explored as a broader part of the research and will be briefly introduced.
  

  Biography: The presenter/researcher is psychologist John Mercer MPsych MAPS. A practitioner of both Soto Zen and traditional Budo, he is a current PhD candidate studying Morita Therapy at Monash University Melbourne under the direct supervision of Dr Peg LeVine. He has spent many years working with clinically complex populations in complex environments, such as war veterans, maximum security prison inmates, and chronic addictions clients in a therapeutic community. He currently practices in a Health Psychology role at the Launceston General Hospital, and is a member of the LeKond Institute Secretariat Committee.

• Possibility of Morita Therapy in Civil War Affected Areas Part 1: Travelogue from Rwanda

  Masahiro Minami

  The possibilities of Morita Therapy application are far reaching. Since its formal development by Dr. Shoma Morita in 1928, Morita therapy has been constantly evolving. Its original form of residential treatment has been stringently maintained and protected by some contemporary followers in Japan. Others have adopted and incorporated principles of Morita therapy into counselling, psychotherapy, and self-help groups. Proliferation of Morita therapy applications in recent years has generated the development of standards and guidelines for the outpatient Morita therapy in 2009 (Nakamura et al., 2009), and stimulated several Morita-based intervention models (e.g., Active Counselling Method). This author contends that expansion of Morita therapy is not limited to a hospital setting per se. While Morita designed his therapy as a home treatment, its practice-ground has been extended to other settings such as universities, industries, community organizations, and clinics. Morita therapy has also gone beyond borders and is now practiced around the world in various countries such as China, Korea, USA, Canada, Australia, Russia, and Laos. Factors leading to the proliferation and successful global expansion of Morita therapy are closely related to the essence of human nature and life that are universal. Many who encounter Morita therapy resonate well with, are touched by, and changed from its core principles. The presenter traveled to various war affected zones during the summer of 2009, exploring the possibility of Morita therapy with local educators, clinicians, and most importantly war survivors who have suffered extreme trauma. In this presentation, impressions of the possible use of Morita therapy with Rwandan genocide survivors are discussed. Verbatim of dialogues held between the presenter and survivors will be featured in this presentation.

  Biography: Masahiro Minami has received his Masters degree in counselling psychology from the University of British Columbia, Canada, and is currently enrolled in a PhD program at the university. He was trained in Morita therapy and has been practicing Morita-based Active Counselling Method under the supervision of Dr. Ishu Ishiyama (UBC). He holds his clinical practice in various settings such as community agencies (e.g. Vancouver Association for Survivors of Torture, South Vancouver Youth Centre), local hospital (e.g. Cross-Cultural Clinic at Vancouver General Hospital), and schools (e.g. UBC, New Westminster Secondary School). His recent travel to Rwanda brought him a new role of consulting faculty with the Kigali Health Institute, Kigali, engaging in the development of a new clinical program for genocide survivors. The area of his scholarly passion includes psychosociospiritual reconciliation process of war survivors. His areas of clinical interest include application of Morita therapy to anxiety, depression, and trauma reconciliation.

• Turning Crises by Aggressive Patients to Advantage through Observation and Strategic Use of Morita Therapy

  Yosuke Mochizuki

  Morita therapy has been used for nearly 80 years as a therapy for anxiety-based disorders (and shinkeishitsu). However, it is sometimes difficult to apply the original procedure to patients who lack tolerance and over-idealise 'happiness', while harbouring dependent personalities, and exhibiting immature interpersonal skills. Therefore, some modifications of treatment protocols may be required to assist positive outcomes. In this regard, we introduced Morita therapy to two inpatients diagnosed with anxiety disorders who felt they could not control their anxiety. During the session, they repeatedly expressed agitated, impulsive and socially inappropriate behaviors to staff. It was assessed that a traditional course of Morita therapy was not appropriate for these types of patients. However we turned these 'crises' (dysfunctional sets of antisocial behaviours) to our advantage by selecting suitable aspects of Morita therapy. More specifically, we re-interpreted patient's aggression as an expression of their feelings of imperfection, particularly when we observed how their low frustration tolerance for not solving problems by themselves was a trigger for their troublesome behaviours. Most importantly, the therapists' fine-tuned observational skills assisted this understanding of the links between patient;'s internal experience and external reaction. Herein, it was found that patients could not endure their dissatisfaction with self. The therapist consistently encouraged them to take the initiative to solve problems based on the fact, and in spite of their frustration. The more they made mistakes and confronted this reality, the more their excessive “desire for life” (interpreted as their hope of doing everything well), was harmonised with their reality. As a therapeutic outcome, they improved in interpersonal communication, and gained an ability to control their impulses and to work on problems alone and with others cooperatively. At the end of the program, they set positive and realistic goals for their course of life and returned to participate in their home and community. Although aggressive expression by patients is sometimes considered to be too challenging for application of the original Morita therapy (and thus a crisis for the therapy application), our strategic intervention via Morita methods led to better outcomes for such patients.
  
  治療中断の危機を治療プロセスの進展に活かす
  
  森田療法は特に不安障害に効果を発揮する精神療法として用いられてきた。しかし、近年、多くの不安障害患者が不安耐性に乏しく、過大な理想をもち、依存的で対人関係スキルも未熟なことが多い。そのため、従来通りの森田療法を適用するのが難しく、こういった症例に対しても有効な治療的関与の工夫が必要となる。
  最近、我々は2名の不安耐性に乏しく、衝動統制の難しい不安障害患者に入院森田療法を施行した。治療中、彼らは衝動的で時に治療スタッフに対する暴力を伴うような短絡的行動を繰り返し起こした。これまでの森田療法では、このような行動化が生じると治療継続は困難であった。しかし、今回我々は、逆にこの行動化を森田療法の治療の進展に活かす戦略をとった。
  具体的には、その短絡的行動を「自分自身で問題解決できないことに対する不満や不全感の代償的表現」であると捉えて、現実を認めて主体的に問題解決に向かうことを繰り返させた。この戦略によって、彼らは失敗を繰り返しながらも現実と直面し、彼らの完全性を求める「過剰な生の欲望」と理想からは程遠い「現実」との調和が促進された。加えて、彼らの対人関係スキルも改善し、自制して自分で問題解決をしていく力を身につけていった。その結果、彼らは自ら進路を決定し、退院していった。
  本症例を通して、これまで治療の危機とみなされた行動化は、逆に森田療法の効果を高める機会となりうると考えられた。
  

  Biography: Yosuke Mochizuki, MA is a clinical psychologist at the University Hospital of Hamamatsu University School of Medicine in Japan. My work at the hospital includes psychological assessments and psychotherapy. I apply psychotherapy to patients diagnosed with anxiety disorders, depression, and schizophrenia. I have also been practicing and researching Morita therapy since 2007, and gave a case presentation at 25th and 27th Japanese Congress of Morita Therapy. I graduated from Kansai University, Department of Sociology in 2004. Then I went to Kansai University graduate school. My major was clinical psychology and I trained as a psychotherapist by Encounter Groups.
  

• Comparing and Contrasting Morita Therapy Methods with Western Therapies

  Teri Nakamoto

  This study was conducted as a doctoral dissertation at CSPP (California School of Professional Psychology) of Alliant International University in California. As a Japanese graduate student pursuing a doctoral degree in the USA, I witnessed the lack of awareness about Morita therapy by Western mental health professionals including professors of psychotherapy at graduate schools. In order to introduce Morita therapy to the West, the following was proposed for my study: (1) to compare and contrast Morita therapy with various Western psychological theories; (2) to describe the effectiveness of Morita therapy through a comprehensive review of the literature, including presentation of research studies from 1919 to the present; (3) and to discuss and describe techniques for the application of Morita therapy with a non-Japanese population. The study found numerous similarities and differences between Morita therapy and the following Western approaches: developmental psychology, cognitive-behavioral, phenomenological/experiential, client-centered, Gestalt, existential, family system, Brief Therapy, psychoeducation, and mindfulness-based therapies. Analysis of the following was also conducted: the effectiveness of Morita therapy using case examples and quantitative studies, populations and diagnostic categories of disorder benefiting from Morita therapy, treatment types, duration of treatment by treatment types, and other unique characteristics of Morita therapy. Analysis of data revealed 12 themes embedded in Morita therapy that contribute to effective outcomes in therapeutic and educational settings for clients who fall outside the traditional Japanese clientele. Lastly, feedback by Western mental health professionals about this study is offered.

  Biography: Teri Nakamoto, Psy. D. (Doctor of Psychology). I am a Japanese clinical psychologist who completed a doctoral degree at CSPP/Alliant International University, San Diego campus in May 2009. I currently teach at CSPP/Alliant International University, Tokyo campus. I became a member of the Japanese Society of Morita Therapy in December 2006 with a recommendation by Professor Kenji Kitanishi, MD. I attended the 6th International Morita Therapy conference in Vancouver and assisted in the presentation by Ms. Mari Iwata (Kikuchi).

• Guidelines for Outpatient Morita Therapy

  Kei Nakamura

  While Morita developed a home care treatment at the turn of the last century, today, the basic form of Morita therapy is inpatient treatment. In recent years, however, the number of medical clinics and counseling services that have incorporated Morita theory and methods into their outpatient practices is rapidly increasing in Japan. Observing such a trend, the Japanese Society for Morita Therapy (JSMT) developed a Guideline for Outpatient Morita Therapy in 2009. The Guideline was based on survey-based data and follow-up feedback from a number of JSMT-certificated Morita therapists in Japan, and can be regarded as their consensus perspective on the practice of outpatient Morita therapy.
  
  The Guideline is comprised of the following five basic components:
  (1) increase clients’ awareness and acceptance of emotion, (2) recognise and mobilise the "Desire for Life" in clients, (3) clarify the vicious cycle of anxiety and suffering, (4) offer behavioral instruction, and (5) facilitate clients’ re-examination of their lifestyles. In this session, Professor Nakamura will outline and explain the Guidelines for Outpatient Morita Therapy. Ms Kubota will then concretely illustrate how the Guidelines are applied in an actual treatment case.
  

  Biography: Kei Nakamura, M.D. is Professor in the Department of Psychiatry at Jikei University, and the
  Director of the Jikei University Center for Morita Therapy.
  Mikiko Kubota, M.A. is Associate Professor in the Faculty of Social Policy and Administration, Hosei University; she is also a clinical psychologist at the Jikei University Center for Morita Therapy.
  

• Bending the River: Adapting Classical Morita Therapy for Western Contexts (Training/Supervision in Allied Health)

  Brian Ogawa

  The historical core of Morita therapy has been the classical four stages of absolute bedrest, light work, intensive labor, and social reintegration. These are sequential stages in that the learning and engagement progresses from one stage to the next. The focus on a natural environmental setting, with a consistent, familial staff-patient interaction, unimposing and available therapist, and patient experience are central elements of this traditional Morita approach. Some key issues in extending the benefits of Morita therapy to the West have been to discern what experiential outcomes and/or core essence might be lost by altering the four stages for a counseling context, while treating anxiety that may fall outside the Japanese complex of shinkeishitsu. This paper attempts to discuss and refine such questions in relation to how Morita therapy is taught to American university students and mental health professionals. The author reviews the relationship between client wellbeing and the classical four stages of Morita therapy, while addressing the use of representative terms, such as Morita therapy, Morita-based counseling, and Constructive Living for Western adaptations. The paper explores how the cumulative goals of each of the four stages could be met by analogous methods, and how classical Morita therapy could revitalise Western residential treatment. The author makes recommendations for "bending" the flow of Morita therapy in the West without impairing its efficacy.

  Biography: Brian Ogawa is Chair of the Human Services Department and Associate Professor at Washburn University, Topeka, Kansas. Dr. Ogawa was formerly the Director of the Crime Victims' Research and Policy Institute, Office of the Texas Attorney General; Director of the National Academy for Victim Studies, University of North Texas; director of a prosecutor-based victim/witness assistance division; mental health researcher; and counselor in private practice. His education includes a doctorate in counseling with a dissertation on the Western adaptation of Morita therapy. In 1995, Dr. Ogawa received the National Crime Victim Service Award, presented by the President in ceremonies at the White House, for his work on trauma and Morita therapy. Dr. Ogawa is the author of the following books related to Morita therapy: Walking on Eggshells (Kendall Hunt), Color of Justice (Allyn and Bacon); and A River to Live By: The 12 Life Principles of Morita Therapy (Xlibris/Random House).

• The Ten Ox Herding Pictures of Zen: Authentic Self and Views from Morita's Life

  Shigeyoshi Okamoto

  Shoma Morita often compared the cure brought on by his therapy to “Satori" (or enlightenment in Zen). In order to illustrate this point, this author will make a comparison between “the ten ox-herding pictures” as a well-known Zen illustrative text, and the "process" by which cure occurs in Morita therapy. The life story of Shoma Morita will be used as the case study.
  The "ten ox-herding pictures” express the process of attaining “satori,” through a parable about a herdsboy and an ox representative of self journey. Pictures are compiled into three stages: (1) self-seeking, (2) self-deepening, and (3) returning to the 'real' or authentic self.
  
  Morita, as therapist and psychiatrist, attached importance to particular kind of liberation that results when one is no longer caught by convention and overcomes the contradiction between the ideal and the real. He also was interested in recovery via “the pure mind.” In this regard, he pointed to three ways to cultivate the mind: (1) through patience, (2) through the recognition of phenomenon as it is, and (3) through developing the desire to live according to Nature (with pure mind). Given that Morita was filled with anxiety in his youth, he developed his theory of health from self reflection, and in turn, became an active and respected psychiatrist and therapist. The process by which Morita realised his 'real self' (and by which his patients experienced him) coincided with the three pathways towards cultivating pure mind-pure heart, while assisting a mature humanity. Morita's life is illustrated by the tenth Ox herding picture of a mature man who is responsive, kind and present to others.
  

  Biography: Shigeyoshi Okamoto, MD is a psychiatrist who practices Morita therapy in Sansei Hospital in Kyoto. He is also Professor Emeritus of the Prefectural College of Himeji (and former professor of Bukkyo University), and is a scholar of Buddhist Studies.

• Enhancing Motivation in Persons Diagnosed with Schizophrenia: Lessons from Morita Therapy's 'Progressive' Strategies

  Natalia Semenova

  While working with patients diagnosed with schizophrenia in Russia, this author has come to the conclusion that Morita therapy principles can be meaningfully and successfully integrated into the general framework of helping patients with this chronic disorder. This paper describes an intervention designed for persons with schizophrenia-spectrum disorders. The intervention is designed to enhance motivation to change maladaptive patterns of behavior, and to facilitate engagement in treatment. Developing a motivation-based intervention for those with schizophrenia is especially challenging because obstacles to motivation are characteristic of the illness. To achieve these goals, the author has adopted selected constructs from Morita therapy. The program integrates a number of Morita therapy strategies into a cohesive treatment package based on the transtheoretical model by Prochaska (1984), which proposes that motivation to change develops over a series of stages; in this way, the facilitation of change requires stage-specific interventions (which is a strength embedded in Morita therapy). In order to motivate clients to learn how to better manage their illness and to help them move forward pro-actively in their lives, the intervention begins with exploring the "meaning of “recovery” to the client. Following, the client sets personal and reality-based recovery goals to work toward. Motivation is viewed as a dynamic state rather than a static trait, readiness-to-change can be enhanced by both therapeutic intervention and naturally occurring events. The result is the enlargement of the patient’s range of activity, and her or his return to as normal and independent a life as possible across all their life activities and settings.

  Biography: I obtained my PhD in Psychology at the Lomonosov Moscow State University. Intrigued by the difficulties in treating psychosomatic disorders, I studied etiology, course and treatment responses. My publications include articles and book chapters on psychology and psychotherapy. As an active psychotherapist with a broad orientation, my treatment with clients is adapted to what is assessed as being most facilitating for clients (at certain junctures in their lives); thus, short-term and/or longer treatments are offered when needed. The experience of being a clinicianresearcher in a large psychiatric center has sensitised me to the delicate balance of psychotherapy, medication, diagnosis and the environments in which treatments occur.

• Morita-based Group Therapy in the Treatment of Social Phobia

  Wang Shi

  This paper explores the efficacy of Group Morita-based Therapy in the Treatment of Social Phobia. As part of the methodology, 25 social phobia patients were treated by Group Morita Therapy for four weeks. The content is as follows: ① Introduce various knowledge about social phobia, while emphasising that symptoms ultimately make no-sense (are nonsense) as the focus of treatment. ② Introduce pathogenesis of social phobia according to Morita’s theory, including sentian temperament, mind interaction, and the mechanism of the disorders. ③ Assist the patients' understanding of the life philosophy, “Let nature take its course; and do what you need to do to respond accordingly”. Use this orientation to assist the client to surmount the mind interaction, and to experience, “Purpose is standard; action is standard”. ④ Introduce the rule of restoration process, the concept of curing, and other correlated knowledge about social phobia.
  
  As a measure of qualitative and quantitative change, patients were asked to record their levels of apprehension and feelings after group sessions.
  Results show that the IAS and SCL-90 scores (except for the somatisation factor) differed significantly from pre-treatment to post-treatment. The post treatment (cure) rate was 72% with an effective power of 96%. Findings indicate that Group Outpatient Therapy with a Morita Therapy Orientation was performed easily and had clinical significance.
  
  
  KEY WORDS Social Phobia the Group Morita Therapy Interaction Anxiousness Scale（IAS） SCL-90
  

  Biography: Professor Shi Wanghong, MD. Department of Psychology, School of Aerospace Medicine, Fourth Military Medical University, Xi’an 710032, China.

• Respecting Complexity

  Graeme Smith

  Speaking from the position of psychotherapist and psychosomaticist, I review the history of the struggle to resist excessive reductionism and to maintain respect for the context and complexity of human beings presenting with distress, epitomised by Morita therapy. I argue that Engel’s biopsychosocial model has been used to camouflage the reductionist push in an age of increasingly specialised medicine, the privileging of randomised controlled trial research methodology, and the institutionalisation of the health care system. I identify emerging trends that indicate a move away from the paradigms of that era towards what Ivan Illich described as good practice; “that which is uniquely and incomparably appropriate in a given setting”. There is increasing acknowledgement of the complexity of presentations to health care professionals and the inadequacy of many “approved” methods to deal with such presentations. Qualitative research is increasingly recognised as being an appropriate complement to more reductionist ways of studying such problems. Psychotherapists should take advantage of the rapprochement that is developing by offering their considerable experience of qualitative methodology in a process of scrutiny of their work by independent qualitative and quantitative researchers. Solutions are required to address adequately the challenges of multimorbidity and increasing complexity of health care, and to answer well the Evidence Based Medical Practice question, “Which therapy, delivered in which way by whom to whom, is most likely to produce specific beneficial outcomes and least likely to produce harmful ones?”

  Biography: Professor Emeritus Graeme Smith, Department of Psychiatry, Monash Medical Centre, Monash University, Australia

• Respecting Complexity

  Professor Emeritus Graeme Smith

  Speaking from the position of psychotherapist and psychosomaticist, I review the history of the struggle to resist excessive reductionism and to maintain respect for the context and complexity of human beings presenting with distress, epitomised by Morita therapy. I argue that Engel’s biopsychosocial model has been used to camouflage the reductionist push in an age of increasingly specialised medicine, the privileging of randomised controlled trial research methodology, and the institutionalisation of the health care system. I identify emerging trends that indicate a move away from the paradigms of that era towards what Ivan Illich described as good practice; “that which is uniquely and incomparably appropriate in a given setting”. There is increasing acknowledgement of the complexity of presentations to health care professionals and the inadequacy of many “approved” methods to deal with such presentations. Qualitative research is increasingly recognised as being an appropriate complement to more reductionist ways of studying such problems. Psychotherapists should take advantage of the rapprochement that is developing by offering their considerable experience of qualitative methodology in a process of scrutiny of their work by independent qualitative and quantitative researchers. Solutions are required to address adequately the challenges of multimorbidity and increasing complexity of health care, and to answer well the Evidence Based Medical Practice question, “Which therapy, delivered in which way by whom to whom, is most likely to produce specific beneficial outcomes and least likely to produce harmful ones?”

  Biography: Graeme Smith, MD is Professor Emeritus in the School of Psychology, Psychiatry and Psychological Medicine at Monash University, Melbourne, Australia. The combination of those disciplines into one School is unusual in the field, but epitomises a long tradition at Monash University of acknowledging the breadth of thinking required to address adequately issues of the mind and body, in both research and teaching.
  
  Professor Smith established postgraduate courses in psychoanalytic thinking and psychotherapy, and together with colleagues in the Faculty of Arts, a Masters degree in Mind and Society. His research embraced the whole biopsychosocial dimension: from basic neuroscience to psychosocial outcomes of living kidney donation through to the qualitative experience of depressive symptoms during a general hospital admission. He practiced as a consultation-liaison psychiatrist and psychoanalytic psychotherapist with individual patients and groups. He does Balint Group work with general practitioners and currently works with the Multiple and Complex Needs Initiative of the Victorian State Government. His recent publication on complexity stems from that work.
  
  Professor Smith has been a long-term advocate of Morita therapy. He maintains his interest in the historical links between Morita and Freud’s scholarly work at the turn of the last century that led to the development of their culturally unique theories and practices.

• A Comparison of ‘Hypochondriacal Temperament’ and ‘Anxiety Sensitivity’: Lessons from Morita and Contemporary Behavior Therapies

  C. Richard Spates

  One of the unique observations in the treatment of anxiety introduced by Morita (1928) concerned Hypochondriacal Temperament (HT). It is embedded in his approach to treatment as well as his theory of anxiety neurosis. It noted that a subgroup of patients with neurasthenia suffered more from discomfort with their own reactions to anxiety than to a primary fear. This view holds that the principal target of intervention should concern the hypersensitivity to symptoms and not the putative object of fear. Morita suggested that if one's 'HT' was dealt with satisfactorily and the patient would begin to behave naturally while facing life as it is, Nature would adequately address any remaining fear, within the context of purposeful living.
  
  Contemporary Behavior Therapy has similarly come to acknowledge a critical role played by a parallel construct called Anxiety Sensitivity (AS). Anxiety Sensitivity refers to a patient’s worry related to catastrophic concerns that early symptoms or sensations will devastate her or him. As suggested by Reiss (1991) “this worry produces additional anxiety, potentially setting up a vicious cycle among anxiety sensitivity, the experience of anxiety and behavioral inhibition)”. Contemporary Behavior Therapies target AS as a primary clinical goal in treatment. This paper will compare the constructs of HT and AS and examine the manner in which they are addressed by Morita Therapy and Contemporary Behavior Therapy. It further raises the question of whether addressing HT and AS are all that is necessary or all that could be helpful in assisting a patient suffering from an Anxiety Disorder.

  Biography: C. Richard Spates, Ph.D. is Professor of Psychology and Director of the Anxiety Disorders Laboratory at Western Michigan University in the United States. As a Visiting Research Fellow at the Center for Morita Therapy at Jikei University in 2003, he studied Morita Therapy under guidance of Kei Nakamura and others. In addition to training doctoral students in Clinical Psychology, he has researched the treatment of a variety of anxiety disorders including social anxiety, Posttraumatic Stress Disorders, and specific phobias among others. One principal focus of his studies concerns identifying the essential features of empirically supported therapies. He is also interested in the clinically pragmatic yet empirical science approach utilized by Morita in the development of his experiential therapy, and in tracing its origins from Western approaches through their adaptation to Japanese culture. Professor Spates is also interested in contemporary parallels to Morita Therapy; both its development and its procedures.

• Comparative Analysis of Morita Therapy and Acceptance and Commitment Therapy (ACT)

  Ayumu Tateno

  Acceptance and Commitment Therapy (ACT), founded in 1999 in the USA, is one of contemporary cognitive-behavioural therapies, sometimes regarded as “The Third Wave.” In ACT, mindfulness (as methods of focus) and an acceptance process, alongside commitment and behavioral-change strategies are emphasised as a means to 'Psychological Flexibility'. By comparison, Shoma Morita, MD created Morita Therapy in Japan in the 1920s, which was designed to treat neurotic symptoms that are exacerbated by the mechanism of “Toraware” within the individuals who have a uniques sensitivity characterised as 'Shinkeishitsu'.
  
  In this study, six core ACT factors are compared to the philosophy underlying Morita Therapy. First, with regard to the Mindfulness and Acceptance Processes, there are three concepts in ACT with which we can find comparative concepts in Morita therapy. In particular, "Acceptance" in ACT corresponds to 'accepting emotions as they are' in Morita therapy. Also, Cognitive Defusion in ACT corresponds to the breakthrough of “Toraware” in Morita therapy, whereas Self-as-Context in ACT corresponds to the "realising the self as it is" in Morita therapy. Secondly, the 'Commitment and Behavioral Change' and 'Being Present' processes/goals underlying ACT seem to correspond to 'focus on work in the here-and-now' that occurs across Morita therapy's stages. In addition, 'Defining Valued Directions' in ACT corresponds to the 'Desire for Life' in Morita therapy, and 'Committed Action' in ACT corresponds to constructive actions in Morita therapy. This author will show how the the clinical interventions of ACT and Morita therapy overlap.
  

  Biography: Ayumu Tateno, MD
  July 2009-present: Senior Clinical Associate at Department of Psychiarty,The Jikei University(Daisan Hospital):The Jikei University Center for Morita Therapy
  August 2008-June 2009: Department of Psychology ,Western Michigan University (Visiting Scholar )
  1998-July 2008: Senior Clinical Associate at Department of Psychiatry, The Jikei University (Daisan Hospital)
  1996-1998:Shonan Hospital
  1995-1996: Department of Psychiatry, The Jikei University (Daisan Hospital)
  1993-1995:The Jikei Universtity Hospital
  
  EDUCATION:1993 Graduated from The Jikei University
  

• The Application of Morita Therapy for Community Mental Health and Suicide Prevention

  Naoki Watanabe

  Since 1997, this author and his mental health team have engaged in suicide prevention activities in Akita Prefecture, which is known to have high rates of suicide. Based on our experiences with Yuri-Town residents, we are challenged to find ways to change residents "Psychological Barriers"�. In our research, we found that residents maintain beliefs that perpetuate their isolation, such as "It is better not to tell someone about my suffering and keep silent because my problems are my own responsibility." Such kinds of thoughts, common in this region, are also characterised by a broader community belief that it is ethical and courageous to take self-responsibility without disclosing one's suffering. This community-based ethics leads to a kind of illusion of bravery, and is a risk factor for suicide when someone faces overwhelming difficulties. This attitude might partially be explained by the fact that it is an honour for someone to attempt to fullfill her or his self-responsibility, while remaining silent about an intention to die.
  
  One research study examined 60%~70% of residents who attempted to kill themselves, but were rescued and transferred to emergency hospitals (of which, 11% died). Of these survivors, no one spoke ahead of time about their sufferings or suicidal intentions (T.Hosaka et al,2004). In our community psycho-education projects on suicide prevention, we continue to find that Morita Principles are useful tools by which to break through these psychological barriers. Namely, re-examining 'Human Nature' and 'Isolation of Self by Oneself' in ways that breakdown such isolation while increasing one's capacity to choose whom they disclose to in their family or community. In addition, one learns to face anxiety as it is and respond accordingly, and to feel pain but to maintain safe actions despite the pain; these are basic standpoints of Morita Therapy, which potentially reduces the risk of acting upon suicidal intentions, while increasing community engagement.

  Biography: Naoki Watanabe, MD is Professor of the Department of Psychology. He teaches 'Suicide Prevention Measures', and as a Psychiatrist and Clinical Psychologist, Professor Watanabe is also interested in the treatment of Eating Disorders and Personality Disorders.

• The Research Trial of the Standard Outpatient Morita Therapy (SOMT) in Japan

  Naoki Watanabe

  Akin to the time course for inpatient Morita therapy, Dr Ichikawa developed an outpatient method of Morita Therapy with short and intensive treatment measures. As this author is working with Dr Ichikawa in the same clinic, I am honoured explain his outpatient Morita Therapy called the "Standard Outpatient Morita Therapy (SOMT)". SOMT consists of 10 sessions with the time structures of 3 stages ( pre-stage, middle, and final stage) with an outlook on the dynamic process of the therapist-client relationship. During the pre-stage (1 to 3 sessions), the therapist works with the client rather than giving directives similar to bed rest instruction in inpatient therapy. In this stage, clients experience rather superficial changes in his or her symptoms. In the middle stage (4 to 5 sessions), the therapist shows rather suggestive behavior with dialogues in ways that resemble the periods of work therapy. In this stage, some clients report having an experience similar to enlightenment (which falls sequentially in the middle phase of treatment). In the final stage (6-10 sessions), the therapist points to “Arugamama” (as it is, or isness), from which the client experiences 'human existence' like that which occurs in the readjustment period in inpatient therapy. Dr Ichikawa studied 100 cases using such procedure, and found an treatment-effective outcome of 85%.

  Biography: Dr Watanabe, Professor of Department of Human Psychology & Psychiatrist and Clinical Psychologist presents this paper on behalf of Mituhiro Ichikawa, MD, at the Koyo Clinic, Ochanomizu iin.

• Coping Strategies for Complex Anxiety from the Standpoint of a Morita Perspective

  Hideyo Yamada

  In our psychiatric clinic, we ordinarily implement programs which are designed to promote the recovery of depression in ways that prevent relapse.
  Almost all of our programs are systematised by design based on the concepts of Morita therapy. Up to just a few years ago, many patients diagnosed with depressive symptoms in Japan have not been able to participate in rehabilitation programs because only a few mental health facilities have such programs, which could be a reason that patients suffer tragedy of recurrence after returning to their offices following conventional treatment, which has been composed of physical and mental rest, pharmacotherapy, and the standard CBT. Considering lack of long-term effectiveness by some modes of treatment for depression, we included a psycho-education element into our practice which in essence consists of the philosophy of Morita therapy. Thus we assist patients in acquiring coping skills for many kinds of complex anxieties and stresses they experience.
  
  In order to make it easy for patients to grasp and understand the key principles of Morita therapy, we select and rearrange some of the core concepts of Morita therapy; some patients with depression are confused or unclear, and so this shift in method accounts for this difficulty by increasing patients' clarity about their 'vicious cycle' (as one example), while decreasing their vagueness. In this way, our purpose for therapeutic gain is realised.
  While speaking about our therapeutic approaches, we will discuss the classification of anxiety as related to Morita therapy. For instance, many anxiety factors were discussed by Morita himself, and Morita's theory, such as “law of emotions”, “Fact is truth” or “Devotion (Narikiru)” remain relevant today as key factors to address in treatment.
  

  Biography: Hideyo Yamada, MD, started to work as a psychiatrist at Tokyo Metropolitan Matsuzawa Hospital and Tokyo Metropolitan Fuchu Hospital after graduating from School of Medicine, Kanazawa University. He is now running private office, Odori Koen Mental Clinic, in Sapporo, Japan since 1997. Currently, he is interested in humour and laughter in psychotherapy, and the construction of the rehabilitation program for depressive patients.