General advice for
symptoms The second series written by Takehisa Kora
1.Know the essence of your
symptom Patients tend to believe that their symptoms are
caused by organic diseases in their bodies, but neurotic symptoms are
never like that. They are caused by their minds. That is to say, patients
must realize that their symptoms are psychogenic. If excess attention is
directed toward their heads, it causes a heavy or dull feeling in the
head. If it is paid to their hearts, it causes accelerated heart
palpitations. If it is paid to their fatigue, they worry about exhaustion.
Once they are conscious of one symptom, they feel sensitivity toward it,
and then they tend to pay more attention to it. Mental effects and bodily
effects spiral, and they convince themselves that they are ill. The causes
of many kinds of obsession are complex. Patients think that unpleasant
sensations and feelings, which everyone may have on some occasions, happen
only to them. They regard these sensations as special, signs of illness
and disadvantageous for self-preservation so that they try to get rid of
them, deny them, or run away from them. All obsessions are caused by
mental states. They must understand this process well and stop all
physical treatments.
2.Leave your symptom as it
is Once a symptom is set, it is difficult to get rid of it
in a short time. No, the harder we try to get rid of it the more we are
hounded by it. The harder patients who suffer from insomnia try to sleep,
the less they can sleep. The harder patients who suffer from heart
palpitations try to run away to a safe place, the more they worry about
very small things. The harder patients who suffer from anthropophobia try
to make themselves calm in public, the more nervous they become. The
harder they try to manipulate all symptoms in order to erase them or run
away from them, the more complex their symptoms become and the more they
worry about them. They must understand this principle very well. They must
take their symptoms as they are and understand that this situation is
normal for them. Even if they feel fear or have some difficulty, they
should accept their problems without objection. Patients who suffer from
insomnia must not try to sleep by forcing themselves. There is nothing
they can do about it when they cannot sleep. If they are given sleep, they
should accept it. If they can think of their symptoms in that way, they
can fall asleep naturally. Other symptoms are the same. Get together with
fears and troubles without objecting to them. Do not try to escape from
anxieties but lead your life with them. To take things as they are does
not mean to do nothing at all because you are troubled. It means to endure
many kinds of anxieties and fears without attempting to remove them and to
do what needs to be done.
3. Live so you are always doing
something Neurosis is a condition that limits observation of
the outside world, and directs attention strongly only toward one's own
mind and body. That is to say, one becomes introverted. In order to become
extraverted it is useless just to hope to become so. The best way to
become an extravert is to work. One starts doing easy tasks while having
symptoms, and gradually one tries tasks that are more difficult. It is
better to chose tasks that involve movement of hands and feet. It is wrong
to aim to start working after getting rid of suffering and fears. It is
important to accept the reality that there is pain, and to keep on doing
something. It is better to do a variety of tasks. The variety allows rest
while moving from task to task, making naps and the like less necessary. I
advise my inpatients to clean up the inside and the outside of their
rooms, to take care of rabbits and chickens, to raise vegetables, to make
handicrafts projects, and to practice calligraphy.
Human beings can't keep their minds calm without working regardless of
whether they have neurotic symptoms or not. People who can be cheerful
without working are exceptions. Ordinary people fall into unhappiness if
they don't work. Ordinary people always lead a disordered life if they
don't work. They lapse into an unhappy mental state. Keeping working
trains them to be more extraverted and makes them have the confidence that
they can do anything they try even while having pain. Then their pain
eases gradually. If they don't work because of pain and fears, they will
feel their pain and fears more terribly.
4. Fix your appearance
first. Anyone who is untidy in appearance can't have a sound
mind. It is impossible to have happy feelings while grimacing. To make
your mind better requires you to make your appearance better. It is not
improper to leave your feelings as they are, but to show them without
controlling them means to be ruled by them. There is no self discipline,
but rather a lack of willpower. If you have pain and fears and tell others
or show them on your face, or through gestures, words and behavior, your
mind becomes weakened because of your appearance. If you keep your
appearance tidy and maintain it while bearing your suffering and fears,
your mind naturally matures.
5. Don't depend on your
mind. If you work only when you are in a good mood, and do
nothing if you are in a bad mood it makes you lazy. You should understand
that moods are like weather. You should do anything that you can do
regardless of your mood while accepting it as it is. It is not good to
think that it is impossible to do something before trying. Also if you are
in an uneasy mood, you may think even everyday occurrences and ordinary
physiological phenomena are abnormal or signs of illness. For example,
people who suffer from anthropophobia have timid feelings. They think they
are being laughed at when others are laughing. They read imagined meanings
into a cough. They misconstrue anything that happens by chance to be
concerned with them. They must understand well that a life depending on
moods tends to cause such conjectures and stop them.
6. Don't
complain. If you complain about your symptoms, it may ease
your mind for a short time, but if you keep doing that it will make your
symptoms worse. You trap yourself. Avoiding complaining makes us strong. A
person who is called a great man usually doesn't complain. It is difficult
for ordinary people not to complain. But if you can just do that, it helps
to train your mind.
7.Don't make your illness an
excuse. When you have a touch of cold but you have an
appointment to attend a meeting and you don't want to go, you suddenly
feel your cold is serious and excuse yourself from going under that
pretext. But when you are going to see a movie that you look forward to,
you don't mind a slight cold at all. People feel guilty about simply
avoiding their distress, so they are likely to use their sickness as an
excuse. Especially people who have neurasthenia tend to do so. To avoid
reality makes life more and more difficult. It makes you believe that your
sickness is more and more serious. If you have an attitude that you are
sick whatever you do, you can't recover from neurosis.
8. Don't be obsessed with
ideals Work and study are different from play. They are
usually hard, therefore they breed genuine satisfaction. Nervous people
have strong desires and hope to work without feeling distress. If they
think in this way they are distressed more and more. They become obsessed
with their best condition as though it were their standard. They think
they must always be so. It means that their present condition is
unacceptable in comparison. They are always betrayed by the reality
because they want to be impossibly perfect. They want to feel no
nervousness when meeting others. They want no idle thoughts and no fatigue
when reading. They want always a clear head and cheerful feelings. Their
ideal is always in contradiction to their reality because they turn their
ideal into what must be.
9. Do have
confidence. Nervous people often have an inferiority
complex. They think that they are inferior to everyone in anything and
complain that they don't have confidence. Thus they don't try to do
anything. They tend to try after gaining confidence. That is why they
can't do anything. There is no need to have confidence to be able to swim
well at first. While you practice swimming without confidence, you will be
able to swim. Then you naturally gain confidence.
We usually do many things before gaining confidence. We are nervous and
uneasy because of lack of confidence, but we force ourselves to do them.
Thus we acquire our confidence. When you are at a loss whether to do
something or not, you had better do it without confidence. If it is
impossible for you to do, you don't even think about whether you should do
it or not. In such a case, when you are at a loss, it is usually possible
for you to do it if you can make effort. In this way you can acquire
confidence that you can do anything if you make effort., You can develop a
strong will to take risks. The only way to overcome your perfectionism
preventing you from taking risks is to go ahead and try.
10. Know what the truth is and
follow it The great Buddhist priests, like Honen and
Shinran, read through thousands of books in order to be spiritually
awakened, but they could not give up their worldly desires. So they could
experience that everything they did to give up their worldly desires was
worthless, and they made up their minds to devote themselves to the
Buddha. That is Ojyo. It means to know the truth and believe it firmly and
never yield.
It is not necessary to devote yourself to the Buddha. What you can do
is to make sure of the facts and to believe and follow them without
objection. No matter how we seek to be good, we have many delusions. We
can't tell others about evil and stray thoughts, crazy ideas and absurd
thoughts going hither and thither in our mind. Unless we are saints, we
can easily know that we have them inside. No matter how we hope to do
something actively, we have laziness, we want to avoid difficulties, to be
at ease. We sometimes feel weariness and fatigue. Though we may have a
mind that willingly goes ahead, it is true that we have many fears,
anxieties and doubts in our mind at the same time. The ability to memorize
and to understand, will power, joys, anger, sorrows and pleasures, they
aren't directly controllable.
Talking about our health, we feel daily that there is something wrong
with our body, for example, with our head, chest, abdomen or other organs.
An ideal is boundless, so it can never be achieved. There is no perfect
attainment of limitless desires.
As mentioned above, to make sure of reality means not only to admit our
faults but also, in a more positive area, to admit that we have limitless
ambition. Through our neurotic distress we can notice our real intentions
and ambition. We are afraid of being sick because we hope to be healthy.
The reason why we hope to be healthy is that health is important for us in
order to be active and improve ourselves. That is our real intention. The
desire to be active and to improve ourselves is our real intention so
illness phobia is just a word that comes from that desire. Because people
who suffer from nosophobia confuse the order of things, they seem to live
in order avoid sickness.
Anthropophobia is a sign that we want to be regarded as a good person,
to be considered important and to be loved. If neurotic people realize
that their anthropophobia is only a mental phenomenon they must understand
naturally that the realistic way to cure is to abandon their efforts to
get rid of their fears and to be loved. Other symptoms are the same. The
proper course for neurotic people is to stop worrying about trivial
details and to improve themselves by leaving trivial details as they are.
Ojyo is not to give up. It is to obey inevitable facts without resistance
and to do what we should do just as we are. I call it "positive
obedience".
11. Healing takes
time Some things can't be solved easily. If there is dust on
a desk, to wipe it at once is the solution. But we are unlikely to be able
to erase an impression we receive in our mind. Using the most familiar
example, we don't regret loss of 100 yen for long, but if we lose 1000
yen, we would regret it longer. And if we lose 10,000 yen, we can't forget
it easily. We understand this in theory but not emotionally. Because
regrets are unpleasant, we try to forget them at once; trying to change
the impossible into the possible, causing complications. If we leave
regrets as they are and don't try to erase them and do daily work
willingly, they fade away and disappear in the end without our noticing
them. If there are some regrets left, they aren't so troublesome.
Agitation, pleasant or unpleasant, fades away with the passage of the
time while being left as it is. . As people get older and gain more
experiences, we notice the fact and cleverly leave our suffering and
unpleasant things to the passage of the time. However some people try in
various ways to escape from present suffering. This effort prevents their
emotion from progressing naturally. Especially neurotic people tend to do
so. They concentrate on getting rid of the present suffering at once by
various means. They go against natural law. They don't know enough to
leave suffering as it is to the passage of the time. When we encounter
tragic events, such as the death of our parents or children, if we strive
to do daily work while sad, even if we can't forget, a year or two later
the strong emotion gradually fades. So most of our unpleasant feelings and
anxieties about small happenings in daily life disappear in a few days if
we let them alone. The more we try to forget something, the more we are
held by it. It is like people suffering from a phobia of noises. They are
annoyed by noises, even a clock's ticking. If they work while listening
openly to what they can hear, they are no longer annoyed by the noises,
even loud train noises. They must change their behavior and realize that,
like some children's diseases, these problems cannot be solved at once.
12.Treatment in a
hospital I treat people suffering from neurosis in my
hospital. There must be some people who get over neurosis by themselves,
but most of them can recover in a short time by treatment in a hospital.
Patients tend to be too free and too lax to carry out their treatment at
home even if they know the theory. Some people can understand the theory
simply by reading our books, but we can't expect all of them to do so. The
best treatment for neurosis was originated by the late Masatake Morita. He
was a professor of the Department of Psychiatry at Jikei Medical
University. I took over his work and treatment of neurosis as my life
work. Even we who have average ability can help many people suffering from
neurosis by Morita therapy, so I realize keenly how great his achievement
was.
At first patients start their treatment in a hospital with complete
bedrest for four days to one week. During that time, they do nothing but
eat, go to the toilet, and wash their faces. They gradually suffer from
boredom Many questions gush up in their mind, and they feel foolish. They
also have a desire to be active. While enduring without resistance these
many thoughts that naturally spring up, the suffering and worries, the
patients let things take their course. After finishing bedrest patients
start with light work and gradually do heavier work. They write a diary
every day and submit it to me. I read it and write my comments. I gather
the diaries in the daytime or at night every day and write comments of
general guidance and personal notes. The purpose of my comments is to
guide patients' lives as concretely as possible. By this means symptoms
which have lasted even many years are completely cured or remarkably eased
in about 30 days at the earliest, in about 70 days at the latest. If a
patient is completely cured, it means for him not only to be free from his
symptom but also to have a deeper awakening. So he becomes active, takes
the initiative and becomes a mentally healthy person. I usually apply this
special educational treatment for neurosis without medicines or physical
therapies. But I use electric shock treatment and extended sleeping
treatment in cases of schizophrenia or melancholia at first. If the
symptoms are eased, I then apply the educational treatment.
Some schizophrenia symptoms are similar to neurosis. They have
depression, loss of interest, no spirit, sluggishness, and insomnia.
Distinguishing between schizophrenia and neurosis should be left to a
specialist. Many cases of this disease are completely cured within a month
if psychotherapy is added to shock therapy and extended sleep therapy.
Almost all of the schizophrenic symptoms don't last over one year if
allowed to take their course. From this point of view, even though
schizophrenia is a serious disease, it is conveniently cured .
But these physical treatments don't work easily on neurosis. So those
of us who treat neurotics have difficulty guiding them. However, if
neurotics completely get over their symptoms, they never suffer from them
again. |