Naikan Therapy: Applying the Japanese Art of Self-Reflection

Naikan TherapyIn their early teens, my eldest daughter and her friends would leave Post-it notes for people to find in the town nearby.

On each was written a thank-you or a message of encouragement.

“You are appreciated.” “Thank you for all that you do.”

I would imagine the unknown recipient’s smile as they found one stuck to an empty coffee cup while clearing the table or attached to a book when closing up shop.

Perhaps it had been a tough day.

Recognition costs nothing but can have a profound impact.

This article explores Naikan therapy and how it helps us reflect on what we have received, given back, and difficulties we may have caused along the way.

Before you continue, we thought you might like to download our three Gratitude Exercises for free. These detailed, science-based exercises will help you or your clients connect to more positive emotions and enjoy the benefits of gratitude.

What Is Naikan?

Ishin Yoshimoto, a Japanese Buddhist, developed Naikan therapy in the 1940s to share a more moderate form of the extreme ascetic contrition called mishirabe, an austere practice of meditation and self-reflection involving sensory and self-deprivation (Krech, 2002).

The Japanese word naikan means looking inside or seeing oneself with the mind’s eye and encourages the student to step back and reflect on the life they are living.

Naikan was later introduced into North America by David Reynolds, who created several programs and retreats across the United States and Europe.

When Greg Krech (2002) was introduced to the idea of Naikan at one such retreat, it was to take him through a process of reflecting on his relationships with people essential in his life.

In Naikan: Gratitude, Grace, and the Japanese Art of Self-Reflection, Krech (2002) describes Naikan as being a structured form of self-reflection that encourages and helps us to understand:

  • Ourselves
  • Our relationships with others
  • The fundamental nature of human existence

Bold claims; yet according to research, they may be justified.

Recent studies have shown Naikan therapy to be beneficial across diverse populations, from criminal offenders to people with schizophrenia. Results suggest the treatment has positive effects on how people perceive themselves and the world in which they live, their mental health, and their adoption of coping styles (Ding et al., 2017; Liu, 2018).

Krech began exploring his connections with significant people in his life by reflecting on:

  • What he had received from them
  • What he had given them
  • What troubles or difficulties he had caused them

And it was, in his words, life transforming.

Krech (2002) describes the powerful nature of examining our lives as offering the chance to “develop a natural and profound sense of gratitude for blessings bestowed on us by others.”

After all, we spend most of our lives focusing on the obstacles that appear in front of us rather than the path already cleared.

But how do you reflect on yourself? How do you self-examine?

First, we need time, space, and a degree of isolation. We are easily distracted, and this needs to be kept to a minimum. We then need a structured approach to “examine our lives with an emphasis on our conduct in relation to other people, creatures, and objects” (Krech, 2002).

And it’s no easy task. It requires us to attend to what we have previously ignored, including our failings.

Yet, the rewards are considerable. According to Krech (2002), self-reflection, while borne out of our suffering, can give us freedom. It “broadens our view of reality. It’s as if, standing on top of a mountain, we shift from a zoom lens to a wide-angle lens.”

Naikan Therapy Explained

See yourself in the futureKrech (2002) offers a practical test to help us examine our lives, the impact we have on others, and the effect of others on us.

This test is equally applicable to our clients and can be used for their own reflection.

If we picture ourselves near the end of our life and look back at how we have lived (as if playing back a movie), what would we see?

Would we see someone who has taken more than they have given, harming others intentionally or through lack of thought?

It can be a sobering exercise.

Rather than waiting until it’s too late, we can better understand ourselves and our relationship with others through awareness and contemplation.

And this is where Naikan therapy can help.

Ultimately, such reflection provides a more complete, authentic, and realistic view of how we conduct ourselves and our place in our environment.

Understanding some of the reasons we don’t show gratitude to one another can also help us thank others more habitually. Krech (2002) offers several reasons for our failure to express gratitude, including:

  • Lack of awareness
  • Lack of reflection
  • Lack of knowledge (The giver is unknown.)
  • Assumption that others know I am grateful
  • Procrastination (If not immediate, our gratefulness may decrease with time.)
  • Forgetfulness
  • Laziness
  • Entitlement (I have a right to what I receive.)
  • They were just doing their duty.
  • It wasn’t much effort for them.
  • They later caused me trouble.

And yet, it doesn’t have to be this way. We can foster a different relationship with ourselves and others.

The following three questions are the foundation of reflection in Naikan therapy and provide clarity to any relationship (Krech, 2002).

Ask yourself or your client, with regards to a relationship:

  • What have I received from _____ ?
  • What have I given to _____ ?
  • What troubles and difficulties have I caused ____ ?

While the questions may appear simple, prosaic, or mundane, they are far more than that. They challenge us to see reality as it is, beyond pure intellectual analysis (Krech, 2002).

As you practice using the questions and the exercises later in this article, you will become more invested in a life of gratitude while improving the balance between giving and receiving.

Download 3 Free Gratitude Exercises (PDF)

These detailed, science-based exercises will equip you or your clients with tools to build daily gratitude habits, express more appreciation toward others, and experience more positive emotions in everyday life.

Fostering Self-Reflection: The 3 Questions

We, as well as our clients, can begin to better understand our relationship with a person, object, or time through the following three questions.

Question 1 – The care and support received from others

Fostering self-reflection

What have I received from ____ ?

We start by considering what we have received from a specific person, object, or a given time.

To do this, we must slow down long enough to see what we typically miss.

Start by making a list of all you have received on a specific day. It will require you to drill down below the surface.

For example, you visit a café.

  • The barista gave a smile along with the coffee.
  • The person behind the counter washed my cup.
  • The owner of the café established the business.
  • The builder, carpenter, plumber, and electrician created the pleasant environment in which I sit.
  • An artisan designed my coffee cup.
  • Pickers, processors, and transporters brought the coffee beans.

Each person plays a crucial part in the long chain of events that gave you your morning caffeine fix.

The act of listing all that you have received promotes gratitude. You become grateful for the warmth of the café on a chilly day and the taste of the coffee.

Question 2 – My contributions to others

What have I given to _____ ?

Yoshimoto’s teaching suggests we examine our life balance. As with our bank account, there are both deposits and withdrawals.

What have you given and received recently?
Am I taking more from the world than I am giving?

After all, much of the support we receive – the work of teachers, doctors, nurses, cleaners, and delivery drivers – often goes unnoticed.

And yet, despite what we may think, we are not entitled to anything.

Consider what you are doing for others and make a list. Be specific.

  • I picked up litter.
  • I held the door open.
  • I helped a mother with a stroller.
  • I paid that invoice on time.

Question 3 – The troubles and difficulties we cause to others

What troubles and difficulties have I caused ___ ?

We rarely notice, or choose to ignore, the harm or inconvenience we cause others.

Ask yourself:

When have I upset others?
When have I caused difficulties to them directly or indirectly?

For example, throwing litter on the street may not appear to harm anyone directly, yet seeing it can be upsetting and annoying, and ultimately someone will need to pick it up.

We must be accountable for our behavior. As Krech (2002) writes, “if we are not willing to see and accept those events in which we have been the source of others’ suffering, then we cannot truly know ourselves or the grace by which we live.”

Create a new list to capture the troubles and difficulties you have caused others in the last 24 hours, and be specific.

Reflecting on the three questions requires practice and can be helped by using the following exercises.

9 Naikan Exercises for Fostering Gratitude

Immediate gratitudeKrech (2002) provides several valuable self-reflection exercises for you or your clients, including:

Daily and weekly Naikan reflection and review

Spend 30 minutes each day reviewing the three essential Naikan questions and completing the Daily and Weekly Naikan Reflection and Review Worksheet.

At the end of each week, summarize the last seven days and recognize actions to be taken, such as sending a thank-you, apologizing for something, or creating a plan for how you will try to handle things better next week.

Belated gratitude

We should already thank people as they do things, but sometimes we forget, miss the opportunity, or are too wrapped up in ourselves.

While the immediate moment may have passed, it is never too late.

Phone or meet the person. Tell them specifically what made the experience special. For example, the chef created something memorable; your friend listened to your concerns; the shop found what you needed.

Immediate gratitude

Over time and with practice, we can learn to slow down and appreciate what others do for us in the present. Set yourself the goal of being more mindful and expressing your gratitude for the service or help you have received.

Try to be specific regarding what you received.

Thank you for the coffee, for your time today on the call, helping my son with his math.

By attending to what has been done, we avoid mindless thank-you’s.

Appreciate objects

It can be a valuable exercise to recognize and be thankful for those objects that go unnoticed yet make our lives safer, more productive, and more contented.

Reflect on all the people who helped in the design, manufacturing, packaging, and delivery.

Self-Reflection on a Single Relationship

While common in Naikan therapy, many of us are unfamiliar with the idea of deliberately reflecting on our relationship with a single individual.

Use the Self-Reflection on a Single Relationship worksheet to review the three Naikan questions and spend some time thinking about your relationship with the person.

Self-Reflection on Lying and Stealing

Krech (2002) points out that many who attend his Naikan retreat experience their most profound revelations when contemplating lying and stealing.

The Self-Reflection on Lying and Stealing exercise is useful for exploring your transgressions.

Self-Reflection in Intimate Relationships

Even in close relationships, we can be guilty of only focusing on ourselves and what the other person can do to make us happy.

Use the Self-Reflection in Intimate Relationships exercise to shift focus from being self-centered to attending to your partner’s needs.

Naikan Therapy for a New Year

Reflection at the end of a year can offer insight into all that has happened in the last 12 months and provide lessons for the year ahead.

Use the Naikan Therapy for a New Year worksheet to reflect and create value and happiness in your life and arrive at goals for the New Year.

The Roots of Stuff

We are all surrounded by things. Some with history and some with value, whether the attachment is personal and emotional, or practical.

Use the Roots of Stuff worksheet to consider the past and our dependency on other things and people in our lives.


Naikan – reconnection to ourselves – Johanna Schuh

Naikan Therapy vs Western Psychotherapy

Naikan therapy differs considerably from Western psychotherapy and its approach to mental health. Yet, it is possible to combine elements of the two, having first considered how they differ.

The table below summarizes the differences (Krech, 2002):

Psychotherapy Naikan Therapy
Focuses on feelings. Focuses on facts.
Revisits your hurts from the past. Revisits how you have been supported in the past.
The client’s experience is validated by the therapist. The client is helped by the therapist to understand the experience of others.
Your problems are blamed on others. You take responsibility for your problems and those you cause others.
Therapist analyzes and interprets the client’s experience. Therapist offers the client a structured framework for their self-reflection.
The purpose is to increase the client’s self-esteem. The purpose is for the client to increase their appreciation for life.

The two approaches differ in perspective but share common aims: notably, the wellbeing of the individual and people in their lives.

Naikan therapy encourages a balance of needs, where others’ experiences are as crucial as our own.

4 Books on the Topic

1. Naikan: Gratitude, Grace, and the Japanese Art of Self-Reflection – Gregg Krech


This book is the definitive guide to Naikan therapy.

Krech begins with his personal experiences of Naikan before exploring the principles underpinning the treatment.

The book guides us through how to develop a profound gratitude for all the good in our lives, which often goes ignored or unrecognized.

Find the book on Amazon.

2. Question Your Life: Naikan Self-Reflection and the Transformation of Our Stories – Gregg Krech

Question Your Life

Krech explores Naikan therapy as an approach for lightening our load.

His fascinating book explains why and how we should transform our lives by letting go of the personal baggage we haul around with us.

Find the book on Amazon.

3. Wabi Sabi: Japanese Wisdom for a Perfectly Imperfect Life – Beth Kempton

Wabi Sabi

If you enjoyed the simple but deep wisdom found in Naikan therapy, then another Japanese concept, wabi sabi, will be equally interesting and insightful.

Kempton helps the reader understand how it is possible to see perfection in imperfection, simplify our lives, and restore a simpler self through reconnecting with nature.

Find the book on Amazon.

4. Gratitude – Oliver Sacks


Sacks is the author of a favorite and unlikely classic, The Man Who Mistook His Wife for a Hat. It is an amazing journey through personal experiences of neurological disorders.

In the last year of his epic life, he wrote his final book, and it became an ode to what makes us unique and the gratitude we should develop for this ultimate gift: life.

Find the book on Amazon.’s Resources

We have several resources that can help transform your own or your clients’ lives through an increased focus on gratitude.

  • My Positive Qualities – Overcome negativity bias, recognize positive qualities, and appreciate yourself and others in a group context using this tool.
  • Gratitude Journal – Gratitude can be practiced and improved through journaling, and this worksheet provides useful prompts for getting started.
  • Expressing Gratitude To Others – Learning to be more grateful can transform our capacity for relationship growth. And feeling loved and admired is the best long-term indicator of relationship success.

For more tools to inspire your clients’ gratitude practice, be sure to check out our free Gratitude Exercises Pack.

This pack features three of our top tools from the Positive Psychology Toolkit©, all of which center on the theme of gratitude:

  • The Top 5 Values
    This exercise draws on key principles of Acceptance and Commitment Therapy to help clients begin brainstorming their values. Following this, clients will then prioritize these values in a list to identify those most central to who they are.
  • Self-Eulogy
    This exercise invites clients to consider how they’d like to be remembered at their funeral as a means to identify and clarify values. Based on this, they can then consider how well they are living in alignment with these values.
  • The Scoreboard Metaphor
    This exercise helps clients recognize how to enact their values through goal-setting. In particular, it draws on the metaphor of a basketball game to illustrate how living into one’s values is an ongoing process and that the paths by which we pursue our goals are opportunities to enact our values in daily life.

You can access all three exercises for free by downloading our Gratitude Exercises Pack.

If you’re looking for more science-based ways to help others harness the benefits of gratitude, this collection contains 17 validated gratitude tools for practitioners. Use them to help others shift to a more positive mindset and experience the joys of life more deeply.

17 Exercises To Nurture Gratitude & Appreciation

Empower others with more hope, satisfaction, and fulfilling relationships with these 17 Gratitude & Appreciation Exercises [PDF] that harness the powerful benefits of gratitude.

Created by Experts. 100% Science-based.

A Take-Home Message

Naikan therapy seems closer to mindfulness than it is to traditional Western psychotherapy. And like mindfulness, it has proven successful in treating several mental illnesses and restoring psychological wellbeing (Sengoku, Murata, Kawahara, Imamura, & Nakagome, 2010; Shapiro, 2020).

After all, we are often told not to sweat the small stuff, and yet isn’t it typically the small stuff that we should notice and be more grateful for?

Nothing we have, be it love, money, friendship, or physical goods, arrives without having formed a relationship with others. We are not separate individuals; we are part of a connected society, and even more in the last two decades of technological development.

Rather than ignore that we are part of a greater whole, dependent on and depended on, we should recognize, reflect, and welcome the opportunity to give and receive from others while reducing the damage we cause.

By applying Naikan therapy practices to our relationships with others, we can create a more valuable and authentic connection with those around us and our environment. After all, a life of balance and gratitude is increasingly likely to lead to happiness and a heightened sense of wellbeing for ourselves and others.

Knowledge of the principles alone is insufficient to transform. Use the tools provided to practice Naikan therapy emotionally and intellectually and continue to reflect on your changing perspective and your place in the world.

We hope you enjoyed reading this article. Don’t forget to download our three Gratitude Exercises for free.


  • Ding, X., Liu, Z., Cao, G., Wei, S., Qiu, Z., Wang, K., … Fucha, H. (2017). The efficacy of Naikan therapy on male offenders: Changes in perceived social support and externalized blame. International Journal of Offender Therapy and Comparative Criminology, 62(11), 3499–3508.
  • Kempton, B. (2018). Wabi sabi: Japanese wisdom for a perfectly imperfect life. Harper Design.
  • Krech, G. (2002). Naikan: Gratitude, grace, and the Japanese art of self-reflection. Stone Bridge Press.
  • Krech, G. (2017). Question your life: Naikan self-reflection and the transformation of our stories. ToDo Institute.
  • Liu, X. (2018). The influence on coping style in patients with schizophrenia by Naikan therapy. Value in Health, 21, S191.
  • Sacks, O. (2015). Gratitude. Knopf.
  • Sengoku, M., Murata, H., Kawahara, T., Imamura, K., & Nakagome, K. (2010). Does daily Naikan therapy maintain the efficacy of intensive Naikan therapy against depression? Psychiatry and Clinical Neurosciences, 64(1), 44–51.
  • Shapiro, S. L. (2020). Rewire your mind: Discover the science + practice of mindfulness. Aster.


What our readers think

  1. Sab

    Thank you for this great article on Naikan. I went once in a hotel and there was a book on Naikan on the table. I wanted to know further about it and found it here!Thank you! Very complete article. Have a good day ✨

  2. MaKenzie Maxwell

    Excellent article which I am interested in using for an upcoming paper. Do you happen to have a downloadable version? Thank you for the worksheets, too!

    • Nicole Celestine, Ph.D.

      Hi MaKenzie,

      Glad you found this post helpful. I’m afraid we don’t currently have an option to download our posts. However, we have some options to help you share them with others if that helps? If you scroll to the end of the post and respond positively to the question ‘How useful was this article to you?’ several sharing options will become available to you.

      Hope this helps!

      – Nicole | Community Manager

  3. Dr. Larry Anthony

    Excellent learning, thank you!

    Krech’s descriptors of western psychotherapy are more accurate for psychoanalysis than other forms of psychotheraphy. Today’s mainstream western psychotherapists would likely say that most of those practices work against healing and understanding, and do not lead to a greater wellbeing and appreciation of others. Naikan Therapy stands very well on its own two feet. It does not need to look good by unfairly caricaturing western practitioners.

  4. Karen Finn

    Thank you for generously sharing your knowledge and the downloads – much appreciated.


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