Castigations of a Selfish Housewife:
National Identity and Menopausal Rhetoric in Japan
Margaret Lock
Introduction
It is from metaphor that we can
best get hold of something fresh
Aristotle, Rhetoric
In stating that "illness is not a metaphor, and that the most truthful way of regarding
illness... is one most purified of, most resistant to metaphoric thinking," Susan Sontag
(1978: 3) has put herself in the company of some strange bedfellows. She has adopted an
extreme, unequivocal position in which she shares the assumption with many physicians
that the physical body should be regarded as a neutral, value-free terrain, and hence one
which can be fully comprehended and explained by the principles of science.
Feeling ill, and being told one is ill, are not scientific facts, however, but conditions
which are culturally constructed and negotiated. In this paper I will consider the topic of
menopause, a state which is currently described in some influential medical joumals as a
"deficiency disease" (Kase 1974), one which can be cured by specific medication: estrogen
replacement therapy (ERT). The "discovery" of this disease, the promotion of ERT, and
the conducting of related research has certainly not been based on sound scientific princi-
ples (Kaufert and McKinlay 1985). Economic gain is obviously central to the interests of
the drug companies which manufacture ERT, a motive which impedes scientific research,
but there are other more complex and equally unscientific stances which are taken visza-vis
menopause. An examination of the rhetoric put out about this mid-life transition illustrates
the futility of Sontag's crie de coeur and exposes its grounding in an unsatisfactory meta-
physics in which mind and body are kept firmly apart.
The research which I carried out in Japan in connection with menopause was
designed first of all to provide comparative quantitative data. Survey research in connec-
tion with menopause is very sparse and, with one exception (Maoz et al. 1977), non-
existent outside of European and North American settings. The survey which I conducted
is directly comparable with Massachusetts and Manitoba studies at present in progress
(Kaufert 1984; McKinlay and McKinlay 1985). Preliminary analysis of this data has pro-
vided comparative information on general health status, physician use, symptom experi-
ence and reporting, treatments received, use of traditional healers, and so on (Lock 1986).
I will summarize only one or two pertinent results from the quantitative research which are
of relevence to the present argument. Secondly, by means of open-ended interviews con-
ducted in the homes of 105 women, data was collected on the subjective, meaning-
centered experience of menopause. Lastly, historical, medical, and popular literature, and
interviews with physicians, counsellors, feminists, and others were used in order to
KAS Papers
examine the cultural construction of menopause in Japan. The sample is large, a population
of 1,300 Japanese women between the ages of 45 and 55, divided into three groups:
middle-class housewives, farming women, and women who work in factories. In the
cross-sectional survey I found that there is little concern about menopause, that it is
regarded, in general, as a long, gradual transition from the late thirties to the late fifties
and is usually associated simply with aging. "Symptoms" most often thought of as meno-
pausal are grey hair, changing eyesight, slowing down of the body, headaches and katakori
("shoulder stiffness" -- a problem common to both sexes and all ages in Japan, and thought
by some informants to be unique to the Japanese). None of these symptoms are linked
statistically with what is defined as menopausal status in the epidemiological literature
(Lock 1986). That is, they are not especially associated with women in their late forties
who have begun to experience irregular menstruation or who have recently ceased to men-
struate.
The symptom most usually associated with menopause in the West, hot flashes, and
purported by endocrinologists to occur in between 75 and 85% of women (Tulandi et al.
1984), does not even have a word in Japanese, a language that is noted for fine discrimina-
tions in connection with body states (Lock 1980). Respondents to a questionnaire were
asked to check off what symptoms, if any, they had actually experienced in the previous
two weeks. A small increase of hot flashes was reported from 5.7% in pre-menopausal
Japanese women to 12.6% and 10.8% respectively in peri-menopausal and post-
menopausal women.1 In a comparable Canadian sample, pre-menopausal women report
14.9% (higher than all the Japanese women) and the rate increases to 39.7% and 38.6% in
peri- and post-menopausal women in Manitoba. Whereas 69.2% of Canadian women
report that they have experienced hot flashes at some time, only 20% of the Japanese sam-
ple recall ever having had them (Lock 1986). One other "classical" symptom of meno-
pause, night sweats, is reported very infrequently by Japanese women and does not appear
to be associated at all with menstrual status. Of all the 57 symptoms that Japanese women
were asked about there is a general reporting rate of between 5 and 10%, whereas in both
the comparable Massachusetts and Manitoba studies, the rate is over 25%. These results
highlight, of course, the naive assumption, made so often, that in medical diagnostics bio-
logical variation between populations is something which can usually be safely ignored.
Assertions about normality or abnormality, and estimations of medication dosages are reg-
ularly made on the assumption of cross-cultural equivalences in biology.
Other more insidious issues are raised by these data on symptom reporting: the con-
temporary Western image of suffering at menopause as a "normal" experience, widely held
in both popular and physician mythology, is derived in large part from data obtained from
clinical samples. Women who are part of that distssingly large popuation who have had
hysterectomies are high users of gynecological services during menopause; it is women
such as these who tend to experience physical discomfort and often undergo considerable
psychological turmoil for large segments of their middle years (Kaufert 1984). Statements
made by medical professionals about symptomatology and menopausal women are, almost
without exception, not based upon a population of normal women (since there are virtually
no data on this subject), but upon upon the biased impressions obtained from clinical sam-
ples, a large proporton of whom have undergone artificial menopause (Kaufert and
McKinlay 1985). The wide dissemination of biomedical opinion in popular literature has
served to reinforce this negative stereotype (a stereotype which is, in essence, old wine in
supposedly scientifically standardized bottles), in the minds of the public at large. With
the emergence of politically oriented feminism, however, this image has been countered in
recent years, both within and outside of the medical profession, but usually on ideological
grounds alone and not as the result of new empirical findings (cf. McCrea 1983, for
2
Lock
Castigations of a Selfish Hlousewife
example).
The Japanese case is even more complex. Medical research into menopause in
Japan has been virtually non-existent until recently and Japanese gynecologists lean
heavily on Western medical journals for information. They diagnose a large number of
their patients as suffering from "menopausal syndrome" (a gynecological clinic at a teach-
ing hospital in Tokyo will diagnose up to half its patients this way in the course of any
one day's work). When asked what criteria they use for applying this diagnostic category
gynecologists reply, "headaches, shoulder stiffness, hot flashes, depression, irritability, and
an imbalance of the automatic nervous system" (a favorite "label") (Lock 1986). Once I
had discussed the preliminary results of my survey in Japan with several gynecologists
they admitted, after reflection, that in fact they rarely have patients who report hot flashes,
or even depression, but they added that complaints about an imbalance of the automatic
nervous system and of irritability are common.
What apparently has happened is that a stereotype about ordinary middle-aged
women created largely out of the suffering of a Western clinical population has been
transmitted to the other side of the world, adopted at face value by a large segment of the
gynecological profession, and applied in a totally different clinical context where it does
not fit at all well with empirical reality. It fits even less well with the experience of ordi-
nary middle-aged Japanese women who rarely visit a gynecologist (only 12% of the sam-
ple had visited a gynecologist in the previous two years), and who, it seems, suffer very
few symptoms at all at this stage of the life cycle. Nevertheless, even though Japanese
women do not usually experience physical distress at menopause, they hold a negative
stereotype about the event in their minds which is shared with many medical practitioners,
both traditional and modern (Lock 1986). This negative stereotype is inflamed by the
cwent images of Japanese women portrayed in the mass media, images which form part
of the current internal cultural debate (Parkin 1978) in Japan.
Modernization and Moral Panic
Unlike most societies undergoing industrialization today, Japan was able to orches-
tate its own entry into the international market and its acceptance or rejection of values
and commodities perceived to be foreign and threatening to traditional order. This rela-
tively gradual transformation since the middle of the last century was brought to an abrupt
halt by defeat at the end of the Second World War with its ensuing economic and spiritual
cnsl.
After an initial period of numbed shock there followed for the next twenty years or
so what appeared superficially to be an all-out embrace of Western values including the
ideas that the nuclear family is the "natural" primary unit for modern times and that indivi-
dual rights and freedom should be given much more consideration than was formally the
case. These ideas were congenial at that time since traditional group-oriented values were
tought to be responsible for the nationalistic regime which had brought Japan to its crush-
ing defeat and crippling poverty.
Today, Japan finds itself in an embarrassingly strong economic position in the world,
so much so that it is at times driven to accusing other capitalist economies of laziness.
However, numerous books and articles, many of them written by foreigners, claim that
Japan's "economic miracle" was in fact based upon a mobilization of traditional values
(Dore 1973; Vogel 1979) and not upon a Western-derived ethos, and it is now generally
accepted that modernization does not by definition necessarily involve an abandonment of
traditon. Shattered post-war egos have been glued together, national confidence restored,
and the dominant theme in the current internal cultural debate in Japan is about a search
Nos. 69-70
3
KAS Papers
for a modem, uniquely Japanese identity in which traditional values figure prominently and
the dry rot of individualism is firmly contained.
Being part of a culture infused with a tradition of self-reflection and introspection,
the Japanese have themselves cast this rhetoric into a genre known as nihonjinron: Essays
on being Japanese. Ideas about the concept of self, the relationship of individuals to the
family and to the state, and about health and illness are all central in nihonjinron.
At the core of nihonjinron is a concept of racial (genetic) homogeneity which leads
"naturally" to language and cultural unity. A line between insiders and outsiders is sharply
delineated and notions of separateness, uniqueness, and of certain irreducible "essences
which make one Japanese are taken for granted. This type of rhetoric is not unique to the
Japanese, of course, nor is it new to Japan (it has been traced back to at least the early
eighteenth century (Kawamura 1980)), but the specific way in which the uniqueness is
defined, the "invention of tradition" as Hobsbawm and Ranger call it (1983), changes
through time and is recast around topical themes which provoke anxiety. Almost 700
monographs in a 32-year period have been identified as part of this genre, and if journal
articles are added to this number the total must be many thousands (Befu 1983).
The outpouring of nihonjinron represents a state which Cohen (writing about Bri-
tain) has termed a "moral panic" (1972:28), when, during times of social and political
unrest self-appointed public moralists including some physicians, air their views in the
media, courtrooms, and in popular literature about the supposed breakdown of morality
and the collapse of social control.
Rhetoric used to account for trouble at menopause draws upon aspects of the current
internal dabate in Japan, and is replete with doubts and contradictions about the effects of
modernization, the rise of individuality, and future directions for change. This rhetoric
serves as a "covert form of oppression and control" (Smart and Smart 1978:2), since sup-
posed personality defects and behavioral faults of individual women are exposed to
national scrutiny and used (not necessarily consciously) as a displacement mechanism for
diffuse but potent political concerns about internationalization, economic growth, and
national identity.
The "Selfish" Housewife
The rise of the urban nuclear family is largely a post-war phenomenon in Japan and
the full-time "professional" housewife, as she is known, has come to represent the epitome
of a modern Japanese woman. Her life is assumed to be devoted to the care of her hus-
band, two children, and to her parents-in-law who will in all probability be incorporated
into the household as they grow old and infirm. The foundation for the modern role of
housewife, traditionally summed up as "good wife; wise mother" (ry6sai kenbo) was laid
down in the Meiji era at the end of the last century. Modelled in part on European ideas
which were current at the time, the argument was based on the assumption that a women's
nature equips her best to nurture others (Nakamura 1976). It was officially acknowledged,
for the first time, that women could be regarded as more than simply a "borrowed womb"
and they were encouraged, within the confines of the domestic sphere, to become guardi-
ans and educators of their children. Hence they should be educated above all in morals
and religion and should expect to exercise power, to a degree, within the household. From
the perspective of the latter half of the twentieth century it is difficult to appreciate the
revolutionary nature of early Meiji thinking on women. Comparison with eighteenth cen-
tury treatises, of which the best known expression is Onna Daigaku (Greater Learning for
Women), is revealing:
4
Lock
Castigations of a Selfish Housewife
Woman has the quality of yin (passiveness). Yin is of the nature of the night and is
dark. Hence, because compared to man, she is foolish, she does not understand her
obvious duties... She has five blemishes in her nature. She is disobedient, inclined to
anger, slanderous, envious, stupid. Of every ten women, seven or eight have these
failings... In everything she must submit to her husband.
Kaibara Ekken (1672)
(translated in Joyce Ackroyd 1959)
The struggle for rights for women in Japan is a story which started from a position
of extreme subservience at the end of the feudal regime. During the first wave of indus-
trial expansion in the latter part of the nineteenth century women of all classes, including
the wives of many ex-samurai, were coerced into working in appalling conditions on pro-
duction lines in factories (Sievers 1983). Since the end of the last century the women's
movement has a history which closely parallels the turbulent times in the West (Sievers
1983), but modem Japanese women have not so far attained the same degree of civil rights
as North American and most European women.
Today, just over 50% of women above 15 years of age in Japan work in the labor
force. Many of them are still thoroughly exploited since they are employed as temporary
laborers and therefore available for periodic hiring and firing according to the vagaries of
Japanese and world economies (Cook and Hayashi 1980). These women, however, hardly
figure at all in the popular image of the average modern Japanese woman. This is a role
reserved for the middle-class housewife whose daily round is sardonically described as
sanshoku hiru ne tsuki (a regular job with three meals and a nap thrown in). The house-
wife is the inheritor of the Meiji image of the "good wife and wise mother"; her life is cir-
cumscribed by the domestic round which, with the spread of affluence and the develop-
ment of household technology, has become somewhat of an anomaly in a society where
the work ethic holds sway.
Recent studies and government surveys indicate that most middle-class women are
largely satisfied with their roles as housewives and mother of two (Kokumin Seikatsu
Hakusho 1983; Lebra 1984; Pharr 1976; White and Molony 1979). Many of them report
that they enjoy what to an outsider appears to be a relatively easy life of material com-
fort.2
The behavior and discipline (shitsuke) which is expected of a modern housewife, is
based upon an assorted mixture of values created in part from the rules laid down in feu-
dal times for the wives of samurai, and often glossed today an onna rashiisa (womanly
behavior). The Confucian ideal encouraged discipline in women, not for military service,
but in order to practice unquestioning submission and obedience. Modem Japanese
women are taught to believe, like their predecessors in feudal times, that patience, dili-
gence, endurance, even-temperedness, compliance, and gentleness all contribute to woman-
liness. Moral training in these virtues leads, it is believed, to the right kind of personality.
This internalized behavior is complemented by a discipline of the body and language usage
(Lebra 1984: 46). Use of feminine language (which is associated with submissiveness and
gentleness) still goes virtually unquestioned by anyone (Ide 1982). Courteous greetings,
good posture, a neat appearance, good manners, elegance in the handling of things, an ord-
erly house, and established routines in one's lifestyle are all connected with womanly
behaviour (Lebra 1984: 42). Modesty, reticence, and a soft voice are considered important
and covering with one's hand the unsightly partly open mouth created by a smile is still
common among many women. Housewives often describe themselves as "weak" if they
do not keep up the appearance of gentle but firm control in their daily lives. Competitive
pride is frequently taken in being the first up in the household at 5:30 or 6:00 a.m. each
5
Nos. 69-70
KAS Papers
day in order to prepare boxed lunches and breakfast for the family, and in staying up last
in order to organize the house for the next day and close it up at night. These traditional
values are compounded by newer Western influenced images:
Young, cute, smiling and apparently mute girl-women are on every genre of [TV]
program at any hour of the day or night.
Why does this phenomenon exist? Television personalities reflect the ideals and
values of any given society, and the women that appear on television are therefore
only "ideal" women... In Japan, women, in order to fit the definition of the ideal
woman, must not only be youthful and pretty, but they should also be sweetly silent.
[A]ccording to Tomoyo Nonaka, a newscaster..."People think of women as
flowers, and if there were no women on TV it would be a bit bizarre. So they think,
'O.K., let's put a nice flower on the table'..."
These televised blossomy do not only represent idealized women but they also
act out the ideal role between women and men. The reason that these women are
not outspoken is because they must be properly deferential towards men. Women
are usually referred to as assistants rather than co-hosts... the role of an assistant is
to "make a man stand out and bring out his good points..." It must not be assumed,
however, that all women in television are in real life subservient or opinionless...
Kikuku Itasaka,
Mainichi Shimbun (1984)
Nor must it be assumed that the housewife is necessarily subservient or opinionless
and a few of them say that they are raising their daughters today with little concern for
womanly behavior.
The middle-class housewife is associated in the minds of many medical practitioners
and in the mass media with many "stress" related problems including "the kitchen syn-
drome" (in which a variety of severe somatic symptoms are experienced every time one
enters the kitchen to prepare the evening meal); apartment neurosis; child-rearing neurosis;
"menopausal syndrome" and so on. There are several contradictory themes associated with
each of these afflictions which I will illustrate by describing the etiologies which are
thought to contribute to the menopausal syndrome.
It is said that women who are busy, hold a job, and who do not have time to dwell
on their problems will not notice menopause or experience any symptomatology. (The
cross-sectional survey demonstrated, in contrast, that symptom reporting, although gen-
erally low, is actually highest among farming women followed by factory employees and
is lowest among middle class housewives (Lock in press)). "Menopausal syndrome" is
thought of as a recent phenomenon and is described as a luxury disease (zeitakuby6),
something which occurs in women who are selfish and turned in on themselves, or in
women who just "play around" all day. People like this are thought to lack a real identity,
to have "no self' (jibun ga nat), to be deficient in the will power and endurance which was
a characteristic of their mothers and to spend their days playing tennis and making plastic
flowers. It is believed that such women are likely to raise children who are undisciplined
or deviant.
A second set of etiologies associated with trouble at menopause (these two explana-
tions can be offered by the same person but usually with different women in mind), states
that women who are "over-socialized," "over-controlled," too concerned with tidyness and
order and of nervous temperament (shinkeishitsu) are vulnerable. These women are
thought to produce children who suffer from psychosomatic illnesses or problems such as
"school refusal syndrome." The stifling atmosphere that they create in the home, and its
6
Lock
Castigations of a Selfish Housewife
effect on their children is described by one commentator thus: "The roots of even a
healthy plant confined in a pot will rot if given too much water" (Higuchi 1980: 90).
Ambiguities are layered one upon another: Hard work, perseverance, and discipline
are valued; but running a small house with the aid of modem technology, where one's hus-
band is absent most of the time, and where the two children are fully occupied in the pur-
suit of an education takes relatively little time. Women who are said to be the pillar of
the family should devote themselves to the care of other family members (and apparently
suffer from guilt if they fall ill and are unable to fulfill these duties -- DeVos and
Wagatsuma 1959; Lock 1982); however, it is agreed that housewives today become lonely
and bored and tend to use "organ" language to express their discontent, as one specialist in
internal medicine put it (Lock 1987). With virtually no exceptions, women are required
to discontinue employment once they become pregnant and, apart from factory employees,
they are highly unlikely to be re-employed once they have raised their family (Robbins-
Mowry 1983); yet, in one final ironic twist, it is often said that women today cannot
endure as their mothers did, that they are selfish and spoilt and they no longer make good
mothers.
Menopausal Syndrome
From at least the tenth century in Japan it appears that special attention was given
by the medical profession to problems thought to be associated with menstruation and its
cessation (Nishiyama 1981). However, there was no special term for the end of menstrua-
tion until a concept konenki (often glossed as the change of life) was created under the
influence of German medicine at the end of the last century. Disorders associated with
k6nenki were usually attributed in part to an unbalanced autonomic nervous system - a
very popular explanatory model in both Germany and Japan and which is still in regular
use today. Since the 1950s, in common with contemporary European medicine, the term
"menopausal syndrome" has become popular in medical circles (Lock 1986). Together
with an imbalance of the autonomic nervous system it is now classified as a "disease"
which, at the request of the Japanese gynecological association, has been officially recog-
nized and for which diagnosis and treatment physicians can receive reimbursement under
the socialized health care system.
Interviews with 15 gynecologists, 15 general practitioners, and 6 practitioners of
traditional medicine produced a variety of etiological explanations for menopausal syn-
drome. At the physiological level some talked about an unbalanced autonomic nervous
system caused by declining estrogen levels while others simply directly focused directly on
lowered estrogen levels. All of the practitioners had, in addition, several ideas about why
some women are more vulnerable than others to menopausal syndrome. The most popular
explanations include those described above: an excess of free time, no clear role, no self-
discipline, selfishness, boredom, no hobbies, and in contrast, too much control, a neurotic
personality, over-protectiveness, turning inward, loneliness. Additional explanations
included suffering from unresolved guilt due to several abortions, no sense of self, and
with much less frequency, family problems and the "empty nest syndrome." Housewives
are thought to be especially vulnerable. Practitioners frequently added that women them-
selves are victims of modem society and discriminatory employment practices. A few
physicians blamed thoughtless husbands for menopausal problems and the majority believe
that the nuclear family especially when it is situated in a small apartment is not a healthy
place for a woman to spend most of her time.
Nos. 69-70
7
KAS Papers
Despite their belief in the social and psychological origins of menopausal syndrome,
the majority of practitioners simply prescribe medication: estrogen replacement therapy,
tranquilizers, or herbal medication. They have neither the time nor the inclination to try to
manipulate anything other than the physical body.
One further characteristic of the menopausal rhetoric is the assumption that mothers
of the middle class housewives of today were not vulnerable to this syndrome. In fact, the
story goes, no Japanese woman has ever been at risk like this before. This particuular
cohort of urban fifty-year old housewives is the first group of Japanese women where the
majority are living their adult lives in a nuclear family, surrounded by technology designed
to facilitate housework, and who are for all intents and purposes excluded from the larger
economic system since they are by custom unemployable.
The Body Physical and the Body Politic
Modem Japanese housewives are indeed leading a life of comparative ease and lux-
ury unknown to any other Japanese women to date (with the possible exception of the aris-
tocracy of historical times), but they are a troublesome anomaly. The work ethic is dom-
inant in Japan. Men, working class women, and children are worked beyond endurance
(Lock 1988) while the housewife decorates sugar cubes for her afternoon cup of European
tea with her friends using delicate traceries of pink and blue icing sugar. These women
are regarded by many, including themselves at times, as weak-willed, lacking in self-
control, and vulnerable to sicknesses, especially compared to their own mothers.
My mother has seven children, and the way it was in those days, she had no free-
dom, in fact she had no self (jibun ga nai); she was always suppressing herself and
not letting anything show on the surface. I can't do that, I'm a spoiled type and I
had trouble at menopause. Women who work or have hard lives don't suffer.
A Kobe housewife
On the other hand, they rarely deny that they are a privileged group and few show
any inclination to give up their daily games of tennis in order to fight for rights to enter
the labor force.
The tennis games have not passed unnoticed by the conservative government of
Yasuhiro Nakasone. Defence and rearmament is a pressing issue for the Japanese govern-
ment right now. There is a need to increase revenues but an unwillingness to upset the
business world by raising taxes. In their recent report based on the findings of the special
Commission on Administrative Reform, the Liberal Democrats put forward their plans for
the new "Japanese Style Welfare State" which is one in which there will be a return to the
ie, the traditional Japanese household (McCormack 1984). At the heart of the modem ie
will be the Japanese housewife, no longer free to play tennis, her hands full, providing
social services for her extended family. She will look after her aged parents-in-law until
they die; she will provide care for any other people with disabilities in the family; she will
practice frugal home economics and produce savings that can be used to supplement
meagre old age pensions. In short, she will become once again, the "Good Wife and Wise
Mother" of turn of the century Japan. This mythological character is being selectively
recalled by the media, politicians, and some medical professionals, and held up for emula-
tion often in the nihonjinron genre of essays with their thinly disguised nationalistic and
idealistic turn of phrase. The Good Wife and Wise Mother endures the unendurable, her
feelings are always controlled, she does not express her selfish desires, her time is fully
occupied with caring for the family; hence she is not troubled by petty illnesses and
8
Lock
Castigations of a Selfish Housewife
complaints such as "menopausal" symptoms, nor has she the time or inclination to seek
work outside the home. Once this paragon is reinstated the body politic, it is believed,
will be in better shape and the pressing need to improve social services, care for the eld-
erly, and the pension system will have been removed, since a fully occupied full-time
housewife obviates the need for an elaborate state welfare system.
Menopause as Metaphor
The rhetoric about menopause is just one of many created for women in Japan at
different stages of their life cycle, each of which serves in part to establish links between
physical vulnerability and the apparent laxity and untrammelled freedom of the modem
Japanese woman. These images are legitimated through their appearance in print in
government documents, the mass media and in some popular medical literature (cf. Kyu-
toku 1979; Nishiyama 1981; Okamura 1977; Sasaki 1983). It is exactly the kind of rhe-
toric that Susan Sontag describes as so destructive in her book Illness as Metaphor and
sounds, in fact, very similar to thinking which was common in the nineteenth-century
West: women who do not fulfill their domestic role as required by society can expect to
experience trouble throughout the life cycle (Smith-Rosenberg 1985). This dominant
model is one of retribution for social inadequacies which can reinforce a sense of guilt and
personal failure - something to which the Japanese are, in general, particularly prone
(DeVos 1973).
But what of the altemative, the clinical construction of menopause using the legiti-
mation of "rationalized scientific" medicine (Habermas 1971)? Here we have another rhe-
toric, no better grounded in empirical data than the political version, but where the origins
of a women's vulnerability are thought to lie in her biology rather than her behavior: the
devil and the deep blue sea. The biomedical model of menopause certainly does not pro-
vide the pristine "scientific" approach, stripped free of damaging metaphor as suggested by
Susan Sontag.
Treatment for menopausally related symptoms is not necessary for the vast majority
of women, although for a few medication can be a great relief. There is, however, clearly
an attempt to medicalize menopause in Japan, and women who go to a gynecologist at this
stage in their life cycle are likely to be medicated for "menopausal syndrome." However,
unlike the situation in North America, most Japanese women do not go to gynecologists
regularly. Perhaps for this reason themes about menopause as a deficiency disease or as a
syndrome have not taken root in daily parlance.
Can metaphorical associations be peeled away from life cycle transitions such as
menopause? The answer, I believe, is the same for all problems which have a biological
component to them: strictly speaking no, since all communication systems including those
of medicine are necessarily metaphoric. However, one can work within the carefully
defined parameters of neuroendocrinology and produce some much needed data on meno-
pause which can then be utilized as though they are isolated facts. Such as approach can
be invaluable in trying to understand the "final common pathways" involved in the female
aging process. Once these "facts" are situated in a context of any kind, however, interpre-
tation and judgement are involved, the "most truthful way of regarding illness" slips away,
elusive, will-o-the-wisp.
For women, once the idea of entry into menopause is entertained, whether due to
subjective experience, the comments of others or through the results of a laboratory test,
then being menopausal takes on a phenomenological reality and is subject to multiple
interpretations which no amount of information about biological changes can, or should,
ever eradicate. If we cease to create poetry about growing old, then we may as well just
Nos. 69-70
9
KAS Papers
die at fifty! On the other hand, a iarge amount of the rhetoric which prevails today is
clearly destructive. It is this rhetoric of oppression that we must work endlessly to expose
and replace.
Going through the mid-life transition is an inevitable and natural process, for both
women and men. For women this part of the life cycle happens to be biologically marked
by the end of menstruation - a "normal" process which has very little impact on the
sense of well-being of most women (Holte 1985; Kaufert, Lock and McKinlay et al 1986;
McKinlay 1985). The social significance of this event, however, should not be underes-
timated. Coming to terms with approaching old age (and eventual death) is probably one
of the hardest tasks we all have to face, especially in youth-oriented post-industrial
societies3. Perhaps women have a potential advantage over men in this connection - it is
hard to practice massive denial and fly in the face of such an obvious expression of aging
as menopause,4 although, because the event has a largely negative rhetoric associated with
it at present, it is tempting to do so. The creation of more positive social and cultural
meanings and metaphors in connection with menopause seems to be rather urgent. Such an
endeavor must, obviously, be undertaken by women, probably in their middle age. In
redefining themselves, their roles and their political power, women can work to replace the
images of depression, uglyness, and failing health usually associated with this part of the
life cycle with something more positive.
Clearly, in post-industrial society the last part of the life cycle are not the golden
years, nor are they in less complex societies where the elderly are theoretically revered
(Amos and Harrell 1981). Obviously suffering and grieving must inevitably be associated
with aging to some extent, especially for those who have led a life of oppression, but it is
not necessary for women to approach the latter part of their life cycle with the extra bur-
den of self-deprication and doubt which is foisted on them through the negative associa-
tions attached to female aging in general and menopause in particular (Kaufert 1984).
Simply stripping away negative rhetoric and regarding the process of aging merely as bio-
logical change is not adequate, however, especially since it is in the latter part of the life
cycle that the ironies and paradoxes of life become most apparent, together with a rather
urgent questioning as to what life to date has been all about. There is no "truthful" way to
view either illness or aging, but some tropes help to sustain individuals while others are
downright destructive. Scientific findings can be used together with interpretive data to
strip away negative associations, but these data can at the same time contribute to the
building of more positive metaphors to live by.
What now needs to be asked about this particular set of data on menopause is why
apparently so few Japanese women are sufficiently influenced by any of the current rhe-
toric in their society for their anxiety to be wansformed into actual physical symptoms,
whereas North American women appear to be more vulnerable in this respect. Is it possi-
bly because Japanese women somehow manage to distance themselves from the rhetoric,
perhaps due to a long tradition of radically separating one's public and private self in
Japan (Lebra 1976; Lock 1987), whereas North American women are more susceptible to
the medical model of menopause in which pathological metaphors are dominant? We
understand the world through our interactions with it (Lakoff and Johnson 1980). Do we
also become the world we understand, not merely conceptually in terms of our sense of
self, but physically too? Does acceptance of a belief that a normal life cycle event is actu-
ally a pathological transformation, a biological breakdown, make one more vulnerable to
actual physical distress? Do we actually become the metaphors we live by? This cer-
tainly seems to be the case with dramatic illnesses such as anorexia nervosa and voodoo
death. I think the argument should not be allowed to rest there with "acute" problems, but
exhaustively explored in connection with more mundane experiences too.
10
Lock
Nos. 69-70
Castigations of a Selfish Housewife
11
Notes
1. Women were asked whether they had menstruated within the past three months, the past twelve
but not the past three months, or within the last year. Based upon their responses a three-part divi-
sion was made between pre-, peri- and post-menopausal groups. Those that had menstruated within
the past three months were assigned pre-menopausal status (33%); those that had not menstruated
within the past three months but within the past twelve were assigned peri-menopausal status (32%),
and those who had not menstruated for over a year were assigned post-menopausal status (36%).
2. In the cross-sectional survey 90%o of the women reported that they were reasonably or very happy
with their present life.
3. Sontag, in fact, believes that accepting the idea of our own death is the single most important
stimulus for the writing of modem literature (1985).
4. This would be limited to industrialized societies where giving birth to only two children and hav-
ing a life expectancy of over 70 years is the norm. For the majority of women in the world, whose
entire reproductive life is one of pregnancies, lactation and relatively few menstrual cycles entry into
menopause is not a clear transition at all, but a state which is normally only acknowledged several
years after the event. The prime maker of aging in cultures such as these is the retrospective
knowledge that one has ceased to bear children; the biological aspect of menopause is in contrast a
process of very little significance, which goes unmarked by rites of passage (Van Gennep 1960).
References Cited
Ackroyd, J.
1959   "Women in Feudal Japan." Transactions of the Asiatic Society of Japan, series 3, 30:62.
Amos, P. T. and S. Harrell
1981   Other Ways of Growing Old: Anthropological Perspectives. Stanford: Stanford University
Press.
Befu, Harumi
1983   "Internationalization of Japan and Nihon Bunkaron." In The Challenge of Japan's Interna-
tionalization: Organization and Culture, H. Mannari and H. Befu, eds. Tokyo: Kwansei
Gakuin University.
Cohen, S.
1972 Folk Devils and Moral Panics: The Creation of Mods and Rockers. London: Macgibbon
and Kee.
Cook, A. H. and H. Hayashi
1980   "Working Women in Japan: Discrimination Resistance and Reform." Ithaca, Cornell
International Industrial and Labor Relations Report No. 10.
DeVos, G. and H. Wagatsuma
1959   "Psychocultural Significance of Concern over Death and Illness among Rural Japanese."
International Journal of Social Psychiatry 5:5-19.
DeVos, G.
1973   Socialization for Achievement: Essays on the Cultural Psychology of the Japanese.
Berkeley: University of Califomia Press.
Dore, R. P.
1973   British Factory - Japanese Factory: The Origins of National Diversity in Industrial Re-
lations. Berkeley and Los Angeles: University of Califomia Press.
Habermas, J.
1971   Toward a Rational Society: Student Protest, Science and Politics. London: Heinemann
Higuchi, K.
1980   "Changing Family Relationships." Japan Echo 7: 86-93.
Hobsbawm, E. and T. Ranger
1983   The Invention of Tradition. Cambridge: Cambridge University Press.
KAS Papers
Holte, A. and A. Mikkelsen
1982   "Menstrual Coping Style, Social Background and Climacteric Symptoms." Psychiatric So-
cial Science 2: 41-45.
Ide, S.
1982   "Japanese Sociolinguistics, Politeness and Women's Language." Lingua 57: 357-385.
Kase, N.
1974   "Estrogens and the Menopause." Journal of the American Medical Association 227: 318-
319.
Kaufert, P.
1984   "Women and their Health in the Middle Years: A Manitoba Project." Social Science and
Medicine 18: 279-281.
Kaufert, P. and S. McKinlay
1985   "Estrogen Replacement Therapy: The Production of Medical Knowledge and the Emer-
gence of Policy." In Women, Health, and Healing: Toward a New Perspective, E. Lewin and
V. Oleson, eds. London: Tavistock.
Kaufert, P., M. Lock and S. McKinlay et al.
1986   "Interdisciplinary Approaches to Menopause." Social Science and Medicine 22: 1285-
1289.
Kawamura, N.
1980   "The Historical Background of Arguments Emphasizing the Uniqueness of Japanese So-
ciety." Social Analysis 5-6(December): 44-62.
Kokumin Seikatsu Hakusho
1983   Keizai kikakucho. Tokyo: Okura Insatsu Kyoku.
Kyutoku, S.
1979   Bogenby6. Tokyo: Sanmaku Shupan.
Lakoff, G. and M. Johnson
1980   Metaphors We Live By. Chicago: University of Chicago Press.
Lebra, T.
1984   Japanese Women: Constraint and Fulfillment. Honolulu: University of Hawaii Press.
Lock, M.
1980   East Asian Medicine in Urban Japan: Varieties of Medical Experience. Berkeley: Univer-
sity of California Press.
1982   'Traditional and Popular Attitudes Towards Mental Health and Illness in Japan." In Cul-
tural Conceptions of Mental Health and Therapy, A. Marsella and G. White, eds. Boston: D.
Reidel Publishing Company.
1986   "Ambiguities of Aging: Japanese Experience and Perception of Menopause." Culture,
Medicine and Psychiatry 10: 22-46.
1987   "Protests of a Good Wife and Wise Mother: The Medicalization of Distress in Japan." In
Health and Medical Care in Japan, E. Norbeck and M. Lock, eds. Honolulu: University of
Hawaii Press.
1988   "New Japanese Mythologies: Faltering Discipline and the Ailing Housewife in Japan."
American Ethnologist 15:43-61.
in press "Mind, Matter and Middle Age: Ideologies for the Second Sex." In Analysis in Medical
Anthropology, S. Lindenbaum and M. Lock, eds. Dortrecht: Kluwer Academic Press.
Mainichi Shimbun
1984   'The Main Dish -- Sweet and Silent." November 26.
Maoz, B. et al.
1977   'The Perception of Menopause in Five Ethnic Groups in Israel." Acta, Obstet. Gyneco.
Scand. Suppl. 65: 69-76.
McConnack, C.
1984   "Beyond Economism." In Democracy in Contemporary Japan, G. McCormack and Y.
Sugimoto, eds. New York: M. E. Sharpe Inc.
12
Lock
Castigations of a Selfish Housewife
McCrea, F.
1983   'The Politics of Menopause: The Discovery of a Deficiency Disease." Social Problems
13: 111-123.
McKinlay, S. and J. McKinlay
1985 Health Status and Health Care Utilization by Menopausal Women. Aging, Reproduction
and the Climacteric. New York: Plenum Publishing Co.
Nakamura, M.
1976   "Creating Good Mothers." Meiroku Zasshi. W. Braisted, translator. Cambridge Mass.
(original in 1875).
Nishiyama, H.
1981 Josei to Kanp6. (Women and Herbal Medicine). Osaka: Sogensha.
Okamura, Y.
1977 Konenki Sh6gai. (Menopausal Syndrme). Tokyo: Bunken Shupan.
Parkin, D.
1978   The Cultural Definition of Political Response. London: Academic Press.
Pharr, S.
1976    'The Japanese Woman: Evolving Views of Life and Role." In Japan: The Paradox of
Progress, L. Austen, ed. New Haven: Yale University Press.
Robbins-Mowry, D.
1983 The Hidden Sun: Women of Modern Japan. Boulder, Colorado: Westview Press.
Sasaki, H.
1983   Kokoro no kenko sodanshitsu. Tokyo: Asahi Shinbun Sha.
Sievers, S.
1983   Flowers in Salt: The Beginnings of Feminist Consciousness in Modern Times. Stanford:
Stanford University Press.
Smith-Rosenberg, C.
1985   Disorderly Conduct. New York: A. Knopf.
Sontag, S.
1978   Illness as Metaphor. New York: Farrar, Straus and Giroux.
1985   'The Literary Imagination Series." Reading with Commentary given at McGill University.
Tulandi, T. et al.
1983   "Effect of Intravenous Clonidine on Menopausal Flushing and Luteinizing Hormone Secre-
tion." British Journal of Obstetrics and Gynecology 90: 854-857.
Van Gennep, A.
1960 The Rites of Passage. Translated by M. B. Vizedom and G. L. Caffee. Chicago:
University of Chicago Press.
Vogel, E.
1979   Japan as Number One: Lessons for America. Cambridge: Harvard University Press.
White, M. I. and B. Moloney, eds.
1979   "Proceedings of the Tokyo Symposium on Women." Tokyo, International Group for the
Study of Women.
Nos. 69-70
13