Purpose-​Centered Therapy

In the West, we tend to believe that what we think influences how we feel, which in turn influences how we act. In contrast, Morita therapy, created by Shoma Morita of Japan, focuses on teaching patients to accept their emotions without trying to control them, since their feelings will change as a result of their actions. In addition to accepting the patient’s emotions, Morita therapy seeks to “create” new emotions on the basis of actions. According to Morita, these emotions are learned through experience and repetition.

Morita therapy is not meant to eliminate symptoms; instead it teaches us to accept our desires, anxieties, fears, and worries, and let them go. As Morita writes in his book Morita Therapy and the True Nature of Anxiety-Based Disorders, “In feelings, it is best to be wealthy and generous.”

Morita explained the idea of letting go of negative feelings with the following fable: A donkey that is tied to a post by a rope will keep walking around the post in an attempt to free itself, only to become more immobilized and attached to the post. The same thing applies to people with obsessive thinking who become more trapped in their own suffering when they try to escape from their fears and discomfort.

The basic principles of Morita therapy

1: Accept your feelings. If we have obsessive thoughts, we should not try to control them or get rid of them. If we do, they become more intense. Regarding human emotions, the Zen master would say, “If we try to get rid of one wave with another, we end up with an infinite sea.” We don’t create our feelings; they simply come to us, and we have to accept them. The trick is welcoming them. Morita likened emotions to the weather: We can’t predict or control them; we can only observe them. To this point, he often quoted the Vietnamese monk Thich Nhat Hanh, who would say, “Hello, solitude. How are you today? Come, sit with me, and I will care for you.”

2: Do what you should be doing. We shouldn’t focus on eliminating symptoms, because recovery will come on its own. We should focus instead on the present moment, and if we are suffering, on accepting that suffering. Above all, we should avoid intellectualizing the situation. The therapist’s mission is to develop the patient’s character so he or she can face any situation, and character is grounded in the things we do. Morita therapy does not offer its patients explanations, but rather allows them to learn from their actions and activities. It doesn’t tell you how to meditate, or how to keep a diary the way Western therapies do. It is up to the patient to make discoveries through experience.

3: Discover your life’s purpose. We can’t control our emotions, but we can take charge of our actions every day. This is why we should have a clear sense of our purpose, and always keep Morita’s mantra in mind: “What do we need to be doing right now? What action should we be taking?” The key to achieving this is having dared to look inside yourself to find your ikigai, what a French philosopher might call a raison-d’être.

The four phases of Morita therapy

Morita’s original treatment, which lasts 15 to 21 days, consists of the following stages:

Isolation and rest (five to seven days). During the first week of treatment, the patient rests in a room without any external stimuli. No television, books, family, friends, or speaking. All the patient has is his thoughts. He lies down for most of the day and is visited regularly by the therapist, who tries to avoid interacting with him as much as possible. The therapist simply advises the patient to continue observing the rise and fall of his emotions as he lies there. When the patient gets bored and wants to start doing things again, he is ready to move on to the next stage of therapy.

Light occupational therapy (five to seven days). In this stage, the patient performs repetitive tasks in silence. One of these is keeping a diary about his thoughts and feelings. The patient goes outside after a week of being shut in, takes walks in nature, and does breathing exercises. He also starts doing simple activities, such as gardening, drawing, or painting. During this stage, the patient is still not allowed to talk to anyone, except the therapist.

Occupational therapy (five to seven days). In this stage, the patient performs tasks that require physical movement. Dr. Morita liked to take his patients to the mountains to chop wood. In addition to physical tasks, the patient is also immersed in other activities, such as writing, painting, or making ceramics. The patient can speak with others at this stage, but only about the tasks at hand

The return to social life and the “real” world. The patient leaves the hospital and is reintroduced to social life, but maintains the practices of meditation and occupational therapy developed during treatment. The idea is to reenter society as a new person, with a sense of purpose, and without being controlled by social or emotional pressures.