A psychological study of fasting therapy with Naikan

Abstract

In an caller study we investigated the psychological aspects of fasting therapy with Naikan, using questionnaires, the Rorschach test, and the Baum test. Our results showed that all patients showed some improvement, and that the therapy contributed toward psychological stability. In the present study, we increased the number of subjects, and used standard psychotherapy as the control condition with which to assess the effectiveness of fasting therapy, its suitability for effect, and its adaptability, based on results from CMI, YG, TEG, and the Rorschach test. The subjects were 37 patients hospitalized due to psychosomatic disease and neurosis who had undergone fasting therapy. Fourteen of these cases were followed for half a year. Controls were patients, matched for age, sex and disease, who had been suffering from psychosomatic disease or neurosis and had been given psychotherapy. The effect of fasting therapy was assessed by having the case physician evaluate patients under nine headings (symptoms, mental stability, interpersonal relations, understanding of the disease, attitudes toward work, disposition, cheerfulness, emotional control, and judgment) all measured on a 4-points scale. No patients received a negative assessment, and treatment was judged to be highly effective in 18 cases and somewhat effective in 19 cases. The 5 patients who interrupted therapy were similarly studied. The results showed that the standard psychotherapy group showed some improvement in subjective self esteem, but little change in deep personality structure. In comparison, those who continued with fasting therapy steadily improved in subjective self esteem, emotional control, ego strength, and self image. In those patients showing a marked improvement, there was also some improvement in conflict concerning affective wants. These results suggest that the fasting therapy induces in patients a sense of having been 'psychologically reborn' after having undergone an extreme physical state. As we had expected, the effects of fasting therapy gave rise to the following observations: questionnaires are inadequate for revealing changes in deep personality structure, while patients in whom the effect of therapy was less pronounced seemed to have less imagination and empathy, but greater internal tension. Furthermore, although the patients who were unable to complete therapy were good at affective expression and introspection, they also tended to be aggressive and to have anxiety about affection. For that reason, these patients are less well suited to undergo fasting therapy with its many restrictions, accordingly, a more mild form of therapy should be devised for these patients.