A Disability of the Soul

"This is a terrific book: moving, clear, and compassionate. It not only illustrates the way psychiatric illness is shaped by culture, but also suggests that social environments can be used to improve the course and outcome of the illness. Well worth reading."

— T. M. Luhrmann, author of Of Two Minds: An Anthropologist looks at American Psychiatry

Bethel House, located in a small fishing village in northern Japan, was founded in 1984 as an intentional community for people with schizophrenia and other psychiatric disorders. Using a unique, community approach to psychosocial recovery, Bethel House focuses as much on social integration as on therapeutic work. As a centerpiece of this approach, Bethel House started its own businesses in order to create employment and socialization opportunities for its residents and to change public attitudes toward the mentally ill, but also quite unintentionally provided a significant boost to the distressed local economy. Through its work programs, communal living, and close relationship between hospital and town, Bethel has been remarkably successful in carefully reintegrating its members into Japanese society. It has become known as a model alternative to long-term institutionalization.

In A Disability of the Soul, Karen Nakamura explores how the members of this unique community struggle with their lives, their illnesses, and the meaning of community. Told through engaging historical narrative, insightful ethnographic vignettes, and compelling life stories, her account of Bethel House depicts its achievements and setbacks, its promises and limitations. A Disability of the Soul is a sensitive and multidimensional portrait of what it means to live with mental illness in contemporary Japan.

Karen Nakamura is Associate Professor of Anthropology and East Asian Studies at Yale University. She is the author of Deaf in Japan: Signing and the Politics of Identity, also from Cornell, which was awarded the John Whitney Hall Book Prize by the Association for Asian Studies.

In A Disability of the Soul: An Ethnography of Schizophrenia and Mental Illness in Contemporary Japan, anthropologist and professor of East Asian Studies, Karen Nakamura provides the type of thick description and careful analysis called for by Mehrotra [author of Disability, Gender and State Policy: Exploring Margins]. Written in plain language and told in a narrative style... this easily accessible and deeply engaging work combines broad historical, social, and cultural context with intimate personal experiences and poignantly articulated vignettes to immerse the reader.

Michael Rembis:

Written in plain language and told in a narrative style, accompanied by a DVD containing two documentary videos and filled with a host of pictures, this easily accessible and deeply engaging work combines broad historical, social, and cultural context with intimate personal experiences and poignantly articulated vignettes to immerse the reader in the lives of members of Bethel House, the professional staff who work with them and the residents of the town of Urakawa located on the island of Hokkaido, Japan.

Amy Borovoy:

In every respect, Nakamura has produced two films and a book that work against stigma and call attention to mental illness as a disability and to the humanity of those who suffer from it. These texts will be of broad interest beyond the world of Japan studies, particularly to clinicians and human rights activists who are looking for ways to do better for the mentally ill.

T. M. Luhrmann, author of Of Two Minds: An Anthropologist looks at American Psychiatry:

This is a terrific book—moving, clear, and compassionate. It not only illustrates the way psychiatric illness is shaped by culture, but also suggests that social environments can be used to improve the course and outcome of the illness. Well worth reading.

Arthur Kleinman, author of Patients and Healers in the Context of Culture:

A Disability of the Soul is an extraordinary description of the lived experience of schizophrenics in the context of an impressive northern Japanese community program. Here we have patient stories interleaved with the history of psychiatric care for psychosis in Japan, which in turn is the context for description and analysis of a truly remarkable intentional community movement, including careful examination of its founders, sustainers, and outcomes. The book is beautifully written with great sensitivity to the tragic and ironic consequences of schizophrenia. Recovery programs such as this one are at the very cutting edge of global mental health and this is one of the first descriptions from Asia.