Japan trauma victims - Alex Levac - November 2011
Trauma victims participating in an IsrAid workshop and (below) numbered motorcycles lined up in a school yard. When workshop participants threw messages into the sea, the fervor was reminiscent of tha Photo by Alex Levac
Text size

SENDAI, Japan - When I was here right after the earthquake in March, I couldn't help but admire the way the Japanese conducted themselves. Despite the triple disaster - the earthquake, the tsunami and the spread of nuclear radiation - the restraint and self-control of inhabitants were extraordinary. It seemed as though all the disasters had passed them by.

Small clusters of people gathered in front of huge screens at the train stations in Tokyo were nearly the only sign that a terrible catastrophe had hit the country. Even in places that were inundated by the huge wave, people maintained a restrained mien. Out of curiosity bordering on admiration for this wonderful people, I subsequently read about Japanese culture and conversed with people who are knowledgeable about it.

The Japanese are still coping with the aftermath of the disaster with an efficiency that would be unheard of in our part of the world. A large section of a tremendous new dock built along the oceanfront here - a reinforced concrete wall for defense against giant waves - is nearly complete. When you climb onto it, it looks endless, in both directions. In many places, there are cube-like prefabs serving as temporary housing for tsunami refugees. People are continuing to live their lives, although in the area suspected of contamination by nuclear radiation, even near Sendai, children are not permitted to spend more than eight minutes a day in the open air for fear of exposure to the radiation. The rubble of the houses has been cleared to some extent, and now only their foundations can be seen poking out from among the weeds.

One of the important foundations of Japanese culture is harmony. This means mainly social harmony, but every visitor to this country will see that harmony is also expressed in the aesthetics and the orderliness here. The tsunami wrought terrible destruction, and the only way to deal with the chaos was to restore order. In one area there are mountains of debris from destroyed buildings. Elsewhere, cars that were swept away in the tsunami are now piled up: rusted ones that have been in the water in one pile, and vehicles that have been totally crushed in another.

In the yard of a school where the pupils fled to the roof and were rescued by helicopters, hundreds of motorcycles, each of them numbered, are lined up in long rows. There are also piles of refrigerators and air-conditioners, which were collected from various locations in a painstaking process.

Psychic pain

Not everything is going smoothly, of course. There are locales where inhabitants have not yet moved into alternative housing. In July the reconstruction minister, Ryo Matsumoto, had to resign only eight days after he was appointed because he insulted the inhabitants of Fukushima by calling it "the city of death." He topped that off with a promise to journalists that, following his own visit to the city, he would mingle with them, so as to make them radioactive too.

This is not a time for jokes. During this period the Japanese are internalizing an important value in their culture: Gaman, a psychological state of determination and perseverance, which helps one endure and cope with disaster. Every Japanese person, even those who have not been directly affected by the catastrophe in March, is biting his lips, carrying on with his work and taking upon himself a kind of Spartanism as a sign of solidarity with the victims. For example, an executive in a large company might come to work on a bicycle, instead of in a chauffeured Mercedes. Someone else might abstain from eating chocolate.

Outwardly, the Japanese person behaves as is expected of him and displays a facade of serenity and confidence: his tatemae. However, what happens to the other, inner part of his personality - his deepest feelings, the so-called honne, which he guards jealously? What happens to the psyche?

Generally, the Japanese attitude toward people with mental illness is extremely negative. Until not long ago, Prozac was illegal. About 10 years ago when the use of anti-depressants was approved in limited circumstances, the manufacturers realized that to market their drugs successfully, they would have to change the prevailing cultural perceptions of anxiety, depression and similar conditions. Thus, instead of mentioning the clinical name "depression" they decided to redefine it as "a common cold of the soul." If one has to take pills to cope with symptoms of the flu, why not take medication against "psychological influenza"?

Before the disaster, Japan had the world's fifth highest suicide rate: Once every 15 minutes, on average, a Japanese citizen takes his own life. Now, in the wake of the tsunami, the rate of suicides has increased by about 20 percent.

Collective healing

Into this maelstrom leaped the people of the Israeli volunteer emergency aid organization IsraAid. For 10 years its activists have been extending a helping hand to disaster victims worldwide. In recent years, they were in Myanmar after it was hit by a typhoon, traveled to Thailand after its tsunami and went to Haiti after the earthquake; in addition, they have also worked in Somalia, a humanitarian disaster zone.

Not long after catastrophe struck Japan this year, IsraAid staff who have accumulated a great deal of knowledge about dealing with trauma victims (a field that is very advanced in Israel, of course ) went to four cities in the northeastern part of the country, the worst-hit region. They met with educators, school and kindergarten principals, psychologists and counselors, and trained them in treatment methods. They also held workshops for therapists, demonstrating the methods they use with schoolchildren.

"We were welcomed with overwhelming enthusiasm," says IsraAid chairman Shachar Zahavi. "We realized we wouldn't be able to answer all the requests for assistance, even though we returned to the area several times. It was decided to train Japanese teams so they would be able to work using methods similar to those we have developed."

"We went to Japan even though we knew about the huge cultural differences," says psychiatrist Dr. Gillat Raisch, a member of the team. "We knew, for example, that they maintain personal distance, and physical contact is not part of the Japanese culture, at least not in public."

Since IsraAid's workshops are based to a large extent on such contact and on displaying emotion, the staff created protected, safe spaces where it would be possible for locals to feel comfortable expressing their deepest feelings, and receive support from, and help others. In fact, relate the volunteers, a type of external framework was created in the workshops: A non-Japanese environment that made it easier for the participants to feel their own emotions and those of others. Within that framework, the staff say that they sensed the profound love and support Japanese children feel from their parents at home. Participants themselves acknowledge that the fact that the workshop felt like it came from outside, from a different culture, helped them stop trying to maintain an austere, inflexible facade and enabled them to surrender completely to their feelings.

Toward the end of a workshop which I observed, which lasted for several hours, participants were asked to write a note bearing a message to the sea. They rolled the message up into a narrow test tube and corked it, and then took it to the beach. The renewed encounter with the ocean was the peak moment of the workshop. Most of the participants had not been to the shore since the tsunami, and the emotional turmoil was great. Some of them evinced palpable fear of the moment they would face the sea again; some walked in silence and others wept. When they reached the water the members of the group held hands, to strengthen one another. When they threw the test tubes into the sea, the fervor was reminiscent of that of a religious ritual. They participated in a kind of exorcism, waving their hands at the ocean threateningly or pleadingly. Then everybody embraced, formed a circle and thrust their hands upward with smiles on their faces.