Sunday, November 11, 2007

One Man's Disorder

Notions of mental illness are, by and large, cultural in nature. One country's disorder is another country's socially acceptable behavior. In no case is this clearer than in the way in which alcohol is regarded in Japan as compared to western cultures. Outside of missionaries or Christian-related treatment programs, alcoholism as a disease does not exist in Japan for all practical purposes.

That is not to say that there are no Japanese people who are dependent on alcohol to cope with the difficulties of life nor those who would have a great deal of difficulty stopping their drinking. It is, by and large, the case that people who use alcohol to cope are not seen as having a problem. Drinking is such an important part of Japanese social culture that it'd be very hard to separate getting loaded and blowing off steam after work as a socially-sanctioned therapeutic choice from being a dangerous addiction to alcohol.

This is a fact that is constantly brought home to me any time the topic of drugs is discussed with Japanese people. Every person I have ever spoken with seems to fully believe that all drugs, from marijuana to heroin, are equally destructive and addictive. In fact, it's shocking how little factual information they have about cannabis smoking. It seems as if they've been shown "Reefer Madness" about a hundred times and embraced every word of it as scientific proof of the horrors of weed usage. Most seem to have no idea about the true effects of illegal, recreational drugs. Of course, many don't have any idea of the true effects of legal, prescription drugs either. This is one of the reasons birth control pill usage is so low. Doctors tell horror stories about their side effects to dissuade people from using them.

It isn't necessarily a shock that the Japanese are misinformed about drugs since all cultures are (at times) exposed to propaganda which they swallow whole depending on the zeitgeist it is presented in. The U.S. has been exposed to some pretty shaky proclamations in regards to security and people have been believing it since 9/11. You can get people to believe a lot of wild notions if they are fearful enough.

What is more shocking is the ignorance and lack of concern the Japanese have for alcohol and its effects. A student I spoke with this morning proclaimed that drugs were very bad for your health but alcohol had no ill effect on one's body. Given this, she felt it was fine that she drinks to relax. To be honest, I'm certain this student has had a drink on occasion before her lessons with me as I've smelled it on her breath on a few occasions. If this doesn't sound like such a big deal, keep in mind her scheduled lesson time is noon on a weekend day. When I told her that drinking alcohol kills brain cells and damages the liver, she had no idea that alcohol had such effects.

The situation in Japan regarding drugs and alcohol demonstrates something one doesn't often see when one does not stray outside one's native culture. That is the fact that all the information you get from your country's native scientific and media sources is skewed to suit the particular biases and prejudices of your culture. If your culture wishes to convince you one thing is bad and another is innocuous, it will tend to showcase evidence that supports this notion. If you look hard enough, you may find both are equally bad or innocuous but tend to reject that information because you agree with the bias and have a vested interest in believing what you want to believe is true rather than accepting objectively-obtained facts.

In the case of the U.S., this situation is best illustrated by the way marijuana tends to be regarded by non-users. European countries which have legalized pot would lend support to the idea that it isn't a horrific drug which will lead you down a path to harder drugs and a life of fuzzy-headed preoccupation with finding munchies and slacking off, but Americans tend to reject information that comes from outside their own country. On some level, I do wonder if all countries are aware of the bias applied to their conclusions but fail to discuss topics more objectively because they are comfortable with their bias and how it supports the rightness of their world-view.


For the record, I'm not endorsing marijuana consumption (or alcohol or anything). Personally, I've never consumed an alcoholic beverage nor used any sort of recreational drug and have no basis from which to draw conclusions other than experiences related to me by others and information I've read.


Miko said...

Your student might be what is known as a "kitchen drinker" although I'm not sure how this term came about - I think it was the title of a book.

Some of my friends have recoiled with horror upon learning that I used to take the Pill, not because they regard it as immoral, but because "it's really bad for your health, everybody knows that!" They are astounded to learn that it is prescribed even to teenagers in NZ. (On the other hand, I was astounded to learn that some Japanese women regard abortion as a handy form of birth control - moral issues aside, that surely cannot be good for the health, either.)

What do doctors in Japan have against the Pill, though?

James said...

I agree that alcoholism often isn't treated with the seriousness it probably deserves over here.

There are notable exceptions though, such Prince Tomohito bringing attention to the problem of alcoholism by sharing his own personal experiences with the public.

Luis said...

Let's not forget about smoking and nicotine. While numbers are declining, they are still higher here than almost every other industrialized nation.

Shari said...

Miko: I'm not sure if she's a "kitchen drinker" but I do believe she sometimes comes to lessons after knocking back a few. Sometimes she's incredibly unfocused and stumbles through the corrections and practice. Her situation is not a happy one and I think this may be something she does to cope or I could simply be mistaken.

I'm not certain why doctors won't recommend the pill. Cynical people claim it's because they want to keep their lucrative abortion business going, but I can't say if that's true because I don't know what sort of profit such procedures bring when compared to forcing someone to come back every 2 months to get a check-up and a fresh prescription. I can't imagine there's more profit in an abortion compared to "required" visits coinciding with taking the pill (Japanese doctors are notorious for stringing out visits and requiring re-visiting to get script renewals).

Personally, I've always felt it has to do with keeping control of reproduction out of women's hands or at the very least it's a way of keeping men in the loop of the situation. For all I know, it's also an attempt to encourage a boost in the birthrate. One of my students is married to a doctor and I'll try to remember to ask her about this some time (the topic doesn't usually come up).

The pill is "bad" for you (though it really depends on risk factors that not all women share) so the doctors aren't lying but abortions are worse, particularly repeat procedures.

James: I had forgotten about the announcement made by Prince Tomohito and I appreciate your mentioning it. At the time of the announcement, I recall thinking it might open up a new era in Japan if a royal person admitted such a thing publicly but nothing much ever came of it. I wonder if the Japanese see the royal family as being under so much stress that they develop atypical problems or if they just aren't interested in them.

There's an interesting snippet about the number of beds for dealing with alcoholics and the cathartic role alcohol fills in Japanese society in the Canadian Medical Association's Journal .

Many thanks to both of you for your interesting comments!

Shari said...

Luis: While smoking and nicotine are certainly addictions in Japan, they're in a somewhat different category because they aren't used in the same manner as drugs and alcohol as a form of escaping one's stress or pain.

Also, addiction to cigarettes isn't treated in special facilities and, while it can make you sick, it doesn't result in relatively immediate and chronic problems living a normal life. Cigarette-related problems mainly come at the end of the cycle when a person develops a terrible illness.

While I agree with you that they're problems, I just figured I'd explain why I didn't include them in the post.

Thanks for commenting!

Emsk said...

Hi Shari, it's Emsk. It's been a while since I've checked up on your blog and I've just spent an enjoyable hour reading away. I'm now in Kokura in Kyushu and when I can I will update my own blog, but right now I don't have internet access at home.

Great subjects as usual here. Last week we had a day off on Saturday because of a national holiday, of course, and I took a detour home to get a feel of my new town. I don't know how I missed all these drunk salarymen before, but I spotted several lying on the sidewalk while their co-workers geed them on. Saddest though was a thirty-something man in tears on another salaryman's shoulder. By Monday morning it was all probably back to normal and brushed under the carpet.

One of my best friends died of acoholism a few years back at the age of 37, so this is not something I take lightly. All of us tried our damndest to help him, but the disease won out in the end. I find it very disturbing how this destructive disease is treated so lightly as well as the bullying of so-called subordinates to join in the 'fun'.

Chris ( said...

The Pill has only been legal here since late 1999 - notably after Viagra got approved.

So it is still *relatively* early days and there is still a lot of misinformation. But clearly the government and medical profession are not pushing the issue, and in many cases are actively discouraging take-up. The health ministry has said on frequent occasions that it believes widespread adoption of the Pill would lead to an increase in HIV infections, as well as raise the environmental threat from estrogen contamination.

I'll leave you to speculate on the degree of misogyny behind their reasoning...

Shari said...

Emsk: Hi there. It's good to hear from you again. Your comments were very much missed! I'm glad to hear you are gainfully employed in the current (perhaps difficult) job market.

I definitely feel you pain on the alcoholism front. My father is an alcoholic and all of the fathers of the kids I grew up with (my father's friends) are now dead due to alcohol-related illnesses. I believe my father is one of the last two standing of a group of men who drank a lot. I think it's a terrible, terrible disease.

Chris: The issue of HIV in Japan is one I've done some research on and it's absolutely a crock on that front in regards to discouraging use of the pill. Japanese people don't diligently use condoms. In fact, they tend to use them regularly but fairly haphazardly, particularly when a committed couple is involved. A lot of them use the rhythm method and only use condoms during "dangerous" times in a woman's cycle. There is also a perception that sex with a Japanese person is "clean" and condoms are not necessary all the time. Condoms only are effective against HIV if they're always used. Given the information I've found, I believe that they are only used consistently when someone is with someone they feel is risky or when the risk of pregnancy seems high.

I don't know about the environmental threat of estrogen contamination issue. This would seem to be a legitimate concern but, if that is the reason, that's what women should be told. They shouldn't be told it's dangerous to their health.

The fact that Viagra was given the green light before the pill is a good indication of the underlying sexism in regards to these issues. I don't believe that the policies are misogynistic but paternalistic and a desire to keep women subordinate to men.

tornados28 said...

Like many things in life, there are different levels of risk etc. The same with drugs. Of course some drugs are not going to be as dangerous or unhealthy as others. No one can say that marijuana is as bad as crack or meth.

Also, with most things in life, it is a matter of moderation. With alcohol, if it makes you relax and enjoy yourself, as long as it is within moderation, then there probably is nothing wrong with it.

Shari said...

tornados28: I absolutely agree with you about risk and moderation. Unfortunately, not everyone is wired for moderation in regards to particular substances. You just don't know how you're going to react to a substance until you've sampled it and it's too late.

The main reason I never touched a drop of alcohol (and never will) is that having an alcoholic parent showed me what it can do to you and I will not risk that kind of addiction for the sake of the pleasure alcohol consumption might bring. It's simply not worth the risk.

I know a lot of people believe it's all about "will" but I strongly believe that really isn't the case. Just like some people eat a food and love it to pieces and others are indifferent or hate it, some people's brains react to alcohol and other substances more strongly than others.

Thanks to everyone who took the time to make such excellent comments!