Introduction

Psychotherapy has mainly been established and developed in the West. Accordingly, Western cultural norms and values are transported into some psychotherapy models. However, the use of psychotherapy has become widely spread in other non-Western societies, making adaptations obvious that transcend cultural boundaries (Koç & Kafa, 2019). In 2003, the American Psychological Association published its Guidelines on Multicultural Education, Training, Research, Practice, and Organizational Change for Psychologists (an updated version was published in 2017). These guidelines recognize and encourage psychologists to understand and embrace the role of diversity and multiculturism in the profession. Psychologists are encouraged to acknowledge the distinctiveness and complexity of one’s identity (their beliefs, attitudes, language, and historical backgrounds) and to endorse culturally adaptative interventions. Furthermore, psychologists are advocated to reflect on globalization’s impact on psychological assumptions and practices given the international context (American Psychological Association, 2003, 2017).

The patient’s characteristics, preferences, and culture are three fundamental principles for evidence-based practice (EBP) (American Psychological Association Presidential Task Force on Evidence-Based Practice, 2006). Due to this APA notion, efforts to culturally adapt EBP have been made to adequately cater to the patient’s needs and improve treatment outcomes (Morales & Norcross, 2010). The most recent meta-analysis (Hall et al., 2016) reported that culturally adapted interventions indicated a better effect over other conditions (e.g., no intervention or other interventions) (g = 0.67). Furthermore, compared with identical non-adapted interventions, culturally adapted interventions reported a medium-size effect (g = 0.52).

When adapting a therapy, surface structure adaptations (e.g., offering ethnically matched therapists, using language familiar to the patient, and designing clinics to be culturally aesthetic) are possible. Additionally, deep structure adaptations (e.g., including cultural ideas, beliefs, and values in the treatment) can be meaningful (Hwang, 2016; Resnicow et al., 1999). A newer framework to help with the cultural adaptation of treatment, the Psychotherapy Adaptation and Modification Framework (PAMF), was proposed by Hwang (2006). The domain that Hwang (2006) called “understanding cultural beliefs about mental illness, its causes, and what constitutes appropriate treatment” is relevant to this article. This domain highlights how understanding patients’ cultural beliefs could influence and enhance treatment. For example, this process includes giving culturally sensitive psychoeducation (e.g., educating the patient about their illness, clarifying misconceptions and stereotypes, and reducing stigmas).

Being acquainted with the patient’s cultural beliefs allows the integration of cultural ideas with therapeutic concepts and practices (Dyche & Zayas, 2001; Ham, 1989). Integrating or adapting common cultural values and terms could enhance acceptance and increase treatment adherence. It might make it easier for people from, e.g., non-Western cultures to understand what a therapist from Western backgrounds means and wants to communicate. For example, chengyu (i.e., Chinese metaphorical sayings to teach ethics and moral ideas) could be used to bridge therapeutic concepts for Chinese patients (Hwang, 2006, 2016). Hwang (2006) used the metaphor “shuang guan ji xia” (= to paint holding two brushes) to illustrate the two fundamental principles of cognitive-behavioral therapy (CBT) – to identify and restructure maladaptive thoughts and to engage in healthier behaviors. Another example of cultural bridging is using culturally specific metaphors, proverbs, and stories. The saying “no se ahogue en un vaso de agua” (= don’t drown in a glass of water) could be used to teach Latino patients not to ruminate on a problem that brings great distress (Hinton & Patel, 2017).

In this article, we propose that cultural bridging is possible between behavioral activation (a concept from behavior therapy) and ikigai (a Japanese life philosophy), as they share the same basic principle, the importance of an individual’s values for becoming motivated and guiding everyday action decisions.

Behavioral activation (BA) as a psychotherapy method to treat depression was pioneered by Lewinsohn and his colleagues in the United States. Based on the assumption that depressive behavior results from a low rate of positive experiences, BA focuses on increasing rewarding experiences through activities that increase activation and engagement despite depressive mood. Such activities provide natural reinforcement and modify the individual’s environment (Dimidjian et al., 2011). The newer approaches to BA especially highlight the relevance of personal values in the treatment (Lejuez et al., 2011; Martell et al., 2010). Assessing the individual’s values assists in determining behavior repertoires which could provide a stable source of positive reinforcements (Kanter et al., 2009). Furthermore, evaluating values helps understand the type of life the individual wants. Personal and meaningful goals can then be deduced from the patient’s value system, and pursuing those will increase the patient’s acceptance of and adherence to therapy (Hoyer & Krämer, 2021; Martell et al., 2010).

In the Japanese culture, a specific term called ikigai, which consists of ‘iki’ (= to live) and ‘gai’ (= reason), is a well-known concept in Japan. Among the Japanese, the term ikigai is used in casual everyday conversation and is something they feel instead of a particular goal they are trying to achieve (Kemp, 2022). This Japanese life philosophy can be roughly translated into a purpose of living (Mogi, 2017). Ikigai can be defined as “that which most makes one’s life seem worth living” (Mathews, 1996b, p. 730). Although some English terms relate to ikigai, a direct translation has not been found in English, making this concept unique to the Japanese (Kumano, 2018). Though this comprehensive concept might primarily have a philosophical nature and does not classically exist in psychology research, the budding research field of ikigai has shown that practicing ikigai impacts physical and mental health (e.g., Fido et al., 2020; Mori et al., 2017). The latest work on the psychological benefits of ikigai revealed that non-clinical participants who reported a higher presence of ikigai showed a greater sense of well-being and lower depressive symptoms. The authors even suggested researching the benefits of ikigai in the context of specific disorders (Wilkes et al., 2022).

Our paper aims to provide a conceptual comparison between BA and ikigai and encourage an improvement of a Western-developed psychotherapy method to be culturally sensitive, especially when treating depressed patients with an Eastern background or with an open attitude toward other cultures. In addition, we explore the possibility of integrating these two concepts by using ikigai to enhance behavioral activation through cultural bridging. Perhaps, examining the characteristics of behavioral activation and ikigai would allow a vicarious learning process for these concepts. Though ikigai is not to be considered as a treatment, instead, we assume that its practice elicits similar effects as BA in the context of prevention of depression. Furthermore, ikigai could work as an ideal continuation or transfer of BA into everyday life.

Methods

This conceptual comparison is written as a narrative review. Our search strategy included literature in English and German. The literature search was conducted using the search terms “behavioral activation,” “cultural adaptation of behavioral activation,” “behavioral activation in Japan,” and “ikigai” in the electronic databases Scopus and PubMed. Due to the authors’ limitation of not understanding Japanese, some secondary references were unavoidable. Furthermore, some popular books were explicitly included as it provides a possibly more accurate cultural representation of ikigai. Primarily printed literature was available through the State Library of Saxony and the Technische Universität Dresden (SLUB Dresden).

Conceptual Comparison of Behavioral Activation and Ikigai

Theoretical Framework

BA has its roots in psychology and psychotherapy, specifically in behaviorism. Peter M. Lewinsohn theorized that a lack of positive reinforcement for an individual’s behavior causes depressive behaviors, which can elicit avoidance behaviors (Lewinsohn, 1974; Lewinsohn et al., 1976). Such behaviors hinder the possibility of contact with positive reinforcement, further increasing depression and creating a vicious cycle. Based on this theory, different manuals have existed over the decades to help therapists aid the patient in increasing the rewarding experiences and decreasing engagement in activities that cause depressive behaviors.

The contemporary approaches include methods for value clarification, which we will explain in detail below. Martell et al. (2010) referred to Lewinsohn’s depression theory. Depressive behaviors such as inactivity and withdrawal are coping strategies to avoid certain events. Such behaviors further reduce the possibility of positive reinforcements. Therefore, understanding the functional role of the behaviors plays an essential part. The authors developed a more practical model to help patients understand the BA model of depression. The primary goal of this model is to identify the “ABC"s of behavior or the contingencies. The patient should identify the situations (A) and the consequences (C) of the behaviors (B) with the therapist’s help. With the help of the functional analysis of behavior, therapy strategies are used to increase contact with positive experiences in the patient’s everyday life (Martell et al., 2010).

Lejuez et al. (2011) assumed that the relative reinforcement value for depressive and non-depressive behaviors influences the relative frequency of depressive and non-depressive behaviors. Concluding, depression occurs when depressive behaviors are rewarded, and non-depressive behaviors are not reinforced. The therapy model assumes that changes in an individual’s thoughts and feelings will occur after frequent positive experiences caused by an individual’s behavior. Environmental support can be beneficial to support these changes (Lejuez et al., 2011).

Ikigai seems rooted in Japanese history and weaved its way into the contemporary Japanese language. However, a specific time frame for the emergence of ikigai seems complicated to determine because of the lack of historical information in contemporary Japanese literature (Mathews, 1996a). Ikigai entered the modern vocabulary in 1908 and has been used to refer to the worth or subjective feelings of a fulfilling life (Kanda, 2011, as cited in Kono & Walker, 2020). Later, Mieko Kamiya, a Japanese psychiatrist, pioneered the research of ikigai and published a book about the meaning of life in 1966 (Kono & Walker, 2020a). However, as of the writing of this article, this book has not been translated into English.

A Western anthropologist, Gordon Mathews, explained the concept of ikigai in English literature. He observed contradicting senses of ikigai across Japanese media and conducted surveys. The surveys suggested that men found their ikigai in work, while women found their ikigai in family and children. In contrast, the press argued that finding ikigai in work, family, and children could potentially pose a problem for the individuals (Mathews, 1996a). These contradictions led Gordon Mathews in 1996 to conceptualize an inclusive theory of ikigai, which might help to explain the discrepancy. He understood ikigai as ittaikan (the idea of belonging to a group or commitment) and jiko jitsugen (self-realization).

If ikigai is understood as ittaikan, an individual’s reasons for living are their families, children, or company. For example, a wife and mother’s ikigai would be her children; due to her role, it is her job to nurture them. A husband and father’s ikigai would be his family and work because he can support and provide for his family by working. Older adults’ ikigai, if they could not acquire the feeling of belonging in the family, should lie in groups where they feel like they belong. However, suppose ikigai implies jiko jitsugen. In this case, somebody cannot simply find an individual’s ikigai fulfilling a social role in the family or work because an underlying self-role drives an individual’s pursuit of ikigai. Therefore, the individual pursues self-actualization. Simply put, an individual’s ikigai is embedded in their relation and commitment to a group or in pursuing their dreams (Mathews, 1996a).

The idea of ikigai as ittaikan and jiko jitsugen was reflected in the Ikigai-9, a psychometric tool to measure ikigai initially provided in Japanese by Imai et al. (2012). Fido et al. (2020), in translating Ikigai-9 to English, stated items such as “I believe that I have some impact on someone,“ “I feel that I am contributing to someone or the society,“ “I am interested in many things,“ “I would like to develop myself,“ “I would like to learn something new or start something.“ The authors found that these nine items were associated with one main factor instead of three different factors, as Imai et al. (2012) proposed. This finding is compatible with Mathew’s idea that ikigai might exist in a spectrum of committing to a community and self-actualization.

Fairly recently, a Japanese anthropologist, Chikako Ozawa-de Silva, explored the meaning of life among Japanese college students in an interview-based study. She found out that among the students, ikigai is understood as something “concrete, down to earth, and personal, including small-scale matters rather than long-term goals” (Ozawa-de Silva, pg. 629). Especially, ikigai was felt most in a relational manner and in the feeling of being needed (Ozawa-de Silva, 2020). The social aspects seem indispensable for the sense of ikigai among older adults. In a cross-sectional study of Japanese older adults (> 75 years old), the authors discovered loneliness negatively correlated with ikigai. Furthermore, there was an interaction function showing that there was a weaker negative association between loneliness and ikigai among the participants with enough social support and frequent social participants than in those with less. In interpreting these results, the authors highlighted how ikigai is closely related to the individual’s perceived social roles (Fukuzawa & Sugawara, 2022). In older women (> 65 years old), participating in social activities did not only enhance ikigai, but ikigai also affected their willingness to interact with new people (Seko & Hirano, 2021).

Values

Assessment and reflection of values play an essential role in the contemporary versions of BA (Lejuez et al., 2011; Martell et al., 2010). Evaluating values might not typically be viewed from a behavioral standpoint because it has been introduced to the modern behavioral theory through Acceptance and Commitment Therapy (ACT) by Hayes et al. (1999). However, assessing values is relevant because it determines which behavior repertoires can provide a stable source of positive reinforcements and should be integrated into the treatment. Furthermore, verbally formulating the values makes the relation between the behavior and the short- or long-term consequences noticeable. Consequently, it allows the behavior to be more influenced by the long-term goals in a situation where immediate competing distractions are present (Kanter et al., 2009).

For example, Lejuez and colleagues (2011) evaluated the values using a protocol with a list of areas of life potentially valuable for the patient (e.g., social relationships, education/training, physical/health issues, and spirituality). The therapist then guided the patient to identify and clarify the values that are important to them. This process results in specific statements of values, which propose a particular assignment of activation that aligns with the patient’s value. In articulating these values, it is suggested to state the form of the patient’s behavior instead of the results of the behavior (e.g., “I value being a good partner” rather than “I value my partner loving me”). This way of articulating the values enables translating the values into more concrete goals and assignments (Kanter et al., 2009).

The importance of an individual’s values is essentially embedded in ikigai. In analyzing the difference between shiawase and ikigai on the concept of well-being, Kumano (2018) implied that the meaning of ikigai resembles more eudaemonic well-being rather than hedonic well-being. Eudaemonic well-being emphasizes life’s purpose and meaning, whereas hedonic well-being emphasizes pleasures and happiness (Kumano, 2018; Ryan & Deci, 2001). Ikigai relates more to actions of devotion to things an individual thoroughly enjoys, and it implies a correlation to aspects concerning a sense of achievement and fulfillment and pursuing goals. Fundamentally the sense of ikigai includes the awareness of an individual’s values, for example, their life goals and the meaning of existence. Ikigai is not simply associated with positive and negative emotions (hedonic well-being) but relates to enduring difficulties and a sense of purpose (eudaimonic well-being) (Kumano, 2018).

Ikigai emphasizes a subjective perception of the sense of a life worth living. Individuals can experience ikigai despite, for example, success in professional life or economic status. This degree of independency illustrates how ikigai can originate from various behaviors and sources in life (Nakanishi, 1999). Recently, a study demonstrated how leisure activities are positively associated with shiawase and ikigai. Notably, active and effortful activities (e.g., physical activities) increased the sense of ikigai. Though not a leisure activity, work, has also shown a positive correlation with ikigai (Kono et al., 2022).

We consider the awareness of values to be essential in both concepts. In BA, these values guided the course of the therapy to increase the behaviors that produce positive reinforcements. Though not explicitly assessed in a top-down process, ikigai communicates that clarity of values is necessary to live a life worth living. In both concepts, these values were tailored according to the individual. BA confines evaluating the values through a rough guideline for the general life areas (e.g., Lejuez et al., 2011). In contrast, ikigai provides a broad spectrum of values because of its multi-faceted nature. Interestingly, BA and ikigai emphasize the importance of actively pursuing these values and turning them into short-term and life goals. Moreover, these behaviors aligning with the values could still be pursued regardless of the initial pleasant feeling.

Practice

The practice of BA is highly structured. Treatment manuals, like those from Martell et al. (2010) and Lejuez et al. (2011), provide a relatively straightforward structure guiding the therapy. In addition, these manuals offer specific worksheets for the used strategies, such as activity monitoring and scheduling. Generally, each session follows an agreed plan between the therapist and patient, including a progress and homework review since the last sessions. The therapist who takes the role of a “coach” helps work on problems that cause trouble completing the homework to maximize the patient’s commitment to action (Dimidjian et al., 2011; Hollon & Dimidjian, 2009). External social supports (e.g., family and friends) are encouraged by creating a formalized agreement or “behavioral contract,“ which outlines specific ways to aid the individual (Lejuez et al., 2011).

However, the BA approach is also idiographic and flexible to be adjusted to accommodate the patient. In reaching the goal of increasing contact with positive reinforcement in the individual’s life, a careful assessment of the factors maintaining the patient’s depression is needed. This assessment helps the therapist establish a suitable therapy model and the appropriate strategies later in the therapy. Therefore, self-monitoring, i.e., activity and mood monitoring is necessary. Primary strategies in implementing a BA treatment involve establishing activation assignments that increase approach behaviors. Furthermore, the therapist aids the patient in scheduling activities and structuring more extensive activities into smaller fragments to increase success. Additionally, the BA approach focuses on problem-solving, meaning in the therapy sessions, the therapist works with the patients to create and evaluate solutions for their problems (Hollon & Dimidjian, 2009; Hoyer and Krämer, 2021; Lejuez et al., 2011).

Compared to BA’s structured approach, the practice of ikigai follows neither a set of systematic guidelines nor is it performed in a clinical setting. Instead, ikigai is a product of cultural and personal references adapted within the individual’s direct social surroundings and the society’s institutional structures. The guidelines are provided on the individual’s cultural and personal values. In addition, experiences (e.g., the families the individual grew up in or the specific society they are a part of) could provide cultural conceptions. In finding one’s ikigai, these cultural conceptions are negotiated with the individual’s current interpersonal relationship (e.g., spouse, children, close friends) to fit themselves best. These types of social structuring and negotiation exist within a larger society’s institutional structures, like the economic system, gender roles, longer life expectancy, and religion (Mathews, 1996a).

Since the cultural context plays an enormous part in understanding ikigai, a glimpse into the popular books about ikigai and Japanese culture could suggest how ikigai is practiced. A famous Japanese proverb, “juunin toiro,“ which translates into “ten people, ten colors,“ reflects the personal (or idiographic) nature of ikigai. Ten different answers would be expected if ten people described their ikigai because each person enjoys various aspects of life. Hence, though a widespread concept in Japan, ikigai teachers do not exist (Mitsuhashi, 2018). However, popular self-help books about finding one’s ikigai suggested several ideas on how to find one’s ikigai, such as finding pleasure in small things, trying new things in small steps, living in the moment, surrounding oneself with friends (García & Miralles, 2017; Mogi, 2017). These ideas illustrate the commonness and easily practicable sense of ikigai since ikigai is often described as “a reason to get up in the morning” (Mitsuhashi, 2018; Mogi, 2017). Generally, the practice of ikigai is not limited to an individual’s one life aspect, i.e., only their work or social roles, but a broad spectrum of experiences that allows you to express your values (Kemp, 2022).

Though distinct in their degree of structure and the role of a person as a “coach” or “teacher,“ BA and ikigai show stunning similarities in the strategies used. In BA, structuring more extensive activities into smaller activities and activity scheduling was used to increase the contact with positively reinforcing activities (Lejuez et al., 2011; Martell et al., 2010). In ikigai, though not formalized as a particular strategy, taking small steps highlights how a journey in finding ikigai does not start with big ambitious goals but with small everyday activities (Mitsuhashi, 2018; Mogi, 2017).

The following case example could help illustrate the practical clinical use of ikigai: Hana, a 23-year-old Japanese architect student in Germany, suffers from depression and is currently receiving psychotherapy using BA methods as a part of a group treatment. She tries to schedule activities that would increase rewarding experiences in her daily routine according to a suggestion of her group therapist for two weeks. However, she experiences problems with rewarding feelings as focusing on this feels “very unnatural, strict, and daunting”. She also feels a lack of purpose in doing these activities. Her group therapist then mentions the concept of ikigai. He explains how having a reason to live doesn’t have to start with big ambitious life goals but rather through simple everyday things. Moreover, these simple things do not mean that it is not effortful to do so. She resonates with these ideas and starts taking a walk through her neighborhood and sharing some of her impressions by uploading pictures on her Instagram account.

The idea of “starting small” is echoed in the 10 Core Principles of Behavioral Activation from Martell et al. (2010). Thus, this illustrates that BA and ikigai prefer specific, concrete actions rather than vague and abstract ones. The practice of BA and ikigai requires the individual to be active and engage in the activities instead of just being passive, regardless of how big the action is (Hoyer et al., 2021; Kanter et al., 2009; Mitsuhashi, 2018). The wording is slightly different, though, as BA rather refers to “activities” corresponding with the individual’s value, while in ikigai, it is instead “experiences” that the individual personally values more or less (Hofheinz et al., 2017; Kono & Walker, 2020b).

Is There a Cross-Cultural Transfer?

Generally, BA can be used to treat depression in culturally diverse populations due to the simplicity of the approach (e.g., Richards et al., 2016) and its connectivity with idiographic and contextual concepts. A systematic review, including 17 studies published in English, indicated that BA was adapted to many cultural contexts in different dimensions, such as language, content, methods, and context. For example, the materials and concepts were translated into the targeted language, an interpreter was involved, cultural symbols or terms relevant to the culture were incorporated, and cultural values were discussed and considered. In the review, studies with minority populations (e.g., Latinos) in Western countries (the United States and Europe) and any people in non-Western countries (e.g., India, Iran, Iraq, China) were included. Generally, adapting BA to suit the cultural context leads to increased accessibility, acceptance, and practicability of the treatment, ultimately positively influencing adherence and outcomes (Lehmann & Bördlein, 2020). However, studies concerning BA as a core treatment, especially in the Japanese population, are currently limited in English literature. One study used BA in a randomized controlled trial to treat late adolescents with subthreshold depression (Takagaki et al., 2016a), and other studies focused more on the mediating effect of the behavioral activation model in various populations (Takagaki et al., 2016b; Yamamoto et al., 2019). Furthermore, whether these studies refer to the specific Japanese cultural background in practicing BA and whether they practice ikigai or are at least familiar with that concept) remains unclear.

Conversely, the sense of ikigai, despite the lack of an exact translation in English, transcends the language boundaries and could also be found in other cultures. In translating the Ikigai-9 into English, a psychometric tool to measure ikigai initially provided in Japanese by Imai et al. (2012), Fido et al. (2020) found the negative association of ikigai and depressive symptoms to be replicable in an English-speaking sample from the United Kingdom. Mathews (1996a) identified in his interviews that Americans also feel the sense of ikigai, meaning in life, like the Japanese. However, the manifestation of ikigai might look different for the Americans and Japanese in various life areas, possibly due to ikigai being an adaptation of cultural and personal references (Mathews, 1996a).

Table 1 summarizes the main similarities and differences between BA and ikigai.

Table 1 Summary of the conceptual comparison of behavioral activation and ikigai
Full size table

A specific field for trans-cultural transfer might be psychotherapy, where the intuitive nature of ikigai may be helpful for the self-verification of feelings about what we want to do: Gaby, a German 35-year-old mother, has been diagnosed with depression. She feels especially overstressed because it is not easy for her to balance her rising career to care for two sons and plan meaningful (recreative) activities within BA. She struggles with her role as a mother not being as acknowledged as her role in her business. To validate her feelings, her therapist then explained the idea of ikigai to her, particularly how finding purpose in her life could exist in a societal context, i.e., through doing things not only for others, but also through doing well in her career. This provided a new perspective for her and made her feel more congruent with her values in life, and she arrived at new ideas on combining recreative activities and being together with her sons.

Discussion, Limitations, and Further Ideas

We proposed that ikigai, a Japanese life philosophy, could be a cultural bridge and a conceptual addition to the therapeutic concept of BA. Despite having different origins and, consequently, differences in their theoretical framework and systematic practice, we found the meaning and purpose of BA and ikigai to overlap largely. The similarities become especially evident as both approaches emphasize the importance of the individual’s values and teach ways to pursue these values actively. The values-directed behaviors start as simple and small steps and that could still be pursued regardless of whether there is an initial pleasant feeling.

The therapist risks low treatment adherence by not considering patients’ cultural values and norms (Leach & Aten, 2010). Hence, blending Western (BA) and Eastern (ikigai) concepts to promote value-driven anti-depressive behavior could become a method to foster adherence in those patients whose thinking is rooted in not only one culture. Depending on the emphasis on each cultural value, including traditional life practices or wisdom, in modern psychotherapy could raise patients’ acceptance of a lower inclination to psychological theories and “non-psychological” cultures (Koç & Kafa, 2019). Furthermore, understanding the influence of the patient’s cultural background seems to help transcend the boundaries created by cultural differences between the therapist and the patient (Levitt et al., 2022). In assessing the values in BA, it is imaginable instead to ask patients about their ikigai. Ikigai asks the question, “What makes your life worth living?“, “What makes you get up every morning?“, “What keeps you going despite facing difficulties?“. These questions may initiate and strengthen a process of value clarification, problem-solving activity, and activity planning that counteracts typical depressive cognitive syndromes such as rumination and brooding. Ikigai offers a broad spectrum to answer these questions and emphasizes the collectivistic values usually found in Eastern cultures.

In cross-cultural practice, it is possible to overgeneralize certain concepts’ collectivistic and individualistic values orientation. However, the reality of these orientations might not be as firm as assumed. For example, the empirical basis of the common claims of European Americans being remarkably individualistic compared to other ethnicities is not as robust as implied. Instead, high variations are expected individually (Oyserman et al., 2002). Though part of Japanese culture may have become more individualistic over time, some social values have remained remarkably collectivistic (Ogihara, 2017). Hence, in treatment, the assessment of values should not be restricted to collectivistic or individualistic ones but rather encompass the two (e.g., the duty to one’s ingroup or independence) (Wong et al., 2018). Rather than focusing on a rigid value system, we speculate that ikigai might capture the essence of people’s core needs, like the need to belong and autonomy, due to its multi-faceted implications.

Ikigai was never conceptualized as a treatment. However, practicing ikigai in everyday counter-depressive activity planning may be a personal resource to decrease typical depressive symptoms. Recent data from thousands of online respondents show that simply selecting meaningful activities from a list can help reduce negative affect in lockdown situations during the COVID-19 pandemic (Hoyer et al., 2021). Though this action may only provoke a short-term transient effect, embedding it into a value-based life orientation might make it essential to prevent depression. Recently, ikigai was observed to reduce psychological problems (e.g., depressive symptoms and hopelessness) and enhance subjective well-being (happiness and life satisfaction) in a nationwide longitudinal study in Japanese older adults (Okuzono et al., 2022). The effect of ikigai also seems to transcend the psychological benefits. In several studies, ikigai was correlated with reduced incident functional disability and lower risk of cardiovascular mortality, especially for unemployed participants (Miyazaki et al., 2022; Mori et al., 2017a). The transdiagnostic benefits are also mirrored in the BA, showing the applicability of BA techniques in disorders other than depression (e.g., anxiety disorders, chronic pain, functional decline) (Dimaggio & Shahar, 2017; Kennedy et al., 2023).

We want to disclose and discuss some limitations. First, the ikigai literature is still very limited in the German and English languages, especially in the context of psychology. Hence, it is probable that our understanding of the concept of ikigai is biased “through a Western lens,” mainly as this work relies partly on Mathews (1996a), a Western anthropologist. Both authors do not speak Japanese and could not consult the original Japanese literature. Second, some popular books were included to understand the cultural context of ikigai better. However, the references used in these books were not explicitly mentioned, resulting in the unfeasibility of pinpointing the original author. Third, this comparison is written as a narrative review. Hence, the methodological approaches, including the studies’ specific inclusion and exclusion criteria, were not explicitly discussed. Fourth, the ideas presented in this paper were theoretical and conceptual. Hence, the practicality of these ideas needs to be tested in the clinical context.

The currently limited ikigai literature is an invitation for further research. Until now, ikigai was mainly assessed with a binary yes or no question, especially in longitudinal studies. Suppose ikigai is a multi-faceted and dynamic concept; a tool to measure ikigai needs to be continually developed and validated in different populations and made available in the targeted languages (e.g., Fido et al., 2020). Furthermore, the association of ikigai with well-being has been primarily observed in older adults. Studies observing young adults and adults should be done to compare the sense of ikigai across the lifespan. In clinical psychology, the short-term benefits of ikigai for reducing depressive symptoms should be observed, and eventually, the preventive benefits of it. BA has continuously been demonstrated in psychotherapy to treat depression effectively across different cultures. It should be explored in therapy sessions if ikigai could be used as a cultural bridge to promote cultural sensitivity in psychotherapy. Moreover, to a certain extent, ikigai could spark new ideas for activity planning and enrich the procedural variants of applying interventions such as BA.