Wards are sometimes locked 24 hours a day. Access to telephones and other means of communicating with the outside world are severely restricted. Day to day patients are “totally controlled”. “Treatment” is equally primitive. Electric-shock therapy is sometimes used to calm or punish patients, as are isolation rooms.
You’d think that this is a quote from a post about Psycho-Pass’ world. The truth is that those are the words of Dr. Fujisawa, as an article in the Economist back in 2001 transfers them. And of course they refer to Japan. The conditions in mental health care establishments there is even nowadays questionable in most cases – what with cases of violent behavior towards the patients being leaked in the newspapers. The mentality that Asians have about mental illnesses doesn’t help people facing such problems either.
Episode 12 of Psycho-Pass was highly discussed for clumsily sticking out of the rest of the narrative and yet it did something right: it allowed us a glimpse behind the closed doors of the so called rehabilitation institutes. It also gives me the chance to discuss mental health care during the ages, through Socrates and Plato, as well as in modern day Japan.
“Psychotic people” are often the subject of curiosity, excitement, and ridicule, among healthy people. They are not considered to be fellow human beings but some kind of creatures from another world who occasionally appear in front of us. There seems to be a transparent curtain that divides healthy and mentally ill people. Most healthy people see the world of mental illness as irrelevant to their lives. – Soda Kazuhiro
The handling of mentally ill people was very cruel in most cases until the 20th century. In primitive societies in such cases that were accompanied by headaches or epileptic crises an operation was perfomed where a circular area of the skull was cut with a sharp stone tool in order for the evil spirit to escape and vanish. Written testimonies by Chinese, Agyptians and Greeks reveal that mental disorders was demons’ work that had possessed the person. Therefore the main therapy was exorcism, an effort to extract the spirit from the body through prayers, spells, whipping, starvation, cathartic etc.
During the 4th and 5th century B.C. Hippocrates claimed that it wasn’t God that harmed the body, but the illness. As an early scientist he defied mythology and acted upon logic. He concerned himself with mentally retarded and psychologically ill individuals. He diagnosed, studied and researched the cause of the problems, applied therapies with miscellaneous medicines and the results he reached at are impressive even for our age.
In the Roman ages ‘specialists; like Celcus suggested ‘therapeutical’ methods like the shaving of the head, locking up the patient in dark rooms, the use of drugs, blood letting etc. Half the way through 1st century B.C. Asklepiades opposes these treatment, since he believed in that they should be treated like human beings, and suggests hydrotherapy, massage, sunbathing, exercise and abstaining from meat.
Middle ages were of course very tough since the emotionally disturbed person is seen as Satan’s possession more than ever. In December 1484, Pope Innocent VIII intensified the hunting of heretics. He wrote a guide, according to which thousands of hundreds people with emotional disorders and other disabilities were recognized as heretics, they were tortured and burnt to death in front of the masses that showed no sympathy. In the 16th and 17th century philanthropy and scientific curiocity slowly upturn the tables. French Revolution sets a milestone by opening people’s eyes and hearts and disabled people were recognized of their human rights.
In the beginning of 19th century doctors still emphasized anatomy and physiology, while considering mental disorders a result of some brain illness. Thus they continued denying the psychological interpretations of emotional disturbances and rejecting psychotherapy. Things started changing with the intervention of great educators and psychologists like Freud, Dorothea Dix and Ferrus. The notion of the ‘special’ child arose together with Special Education and the state’s responsibility to protect it.
In the 20th century the developments in this area were rapid and hopeful. Tests were created for diagnosis and schools along with curriculums were built in USA, Germany and France to help children with mental disabilities. It’s the WW I & II that contributed positively to the research of both causation and understanding of impairement due to the obligatory examination of soldiers’ mental health and the return of those who survived the war.
[Translation and slight modification from the book: Children and Adolescents With Special Needs and Abilities – Modern Trends in Education and Special Support, Volume 1 by Polychronopoulou Stauroula, Athens 2003]
Plato about mental diseases and music and how these tie to Psycho-Pass
Psycho-Pass is a series that has a quote fetish. Among the prevalent philosophical and literature figures mentioned, Plato is a reoccuring one. He is a very well known ancient Greek philosopher and many think highly of him, but the tough truth is that he wasn’t much of an angel. He surely went through a lot of things in his life, having witnessed the failures of both democracy and oligarchy, yet what he describes in his work Republic is quite totalitarian and harsh and not much better from what he experienced.
Socrates imagines a class society where everyone does what (s)he knows best. He talks mainly with Glaucon and Adeimantus about the ideal city-state. When it comes to people with physical disabilities Plato says through Socrates that “the offspring of the inferior, or of the better when they chance to be deformed, will be put away in some mysterious, unknown place, as they should be” because the “breed of the guardians is to be kept pure” (460c). I don’t think that people with mental and psychological problems would be treated somehow kinder, since they would be unproductive and unstable according to such an utilitarian society.
How the episode ‘Devil’s Crossroads’ ties in with Plato, you may ask. Not only do we see how people with detected clouded hues are treated as some pesters, being sprayed and their requests ignored, but we also hear the explanation that Ginoza gives Sasayama as to how Yayoi, who was a guitarist approved by Sibyl, ended up in a ‘rehabilitation clinic’. In Republic a shameless flat-out discussion about cencorship in poetry and music takes place, and the emphasis is given on trying to build a strong moral and psychological compass for both men and women:
We must begin, then, it seems, by a censorship over our storymakers (377b-c) […] speakers and poets will be required to conform, that God is not the cause of all things, but only of the good (380c).
“What, then, are the dirge-like modes of music? Tell me, for you are a musician.” “The mixed Lydian,” he said, “and the tense or higher Lydian, and similar modes.” “These, then,” said I, “we must do away with. For they are useless even to women who are to make the best of themselves, let alone to men.” “Assuredly.” “But again, drunkenness is a thing most unbefitting guardians, and so is softness and sloth.” “Yes.” “What, then, are the soft and convivial modes?” “There are certain Ionian and also Lydian modes that are called lax.” “Will you make any use of them for warriors?” “None at all” (398d-399)
Art is to be tampered with because it can influence the soul; the same thing happens in the anime series with your Psycho-Pass. Many non-democratic regimes have tried to hash certain types of music and certain songs that spoke of rebellion, riots, freedom and anything relevant. They don’t want people to get ‘drunk’ with ideas and emotions that could upturn the status-quo. I get the sense that Sibyl chose not only the gifted but the ‘obedient ones’, too. That could be the reason Rina, Yayoi’s romantic interest, was unauthorised -she was quite a wild spirit- in contrast with Yayoi herself -who only sought enjoyment with people she admired and cherised, and didn’t aspire big things.
What it means to have mental illness in modern Japan
What I totally forgot at first, blinded by hopeful assumptions of progress, was the social context of the creator of the series, who is of course Japanese. When I did a quick internet search I realized how wrong I was to believe that since Japan has been westernized in a lot of her aspects, mental patients wouldn’t face mistreatment. You already took a taste at the beginning of this post. Until as recently as 1987, patients with more severe emotional problems could be institutionalized against their will under the “Mental Hygiene Law.” And I wonder in what extend things have improved today.
Asian people seem to deeply believe that effort is everything. They deny the western beliefs about IQ and anything that is inherent. If there’s a word representing Japan, that is ‘ganbatte’ which roughly translates to try, endure, aushalten. This idea permeates everything including someone’s health condition. They don’t accept, for example, that depression is something real, rather that people suffering from it were simply weak and couldn’t perservere enough.
Feeling depressed? You’re not working hard enough. You’re not focusing enough. You’re not managing yourself well enough. (Oh look, something that we see in Psycho-Pass with managing one’s hue.) You’re lazy and using it as an excuse. ‘Cause that’s the thing – “The loss of mental self-control is essentially seen as something over which the person is unable to exercise will power. Japanese are socially programmed to feel a sense of shame if they lack this will power.“ (source: Kairos at The Midnight Channel)
Moreover, Japanese feel the pressure to not only keep going no matter the circumstances, but they are also are supposed to let some steam off only in private to very close friends and family. Otherwise it’s considered very shameful to let your true feelings in public- this is the concept of honne and tatamae. Society and societal bonds are prioritized. The individual’s problems aren’t society’s problems necessarily and everything should be kept the way they are and appear. Standing out is frowned upon. Speaking about your feelings and problems both disturbs the established ‘peaceful’ environment and is perceived as a selfish desire to take the spotlight with your ‘weirdness’.
As Kairos points out, this stance is very evident when Yayoi says to a girl to cry about her friend’s death away from the Sibyl’s cameras and while she can, not to let herself pile stress and be labeled as ‘problematic’. It pops up again later on with Ginoza, when his councilor advices him to talk to someone close to him, because his Psycho-Pass started rising dangerously due to stress, all the while trying to hold up a facade towards his subordinates that nothing suspicious is going on.
I’ll close the post with more words from Soda Kazuhiro, someone who after having experienced depression himself decided to make a film, ‘Seishin’, to record life inside a small mental health clinic in Okayama Prefecture.
In the case of the woman I talked about, in the news she would just be portrayed as an evil mother — it’s always black and white,” he says. “But if you listen to the stories of some of the people involved in these things, it’s not that simple… Demonizing people doesn’t solve anything. In a sense, I want to provide an antidote to that kind of attitude. It wasn’t my purpose when I started filming, but I am hoping this film will show that these people are human beings and they are vulnerable. We are all vulnerable and need support. If somebody was there to listen to these people, maybe some of the crimes wouldn’t happen.