A reader has a query about alcoholism in Japan: "How is it generally perceived and what kind of help is available for foreign alcoholics who speak little to no Japanese?"
It will come as no surprise to any Japan resident to hear that alcoholism is a problem in this country, just as it is in other parts of the world. Needless to say, this disease affects not only Japanese but non-Japanese living here as well.
However, many people still believe that alcohol dependency is something that affects only certain groups, such as the homeless, and that it isn't a disease at all, says Sachio Matsushita, Vice Director of the National Hospital Kurihama Alcoholism Center, the largest treatment center in Japan. Only recently, Matsushita says, have these misconceptions begun to change.
So is it more difficult for English-speaking foreigners to deal with alcoholism in Japan?
Not necessarily, says Andrew Grimes, a licensed clinical psychologist in Japan, of Tokyo Counseling Services. The unfamiliar circumstances in which an expatriate might find themselves in Japan could actually force them to face up to their drinking habits and the issues behind them.
"Because of the lack of support and lack of roots, as it were, it's actually a place sometimes where people have to confront their problems," Grimes explains. "Although it can feel like an absolute hell to do so in a foreign environment, sometimes people with alcoholism find it's easy to avoid facing up to the truth of their addiction while still in their home countries.
"In their own language and culture it's easier to move around and the addiction knows how to deny and delay the realization that their drinking is the problem."
TR, a non-Japanese member of Alcoholics Anonymous living in Japan, adds: "In Japan, since there are fewer foreigners around, drinkers may become lonelier faster than if they were, say, lonely in New York where people speak English. Loneliness is kind of a killer and drives many people, like me, to seek help and call AA for the first time. So the lonely factor — the 'gaijin isolation' factor — may actually help an alcoholic to 'hit bottom' and reach out for help.
"Also, since drinking a lot is tolerated in Japan, a problem drinker may go ahead and drink a lot, and get very sick and tired of it, and want to quit, versus in the U.S. For example, sometimes a person gets in some kind of legal trouble for drinking and doesn't really want to quit, but is told to do so by a judge.
"Many people are 'sentenced' to AA meetings and come with a paper that must be signed as proof of attendance, but they don't want to be at the meetings and don't want to stop drinking. Yes, some eventually are attracted by our laughter in AA meetings and find they do want our way of life, without drinking. But many go out and do what we jokingly call 'further research' into alcoholism — i.e., drink a lot more."
One obstacle that may stand in the way of recovery is the "expat bubble." Grimes says that though there are many expats who will only drink the same amount as they did in their home countries, and those who don't drink at all, "expatriate communities tend to drink a lot. Some people may drink more in an expatriate community than they might at home. When you are a long way from home, the pressure is on to be sociable and maintain friendships, and drink more."
Another stumbling block is the potential difficulty of finding resources in English. Rest assured, though, wherever you are in the country, you can get help if you want it.
In severe cases when a rehab center might be ideal, most, if not all, treatment centers in Japan typically only offer support for Japanese-speakers.
Grimes explains: "When alcoholism is such a problem that it requires staying in a rehabilitation facility, there are perhaps one or two facilities where people can go — of course if they speak Japanese there are many — but my experience with English-speakers from other countries who only speak some Japanese or no Japanese at all, usually if it's so extreme then I recommend that they go into rehab back in their home countries."
Alcoholics Anonymous exists in Japan and there are some English meetings, though most are in Japanese.
"The number of English-speaking AA meetings is limited," TR says. "However, with the Internet (Skype), email, phone calls and visits, a person living in the deep countryside in Japan who wants to quit drinking can find help."