The Hidden Isolation
Hikikomori or to “shut-in” is a Japanese term that describes a person who seeks isolation or spends an abnormally amount of time socially and psychologically isolated. About half a million in Japan are affected but it can occur in any culture or country. However, hikikomori is not mainstream or rarely recognized in societies outside of Japan, however current research has mentioned it with other mental problems:
Several recent empiric studies have emerged from Japan. Most of such cases of hikikomori are classifiable as a variety of existing psychiatric disorders. However, a notable subset of cases with substantial psychopathology does not meet the criteria for any existing psychiatric disorder. We suggest hikikomori may be considered a culture-bound syndrome and merits further international research into whether it meets accepted criteria as a new psychiatric disorder. Research diagnostic criteria for the condition are proposed. –Pub Med
Hikikomori is not a medical diagnosis but is primarily viewed as a “social problem”. It can be a phase, a coping mechanism, or possibly a symptom of depression. However, Hikikomori does not mean people are spoiled or lazy, and other myths, which can create more confusion and anguish. Social isolation can be so debilitating that it may force the person to be dependent on a guardian:
One social factor of Hikikomori is the amae – dependence – that characterizes Japanese family relationships. Young women traditionally live with their parents until marriage, and men may never move out of the family home. Even though about half of hikikomori are violent towards their parents, for most families it would be unthinkable to throw them out. –BBC
The second force is called sekentei, a person’s reputation in the community and the pressure he or she feels to impress others. The longer the hikikomori remains apart from society, the more aware they become of their social failure. They lose whatever self-esteem and confidence they had and the prospect of leaving home become more terrifying. -BBC
A hikikomori is defined by the Health, Labor and Welfare Ministry as someone who has remained isolated at home for at least six consecutive months without going to school or work, and rarely interacts with people from outside their own immediate family. –Japan Times
Major Risk Factors for Isolation
- Young Adult Males
- Unemployed or Uneducated
- Psychological Trauma; Harassment, Abuse, and Bullying
- Low Tolerance for Stress
- Feeling Worthless & Hopelessness
Due to the isolation, it takes a long time for a hikikomori person or the family to seek help. Like most people battling with mental disturbances, the taboo and stigma of mental health continue to cripple many families and communities. However, with much compassion and time, the person can have a breakthrough and begin a rehabilitation process of interacting with others.
Interventions
The treatment of hikikomori includes integrating the person back into society with initiatives such as an assertive community treatment or a form of “wrap-around” services to help those recover from the isolation. Family support is important but not a necessity since some people isolated themselves despite having a normal family life. Technology i.e. social media or computer games may be helpful but also have risks such as not improving human interaction or online harassment.
Writing letters may be more progressive and could allow the individual to slowly integrate with others then eventually outside the home. Medications are not indicated because it’s not considered a mental disorder, rather most of the people affected by hikikomori were normal or had no major concerns with a decent upbringing. However, there is treatment for depressive symptoms and agitation, but people with hikikomori are not usually depressed.
Lastly, continue to practice or promote stress management. Finding activities that emphasized creativity and relaxation is important for managing stress and building coping skills. Improving social/communication skills are crucial in so many different situations. It’s one of the main reasons why hikikomori is not just a cultural problem since other societies may have different forms of social phobias that just probably go by different names…
Hikikomori cases have been found in Morocco, Oman, Spain, Italy, South Korea, Finland, and France. Recent research using the same standardized definition of hikikomori has found evidence of its existence in other countries as wide-ranging as the United States and India. –Wiki
The syndrome also closely parallels the terms avoidant personality disorder, schizoid personality disorder, schizotypal personality disorder, or social anxiety disorder (also known as “social phobia”). It’s also described with social withdrawal, culture-bound syndrome, & Asperger’s.
Otaku vs Hikikomori–BBC
- An overlapping group of people with the hikikomori, otaku are “geeks” or “nerds”.
- They are known for their obsessions, especially manga cartoons and anime.
- “Otaku” is the formal word for “you” in Japanese – it’s thought that the term came about from the tendency of socially awkward manga fans to use over-formal language.
- In press coverage, both otaku and hikikomori have been linked with serious sex crimes.
Taijin Kyofusho: a culture-bound syndrome that’s considered a social phobia is commonly seen in Japan and Korea. It is characterized by extreme fear/anxiety of social evaluation. Patients may report how they believe they are making other people very uncomfortable because of their presence. For example, a patient might state, “My look upsets people, so they avoid me.” This fear also has some traits of body dysmorphic disorder where the patient may believe they possess an offensive body odor that can intensify the delusions. The causes of this disorder are mainly from emotional trauma or psychological defense mechanism. –Very Well Mind
More Information & References
- Hikikomori by Wikipedia
- Hikikomori: Why are so many Japanese men refusing to leave their rooms? by BBC
- Japan: The Missing Million by BBC
- Japan’s modern-day hermits: The world of hikikomori, video on YouTube
- The prison inside: Japan’s hikikomori lack relationships, not physical spaces by Japan Times
- What Is Hikikomori? Could It Be One of Japan’s Most Serious Problems? by Japan Info
Pub Med
- Teo, A. R., & Gaw, A. C. (2010). Hikikomori, a Japanese culture-bound syndrome of social withdrawal?: A proposal for DSM-5. The Journal of nervous and mental disease, 198(6), 444–449. doi:10.1097/NMD.0b013e3181e086b1
- Teo A. R. (2013). Social isolation associated with depression: a case report of hikikomori. The International journal of social psychiatry, 59(4), 339–341. doi:10.1177/0020764012437128
