Table 1 Key components of Morita therapy (MT)
Components | Definition | |
|---|---|---|
Principles | Natural world | MT conceptualises unpleasant thoughts and emotions as part of natural human experience. It draws upon the natural world, and the place of humans within it, to emphasise that symptoms are not subject to the patient’s control, and will naturally ebb and flow with time |
Acceptance and allowance of internal states | All emotions and thoughts (internal states) are accepted as they are. Any attempts to control, resist, avoid or intervene in symptoms are considered to exacerbate them within a vicious cycle; therapists thus help patients to move away from symptom preoccupation and combat and towards acceptance and action-taking. Thus, the objectives are to shift attention and perspective, and move patients to a position of accepting and responding to phenomenological reality as it is, rather than controlling or “fixing” symptoms | |
Normalisation | Therapists label internal states as “unpleasant” and “pleasant” but not “good” or “bad”. They emphasise that all emotions are natural, or normal, and will ebb and flow on their own so long as attempts are not made to resist them | |
Fumon (inattention to symptoms) | Therapists, in an effort to shift patients’ attention away from symptom preoccupation and combat, will not focus on discussion or analysis of patients’ symptoms or their causes, but will “steer” the conversation towards action-taking and the external environment | |
Process/ practice | Diaries | Patients complete daily diaries on which therapists provide comments to facilitate an acceptance of internal states and refocus attention on action-taking and the external environment |
Four-phased model | Rest and action-taking are structured within 4 phases: (1) rest; (2) light repetitive activities; (3) more challenging activities; (4) social reintegration. The process is understood to aid experiential acceptance of the natural ebb and flow of internal states; re-orientate patients in nature; and refocus attention from the “self”/internal states to external reality | |
Rest | MT seeks to potentiate patients’ natural healing capacities, in contrast to resisting and exacerbating symptoms. Patients sit with their internal states as they are, to learn how they naturally ebb and flow with time if left unattended, and to build a natural desire to take action | |
Action-taking with symptoms | Patients learn to undertake purposeful and necessary action, with or without their symptoms; action which is driven by “desire for life” rather than a desire to change internal states. MT thus aims to improve everyday functioning in spite of symptoms, with symptoms reducing as a by-product of moving from a mood-oriented to purpose-oriented and action-based lifestyle |