The Faultline of Kokoro no Kea: Mental Distress and Post-Disaster Psychosocial Care After the Great East Japan Earthquake

Abstract

The Japanese concept of “ kokoro no kea” (care for the heart/mind) plays a crucial role in shaping disaster mental health response systems. Following the 2011 Great East Japan Earthquake and tsunami, and the subsequent nuclear plant accident, the government quickly implemented kokoro no kea initiatives. However, many locals reported reluctance to seek support from kokoro no kea teams. This article explores therapeutic governance in response to these disasters, a multifaceted, disavowed, and diffusive mode of governing. It highlights how recovery politics emphasized solidarity—referred as “kizuna” (social bonds)—while also gendering and pathologizing women’s fears and anxieties regarding radiation exposure. Through a narrative review of ethnographic studies, this analysis demonstrates that kokoro no kea is not simply a static post-disaster mental health and psychosocial support system; rather, it is an open, fluid, and evolving process where diverse actors—such as politicians, men, women, health professionals, and religious practitioners—interact with socio-political forces and cultural values, creating unique pathways for individuals and communities to foster connections, build trust, and nurture resilience in coping with psychological pain and loss.