The ‘polycrisis’ of global capitalism has regional and national particularities that are worthy of exploration. In the case of East Asia, we see rising military, political and economic tensions which mirror global trends, but take a specific concrete regional form. We offer an explanation for these tensions in East Asia that highlight their roots in developments within the national models of capitalism that make up the region, in this case from the perspective of Japan. Drawing on a regulation theory framework, we show how Japan’s faltering national regime of accumulation has been through a constant process of neoliberalization since the early 1990s. This has prompted a number of institutional shifts, one of which includes increasing integration within the East Asian region. This, however, has produced a number of new problems, which we might consider to be general pathologies of late-stage neoliberalization and that are typically experienced at the regional level. In particular, we identify four interconnected and mutually reinforcing pathologies: heightened national economic and political rivalries; heightened market competition; increased vulnerability to disruption to region-wide commodity chains; and declining popular support that is being met by political attempts to adopt nationalist legitimation strategies. Such an account allows us to understand the obstacles and tensions preventing moves towards a smoother process of accumulation in the case of Japan in East Asia, and more generally throughout the contemporary global political economy, as well as offering a more complete account of the complexity and contradictions associated with the growing assertiveness of the Japanese state.