I think that the object of Naikan Therapy includes the realization of the true self and the actualization of total life release from ego restriction. Today the paradigm of medical treatment is shifting in the direction of holistic medicine involving life-span-development, and community based medicine. I would like to discuss about the introduction of Naikan Therapy into the medical field based upon today's tendency. To be concrete, I explain the method and the mechanism of Naikan Therapy, and then the clinical approach including its current trend. As we can understand that all diseases are psychosomatic in a broad sense, I would like to suggest that the introduction of Naikan Therapy to the medical area could contribute to a new concrete model.

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Acupuncture, the traditional medicine which gives minute physical stimulation such as needling or moxibustion to the body, has also been used to treat psychosomatic diseases. The reason for this is that the theory of the remedy is based on the physical model of which the body and the mind are united. We have been studied clinical effects of acupuncture on several kinds of psychosomatic diseases such as depression, irritable bowel syndrome (IBS) and atopic dermatitis, as well as its influences on the activities of the brain reward system. 1. Clinical Effect of Acupuncture We have been studing the effect of acupuncture on IBS using a single-case research design. All of the patients we studied (n=4) had persistent and refractory symptoms due to IBS. Primary outcome measure in the study includes abdominal symptoms, general conditions, quality of life (QOL), Oriental medical score and the profile of mood states (POMS). The result showed that acupuncture affected both somatic and psychological symptoms, which indicated that the remedy have certain ability to improve symptoms of IBS. On the other hand, in the study where elderlies with depression (n=33) had been involved and evaluated with geriatric depression score (GDS) and visual analogue scale (VAS), we found that acupuncture treatment based on traditional chinese medical thery (TCM theory) was useful in such cases. 2. Effect of Acupuncture on the Brain Reward System We have been studing with the focus on the comfortableness of the acupuncture treatment, the effect of acupuncture on the brain reward system through observation of the changes in the monoamine in the nucleus accumbens. Using Sprague-Dawley (SD) rats, we observed changes in the monoamine level and its metabolite after acupuncture or moxibustion. The results showed that both acupuncture and moxibustion appeared to have ability to increase serotonin level in the nucleus accumbens. These results indicate that acupuncture may affect the brain reward system and consequently causes comfortableness and/or relaxation

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Kampo, Japanese traditional medicine, was transmitted from China since about 1, 500 years ago and adapted to Japanese people, and with confidence on clinical usefullness of ancient Chinese formulations. We frequently have the opportunity of treating patients suffering from psychosomatic diseases with Kampo medicine. Therefore, we evaluated an index of the health-related quality of life (HQOL) on the out-patients before and three months after treatment with Kampo medicine. HQOL was assessed with the Short Form 36 (SF-36) item health survey, Japanese version. On all eight scales (physical functioning, role physical, body pain, social functioning, general health perceptions, vitality, role emotional and mental health) of the SF-36, the patients' score before treatment were significantly lower than the Japanese national norm scores. Particularly, 5 scales such as the physical functioning, role physical, general health perceptions, social functioning and mental health significantly improved after treatment with Kampo medicine. The results indicate that the patients excepted of Kampo medicine display various physical, emotional and social dysfunctions, and Kampo medicine could improve the HQOL of patients. We usually diagnose the patient's condition by his or her symptoms and signs, and prescribe the Kampo formulation which can rectify the shift from the healthy condition and can assist the patient's biological reaction against the disease. The most basic scale in Kampo diagnosis is Yin and Yan ; Yin disease is negative or inactive state of the patient's biological reaction with coldness, and Yan disease is positive or active, with fever or without coldness. We presented the clinical courses of three cases with psychosomatic diseases. All of them were diagnosed as Yin pattern and treated with Kampo formula containing medicinal plants after taking which the body was warmed up. Then the treatments were effective and their SDS score decreased. We believe Kampo therapy due to Yin or Yan diagnosis is important and useful to treat psychosomatic diseases.

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This paper introduces a brief history of Yoga therapy in Japan, along with an explanation of the five layers theory of our existence and the eight-fold approach to yoga exercises. Currently, the number of Yoga practitioners in Japan is estimated to be hundreds of thousands. The main motivation of people who practice Yoga is to promote good health and prevent illness. The benefits of traditional Yoga have been scientifically examined by the Kaivalyadhama Yoga Research Institute since the 1920's. The Kaivalyadhama Institute is located in Lonavla city, in the state of Maharashtra, India. The Central government of India has supported this scientific movement, and a Yoga college was established in 1950 as part of the Institute. The college has given skills and knowledge to many talented Yoga therapists who currently work at various medical facilities throughout India. A post graduate college, established by the Swami Vivekananda Yoga Research Foundation (sVYASA), was approved by India's Ministry of Human Resource Development in 2003. The college has researched the medical effects of yoga on chronic bronchial asthma, diabetes, and rheumatoid arthritis among other medical conditions. The Japan Yoga Therapy Society was established in 2003. The society, through cooperation with the sVYASA, educates yoga teachers about therapy theory and techniques during a three-year program, with 180 hours of instruction. In ancient yoga belief, the human being is understood as five layers of existence. The main cause of disease is the ignorance and misunderstanding of our real existence. Yoga therapy improves health through the recognition of our real existence. Yoga has eight practices: self-restraints, fixed observances, posture, regulation of breath, abstraction, concentration, contemplation and trance. These techniques guide us to realization of our true existence, through what is known as recognition therapy.

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Neuropathic pain (NP) is a bother to both patient and doctor, related to severity, chronicity and resistance to licensed analgesics. It damages the quality of life (QOL) of people with NP and the relationship with their therapists. Author reported 3 elder female cases whose lower QOL caused by NP improved with its remission, using milnacipran, which is the only serotonin norepinephrine reuptake inhibitor (SNRI) in Japan and recognized as safer than tricyclic antidepressants. Possible antinociceptive mechanisms of them include direct effect, activation of descending inhibition pain system and, psychosomatic which is effect considered as main effect by most clinicians in Japan. There are lots of reports indicating antidepressants as the gold standard treatment for NP, suggesting that SNRIs may work as analgesics, independent of antidepressants. These cases indicated that primary care physicians as well as psychiatrists must recognize the analgesic efficacy of milnacipran and facilitate to use it in daily practice also in Japan, and it may significantly improve QOL of people with NP, especially elderly.

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