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Yoshiba Hiroaki (Jesuit Brother)
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I visited last September the "House of Bethel" located in Urakawa-cho, South of Hokkaido. Time ago a Protestant
seminarian that attended a meeting on "mental issues," organized by a church, exposed her experiences working with the
mentally disabled and that provoked my interest. I remember that she explained
how she saw persons with mental problems that were living and coexisting
vigorously with their local communities
Although we accustom to say "persons with mental problems," in fact the definition is very broad. Some people can live painfully
going everyday to work or to school, while others remain home with much
daily suffering they hide even to their own family members. I heard that
among them there are those who make smiling faces to their husbands coming
back home.
But when suffering reaches a definite level medical treatment is needed.
Thinking that depression reaches maybe 5% of the population and realizing
that most people do not receive medical treatment, one can imagine how
spread psychological suffering is. And as a result, many are obliged to
live mentally disabled.
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How have these people been treated and did we do anything for them? Nothing
can be said in general, but most probably we treated them as "persons different from us" or maybe we mocked at them and put them aside. Normally speaking,
will patients going to a psychiatrist or those interned or leaving psychopathic
wards claim openly their disease? If in our neighborhoods an institution
for mentally disabled people is going to be built, people, nowadays, will
not oppose it publicly as before, on the grounds that it will become troublesome
for everybody if an assassination occurs, but instead people will say:
"the environment here is not fit for such an institution." The truth is that we do not want to live nearby with "people who are not normal" and with people we don’t know.
We do not feel comfortable hearing of a person with psychological problems.
Groups of supporters are increasing steadily but, in spite that they are
not doing anything bad, the mentally disable usually experience people
looking at them in strange ways. To avoid to be taken as "spoilt children," many make great efforts to look as the others, but they fail and
their psychological wounds become more serious.
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When it comes to that, the only way available will be to assume a defiant
attitude, to scream loudly or to continue enduring the suffering. Nevertheless,
when they meet persons that understand them they can walk by themselves,
no matter the problems facing them.
I want to deal with people who are living with mental disabilities so I
went to Urakawa, a town where the mentally disable can live without shrinking
their lives, thinking that I could find there hints to know and reflect
on ways how people with psychological and/or mental disabilities could
live developing their own selves.
The Bethel Home consists of a workshop with training facilities, a "group home" under a socio-welfare moral corporation supporting community living
and a private company selling medical instruments. About 150 community
members gather there. The name Bethel comes from the Old Testament and
from the name of a German town. Germany’s Bethel is historically known
because, during the Second World War when the Nazis tried to massacre all
disabled people, citizens of that town without disabilities demanded to
be also brought with the disable. Even now the town is known for its solidarity
with disabled people.
At Bethel there are people living at the "group home" facilities and people living with their families. Recently there
are some that moved from outside Hokkaido to live in nearby apartments
alone by themselves or with their families, often single mothers with children.
My impression was that Bethel accepts any comer and outdoor hospital patients
can easily join any number of programs organized there.
Although most of the disabilities of Bethel's community companions are
psychological, other disable and a few mentally retarded persons use also
the facilities. The mental cases are mainly patients with schizophrenia
and some alcoholic persons. The disable receive pensions and/or socio welfare
assistance. The administration posts are in their hands and this I thought
is a proper system to assure the continuation of the work. The President
of the board is Mr. Sasaki Minoru and the Directors of the institutions
are Ms. Shimizu Rika and Mr. Ogino Hitoshi.
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Several years back a former patient of the psychiatric department of the
Red Cross Hospital of Urakawa organized a group, called "Dongurikai,"
that became the historical beginning of the Bethel Home. Members of the
"Dongurikai" started to live by the church of Japan Christian Association and
under the suggestion of the Protestant Minister and his wife started to
pack a local product called "Hidaka Konbu (tang)" under contract. Later, on they established their own business for
the production and sale of Konbu and, at present, run a company for the
manufactory and sales of sea products, Video production and a printing
shop, shops called ‘4 chome stroll’, like Internet use, orientation seminars and the organization of events
to promote local inter-exchange. Recently they have expanded to new schemes
on ecological and agricultural products, besides the existing "group
home" with community housing facilities.
Visitors have also increased to the point that about 2,000 people visit
Bethel every year. When I was there, people from even Kyushu came for a
visit, as well as persons from foundations, socio-welfare specialists,
psychiatric social workers, nurses, students in social welfare schools
and even economic experts. Members of Bethel perform speaking tours in
Sapporo and other cities, including Tokyo, for auditory hallucination and
special meditation that have received several rewards. They are also in
close contact with the members of the Council of Social Welfare, Japanese
Red Cross and other official local committees and conduct routine meetings
to examine problems involved.
I have heard that the relationship with the local residents was difficult
at the beginning. This is different now that the institution has become
a natural part of the town. There was no other business in the locality
except fisheries, but because of groups visiting Bethel, the place has
developed the concept of common prosperity. Ms. Shimizu, Director of one
of the institutions, holds the opinion that, since the mental disable have
been obliged to live apart in society, in medical centers, and due to the
dosage of medicines that left them weak without their own thinking, they
have been deprived of "suffering hardship." That is why, she explains, by conducting business they are trying
to bring back the experience of hardship.
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In order to summarize what Bethel is about, the expression that fits more
will be 'a place where nothing is done accurately.' For instance, during the meetings it is natural for the members to come
in and out at any moment. Since mental disabilities have unexpected symptoms
it is often difficult for people to continue coming and, from time to time,
one can hear greetings like this "we haven’t seen you for over a month." Anyhow people do not worry much about it. Of course, this presupposes
that close relatives or friends are well aware of the whereabouts. Once
somebody visiting the packing of konbu asked, "how many boxes do you usually pack?" Then, Hayasaka Kiyoshi, representative of Bethel and a celebrity
with schizophrenia answered, "we don’t care. No matter how good the plan is we can’t accomplish it. We
do as much as we can and that’s all." Efficiency is not a priority there. Priorities are impossible and
after all nobody cares.
I felt that, no matter somebody disappears for a while others recognize
that person, because there is a relationship of trust, people feel at home
somehow there.
I had never been in contact before with schizophrenics and thus I kept
a selfish image of that disease, without realizing that there is no other
disease with so many varieties. Some patients suffer from auditory hallucinations
while others, in fact only a few, from soliloquy. Some persons can just
perform one type of work due to side effects of medicines, while there
are others that hardly show their disability.
The day starts with one-hour morning meeting where everyone makes sure
of his/her tasks.
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Depending on the work to be done much time is given to group sharing, like
social skills training (SST) or self-reliant group for Schizophrenics (SA:
Schizophrenics Anonymous). Bethel conducts meetings at the beginning and
end of the day. Bethel's characteristic motto is: "to move your lips is more important than to move your hands"
This is part of Bethel’s ideological statement. It manifests that with
confidence in the strength of each moment one should express what he is
thinking. For instance, it was interesting to hear the patients in all
meetings to talk about their health, about what "went all right" and "what was really hard." There was no talk about "what went wrong." In other words, it shows that "what had been hard was different from mistakes done."
It is clear that they have an original concept with regard to hallucination.
Normally, doctors or patients will immediately try to make hallucinations
disappear using medicines. Here, instead of saying "hallucination" they will say friendly, "Mr. Hallucination." Once in a meeting a person mentioned that he was quite annoyed
by hallucination and then an expert said that, it would be wonderful if
you could say: "Mr. Hallucination thank you very much, let’s become friends." Then, a different person said that there are two types of hallucination,
"hallucination of light and of darkness." The one of darkness looks good at first sight, but when you follow
it, might be troublesome. On the contrary, the one of light is critical
of oneself but, after all, makes one reflect. I found this very inspiring.
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Normally a disease is a symbol of some weakness, but there is nothing wrong
with being weak. I found out that Bethel is a place that gives recognition
to that and has the proper atmosphere for patients to share their existence.
Although many meetings are held here, I will only refer to Schizophrenics
Anonymous (SA) and the Supporting Conference.
SA consists only of patients with schizophrenia. It is a self-reliant group
where people discuss the themes agreed upon by them. The chairman is also
a companion patient. The day of my visit I was admitted as an observer
sitting down at a corner of the room.
The meeting following the characteristic line of Bethel started with, "How is your health? What was good today? What kind of hardships did you
experience?" I must refrain from exposing the content of the discussion, but
a patient approached me at the end of the meeting and told me, "I felt much helped by your silent presence listening to my talk regarding
my hard experiences, something like a scream, no matter how small it was." To tell the truth, I did not receive the impression that the atmosphere
was one of listening attentively to each other. Nevertheless, they seemed
to feel a sense of security joining companions that were screaming and
I felt that the atmosphere was fit to reassure them of a meaning in their
own actual existence.
The "Support Conference" was also quite moving. The patients gathered at the facilities of
the Japan Red Cross Hospital to discuss the problem of one person. I was
astonished at the experiment of picking up a concrete problem to reach
a solution at the conference. Including visitors there were about 30 persons
there. Most of the participants were patients from Bethel. A hospital social
worker acted as facilitator clarifying the issues involved in the case.
She asked the participants for their internal moves and feelings hearing
the case, how do they see the person of the case and her situation. What
do they think could be done (just cry? be patient?) She, then, invited
them to find ways to proceed ahead. I was impressed at how the meeting
was held. When the facilitator asked a companion for some reactions the
first remark consisted of praising words "his/her smiling face was good."
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From the beginning nobody speaks about "bad points or things to be improved." I felt that this fact proves that they live in a community of mutual
trust.
As a matter of information I already mentioned about the social skills
training (SST). It is difficult for them to express themselves and in the
training sessions they make them imagine a concrete situation, like, for
instance, one of their companions moves to another place and they want
to say a farewell but start crying. The training consists in finding ways
to express the feelings they have in occasions like that. Since they are
not skillful to express themselves such training sessions are very important.
I mentioned above that the beginnings of Bethel created some tensions in
the locality but now the situation looks very friendly. The local residents
do not object to the increase of disabled people in their area. According
to a patient I talked to, local residents do not make any opposition now
at the construction of group-home community housing of Bethel. There are
10 new apartments now.
The relationship with other official organizations in Urakawa town, as
I already mentioned, like Urakawa’s Educational Council, Japan Red Cross
and others proceed smoothly. There is a Liaison Committee that meets often
and mental health issues are regularly on the agenda. Social workers of
Japan’s Red Cross Hospital work often in Bethel also. I realized how important
it was to involve the local community to cooperate with families of mental
patients and to reflect how to build healthy relationships on an equal
basis.
For instance, there are cases like this. One member of the community was
urgently interned in the hospital without anybody being aware. The owner
of a local shop told the people of Bethel that the person had not been
feeling well for the last 3 days. This, I felt, was a sign of the natural
ways to care of each other. The members of the Group-Home, without interfering
in others’ life, knew exactly that one of their companions had been hospitalized
and discussed among themselves the health problems concerning the patient
at the Home meeting.
During my stay there I could not see many resident visitors at the shop
"4 chome Stroll" that sells goods from Bethel and promotes exchange programs in the
locality. Most probably they will have to reassess the meaning of it.
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During one of the meetings of the Group Home I sat down by the side of
a teacher of a Nurse College and a nurse of a Medical Faculty specialized
on mental diseases of a University.
Then a discussion took place out of some odd issues between Mr. Hayasaka
and one of the nurses. Mr. Hayasaka asked whether the policy of the hospital
was to let patients leave the hospital in case they were willing to do
so. A nurse replied, "It is up to the doctor' s judgment."
When Mr. Hayasaka heard that said angrily, "Why does not the doctor allow a patient to leave the hospital, if s/he
wants to go home?" Mr. Hayasaka reacted angrily at the tendency of medical institutions
for mental patients to keep the patients interned, in spite of the fact
that, by establishing communication with mentally disabled people, one
can make sure that they are not strange people. When patients get somehow
healthier it is better to continue rehabilitation in society.
Certainly, living in Urakawa one meets often members from Bethel that look
a little peculiar sometimes but without calling much your attention. This
is the result of the acceptance given by the population of disabilities
of patients from Bethel that are living shoulder to shoulder with the local
residents.
Dr. Kawamura Toshiaki, specialist in schizophrenic diseases at Urakawa'
s Red Cross Hospital, writes often in books that medical treatment should
rely on the strength hiding behind the disease, not on given drugs.
I had the opportunity of asking people in Bethel for their good experiences.
Their answers were: 1) I could meet many people; 2) When I want to remain home I do it and when I want to work I go;
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3) People, in similar situations like myself, are able to work; 4) I can naturally show my sickness 5) Before coming to Urakawa if I became sick I had friends visiting me, but
here I enjoy the friendship of many.
The fact that Urakawa is located in an isolated region and its streets
form a compact small area everybody is easily visible. The experiments
done at Bethel cannot all be repeated in urban environments, but some could
also be viable in modern cities. For instance, SA self-supported groups
are in fact, existing and can develop further in cities.
The building of cities stresses heavily extreme efficiency and seems to
be impossible to act with flexibility, but maybe by chance a "crevice" appears and from that the whole system starts crashing down. Because it
is not allowed to lose courage one has always to make great efforts while
one’s heart screams loudly. As a member of Bethel’s community explained,
one of the good characteristics of Bethel is that people move from "doing the impossible to some kind of liberation."
In the final stage and in the process of evangelizing society one has to
solve the sense of impossibility. In the cities there is a need for space
to share suffering in common within an atmosphere of forgiveness, an attitude
like the one practiced at Bethel, getting interested in the difficulties
of others and without rejecting persons with mental problems as if they
were "strange persons."
Ms. Shimizu has a message for those dealing with "mental problems." "Before getting sick it never came to my mind that I could come to live
in this town. Once I came to Urakawa I reflected for the first time on
my own identity and relationships with others. If I were a healthy person
I would have hardly thought about this. My sickness helped me to reflect
deeply about it."
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