Dr. B. Rudolph
December 15, 1999
Naikan Therapy Defined
The man responsible for the development of Naikan Therapy is Mr. Ishin Yoshimoto. Mr. Yoshimoto developed Naikan therapy as a short term structural treatment that is useful in treating marital and familial conflicts, interpersonal relationship issues, depression and anxiety, self-esteem issues, behavioral disorders, and addictive behaviors (Ramaswami & Sheikh, 1989, p. 106). Nakian translates to mean ‘to look within one’s self. The purpose of Naikan therapy is to increase awareness of oneself as well as acceptance without becoming judgmental (Walsh, 1989).
Naikan therapy was developed in the 1950’s with its roots being maintained in Buddhist philosophy and practice. Similar to Morita therapy and other Asian therapies, Naikan therapy’s main focus is primarily on transpersonal and existential levels and relies very little on pathology. In Japanese Nai means inner and Kan means observation and introspection. It is believed in Japanese Buddhist philosophy as well as Naikan therapy that personal problems and dissatisfaction with life issues or often between a person’s ideal self and their actual self (Walsh, 1989, p.547).
Naikan Therapy Process
Naikan therapy hopes to allow the individual to realize that they have a responsibility to how they relate to other people and their environment. In order to do this; Naikan therapy combines meditation and Buddhist therapy models to fortify western psychotherapy models. It does so in the following ways, “ 1) by offering insight into
self-defeating behaviors by focusing on them and exaggerating them; 2) by severing the tight grip of thinking on behavior by retraining attention; and 3) by producing an integrated hypothalamic response that decreases sympathetic activity” (Ramaswami and Sheikh, 1989, p.109). People using the Naikan therapy approach are assisted in letting go of selfish attachments and guilt that accompanies living a self-centered life. The therapist’s role is to carefully guide the client on introspection and recollections the client’s share with the therapists. These recollections focus on what was received from significant others in terms of services, gifts, kindness and other objects, what has been returned to significant others in life, and what troubles, inconveniences, deceits, pettiness and other selfish things that happened with these significant others (Ramaswami & Sheikh, 1989, p.108). Naikan therapy’s main goal is to have clients recognize their responsibility to the people in their life as well as to the environment surrounding them.
The Naikan Therapeutic Process
Traditional Naikan therapy consists of two parts: immersion and counseling.
Immersion takes place where a person can be isolated. The client will sleep and eat alone and undergo training in meditation techniques. Meditation may last from 4:30 a.m. until 7 p.m. Clients receive visits from their therapists and different times during the day that will typically last one to two hours. The purpose of these visits is to further instruct them on meditation and to hold dialogues with them concerning introspection and reoccurring life themes. For example, clients can explore desires that block constructive living, such as dishonesty, negativity, and blaming. It is important that therapists show honor and respect to their clients and consistently reinforce their ability to solve their own problems.
To show honor and respect and to offer empowerment to the client, the therapist will…”bow his or her head to the floor, open the folding screen, bow again, and ask what topic the client is focusing on for that current meditation. This ritualized format symbolizes the therapist’s humility as he are she prepares to listen to the client’s confession. The client’s response is similarity in ritual form. He or she reports the person and time period of his or her recollections (Reynolds, 1982, p.47).
Approximately 20 percent of the time the client spends meditating are spent on what significant people in their lives have given them and what they have returned. 60 percent is spent on the trouble or inconveniences that they have caused to their significant others. The most common theme that occurs during meditation is the relationship between the client and his or her parents. Since a person’s relationship base is strongly influenced by parents, this theme is often discusses early in therapy. One assumption of Naikan therapy is that people, as they grow up, often develop distorted personae and/or destructive patterns. Traumas and past failures cannot be forgotten or undone but it is possible to change a client’s attitude. Naikan therapy tries to restructure the thinking patterns of clients. Naikan therapy also tries to give clients a moral structure for living based on the Buddhist principle of ‘giving. Clients work from past to present, sharing their ideas about past events. During the first week of therapy, the client shares their past experiences with the therapist while the therapist listens without commenting.
This process, besides meditation, includes, rephrasing, recasting, and reflecting any statements the client makes. Only when the therapist has a thorough understanding of the client’s issues, will he or she begin to interpret and guide their client.
According to Reynold’s (1982) the therapist “…directs the client away from abstract or vague descriptions of past events and personal suffering. The goal is [for clients to use]
Concrete statements about specific personal experiences” (p.48).
The second part of Naikan therapy, counseling, consists of weekly or monthly visits to therapists to report the activities they have participated in and the results of their meditation. Most clients and therapists use journaling as a way to generate client/therapist communication. A therapist also employs homework assignments consisting of ‘doing good deeds’ and saying things that show appreciation. Reynolds (1989) also describes how a client must also consider how objects as well as other human beings (p.191) serve them. Since Naikan therapy’s goal is to reach a higher consciousness, an ability to practice daily meditation at a constant place at a constant time is vital.
Naikan Therapy in a Western Approach
In Walsh’s book, he illustrates the use of Naikan Therapy in a western context
With a 35 year old man trying to come to grips with a relationship breakup.
“’M’ came to therapy with the desire to reduce stress and
overcoming a generally “blue feeling”. ‘M’ reported that
he felt a great deal of anger, yet even after expressing his
anger, he felt “stuck”. After explaining the Nakain form
therapeutic intervention, ‘M’ was invited by the therapist
to share his feelings. He talked for over an hour about his
state if mind and how he thought he had been coping. The
Therapist listened and asked only clarifying questions.
The therapist’s sense of ‘M’’s condition is personified
In ‘M’’s imagery of how he saw his life. ‘M’ described
His existence as: “Going down the road of life, minding
My own business, and being attacked by colleagues
who disagreed with me. The viciousness of their
attacks was a real surprise and I felt myself being
knocked down in the mud. The sorrow of their attacks
seems to have somehow paralyzed me… I don’t feel like
I can get up, yet I see the usefulness of staying and
wallowing in the mud.”
After the client had mastered the skill of meditation, the therapist concentrated on the significant relationships in the client’s life whether they are positive or negative.
This particular client chose to work on his relationship with a colleague who he felt was attacking him. Instead of concentrating on the negative aspects of his relationship with the colleague, he asked to focus on what he had learned in the encounter with that person.
The client found it difficult to concentrate on the positive parts but he was able to list accomplishments and what he had learned about himself.
Counseling with the basic strategies and philosophies remaining the same followed the basic Nakian approach. In consistency with western tradition instead of interpreting the client’s issues for him, the therapist let the client come to his own meaning (Walsh, 1989).
I think that Naikan therapy has several strengths. For one, the use of meditation can be carried over for non-therapy reasons. Day to day stress relief, spiritual cleansing and other reasons that may remain personal. The authors state that Naikan therapy has its basis in the existential camp, but it is also cognitive-behavioral and in that way can be made to be conducive to the Western psychotherapies. Second it takes the focus away from “I” and transfers it to “you, it, they, them, environment”, this enables the client to escape detrimental patterns.
Another strength is that it is a short- term therapy and this makes it more attractive to individuals seeking counseling. The idea of long -term counseling may dissuade potential clients from seeing a therapist.
A major weakness that I find with the Naikan therapy is the amount of time spent in immersion. This leads me to believe that this therapy will only be beneficial to individuals who can afford to devote that kind of time to meditation.
The sources that I read did not offer any indication that this therapy was used for people with different affectional orientation, people of African-American, or Latino ethnicities. There also was no evidence that people form a low SES background were given Naikan Therapy. So far Naikan therapy has been mainly focused in Japan, Germany and Australia, there is however a Naikan therapist in California.
The interviewing skills that are necessary for Naikan therapy, rephrasing, recasting and the reflecting of client’s ideas. This means that good listening skills are needed as well.
I like this therapy because of the use of meditation. By tradition, the western culture is in a perpetual state of motion and learning the skill of meditation we can learn to slow down and concentrate. It also appeals to me because it teaches you to be more aware of the other people in your life and to pay attention to your environment. America is the home of the “I” philosophy…. I this and I that, etc. Naikan therapy forces us to focus on the others.
There was no research supporting the effectiveness of the theory. Some information was available in Ramaswami’s article but it was unsubstantiated and not clearly described.