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Having trouble wrapping your head around Japan? Help with mental health is at hand

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Special To The Japan Times

Adjusting to life in an unfamiliar society and culture can be a formidable undertaking. Comparing my first couple of years here with the two that followed, the difference was like having a FastPass at the coolest theme park ever built, only to wake up one morning and discover that you were one of the themes at that park. It took some doing to make peace with that fact of life here.

Fortunately, though little did I know at the time, my blogging was acting as a sort of valve that kept me from blowing my top, as well as kept me active in a community, albeit a virtual one. But those who don’t have an outlet can find themselves suffering in silence and isolation. And this is just one of many issues that can have a catastrophic effect on individuals, couples and families living abroad.

Black Eye has spoken with a couple of professionals trained to help and/or offer guidance to people going through the various adjustments that come with acclimating to a new environment.

Kisstopher Musick, an American with a 30-year career as a psychologist and therapist, believes “everyone deserves to have more good days than bad,” and has dedicated her life to just that. For 15 years the California native led a group practice in the U.S. before moving to Japan with her husband and son in 2007, and proceeded to pick up where she left off.

“My husband has his doctorate in mathematics from Nagoya University,” says the 47-year-old Musick. “He wanted to study knot theory, a type of topology. All the world’s leading knot theorists are here in Japan. So that’s what brought us here.”

When she first arrived in Japan, Musick taught English to supplement her income while studying for her masters in psychology, then set up a practice, determined to resume her career here in Japan.

“I began by working with individuals who were shut-ins,” Musick says, “a condition known as hikikomori — basically, people who have withdrawn from society and from life. I was looking at the intersection of language and how that can give us a new identity, and how possibly pursuing English study and taking on a different persona might help people who were shut-ins re-enter the world. Then I started working with families, children and couples, and my practice grew from there.”

I shared with Musick that, though I had convinced myself that I did so for the sake of my writing and for the sanity-preserving perks of avoiding being unnecessarily in the midst of Japanese people — where I was subject to some intense scrutiny, unwarranted fear and irksome ignorance — at various periods in my years here, I too have suffered from what might be classified as a modified form of hikikomori. But, to my knowledge, in this country, this condition is thought to be fairly exclusive to Japanese.

“I have counseled foreigners who are at an early phase of hikikomori,” she says. “But it hasn’t fully manifested itself where they’re beginning to withdraw from society, from work and such. And I’ve helped them to re-enter into the mainstream again. I went through very severe culture shock myself when I moved here, so I know from my own experience as well as my training how it can reverberate through every aspect of your life. But sometimes it’s just a matter of finding that one turnkey moment that can turn things around.

“But I don’t focus on any specific kind of disorder,” Musick says. “I work with every kind of disorder you can think of. It’s a really well-rounded general psychology practice that focuses on wellbeing. I love living in Japan and I have a real passion for it, and I think everyone should have the opportunity to live their best lives here, whether they’re Japanese or not.

“I even work with a lot of Japanese nationals who lived or studied abroad and are having a lot of trouble with the repatriation process and experiencing culture shock. When they come back to Japan they don’t feel Japanese. Turns out, the story the world has given them is not their story, but everyone expects them to be good Japanese when they don’t really fit that mold.

“But we don’t have to be what the world tells us we are,” Musick stresses. “We can define ourselves. So I help them get to the root of things and find their tribe and their space and learn to enjoy life again in Japan. However, some people simply can’t make it work here, so I aid them in transitioning out of Japan and help them re-expatriate and learn to live biculturally.”

Musick’s practice is called Adjustment Guidance. Using a client-centered talk therapy approach grounded in compassion-focused therapy, her practice involves listening to the client’s needs, identifying what the barriers to happiness are, and developing the tools and techniques to overcome obstacles.

Back when my struggle to identify and overcome obstacles could best be described as an ordeal, I did hear of a service called TELL Lifeline that might be worth a call. But I didn’t make that call. A comedian once said that black Americans would sooner self-medicate or faith-heal than seek professional help, particularly when it comes to mental health — not necessarily out of ignorance, but out of a sordid tradition of being denied or distrustful of such services and learning to make do, the mental health equivalent of making soul food out of scraps from the big house.

But after speaking with Najwa Waheed Naohara, an American serving as outreach coordinator at TELL Counseling, I feel compelled to use my humble platform to broadcast the fact that services are available for those who might be in need but not in the know.

“TELL is an NPO that supports the mental health needs of the international community,” says the Atlanta native. “Whether the client is a foreigner or a Japanese who speaks English doesn’t matter. Here in Japan there are loads of resources for those who speak Japanese — like the FIND (Federation of Inochi no Denwa) suicide prevention line — but there are very few for English-speakers. TELL was started way back in 1973 to address this need for mental health support in the foreign community.

“Initially the majority of the calls to the crisis hotline were from foreigners living here, but that has changed. Now you have more Japanese who are experiencing life abroad, but once they’ve returned to Japan feel like they no longer fit in, or feel isolated, and many of these people feel more comfortable discussing their issues in English than in Japanese. Nowadays, 60 percent of the callers to the TELL Lifeline are Japanese nationals. So ultimately we serve everyone.”

Naohara has been living in Japan off and on for 21 years, and working with TELL for the past three, and in that time has focused her efforts on awareness-building and changing the image of TELL.

“My job is to keep in touch with the community, to find out what type of mental health issues are out there and how TELL can help address those issues,” she says. “We have both a free confidential, anonymous lifeline, and we also offer face-to-face counseling services for a fee, which are conducted by professional licensed therapists and offered on a sliding scale based on income. There are also distance counseling services available for certain issues for adults who cannot come to the TELL Counseling offices in Tokyo or Yokohama. It’s a service that can be used via phone or Skype.

“As outreach coordinator, I go to the schools and I conduct workshops,” Naohara explains. “An example of the type of community outreach we do is our Exceptional Parenting Program, which offers a series of free workshops throughout the international-school year — workshops that touch on topics that are relevant to educators, parents and others, like teen depression, cyber-bullying, eating disorders and helping teens manage exam stress.”

I was very impressed that the Japanese government had taken such a keen interest in the mental wellbeing of its non-Japanese residents, to the extent that it was funding such a program. But Naohara informed me that I was mistaken big time.

“The existence of TELL is nothing short of a miracle,” she says “We have received zero support from the Japanese government, which is interesting because we are supporting both the Japanese and the international communities.

“It is so ingrained — this image that TELL is just a service for wealthy expats living in Minato Ward of Tokyo and connected to an international school — when actually, TELL is here for the JET Programme participant, young people who are studying abroad in Japan, for the day laborer, for any and everybody. I consider it part of my mission to change that image.

“I think perhaps the government thinks it’s just a foreign thing and it’s not really serving Japanese people,” Naohara says. “A lot of Japanese people think if you’re foreign, you’re only here short-term. But they’re not really thinking about the people who have made Japan their home and need the same kind of support as anyone else who is living somewhere long-term. We’re currently looking forward to hearing the results of our application for funding from the Tokyo Metropolitan Government.”

I knew of many black people’s — and, of course, my own — hesitancy to take advantage of such services back in the States, but I was curious whether that was a thing or not here in Japan.

“I don’t know that so many black people know about TELL,” Naohara says. “And I think that reflects how mental health issues aren’t addressed amongst black people. It’s just not something we’re diving into, neither on the side of those seeking help nor those who can provide it. I just don’t really see people who look like me being very involved. And that’s troubling.”

Adjustment Guidance: www.adjustmentguidance.com, TELL: www.telljp.com. Black Eye usually appears in print on the second Monday Community page of the month. Baye McNeil is the author of two books on life in Japan. See www.bayemcneil.com.