他人との境界線とは何か？　どこまで自分を守るのか？　自立とか #早稲田メンタルクリニック #精神科医 #益田裕介

00:00 OP 00:41 What are boundaries? 02:07 Based on Western values 04:47 Therapy is a "contractual relationship" 06:32 Be honest. The rest is up to the other person. 08:51 Maintaining boundaries through intuition is a Japanese thing. Today, I'll be talking about the theme of "boundaries with others." I often hear people talk about "the boundaries between self and others are vague" or "not knowing the boundaries between self and others" in my clinical practice and videos, but you might be wondering, "What exactly are boundaries?" I think it's hard to understand what I'm talking about, so I thought I'd share a few of my thoughts on boundaries. ■What are boundaries? When you think of boundaries, you probably think of things like privacy and personal territory. I think that's basically a good way to think about it. Each individual has their own privacy that needs to be protected, and each individual has their own place, peace of mind, and space that needs to be protected. These boundaries, or areas, are clearly defined, and others must respect and honor them. You have to value what the other person holds dear, their heart. You have to respect them, you have to show respect. Conversely, the other person must respect your heart's space. This doesn't mean building a wall in your heart to stop people from entering, but rather it must remain a very important part of your heart. It's very important to properly protect this as personal privacy and private space. It's not about high ability/low ability, or having money/not having money, but rather it's a right that should be recognized by everyone, a place that should be recognized. That's what boundaries are. However, with patients, these boundaries tend to become muddied. They may break down their boundaries and let others in, or they may break down their boundaries and become too accommodating to others. ■Based on Western values I believe this idea of ​​boundaries comes primarily from European culture. In fact, the medicine and psychology we study are influenced by continental and Western cultures. We're learning things that have been somehow assimilated from the West into Japanese culture, but they are still based at their core on Western thinking and values. What I mean by Western values ​​is that the concept of contract is quite important. From Judaism to Christianity and Islam, people believed in what are called monotheistic religions, and some still do. These are beliefs based on a contractual relationship between God and ourselves. The value system is that we will abide by the rules of God. But in Japan, I don't think there is much respect for such contracts and rules, or a strict sense of command. But those are the values ​​that define Europe, and psychology, medicine, and counseling techniques come from there, so we therapists are naturally influenced by them, and I would like patients to understand this culture as well. These kinds of concepts are increasingly being incorporated into Japanese culture, so I think it would be good to adopt the good parts. And it's also continental culture. I want you to remember that this European culture is at the core of it all. Japan is an island nation, so there are no borders. There are no national borders, but as you can see if you look at a map of Europe, it's packed with small countries jostling for territory. This feeling is definitely there, and the lines drawn, like "this is our place from here to here" or "we'll cooperate from here to here," are at the core of our culture when we think about our minds, psychology, and psychiatry, so if we ignore that, it becomes confusing. If the foundation is shaky, everything else that's built on top of it will also be shaky, so I think this aspect is very important. ■Treatment is a "contractual relationship" What counseling and treatment are is the act of stealing the other person's time and energy. They are stealing my time and energy as the therapist. I am giving it to them. That's the kind of "contractual relationship" it is. In exchange, the patient pays money and shows their motivation and willingness to continue treatment. This contractual relationship is the basis. So it's not like, "It's okay because I'm paying." It's a contract that says, "I'm here to get better, so please heal me, but I'll also do my best, so please heal me and cooperate." I think this feeling is probably hard to understand. We have universal health insurance, and you can receive medical care at a low cost by paying a little money, so it might feel a bit confusing, but this is the basis of it. A sense of guilt and gratitude arises toward the therapist. This is what drives treatment. These feelings, "Oh, is it okay to be so dependent on him, but at the same time, Dr. Masuda has been so kind to me," work together to heal him. This is because there is a contractual relationship. If you think, "It's okay because I'm paying money," or "It's Masuda's job to heal me," it w...