Reading Teruhisa Miike's "Let's Get Rid of School! (Let's Not Attend School)--The Minds of Children are Worn Out"
Miwako YOSHIDA1) Takeshi MATSUISHI1)

1) Yokohama National University

I. Introduction

This book, with its bold title "Let's Get Rid of School! (Let's Not Attend School), says that the problem of school avoidance (The definition used in Japan of "students that avoid school" is those that do not attend school because of some psychological, emotional, physical or societal cause or background and also those that are absent 30 or more days per year because they cannot attend even if they want to, with the exception of those with reasons such as sickness and economics. This is a big problem in Japan, which has school education strongly controlled by the Ministry of Education, Culture, Sports, Science and Technology), which has had various interpretations mainly as a psychological problem up to this point, is actually juvenile chronic fatigue syndrome accompanying learning and memory functional disorders, in addition to the three major disorders that significantly reduce mental functions, such as central nervous system functional disorders, hormonal secretion functional disorders and immune functional disorders such that "the minds of children are worn out" as the subtitle indicates.

The importance of this book is in the point of its distancing itself from the psychological approach that has not found any effective solutions for this and engaging the school avoidance problem in the new terms of the "brain," regardless of its being talked to death in recent years. Well then, concretely, just what kind of phenomenon is the school avoidance problem when viewed from the standpoint of the brain? The author directly states that the condition of school avoidance and juvenile chronic fatigue syndrome is a confusion of the functions of the brain controlling life forces and the higher order brain functions. This functional disorder comes from neural cell fatigue based on continuous anxiety and tension, and as a result, learning functions are obstructed, and a marked lowering of academic achievement occurs. If we get a new grasp on the rearing of children from the standpoint of fostering lively mental activity in them, this naturally has an intimate connection with the current state of society and the educational system. Therefore, this book first investigates the changes in the brains of children in recent years, next considers the environmental problems of home, school and society involved in this, and finally proposes concrete measures, that is something like a medical prescription, based on experience with children that have been in clinics. Focusing on the changes in the brains of children in particular, this article summarizes the content simply in the following.

II. Changes in the Brains of Children
(1) Characteristics of Brain Changes
If we take a look at the changes in the brain functions of children, we can confirm a deep correlative relationship between them and the modern school and societal systems. These can be summarizes as follows. There are three points. First, video games and computers drive the development of brain functions, and problems are solved immediately based on a large quantity of knowledge. In other words, there is quiz-oriented "knowledge accumulation and extension of problem solving capabilities centered on the temporal lobes" and "speed in information processing functions from the visual area to the cognitive area," and the results that have arisen in the continued demand for being a "good child" in the group oriented life at school are "the development of a self inhibiting and cooperative brain." Conversely, four points are indicated in the phenomenon of reduced brain function. First, because of the fatigue and anxiety arising from constant tension resulting from the excessive inhibition (autoinhibition) of amygdaloid bodies, which are intimately related to one's own values, because of playing the part of a "good child," it is noted that we see "underdeveloped frontal lobe functions," inclusive of the prefrontal cortex, which is called "the brain of the mind." This is tied to symptoms of passiveness and the phenomenon of quickly losing control over agressive emotions. Second, "the underdevelopment of the brain functions for spatial perception and stereognosis," third "functional atrophy of the autonomic nervous system and the brain for the life force (the limbic system mainly centered on the hypothalamus)," and finally "the absence of overall brain balance and the underdevelopment of linguistic functions" that can be seen in poor vocabulary and linguistic abilities are raised.

(2) Juvenile Chronic Fatigue Syndrome and School Avoidance
The major problem behind these changes in the brain and especially the lowering of brain function is "fatigue." If this were simple transient fatigue for which recovery is possible, it would be fine, but chronic fatigue knocks biological rhythms out of alignment, and everyday life is disrupted because of sleep disorders, making for a chronic jet lag like state. The result of this continuing over a long period of time is said to be juvenile chronic fatigue syndrome (state of school avoidance). In a word, it is not too much to say that this juvenile chronic fatigue syndrome throws the functions of the body into confusion. In the United States, chronic fatigue syndrome is called Chronic Fatigue Immune Disfunction Syndrome, and as demonstrated by the fact that calling it Neuroendocrine Immune Disorder (NEID) was examined at the Fifth International Chronic Fatigue Society Conference in 2001, it is a pathological condition in which functional abnormalities in the central nervous system, abnormalities in hormonal secretions and abnormalities in immune functions appear toghther. The more you read about the details of the conditions in which functional abnormalities in the central nervous system, abnormalities in hormonal secretions and abnormalities in immune functions appear together, the more you cannot but be alarmed by the importance of this occurence in the bodies of children that avoid school. In other words, it shows that the state of school avoidance is not only physical fatigue, but also fatigue in the brain. Typical Symptoms of School Avoidance: They cannot get up in the morning, and activity begins around noon, but no matter how much they sleep, they are always tired. Because of too much sleep, the rythm of everyday life is broken down, and there is a drop in mental activity as a whole, starting with will power and the power of concentration. Their heads are confused and concepts are not realized, and within this, they can suddenly become violent within the family. All of this can be explained through the relationship with juvenile chronic fatigue syndrome. For example, one serious problem largely related to the development of juvenile chronic fatigue syndrome is the malfunction of hypothalamic functions, particularly the body temperature regulation function. Because of this, the deep body temperature is maintained at a high level thought to be near the temperature of the brain. It does not drop even during sleep, and the brain is always overheated (there generally being a 1.5 degree gap between the deep body temperature during sleep at night and druing activity in the day, and there is a fluctuation of 1/f representing the life force of a person, but with chronic fatigue syndrome, there is no fluctuation, and the brain temperature does not drop during sleep). While the secretions of adrenal cortical hormone should be the highest up to 7:00 a.m., this slips three hours or more on average, and secretions are lowered by that amount. Furthermore, along with melatonin which lead to sleepiness, and beta-endorphins, both with, cortisol, which provide for morning activity, have lower secretions in the same manner, and slippage in the secretion times arises. Thus, juvenile chronic fatigue syndrome forms obstructions to the appropriate secretions of hormones and body temperature regulation necessary for carrying out everyday life, confuses the brain that maintains the life force and higher order brain functions, and results in the complication of obstructing learning functions as will be discussed next.

(3) Functional Disorders in Learning and Memory
I would like to introduce the results of three tests with extremely deep significance for the functional learning and memory disorders that accompany this juvenile chronic fatigue syndrome.
One is the examination of cerebral blood flow using SPECT, Xe-CT, etc., and the results are that the flow of blood in the thalamus and frontal lobe is poor with juvenile chronic fatigue syndrome, but there is an increase in the blood flow in the basal ganglia. The reduction of blood flow in the thalamus, which has the function of distributing the information collected from the entire body and the frontal lobe, which governs concepts, creativity, planning, sociality and ethics and further, has functions for adjusting behavior, sensory integration and autonomic nerves, corroborates the symptoms of new information having trouble getting in, reduction in cognition, poor attentiveness, as well as learning and memory disorders. The authors view the increase in the blood flow in the basal ganglia, that is in the amount of information, as an increase in "anxiety information within the brain," but this point is very interesting and probably requires further examination in the future. As an even more shocking thing about blood flow in the brain, results have come out in recent reports showing that there is an overall reduction in cerebral blood flow in adults, and in particular, a reduction in the blood flow in the 24 Broadman areas intimately related to emotions, adjustments in the autonomic nerves and metabolic functions, the important nine areas for communication responsible for working memory and areas of the frontal lobe. This is not just limited to juvenile chronic fatigue syndrome, and it can be thought to indicate that important changes in the brain are progressing in our society as a whole.
Second, the results of investigations of the cognitive abilities of children avoiding school teach u! s that the root of the problem is "a state of continued stress." As a result of investigating the latent delay of P300 brain waves (showing a drop in cognitive ability), school avoiding children react to all stimuli in a supersensitive manner whether necessary or not. In other words, their brains are always tense.
Third, accumulated choline is present in the frontal lobe, and this corroborates the reduction in scholastic ability. Behind choline, which is a part of the neurotransmitter acetylcholine, not being reused by the synapses, is the fact that in a condition of continued sympathetic nerve tension, the supply of acetyl CoA does not keep up with the choline and acetic acid broken down from acetylcholine being consumed in large quantities. As a result, there is a reduction in the production of acetylcholine, causing a functional disorder in the choline operation nerve cells for learning and memory, making study impossible. Looking at the above results, this cannot be dismissed with just "they don't want to do it", and we see a reality of the brain that cannot be dealt with solely by rote memory learning.

III. The Atmosphere around Children and the Brain

Behind the drop in brain function of children is the presence of a situation in current families, schools and society that weakens the will to live itself. If we look at the conditions necessary for a lively fostering of their brains tracking the development of the human brain, the first is emotional stability, and based on this, there is development of the limbic system, which includes the hypothalamus and pituitary gland, followed by the possibility of a forward development of the brain, from the occipital lobe to the frontal lobe. However, if there is no loving care in the home or a sense of security that confirms existence unconditionally, the self is lost in the requirement for autoinhibiting cooperativeness at school, and a target adult form cannot be found in society either. If there are no desires or goals for the future, what will happen to children? In this environment full of anxiety, confusion arises in the limbic system, which can be called "brain of life" indispensable for supporting life. The authors, who have seen a large number of cases of school avoidance, have daringly proposed "getting rid of school," strongly criticizing the current school system and assert that education from here on should be carried out in an intimate relationship with the developmental physiology of the brain. In addition, they raise ideas such as suitable medical responses and making schools open places through regional cooperation and cooperation with guardians for realistically handling school avoidance, and having complete mental health care.

IV. Conclusion
Currently the number of children avoiding school at the elementary and junior high school levels has reached 130,000, and this is said to exceed 2.5% of the total. The fact that this number of school avoiding children has appeared and that it is currently increasing should make us recognize that there is a problem with the school educational system itself and with our societal system itself. This book analyzes the school avoidance problem based on medical and physiological data concerned with the brains of children and actual clinical cases, and it concludes that with the current school system, it is necessary for children to "get rid of school" rather than "return to school," as a specific medical remedy. Get rid of school? That may have more significance for children suffering from school avoidance in terms of obtaining various options when earnestly searching for to secure a lively brain and way of life rather than for the current behavior itself. Aside from the question of wanting to actually get away from school, the ability to have a varied sense of values is at the very least a force in escaping from the feeling of being cooped up. Finally, I think the brightest side in this book that handles the school avoidance problem from the viewpoint of the brain is that the problem is not the children suffering from school avoidance themselves. By being able to talk about the problems of the school avoidance specifically in terms of the body( particularly brain), we can grasp our own vague situations more concretely from an approach other than the psychological one and view the problem objectively. I would like to have expectations for the results of this brain research not only in terms of the school avoidance problem and educational problems but also in terms of its becoming a foundation for deepening the quality of life in the future based on the realities of children.