Finding Mindfulness in Japanese Psychology, Part 2

Naikan: Structured mindfulness reflection by asking 3 questions.

Posted Apr 08, 2018

Saori Miyazaki
Source: Saori Miyazaki

by Saori Miyazaki, LMFT

I am a psychotherapist trained in Western psychology modalities. Although I believe counseling and psychotherapy can be helpful when we suffer from various challenges and mental health symptoms, I am also interested in how some people in the East, specifically Japan, seek help at Buddhist temples and from meditation when faced with personal challenges. I also wondered if there are any modalities available that do not require one to access a religious institution. I was seeking options for people in the West who do not seek talk therapy because they feel that it comes with a label of “you are crazy and that is why you are seeing a therapist.”

When I was in a search for “self-reflective” mindful based mental health modalities that could be an alternative to Western psychotherapy, I came across Naikan therapy, which literally means “looking inside” or “introspection."  It is based on the intensive training called “Mishirabe” from the Jodo Shinshu (Pureland) sect of Japanese Buddhism. Naikan is a structured self-reflective method designed to increase self-awareness.  It was modified in the 1940’s by Ishin Yoshimoto, a successful retired Japanese businessman who refined “Mishirabe” to be much more accessible to the general public by omitting the religious aspect.

Yoshimoto decided to devote his time and energy to help people, establishing a retreat center in Yamato-Koriyama in Nara prefecture, for anyone who was willing to reflect on their daily lives through Naikan.  He welcomed anyone from ordinary folks who had depression and/or substance abuse to Japanese mafia members with serious criminal history. Yoshimoto also fostered many disciples from all over Japan who eventually went back to their hometowns to open their own Naikan centers to continue helping others.

Naikan became known outside of Japan and is practiced in Australia, Europe, and China.  Some practitioners use it with Western psychotherapy to treat people with various mental health symptoms and incorporate it as part of their rehabilitation process. I think Naikan was accepted worldwide as a guided self-reflection tool because its practice does not imply you have a particular mental illness, and it is conducted at Naikan centers rather than mental hospitals.

Normally, a Naikan retreat lasts five to seven days.  Participants sit quietly in a corner of the room, isolated by screens and are asked to reflect on three fundamental questions regarding one’s caretaker.  This practice increases awareness and enhances mindfulness.  The fundamental three questions are:

1. What support has this person (your caretaker) given you?

2. What have you given this person in return?

3. What trouble have you caused this person?

There is no therapist but approximately every two hours an interviewer will follow-up with each participant and has them report, based on the three questions, what they have reflected on. The interviewer never gives suggestions but provides support throughout the reflection process by listening. While Naikan is effectively used to reflect on inner-personal relationships with people of your choice, it is suggested you start with your caretaker(s) and self-meditate on your own character and past actions.

During a Naikan reflection, we do not get a chance to reflect on what trouble the people that we are reflecting on have caused us. This is because we are naturally good at finding what wrong action others have done to us. The Naikan process guides us to look at a situation from the perspectives of others and not only our own.  It makes us examine our inner-relationship to this particular person because we often fail to see the “whole picture” when we have tunnel vision due to our feelings.

I have gone through the whole seven-day and short Naikan retreat in the past several years. My responsibility was to just sit quietly and do Naikan all day and clean my space in the morning.   You may think it is going to be very difficult because of these restrictions but you will soon realize that you are nurtured all day long by others’ kindness.

For instance, your meals are taken care of by the staff members who cook and bring very delicious and healthy dishes.  The interviewer will come and follow-up with you every couple of hours and devotes his/her attention to support you throughout the Naikan process. It is almost like a luxurious “mindfulness” vacation because you are free from your daily responsibilities and are allowed to just reflect.

I felt privileged to be able to slow down and meditate on my life history and people who nurtured me. Some of them hurt me emotionally as well yet it was necessary for me to view that person as a whole, not just my perspective since it was so easy for me to fall into a “black or white”, “good or bad” mentality. It was an eye-opening experience where I become aware of many factors in life. I soon also realized that there are so many people that are quietly supporting me without needing to be recognized/acknowledged by me or anyone. Naikan reflection can also bring out some challenging feelings and subsequently it is not unusual if you end up shedding some tears. Thus, Naikan is most effective when it is carried out as a daily reflective practice after you complete the seven-day intensive retreat.

When I worked at a local high school here in the U.S., I incorporated Naikan reflection during my psychotherapy session. Some students found it useful but others had difficulty in identifying answers to each question. Since there was no way that I could possibly replicate the intensity of Naikan at a school setting, I instead made Naikan a closing activity when I was facilitating a support group. It was an amazing experience to witness teenagers trying out Naikan, not knowing what to expect, yet it lead them to become aware of others’ selfless actions. This discussion lead one particular student to regular psychotherapy sessions with me after having a moment to explore her inter-personal relationship with her step-family.

I believe Naikan helps to de-stigmatize “already stigmatized” populations by offering mental health services which help them to shift themselves from non-participants to active participants in psychotherapy. Naikan might not be suited for everyone, yet it certainly helped some of my clients to understand how to lead a mindful life especially when they faced some challenges. I suggest Naikan for anyone who needs a bit more structure in their “meditation” because their mind tends to wander off. All you need to do is to follow these three questions that I mentioned above to examine your relationship with one person at a time. I suggest you trying for 5 minutes at the end of the day.

Saori MIyazaki
Source: Saori MIyazaki

In the next post, I will discuss another Japanese modality that is based on mindfulness.

Saori Miyazaki is a licensed marriage and family therapist in California. She is certified in Japanese Psychology and expressive arts therapy and has been implementing mindful-based psychotherapy in her private practice in San Francisco. Her work experiences include working with LGBTQ community, traumatized teens, and adults with depression and anxiety. She studied photography in college and worked as a freelance photographer before becoming a psychotherapist. She enjoys hiking, cultural events, traveling, photography, watching classic movies, having afternoon tea and chasing and being chased by her cat.