As mentioned before, several parts of my Master’s dissertation (“The Stigmatization of People with a Mental Disorder in Premodern Japan: Research from a Cultural Historical Perspective”) will be posted on Nippaku. Click here to check out the first introductory part! Another history post related to this topic that might be of interest to you is this one about the similarities and differences between the Belgian city of Gheel and the Japanese hamlet of Iwakura. Today, we will go as far back in time as the eighth century to discover how people with a mental disorder were regarded and treated during the Nara and early Heian period.
“Madness” as a Privilege of the Shaman
The oldest notion of “madness” can be traced back to shamanism, a spiritual practice that originated in the Paleolithic period. The Japanese form of shamanism, mikoism, was shaped with the diffusion of shamanism in Central Asia, although there are as many differences as similarities. In the hunter-gatherer society, it was believed that the animals they hunted down for food could reincarnate. A Siberian fortune teller, or shaman, descended into the world of the sacrificed animals to predict by means of their bones whether this was the case or not. The shaman also wore animal hair and skin to adopt animalistic features. In order to psychologically immerse himself in the underworld, the shaman drank extracts of poisonous mushrooms, uttered incantations, danced fanatically until he or she eventually fell down on the ground and entered a state of apparent death. The poisonous substances triggered a state of altered consciousness, interpreted as “madness” and today known as a mental disorder caused by narcotics or alcohol. The fact that the character for “mad” (狂) in Japanese has the radical for dog or animal (犬) can be traced back to this shamanistic practice.
With the emergence of sedentary agricultural societies, shamans continued to play an important role by predicting successful harvests. The harvest was a matter of life or death, and shamans were often appointed as king or queen of newly-formed states. Although they combined a spiritual responsibility with a political role, shamans still carried a strong link with “madness”. During times of war, the king or queen, “raging with anger” would lead the troops. “Anger” expresses just like “madness” a strong affective change. In the shamanistic society, the privilege of being “mad” inferred a supernatural statute, and was only granted to shamans, or kings and queens.
Footnotes:  Omata, Waichirō 小俣和一郎. The History of Psychiatry 精神医学の歴史 (Seishin igaku no rekishi). Tokyo: Daisan Bunmeisha, 2005, p. 21ff.  Fairchild, William P. “Shamanism in Japan.” Folklore Studies 21 (1962): 1, p. 105.  Kamada, Tadashi鎌田正and Toratarō Komeyama米山寅太郎 “狂.” (kyō) in New Kanji Forest新漢語林, Taishūkan Shoten, 2011.
Early Accounts of Mental Disorders
The oldest preserved Japanese law documents that gives an account of the treatment of mentally disordered citizens, is the Taihō Ritsuryō (701). According to this premodern law system, mental disorders were divided into three categories based on the severity of the disorder. Citizens suffering from the two most severe disorders, were registered as fukakō (不課口) or fukuwa (不課), and discharged from corvée. The law also stipulated that people with a mental disorder of the most severe type should receive nursing care. Moreover, the punishment for crimes committed by individuals with a mental disorder was slightly reduced. Although it remains unclear whether these provisions were actually realized, we can see that during the eighth century, the law system did not prescribe the proactive banishment or persecution of individuals with a mental disorder but pursued a policy of social integration.
Records of Ancient Matters (Kojiki古事記, 712), the oldest literary work in Japan, comprises another description of the reaction to “madness”.
Then His-Swift-Impetuous-Male-Augustness said to the Heaven-Shining-Great-August deity: “Owing to the sincerity of my intentions I have, in begetting children, gotten delicate females. Judging from this I have undoubtedly gained the victory.” With these words, and impetuous with victory, he broke down the divisions of the rice-fields laid out by the Heaven-Shining-Great-August deity filled up the ditches, and moreover strewed excrements in the palace where she partook of the great food. So, though he did thus, the Heaven-Shining-Great-August deity upbraided him not, but said: “What looks like excrements must be something that His Augustness mine elder brother has vomited through drunkenness. Again, as to his breaking down the divisions of the rice-fields and filling up the ditches, it must be because be grudges the land they occupy that His Augustness mine elder brother acts thus.” But notwithstanding these apologetic words, he still continued his evil acts, and was more and more violent. As the Heaven-Shining-Great-August deity sat in her awful weaving hall seeing to the weaving of the august garments of the deities, he broke a hole in the top of the weaving-hall, and through it let fall a heavenly piebald horse which he had flayed with a backward flaying, at whose sight the women weaving the heavenly garments were so much alarmed they died of fear.
His-Swift-Impetuous-Male Augustness, otherwise called Susanoo, drank too much out of excitement and started to act like a “madman”. His sister the Heaven-Shining-Great-August deity, or Amaterasu, forgave him the first time, attributing his vicious behavior to a mental change caused by alcohol. However, when Susanoo threw a skinned horse through the roof, Amaterasu was terrified and hid herself into a cave.
The “madness” here illustrated can be further explained by the hare and ke dichotomy theorized by Yanagita Kunio in A History of the Meiji and Taisho periods: Social Conditions 明治大正史 世相篇 (Meiji taishō shi sesō hen, 1930). Hare, “the sacred”, refers to something formal, festive, ritual, public and extraordinary whereas ke, “the secular”, alludes to the profane, mundane, private and everyday life. Based on Yanagita’s thesis, the suggestion here is that people who lost the ability to discern between hare, the sacred and ke, the profane, behaved as was only permitted on hare days, and were, therefore, labeled as a “mad”.
Susanoo, for example, was so proud of his accomplishment that he started drinking alcohol and acting violently, this in contrast with his sister and the other women, who were dealing with their daily activities. His actions were seen as “defilement”, kegare, in a ke context, whereas it would have been perceived as a sign of spirituality in a hare context. Although Susanoo was heavily punished for his vicious acts in the end, it should be noted that Amaterasu first shows some mercy regarding his mental condition.
Footnotes:  Perhaps best illustrated in the English language, where the word “mad” covers those two connotations.  Zenshichi残疾, haishichi癈疾 and tokushichi篤疾. Hashimoto, Akira橋本明. The history of psychiatric care in Japan. Were there rights for “mental patients”? – Gleaners in the history of psychiatric care in Europe.日本の精神医療史. “精神病者”の権利はなかったのか？―ヨーロッパ精神医療史の落穂拾い― (Nihon no seishin iryōshi. “seishin byōsha” no kenri ha nakatta no ka? – yōroppa seishin iryōshi no ochibohiroi), 2002.  Omata, History of Psychiatry, p. 48. Chamberlain, R. H. The Kojiki. Seattle: PublishingOnline, 2001, p. 32-33.
“Mad” People and Religion
One way to discover elements of (non-)stigmatization in a certain period in time, is by looking at the terminology used for individuals with a mental disorder and the positive, neutral or negative connotations these words bear. In Chronicles of Japan (Nihon shoki 日本書紀, 720), Shoku Nihongi続日本紀 (797) and Saimeiki 斎明記, the word tabure 狂is used to describe “madness”. Tabure has a double meaning: on the one hand, it is connected with the word tawamure 戯れ, meaning nowadays “jest”, “flirtation” or “joke”, and indicates a deviant social behavior, such as in the story about Susanoo’s ravage. On the other hand, tabure is derived from the phrase tamashii ni fureru 魂に触れる, “to touch the soul”, and refers to spirit possessions, as was practiced in Shintoism. Accordingly, “mad people” were called taburebito狂人. This term appears neutral, even positive in combination with a context based on hare. Notwithstanding, only one word existed to point out “mad people” at that time, so it could in se also express strong disapproval of others’ deviant social conduct.
An example of taburebito used to condemn those not in their right mind, can be found in Veritable Records of Three Reigns in Japan (Nihon sandai jitsuroku日本三代実録, 901). An imperial edict from the year 866 warns that “in the case lunatics would conspire to destroy the state, all deities will quickly resurrect”. This criticism is directed towards the conspirators of the Ōtenmon incident of the same year. Those who would harm the state and therefore also its fundament, the emperor, officially the descendent of the gods, must be crazy. Taburebito is used here to argue that rebellion against the political institution or emperor is pure “madness”.
Around the Nara period, the Sino-Japanese reading of the character for “mad”, kyō 狂, came into use. Kyō is not as old as the Japanese reading tabure and bears in addition a slightly more negative connotation: it is used to direct social criticism towards people behaving differently from what convention prescribes, especially when the motive or reason for this demeanor is known. In other words, Kyō roughly overlaps with the first meaning of tabure, but has an additional element of criticism.
Another characteristic of “madness” in Ancient Japan lies in the connection between taburebito and the practice of mountain worship (sangaku shinkō山岳信仰). With the development of an agricultural society on the flatland, mountains were held to be the abode of kami and became objects of worship. They were, therefore, forbidden ground for normal villagers. On hare days, kami descended from the mountains to the village, and the “madness” originating at sacred heights was temporarily transferred. People who entered the mountains were thus regarded as “madmen”. Especially on ke days, this kind of deviant behavior represented a breach or escape from everyday interpersonal relations.
At the same time, however, mountains were supernatural places where an encounter with the gods became possible, and attracted for that reason people wandering around in search of spiritual enlightenment. Taburebito who used to do so on normal days were regarded as “close to the gods” and gained a special status. Their aberrant conduct was not judged on a personal level but in a religious context, in the sense that their connection with kami was predestined and necessary for a smooth communication with the supernatural world. In the footsteps of shamans and miko, taburebito played an important role in mediating between the two worlds. Considering that “madness” was strongly connected with hare, we can conclude here that an interpretation of non-stigmatization can be applied.
Footnotes:  E.g. tabure gokoro no mizo 狂心渠 “the ditch of madness”, an enormous water construction ordered by empress Saimei (chapter 26).  E.g. tabure madō 狂迷 “go astray in madness” (16th emperial edict). Frellesvig, Bjarke, Stephen Wright Horn, Kerri L. Russell, and Peter Sells. The Oxford Corpus of Old Japanese.  Actually a part of the Nihon Shoki. Saimeiki gives an account of the feigned “madness” (itsuwari tabure) of prince Arima. Oda, Japanese Sources on Madness, p. 15, 17-18.  Original text: 若狂人乃國家乎亡止謀留事奈良波。皇神達早顯出給比 (若し狂人の国家を亡さむと謀る事ならば皇神達早く顕出し給ひ).  Although it is unclear who actually conspired against who, the incident started with the main gate of the royal palace (Ōtenmon) burnt down. Several accusations were made, but in the end Fujiwara no Yoshifusa seized the power, executed his political enemies and was promoted as Regent.  Dismissing those who rebel against the emperor and imperial family as “madmen” is not only limited to this period, but is a recurring phenomenon throughout Japanese history, also referred to as a side effect of the “chrysanthemum taboo菊タブー(kiku tabū, chrysanthemum refers to the imperial house)”. For an overview of such incidents in modern Japanese history, see Inoue, Shōichi井上章一. Madness and Royal Authority 狂気と王権 (Kyōki to ōken), Tokyo, Kodansha, 2008.  Oda, Japanese Sources on Madness, p. 15.  Yano, Kazuyuki. “Sacred Mountains Where Being of ‘Kami’ Is Found.” 16th ICOMOS General Assembly and International Symposium: Finding the Spirit of Place – between the Tangible and the Intangible. Quebec, Canada, 2008, p. 1.  Oda, Japanese Sources on Madness, p. 27-28.  Yanagita, Kunio. Mountain Village Life. Tokyo: Heibonsha, 1961.
“Madness” in Buddhism
During the 6th century, Buddhism was introduced in Japan and later adopted as the official religion. The monk Keikai edited 116 Buddhist stories from the Nara period and earlier in the Nihonkoku (Genhō Zenaku) Ryōiki日本(国現報善悪)霊異記 (822). In this compilation there are several stories dealing with mental disorders, but remarkable is that this “madness” is often reported as punishment for a crime committed towards Buddhism. For example, it is described how one man harbors ill feeling towards Buddhism and tries to lock up a Buddhist monk begging for money. The monk escapes and recites incantations, upon which the man loses his mind and starts running around like crazy.
It is likely that the introduction of Buddhism from mainland China via Korea brought along a change in the perception of “madness” in Ancient Japan. In contrast with the positive connotations attributed to taburebito in Shintoism and folk religion, “madness” here is in nothing related to supernatural beings, but perceived as a punishment on a personal level, a prevalent understanding of “illness” as “evil” in several religions around the world. “Mad” people do not contribute to society or gain a special status in a Buddhist context. They are marked with a mental disorder as proof of their “defiant” behavior and categorized as impure together with criminals, debtors et cetera. In such cases, the Sanskrit word ummatta is used to express “insanity”. Nevertheless, there was legal and social consideration towards people with a mental disorder, for example, monks who developed a mental illness were not accountable for crimes against the Buddhist law. On the other hand, religious experiences such as possessions, illusions or hallucinations are not unusual in Buddhism. These experiences are temporary, caused externally and mystically significant, but unlike Shintoism and folk religion in Japan, Buddhism differentiates between experiences with a spiritual connection and other “madness”, or ummatta. This perception views ummatta as devoid of religiosity (hare) and is more likely to encourage the stigmatization of individuals with a mental disorder, rather than the generalizing notion of “madness” in Shintoism does.
Footnotes:  This work is translated by Watson, Burton as Record of Miraculous Events in Japan: The Nihon Ryōiki. Translations from the Asian Classics. New York: Columbia University Press, 2013. Koike, Kiyoyuki. “Mental disorders from a Buddhist View, especially those within the Nikaya, the Vinaya Pitaka and the corresponding Chinese translations” in Indian and Tibetan Studies Research, 7 & 8, p. 178. Oda, Japanese Sources on Madness, p. 55-56.