Depression as a Problem of Labor: Japanese Japanese Debates About Work, Stress, and a New
Debates About Work, Stress, and a New Therapeutic Ethos
Therapeutic Ethos
Junko Kitanaka Junko Kitanaka
Abstract
Abstract The global rise of depression is often linked to the spread of neoliberal-ism, which urges workers to constantly design and (re)make themselves in order to advance their careers through their ever-widening social networks. Depression can be read as both the pathological breakdown of this self-production and an adaptive response against the increasing demand for affective communication. The funda-mentally social nature of depression has been heatedly debated in Japan, where, since the 1990s, it has surfaced as a “national disease” that disrupts the workplace.
Many workers are said to have become depressed as a result of their traditional work ethic, notable for its loyalty and diligence, which is less valued in a neoliberal econ-omy. Using this argument, a workers’ movement has successfully established depression as an illness of work stress, thereby winning economic compensation and long-term sick leave for afflicted workers. Yet, this radical reconceptualization of depression as socially produced has also created an impetus to collectively man-age workers’ mental health, with the government’s much-disputed plan to impose
“stress checks” on all workers in order to screen out the vulnerable. The emerging psychiatric science of work also questions the traditional clinical approach to depression that emphasizes “natural” recovery through rest; instead, it is cultivating modes of restoring health in ways that render workers more efficient and productive for business. This paper examines Japanese debates about the nature of workers’
psychopathology, their vulnerabilities, and their recovery – or even their potential for further transformation – against the backdrop of the new therapeutic ethos.
Depression as a Problem of Labor Depression as a Problem of Labor
In a teachers’ strike in Chicago in 2012, American workers debated whether they should join a “wellness plan” that would enable employers to observe and intervene in the realm of workers’ physical health (Finamore 2012 ). In Japan, where workers
J. Kitanaka, Ph.D. (*)
Department of Human Sciences, Faculty of Letters, Keio University, Tokyo, Japan e-mail:kitanaka@flet.keio.ac.jp
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have long accepted annual physical health checks as a routine matter, they are now debating who has the right to intervene into workers’ mental health. This question has become imminent over the last decade, as Japan has witnessed an “epidemic” of depression (with its patient number exceeding a million) and a surge in national suicide rate (hitting historical highs of more than 30,000 per year for fourteen con-secutive years), both of which are seen as related to the long-lasting recession (Cabinet Office 2014 ). Depression, which has been labeled by the World Health Organization as an important part of the “global burden of disease” impeding pro-ductivity (WHO2002 ), seems to be afflicting Japanese workers on a massive scale.
As many in Japan are said to have become depressed and even suicidal from exces-sive work stress, the government recently announced a plan to introduce stress checks on all workers across the nation (Asahi 2010 ). This has stirred up heated opposition from workers, psychiatrists, and occupational doctors (Asahi 2014 ), many of whom argue that such a move is an insidious form of psychiatric surveil-lance and a sign of the neoliberal order that puts a new demand of responsibility on individuals for their own health.
What is ironic about this national call for stress checks, however, is that it is partly a product of a hugely successful workers’ movement. Since the 1990s, left-wing lawyers, doctors, workers, and their families have been engaged in legal bat-tles concerning what they call “overwork suicide” and “overwork depression”, whereby workers have allegedly been driven to depression and/or suicide from excessive work stress (Kawahito 1998 ). With the 2000 Supreme Court verdict that held a company liable for a worker’s suicide and ordered the highest amount of compensation ever paid for a worker’s death in Japan, the government has begun to discuss mental health as a matter of social responsibility (Kuroki 2002 ). This is a significant change, as depression had long been regarded in Japan as a constitution-ally determined, biological disease, and, moreover, a private matter. Recognizing how excessive fatigue, stress, and sleep deprivation can destroy a healthy mind, the government has created Stress Evaluation Tables, which lists 31 typically stressful work events, including demotion, relocation, and harassment, along with standard-ized scores, to aid Labor Standards Offices to objectively measure workers’ stress levels and provide worker’s compensation for stress-induced psychopathology (Okamura 2002 ). Reconceptualizing the workplace as a potential psychological minefield, the government has also begun to implement other policy changes, including the revision of the Labor Safety Law and the creation of the Suicide Prevention Law, thereby acknowledging the responsibility of the state and corpora-tions for keeping workers mentally healthy (Asahi 2005 ; Kōsei Rōdōshō 2001 ). In this context, the government’s latest call for stress checks might even seem like an inevitable evolution of its Durkheimian stance, which regards psychiatric break-down and the increased number of suicides as a product of society.
Yet, the government’s stance is also conflicted, insofar as it encompasses two perspectives on depression as a problem of labor – that is, as an impediment to work and a product of work itself. This also points to the inherent tension in today’s global discourse about depression, that is, as an illness of productivity in the way it involves competing politics of causality (cf. Young 1995 ; Martin 2007 ). The first J. Kitanaka
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perspective sees depression mainly as a biological anomaly, to be detected and located within the individual, who then becomes primarily responsible for ensuring his or her own mental health. The second regards depression as a kind of normal response to a pathogenic work environment, for which the employer and the govern-ment become accountable. While the lawyers and doctors in Japan involved in the workers’ movement concerning suicides related to workplace-induced stress and depression are strongly committed to the latter perspective, they have also grappled with the fact that suicide, at its core, is an agentive act, and they realize they cannot completely disregard the role that workers – including their subjectivity – play in the development of depression (Okamura 2002 ). Particularly in cases where work-ers appear as if they have driven themselves to pathogenic overwork, those involved in the movement have had to ask about workers’ agency and their self-subjugation – that is, how they become complicit in structuring a pathogenic situation (Kawahito 1998 ). As such concerns are increasingly voiced in Japan by those outside the work-er’s movement, I want to examine what political consequences are brought about by the understanding of depression as a problem of labor. More specifically, I want to explore how the shift in the conceptualization of depression from a “private matter”
to a “public illness” has come to make individual workers responsible for both their physical and psychological health, thereby recreating the realm of the psychological as a new object of self-governance and public surveillance. 1