Creating “Idiom of Distress” Collaboratively: An Analysis of Practices of Self-Directed Research By People with Mental Illness

We clarified the interactive practices in which participants create “idioms of distress” collaboratively during a tojisha kenkyu session as a form of self-directed research by people with mental illness. In Japan, psychiatry is still in the middle of deinstitutionalization, with various attempts made to support people with mental illness to live in their communities. The practice of tojisha kenkyu is now attracting much attention; this is a type of peer-support practice in which participants talk about their troubles in their daily lives in order to understand the meanings behind them and the causes of them in their own words. This practice began in a group of individuals with mental illness in the town of Hokkaido, Japan, and has since been used with many other groups of people with various impairments. It is frequently used because it allows participants to collaboratively put their troubled experiences into words. In order to study these methods, we analyzed ten videotaped sessions of tojisha kenkyu. The focus was one type of action sequence often found in the early stage of each session. The sequence involves one participant discussing their troubled experiences and his/her own thoughts about them. Then, the audience tries to make sense of this, usually by confirming their understanding in relation to their own troubled experiences that they think are analogous to the experiences discussed by the teller. In other words, the audience confirms their understanding by trying to check the adequacy of the analogies they make between the teller’s experience and their own experiences. Through this process of orienting themselves to the individuality of their own experiences, audiences seek to accomplish mutual understanding. Using this procedure, they eventually create new “idioms of distress,” which are concepts through which they can understand their own troubled experiences in their own way.