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Unrelenting slander pushed Japan's Princess Mako into C-PTSD: Imperial Household Agency

Princess Mako, the elder daughter of Crown Prince Akishino and niece of Emperor Naruhito, is seen in Tokyo's Shibuya Ward in this Nov. 6, 2020 file photo. (Pool photo)

TOKYO -- Princess Mako is suffering from complex post-traumatic stress disorder (C-PTSD) due to years of public slander, even as the Imperial Household Agency announced her and her fiance Kei Komuro's wedding date, the agency revealed at an Oct. 1 press conference.

    Princess Mako, the 29-year-old elder daughter of Crown Prince Akishino and niece of Emperor Naruhito, is set to wed Komuro, also 29, on Oct. 26. They were unofficially engaged in 2017 and set to marry on Nov. 4, 2018, but this was postponed after reports of a financial dispute between Komuro's mother and her ex-fiance. Komuro lives in the United States after graduting from a law school in New York, but returned to Japan on Sept. 27.

    Psychiatrist Tsuyoshi Akiyama, director of NTT Medical Center Tokyo's quality improvement division, explained at the press conference that Princess Mako had been "subject to prolonged and repetitive instances of what she felt as slander against her and her family as well as her future husband and his family, and she had been unable to escape from it."

    According to Akiyama, Princess Mako started to feel it was difficult for her to correct what was being written and said about her from around 2018 and 2019, and that her dignity as a human being was being trampled on. She also felt worthless at times as her wish to "live a peaceful and happy life after marriage" could not be attained.

    Princess Mako reportedly has flashbacks of the fear she felt when she saw something that appeared slanderous, and "feels pessimistic and finds it difficult to feel happy due to the persistent fear of her life being destroyed." Although her condition won't hinder public affairs or preparations for the marriage, it often causes her great pain.

    Takaharu Kachi, a top aide to the crown prince and his family at the Imperial Household Agency, told the press conference, "After hearing the diagnosis, my heart aches as a person in a position to offer support. I wonder if my support was sufficient, and I feel apologetic. I would like to make renewed effort to fulfill my duties."

    According to trauma and PTSD researchers, the latter manifests as physical symptoms including insomnia plus flashbacks to painful memories of accidents, disasters and other traumatic events. Complex PTSD is characterized by emotional instability, negative self-image, and unstable interpersonal relationships. The condition is apparently common among people who have experienced continuous and repetitive danger to their life, such as refugees and victims of torture or child abuse.

    Interest in C-PTSD has been rising in Japan since the World Health Organization established diagnostic criteria for it in 2018.

    Recovery from C-PTSD may be possible by keeping the patient away from harmful and dangerous things and making sure they are in a stable, protective environment. Symptomatic treatment including therapy for anxiety also often ameliorates the condition.

    When it becomes chronic, cognitive behavioral therapy, which can fix negative thinking through dialogue, is said to be effective in some cases. One expert said, "It's important to send the message that 'you are being protected.'"

    (Japanese original by Takeshi Wada, Tokyo City News Department, and Hitomi Tanimoto, Lifestyle and Medical News Department)

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