¹Doepp, Manfred, Holisticcenter, 13 Haupt St., Abtwil 9030, Switzerland.

*Corresponding Author:Dr. Med. Manfred Doepp, Holisticcenter, 13 Haupt St., Abtwil 9030, Switzerland, Tel: +91- 0041 79 924 00 88, Fax: +91-0041 79 924 00 88, www.drdoepp.org

Citation: Dr. Med. Manfred Doepp (2024) Ikigai, A Method of Disease Prevention - An Opinion. Medcina Intern 6: 233. doi: 10.1579/BGG.1000233

Received: June 09, 2024; Accepted: July 06, 2024; Published: July 11, 2024.

Copyright: © 2024 Dr. Med. Manfred Doepp, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Japan has a strong meritocracy, but this is combined with a high life expectancy and an inexpensive healthcare system. How does this come about ? There is a method, or rather a basic attitude, called Ikigai. It consists of giving meaning to the way of life, filling life with contentment and satisfaction. Primarily, no answers are given, but questions are asked, the answers to which bring about an inner evolution. In contrast to Western positive thinking, which can lead to compulsiveness, it is a relaxed method. It has proven its effectiveness in studies and could be integrated into medical psychology. 

Is a positive attitude to life, combined with positive thinking, useful for preventing illness? If so, how can this work? These questions are asked by life coaches all over the world. In Japan, a method called Ikigai has been developed for this purpose. Ikigai (Japanese ???? 'meaning of life') is loosely translated as "that which is worth living for”, (1) "the joy and purpose of life". (2-8) From a Western perspective, this would be described, for example, as : inner contentment, being in harmony with oneself, satisfaction, meaningfulness, fulfillment and even enthusiasm for life. An Ikigai practitioner gets up in the morning with gratitude and in joyful anticipation of what the day will bring. Integrated are 10 areas of life for a meaningful life that are worth living for, i.e. family, partnership, children, nature, garden, travel, profession as à vocation, art, music, sport. It should not be concealed that at the time of absolute imperial rule (Tenno) and the Second World War, the willingness to die joyfully (kamikaze) was also part of it. This has been a thing of the past since Hiroshima and Nagasaki. In Japan, the effects of the cultural heritage of Ikigai have been scientifically investigated in the form of two major studies. They are reported hère :

Toshimasa Sone et al. from the Faculty of Medicine at the University of T?hoku (Sendai, Japan) conducted a seven-year longitudinal study from 1994 onwards with 43,391 adults (aged 40 to 79), who they also interviewed in relation to ikigai. The researchers described the term as a "belief that one's life is worth living". During the study period, 3,048 subjects (7%) died. Almost 60% of the study participants had said yes to feeling ikigai. Most of these people were married, had an education and were employed; they stated that they had little stress. The analysis showed that people who said no to Ikigai had a higher mortality rate than those who answered yes. After categorizing the type of death, those who said no had a significantly higher risk of cardiovascular disease and death from external factors. The study was published in 2008. (8,9) It concludes that reporting a perception of ikigai has the quality of a prognostic value : 95% of people with ikigai were still alive after 7 years, compared to about 83% of those who did not experience ikigai. Similar statements - that a positive attitude to life is associated with physical health and thus with à longer life expectancy - are also confirmed by other authors. (10,11)

From the longitudinal Japan Gerontological Evaluation Study (12), which examines the health data of people over the age of 65, a subgroup of 10,867 subjects was randomly selected and asked about Ikigai. The question was "Do you have Ikigai?" with the answer options "Yes" and "No". The answer "yes" was associated with a 31% lower risk of developing functional disability and a 36% lower risk of developing dementia. (13)

Now that the Ikigai effects have proven to be positive in Japan, one may ask: How can a Western-oriented person approach Ikigai? Do you have to develop it yourself or can you train it? You can start by asking yourself the following questions :

1. Who and what do I love ? Do I have a passion, a passion for someone or a behavior ? If not, how can I develop it ?
2. What am I good at, what gifts and talents do I have ? Do I realize them in everyday life ? Do I even feel a calling? If not, how can I develop it ?
3. What is the best way to earn my money ? Does my professional attitude and motivation need to change ?
4. What does the world need from me ? What can I give it ? What is possibly my mission ?  

Answering these questions can lead you to start or increase your efforts to live consciously, to live authentically. If you are unemployed or already retired, there is an increased risk of these issues : A crisis of meaning or even a feeling of meaninglessness, a lack of identity or even a loss of identity, self-alienation, a lack of interest or even loneliness. It is possible and important to replace the job with a satisfying hobby. It is crucial not to become or remain passive, not just to consume, but to be creative. There is no one who does not have at least one talent. You can also ask yourself the question : how can I leave the world a little better than I found it ? An apartment building in which three or even four generations live together (or at least close to each other) is ideal for Ikigai. Here, the middle, working generation can hand over the care of the children to the older generation. This helps everyone involved, and many overburdens in our society can be avoided. Architecturally, this can be achieved by means of an atrium house, i.e. a ring-shaped arrangement of houses and apartments with a center including a playground in the inner courtyard. Wherever this has been implemented (e.g. in Denmark), positive experience has been gained.

Criticism

In addition to representatives of positive thinking in Western countries (Ralph Waldo Emerson, Dale Carnegie, Prentice Mulford etc.), there is a related "folk medicine" in Japan, the Ikigai. It does not contain grafted thoughts and artificial sentences, but rather a changé in motivations and backgrounds. The world's first comprehensive critique of positive thinking on the basis of scientific psychology was carried out by G. Scheich. (14) His book "Positives Denken macht krank. Vom Schwindel mit gefährlichen Erfolgsversprechen" has been considered a standard work since 1997. It neglects the different abilities of people, their different personality structures and the interaction between the individual psyche and the social environment. Positive thinking becomes particularly problematic when misfortune and suffering are considered to be self-inflicted. Oswald Neuberger, Professor of Psychology at the University of Augsburg, sees the method of positive thinking as a circular trap : "If you don't succeed, then it's your own fault because you obviously didn't do it right." In addition, the problem of failure is individualized, failures are personalized, but the economic and social system is absolved of any causation. (15) Colin Goldner, head of the Forum Kritische Psychologie e. V., increasingly diagnoses "deficits in thinking and perception" in people who fall for the "trivialized hypnosuggestions" and "pseudo-dialectical promises of salvation" of tingling "gurus", and criticizes the "psycho- and social Darwinist delusion of feasibility" of motivational trainers. (16) The obsessively imposed positive thinking known in Western countries can be seen as a kind of substitute religion. There is a belief that this thinking can be an apparent path to self-redemption on earth. Repressed content in the subconscious, unresolved conflicts and the so-called shadow are hidden. A "lid" is put on it so as not to jeopardize the egocentric delusion of success. This criticism is justified, but it does not apply to Ikigai. Ikigai goes deeper, it goes into the world of feelings and motivations. It is a basic attitude that involves always seeing the positive in the negative. Success is not an important yardstick, but it often occurs - because it is unintentional. Ambition remains hidden.

Ikigai represents a positive attitude towards life, a positive sense of life, a positive approach to and interpretation of life, a basic attitude. It is obviously successful. From a medical point of view, Ikigai harmonizes and stabilizes the autonomic nervous system, possibly also increasing gamma-amino-butyric acid (Gaba) in the brain. This would need to be clarified in a study. Western compulsions with regard to success do not occur. It can therefore be used as a prophylaxis against diseases.

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