**3.3 Turning point 1: changing the flow of life**

*Quality of Life - Biopsychosocial Perspectives*

15 years and entering the sanatorium at 19 years.

recovery from spiritual pain is shown in **Figure 3**.

at 48 years. The second, when he discovered his love for ceramics at the age of 60. These turning points, respectively, came about 30 years after his diagnosis at

**3.1 What sustained Mr. Takahisa Yamamoto through the suffering?**

good reputation in the patient community in Oshima Seisho-en.

*Recovery from spiritual pain of Hansen's disease survivor, Mr. Takahisa Yamamoto.*

The analysis of his recovery from spiritual pain was conducted in the same way as the analysis of construction of spiritual pain. His life review about recovering from spiritual pain is omitted because of lack of space. The process of Mr. Yamamoto's

Mr. Yamamoto's spiritual pain indicated a negative cycle: I cannot set out on my own and carve out my life→Crashed by despair→I want to die→I cannot die easily→slapdash・Nihilistic→I do not deserve to be alive →I ask myself why am I alive→Self-criticism. The first period of sustained suffering of 30 years was for the affection of his family. He had no one to blame for his sickness and he had no opportunity other than to vent to his mother. He blamed his mother; she accepted his lashing and continued to visit him regularly. His brothers could not tell their spouses and children about his disease, but his sisters visited and expressed their affection as they felt sorry for him. In his married life, his unrelenting misconduct had an impact on his wife, but her maturity and common sense prevented the marriage from breaking. In addition, the elders in Oshima Residents' Committee and the group for the blind continued to care for him even though he did not have a

The second period of suffering was seen in his gambling and the glimmers of love with a student nurse during his adolescence. Gambling brought momentary pleasure and helped him to forget the despair temporarily; therefore, he got the opportunity to let off some of the negative energy from the negative cycle.

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**Figure 3.**

The first turning point was the visit to the Tokyo office of the National Hansen's Disease Council. This opportunity was created by the elders in the Residents' committee. As they had looked after him during his period of suffering, they could notice his reflection and the internal changes. They knew that they could change the flow of his life in anticipation of the better times ahead; therefore, they are referred to as "bellwethers." In addition, his wife and the head of the group for the blind agreed that this would be a chance to change his life. This was contrary to his expectations and it encouraged him. Mr. Yamamoto himself was ready to proceed to the next step by reflecting that it was time for a change, but he did not have the power to make the change in his flow of life.

Living in Tokyo was a fulfilling experience for him. He negotiated with the government and did his best to not harm the reputation of the Oshima Residents' committee. On vacations, his good friends took them for sightseeing in their car and his wife enjoyed this time as well. She also led a fulfilling life in Tokyo.

After 4 years here, his friends at the sanatorium, who were waiting for him to come back said "Are you just going to abandon us?" and Mr. Yamamoto and his wife resolved to return to the sanatorium. After returning, he was elevated to the position of the Residents' Committee's chairman in the sanatorium. This implied that he was expected to be a leader and was given a position where he could use his experience. This was a sign of approval from his friends and associates and a way of expressing gratitude.

## **3.4 Turning point 2: meeting a friend for life (ceramics)**

The second turning point was his introduction to "ceramics" (see **Figure 4**). When he entered the sanatorium, there were no elderly patients. Therefore, he had not expected to live to the age of 50; this strengthened his despair and he turned to gambling to dissipate the negative energy. After he crossed the age of 50, he realized that he still did not seem to be ready to die. A budget was allocated for residents' recreational activities for the first time. He did not have any hobbies, because he believed that anything that he attempted would end up being merely half-baked. At this point, he thought that "if I will continue to live, then I will try new things." In addition, he was also afraid of developing dementia and becoming a burden on others. This is when he stared making ceramics.

Making ceramics brought him pleasure as he realized that he could create something from a lump of earth. It gave him fulfillment that could be compared to the same that he got from gambling. This could temporarily make him forget the

**Figure 4.** *Ceramics made by Mr. Takahisa Yamamoto.*

despair. Therefore, ceramics became his friend for life. When he successfully made a shape, he wanted other people to see his artwork. The head of the sanatorium sent his work to a gallery off the island, and this gave him the opportunity to present his work and get honor.

#### **3.5 After the turning point**

Mr. Yamamoto was a boy with a strong sense of autonomy and independence to carve out his life, and he hoped to have the independence to do so at an early age. His spiritual pain occurred as he was trapped in an environment where he could not carve out his own life. In other words, his strong desire to carve his life was lost and he stagnated; as a result, he blamed himself, and this negative energy brought despair. Gambling helped him to get rid of this negative energy. Being the Chairman of the Residents' Committee and making ceramics helped him to channelize his energy. It gave him an outlet for the enormous energy, and he stopped wasting time and found useful ways to use his time.

Although initially he could not endure the same as life seemed to be dull and infinite, he believes that he can endure it now, as he believed that as he had aged, and he did not have as much time left. Therefore, if he was still healthy and young, he could go to Tokyo, again, but at this age, he preferred to stay at the sanatorium. Finally, he generalized his life saying that it was "Overall, a half-baked life," and he therefore did not have the sense of accomplishment of having carved his own life.
