We all have days when we feel we can’t face the world. Usually, we’re able to overcome this feeling and get on with our lives. But, for a growing number of people in Japan, this is impossible, and they are choosing instead to live in near-total social isolation for months, if not years, on end. These people are known as the hikikomori (the word is also used to describe the condition they exhibit). The syndrome was first described by the Japanese psychologist Tamaki Saitō in his 1998 book, Hikikomori: Adolescence without End.
Who are the hikikomori?
The hikikomori are men and women of all ages, though the majority are young men between the ages of 18 and 25. They typically avoid all face-to-face social interaction, including attending school or work, and will spend their days confined to their rooms, usually in their parents’ homes. Communication with the outside world is often limited to online interactions.
People affected by this debilitating condition struggle with intense feelings of anxiety and depression and feel highly exaggerated societal pressures. To be recognised as hikikomori, this behaviour must have persisted for at least six months, and there should be no other physical or mental cause for the symptoms.
Debate on whether hikikomori is a cultural or a psychiatric issue
Since its first recognition, scientists have argued whether hikikomori should be classified as a psychiatric condition or as a cultural phenomenon. Initially, because the condition mainly affected Japanese people, psychologists assumed that hikikomori arose from cultural factors specific to Japan, such as the education system or maybe the economic environment.
However, hikikomori has now been observed in many countries that don’t appear to have much in the way of cultural similarity, including India, South Korea, Nigeria, the United States, Spain, and Canada, among others. Nonetheless, it’s agreed that specific aspects of Japanese society make the condition far more prevalent in Japan.
In other countries, individuals experiencing mental health conditions such as depression, anxiety, or other psychiatric disorders may become socially isolated due to bullying, trauma, or difficulties in adapting to societal expectations. So, while such cases lack the label ‘hikikomori’, it’s likely that there is a great deal of overlap.
Known causes or risk factors
While hikikomori currently lacks formal definition as a psychiatric disorder, it frequently occurs with, though is not caused by, recognised mental illness (secondary hikikomori). OCD, autism spectrum disorder, mood disorders, psychotic disorders, and personality disorders are all associated problems. However, hikikomori often (about 60%) occurs in the absence of mental illness, when it is termed primary hikikomori.
Young people are most at risk, though the condition is being recognised in older individuals. Factors proposed to have a role in the condition’s development include traumatic events or dysfunctional family environments, resulting in socially avoidant behaviour, which eventually progresses to full hikikomori. Commonly cited triggers are painful instances of failure and shame, such as failing important exams or not landing a coveted job (or one that parents would like for their child).
The internet may have a role
It has been speculated that social media and the internet play a role. Hikikomori and internet addiction does co-occur, but causality has not been established. Another theory is that, because the internet allows individuals to communicate without physically being together, it may limit people’s ability to form emotional ties and develop trust.
In a comparison study with university students, hikikomori were shown to have experienced more rejection from friends and parents, a larger predisposition towards shyness, and a higher level of school maladjustment. Trends revealed in hikikomori studies show that the hikikomori are more likely to have a previous record of psychiatric treatment, to have dropped out of school, and to be violent towards themselves (self-harming, for example), but not towards others. The longer hikikomori retreat from society, the more they dwell on their social failings, causing them to further lose confidence and self-esteem, making the prospect of leaving home even more difficult and daunting.
Why more people are affected in Japan than anywhere else
According to the Japanese government, the country has 1.15 million hikikomori. However, Tamaki Saitō, the psychiatrist who first brought the phenomenon to public attention, believes that the total is more like two million, and may eventually exceed 10 million. While most of these people are young, there are around 613,000 hikikomori aged 40 to 64, some of these having remained isolated for more than ten years. Parents in their 80s are having to support hikikomori offspring in their 50s, resulting in the so-called “8050 Problem”.
Japan is a society that places great importance on conformity and social harmony. Japanese individuals, whether they realise it or not, are under enormous pressure to conform, in everything from important life decisions to minor details like hairstyle or what to wear. Inadvertently, this has led to the development of a culture that stigmatises failure or just ‘being different’.
Departure from the social norm can result in exclusion by peers, criticism from teachers or parents, or bullying from classmates or coworkers. Those that struggle in such a culture appear to be at a greater risk of retreating from society and spiralling into hikikomori.
Approaches to managing hikikomori
Just as it lacks formal diagnostic criteria, the treatment of hikikomori is similarly diffuse. Treatment centres around rehabilitation into ‘normal’ life. Physical activity is helpful, along with cognitive behavioural therapy, family therapy (to resolve conflicts and improve communication), social skills training, occupational therapy and support groups.
Although technology may play a role in the development of hikikomori, its effects are not entirely harmful. For instance, games such as Pokémon Go, which use augmented reality to overlay characters onto the actual environment for players to gather can link between the virtual and actual worlds, making it easier and more appealing for hikikomori to leave their homes.
Introducing the rental sisters
An unorthodox form of assistance is provided by women – known as ‘rental sisters’ – paid by parents to break through the hikikomori’s isolation. Contact is established very slowly, starting perhaps with letters from the ‘sister’ left outside their rooms. After months of letters, phone calls and talking through the door, the individual may feel comfortable enough to meet in person and begin rehabilitation.
In conclusion, the hikikomori phenomenon will continue to grow, both within Japan and increasingly outside of it. By fostering understanding, reducing stigma, and enhancing mental health support, there is much hope for individuals affected by hikikomori to reintegrate and lead fulfilling lives.
