自分の医療に限界を感じた精神科医が得た気づきとは？

Hello. I'm Haga Takahiro, a psychiatrist. Today, I'm making this video because I really want to share my passion with you all. I usually speak with the desire to share what I've learned in my practice with both patients and supporters, but today's video is a little different. I was deeply inspired by a scene in a manga I read today. It's more of a lesson for supporters than for patients. That's why I wanted to share with you what's really touching me right now. The manga in question is "Kingdom." It's a very well-known manga, so many people have probably read it. "Kingdom" tells the story of a slave boy named Shin, who meets King Ying Zheng of Qin and strives to achieve his incredible dream of unifying China. Currently, the arch rivals Zhao and Qin are engaged in a fierce battle. The latest episode depicts a "single archery duel" that takes place in the middle of a battlefield. Two archer brothers face off against one of the Ten Archers of China—said to be one of only ten master archers in China. In the midst of a battle between tens of thousands of people, for just a moment the world shrinks and two bows face each other. This is a thrilling plot twist common in manga. But it wasn't the "win or lose" that captured my heart. The master of the Ten Bows of China has perfected his bow. That's why he can shoot down any military commander. In other words, he possesses overwhelming power. However, he despairs at the very essence of conflict in the human world. Man kills man, and the killing continues endlessly. In such a world, what meaning does the bow he has mastered? With this in mind, he put his bow away. Then Li Mu of Zhao appears and brings him back, saying, "The answer is sure to be on the battlefield. Let's go and find it together." Then the archer brothers talk about their "father's teachings." The nameless archer's father tells them, "You may one day face true masters like the Ten Bows of China. But you may not win by mere skill alone. That's why I will teach you the ultimate bow and the ultimate arrow. Take this to heart." Naturally, the brothers have no idea what he's saying. So my father said, "The ultimate bow is one that never falls." What is a never-falling bow? If you shoot an arrow into the future, someone will catch it, and someone else will shoot it again. That's how human paths are woven. That's why arrows never fall. Conversely, my father said, it's arrogant to "despair about the human world." People are complex, imperfect, and can't do anything on their own. That's why there's meaning in believing in the future and shooting an arrow, even if it's imperfect or insufficient. With this teaching in mind, my brother releases his arrow. A master cannot read the trajectory of an arrow. He has always viewed the world within the "scope of his current ability," fighting for win or lose, hit or miss. But my brother's arrow is shot toward "a future that someone else may be able to weave." It flies from a place outside of calculation or prediction. That's why it's impossible to see through. And yet the arrow pierces. This really struck a chord with me. Why does this lead to psychiatric treatment? Let me explain. I've been a doctor for 20 years. The first 10 were in internal medicine, and the next 10 in psychiatry. The essence of medical treatment is the same in both internal medicine and psychiatry. You face patients by mobilizing all of your current knowledge and experience. The harder you work and the more you strive to improve your skills, the stronger your desire to help your patients. But when you've been doing this for a long time, there are times when you inevitably reach your limits. Take a patient with depression, for example. I know intellectually that even small changes in their lifestyle, like going for a walk or taking a bath, are likely to lead to improvement. So I try every trick in the book. Adjust their medication. Change the topic. Try not to rush them. But even so, there are patients who, for a year or two, can't go outside or take a bath, and keep saying, "I can't do it, I can't do it." This can lead to a sense of emptiness and despair. No matter how much literature I dig through, how much I study, or how much I invent, I feel like I can't encourage behavioral change. Is psychiatry powerless? There are moments when I think that. This feeling was somewhat similar to the emptiness felt by the master in Kingdom. Of course, I'm not one of the Ten Bows of China, nor am I one of the best psychiatrists in Japan. But the more you strive to "master," the more likely you are to despair when the world doesn't change even after you've achieved that level of mastery. The stronger your belief that you can save or change your patients on your own, the more painful it becomes when things don't go as planned. However, please don't misunderstand this: I'm not saying that supporters can slack off and say, "It's okay because the arrow won't fall." Unfortunately, there are some supporters out...