1.Thoughts behind Morita therapy
The Morita therapeutic method is grounded in a philosophical perspective on the human experience, positing that anxiety and the fear of death form a foundational basis for all neuroses. Humans are mortal, with limited lifespans, and must inevitably face death. Consequently, death and its associated fears are intrinsic and universal to the human experience and existence. Yet, on the other side of this fear lies a fundamental desire for life and the pursuit of a meaningful existence.
The understanding that the fear of death and the desire for life are two sides of the same coin—and that both are intrinsic to human nature—is a defining characteristic of Morita therapy. In other words, the same mind that harbors anxiety and fear of death also holds a desire to live a constructive life. Actualizing this desire allows us to improve and progress as individuals.
Neurotic individuals share the same natural fear of death in their psychological makeup as anyone else. However, they often make desperate attempts to eliminate this fear, and it is this effort to override the reality of fear that gives rise to inner conflict. The Morita therapeutic method helps patients learn to accept fear and anxiety about death as they are, without trying to deny or suppress them. It aims to free the mind from 'psychic interaction' (a fixation on unpleasant thoughts and sensations) and encourages patients to abandon efforts to alter their emotional state. The idea is that when the mind is freed from fixation and flows naturally and spontaneously, people can better realize their desire to live.
2.Fundamentals of the Morita therapeutic method
Techniques for shifting a patient's attitudes regarding anxiety are the bedrock of Morita therapy. This concept is encapsulated in the term arugamama, which means accepting things as they are. In the Morita understanding of the etiology of neurosis, patients fight against their anxiety in an attempt to eliminate it, which often exacerbates its prevalence. The Morita therapeutic method encourages patients to give up this struggle and reorient their attitudes toward accepting anxiety as a natural part of life.
When we speak of arugamama in the context of leaving symptoms as they are, one might perceive overtones of endurance or submission. However, as practiced in Morita therapy, the nuance of arugamama is more active and empowering than mere resignation. It serves as a call to take positive action based on the desire for life that exists on the other side of anxiety, aiming for a full and meaningful existence. Thus, the second fundamental principle of Morita therapy asserts that after accepting symptoms as part of one’s self, patients must take action toward constructive living.
In that spirit, the ultimate goal of treatment is not simply to find ways to prevent symptoms but also to motivate patients to work toward greater psychological growth and development.
The section that follows outlines the basics of the Morita therapeutic method. For the sake of convenience, these elements are divided into inpatient and outpatient categories.
Fundamentals of inpatient Morita therapy treatment
It is crucial for patients to recognize that anxiety is a natural human experience and that a strong desire to live, improve, and progress exists on the other side of that anxiety (i.e., anxiety and desire are two sides of the same coin). The desire to live a full life is the true source of their distress; without this desire, there would be no anxiety. Most importantly, they need to achieve an experiential understanding of this reality. Thus, Morita therapy encourages patients to stop struggling against their anxiety and fear of death and instead engage in constructive activities that fulfill their true and healthy desire for life.
The benefit of shifting attention from symptoms to action can only be realized by actually taking that action; the process cannot be fully understood through intellectual insight alone.
Inpatient treatment provides an important setting for the action and activity that Morita therapy patients need. Residential inpatient care is appropriate for patients whose conditions are severe enough to interfere with their daily lives in a normal environment. Examples include individuals with panic disorder who find it challenging to leave home or use any form of transportation, those suffering from a fear of interpersonal relations who feel unbearably uncomfortable in public, and patients with obsessive-compulsive disorder who spend hours each day engaged in checking or hand-washing rituals. Additionally, certain outpatient clients who have been unable to engage in a wide enough range of productive activities in their outpatient setting may seek inpatient care.
Fundamentals of outpatient Morita therapy treatment
Recovery is possible outside the formal outpatient structure. Self-study methods, such as reading relevant texts, using workbooks, listening to lectures, and participating in interactive workshops, can help build an understanding of Morita therapy. However, even with an intellectual grasp of the underlying theory and practice, it can be challenging to leave one’s anxiety alone and increase the range of experiential activity to a therapeutic level.
Outpatient therapy is designed for patients who function well enough in society that residential care isn’t necessary but who require a setting where they can learn Morita therapy experientially, as intended.
In outpatient therapy, diaries and other observations of the patient’s daily life serve as the basis for a series of questions that help clarify the issues the individual is facing. For example, a therapist might begin by asking, "What is it that you'd like to improve?" This could be followed by forward-looking questions, such as "What would you want to see happen that would make these things better?" or "When things do get better, what will you do? What kind of person do you hope to become?”
Most people think, 'I’d like to relieve my distressing symptoms,' when they answer the first question. However, it is crucial for the therapist to help the patient begin to shift their focus from symptoms to desires at this point. Rather than concentrating on their current condition, therapists encourage clients to envision a scenario in which their condition has improved, thereby directing their attention to their true desire for life after recovery. They then ask what actions the patients want to take to achieve that vision. In short, treating psychiatrists guide patients to discover and act on the desire for an active, constructive life that has been hidden beneath their symptoms. This is an essential element of therapy because it fosters the awareness that anxiety and desire exist in counterpoint within the mind, indivisible in their correlation.
As they look forward, individuals with shinkeishitsu (neurotically anxious) personalities demonstrate a characteristic thought pattern. They tend to lose sight of their true objectives, instead focusing on the means or necessary conditions to achieve them. In this way, the means become the ends. Sleep disorders serve as one example of this phenomenon. Insomnia reflects the need for restoration to a sharper mental state, with the ultimate objective being better performance in work or studies. While getting sufficient sleep is indeed a necessary condition for the body to repair itself and achieve maximum performance, individuals with shinkeishitsu personalities become intensely preoccupied with sleeping itself, which is merely a mechanism for improvement. Unfortunately, they often find that the more they will themselves to sleep, the less sleep they actually obtain.
Thus, simple symptomatic relief should not be the goal of treatment. In Morita therapy, it is vital to help patients free themselves from fixation on symptoms and move toward the true objective of restoring themselves to healthy lives.
▶ More on outpatient treatment HERE