In 1919, Morita Shōma first published his theories on the nature of a disorder he called shinkeishitsu. While it was often translated as “neurasthenia” after the definition of George Miller Beard (1869), Morita himself maintained that it was a nervous disorder with symptoms that included a range of ailments. Anything from physical and mental fatigue, headaches, heart palpitations, insomnia, nausea, or even dizziness could be a symptom of shinkeishitsu. The treatment that Morita recommended for this disorder was a combination of what is now considered behavior modification therapy, self-assessment, and meditation. After his death, this treatment came to be known as Morita Therapy, and it has persisted as a form of therapy for a variety of nervous disorders to the present day. In this thesis, I will demonstrate how Morita, through his education and connection with western psychiatrics, adapted Western mental health concepts to the Japanese context. At the same time, however, Morita attempted to extend concepts of mental illness that he considered to be Japanese culture-bound syndromes--specifically shinkeishitsu, which in addition to symptoms of neurasthenia caused patients to exhibit signs of obsessive-compulsive or perfectionist tendencies and a social phobia known as taijin kyōfushō. Morita Therapy exemplifies the general trends of psychiatric healthcare in the prewar period; the medicalization of nervous disorders and his interaction with the larger psychiatric community demonstrates how Japanese psychiatrists attempted to take part in the international discourse on mental health and wellness. / text

Background. Depression and anxiety are common and debilitating disorders, and at least one third of patients do not respond to available interventions. Morita Therapy, a Japanese psychological therapy which contrasts with established Western approaches, is currently untested in the UK and may represent a potentially effective alternative approach. Aim. To optimise and investigate the feasibility and acceptability of Morita Therapy as a treatment for depression and anxiety in the UK. Design. Three studies were undertaken in line with the MRC framework (2008) for complex interventions. Study One: scoping and systematic review to describe the extent, range and nature of Morita Therapy research activity reported in English. Study Two: intervention optimisation study, integrating literature synthesis with qualitative research, to develop the UK Morita Therapy outpatient protocol. Study Three: mixed methods feasibility study encompassing a pilot randomised controlled trial (RCT) and embedded qualitative interviews to prepare for a fully-powered RCT of Morita Therapy versus treatment as usual (TAU). Results. Study One: 66 papers meeting the inclusion criteria highlighted heterogeneity in the implementation of Morita Therapy, and an absence of both UK-based research and relevant unbiased RCTs. Study Two: a potentially deliverable and acceptable therapy protocol and tailored therapist training programme were developed for a UK population. Study Three: 68 participants were recruited and 94% retained at four month follow-up; 70.6% of Morita Therapy participants adhered to the minimum treatment dose, and 66.7% achieved remission in depressive symptoms (compared to 30.0% in TAU). Qualitative and mixed methods findings indicated that Morita Therapy was broadly acceptable to therapists and participants, and highlighted potential moderators of acceptability, treatment adherence and outcomes. Conclusions. Patients in the UK can accept the premise of Morita Therapy and find the approach beneficial. It is feasible to conduct a large-scale UK-based trial of Morita Therapy with minor modifications to the pilot trial protocols.

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This editorial chapter addresses the problem of burnout in academic libraries by introducing a fusion of principles from trauma-informed care (TIC) and Constructive Living (CL) to offer unique, easy-to-incorporate plans of action to identify and mitigate symptoms of burnout. These two action-based philosophies, which may be new to most readers, provide strategies for considering, practicing, and adopting perspectives and behaviors that may give those suffering from burnout new ways of thinking about their professional and personal lives. We identify accessible opportunities to connect mind and body in self-care to neutralize negative self-talk, regain perspective and balance, and foster lifelong resiliency at a pace wholly determined by the individual and without formal training or expense.