Culture, Medicine, and Psychiatry

, Volume 42, Issue 4, pp 755–777 | Cite as

Extraordinary Care for Extraordinary Conditions: Constructing Parental Care for Serious Mental Illness in Japan

  • Ellen B. RubinsteinEmail author
Original Paper


This article presents an account of how Japanese parents in a family support group for mental illness constructed understandings of care for adult children with serious mental illness, primarily schizophrenia. I build from Janis H. Jenkins’s research on the “extraordinary condition” of schizophrenia to discuss “extraordinary care,” which parents practiced as a way to refute cultural and clinical beliefs about pathogenic families and degenerative diseases. Parents’ accounts of extraordinary care revealed a reliance on biomedical knowledge to treat the symptoms of mental illness coupled with an ongoing determination to improve children’s lives beyond what psychiatry could offer. Extraordinary care thus points to the therapeutic limits of biomedical psychiatry while also reinforcing the significance of social relations as families work toward recovery.


Care Families Schizophrenia Psychiatry Recovery Japan 



Portions of this manuscript have appeared in different guises at American Anthropological Association (2016, 2017) and Society for Psychological Anthropology (2017) meetings, and I am grateful for comments I have received from discussants Janis H. Jenkins, Lenore Manderson, and Narelle Warren (and panel organization wizardry from Emily Hammad Mrig, Merav Shohet, and Narelle Warren). I would like to thank William W. Kelly, with whom I began this project, and Daniel M. Goldstein, who enabled me to finish it. I have also benefited from thoughtful feedback from two anonymous peer reviewers. I would like to thank Etsuko Kosuge, Ai Ohtani, Toko Shiiki, Ellen Tilton-Cantrell, Hiromi Yamashita, and the amazing Rae Sakakibara for transcription and translation assistance. My deepest thanks are due to the members of Tomodachi, who allowed me to participate in their group and become part of their lives.


This study was funded by the Japan-U.S. Educational Commission (Fulbright IIE) Dissertation Research Fellowship, Yale University’s Whitney and Betty MacMillan Center for International and Area Studies Dissertation Grant, and Yale University’s Council on East Asian Studies Dissertation Research Grant.

Compliance with Ethical Standards

Conflict of interest

Ellen B. Rubinstein declares that she has no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of Yale University’s Institutional Review Board (IRB Protocol #: 0909005658).


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Authors and Affiliations

  1. 1.Department of Family MedicineUniversity of MichiganAnn ArborUSA

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