Venerable Master Gangxiao: ECT Therapy for Intractable and Complicated Diseases, Chapter 2: Inspirations from Morita Theory

Chapter 2: Inspirations from Morita Theory

Morita Therapy, built on the theories of Dr. Shoma Morita, is now widely recognized around the world, so I figure starting here shouldn't ruffle too many feathers. Morita Therapy was developed around 1920 by Professor Shoma Morita of Japan. As a school of psychotherapy, it stands among the best in the world. A special session on Morita Therapy was held at the 1977 World Congress of Psychiatry. An American-authored book on the subject has appeared in both English and Spanish editions. Several of Morita's own writings have been published in China. Hospitals practicing Morita Therapy can be found in China, the United States, Canada, Japan, and elsewhere. The first international academic conference on Morita Therapy took place in 1990, drawing representatives from eleven countries. The International Morita Therapy Proceedings (in English) and the Journal of the Morita Therapy Association (in Japanese) are both in official publication. The Chinese Association for Mental Health includes a professional committee devoted to the application of Morita Therapy, which by 2000 had already convened four academic conferences.

Morita held that a certain kind of person is born with a hypochondriacal predisposition—introverted, excessively attentive to their own bodily state. He called these people "neurotics," and the term later stuck: Morita neurotics. Many of the physical illnesses such people develop are actually psychogenic in origin—rooted in the mind, not the body.

1. Fixation on Illness Perceptions

Professor Morita observed that some people, after a bout of something like the flu, or after a woman has given birth, physically recover completely—yet certain uncomfortable sensations linger in the mind, stubborn and persistent, so that they always feel as though they haven't fully healed. In cases like these, medication amounts to nothing more than temporary reassurance. It can even backfire, reinforcing the discomfort: I'm taking medicine all day—I really am sick.

We've all heard stories of people left with hemiplegia after a stroke who have actually recovered and should be able to toss the crutches and walk on their own—but fear, hypervigilance, and excessive caution keep the symptoms locked in place. Yet if a fire breaks out or some other emergency arises, they may suddenly bolt—running so fast they astonish even themselves.

Ordinary people experience something similar. After getting off a boat, you might still feel a rocking sensation for a long while, even after you've crawled into your own bed. Wear a hat in the spring, take it off, and you still feel it on your head. Ride a motorcycle wearing non-prescription windproof goggles, take them off, and you still feel the arms resting on your ears.

These are the so-called "rooted" illnesses—conditions where people say they "laid down a root" of arm pain, headache, or stomach ache at some particular time or place, and the root has stayed ever since. This is a vast category of illness. Think about it: from a biological standpoint, there's nothing actually wrong. How could biomedicine—pills, injections—possibly work on something that isn't, biologically speaking, there?

2. The Mental Interaction Effect

There's a Chinese saying: the more afraid you are, the more the wolf comes to scare you. If you're constantly afraid of insomnia and have stockpiled all sorts of tricks—counting sheep and so on—then night falls and you deploy every one of them, desperate to sleep. The more anxious and agitated you get, the more sleep slips away.

Heart rate is already quite sensitive to psychological states. Suppose you've watched a loved one or friend die in agony from heart disease. At the time, fear alone might send your own heart racing. You take your pulse—sure enough, it's fast, over a hundred beats per minute. Now you're even more frightened: Could something be wrong with my heart too? You keep checking your pulse. Lying in bed at night, you lie there feeling for it again. Under that cloud of "anticipatory terror," your pulse is bound to be rapid—you might even feel your whole body vibrating with each beat. And so, eventually, you become a patient with heart disease or high blood pressure.

This is the mental interaction effect that Morita described. Here is the definition, which I've taken from The Essence and Treatment of Neurosis (People's Medical Publishing House, 1992): "The so-called mental interaction effect in neurosis refers to the process whereby attention becomes concentrated and directed toward a certain sensation that happens to arise by chance. This makes the sensation more acute. The acute sensation then draws even more attention, further fixating upon it. In this way, sensation and attention reinforce each other in a cycle of mutual amplification, and the sensation grows ever stronger."

Headaches, dizziness on standing up suddenly, mental fog, palpitations, poor concentration, insomnia, abdominal bloating, pain—symptoms like these are all easily worsened by the mental interaction effect.

This kind of focused attention can actually amplify sensations. Picture a couple sitting down to whisper to each other at a dance. The music is blasting, yet they can hear every word between them perfectly well. Ask them afterward what song was playing, and they won't know—they weren't paying attention. Their concentrated focus amplified those quiet whispers until they were, for them, louder than the thumping music.

Or picture a mother whose child has been sick for days. The child's condition finally improves a little, and the exhausted mother, holding her baby, falls asleep. Thunder cracks overhead and doesn't stir her. But the slightest rustle from the sick child, and she's instantly awake. The child's tiny movement, amplified by her attention, registered louder than the thunder.

"The jingling of a horse's bridle wakes the sleeping soldier."

It's the same principle.

Uncomfortable experiences that anyone might have get amplified, through the mental interaction effect, into genuine illness perceptions and full-blown symptoms in the neurotic mind. Professor Morita documented many such cases—attacks of stomach pain, bouts of abdominal cramping, sudden palpitations—all of which he saw through and cured.

Remember this: the symptoms of Morita neurosis are physiological. They're physiological symptoms with no physiological cause. If you can't see through that, you'll end up helplessly filing these conditions under "mystery illnesses" or "intractable diseases."

3. Morita Therapy

"Surrender to nature" is the overarching principle of Morita Therapy, though the specifics vary from case to case.

First: for acute, episodic neurotic symptoms, cutting off the mental interaction effect and eliminating anticipatory terror can bring rapid relief. With certain recurring attacks of pain—especially ones that follow a regular pattern—Morita would instruct the patient to adopt whatever posture most readily triggered the episode, and to welcome the attack rather than fear it. And the attack wouldn't come. Professor Morita described one such case: a sixty-nine-year-old woman who had first fallen ill ten years earlier. Initially, a university hospital's internal medicine department diagnosed her with stomach cancer. The following year, the same hospital diagnosed gallstones and recommended surgery, which she refused. After that, she saw twelve more doctors, with no improvement. Dr. Futaki suspected neurosis and referred her to Professor Morita. By the time she arrived at Morita's clinic, she was suffering severe stomach pain twice a day—morning and night—each episode lasting one to two hours. Morita confirmed it as neurotic in origin: a stomach pain hallucination, much like experiencing stomach pain in a dream and being terrified, not realizing it's only a dream. He had her hospitalized. On the first day, under the pretext of diagnosis and treatment, he instructed her to do everything in her power to bring on an attack—the more severe and obvious, the better. She was to welcome the episode rather than dread it. For three straight days, she couldn't produce one. Later, when the faintest sign of an attack appeared, she was delighted: Finally, an attack for the doctor to observe! But the moment that thought crossed her mind, the attack dissolved. She was discharged, cured, not long after.

For severe insomnia, Morita used a similar approach—having the patient lie in an uncomfortable position while the doctor "observed" the insomnia. The patient would fall asleep almost immediately.

Second: for chronic neurotic patients, the goal shifts to transforming the neurotic, introverted personality itself. The treatment unfolds in stages:

Step one—the patient lies in bed, perfectly still, for a solid week. You might think that sounds like nothing—just sleep! But it isn't so simple. The first day or two, you might still feel fine, drowsing after meals with nothing to complain about. By the third or fourth day, restlessness sets in—building until it becomes unbearable. Stripping someone of their freedom of movement has always been a form of punishment. Solitary confinement is still used as one today. On May 13, 1998, the Henan Daily ran a critical report headlined "What Kind of Police Discipline Is This from the Huixian Public Security Bureau?" The story: a police officer in the city had gotten drunk and beaten a taxi driver, and received only seven days of confinement as punishment. The paper argued the penalty was far too light, noting: "He flagrantly broke the rules by assaulting someone, and got off with nothing more than solitary confinement."

Morita Therapy deliberately creates an environment of sensory deprivation: blank walls, near-total silence. Some setups even add a clever physical cue—placing an ice cube on the patient's head so that the slightest movement will send it sliding off. At first, your attention stays fixed on your symptoms: This hurts, that feels wrong. But by the third or fourth day, the sheer frustration of being confined pushes all those complaints aside—the fixation breaks. From there, the patient's range of activity is gradually expanded. With each new freedom comes a small sense of relief, and the process moves forward: into step two, the light-work period—simple, undemanding tasks; then step three, heavy work; and finally step four, exercises in social adaptation. The full course runs about forty days, by which point most patients are cured.

If you think it through, Morita Therapy is deeply logical—and its clinical results around the world have been impressive.

Covering Morita Therapy in depth isn't really the aim of this booklet. Besides, Morita's own writings are fairly short, and you can seek them out on your own. What I want is simply to draw out the essence—because as we've seen, the full Morita treatment course runs too long, around forty days, which most people today would find hard to accept. But the theory behind it is full of insight, and it's up to us to absorb those insights and improve on the method.