How Japanese philosophies help therapists when they lost their clients by suicide

My expertise is in trauma, crime, mental health, addiction, and other areas which means I am exposed to the risk of getting secondary traumatic experiences through the critical incident. Bride et al (2004) explained, “Secondary traumatic stress has been defined as the natural consequent behaviors and emotions resulting from knowledge about a traumatizing event experienced by a significant other” (p.27). For instance, I work for suicide intervention and criminal cases such as homicide, public shootings, and terrorist attacks and I must be aware of my emotional impact. According to Caine and Ter-Bagdasarian (2003, as cited De Boer, 2011,p.316 ), “For the present study, a critical incident is defined as a sudden unexpected event that has an emotional impact sufficient to overwhelm the usually effective coping skills of an individual and cause significant psychological stress”.

I lost my client in 2021 by suicide. Qayyum et al (2021) explained “There were categorized into two major areas that spoke to (1) unpreparedness for the death of a patient by suicide, and (2) mediating/complicating factors related to the event itself” (p. 281). As a self-employed, I could get peer- support and call my supervisor. Qayyum et al (2021) found, “Processing with a grieving supervisor had been helpful” (p.285 thoughts). Lyra et al (2021) discussed, “Vicarious trauma (VT), defined as a disruption and caused by the transmission of trauma experiences when cumulatively witnessing disturbing clinical material or due to work-related emotional toll, can have both personal and professional impacts” (p.2). Even though I had supervision meetings, I could not get rid of feelings of guilt, shock, and sadness and it impacted my personal life because I could not feel safe when I talked with my supervisor. Qayyum et al (2021) pointed out, “Some trainees also commented on being aware of their supervisor’s own struggles with the death of the patient by suicide” (p.285). I found her struggles during our sessions. I ended up using Naikan therapy (self-reflection)  because I felt her limitation to help me. Sutton (2021) found Naikan reflection provides a more complete, authentic, and realistic view of how we conduct ourselves and our place in our environment.

As a self-employed, my own company is my organization. I refer to the Japanese ‘Ikigai’ concept as the most important organizational philosophy and goal.

Eatough (2021) described:

“Ikigai is a Japanese concept that means your ‘reason for being.’ ‘Iki’ in Japanese means ‘life,’ and ‘gai’ describes value or worth. Your ikigai is your life purpose or your bliss. It’s what brings you joy and inspires you to get out of bed every day.”

Ikigai gives me a holistic way of viewing my professionalism, compassion, mission, and vocation within both professional and personal contexts. Ikigai concept also gives me both my individual and collective views. For instance, Ikigai will give me the questions of what the world needs, what I love, what I am good at, and what I can be paid for. These questions give me the wisdom to build my resilience as a therapist and human. Especially as a Japanese non-binary therapist, Ikigai concept keeps my power and energy to be able to keep working for the community even though I sometimes get discrimination against both my nationality and gender.

References

Bride, B. E., Robinson, M. M., Yegidis, B., & Figley, C. R. (2004). Development and validation of the secondary traumatic stress scale. Research on Social Work Practice, 14(1),27–35. https://doi.org/10.1177/1049731503254106

De Boer, J., Lok, A., Van't Verlaat, E., Duivenvoorden, H. J., Bakker, A. B., & Smit, B. J. (2011). Work-related critical incidents in hospital-based health care providers and the risk of post-traumatic stress symptoms, anxiety, and depression: a meta-analysis. Social science & medicine, 73(2), 316–326. https://doi.org/10.1016/j.socscimed.2011.05.009

Eatough, E. (2021 May 7). What is ikigai and how can it change my life?Better up. https://www.betterup.com/blog/what-is-ikigai

Lyra, R., McKenzie, S.K., Every-Palmer, S.,& Jenkin,G. (2021) Occupational exposure to suicide: A review of research on the experiences of mental health professionals and first responders. PLoS ONE 16(4), e0251038 https://doi.org/10.1371/journal.pone.0251038