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January 20, 2015
by Lisa La Rose, M.A., L.P.C.

Eastern Approaches to Wellness: Morita and Naikan Therapies

January 20, 2015 05:55 by Lisa La Rose, M.A., L.P.C.

The foundations of western psychology can be found in Europe and America, with eastern influences only recently being introduced into the mix. Eastern philosophies and religions have made their way westward over the past several decades, and many have embraced these belief systems and practices. There are countless books and magazines about eastern religion, philosophy, and eastern psychology—from Confucianism, to Taoism, to Zen.  Many are drawn to these ideas from far away, some searching solutions for life’s challenges and a sense of inner peace.  Western psychology has begun to incorporate components of eastern wisdom into their treatment regimes. For example, Dr. Marsha Linehan, the creator of Dialectical Behavior Therapy, incorporates mindfulness practices from Zen Buddhism into her treatment for people struggling with Borderline Personality Disorder (Linehan, 1993).

There are some eastern philosophies and treatments that aren’t as well known here in the west, but which may offer alternatives and help for those struggling with conditions like anxiety and depression. Two such approaches are Morita Therapy and Naikan Therapy, which both have their origins in Japan.  With a little investigation, we can see that Japanese therapies such as Morita and Naikan have different philosophies about why people suffer and develop symptoms of mental illness and how they can recover and feel better.  

Morita Therapy

Morita Therapy was developed by Japanese psychiatrist, Shoma Morita (1874-1938).  He was influenced by Zen Buddhism, and his work focused great deal on assessing and treating anxiety disorders, which are called “shinkeishitsu” in Morita Therapy.  Morita’s treatment approach was highly structured, and even had a residential component.  Morita himself would bring clients into his home, creating a safe and nurturing environment. 

Treatment included times of isolation and bed rest, easy, monotonous work, more vigorous work, purposeful activity with other people, and refraining from self-focused talk. Spending time in natural outdoor settings was also important (Morita, Kondo & Levine, 1998).  These types of interventions are very different from the general course of treatment in the west, which often does not include residential or inpatient treatment, and is much briefer. However, components of Morita Therapy have made their way into western psychology. Some essential tenants of Morita Therapy include:

  1. Feelings are natural responses to events that happen in life, and they are not something that needs to be changed or “fixed”.   Acceptance of reality and feelings, pleasant of unpleasant, is important.
  2. Feelings are to be acknowledged and valued, but our attention and energy should be more focused on living our life well, rather than focusing on changing or escaping painful feelings. This means that we set goals and work toward accomplishing them, even while we co-exist with unpleasant feelings once in a while.
  3. It’s not necessary to change or control our feelings before we take constructive action in our life.  In fact, feelings may not be “controllable”.  For example, we may think we have to overcome our fear of public speaking before we give a presentation at work.  Working on overcoming the fear can actually make it worse. Sometimes taking action is the best way to deal with anxious feelings.
  4. A reality-focused attitude is more helpful than self -focused attention.   Preoccupation with our self and our moment to moment feelings can be unhealthy, and increase suffering. However, when we can get absorbed in what we’re doing, our anxiety may decrease because we’re focused on the activity.
  5. Clients (or students) learn to accept that feelings fluctuate from moment to moment, and learn to ground themselves in the reality and purpose of the present moment.  “Cure” does not mean getting rid of unpleasant emotional states, but instead focuses on taking constructive action to create a meaningful life that is not ruled by ever-changing emotions (Morita, et al, 1998).

Some might say that Morita Therapy encourages clients to ignore or “stuff” their feelings. This is not the case.  Feelings are acknowledged, but not at the expense of living a constructive and productive life.  This approach may be helpful for people who are paralyzed by painful emotions or stuck in existential anxiety.  Traditional Morita Therapy is not generally available in the west, even in inpatient and residential treatment settings. However, individuals and behavioral health professionals can incorporate the strategies for working with behavior, emotions, and attention.  

Naikan Therapy

While Morita therapy is a more action- oriented treatment approach, the practice of Naikan is more reflective, but also structured.  Naikan was developed by Yoshimoto Ishin, a Japanese Buddhist.  Naikan is Japanese word that means “inside looking”, “introspection” or “seeing one’s self with the mind’s eye”. This structured method of self-examination and reflection can help people understand themselves and their relationships with others (Naikan, 2012).  The practice of Naikan is based on answering three basic questions and reflecting on the nature of relationships with various people in our lives (filling in the blank with a person’s name:

  • Question 1:  What have I received from________:   This question enables us to appreciate what others do for us, and how the world supports us.  Noticing all the things that other people do, even strangers, can help prevent us from getting bogged down in struggled and discouraged by obstacles.  It may be as simple as being grateful that your wife made you pancakes, or someone opened the door for you when you had your hands full.  Or, it may be as profound as reflecting on what was given to you by a person with whom you have a difficult relationship.
  • Question 2: What have I given to_________:  This is the other side of the coin, and encourages you to see what you have given to others.   This balances reflections on what you have received.
  • Question 3: What trouble and difficulties have I caused________: This final question may be the most difficult.  We are often much more aware of the trouble and inconvenience that other people cause for us, and we may not like looking at how we sometimes make life difficult for others.  This question enables us to take a real look at our behavior, and how what we do impacts others.  It’s not meant to cause guilt or shame, or lower self-esteem, but can help us modify our behavior, if we choose to.  Self-esteem and self-image is often build upon how we interact with others and life in general (Krech, 2002).

The practice of answering the three Naikan questions can be applied to any relationship.  Many choose to examine their relationships with their mother, father, and significant other.   Individuals can even attend Naikan retreats during which they spend significant time reflecting and meditating on the answers to these questions (Krech, 2002).  The value of this process can be a deeper understanding of and appreciation for relationships, and the fundamental nature of being human.  In Naikan, more value is placed on discovering truth and being of service than on feeling good.  A desired outcome of Naikan is that people come away with a more accurate self-image and understanding of reality.

The practice of Naikan has been applied successfully in Europe and Japan with issues like substance abuse, depression, anxiety, criminal behavior, and family discord.  The approach differs in many ways from traditional western therapy approaches.  For example, traditional treatment approaches focus on feelings, while Naikan focuses on facts and the reality of relationships.  Western approaches may place more emphasis on looking at how the client has been hurt or mistreated by others, while Naikan encourages more focus on how the client has been cared for and supported.

In traditional approaches, the therapist offers significant validation of the client’s experiences, while in Naikan, the therapist also helps the client understand the experience of others, and take responsibility for their own actions and outcomes.  Finally, in western approaches the therapist may provide analysis and interpretation of the client’s feelings and experiences, while a Naikan therapist helps the client create a framework for self-reflection (Krech, 2002).

Understanding eastern approaches to wellness, like Morita Therapy and Naikan, can provide individuals and behavioral health professionals with additional strategies to address emotional, behavioral, and relational issues.  Both of these therapies acknowledge feelings and beliefs, but stay grounded in the reality of the present moment.  For example, a client in Morita Therapy who is struggling with “their purpose in this life” may be told that their purpose today is to wash the dishes that have been piling up in the sink.  These approaches offer different perspectives on what causes suffering and psychological symptoms, as well as the course of action people may take to alleviate pain and create authentic and meaningful lives.


Krech, G. (2002). Naikan: Gratitude, grace, and the Japanese art of self-reflection. Berkeley, CA: Stone Bridge Press.

Linehan, M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford Press.

Morita, M., Kondō, A., & LeVine, P. (1998). Morita therapy and the true nature of anxiety based disorders (Shinkeishitsu). Albany, NY: State University of New York Press.

Morita Therapy. (2014). Retrieved August 28, 2014, from

Naikan. (2012). Retrieved August, 2014, from

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