The “Therapeutic Landscapes” of Alcoholism in Japan: Establishment of Self-Help Groups and Restructuring in the Yoseba

Abstract

This paper focuses on the yoseba (the space served as a catchment place of the unskilled labors), especially Kamagasaki in Osaka and Sanya in Tokyo, in the 1960s and 1970s, and examines the development of various recovery systems for alcoholics, using the concept of “therapeutic landscapes.” In Japan, male-centered drinking customs formed in modern times. As a result, alcoholism has been regarded as a male-specific disease. Medical institutions and Danshukai, a self-help group established in line with the Japanese patriarchal drinking custom, first included mainly alcoholics with family for treatment. The way homeless alcoholics were included in the existing system led to them becoming an object of exclusion from recovery. It was foregrounded as a “problem” in the yoseba, where the homeless were treated as a source of supply for the male day-laborer force. In Sanya, the limitations of the Danshukai and medical institutions gave rise to new actors and the development of the AA (Alcoholics Anonymous) organization. In Kamagasaki, doctors played a key role in securing the combined support of Danshukai, the government, and private welfare organizations to help homeless alcoholics recover. This led to establishment of the “Osaka method,” which is the only method used by the Danshukai. In this way, the “therapeutic landscapes” for alcoholics differed according to the actors in each region and were produced in a historically contingent process.