The twenty-year-old woman sitting across from me told me how she daily struggled with sadness and depression that resulted in suicidal thoughts and a firm plan for how to take her own life. It was difficult for me to comprehend her level of desperation. On the outside, she seemed to have checked all the boxes for a dynamic, meaningful life.

She was a daughter in a wealthy, influential family and a student at the best university in Japan. She made excellent grades, had great physical health, and kept a wide circle of supportive friendships. Yet prior to sharing her hopelessness with me, she had voiced these thoughts with only one other person—a young pastor who had referred her to me for consultation.

At the time of our session, I had been in Japan for almost five years. I spent the initial two years in Tokyo studying Japanese language and culture. I studied for a third year with a Japanese social worker, Saito Sensei, who taught me specific counseling vocabulary and provided training for how to counsel in the Japanese culture. This additional year of training was critical for counseling the Japanese in various states of need.

Why 70 Japanese Commit Suicide Every Day

From week one, Saito Sensei and I discussed the Japanese people’s long history of accepting and honoring suicidal behavior. We examined three cultural factors contributing to the frequent decision to end one’s own life.

One factor is the lack of opportunity for the Japanese to discuss their personal struggles. There aren’t many acceptable ways to voice feelings of anger and frustration in Japanese daily life. When you have no real means of expressing anger or feelings of loss in light of something unjust, neglectful, or abusive, you can swallow those feelings and end up chronically sad or clinically depressed.

My psychopathology professor in graduate school defined depression as nothing more than anger turned inward on the self. Sadly, the college student mentioned above felt no freedom whatsoever to share the depth of her dark thoughts and feelings with family, friends, or teachers.

“When you have no real means of expressing anger or feelings of loss in light of something unjust, neglectful, or abusive, you can swallow those feelings and end up chronically sad or clinically depressed.”

Two other factors contributing to suicide in Japan are the strong sense of honor and duty to the group or family, and the use of shame and guilt as chief motivational techniques in education and work settings. Saito Sensei and I discussed amae, the need to be dependent on and accepted by others—family, friends, community, and work groups.

Japan is an extremely group-oriented and intricately networked culture where personal identity is submerged within the bigger identity of the groups in which individuals function. These groups—whether in school, at work, or in families—inflict guilt and shame upon members to ensure the image of the group is preserved.

Consequently, when someone struggles with anxiety, low self-esteem, or depression—all normal mental health issues—asking for outside assistance may be seen as bringing dishonor to his or her family’s standing in the community. The Japanese believe one should be able to gain enough love and affirmation within the group to address personal struggles without seeking the help of a professional counselor. In this context, the prospect of inflicting harm on oneself is more favorable than bringing shame to the group, and suicide appears to be a reasonable choice to end suffering.

Nearly three-fourths of all suicides in Japan are carried out by men. Japan is a male-dominated culture where men are under pressure to provide well for their families. The male clients I worked with in Tokyo most frequently cited depression, unemployment, work, and social expectations as their reasons for contemplating suicide. With no feasible avenues to voice the feelings associated with high stress, and living in a culture where suicide is viewed as a morally acceptable action, suicides occur at a high rate.

In 2006, the Japanese Parliament passed the Basic Act on Suicide Prevention, which requires local governments to enact suicide prevention plans and help the relatives of those who die by suicide. In recent years the rate of suicide among middle-aged men and the elderly has fallen slightly. However, suicide rates in the younger generations are still high.

A Christian Response to Suffering and Suicide

I learned that while the Japanese regard suicide as an acceptable way to depart this world, paradoxically, they strongly value life. Biblical teaching speaks against suicide by saying all life is a gift from God, and taking anyone’s life would be disobedience (1 Cor. 6:19–20; Ps. 139:13–16; Ex. 20:13).

Suicide also fails to take into account the grace and mercy of God. Although individuals in the Bible such as Elijah and Job despaired to the point of death, the Bible uses their lives to teach how turning to God in times of suffering results in recovered, changed, and empowered lives.

“Church communities must reflect the reality that we’re all works in progress and in desperate need of the life-changing power of the gospel.”

Approximately 1 percent of Japanese profess Christian beliefs, which makes it difficult to imagine how the Christian community can impact this endemic problem. There are, however, approaches that local church bodies and individual believers can utilize to significantly minister to the hurting Japanese with whom they come into contact:

• Assemble a list of local professional resources to which you can refer when there is specific, serious intent of self-harm. It’s very helpful to have immediate access to contact information when professional assessment and treatment seem necessary.
• Provide an atmosphere of acceptance and affirmation in local church bodies to those in need. Church communities must reflect the reality that we’re all works in progress and in desperate need of the life-changing power of the gospel.
• Develop, model, and teach a solid, Bible-based model of suffering. We all have and will continue to suffer in this life. It’s an essential part of the Christian lifestyle to offer human comfort with a compassionate, listening ear, and present the hope and peace that only Jesus Christ provides.
• Consider specific small group opportunities to provide safe, confidential, and guided processing of thoughts and feelings. Bible studies on specific individuals in Scripture, as well as Paul’s New Testament teachings on suffering, contain excellent discussion starters and opportunities to share the gospel.
• Be patient and available. Most individuals considering suicide don’t develop those feelings overnight. Stay in touch by offering prayer and conversations.

It was a tremendous blessing to walk with this young woman over a six-month period. Along with weekly counseling, I strongly recommended she attend a local, dynamic church. They loved her with Christ’s love and ministered to her as only Jesus followers can.

Her life was radically impacted by exposure to the gospel, which resulted in her giving her life to Christ. Hallelujah. Truly, our only sure hope to ease suffering in this world is to be totally dependent on God’s power in our lives. He loves us perfectly, we are his children, and we must live in that reality on a daily basis.