I returned to Japan last November after spending much of the last twenty years in America. Living abroad for so long has helped me enormously with my work, enabling me to experience first-hand the different kinds of psychiatric problems that appear in each culture, and how they are dealt with.

I made my first trip to America not long after I graduated from medical school in Tokyo. Yale granted me a scholarship to study child psychiatry?a discipline for which there were no training facilities in Japan?and this gave me a unique opportunity to learn about both America and modern psychiatric theory. On completing the scholarship, I returned to Tokyo to teach what I had learned and to help open Umegaoka Hospital, which was the first and largest psychiatric hospital for children in Japan. I was Chief Psychiatrist there until it was decided that the hospital should try to help the families of emotionally disturbed children as well as the children themselves, so I returned to America to study again.

Much of my work is now taken up with family psychiatry?helping families that seem to be functioning quite normally on the surface, but who actually have severe problems for which they have no outlet. I guess my job is to try to decrease the tension in situations where one member of the family is emotionally disturbed.

I also deal with many patients suffering from illnesses which I believe are modern and specific to Japan. Couples in international marriages?most of those that I see are Japanese wives with American husbands?sometimes run into trouble because the husbands don' understand their wives' expectations. On the other hand, Japanese couples, especially those in their late thirties and early forties, are experiencing difficulties due to the changing shape of Japanese society.

One of the most common problems I encounter with Japanese relationships is that the women are becoming stronger, and want more from their lives; some have even gone as far as to turn around and leave their husbands to achieve greater freedom. When this happens it causes Japanese men great distress, as they traditionally rely on their wives to manage their finances and provide emotional support. Without someone to fill this role, the men don't know what to do, and many end up very, very depressed.

Japan is my home, so of course I love being here, and I especially enjoy playing a more active part in my family's life than I could when I lived in America. I do think that Japan is in a crisis right now, and I'm not sure that we will be able to get over it. My role is to observe and help those who are having difficulties adjusting, and I'll continue to do that until I retire.

Info: Dr. Ishikawa is one of only two psychiatrists licensed in both America and Japan. For an appointment, call 010-041-9569.