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Too Lonely to Die Alone: Internet Suicide Pacts and Existential Suffering in Japan



Most striking in the recent rise of suicide in Japan are the increase in suicide among young Japanese and the emergence of Internet suicide pacts. An ethnography of suicide-related Web sites reveals a distinctive kind of existential suffering among visitors that is not reducible to categories of mental illness and raises questions regarding the meaning of an individual "choice" to die, when this occurs in the context of an intersubjective decision by a group of strangers, each of whom is too afraid to die alone. Anthropology's recent turn to subjectivity enables analyses of individual suffering in society that provide a more nuanced approach to the apparent dichotomy between agency and structure and that connect the phenomenon of suicide in Japan to Japanese conceptions of selfhood and the afterlife. The absence of ikigai [the worth of living] among suicide Web site visitors and their view of suicide as a way of healing show, furthermore, that analyses of social suffering must be expanded to include questions of meaning and loss of meaning and, also, draw attention to Japanese conceptions of self in which relationality in all things, including the choice to die, is of utmost importance.
Too Lonely to Die Alone: Internet Suicide Pacts
and Existential Suffering in Japan
Chikako Ozawa-de Silva
Published online: 18 September 2008
©Springer Science+Business Media, LLC 2008
Abstract Most striking in the recent rise of suicide in Japan are the increase in
suicide among young Japanese and the emergence of Internet suicide pacts. An
ethnography of suicide-related Web sites reveals a distinctive kind of existential
suffering among visitors that is not reducible to categories of mental illness and
raises questions regarding the meaning of an individual “choice” to die, when this
occurs in the context of an intersubjective decision by a group of strangers, each of
whom is too afraid to die alone. Anthropology’s recent turn to subjectivity enables
analyses of individual suffering in society that provide a more nuanced approach to
the apparent dichotomy between agency and structure and that connect the phe-
nomenon of suicide in Japan to Japanese conceptions of selfhood and the afterlife.
The absence of ikigai [the worth of living] among suicide Web site visitors and their
view of suicide as a way of healing show, furthermore, that analyses of social
suffering must be expanded to include questions of meaning and loss of meaning
and, also, draw attention to Japanese conceptions of self in which relationality in all
things, including the choice to die, is of utmost importance.
Keywords Internet · Japan · Loneliness · Subjectivity · Suicide ·
Mina: I decided to die today. I’m sorry I caused trouble.
NATO Dan: Well, I won’t stop you, as I don’t think you are serious about it. If
you do want to die, then please die quietly without causing trouble for other
people. Jumping in front of a train is out of the question. I hear that a body that
has died from freezing to death or from carbon monoxide still looks pretty. Well,
C. Ozawa-de Silva (&)
Department of Anthropology, Emory University, Atlanta, GA 30322, USA
Cult Med Psychiatry (2008) 32:516–551
DOI 10.1007/s11013-008-9108-0
I have to say that it’s too late to regret it after you’re dead. Good night. So, does
my reaction satisfy you?
NATO Dan: The way you are, you’re going to be driven into a corner even in the
afterlife, too.
Mina: Mizuho-san, have you already died? Would you like to die together? After
I’ve died, I am going to kill myself in the afterlife also.
Mina: I will certainly not cause anyone any trouble. I ran away from home when I
was at elementary school. I don’t think there’s anyone who remembers me. I’ll
hide in the woods and take poison, and die by falling into a hole made in the past.
Kantaro: Wait, Mina. Don’t die!
Mika: I really want to commit suicide. I really want to commit suicide because
everybody bullies me and I don’t want to go to school. God, I want to die. Aaah! I
want to die!!!
Ruru: It seems no one’s around right now….
Ruru: Mika-san, nice to meet you.
Ruru: Mika-san, are you also bullied? GGGGGGGGGGGGGG.
Mika: Would you like to go to Mt. Fuji’s sea of trees? I was about to go. My
regards. I am Mika. Let’s be friends, shall we?
Ruru: Me, too. I tried to kill myself many times and strangled my own neck.
Recently my wrists…. But I cannot die.
Mika: When would you like to do it?
Ruru: Personally, I prefer the winter break. The forest will be cold. If we wander
around, I think we would die from hunger or the cold…. Otherwise, shall we hang
Mika: Ruru-san, thank you! When shall we do it? I am always free! Please give
me a call at home. (086) 922 4831. Other people, please don’t give me nuisance
calls! Ruru-san, only you can call me. Are we agreed?
Mika: Ahhh….
Mika: Death.
Ruru: Got it. I will give you a call tonight. I have to go now as my class is about
to end. I wonder when I can come again.…
Marcy [Moderator]: By any means, it’s not that I want to prevent you from
committing suicide. But I would want you two to understand the responsibility of
posting these comments seriously, as it is disgusting. Mika asked for a suicide pal
by posting her phone number. In general, such actions will give a sense of
companionship and the courage to die to people who want to die, but who are
half-heartedly suicidal, and who lack the courage to die by themselves. This is a
state of mind arising out of a human “group mentality.” Suicidal individuals tend
to fall for such a technique, as they tend to have few friends. They can easily
come to “depend” on “relationships of mutual trust.” Ruru, please analyze your
own head before calling. Mika, be aware that you might end up dragging along
someone who might not commit suicide on her own. Anyway, I won’t request
that this correspondence be deleted, as these two seem to have already written
down the contact information.… Well, as it is your life, it is your freedom to put
an end to it, but … please don’t ask for company! (Za Keijiban 2003)
Cult Med Psychiatry (2008) 32:516–551 517
The above two dialogues do not stem from a melodramatic fictional radio or
television drama, but from an actual transcript of an Internet suicide Web site—in
this case a chat site—with only the contact information changed. It is not known
whether any of the individuals involved ended up committing suicide, but the rising
rate of “Internet suicide pacts”—a new type of suicide in Japan—has led to
widespread concern about the presence of such Internet sites and questions about the
nature of group suicides and suicide pacts in Japan.
Suicide has long been an important topic of study in various fields including
anthropology. Its relevance for study is not only due to its being a locus for central
issues such as the value of life and the meaning of death, suffering and violence, but
also because it is a topic that clearly reveals the necessity for explanatory models
that mediate social and individual factors. One could broadly categorize the main
approaches to suicide as falling into these two extremes: on the one hand, social,
economic and cultural analyses that emphasize social determinism and, on the other
hand, analyses of individual factors such as psychology and psychopathology.
Whereas discourse on suicide in the United States focuses predominantly on
individual pathology and factors such as depression, discourse in Japan has focused
on social pathology, economic factors, a “culture of suicide” and cultural aesthetics.
The recent rise of suicide in Japan, and of new forms of suicide, such as Internet
suicide pacts, has revealed the inadequacy of either of these two approaches when
taken independently. Internet suicide pacts, in particular, provide instances where
the inseparability of agency and social forces becomes particularly evident. Given
the statements of those who commit such suicides, such as “I am too lonely to die
alone” and “It could have been anyone to die with,” what is the meaning of an
individual “choice” or “decision” to die, when this occurs in the context of an
intersubjective decision by a group of strangers to die together, each of whom is too
afraid or too lonely to die alone? In contrast to the popular Japanese discourse that
suicide is one way that individuals can assert their autonomy in a collectivist
Japanese society, suicide pacts seem to involve individuals giving up, or
subordinating, their autonomy to a collective decision, a group choice.
Anthropology as a discipline has long acknowledged the importance of
understanding the nature of the relationship between agency and structure. This is
no easy task in the study of suicide, however, as there are limitations on the ability
of anthropologists to engage in participant-observation and other methodological
approaches, given the nature of the phenomena. The case of suicide pacts, in
particular, presents an added dimension. Here, I feel that anthropology’s recent turn
to subjectivity (Biehl et al. 2007; Csordas 2002; Good et al. 2007) represents a
positive move and makes possible an analysis of individual suffering in society that
provides for a more nuanced approach to the apparent dichotomy between agency
and structure and that connects the phenomenon of suicide to conceptions of
selfhood. Japanese understandings of relationality are much more amenable to the
view that self is only understood in relation to other, and not as if a “self” could
exist independently, and Japanese cultural understandings of death and the afterlife
518 Cult Med Psychiatry (2008) 32:516–551
make it possible to understand how individuals might unfortunately see collective
death and suicide as a form of “healing” and connection with others.
Death in a “Suicide Nation”
Japan has been known as a “suicide nation” (Pinguet 1993, p. 14; Takahashi 2001,
p. 26; Ueno 2005) due to the various forms of suicide that have gained prominence
and public attention, as well as the fact that suicide has been seen, in certain cases,
as a moral action and a last place to practice one’s “free will” in a generally
conformist society (Doi 2001). Up until recently, suicide prevention was not a
popularly acknowledged concept, but the recent sharp rise in suicide rates and new
types of suicide, such as Internet suicide pacts, have attracted international attention
and disturbed Japanese society to the extent that suicide prevention is now being
taken more seriously. Until a decade ago, Japan’s suicide rate stayed at about 18 or
19 suicides per 100,000 people, roughly in the area of suicide rates for France and
Germany (Takahashi 2001, pp. 25–26), but it surged suddenly in 1998 and has been
elevated ever since. Since 1998, Japan has had the second highest suicide rate
among the G-8 nations (26.0 in 1998, 24.2 in 2005), after Russia (34.3 in 2004) and
significantly higher than France (17.8 in 2002), Germany (13.0 in 2004), Canada
(11.6 in 2002), the United States (11.0 in 2002), Italy (7.1 in 2002), and the United
Kingdom (6.9 in 2002) (Jisatsutaikougaiyou 2006, p. 2).
Suicide is also the leading cause of death in Japan among people under the age of
30. The year 2003 saw Japan’s highest number of suicides historically, at 34,427, or
27 suicides per 100,000 members of the population, followed by 32,325 in 2004
(Keisatsu Chou 2005, p. 4). These figures are all the more startling when one
considers that there are 100–200 times as many unsuccessful suicide attempts as
there are actual suicides (Takahashi 1999, p. 24). Looking into suicide rates by
gender, the suicide rate for men in 2005 was 36.1, compared with 12.9 for women,
supporting a general tendency showing that men have higher suicide rates than
women. The number of suicides among middle-aged men between 40 and 54 was
five times higher than that among women in the same age category, a figure some
have pointed at as evidence of the link between suicide and the recent economic
recession and rise in unemployment (Desapriya and Iwase 2003, p. 284). In the past,
women’s suicide rates were prominently high in the age group of women 80 and
above, but since the sudden rise in suicide rates among youth and adults (such as age
groups 15–19 and 40–44) and the decrease in suicide rates of age groups 60 and
above, the age curve, which used to increase steadily with age, has looked more
even. Thus, for women, younger individuals are the main contributors to the rise in
suicide. For men, the basic curve of suicide rates among different age groups before
and after 1998 has not shown a significant change, although, again, suicide rates
The fact that the data from this report compare suicide statistics from different years is likely due to
variances in the collection of suicide data in different countries, which means that the most recent official
suicide rate for a given country may be a few years earlier or later than that for another country.
Cult Med Psychiatry (2008) 32:516–551 519
among the elderly (75 and above) show a decrease in the last decade, despite a rise
in overall suicides.
Most disturbing has been the rise in suicide rates among young Japanese.
Comparing the sudden rise of suicides in 1998 against the rate in the previous year,
women under the age of 19 show the most significant rise, with an almost 70%
increase in suicides, followed by a 50% increase among men under 19 (Police
Office Reports, in Takahashi 2001, p. 14). Both men and women between 20 and 29
show the next highest increases, and the third highest are for those between 30 and
39. This indicates that the recent rise in suicide is closely connected to the increase
in suicide among young people in Japan. Supporting this is the fact that the age
group of individuals over 80 has not shown a significant increase in the number of
suicides, and in some cases the suicide rate has gone down. Among women,
especially, it is clear that young persons are primarily responsible for the increase in
suicide rates.
While Japanese cultural attitudes toward suicide in general have been tolerant,
the public and mass media have not been inclined to view Internet suicide pacts in
this way. Rather, because the underlying cause of these suicides is neither apparent
nor clear, such suicides garner little sympathy. Instead, they are seen as
irresponsible, thoughtless acts, and those who engage in them are considered
copycats or too weak-willed to die alone. It has also been said that such individuals
are incapable of understanding life and its depth and weight, seeing it instead as
something light and virtual, and therefore they view death in the same virtual way
(Ohsawa 1996, 2005, p. 102; Saito 2003; Usui 2002); computer games, television,
films and so on have been invoked and blamed for this (Machizawa 2003, pp. 113–
114; Usui 2002). Thus, such individuals are merely irresponsible for choosing to die
when they have no good reason to do so, and when they are not undergoing any
serious kind of suffering. One can detect aspects of this feeling tone in the
comments of the Web site moderator in the above transcript. But how accurate and
insightful is this popular view?
In this article I seek to shed light on this apparently “callous” and “thoughtless”
category of group suicide by examining a particularly controversial type of group
suicide—Internet suicide pacts. I begin by examining the recent rise in suicide in
Japan and the most common public explanations given for this. I then examine the
case of Internet suicide pacts, placing them within the context of suicide in Japan in
general, and provide a representative selection of ethnographic findings from my
study of Japanese suicide-related Web sites. These findings suggest that, far from
being conducted by individuals who are not undergoing any serious kind of
suffering, Internet suicides are characterized by severe existential suffering, a loss of
the “worth of living” (ikigai), or its absence in the case of many Japanese
adolescents and young adults, and a profound loneliness and lack of connection with
others. I then place the suffering evident in Internet suicides within the broader
context of social transformation, upheaval and collective traumas in contemporary
Japan that have resulted in a “healing boom”—a public turn to healing and
spirituality. As Durkheim (1966) noted in his classic study of suicide, social factors
such as these can play an important role in suicide. Many questions, however, seem
to fall beyond the limits of Durkheim’s sharp divide between social facts and
520 Cult Med Psychiatry (2008) 32:516–551
individual agency, including the question of why young Japanese are choosing to
die collectively and with complete strangers, showing the need for an investigation
into how social facts are instantiated within the context of individual subjectivity.
Suicide or Social Murder? The Rhetoric of Suicide in Japan
Any attempt at a cross-cultural understanding of suicide reveals the complexity of
this task and ultimately challenges the standard definition of suicide in the West,
which equates suicide to “deliberate self-harm” (see Desjarlais et al. 1995, p. 68).
Although attempts have been made to understand suicide from sociocultural
perspectives, suicide in the West has been predominantly understood through the
lens of individual pathology, and many statistics indicate that more than 90% of
individuals who attempt suicide suffer from psychiatric disorders such as depression
or psychosis (74). In Japan, however, one of the dominant features in the rhetoric of
suicide has been cultural aestheticization, whereby certain suicides are given a
positive cultural valence (Pinguet 1993; Takahashi 1997,1999,2001; Traphagan
2004, p. 319). In the cases of Mishima Yukio and Eto Jun, for example, two famous
writers who took their own lives, the public reaction and mass media reports
included praises of their heroism. Overall, Japanese cultural perceptions of suicide
are more tolerant than those in the United States, and in numerous cases suicides are
viewed morally as a sign of maturity and responsibility.
In his work Voluntary Death in Japan, Pinguet (1993, p. 3) asserts, “The essential
point is that in Japan, there was never any objection in principle to the free choice of
death—a question on which Western ideology has always found it difficult to
pronounce.” To this he adds, “If Japanese culture does indeed have an originality
worthy of our sustained attention, it must ultimately be sought in an absence of
metaphysics and idealism” (11). He traces this absence to the influence of
Buddhism, especially the So¯to Zen school, with its emphasis on the impermanence
of all things. This absence is not a lack, and within it, suicide for Pinguet becomes
“a fierce excess … an austere necessity … which Japan resolved never to surrender
on principle, as if she understood how much of the essence of grandeur and serenity
vanishes from a civilization when its people let slip their freedom to die” (13).
Although Pinguet’s choice of language seems to carry with it a trace of Orientalism,
there is a tradition within Japan of nihonjin-ron (theories of Japanese uniqueness
propagated by Japanese thinkers), and Pinguet points out that the term “suicide
nation” was coined first by Japanese themselves in the 1950s (14; Ueno 2005).
When suicide in Japan is not aestheticized and is in fact seen as a pathology, it is
typically as a “social pathology.” Japan’s economic downturn has frequently been
cited as contributing to this social pathology, and to the rising rates of depression
and suicide. There has been a strong tendency in Japanese thought on suicide to
blame society itself and to look outside the actual individuals involved for the cause
of suicide (see, e.g., Ueno 2005). However, while it is certainly necessary and
helpful to broaden the view beyond the individual to include social, cultural and
economic dimensions, completely removing the individual can have negative
repercussions if it overemphasizes social determining factors. As Kitanaka (2006,
Cult Med Psychiatry (2008) 32:516–551 521
p. 9) notes, “Examining the medicalization of socially withdrawn children, Lock
(1986,1988) has shown that socially oriented medical discourse in Japan is not
necessarily liberating, but can be moralizing and hegemonizing in the way that it
overdetermines the meaning of people’s distress.” In her research on end-of-life
issues in Japan, Long (2005, pp. 4–13) argues that “choice” is not the same as
“autonomy,” as choices (such as making a decision how to die) are limited within a
given context and environment. Since an individual’s choice is not separable from
social limitations, this calls into question what we consider “individual” and
“social,” as will be shown.
These two distinguishing factors of suicide in Japan—its cultural aesthetic
dimension and the fact that it is seen as resulting from a social pathology—are, in
my opinion, also the two factors that complicate the Japanese approach to suicide
prevention. Both the strong tendency to want to see suicide as a responsible act in
given situations, on the one hand, and seeing the causal efficacy of factors resulting
in suicide as residing in society rather than in the individual, on the other hand,
inhibit Japan from formulating a clear policy with regard to suicide prevention. The
former view has resulted in arguments that to prevent suicide is to cruelly deprive
individuals of one of the few, free, important acts they can make in an extremely
conformist society. The latter view places the entire blame on society by arguing
that Japanese society is so sick that until the entire society is restructured, high rates
of suicide will be the inevitable result—to immobilizing effect. They therefore
represent two extremes that arise from not recognizing sufficiently the interdepen-
dence of individual and social factors.
Public Explanations for Suicide in Japan
The Japanese government is highly aware of the recent steep rise in annual rates of
suicide in Japan, but discussion around this issue has focused blame on the current
social and particularly economic situation of Japan. The vast majority of news and
journal articles discussing the issue attribute the rise in suicide to the economic
recession, which they claim caused financial and psychological insecurity among
middle-aged Japanese men in a society that had previously enjoyed extremely low
levels of unemployment. The most common explanatory model provided is a three-
step process: (1) the long-term economic recession has led to (2) depression among
those who are unemployed or concerned about the possibility of losing their
financial security, which then causes (3) a rise in suicide rates. Other factors invoked
to explain the rise of suicide in Japan include Japanese culture, Japan’s status as a
“suicide nation,” the nefarious role played by the Internet, the publicity provided by
the media of high-profile suicides, which leads to imitation suicides, and patriarchal
gender roles.
All of these factors are invoked in the informative article entitled “Suicide as
Japan’s Major Export,” written by Japanese sociologist Ueno (2005), but she mainly
focuses on the issue of the economy, especially insufficient welfare and
unemployment. Ueno writes:
522 Cult Med Psychiatry (2008) 32:516–551
In light of an ongoing increase of suicide rate[s], although many things have
been proposed regarding prevention, they [all] more or less fall under a mental
health type of prevention policies. Launching a counseling system with [a]
hotline may work well for some people, but not those with serious financial
problems. Mental health is not about policy but more about how the
unemployment rate is to be curved [curbed] and the social net to be placed
rightly, so that a just society can be achieved. Preventing economically
induced suicides with a tightening of the welfare budget is quite impossible.
Jobs with livable wages for men and women with more generous public
assistance might seem an indirect route, but is in fact the most secular way to
prevent suicide…. Economic problems, disease, and pessimism, have played a
part, for which … society is first and foremost responsible.
While Ueno’s general analysis in the article is helpful in many ways, the
conclusion she gives so definitively above is problematic for several reasons. Ueno
points out the higher rates of suicide among men (rather than women) and increases
in suicide rates when men reach the age where they can leave life insurance policies
to their families. What she neglects to mention, however, is that suicide is the
leading cause of death not among middle-aged Japanese men, but among youth. Nor
does her analysis explain the suddenness of the rise in suicide rates over a very short
period of time, or why this does not appear to correspond with any sudden change in
Japan’s economic situation. In 1998, the number of suicides suddenly shot up by
34.8% over the previous year. Looking just at adolescents, the increase was 53.5%
over the previous year (from 469 deaths in 1997 to 720 deaths in 1998). Until 1997,
the average number of annual suicides for more than 10 years stood at 22,410, but in
1998 it rose to 32,863, and in 1999 to 33,048 (Keisatsu Chou 2005, p. 4). Deaths due
to traffic accidents have numbered only about 10,000 every year; thus, more than
three times as many people lost their lives by suicide than by auto accidents in 1998
and 1999 (Takahashi 1999, p. 3). These figures stand out particularly in comparative
context. In 2003 there were 34,427 suicides in Japan, or 27 per 100,000 (Keisatsu
Chou 2005, p. 4), whereas in the United States the rate was 10.8 per 100,000 and
suicide was only the 11th leading cause of death (McIntosh 2004, p. 1).
Ueno explicitly discounts mental health issues to focus on economic issues, but
given the fact that Japan remains one of the most affluent countries in the world—
economic downturn or no—this approach is insufficient without taking into account
the more nuanced social dimensions of expectations, aspirations, and ideas about
what Japanese call the “worth of living” [ikigai], that is, one’s motivation in life.
These, in turn, connect with the question of mental well-being and health, in a broad
sense. Although economic deprivation and poor physical conditions certainly
contribute to mental distress, it is clear that material affluence, without attention to
social relations, is no guarantee of mental well-being and happiness (Keyes 1998,
2002; Ryff et al. 2003). The belief that greater affluence by itself will lead to less
mental suffering and less suicide is unsubstantiated, as is the idea that the economic
recession, taken by itself, led to higher rates of depression, which in turn resulted in
the rise in suicide. As Kitanaka (2006) has shown, the rise in depression in Japan in
the 1990s was not merely a result of economic hardship, but is connected to a
Cult Med Psychiatry (2008) 32:516–551 523
complex range of factors including the campaigns of pharmaceutical companies and
psychiatrists to make the concept of mild depression more widespread. Kitanaka
illustrates how Japanese psychiatry succeeded in creating a public consensus that the
economic recession and resultant depression were the cause of suicide—in a society
that historically had viewed suicide as a voluntary act, rather than one stemming from
individual pathology (100). The notion of mental illness had long been stigmatized in
Japan (Ohnuki-Tierney 1984; Ozawa 1996; Ozawa-de Silva 2006,2007; Roland
1988), and depression was not an exception. However, corresponding with the recent
rise in depression has been the success of the pharmaceutical industry in publicizing
depression as a kokoro no kaze [cold of the heart] (Kitanaka 2006, p. 100; Schulz
2004), lessening the social stigma associated with depression and making it normal,
something ordinary individuals can get, like a cold or the flu.
Another popular contention by scholars and the mass media in Japan has been
that the growth of Internet access and use is partially to blame for the rise in suicide.
Suicide Internet Web sites are one widely cited aspect of this. In an article by the
Associated Press, Usui Mafumi, a professor of psychology at Niigata Seiryo
University with a popular Web site dedicated to the topic of suicide in Japan, is
quoted as saying:
Depressed, young people and the Internet—it’s a very dangerous mix….
When Japan was poor, families did more things together out of necessity, like
sharing a bath or eating together, and the community was much more
important, especially in rural communities. But now it’s increasingly all about
the individual. This leaves people more isolated and likely to contemplate
suicide. (Woman 2006)
Although the exact relationship between the rise of the Internet and the rise in
suicide remains unclear, Internet access does seem to have contributed to a rise in
hikikomori [withdrawal syndrome], which refers to the more than 1 million Japanese
who have stopped going to school or work for more than 6 months (but in many cases
for several years, even more than 10 years), and who instead remain at home, never
leaving their houses, and sometimes never even leaving their own rooms (Borovoy
2006; Machizawa 2003, p. 21; Saito 1998). In the 1980s, most of these people were
diagnosed with schizophrenia and depression. Nowadays, however, according to one
Japanese psychiatrist, Machizawa (2003), many of these persons do not have either
clinical condition, yet still have great difficulty interacting with other people and
choose to remain at home. Machizawa points out that the convenience of the Internet
seems to make them self-sufficient, as despite their lack of social skills, they can still
develop emotional closeness with others through the Internet (112–115). There is a
clear resemblance between hikikoromi and Internet suicide pacts, as their main
communication tool is the Internet, and these individuals have reduced social
interaction and social support. However, neither Internet suicide pacts nor hikikomori
is easily explained by citing the economic recession as a primary reason.
Finally, when it comes to adolescents, both the mass media and researchers have
tended to attribute suicide to two main causes: ijime [bullying] and the competitive
school examination system called jyuken jigoku [examination hell]. They point out
that many of the notes left by adolescent suicides say things like “I am a failure,
524 Cult Med Psychiatry (2008) 32:516–551
because I did not make it into such-and-such university,” or “I was afraid that I
would fail the examination, and I lost hope in life,” or “I have been bullied by such-
and-such a person. They did this and that to me, and therefore, I am going to die.”
These letters sometimes seem to indicate that the act of suicide itself is revenge
against the bullies by listing the names of the students who bullied them.
Interestingly, however, this aspect of suicide as revenge seems to be missing from
most cases of Internet suicide pacts. It is clear therefore that one cannot simplify all
cases of suicide into one or two reasons such as “examination hell” and “peer
abuse,” as important as these factors may be in many incidents of suicide. To attain
a more nuanced understanding of this phenomenon, it is important to examine
broader social and cultural factors that have been undergoing significant transfor-
mation in recent times in Japan.
Shinjyu and Internet Suicide Pacts
In the study of suicide, the term “suicide pact” is used to refer to an arrangement
between two or more individuals to die together or at close to the same time. Unlike
mass suicides, where a large group of people may choose to die together for
religious, ideological or military reasons, suicide pacts are typically made between
individuals with a close personal relationship, such as close friends or lovers, and
the reasons are diverse and usually highly personal in nature. The term in Japanese
for these types of suicide pacts is shinjyu (), for which there is no exact
translation in English, and which has particular historical and cultural connotations.
Shinjyu is now the general term for a small group of people choosing to die
together, although, interestingly, the consent of all those involved is not a
prerequisite for the deaths to be considered a result of shinjyu. The term jo
describes the traditional idea of lovers choosing to die together because their
relationship cannot be accepted in this world and they hope that they will be
reunited in the afterlife. Ikka Shinjyu [one-family suicide], Kazoku Shinjyu [family
suicide], and Oyako Shinjyu [parent-child suicide] describe family members dying
together, usually in the manner of a parent or parents killing the rest of the family
members before committing suicide, and with the idea that the parent is concerned
that the rest of the family would not be able to continue in this world upon his or her
death. The tendency in Japanese culture is to see such shinjyu as tragic suicide,
whereas in the West such cases would often be seen as deplorable homicides.
The first connection between the Internet and suicide that caught the public eye
was in 1998, when a 27-year-old man created a Web site called The Counseling
Office of Dr. Kiriko. Through this Web site, he sent potassium cyanide to six people
who wanted to commit suicide, and one woman successfully committed suicide by
taking the potassium cyanide she was sent (December 25, 1998, Asahi Shinbun).
Since then, there have been numerous reports about suicides involving Web sites.
It is difficult to say when Internet suicide pacts started taking place, as early cases
were first treated as ordinary shinjyu [suicide pacts] before the category of Internet
suicide pact was established [inta
¯netto shu
¯dan jisatsu; literally “Internet group
suicides”]. However, Ueno (2005) notes that the first mention of Internet suicide
Cult Med Psychiatry (2008) 32:516–551 525
pacts in Asahi Shinbun, a major Japanese newspaper, dates to October 2000, in a
note that at the time there were 40,000 Japanese Web sites on suicide, 150 of which
were devoted to “how to commit suicide.” The first widely popularized case of an
Internet suicide pact took place in February 2003, when a teenage girl found one
man and two women dead in an apartment room, lying down side by side like the
Japanese character for “river” (). There were numerous charcoal briquettes in a
shichirin stove oven, and all the windows were sealed up with Scotch tape. It later
turned out that the man had set up his apartment to commit suicide, and had invited
others to join him over the Internet; the two other women and the girl who later
found them had agreed to do so.
Since this incident, a chain of suicide pacts has been recorded involving this
method, which has become a popular way of committing group suicide. In October
2004, seven young men and women were found dead in a car in the parking lot on a
mountain in Saitama Prefecture. There were four shichirin in the car and all the
windows had been sealed up with Scotch tape. This was the largest number of
individuals who had died through an Internet suicide pact until nine individuals died
together in 2006 (Hi-ho Kai-in Support 2007).
At the end of 2006, entering the word “suicide” at the Japanese-language site of the
popular search engine Google yielded 3,140,000 Web sites, and the phrase “suicide
methods” [jisatu no houhou] returned 22,600 results. The suicide-related Web site
Ghetto ( reports having had 976,580 hits (visits to the site)
since it was opened, and 821 hits in one day (as of December 18, 2006). Another Web
site, Jisatsu Saito Jisatsu Shigansha no Ikoi no ba, which literally means “Suicide
Site: A Relaxing Place for Suicidal People” (, reports
having had more than 3 million hits since it opened and as many as 1,121 hits on a
single day as of December 18, 2006.
Since September 2003, I have visited more than 40 of these Japanese suicide
Web sites in an attempt to understand better the nature of Internet suicides and the
role these Web sites play in them. Although participant observation is a more
standard model for ethnography in cultural anthropology, I found that closely
monitoring the statements of numerous suicidal individuals on more than 40 Internet
suicide sites provided a means of gaining insight into their suffering and their
motivations for seeking out communication with others. Among the more than
40,000 sites on suicide, I narrowed down the list of those to study by searching the
Internet for phrases such as jisatsu saito [suicide sites], shu
¯dan jisatsu [group
suicide], or jisatsu kurabu [suicide club] in order to identify suicide Web sites that
were organized and run by a regular moderator with features such as a bulletin board
(BBS) and chat rooms. Also useful was a site that listed and ranked the most
popularly visited suicide sites (Site Rank 2005). The majority of the suicide-related
Web sites I visited were composed of the following standard elements: (1) a site
guide, (2) a BBS, (3) a chat area, (4) links to other Web sites, and (5) an area about
the moderator who ran the site. Regulation of suicide Web sites increased over the
time I studied them; thus, by 2006 most suicide sites stated that any message
containing information such as a telephone number, address, and time/place to
organize the suicide, would be immediately deleted by the moderator, while this
was not the case in 2003.
526 Cult Med Psychiatry (2008) 32:516–551
Most suicide sites present themselves as functioning for the purpose of suicide
prevention, that is, as spaces where suicidal individuals can openly share and
discuss their troubles and suffering. However, the sites have also been blamed for
having a bad influence on children. One Internet site that is opposed to the standard
suicide sites, for example, is titled “Lured into Group Suicide by Recruiters: The
Danger of Suicide Websites!” (Hi-ho Kai-in Support 2007). This Web site says:
Suicide sites have been places for exchanging ideas about group suicide. They
have introductions to suicide methods and people can find suicide partners
through these sites. There are vivid, persuasive words on these sites. There are
persuasive recruiters who powerfully lure individuals, who are not yet sure
about suicide, to commit suicide, and this is the pattern. Sometimes there are
cases of individuals who initially tried to prevent someone from committing
suicide, but who ended up being convinced by that person, and ended up
involved in a case of attempted suicide.
The site also suggests that parents block terms like “suicide” by using Internet
filters to protect their children from this danger by preventing them from accessing
suicide Web sites.
The language of the warnings contained on this site projects an interesting image
in that it suggests that the concern is not with individuals who have firmly and
consciously decided to commit suicide but, rather, with a group of people who are
unsure about what to do, are impressionable and might succumb to suicide if
convincingly persuaded. This category of susceptible individuals appears in the
moderator’s comments quoted at the beginning of this article. It is also a theme of
Sono Sion’s powerful and disturbing film Suicide Club (Jisatsu Saakuru 2002),
which portrays a wave of suicides that take place for no apparent reason, including
groups of schoolchildren who decide to commit suicide simply because they have
heard about others doing it. There is a strong sense, therefore, that Japanese
adolescents are not immune to the dangers of suicide and may in fact be particularly
susceptible to it.
The suicide Web sites have many regular visitors and they are often young (many
identify themselves as being in their 20s or as junior and high school students, 14–
18 years old). In some cases the moderator is completely invisible, but in others the
moderator has a visible role and regularly responds to visitors’ comments like a
counselor. At one site, some visitors’ comments made it clear that they were visiting
the site because they felt the moderator was supportive and understanding.
A typical example is the suicide Web site called Ghetto, which is composed of
two chat rooms (one open to all visitors and one restricted to members), several
discussion forums with titles such as “Grassland for Suicidal Individuals” and a
links section called “Suicide Station.” The moderator states:
This site’s main purpose is to discuss suicide and mental illness. We welcome
those who may not particularly want to discuss only sensitive issues such as
suicide, but who would like to be connected with others who may have similar
problems. For those who are facing a serious situation but still want to live, we
recommend that you call the national hotline (inochi no denwa). (Ghetto 2006)
Cult Med Psychiatry (2008) 32:516–551 527
The moderator further explains how certain activities are prohibited on the site,
including “writing in private information such as addresses and telephone numbers,”
“spurring others on to actually commit suicide or other illegal acts,” and “suicide
announcements with precise information such as place, date and time” (Ghetto
In studying Web sites like Ghetto, I decided to concentrate on the BBS sections,
as I found these most useful in getting a sense of how individuals contemplating
suicide might express their thoughts on-line. I preferred this to visiting chat rooms
due to my reluctance to affect the visitors to these Web sites. Unlike chat rooms,
BBSs allow individuals to post their comments on the Web site with the full
knowledge that they will be public and can be read by anyone. The BBS forums
varied from collections of poems, to sustained discussions about a theme or topic
(such as “afterlife”), to a random assortment of monologues without much feedback
or comments.
During my study, I was struck by certain recurring themes, comments and
expressions. A very large number of the posts were by individuals who said they felt
that they could find no meaning in this world, or did not know what they were
supposed to do in this life. Teenagers complained about bullying at school, and
many stated that they had not been attending school for a while. Some said they
started visiting the site after losing their job, losing their spouse or contracting an
illness. Others claimed nothing was wrong in their environment, yet they still felt
empty. The following is a small, but representative compilation of examples of
some of the most common types of expressions I found at the Web sites I studied,
grouped into major themes.
One of the most frequently expressed concerns is an absence of meaning. Some
posts reflect a general existential concern, such as Why was I born? Who am I
anyway? Where am I going to go? I think there is no meaning to life as I do not even
know that (Ikizurasa kei no foramu, November 22, 2006). Others cite specific
incidents that led to a sense of life having no meaning: “I turned 21 this year. There
is something I have been thinking about for a long time. Why was I born in this
world? When I was 10 years old, I was scolded badly by my parents. Since then I
started thinking that there is no meaning for me to live and I’ve attempted suicide
many times” (Ikizurasa kei no foramu, September 16, 2006). This comment hints at
resentment, and hatred is indeed an emotion that surfaces in some of the posts in
connection with an absence of meaning. One visitor wrote, “Why was I born? Why
am I living? … I can hardly sleep nowadays as I hate everything” (Jisatsusha no
So¯gen, December 22, 2006). Several express that even though nothing is wrong with
their life in terms of external conditions, such as family life, finances and so on, they
experience despair as a result of finding no meaning in life.
Conjoined with this absence of meaning is a sense of loneliness. Almost all the
posts I came across at suicide Web sites made reference to how lonely the site
visitors were. One individual wrote:
My dependency got worse as I started to participate in chat rooms. I feel
anxious when I am alone. I cannot leave the computer even for a second. I feel
anxious that I am not needed by anyone. Just being told that I am necessary
528 Cult Med Psychiatry (2008) 32:516–551
would be enough—I would have a peace of mind. I would do anything asked
of me so as not to be disliked.… I am lonely. I cannot live alone. I want to be
strong.… To be honest, I am becoming unsure of what I am living for.… As I
cannot believe in true love, I seek even just the words.… I want to be loved
and needed. (Nageki Keijiban, October 12, 2006).
Loneliness is often linked with an inability to interact socially. One comment
notes, “I cannot stand loneliness! But I cannot trust people. I cannot trust anything
except myself and my pet” (Nageki Keijiban, October 13, 2006). Loneliness is also
experienced despite the physical presence of other people, as in the post of one
student who wrote, “I am so lonely! Even at school, I am so lonely and I want to
die” (Ikizurasa kei no foramu, December 13, 2006).
What is notable is how many of the posts do not give an explicit reason for this
feeling of loneliness. The phrase nanto naku, meaning somehow or for some reason,
occurs frequently, as in the following post: “For some reason, I am lonely … all
alone … I wish I had not been born.… Life is long.… I will serve my life! Please
come and fetch it [my life] if there is anyone who wants it” (Ikizurasa kei no
fo¯ramu, November 1, 2006). Another wrote, “For some reason, I am living. For
some reason, I want to die … but I am afraid of pain and I am also afraid of meeting
Yama [the Lord of Death in Buddhism] in hell, and it does not matter much about
living. I do not know what I want to do.… I just want to die. I wonder why”
(Jisatsusha no So¯gen, December 24, 2006).
There are also comments in posts that explicitly call out for a change that will
alleviate the loneliness being experienced, such as “I want to be alone, but I wish
someone were there by me” (Ikizurasa kei no fo¯ramu, October 28, 2006), and “I do
not want to be alone. Even though I am a failure, I still want someone to love me”
(Kokoro no Hanazono, November 19, 2006). Some, however, express a loneliness
that does not seem like it would be eliminated by merely meeting someone. One
individual wrote simply, “I do not have any place” (Ikizurasa kei no fo¯ ramu,
December 21, 2006), and a school girl commented, “I feel lonely whenever I am by
myself.… I feel like I would like to die, but then I am too afraid to commit suicide”
(Kokoro no Hanazono, November 16, 2006).
Loneliness and an absence of meaning in life seem to be closely connected in the
comments of these individuals, and both are given as reasons for suicide. There is
often a sense of inner conflict: on the one hand, they experience intense loneliness
when by themselves, but on the other hand, they feel mistrustful of others and do not
like to be in social settings. In certain cases, these feelings seem to combine in the
wish to die with others—in other words, to escape the pain of loneliness and
absence of meaning in this life but, at the same time, to do so in connection with
another person or persons, because to die alone would be too painful.
Thus, the following comments are common: “Are you suicidal and would you
like to die with me? I don’t have the guts to die alone. I’m asking for people who
would like to die with me” (Omae ha mou shindeiru, December 24, 2005), and “Is
there anyone who wants to die but who can’t die alone? Please, let’s die together”
(Ikizurasa kei no fo¯ramu, November 7, 2006). The tone of suggestions to commit
suicide together is often shockingly casual. One person wrote, in response to another
Cult Med Psychiatry (2008) 32:516–551 529
post: “Sleeping pills won’t kill you, as Kumagorou says. Is there anyone who would
like to die using another method?” (Ikizurasa kei no fo¯ramu, November 6, 2006).
Another wrote, “Would you die together? By the way, I live in Gunma prefecture”
(Ikizurasa kei no fo¯ramu, November 4, 2006). Often, the tone is pleading or
supplicatory: “I have been wanting to die and have been thinking about suicide
methods. Please let me die with you” (Ikizurasa kei no fo¯ramu, Sepetember 15,
2006); “If it is all right with you, would you like to die with me?” (Ikizurasa kei no
fo¯ramu, Sepetember 14, 2006); “I no longer wish to suffer. But I am too afraid to die
alone. Is there anyone who wishes to die with me?” (Ikizurasa kei no fo¯ramu,
August 14, 2006).
One of the comments cited above mentions Yama, the Lord of Death in Buddhism,
and it is quite relevant to ask what kind of afterlife, if any, such individuals are
envisaging following suicide. However, many Japanese claim that they are not sure
what the afterlife is like, and this uncertainty is prevalent on the discussion boards of
the suicide Web sites as well. Christianity represents less than 1% of the Japanese
population, and although the majority of Japanese families have some connection to a
Buddhist sect, these ties are often only apparent during certain ceremonial occasions,
and most Japanese are not practicing Buddhists, while even fewer would self-identify
as practicing Shintoists. The largest type of religious affiliation held by Japanese
would be the so-called “new religions” and “new new religions,” which are various
sects that draw from Buddhism, Christianity and other traditions, and are often
organized around a particular charismatic religious figure, but these are also regarded
as suspect by many Japanese. Thus, the situation in Japan bespeaks a significant
openness and variety of views when it comes to how the afterlife may be envisioned
(one such envisioning takes place in the film Afterlife (Wandafuru raifu [literally
“Wonderful Life”], Japan, 1998) by Kore-Eda Hirokazu, which was influenced by and
partially based on the narratives of hundreds of “real-life” Japanese) and this is
reflected in discussions about the afterlife on suicide Web sites.
One visitor commented, “Miwa Akihiro [a TV personality] said that even if you
commit suicide and die and are reborn, it is just like running away. As you have not
conquered the problem, you will repeat the same thing again and again [in future
lives], so it’s meaningless to commit suicide” (Nageki Keijiban, December 11,
2006). Another wrote:
The mainstream view is that life is one time, but I think life repeats many
times. That way, I think people can lead an easy life, be able to be kind to
other people, not become desperate, and be unselfish. I think looting occurs
during disasters because people think life is only one time. Regarding suicide,
I don’t think it’s a solution to end this life, so I won’t do it. I think I would just
have to go through the same thing again. (Nageki Keijiban, December 20,
Here, as in the case of the visitor who wrote about Yama, a certain conception
about the afterlife serves as a disincentive to resort to suicide.
There are many posts that do not explicitly connect a wish to die to with an
absence of meaning. However, these posts do often express a certain uncertainty
with regard to what to do in life, which seems to be a milder awareness of an
530 Cult Med Psychiatry (2008) 32:516–551
absence of meaning. Such individuals seem to be on the borderline, as they do not
wish to experience any pain that might be involved in dying, yet they also express
the sentiment that neither living nor dying would make much difference to them.
Committing suicide often has an active and intentional connotation, but these
individuals express a great deal of passivity. They seek a painless death, and dying
with others seems to be one way of eliminating some of the pain of death. One such
individual wrote, “I’m so tired. What’s the point of living any longer? But I don’t
want to die in pain. I want to vanish in a second” (Ikizurasa kei no fo¯ramu, October
15, 2006).
The last common theme that I found among the posts and discussions was a sense
that one’s social interactions were “fake,” a sentiment connected with the idea of not
being able to trust others. One person wrote, “Recently I’m not sure why I’m alive. I
go to school, do some part-time job, and it’s a nothing special, everyday life. But I
can’t make friends, perhaps because I don’t trust people. I always suppress myself
and show a fake self.… The only thing I think about is life and death. I really
wonder why I’m living” (Jisatsusha no So¯ gen, December 16, 2006). And another
wrote, “I want to be normal. I’m pretending to be normal. If people find out that I’m
not normal, then they will all leave me. I will then be all alone” (Kokoro no
Hanazono, November 19, 2006). This sense of the pain of not being accepted for
who one is comes through in statements made by those who have emerged from
such a state as well, such as in this comment: “By the way, my environment has
changed and I am now surrounded by people who accept me so I stopped thinking
about death at all. At one time I really wanted to die” (Ikizurasa kei no fo¯ramu,
October 17, 2006).
Becoming an Adult in Japan and the “Worth of Living” (Ikigai)
The rise in group suicide among strangers, exemplified by Internet suicide pacts,
raises challenging questions about the nature and causes of suicide in Japan.
Commenting on the death of nine young Japanese in October 2004, who arranged a
group suicide over the Internet and died in their cars due to carbon monoxide
poisoning, caused by charcoal-burning stoves, one Japanese man wrote at a BBC
News Web site:
In 70s we were not rich but we had dreams. If we studied and worked hard, we
could buy TV sets, cars and so on. We’ve never imagined that our companies
go bankrupt or we get fired for a recession. We are pessimistic and vulnerable.
Once we lost a life model, we have a difficulty finding new one [sic.]. Now
adults in Japan are struggling to find new dreams or purposes to live. We have
to change or we can’t show a brighter future where young people will want to
live. (Akira Tsutsumi, Nara, Japan; BBC News 2004)
Such comments point to both Japan’s economic situation and the loss of a clear
ikigai [literally “worth of living”], or reason to live, among both older and younger
generations. As Traphagan (2004, p. 316) notes, “For many Japanese, younger and
older generations are perceived as having completely different core values, which
Cult Med Psychiatry (2008) 32:516–551 531
leads to considerable stress between those generations.” In addition to these factors,
one is naturally left to question the state of mind such individuals are in when
contemplating and committing shinjyu
¯, or suicide pacts, with relative strangers. One
woman who died with a man she had just met over the Internet stated in her will:
“It’s sad to die alone. It could have been anyone” (Sasaki 2007). The actual nature
of the relationship is difficult to define: on the one hand, the individuals are
strangers who may mean very little to each other. On the other hand, the fact that
they are doing something together—even if it is suicide—creates a bond and
requires a relationship of trust. We have seen comments such as “Will you be my
friend? Will you die with me?” This is a strange kind of friendship and—for the
many Japanese who believe in the continuation of life after death—a strange kind of
companionship on the journey from this life to the next, a journey that they may not
have the courage to venture alone.
While we commonly understand how social conditions can result in social
suffering, anthropology has tended to focus on particular social conditions of
deprivation, such as poverty, oppression and prejudice. This is not the case for the
social suffering in Japan that we are investigating here. Although Japan did suffer
from a long-term economic recession, the society has nevertheless succeeded in
modernization and development in the post-World War II period, becoming a major
capitalist power with tremendous success in terms of education, standard of living
and medical care. It is an affluent society in terms of material well-being, and it
remains so despite the recent economic recession, which has commonly been
blamed for the recent rise in suicide rates and depression. Despite all this, the social
and cultural environment that such individuals are born into is one within which
they feel the absence of a clear ikigai, conjoined with a loss of traditional family
values, changes in family structure and a perceived failure to meet the aesthetic
expectations of society. These and other complex factors seem to be resulting in a
profound sense of loneliness and alienation.
Adolescent suicides have often been characterized by the intention of punishing
others, for example, with the thought, “If I die now, I will make all those bullies feel
bad about themselves.” But the latest group suicides show no sign of wishing to
punish others, and the method of carbon monoxide poisoning seems to lack
dramatic appeal; rather, it seems to be popular because it is perceived as the most
painless and comfortable method. In addition, suicide in Japan has often been
characterized as a way to “take responsibility.” Through one’s strong connection
and affiliation with a larger entity—the nation, the company, one’s code of honor—
one commits suicide as a form of corporate atonement. Yet recent adolescent
suicides and group suicides, such as Internet suicide pacts, seem to be quite the
opposite of this. Rather than arising from a sense of connectedness and self-
sacrifice, they seem to indicate a fundamental disconnectedness or anomie.
A strong sense of isolation, loneliness and alienation alone might not be so
distinctive or unique, but the choice to die with others, especially strangers, is less
usual. It is not hard to see such suicide pacts as a sad cry for individuals who are
seeking reconciliation, connectedness and unity with others and, perhaps, the world.
In Japanese society, dying alone is stigmatized, and it is a cultural imperative for
family members to be present when a person dies. Long (2001, p. 273) writes, “The
532 Cult Med Psychiatry (2008) 32:516–551
potential for loneliness of the dying seems to be a particular concern, expressed not
only in words (for example, kodoku na shi, “lonely death”), but also in the near
obsession with shini me ni au (being there at the moment of death).” In most cases
of individual suicide, one might not actively wish for others to die alongside oneself.
In cases of group suicide, however, this wish to avoid a “lonely death” seems to
obtain. Even the choice of the shichirin stove itself is significant, for it is a nostalgic
symbol of comfort, togetherness and communal action, like gathering around for a
barbeque. This raises the question of whether modern Japanese are paying the price
of pursuing “individualism” with a sense of loneliness and alienation. If suicide is
not being used as a way to punish others, or make a dramatic statement, and if it is
not arising as a form of sacrifice or corporate atonement, is it possible to think that
these suicides are something entirely different: an attempt to bring about healing
from a state of existential loneliness?
To understand this suggestion, it will be necessary to place it in a broader
context. The year 1995 was a tragic year for Japan. The Kobe earthquake hit on
January 17, and the cult group AUM attempted mass murder by spreading sarin gas
in a Tokyo subway station on March 20. Because AUM employed many concepts
and techniques from established religions like Tibetan Buddhism, yoga and
Hinduism, these came to be associated with violent extremism. Previously, large
numbers of people in Japan had turned to established and new religions when
confronted with serious internal problems, but after the AUM incident, new
religions especially came to be seen with aversion and suspicion. Counseling, which
had been stigmatized, became more popular in the wake of these two tragedies.
In addition to the tragedies of 1995, the broader social and cultural situation in
Japan has been affected by rapid structural and ideological changes following World
War II, such as the decline of traditional extended family structures, changes in
traditional values such as placing the family above the individual’s needs, suspicion
of the idea of religion and changes in company structure such as the loss of life-long
job security. Many contemporary Japanese individuals are torn between adopting
Western individualistic values and maintaining traditional values, as in the case of
wondering whether they should put their own or others’ happiness first. Tradition-
ally ikigai would have been closely associated with social roles, such as one’s job
for men and caring for the family and one’s in-laws for women. Ikigai has now
become more of an open question for many Japanese, who must struggle to find a
meaning for their existence without the traditional social roles to fall back on.
Yamamoto-Mitani and Wallhagen’s (2002) study among Japanese women caring
for their elderly in-laws reveals a range of responses from an acceptance of
traditional social roles and finding one’s ikigai in them (“Caregiving and ikigai,
after all, for me … they are inseparable” [407]) to a more ambivalent intermediate
position (“I have to believe that taking care of Mother is my ikigai. I have to believe
that, otherwise I feel empty” [409]), to a feeling that one’s social role is a
suppression of the self and should not be one’s ikigai (“It is really sad if caregiving
is my ikigai” [407]). They write that “[The] moral imperatives that underpin the
lives of Japanese women are undergoing significant modification.… The introduc-
tion of more Western institutions has also encouraged more individualistic views of
self, family, and well-being” (403).
Cult Med Psychiatry (2008) 32:516–551 533
Mathews (1996, p. 734) notes how a strong sense of ikigai is linked with a feeling
that one is needed, essential, not merely a nameless cog in the machine that could be
replaced without anyone noticing; this explains why, in his interviews, “family as
ikigai tended to breed less ambivalence than work.” The comments of suicidal
individuals at Web sites illustrate an absence of feeling needed, a yearning to feel
needed and a corresponding lack of being able to find a reason to live. Company men
who may realize that they are not essential to their company’s survival still need to
convince themselves that they are, in order to make their work their ikigai and thereby
have a reason to live (735). Yet the comments of suicidal individuals at Web sites
seems to indicate that they are not integrated into any kind of framework—either work
or family—that makes them feel essential and needed.
It therefore does not seem a coincidence that this lack of integration, feelings of
worthlessness, a lack of ikigai and loneliness are more prevalent among young
persons than adults, who would already be integrated into larger networks that
would create a sense of being needed and an ikigai. A younger person does not have
a clearly defined role or position of responsibility within a family (as a caregiver and
provider, for example, which a father or mother can be, either through company
work or by taking care of the home) and has not yet assumed a position within a
company or as a caregiver in his or her own family. Mathews (1996) has noted that
for younger persons, ikigai comes not from the self’s embeddedness in these
networks, but from anticipation of future selves and, one would assume, future
relational networks. It would seem therefore that the anticipation of ikigai serves as
a kind of ikigai when a network of social embeddedness, obligation and a feeling of
being needed have not yet been established. In that case, what is missing in these
young persons’ lives is this sense of anticipation—that there is something in the
future worth living for, and a clear set of paths to the future or scenarios that can be
Further complicating this issue is the conflict of ideals Japanese youth face with
regard to what it means to become an adult in Japan. While the influence of Western
values is clearly visible in Japan, the model of adulthood presented through such
values differs significantly from traditional Japanese notions, and when these
models come into conflict, the difficulty of combining Western ideals into existing
conceptions can result in tensions (Pike and Borovoy 2004). One point of
contradiction concerns the notion of adolescence, and another is the ideal sense of
selfhood that is to be achieved.
Adolescence, of course, takes on varied significance in different cultures, and
lasts for varied periods according to diverse cultural logics. In Japan, the adolescent
period is considered rather prolonged, due to the fact that many young Japanese
remain resident at their parents’ houses and continue to lead financially dependent
lifestyles after high school or college graduation. Adolescence or seinen-ki is
broadly defined as the period between 15 and 24 years of age (by the Ministry of
Health and Welfare, for example), but this period can be conceived of as extending
as long as to age 34. It is also common to consider people who are in high school
and college (15–22 years old) as being in seinen-ki.
Thus, unlike the United States, the link between adolescence and puberty as a
period of biological turmoil is not emphasized in Japan (LeTendre 2000; Mead
534 Cult Med Psychiatry (2008) 32:516–551
2000; Pike and Borovoy 2004; White 1994). Rather, it is seen as a period in which
one engages in highly competitive examination preparations (for junior high school,
high school and college) while training to become a responsible adult (LeTendre
2000; White 1994). However, as Pike and Borovoy (2004, p. 508) note, adolescence
in Japan is not emphasized “as a time of emerging autonomy and independence”
but, rather, “as a time of social integration, great energy, and potential, rather than
as a turbulent time of transition and antisociality.” White (1994) also notes that
adolescence in Japan is the period to prepare and discipline individuals for social
relations in adulthood.
Being an adult in Japan comes with a strong emphasis on being a responsible
member in society. For an equivalent of “worker,” Japanese use the term shakai jin,
which literally means “social being,” emphasizing a sense of belonging. For women,
being a mature adult is intimately connected with motherhood (Kinsella 1994; Lebra
1984; Pike and Borovoy 2004), and Pike and Borovoy (2004, p. 502) even describe
the prevalent view of “motherhood as the only route to maturity.” Higher education
for women is still seen as a period for them to train to be good wives and mothers,
especially at two-year junior colleges (McVeigh 1997). For men, being a mature
adult is strongly associated with being employed at a company and being financially
responsible to one’s dependent family.
Given these considerations, a prolonged adolescent period among unmarried
single men and women may be seen as a sign of resistance and unwillingness to
enter an adulthood that comes with highly defined and highly gendered social roles
and, therefore, a more tightly constrained social existence. The rise in age for
marriage and the bearing of children maybe an indication of young women’s wish to
prolong adolescence and delay their entry into the responsibilities of adulthood.
Scholars like Kinsella (1994), for example, have argued that the obsession of young
Japanese women with “cuteness,” such as Hello Kitty merchandise, can be read as a
form of protest against the gendered role of mature motherhood.
The liminal state between childhood and adulthood may be appealing to young
Japanese because of the relative degree of freedom it affords. At the same time,
however, the flip side of that freedom from entrapping social relations is a degree of
uncertainty and isolation caused by the absence of those very same social relations.
Remaining in such a state for a prolonged period of time, as happens with the many
young Japanese who stay at home late into their twenties and thirties, could allow
that uncertainty and disconnection to develop into anxiety; the prolongation of the
period before transition into adulthood could make that transition all the more
difficult and concerning. Thus it is not surprising that these themes—existential
anxiety, loneliness, lack of satisfying social relations and lack of a role or meaning
for oneself—all appear regularly in the posts and conversations recorded on suicide
Healing and Social Well-Being
After 1995 many Japanese began seeking therapeutic help for their suffering, giving
rise to a “healing boom” of healing practices, healing techniques, healing music and
Cult Med Psychiatry (2008) 32:516–551 535
even healing drinking bars, which has continued to this day. Prior to 1995, the word
iyashi, or healing, had hardly been used in Japan, but it quickly rose to widespread
use, alongside imported words like torauma [trauma]. Women’s magazines started
reporting that “healing makeup” was trendy because many people wanted the
“healing look” (some actresses got grouped into this iyashi-kei face). The meaning
and connotations of the term iyashi, however, do not correspond identically to the
word “healing” in English. It refers to something that is soothing, is comfortable or
brings one heavenly feelings. Ironically, the shichirin—the stove used for carbon
monoxide poisoning—is the ultimate icon of the nostalgic warm fireplace in a
traditional Japanese house, as it was commonly used in homes until the 1950s.
The sudden rise in suicide in Japan in the late 90s is therefore best explained as the
result of the coming-together of many factors: the background of modernization—
with its promise of progress, development and wealth as an ersatz ikigai—and the
corresponding gradual erosion of traditional social and familial networks; the burst of
the economic “bubble” that shattered this promise of ever-increasing economic
wealth as a new source of meaning and orientation; the punctuated tragedies of 1995,
which were not preventable by Japanese affluence and could not be solved through it
or other modern means; and the consequent rise not only of mental health issues and
awareness of mental illness, but also of a turn to healing and spirituality and an
increased awareness of existential alienation, loneliness and loss of meaning. The
phenomenon of group suicide—dying with other people, rather than terminating
one’s life alone—seems to be an effect of this problematic progression, indicating a
wish for a sense of “comfort” and a fleeting, final sense of embeddedness while, at the
same time, expressing a reluctance to take full, individual responsibility for cutting
oneself off from life. The wake of the 1995 tragedies has witnessed both a strong
antireligious sentiment among Japanese and yet an increased awareness of their
suffering and need for holistic, even spiritual, healing. Seeking out solutions for
mental and spiritual well-being, it is possible that some have gone for counseling and
healing practices, while others, unable to find comfort in such methods, have chosen
the way of individual or group suicide.
For people living in the West, the decision to kill oneself would generally be
something private, shared perhaps with a very close friend or relative—certainly not
something involving a stranger. To open up one’s apartment or home for others to
come in—others whom one had only contacted via the Internet—to participate in an
act of group suicide would seem a violation of one’s privacy, to say the least. The
fact that some Japanese do so reflects a sense of communal trust that exists in Japan
but is far less prevalent in American society. My (2006) work shows this difference
in privacy and trust in my research on the Japanese therapeutic practice of Naikan,
where I found that Japanese clients at Naikan centers would allow their confessions
(very intimate and personal reports of their life stories from birth to the present) to
be recorded on tape, kept at the Naikan center and rebroadcast later for the Naikan
sessions of others, whereas this practice is never done at Naikan centers in Europe
or the United States.
Yamamoto-Mitani and Wallhagen (2002, p. 402) write that for Japanese,
“psychological well-being is typically sought through belonging to a group in a
harmonious manner and achieving certain goals by means of group activity; it is not
536 Cult Med Psychiatry (2008) 32:516–551
experienced as an individually derived construct (DeVos 1985; Lebra 1976).” In her
discussion of Japanese selfhood, Tsuji (2006, p. 417) writes that social embedd-
edness, obligations and conformity are the “three closely interconnected
components [that] play a crucial role in forming Japanese identity.” Of social
embeddedness, she writes:
Playing one’s role properly weighs more heavily for self-realization than does
pursuing one’s interest (DeVos 1973). Furthermore, because group affiliation
is so essential in attesting to who one is, being unaffiliated means social
anonymity and makes one an object of suspicion. As Plath (1980:217)
commented, “The ‘cultural nightmare’ of Japanese is to be excluded from
others.” (417)
Here, “playing one’s role properly” recalls statements at Japanese suicide Web
sites about “faking it” and being unable to show one’s real self; and the Web site
statements we have mentioned above (such as “I do not have any place”) reinforce
Tsuji’s claim that being excluded from others is a powerful source of suffering for
Japanese. Of obligations, she writes, “Group membership serves as informal social
control, encouraging people to behave in a way that is acceptable to, and expected
by, other members of the group. Uncodified though such control may be, it is
effective nonetheless because leaving a group one finds intolerable is not an easy
option for the Japanese (Hendry 1998)” (Tsuji 2006, pp. 417–418). Of conformity,
Tsuji notes that “underlying the importance of conformity is the belief that an
individual is incomplete by him- or herself, so interdependence is imperative
(Edwards 1989). To promote interdependent relationships, Japanese culture …
equates the assertion of individual desire with selfishness or arrogance” (418).
What is the nature of this relationship formed through Internet suicide pacts—at
once a relationship of strangers, yet requiring a basis of trust and mutual
understanding, and involving the decision to terminate one’s life? Committing
suicide with another person presupposes a relationship of trust, and the act itself—
given its paramount seriousness and gravity—creates a new type of relationship,
bond or connection between the people involved. Then is it not a paradox that the
statements of suicidal individuals—as shown at Internet discussion board and chat
sites—contain constant references to how they cannot trust others, are lonely and
have failed to connect with others and form meaningful relationships? In such a
situation, a stranger may act as a tool to create a form of quasi-community, but
without the emotional trappings that inevitably accompany a relationship with
someone one knows better. Taking the threefold categorization of relationships
employed in Buddhist psychology of those whom one likes or feels close to
(friends), those whom one dislikes or feels hostile toward (enemies) and those to
whom one is merely indifferent or about whom one knows little or nothing
(strangers), then there is an advantage to choosing someone from the third category
to die with. Persons who wish to commit suicide may not want friends to die with
them, due to their friendly care or emotional attachment; these same persons may
not want to die with an enemy, due to feelings of aversion. A stranger, however,
causes neither problem, while still creating the safety of a group environment and
the comfort of taking a communal rather than an individual action.
Cult Med Psychiatry (2008) 32:516–551 537
Another aspect of group suicide with strangers is the trade-off between individual
agency and responsibility: when one assumes agency, one also needs to take
responsibility. For example, traveling abroad on a group tour, a common way of
traveling for Japanese, involves relinquishing a degree of individual freedom, but
with it one also relinquishes individual responsibility and the burden of bearing that
responsibility solely by oneself. If the group decides something, or the group takes
an action, it is not so much that “I, the individual” am taking that action; rather, “I
am merely going along with the group.” It may even be something the individual
wants to do, yet feels uncertain about doing by oneself; if so, joining a group that is
doing it makes it easier for individuals to fulfill their own wishes. In fact, the
alignment of autonomy with social obligations, rather than autonomy over and
against social obligations, seems to be an important factor in social well-being
cross-culturally (Keyes 1998; Sheldon et al. 2004), and one would expect this to be
especially true of societies such as Japan, given the importance of social relations in
the constitution of selfhood (Kondo 1990).
The fact that the group chosen in
suicide pacts is a group of strangers seems to indicate that existing relations—at
home, school, work and so on—are perceived as inadequate and deeply problematic,
and that future relations, if formed within these same networks, would be equally
unsatisfactory. This isolation creates a feeling of profound loneliness that only
intensifies the need to merge with others and forge new, authentic relations of a
wholly new and other kind, unmediated through the unsatisfactory, preexisting
modalities of social interaction.
Loneliness and Existential Suffering
There is no question that loneliness is a central factor in understanding the situation
of suicidal individuals and those who participate in suicide Internet Web sites, and
we have seen that comments on loneliness are very prevalent at such sites. Yet what
role does loneliness play in understanding the phenomenon of Internet suicide? Up
until recently very little work has been done on the topic of loneliness in
anthropology despite its pervasiveness cross-culturally and its interesting relation-
ship with modernity. However, the last 10 years has seen a significant increase in
work on loneliness in sociology, social psychology and the health sciences, although
most of it has concentrated on the elderly and children. These studies have identified
three essential characteristics of loneliness: that it involves perceived deficiencies in
one’s social world, that it is a subjective state experienced by the individual rather
than an objective feature of the individual’s social world and that it is experienced
as unpleasant and distressing (Kraus et al. 1993, p. 37). As scholars have
emphasized either the social factors involved in loneliness (social networks, number
of friends, level of social interaction) or the individual factors (personality variables,
In some studies, individuals acting because of autonomous reasons have reported greater subjective
well-being than those acting because of controlled or externally regulated reasons (Deci and Ryan 2000;
Sheldon 2002; Sheldon et al. 2004, p. 99), and one cross-cultural study has argued that older individuals
feel greater autonomy in performing social duties (rather than seeing them as externally imposed
injunctions) (Sheldon et al. 2004).
538 Cult Med Psychiatry (2008) 32:516–551
cognitive bias), depending on their disciplinary bias (sociology favoring the former,
psychology the latter), the proposed responses have likewise been for changes in the
social situation or individual therapy (Carden and Rettew 2006; Hawkley et al.
2005; Kraus et al. 1993; Lopata 1969; Mahon et al. 2006; Martina and Stevens
2006; Renshaw and Brown 1993; Stack 1998; van Tilburg et al. 1991). Interestingly,
this parallels our earlier discussion of the way suicide is viewed in Japan
predominantly as a social ill or pathology, and in the West as an individual one, with
corresponding theories for treatment and response.
The predominant approach taken in sociology and social psychology has been
criticized as being too simplistic, and those seeking a deeper understanding of
loneliness that goes beyond whether one is married, has enough friends or enjoys a
high enough level of social interaction, have turned to the extensive literature on
loneliness in existential thought and phenomenology, such as Heidegger, Merleau-
Ponty, Tillich, and Buber (Karnick 2005; Nilsson 2006). Surveying the literature
across this broad range of disciplines reveals the complexity of loneliness and the
fact that it can refer paradoxically to both a dysfunction and a cause of pain, which
has been primarily the approach taken by the social and health sciences, and a
beneficial quality that leads to deeper self-understanding, which is a quality more
emphasized by the philosophers (Karnick 2005; Nilsson 2006). Another dimension
added by philosophical reflections on loneliness is its ontological and existential
nature. Yalom notes three kinds of loneliness, of which, along with interpersonal
and intrapersonal isolation, the third is existential isolation, a “‘separation from the
world,’ where the person is confronted with an anxiety in the face of nothingness
but also his own freedom. Loneliness is regarded as the deepest source of normal
anxiety” (Nilsson 2006, p. 95). Nilsson (2006) notes:
¨m and Lindholm’s (60) study shows that loneliness is one category of
existence. Furthermore, the same authors demonstrate the existential mean-
ingfulness of loneliness and write: “It belongs to the mystery of love that one
attempts to uphold another’s loneliness and create a free space in which
existential loneliness can be transformed into a mutually shared loneliness (60,
p. 41).”
Attention to the existential dimension of loneliness helps to explain how Internet
suicide sites create a space of communication and acceptance where lonely and
potentially suicidal individuals can enter in, express themselves and feel accepted
and understood by like-minded individuals who are also lonely, thereby transform-
ing their individual loneliness into a shared loneliness, and their dysfunctional
loneliness into a more beneficial form of loneliness, one less dominated by
consuming mental pain and more conducive for introspection and growth. In a study
examining the use of cell phone text messaging by Japanese schoolchildren, Ogata
et al. (2006) showed that mobile phone use decreased feelings of loneliness and
facilitated friendships and connectedness when used in an informed manner. It is
worth noting also that Internet suicide Web sites also contain forums for poetry;
poetry as a literary form is solitary in terms of composition and typically understood
in Japan as born from intense self-reflection and solitude, yet it is nevertheless a
form of communication, and an intensely personal and meaningful one. Poetry is
Cult Med Psychiatry (2008) 32:516–551 539
closely related to the idea of solitude and loneliness as positive forces for
introspection, contemplation and creativity.
I would suggest greater terminological sophistication by calling the negative
dimension of loneliness “afflictive loneliness,” borrowing from the Buddhist
taxonomies of mental states, which note that certain mental states are afflictive
when they disturb the peace of mind of the individual and are based in cognitive and
affective distortions not in accord with reality and not conducive to happiness
(Guenther and Kawamura 1975). The positive dimension of loneliness would be
better described as “nonafflictive loneliness” or solitude. Afflictive loneliness seems
to include a state of threat to the person, and reflects existential suffering.
Nonafflictive loneliness, or solitude, is not a dysfunction. Both types of loneliness
are connected with the ontological and existential dimension of loneliness, but differ
in terms of the way that ontological dimension is cognitively and affectively
received and engaged by the individual. Reorienting the framework on loneliness in
this way opens up room for interventions that do not need to be limited to the single
agenda of “eliminating loneliness,” but that could include ways of helping
individuals to learn mental and behavioral habits that reduce levels of cognitive and
affective distortion, which would result in a decrease in loneliness or, alternatively,
in a transformation of afflictive loneliness into solitude.
Furthermore, it is very important to make this distinction between existential
suffering and clinical depression, because psychiatrists have noted that when people
who were severely depressed are treated, it is often when they emerge from
depression that they experience existential despair and can then become more prone
to suicide than when they were actually depressed. This distinction has been
employed by Havens and Ghaemi (2005, p. 138) in their article suggesting the use
of therapeutic alliance with patients with bipolar disorder who suffer from
subsyndromal depression, often as a result of the medications prescribed to treat
their bipolar disorder:
It is our view that many bipolar patients may not have clinical depression
viewed as an endogenous disease entity, but rather they may be suffering from
clinical ‘despair,’ as defined by the existentialist philosophers Soren
Kierkegaard (Kierkegaard, 1989) and Karl Jaspers (Jaspers, 1998). Patients
may suffer, too, from a complete loss of hope for the future and a loss of any
grounding in the world.
This is a point Arthur Kleinman has been making in his work on depression and
neurasthenia in cross-cultural perspective (1986,1988,1991,2006; Kleinman and
Good 1985; Kleinman et al. 1997). His early work addresses the possible dangers
inherent in the medicalization of human despair, and in his most recent work
(Kleinman 2006, p. 9, italics added) he explicitly states:
Perhaps the most devastating example for human values is the process of
medicalization through which ordinary unhappiness and normal bereavement
have been transformed into clinical depression, existential angst turned into
anxiety disorders, and the moral consequences of political violence recast as
540 Cult Med Psychiatry (2008) 32:516–551
post-traumatic stress disorder. That is, suffering is redefined as mental illness
and treated by professional experts, typically with medication.
Not just Western philosophical thought, but also Buddhist analyses of suffering
are of relevance here. In Buddhism, suffering is divided into the three categories of
manifest suffering (obviously painful experiences), the suffering of change (the
impermanence of pleasurable experiences) and the pervasive conditioned suffering
of existence (one’s existential situation; the fact that one is endowed with a body
and mind that are subject to suffering).—The third category—that of existence—
connects with the ontological and existential dimension of suffering involved in
existential loneliness and recognized by Western philosophers and theologians such
as Tillich (1952), Kierkegaard, and others. That is to say, the mere fact of one’s
existence as a limited, delineated, separate individual with limited connectedness to
others and to the universe, and a limited understanding of one’s place in it, reflects a
situation of pain, anxiety, doubt and fear—in other words, suffering. This third level
of suffering is considered the most subtle, but also the most pervasive and lasting.
As Tillich notes, in writing of existential anxiety, “it belongs to existence as such
and not to an abnormal state of mind as in neurotic (and psychotic) anxiety” (41).
This helps to show the difference between existential suffering and mental illness,
such as depression. Similarly, Frankl (1992, p. 125) writes:
I would strictly deny that one’s search for a meaning to his existence, or even
his doubt of it, in every case is derived from, or results in, any disease.
Existential frustration is in itself neither pathological nor pathogenic. A man’s
concern, even his despair, over the worthwhileness of life is an existential
distress but by no means a mental disease.
A clear recognition of this level of suffering would help in understanding the
phenomenon of Internet suicide in Japan. The suffering caused by painful
experiences, the loss of a loved one or a change in one’s circumstances is easier
to understand, and suicides arising from these kinds of suffering evoke sympathy
and understanding. A deeper understanding of pervasive, existential suffering, as
evidenced by afflictive loneliness, would help reduce the tendency to see suicides
that arise from this suffering as incomprehensible acts, or as merely the result of
mental illness, as commonly understood. Social psychologists informed by an
existentialist approach, for example, have noted that an inability to maintain a
certain consistency of self-understanding across multiple social roles (what William
James described as Zerrissenheit, or a feeling of being torn apart). This creates a
sense, therefore, of being inauthentic or fake to one’s true self and an inability to see
actions of social duty as autonomous engagement (rather than imposed externally)
—an ability that seems to increase with age and maturity—are correlated with
reports of lower subjective well-being and suffering (Sheldon et al. 1997,2004).
This speaks to the comments made by visitors to Japanese suicide Web sites—
comments on loneliness, feeling fake, being unable to relate to others—and supports
the idea that this existential suffering is connected with a difficulty experienced at
the entrance into adulthood and its concomitant establishment of a self-identity
congruent with social relations and roles, that is, the reconciliation of individual
Cult Med Psychiatry (2008) 32:516–551 541
autonomy with social relations and obligations that may be a prerequisite to a strong
The work of Schwab and Petersen (1990) on correlations between religiousness
and loneliness shows that not mere religiousness, but rather the nature of the content
of religious belief, was correlated with loneliness, supporting the idea that the
content of cognitions plays a significant role in loneliness and therefore that changes
in cognitions could effect positive change in dealing with loneliness and promoting
psychosocial well-being. They also note:
Further investigations of the relation between religiousness and loneliness
should take into account not only the multidimensionality of religiousness, but
also various dimensions of loneliness, especially something like “cosmic
loneliness,” one aspect of which is “a sense of broken relationship with Being
or God” (Sadler and Johnson 1980:45). The UCLA Loneliness Scale used in
this study does not include such a dimension. (343)
As noted, loneliness can be seen to involve two factors: the external environment
and effect of social forces on the individual, and the attitude or perception of
individuals themselves. A response to loneliness must therefore involve both these
dimensions: on the one hand, changes to social structures that will reduce the social
isolation of individuals and, on the other hand, methods for individuals to be able to
change attitudes, perceptions and behaviors, and thereby to find increased social
satisfaction from the situation they already find themselves in. A suitable response
must acknowledge both the social factors involved in promoting loneliness and
suffering, but also the individual cognitive biases, attitudes and propensities of
individuals that perpetuate them. This response would seek to effect social change,
but also to provide resources for individuals to change their own perceptions and
modes of interaction. In such a way, individuals are not disempowered from being
able to take positive action to change their own situation; yet by addressing social
factors, it is not merely left up to individuals to fix their own problems—rather a
social network is created to support them in that process through education,
opportunities for interaction and so on. Both dimensions are necessary, because
research has shown that loneliness depends both on the presence of social networks
and on individuals’ subjective evaluations of their social networks (Kraus et al
1993, p. 38). My research on Naikan has shown the powerful effect that a cognitive
reevaluation of one’s own situation—even, or especially, in the case of severe
circumstances or trauma—can have on an individual’s long-term affect, mental
health and well-being (Ozawa-de Silva 2006,2007).
Cultural Understandings of Death, Selfhood and Afterlife
It seems anathema to consider suicide as a path to well-being, a form of healing, a
therapeutic move to relieve suffering or a way of establishing connectedness to
others. It also seems illogical. Yet the decision to kill oneself—if it can even be
called a decision in the usual sense of the word—seems in these cases to be made
under tremendous emotional suffering, with the mind engaged in thought processes
542 Cult Med Psychiatry (2008) 32:516–551
that might not appear rational to a person in ordinary circumstances. In Japan,
moreover, the troubling idea of suicide as healing is reinforced by the social
presentation of death. When viewed cross-culturally it is evident that there is a
variety of competing interpretations of what constitutes identity and whether or not
death, whether voluntary or involuntary, signals the termination of the person or,
rather, his or her transition or transformation to another state of being.
The cultural basis of suicide behavior needs very centrally to be related to
conceptions of death prevailing in a given culture. To speak as Durkheim does of
categories of suicide—anomic, altruistic and so on—makes little sense in itself
unless these categories are themselves related to the cosmology and to the social and
historical construction of ideas about the meaning of death. In his desire to
sociologize the explanation of suicide, Durkheim suppressed such dimensions of the
problem, which, in a more adequate theory, clearly need to be incorporated. For
example, while altruistic suicide is not uncommon in Japan (for example, the
suicide of elderly people stricken with illness or of women upon their husbands’
death), DeVos (1973, p. 448) finds that Durkheim’s four categories of suicide do not
adequately fit the data, suggesting that “the feeling of inner insufficiency,
worthlessness, and lack of satisfaction with what life has to offer is the core
concern not only in egoistic suicide, but in many supposedly altruistic suicides as
In Bataille’s (1993) view there is an interplay between the life and the death
instincts: death represents not discontinuity—the interruption of life—but, rather, a
greater continuity that is the context of the differentiation caused by birth into life.
Death is nondifferentiation. Life is separation, and death, whether through natural
causes or through its embrace in suicide, represents a reentry into the continuity
shattered by birth. As Richardson (1994, p. 103) phrases it, “Death, then, is
violence, but it is at the same time communication. It is the consciousness of death,
not life, that makes community a possibility.” Both sexuality and death for Bataille
are transgressive—both represent the collapse of the possibility that life is
dominated by work. As such, his ideas are a challenge to the established value
structure of Japanese society and of those economists in particular who see
production and productive activity (in industry or in education) as the heart of
postwar Japanese culture.
In addition, the assumptions that religion is a spent force in modern society and
that Japan, in particular, is a “nonreligious” culture need challenging both at the
theoretical level (especially in light of the rise of fundamentalism and the “post-
materialism” of the New Age movement) and, specifically, in terms of the
constitution of Japanese society. Not only can a case be made for the position that
Japan represents an interesting example of a society pervaded by religion, though of
a largely noninstitutionalized kind, but also that it is necessary to consider some
specific aspects of the religious culture of Japan. These might include the social
significance of beliefs in reincarnation and the transmigration of souls, the
explanation of the very widespread cult of mizuko kuyo
¯, the Buddhist cult of
appeasing the spirits of aborted children (LaFleur 1992) and the explanation of what
are known as “sudden death” temples, to which elderly and infirm Japanese resort to
pray for a “good death” and, in particular, one not marked by pain or destitution
Cult Med Psychiatry (2008) 32:516–551 543
(Davis 1992). Each of these represents, in its own way, an element of a model of the
religious interpretation of death in Japan.
In societies where an “essentialist” sense of self prevails, suicide tends to be seen,
in secular terms, as a termination of life and as the cessation of all worldly
responsibilities and, in religious terms, as a sin—the fleeing of responsibilities and,
more importantly, as the abolition by the self of God’s absolute privilege of
presenting and removing life. But in Japan, where none of these characteristics
prevails, suicide is not seen as a sin (but in some cases as a duty), is not the
termination of life, but its translation to another level, and is not even the cessation
of responsibilities, since one can act in death in ways that influence life (the whole
Sino-Japanese system of ancestor worship is based on exactly this premise). To
speak of suicide as simply the termination of the self is thus not strictly accurate in
Japan: suicide can be seen as a return to nature, as the merging of oneself with that
of another (especially in love or double suicides or in the fairly frequent suicides of
elderly people following the death of their partner) or as withdrawing from society
in order to influence it from the outside. These are difficult issues to address, but a
consideration of how group suicide, death and the afterlife are represented in
contemporary Japanese popular culture reveals that cultural views of death may play
an important role in group suicide.
People can receive relief and comfort from finding that they are not alone, that there
are others who are undergoing a similar kind of pain or suffering along with them.
The majority of traffic at the suicide Web sites may involve Japanese visiting them
and receiving enough comfort from them to go on living. But for some, this comfort
might extend to taking one’s life: cases in which, for Japanese experiencing
afflictive loneliness, it would be more comfortable to die with others than alone. The
idea of suicide as an escape into freedom from the intractable and unbearable
constraints of life is neither new nor unique to Japan. Nor is the idea that the journey
into what lies beyond death—if anything—can be faced more readily and less
fearfully when done with companions. The ending of the 1991 American film
Thelma and Louise thematized both these ideas, when the two women protagonists
chose to drive off a cliff to their deaths, holding hands, rather than face the police,
who had finally tracked them down, and return to the drudgery and pain of the world
they left behind. Or as Doi wrote in 1971:
The West as we see it today is caught in a morass of despair and nihilism. It is
useful to remember here that the Japanese experience long ago taught the
psychological impossibility of freedom. For the Japanese, freedom in practice
existed only in death, which was why praise of death and incitements towards
death could occur so often. (Doi 2001, p. 95)
Internet suicide, then, while not something completely new or emerging ex
nihilo, may be a recent and troubling manifestation of widespread psychological
suffering in a different guise: involving strangers and the Internet. The widespread
544 Cult Med Psychiatry (2008) 32:516–551
nature of what I have termed afflictive loneliness, and its connection with social
transformations in Japanese society, requires an investigation of what is undoubt-
edly a kind of social suffering. The term “social suffering” has been employed in
anthropological literature to refer to the “assemblage of human problems that have
their origins and consequences in the devastating injuries that social force can inflict
on human experience” (Kleinman et al. 1997, p. ix). It is a useful way of bringing
together the arenas of mental and physical health, politics, culture and socioeco-
nomic forces and institutions, and of highlighting “the often close linkage of
personal problems with societal problems” (ix). While social suffering has been
examined primarily with regard to the “desperately poor and powerless” (ix), the
case of rising suicide rates in Japan challenges us to expand and refine our
understanding of social suffering to include not only the outward-in or top-down
effects of social forces on individuals living in poverty or oppressed conditions, but
also the internalization and externalization of cultural ideas and social forces that
individuals participate in and cocreate in the more complex dynamic of meaning
and loss of meaning—including what Doi, perhaps dramatically, terms “a morass of
despair and nihilism.” Just as the earlier work of Kleinman (1988) focused on the
role of meaning in individual suffering, and his later work came to encompass the
social dimensions of suffering (1997), an important direction for the future is
increasing our understanding of the interrelationships between these two levels.
Concretely, this would lead us to consider critically the project of the
modernization of Japan and the importation and imitation of Western cultural
ideas and practices. Since the Meiji Restoration, Japan has sought to import models
from Western societies, such as looking to Germany for its medical system, to the
United States for its school system and so on. Similarly, when social problems have
arisen, it has looked to the West for solutions, as in the case of karo
¯shi [death by
overwork], which led the Japanese government to reduce workdays and introduce
more national holidays, in imitation of the European system. Rather than seeking a
solution from the outside, however, the case of Internet suicide pacts may indicate a
need to gain more insight from within Japanese society itself and to construct a
solution that stems from this deeper understanding.
Contemporary Japan has adopted a Western conception of individualism in a way
that has resulted in a rejection of traditional Japanese extended-family structures.
Early Showa (1926–1989) literature depicts a rejection of amae [roughly,
“dependency”] to family members, and Japan in the second half of the 20th
century was also characterized by a sentiment of rejecting concepts of giri [duty or
obligation] and duty and a feeling that one should be able to pursue one’s own
interests rather than that of the collective or the family. But this rejection of
Japanese traditions may have come at a price. In some cases, it seems that this
process of imitation and importation has proceeded in a partial or distorted way. The
incorporation of Western “individualism,” without the surrounding social structures
that temper that individualism (ideas and practices of charity, the social service
orientation of religious associations and so on, which have not caught on in Japan),
seems to have resulted in Western individualism’s being localized as mere
egocentrism. In light of the decline of traditional family and social structures, this
leaves contemporary Japan in a difficult in-between state.
Cult Med Psychiatry (2008) 32:516–551 545
What implications does this have for future research on suicide and its prevention
in Japan? What is needed, I believe, is an integrated approach that moves beyond
the problematic dichotomy of social vs. individual perspectives, as if a complete
explanation could be achieved from either alone, and that explicitly recognizes
instead the complex dynamics of the social in the individual and the individual in
the social. This would be an approach that does not seek a simple explanation or
focus exclusively on one factor—such as the economy, school bullying or the
Internet—but that considers also the social transformations of Japan; Japanese
cultural understandings of suicide, death and afterlife; and an understanding of
mental states of suffering, and of mental development, that acknowledges the
importance of individual meaning-making and acknowledges individual agency.
Also important is a more refined understanding of the nature of individual choice,
a direction pioneered by Long (2005), and autonomy (Sheldon et al. 2005). The case
of Internet suicide pacts in Japan draws attention to the question of what kinds of
choices are possible—What is one allowed to choose?—within the contexts of one’s
culture. In Japan suicide is culturally acceptable only in certain prescribed
circumstances—when there is a clear reason for the person to commit suicide
according to cultural norms. Outside of those culturally prescribed circumstances,
suicide is clearly not acceptable. Thus it is simplistic to say that the rise in suicide is
accounted for by the fact that Japan is a “suicide nation” with a culture that permits
or promotes suicide; this would be true only if the individuals committing suicide
were doing so for the culturally accepted reasons. In fact they are not; hence the lack
of public acceptance regarding these suicides, which are seen instead as evidence of
people who are weak-willed. If, then, this is a case of individuals committing
suicide when the culture does not condone it, how can they justify it? This is not
something they can choose individually; it is something that causes trouble for
others, for the group. But if it is something that the group chooses, then it is not a
question of them as individuals violating a communal standard. The decision of the
group, then, becomes something that they can follow—are indeed obligated,
according to cultural prescriptions, to follow; social obligation is thereby reconciled
to individual choice. This in turn points to the idea that if a solution to the problem
of suicide in Japan is to be found, some attention must be paid to the very traditions
and structures that modern Japan has sought to cast off—not through a return to
outmoded social relationships that are no longer possible or relevant, but through a
deeper understanding of the values of interpersonal connections that were embodied
in those roles and relationships and that now need to be cultivated again, albeit
perhaps in different forms.
Bataille, Georges
1993 The Accursed Share, Vols. 2 and 3: The History of Eroticism. New York: Zone Books.
BBC News
2004 Have Your Say: Why Are Suicide Pacts on the Rise in Japan? Available at: Accessed October 15, 2004.
546 Cult Med Psychiatry (2008) 32:516–551
Biehl, Joao, Byron Good, and Arthur Kleinman
2007 Introduction: Rethinking Subjectivity. In Subjectivity: Ethnographic Investigations. Joal Biehl,
Byron Good, and Arhur Kleinman, eds., pp. 1–23. Berkeley: University of California Press.
Borovoy, Amy
2006 The Hidden: Sheltering and Rehabilitating the Emotionally Distressed in Japan. San Jose, CA:
American Anthropology Association.
Carden, Randy, and Sheri Rettew
2006 Internet Chat Room Use, Satisfaction with Life, and Loneliness. Psychological Reports 98: 121–
Csordas, Thomas
2002 Body/Meaning/Healing. Palgrave, UK: Macmillan.
Davis, Winston Bradley
1992 Japanese Religion and Society: Paradigms of Structure and Change. Albany: State University of
New York Press.
Deci, E.L., and R.M. Ryan
2000 The ‘What’ and ‘Why’ of Goal Pursuits: Human Needs and the Self-Determination of Behavior.
Psychological Inquiry 11: 227–268.
Desapriya, Ediriweera B.R., and Nobutada Iwase
2003 New Trends in Suicide in Japan. Injury Prevention 9: 284.
Desjarlais, Robert, Leon Eisenberg, Byron Good, and Arthur Kleinman
1995 World Mental Health: Problems and Priorities in Low-Income Countries. Oxford: Oxford
University Press.
DeVos, George A.
1973 Socialization for Achievement: Essays on the Cultural Psychology of the Japanese, ed. Berkeley:
University of California Press.
DeVos, George
1985 Dimensions of the Self in Japanese Culture. In Culture and Self: Asian and Western Perspectives.
A.J. Marsella, G. DeVos, and F.L. Hsu, eds., pp. 141–184. New York: Travistock.
Doi, Takeo
2001 The Anatomy of Dependence. Tokyo: Kodansha International.
Durkheim, Emile
1966 Suicide: A Study in Sociology. New York: Free Press.
Frankl, Viktor
1992 Man’s Search for Meaning. Boston: Beacon Press.
2006 Ghetto. Available at: Accessed December 18, 2006.
Good, Byron, Subandi, and Mary-Jo DelVecchio Good
2007 The Subject of Mental Illness: Psychosis, Mad Violence, and Subjectivity in Indonesia. In
Subjectivity: Ethnographic Investigations. Joal Biehl, Byron Good, and Arhur Kleinman, eds.,
pp. 243–272. Berkeley: University of California Press.
Guenther, Herbert V., and Leslie S. Kawamura
1975 Mind in Buddhist Psychology. Emeryville, CA: Dharma.
Havens, Leston L., and S. Nassir Ghaemi
2005 Existential Despair and Bipolar Disorder: The Therapeutic Alliance as Mood Stabilizer.
American Journal of Psychotherapy 59(2): 137–147.
Hawkley, Louise C., Michael W. Browne, and John T. Cacioppo
2005 How can I Connect with thee? Let me Count the Ways. Psychological Science 16: 798–804.
Hendry, Joy
1998 Introduction: The Contribution of Social Anthropology to Japanese Studies. In Interpreting
Japanese Society: Anthropological Approaches. 2nd Edition. Joy Hendry, ed., pp. 1–12. London:
Hi-ho Kai-in Support
2007 Hikite yaku ni hikizurarete shu
¯dan jisatsu: Jisatsu saito no kyo¯fu [Lured into Group Suicide by
Recruiters: The Danger of Suicide Websites]. Available at:
info/security/colum/column05.html. Accessed March 10, 2007.
Ikizurasa kei no fo¯ ramu
2006 Ikizurasa kei no fo¯ ramu [The Forum about Difficulty in Living]. Available at: Accessed December 1, 2006.
Cult Med Psychiatry (2008) 32:516–551 547
Jaspers, Karl
1998 General Psychopathology. Baltimore: Johns Hopkins University Press.
Jisatsusha no So¯ gen
2006 Jisatsusha no so¯ gen [A Field for Suiciders]. Available at:
ibbs/ibbs.cgi. Accessed December 24, 2006.
2006 Ikiyasui Shakai no Genjitsu wo Mezashite [Aiming for the Society for Comfortable Living].
Available at: Accessed
March 16, 2008.
Karnick, Paula M.
2006 Feeling Lonely: Theoretical Perspectives. Nursing Science Quarterly 18: 7–12.
Keisatsu Chou Seikatsu Anzen Kyokyu Chiiki ka
2006 Heisei 16 nen ni okeru jisatsu no gaiyou shiryou [Abstract Resources on Suicide in 2004]. June.
Keyes, Corey
1998 Social Well-Being. Social Psychology Quarterly 61(2): 121–140.
2002 The Mental Health Continuum: From Languishing to Flourishing in Life. Journal of Health and
Social Behavior 43(2): 207–222.
Kierkegaard, Soren
1989 The sickness unto death. London: Penguin.
Kinsella, Sharon
1994 Cuties in Japan. In Women, Media, and Consumption in Japan. Brian Moeran and Lisa Skov,
eds., pp. 170–196. Honolulu: University of Hawaii Press.
Kitanaka, Junko
2006 Society in Distress: The Psychiatric Production of Depression in Contemporary Japan. Ph.D.
dissertation. McGill University.
Kleinman, Arthur
1986 Social Origins of Distress and Disease: Depression, Neurasthenia and Pain in Modern China.
New Haven, CT: Yale University Press.
1988 Illness Narratives: Suffering, Healing and the Human Condition. New York: Basic Books.
1991 Rethinking Psychiatry: From Cultural Category to Personal Experience. New York: Free Press.
2006 What Really Matters: Living a Moral Life amidst Uncertainty and Danger. Oxford: Oxford
University Press.
Kleinman, Arthur, and Byron Good
1985 Culture and Depression: Studies in the Anthropology and Cross-Cultural Psychiatry of Affect
and Disorder. Berkeley: University of California Press.
Kleinman, Arthur, Veena Das, and Margaret Lock
1997 Social Suffering. Berkeley: University of California Press.
Kokoro no Hanazono
2006 Kokoro no Hanazono [Flowerbed of the Heart]. Available at:
asiato01/. Accessed December 22, 2006.
Kondo, Dorinne
1990 Crafting Selves. Chicago: University of Chicago.
Kraus, Linda A., Mark H. Davis, Doris Bazzini, Mary Church, and Clare M. Kirchman
1993 Personal and Social Influences on Loneliness: The Mediating Effect of Social Provisions. Social
Psychology Quarterly 56: 37–53.
LaFleur, William
1992 Liquid Life: Abortion and Buddhism in Japan. Princeton, NJ: Princeton University Press.
Lebra, Takie Sugiyama
1976 Japanese Patterns of Behavior. Honolulu: University of Hawaii Press.
Lebra, Takie Sugiyama
1984 Japanese Women: Constraint and Fulfillment. Honolulu: University of Hawaii Press.
LeTendre, Gerald K.
2000 Learning to Be Adolescent: Growing Up in U.S. and Japanese Schools. New Haven, CT: Yale
University Press.
548 Cult Med Psychiatry (2008) 32:516–551
Lock, Margaret
1986 Plea for Acceptance: School Refusal Syndrome in Japan. Social Sciences and Medicine 23(2):
1988 A Nation at Risk: Interpretations of School Refusal in Japan. In Biomedicine Examined.
Margaret Lock and Deborah R. Gordon, eds., pp. 377–414. Dordrecht, Boston, London: Kluwer
Long, Susan
2001 Negotiating the “Good Death”: Japanese Ambivalence about New Ways to Die. Ethnology 40
(4): 271–289.
2005 Final Days: Japanese Culture and Choice at the End of Life. Honolulu: University of Hawaii
Lopata, Helena Znaniecki
1969 Loneliness: Forms and Components. Social Problems 17: 248–262.
Machizawa, Shizuo
2003 Hikikomoru Wakamonotachi [Withdrawn Youths]. Tokyo: Daiwa Shobo.
Mahon, Noreen E., Adela Yarcheski, Thomas J. Yarcheski, Barbara L. Cannella, and Michele M. Hanks
2006 A Meta-Analytic Study of Predictors for Loneliness During Adolescence. Nursing Research 55:
Martina, Camille, and Nan L. Stevens
2006 Breaking the Cycle of Loneliness? Psychological Effects of a Friendship Enrichment Program
for Older Women. Aging & Mental Health 10: 467–475.
Mathews, Gordon
1996 The Stuff of Dreams, Fading: Ikigai and “The Japanese Self”. Ethos 24(4): 718–747.
McIntosh, John L.
2004 Year 2004 Official Final Data on Suicide in the United States. American Association of
Suicidology. Available at:
McVeigh, Brian
1997 Life in a Japanese Women’s College: Learning to be Ladylike. New York: Routledge.
Mead, Margaret
2000 Coming of Age in Samoa. New York: Harper Perennial Modern Classics.
Nageki Keijiban
2006 Nageki Keijiban [Wailing BBS]. Available at:
Accessed December 15, 2006.
Nilsson, Brita, Unni A
˚. Lindstro
¨m, and Dagfinn Na
2006 Is Loneliness a Psychological Dysfunction? A Literary Study of the Phenomenon of Loneliness.
Scandinavian Journal of Caring Sciences 20: 93–101.
Ogata, Yasuko, Yukiko Izumi, and Tadashi Kitaike
2006 Mobile-Phone e-mail Use, Social Networks, and Loneliness Among Japanese High School
Students. Japanese Journal of Public Health 53: 480–492.
Ohnuki-Tierney, Emiko
1984 Illness and Culture in Contemporary Japan. Cambridge: Cambridge University Press.
Ohsawa, Masaki
1996 Kyoko¯ no Jidai no Hate: AUM to Sekai Saishu Sensou [The End of the Era of Fiction]. Tokyo:
Chikuma Shobo.
Omae ha mou shindeiru
2005 Omae ha mou shindeiru [You Are Already Dead]. Available at:
Ozawa, Chikako
1996 Japanese Indigenous Psychologies: Concepts of Mental Illness in Light of Different Cultural
Epistemologies. British Medical Anthropology Review 3(2): 11–21.
Ozawa-de Silva, Chikako
2006 Psychotherapy and Religion in Japan: The Japanese Introspection Practice of Naikan. London:
Routledge Press.
2007 Demystifying Japanese Therapy: An Analysis of Naikan and the Ajase Complex through
Buddhist Thought. Ethos 35(4): 411–446.
Cult Med Psychiatry (2008) 32:516–551 549
Pike, Kathleen, and Amy Borovoy
2004 The Rise of Eating Disorders in Japan: Issues of Culture and Limitations o the Model of
“Westernization”. Culture. Medicine and Psychiatry 28: 493–531.
Pinguet, Maurice
1993 Voluntary Death in Japan. Cambridge: Polity Press.
Plath, David W.
1980 Long Engagements. Maturity in Modern Japan. Stanford: Stanford University Press.
Renshaw, Peter D., and Peter J. Brown
1993 Loneliness in Middle Childhood: Concurrent and Longitudinal Predictors. Child Development
64: 1271–1284.
Richardson, Michael
1994 Georges Bataille. London: Routledge.
Roland, Alan
1988 In Search of Self in India and Japan. Princeton, NJ: Princeton University Press.
Ryff, Carol D., Corey L.M. Keyes, and Diane L. Hughes
2003 Status Inequalities, Perceived Discrimination, and Eudaimonic Well-Being: Do the Challenges
of Minority Life Hone Purpose and Growth? Journal of Health and Social Behavior 44(3): 275–
Sadler, William, and Thomas B. Johnson
1980 From Loneliness to Anomie. In The Anatomy of Loneliness. J. Hartog, J. Audy, and Y.A.
Cohen, eds., pp. 34–64. New York: International Univ. Press.
Saito, Kan
2003 Iki Kihaku sa, Kontei ni [On the Fundamental Thinness of Life]. Asahi Shinbun May 2, morning
Saito, Tamaki
1998 Shakai teki Hikikomori [Social Withdrawal]. Tokyo: PHP Shinsho.
Sasaki, Tishinao
2007 O
¯te masukomi inta¯netto shinjyu
¯ho¯do¯ no otoshiana [The Catch of the Major Mass Media Reports
on Internet Suicide Pacts). Available at:
5.html. Accessed January 3, 2007.
Schulz, Kathryn
2004 Did Antidepressants Depress Japan? The New York Times, August 22.
Schwab, Reinhold, and Kay Uwe Petersen
1990 Religiousness: Its Relation to Loneliness, Neuroticism and Subjective Well-Being. Journal for
the Scientific Study of Religion 29: 335–345.
Sheldon, Kennon M.
2002 The Self-Concordance Model of Healthy Goal-Striving: When Personal Goals Correctly
Represent the Person. In Handbook of Self-Determination Research. E.L. Deci and R.M. Ryan,
eds., pp. 65–86. Rochester, NY: University of Rochester Press.
Sheldon, Kennon M., Richard M. Ryan, Laird J. Rawsthorne, and Barbara Ilardi
1997 Trait Self and True Self: Cross-Role Variation in the Big-Five Personality Traits and Its
Relations with Psychological Authenticity and Subjective Well-Being. Journal of Personality
and Social Psychology 73(6): 1380–1393.
Sheldon, Kennon M., Tim Kasser, Linda Houser-Marko, Taisha Jones, and Daniel Turban
2005 Doing One’s Duty: Chronological Age, Felt Autonomy, and Subjective Well-Being. European
Journal of Personality 19: 97–115.
Site Rank
2005 Jisatsu Saito no To¯hyo¯ Rankingu [Ranking of Suicide Sites]. Available at:
org/jp/cat/1100102562/. Accessed January 15, 2005.
Stack, Steven
1998 Marriage, Family and Loneliness: A Cross-National Study. Sociological Perspectives 41:
Takahashi, Yoshitomo
1997 Culture and Suicide: From a Japanese Psychiatrist’s Perspective. Suicide and Life-Threatening
Behavior 27(1): 137–145.
1999 Seishounen no tameno jisatsu yobo manuaru [A Suicide Manual for Young People]. Tokyo:
Kongo shuppan.
550 Cult Med Psychiatry (2008) 32:516–551
2001 Jisatsu no sain wo yomitoru [Reading a Signal of Suicide]. Tokyo: Kodansha.
Tillich, Paul
1952 The Courage to Be. New Haven, CT: Yale University Press.
Traphagan, John
2004 Interpretations of Elder Suicide, Stress, and Dependency among Rural Japanese. Ethnology 43
(4): 315–329.
Tsuji, Yohko
2006 Mortuary Rituals in Japan: The Hegemony of Tradition and the Motivations of Individuals.
Ethos 24(3): 391–431.
Ueno, Kayoko
2005 Suicide as Japan’s Major Export: A Note on Japanese Suicide Culture. Revista Espaco
Academico No. 44 (January). Available at:
44eueno_ing.htm. Accessed December 25, 2006.
Usui, Mafumi
2002 Internet Shinrigaku [Internet Psychology], September 24. Available at: http://www.n-seiryo. Accessed February 17, 2007.
van Tilburg, Theo, Eric van Sonderen, and Johan Ormel
1991 The Measurement of Reciprocity in Ego-Centered Networks of Personal Relationships: A
Comparison of Different Indices, Social Psychology Quarterly 54: 54–66.
White, Mary
1994 The Material Child: Coming of Age in Japan and America. Berkeley: University of California
2006 Nihon de Kyu
¯zo¯ suru Netto Jisatsu: 2 nen kan de 3 bai ni [Internet Suicide on the Rise in Japan:
It Has Tripled in the Last 2 Years]. Available at:–1001013
8363.html. Accessed March 12, 2007.
Yamamoto-Mitani, Noriko, and Margaret I. Wallhagen
2002 Pursuit of Psychological Well-being (Ikigai) and the Evolution of Self-Understanding in the
Context of Caregiving in Japan. Culture, Medicine and Psychiatry 26: 399–417.
Za Keijiban
2003 Jisatsu shitai hito ha oide yo bisshitto shikatte ageru kara [Come Here, Those of You
Who Want to Commit Suicide, and I’ll Give You a Stern Scolding!]. Available at: Accessed September 26, 2003.
Cult Med Psychiatry (2008) 32:516–551 551
... Эрих Фромм «Искусство любить» Порой созависимость (чрезмерно близкие, симбиотические отношения) -проявления личностных (пограничных, конформных) расстройств участника (участников). Им «слишком одиноко умереть в одиночестве» [11]. Взаимозависимость превращает внешнюю общую угрозу в фактор риска договора. ...
... Месть может быть «холодным блюдом», отчаяние подпитано кумуляцией жизненных невзгод и совместный tions of personal (borderline, conformal) disorders of the participant (participants). They are "too lonely to die alone" [11]. Interdependence turns an external common threat into a contractual risk factor. ...
... On May 1, 1945, an SS medical officer, at the behest of their mother, administered morphine to Goebbels' six children (4)(5)(6)(7)(8)(9)(10)(11)(12) in bed. Frau crushed the ampoules of cyanide in their mouths. ...
... Известны казуистические «тройственные» [9] и четверные [10] договоры. Семь жертв в групповом киберсуициде (не требующем условия единства места и времени) -в Японии в 2004 г. [11]. ...
... Casuistic "triple" [9] and quadruple [10] pacts are known. There were reported seven victims in a group cybersuicide (which does not require the condition of unity of place and time) in Japan in 2004 [11]. ...
... Интернет-парадокс в положительных (антисуицидальные сайты, программы кризисной помощи) и отрицательных последствиях Сети [26,27], усугубляющих риск суицидального поведения [28]. Социально изолированные, затравленные (буллинг, кибербуллинг) маленькие изгои, используя интернет для облегчения дистресса, наиболее уязвимы [11] онлайн-рискам [29,30]. ...
... Thus, the individuals' support requirements remained unmet. In this respect, the literature shows that the Internet is used in search for solutions to problems and difficulties no remedied in the offline world (Ikunaga et al., 2010) and may facilitate the gathering of strangers that can provide support, feelings of belonging, intimacy (Ozawa-De Silva, 2008), but can also enhance relations between anonymous identities that are both mutants and superficial (Niezen , 2013). ...
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Este estudo analisou os temas relacionados ao suicídio em postagens de blogs com língua portuguesa. Trata-se de um estudo qualitativo, realizado na plataforma Tumblr. Através da busca da palavra “suicídio”, Foram selecionadas as 250 primeiras postagens de texto em língua portuguesa classificadas como “mais populares” e submetidas à Análise Temática. Após a análise, algumas categorias surgiram: “O sofrimento e a insatisfação com a vida” foi o principal tema abordado; Os relacionamentos dolorosos e o sofrimento reforçaram-se mutuamente e ambos intensificavam a expectativa de que a morte poderia ser benéfica e eliminar problemas e sofrimentos; os relacionamentos insatisfatórios e pressões sociais de “estar bem” dificultavam a expressão do sofrimento e busca por ajuda. A Automutilação representou a materialização da dor e apresentou relação ambígua com o suicídio. O tema “prevenção do suicídio” foi retratado na minoria das postagens e esteve relacionado principalmente à manifestação de críticas, depreciação, oposição ao suicídio e ao comportamento suicidário. As ações de prevenção do comportamento suicida online e off-line precisam abordar a perspectiva sobre a vida e morte, os relacionamentos interpessoais, a automutilação, as estratégias de enfrentamento e pedido/oferta de ajuda.
... After all, jurisdiction sets norms and rules and interacts with societal views. Japan's approach to suicidality is a particular exception: Suicidality is little stigmatised there, but suicide rates are particularly high because suicide is socially suggested as an honourable solution to the social understanding of "shame" or "failure" [16,17]. ...
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This article provides an overview of suicide and how society deals with it. Starting from early societal imprints through historical, religious and political influences, the origins of stigmatization are addressed. Even today, suicidal people experience stigmatization not only from society but also from the health system that treats suicidal people. This has far-reaching consequences for the people affected and runs counter to optimal treatment. Different approaches to a possibly improved handling of suicidality will be discussed.
... After all, jurisdiction sets norms and rules and interacts with societal views. Japan's approach to suicidality is a particular exception: Suicidality is little stigmatised there, but suicide rates are particularly high because suicide is socially suggested as an honourable solution to the social understanding of "shame" or "failure" [16,17]. ...
Full-text available
This article provides an overview of suicide and how society deals with it. Starting from early societal imprints through historical, religious and political influences, the origins of stigmatization are addressed. Even today, suicidal people experience stigmatization not only from society but also from the health system that treats suicidal people. This has far-reaching consequences for the people affected and runs counter to optimal treatment. Different approaches to a possibly improved handling of suicidality will be discussed.
Full-text available
It is understood that suicide is a major health problem and the leading cause of death worldwide. Because, this subject, which needs much more work, needs to be explained, although it is essential to be developed in the literature. Recent reports report that approximately one million people die by suicide each year, representing the annual global age-standardized suicide rate of 11.4 (15.0 for men 2 CURRENT SCIENCE EMAIL: ASI@EUROPE.DE Multidisciplinary Journal with Arbitration Committee International Refereed Multidisciplinary Journal and 8.0 for women) per 100,000 population. [1] Considering a time perspective from 2000 to 2016, there has been a 30% increase in suicide rates by age. [2] These ratios are just the tip of an iceberg. There are many more who try suicide every year. A cautious estimate shows that more than 20 million people engage in suicidal behavior each year. In addition, considering the WHO's announcement that suicide rates will exceed the one million mark in the next 15 years, it is predicted that suicide rates will increase in the future. [3] Behind every suicide and attempt, there is a long-term struggle of these individuals, their experiences of trauma and distress among their relatives and friends. However, preventing suicide is a global priority. As clinicians and researchers, we must make every effort to find, intervene, and after preventing suicidal behavior. Above all, our mission is to advance our knowledge by understanding the mechanisms, factors, and facilitators of suicide from interdisciplinary perspectives.
Full-text available
It is understood that suicide is a major health problem and the leading cause of death worldwide. Because, this subject, which needs much more work, needs to be explained, although it is essential to be developed in the literature. Recent reports report that approximately one million people die by suicide each year, representing the annual global age-standardized suicide rate of 11.4 (15.0 for men and 8.0 for women) per 100,000 population. Considering a time perspective from 2000 to 2016, there has been a 30% increase in suicide rates by age. These ratios are just the tip of an iceberg. There are more who try suicide every year. A cautious estimate shows that more than 20 million people engage in suicidal behavior each year. In addition, considering the WHO's announcement that suicide rates will exceed the one million marks in the next 15 years, it is predicted that suicide rates will increase in the future. Behind every suicide and attempt, there is a long-term struggle of these individuals, their experiences of trauma and distress among their relatives and friends. However, preventing suicide is a global priority. As clinicians and researchers, we must make every effort to find, intervene, and after preventing suicidal behavior. Above all, our mission is to advance our knowledge by understanding the mechanisms, factors, and facilitators of suicide from interdisciplinary perspectives.
Objective. There is concern regarding use of the phrase ‘committed suicide’, given its connotations of immorality. Limited research has examined influences on people’s use of this phrase. The current studies examined whether portraying a suicide as highly immoral affects perceptions of the phrase ‘committed suicide’. Method. Undergraduate participants in western Canada read a suicide vignette in which the suicide was depicted either neutrally or as sinful (Study 1, N = 188) or as either altruistic or vengeful (Study 2, N = 204). They then judged, from the perspective of the deceased person’s family, the preference for statements employing ‘committed suicide’ or ‘died by suicide’ (Study 1) or the acceptability of statements employing ‘committed suicide’, ‘ended her[his] life’, ‘took her[his] own life’, or ‘died by suicide’ (Study 2). Results. In Study 1, ‘committed suicide’ statements received higher preference judgments for the scenario depicted as sinful. In Study 2, phrases alternative to ‘committed suicide’ received higher acceptability ratings for the altruistic scenario. Discussion. We consider limitations of our work, directions for future research on the language of suicide, and implications of our findings.
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It is understood that suicide is a major health problem and the leading cause of death worldwide. Because, this subject, which needs much more work, needs to be explained, although it is essential to be developed in the literature. Recent reports report that approximately one million people die by suicide each year, representing the annual global age-standardized suicide rate of 11.4 (15.0 for men 2 CURRENT SCIENCE EMAIL: ASI@EUROPE.DE Multidisciplinary Journal with Arbitration Committee International Refereed Multidisciplinary Journal and 8.0 for women) per 100,000 population. [1] Considering a time perspective from 2000 to 2016, there has been a 30% increase in suicide rates by age. [2] These ratios are just the tip of an iceberg. There are many more who try suicide every year. A cautious estimate shows that more than 20 million people engage in suicidal behavior each year. In addition, considering the WHO's announcement that suicide rates will exceed the one million mark in the next 15 years, it is predicted that suicide rates will increase in the future. [3] Behind every suicide and attempt, there is a long-term struggle of these individuals, their experiences of trauma and distress among their relatives and friends. However, preventing suicide is a global priority. As clinicians and researchers, we must make every effort to find, intervene, and after preventing suicidal behavior. Above all, our mission is to advance our knowledge by understanding the mechanisms, factors, and facilitators of suicide from interdisciplinary perspectives.
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Loneliness is associated with mental and physical health problems and elevated suicide risk, and is increasingly widespread in modern societies. However, identifying the primary factors underlying loneliness remains a major public health challenge. Historically, loneliness was thought to result from a lack of high-quality social connections, but broader cultural factors (e.g. social norms) are increasingly recognized to also influence loneliness. Here, we used a large-scale survey (N = 4977) to assess to what degree the loneliness epidemic in Japan is associated with traditional measures of social isolation (number of close friends), cultural factors (perceptions of social rigidity, as measured by relational mobility), and socioeconomic factors (e.g. income). We confirmed that a lack of close friends is a dominant factor underlying loneliness in Japan. We also found that perceptions of the social rigidity in one’s environment was a major correlate of loneliness. Subjects who perceived lower levels of rigidity in their social environments felt significantly less lonely than those who perceived higher levels of social rigidity, though the association was weak in low income males. Thus, Japanese society and other high social rigidity cultures may need to reflect on the possibility that inflexible traditional norms of socialization are exacerbating loneliness.
Health care in contemporary Japan - a modern industrial state with high technology, but a distinctly non-Western cultural tradition - operates on several different levels. In this book Emiko Ohnuki-Tierney provides a detailed and historically informed account of the cultural practices and cultural meaning of health care in urban Japan. In contrast to most ethnomedical studies, this book pays careful attention to everyday hygienic practices and beliefs, as well as presenting a comprehensive picture of formalized medicine, health care aspects of Japanese religions, and biomedicine. These different systems compete with one another at some levels, but are complementary in providing health care to urban Japanese, who often use more than one system simultaneously. As an unequalled portrayal of health care in a modern industrial, but non-Western, setting, it will be of widespread interest to scholars and students of anthropology, medicine, and East Asian studies.
PART I: CHARISMATIC TRANSFORMATIONS The Rhetoric of Transformation in Ritual Healing Embodiment as a Paradigm for Anthropology A Handmaid's Tale The Affliction of Martin PART II: NAVAJO TRANSFORMATIONS Ritual Healing and the Politics of Identity in Contemporary Navajo Society Talk to Them So That They Understand The Sore That Does Not Heal Words from the Holy People PART II: MODULATIONS OF EMBODIMENT Somatic Modes of Attention Shades of Representation and Being in Virtual Reality
It is well known that Japan now has the second largest economy in the world, the greatest longevity for women, and the second longest for men. It also has a highly literate population, relatively little poverty, and a long established socialized medical system. All ingredients for a smoothly running, salubrious society one would assume, but a glance through a few recent newspaper headlines indicates otherwise: “More Girls, Housewives Becoming Drug Addicts”; “Schools Reverting to Corporal Punishment”; “More Middle-Aged Men Killing Selves”; “Stress: Serious Problem of Japanese Work Force”; “Number of Suicides By Youths Up 30%”; “School Phobia Caused by High-Pressure Education”; “Japanese Youth Unhappiest [among eleven industrialized countries polled], in Spite of Economic Growth.” This last article concludes with the statement: “they are like a floating generation, without any sense of purpose. And the real problem lies in the family” (emphasis added, Asahi Evening News 1984).