We have only begun to look at the evidence, but it appears that different aspects of well-being matter for health in different ways depending on the cultural context where people reside
Well-being in the West is formulated more in terms of the individual and how he or she may feel about how they’re doing in life.
In the East, well-being is much more about the self embedded within social relationships; for example, how well you’re doing in meeting your obligations to others.
In the U.S., self-report tools ask people to report on their levels of positive and negative affect. Usually the two types of affect tend to be inversely correlated. Emotions are strongly related to people’s health in the U.S.: those with more positive and less negative affect report better health. This is true even when we look at more objective health criteria, like stress hormones, or other biological risk factors.
That is not true in Japan. Both affects tend to be more moderately reported. That is, there is no cultural prescription for feeling mostly positive emotion and not feeling much negative. In Japan there’s nothing wrong with feeling negative emotion; it’s not viewed as something amiss that possibly needs to be fixed in therapy
In the West, the core objective is to get people out of the experience of negative emotion – whether it’s anxiety or depression. The way that well-being tries to do that is to get patients to focus on their experiences of well-being by keeping daily diaries of positive experience.
In Japan therapy is designed to treat distressed or maladjusted people, but the focus is not on fixing emotions. In fact, they are viewed as beyond the person’s control. Emotions come and go and people do not control them. They may be positive or negative, and you can observe them, but it’s not worth your time to try to fix them. What you can fix is what you do. So the therapy tries to get people to shift into thinking not so much about how they feel, but what they are doing.