Original article

Journal of Psychopathology 2013;19:191-198 191

Summary
Objectives
In Japan today it is believed that there are a million young adults
who refuse to work and who avoid social contact. This phenomenon, known as
�hikikomori� (social withdrawal), has become
a serious socio-psychological problem throughout the country.
However, there has been little psychopathological consideration of this phenomenon,
and no detailed discussion of diagnosis. In this article, we investigate the
phenomenon from a
psychiatric perspective by introducing the concept of �primary
hikikomori� and examining its relationship to recent changes in
Japanese society.
Methods
We reviewed several studies concerning the epidemiology
and psychopathology of hikikomori. As psychiatrists, we have
considerable experience treating hikikomori youth (referred to
simply as hikikomori) in individual therapy, group therapy, family therapy and
family group therapy sessions. Based on this
experience, we present a typical case of �primary hikikomori�
and identify its psychological features. We also analyze hikikomori from a socio-
cultural perspective. The observations made
herein are based on this first-hand clinical experience as well
as careful consideration of a number of other psychiatric and
sociological reports concerning hikikomori.
Results
Firstly, a typical case of hikikomori is presented. Secondly, we
identified the psychological features of �primary hikikomori�,
or hikikomori with no obvious mental disorder, as follows: 1)
display a tendency to avoid competitive settings; 2) cherish an
�ideal image� based on the expectations of others; 3) are unable to make a fresh
start from their current situation; and 4)
have parents who continue to invest in their child�s ideal image. We assert that
�primary hikikomori� is a new manifestation
of the conflict prevalent among contemporary Japanese youth.
Thirdly, we discuss possible contributing factors to the phenomenon from three
viewpoints: 1) changes in the socio-cultural
constellation; 2) changes in communication; 3) changes in the
labour system and examined the implications of such widespread change.
Conclusions
We believe that it is necessary to consider the possibility that the
hikikomori phenomenon, which emerged in Japan in the 1990s,
might be the first sign of a larger disturbance within present-day
society in general. Moreover, the pathology of societies giving
rise to this hikikomori phenomenon ought to be examined.
Key words
Hikikomori (social withdrawal) � Primary hikikomori � Psychological
feature � Japanese culture
Correspondence
Mami Suwa, Faculty of Health and Medical Sciences, Aichi Shukutoku University, 9
Katahira, Nagakute-city, Aich-ken, Japan � Tel. +81-561-62-
4111 � Fax +81-561-56-0025 � E-mail: msuwacci@asu.aasa.ac.jp
The phenomenon of �hikikomori� (social withdrawal)
and the socio-cultural situation in Japan today
Il fenomeno del ritiro sociale �hikikomori� e la situazione socio-culturale in
Giappone oggi
M. Suwa, K. Suzuki
Faculty of Health and Medical Sciences, Aichi Shukutoku University, Graduate School
of Medicine, Nagoya University, Nagoya, Japan
Introduction
Hikikomori (social withdrawal) means behaviour in which adolescents and young
adults refuse all contact with society and
withdraw from all social activities. The word hikikomori describes both the
phenomenon and the person suffering from it.
Since the 1990s, hikikomori among young adults, and occasionally adults up to their
40s, has been the focus of considerable attention as a new social problem in Japan.
It is a
phenomenon in which young adults who have either graduated from high school or
university, or who have dropped
out and not completed their education, do not take up employment but rather cut off
contact with society and confine their lives mainly to the family home. In some
instances
they do not even speak with other family members, and shut
themselves up in their rooms with day-night reversal, sleeping during the day and
staying awake all night. Others may
sometimes leave the house for such things as going to the
library or shopping in the neighbourhood.
The hikikomori phenomenon in youth has been a social
problem in Japan for the past two decades. It has also been
recognized in other countries in recent years, particularly in
Europe. At the same time, there has been no detailed psychopathological discussion
of hikikomori in Japan. We have
therefore attempted a psychiatric placement of this problem
by presenting the concept of �primary hikikomori�.
In this article, we firstly review several studies concerning
hikikomori in Japan. Hikikomori is not a diagnosis, but a
192
M. Suwa, K. Suzuki
pling of citizens from 6 of the 47 prefectures in Japan. Of
the 4,134 people interviewed, 1,660 were aged from 20
to 49 years, and among this group 19 people (1.2%) had
experienced hikikomori themselves. Koyama suggested
that the number of people within that age group who
had experienced hikikomori during their lifetime was in
fact higher because participation in the investigation was
voluntary. Therefore, based on Koyama�s study in which
1.2% of the sample group had experienced hikikomori,
we can postulate that in the total population the number of hikikomori youth aged
from their 20s to 40s years
might be over 600,000. With respect to diagnosis, Koyama also stated that 45.5% of
hikikomori cases had no
lifetime experience of a psychiatric disorder, which we
call primary hikikomori 2. Kondo et al. 6 investigated 183
subjects who utilized mental health welfare centres and
met the definition of hikikomori. Based on DSM-IV-TR
criteria, 49 of these patients (33.3%) were diagnosed with
schizophrenia, mood disorders or other mental disorders,
47 patients (32%) were diagnosed with developmental
disabilities, and 51 patients (34.7%) were diagnosed with
personality disorders (including personality features not
reaching the threshold of actual personality disorder).
As for the long-term prognosis of hikikomori, there is little information since it
is a relatively new phenomenon.
However, of the 183 subjects in the study of Kondo et
al. 6 28 (15.3%) achieved social participation after 21.7
months of consultation.
Studies on hikikomori and psychiatric personality
disorders
Some psychiatrists have reported on the hikikomori phenomenon by discussing the
patients� pathology from the
viewpoint of personality disorders or neurotic disorders.
Kondo 7 reported that schizoid pathology is commonly
found among hikikomori cases. Kinugasa 8 indicated that
most hikikomori youth have schizoid personality disorcondition in which young
adults avoid social activities. It
may be caused by depression, anxiety disorder or some
personality disorders. In an earlier paper 1 we reviewed 82
articles about hikikomori, and will discuss some of them
herein. Secondly, we present a typical case of �primary
hikikomori�, and outline the psychological features of this
condition that we defined in a previous report 2. As psychiatrists, we have
treated hikikomori in individual therapy,
group therapy, family therapy and family group therapy.
Therefore, our considerations in this paper about the pathology of hikikomori are
based on these clinical experiences. Lastly, we consider possible contributing
factors to
this phenomenon. We bring together the analyses of three
major contemporary Japanese sociologists and the clinical
presentation of hikikomori, and consider them from the
perspectives of social change in general, change in communication and change in the
labour system.
The hikikomori phenomenon
History of the usage of the word �hikikomori� in Japan
Before discussing the phenomenon of hikikomori, we
shall first explain the changes that have occurred in the
usage of the word hikikomori in Japan. Originally, hikikomori was simply a general
term referring to a condition in
which people withdrew from relationships with others. It
was also used as a psychiatric term describing the symptom of withdrawal in
autistic, schizophrenic, depressive
or aged patients. After 1990, hikikomori among youth received increasing attention
from psychiatrists and society
at large, and came to be used mainly for young adults. In
Figure 1, we show the changes from 1986 to 2011 in the
number of papers about hikikomori with other pathologies, compared with those
specifically about hikikomori
in young adults. It is evident that the number of the latter
increased quickly, and among young adults this phenomenon became a new area of
interest in psychiatry. Some
psychiatrists have written about the psychopathology of
hikikomori, which we discuss further in a later section.
Review of studies about hikikomori
Epidemiological studies
The number of hikikomori adolescents and young adults
in Japan is believed to range from 500,000 up to one million 3. In the first
epidemiological study 4 of this phenomenon in 2003, the Japanese Ministry of
Health, Labour
and Welfare defined hikikomori as a state in which a
young person (a) mainly stays at home, (b) cannot or does
not engage in social activities such as going to school or
working, (c) has continued in this state for more than 6
months, (d) has neither a psychotic pathology nor medium to lower level mental
retardation (IQ < 55~50),
and (e) has no close friends. They reported that 6,151
cases had presented at public health centres during the
previous 12 months. Among these, males outnumbered
females, comprising 76.4% of the total. Koyama et al. 5
interviewed 4,134 people (55.1%) from a random samFIgure 1.
The number of hikikomori studies. Numero delle ricerche su
�hikikomori�.
193
The phenomenon of �hikikomori� (social withdrawal) and the socio-cultural situation
in Japan today
that NEET do not work or study. However, we regard the
phenomenon of NEET as simply a labour-related problem
that is not concerned with the individual�s mental tendencies. Thirdly, there are
some case reports of �hikikomori�
from Oman 18, Spain 19 20 and Italy 21. As these reports
were based on a limited number of cases and insufficient
information, it is questionable whether their psychological features are the same
as those of Japanese hikikomori.
Kato et al. 22 surveyed psychiatrists from 8 other countries, asking whether they
believed that hikikomori existed in their own country based on two typical
hikikomori
case reports. A total of 124 psychiatrists from 8 countries
said that they felt that people with hikikomori syndrome
could be found in their own country. From this result,
Kato concluded that hikikomori cases may exist not only
in Japan but also in other parts of Asia, Australia and the
USA. However, Kato�s report indicated that there were
differences regarding diagnosis and treatment between
Japanese psychiatrists and their peers in other countries.
It may be that these differences came from varying interpretations of the features
and pathology of the hikikomori
evoked by the two case reports. Hence, we cannot directly conclude from Kato�s
investigation that the same
kind of hikikomori found in Japan exist in other countries.
As there is insufficient data available at the present time,
we feel that is worthwhile pursuing our investigations of
this phenomenon.
Primary hikikomori
Primary hikikomori and secondary hikikomori
As noted above, hikikomori includes individuals suffering
from a variety of severe mental disorders including affective disorder, anxiety
disorder, obsessive-compulsive disorder, personality disorders and pervasive
developmental
disorders, which we classify as �secondary hikikomori�.
We define �primary hikikomori� as one manifestation of
the hikikomori phenomenon that cannot be described
using current concepts in psychiatric disease 2. Primary
hikikomori youth do not have any serious diagnosable
psychopathology, yet they are unable to enter society or
adapt to their surroundings. Our classification of hikikomori, which is a reworked
version of the original one
provided by the Japanese Ministry of Health, Labour and
Welfare, is shown in Figure 2.
Importance of the concept of primary hikikomori
The concept of primary hikikomori is important because,
firstly, one cannot understand the basis of this pathology by considering only
hikikomori in relation to other
disorders. This pathology and the peculiarities of such
withdrawn young adults can only be elucidated if we regard them from the viewpoint
of the concept of primary
der, narcissistic personality disorder or avoidant personality disorder. Nakamura
et al. 9 reported that a new type of
taijin kyofusho*, characterized by avoidant and withdrawal tendencies, has been
increasing. In our experience,
however, hikikomori usually do not have sufficient deviation in personality before
withdrawal to be classified
as having a personality disorder. When observing them
in their present state, they might possibly be diagnosed
with avoidant personality disorder or schizoid personality disorder. However, they
are in fact not so avoidant
or misanthropic and fundamentally desire contact with
people. Moreover, having adapted reasonably well until
they reached a hikikomori state in their 20s or 30s, most
would not be diagnosed with a personality disorder.
Studies on PDD
In recent years, some cases of hikikomori with pervasive
developmental disorders have been reported. They include
high functioning autism and Asperger�s syndrome without
mental retardation, which are not usually diagnosed during childhood. Such cases
are not rare, and while patients
may have some problems with personal relationships they
are able to adjust to school life because of their high scholastic ability. In
adolescence or young adulthood, however,
when they are forced to decide their career course or adjust to a new job, they
become hikikomori. They first present at the clinic as hikikomori and are finally
diagnosed
with PDD based on their life history, psychological testing
and anecdotal evidence provided by their parents. Kondo 10 reported a diagnosis of
PDD in 22 of the 78 (28.2%)
hikikomori patients he saw. In our experience 11, 6 of 27
(22.2%) hikikomori patients had PDD.
A similar phenomenon in other countries
The hikikomori phenomenon is often said to be unique to
Japan and related to Japan�s psychosocial background 12-
14. However, other phenomena elsewhere in the world
are considered to be similar to hikikomori in that there is
some degree of withdrawal from society. Firstly, Internet
addiction has been reported in several countries. In South
Korea, for example, it is said to be a serious problem
among adolescents 15. Kim 16 stated that �recluse type�
Internet addiction in South Korea has some psychological resemblance to hikikomori.
He reported that �recluse
type� Internet addicts do not leave the home not only
because they are totally absorbed in the Internet, but also
because they have a tendency to avoid communication
with others. However, in general Internet addiction the
hikikomori state occurs as a result of people simply becoming absorbed in the
Internet. Secondly, in England
young people not in full-time education, employment, or
training (NEET) are the subject of policy concern 17. This
phenomenon is similar to hikikomori behaviourally in
* This is one type of neurosis related to interpersonal relationships. It is also
called anthropophobia. Taijin kyofusho patients feel
strong fear when they think they are despised or detested by others because of
their inappropriate expression.
194
M. Suwa, K. Suzuki
at home. He felt ashamed of himself for giving up before
really trying. For about 6 months he could not leave his
room and reversed his day-night schedule. After that he
was able to leave the house, but only in the evening and
he was anxious about meeting acquaintances.
Although he feared others would notice that he had not
worked for several years, he believed that he could handle regular communication
and had no anxiety about
having conversations with people unconnected to his
work or life. After 7 years of counselling, he still stays at
home and is unable to take on a job, complaining that
he has no confidence in his ability to cope with society.
Differential diagnosis
Firstly, schizophrenia may be excluded because there were
no hallucinations, delusions or other morbid experiences,
and communication in one-on-one interviews was good.
Differentiation between depression and mood disorder
was a problem, but although he presented a strongly suppressed state, such as
shutting himself in his room after
experiencing setback, there were no obvious depressive
feelings and periodic changes did not occur. Depression
can also be excluded from the premorbid character of
hypodynamia and low role identity. With regard to neurosis, no neurotic symptoms
that would be classified as
dissociative disorder, somatoform disorder, or anxiety disorder were seen, and
there were no conspicuous compulsive tendencies. In the area of personality
disorders, while
�schizoid,� �narcissistic,� and �avoidance� pathologies
were problems, these cover a wide range from character
tendencies to personality disorders, and diagnosis of their
pathological level is important. To diagnose a personality
disorder, some kind of interpersonal problem or behavioural problem other than
hikikomori would need to be
seen. He did not have any adaptive problems other than
hikikomori, and a diagnosis of personality disorder was not
made. Thus, this case does not seem to fit into any current
psychiatric diagnostic concept.
Psychological features
We have identified the following five pathological features of �primary
hikikomori�:
Episodes of defeat without a struggle � prelude
to hikikomori
Not only in the case described above, but in many cases
of hikikomori, there is an episode of �defeat without a
struggle� before the person becomes hikikomori. Examples include quitting the
school volleyball team because
one was not selected as a player, as in our case study,
or giving up taking an entrance examination after having prepared for it. All
competitive settings are avoided.
Finally, hikikomori depart from their envisioned �ideal
path� without ever having struggled for what they wanted. Since they did not
struggle and fail, this �envisioned
path� remains within them unchanged and they feel uncomfortable with themselves for
not being on that path.
hikikomori. Secondly, based on the psychopathology of
primary hikikomori, we might be better able to understand the sociological problems
of Japan today. It is not
only a problem in young adults, but also a social problem
confronting contemporary Japan. Thirdly, the concept of
primary hikikomori is important when considering therapy or treatment. If patients
are suffering from obsessivecompulsive disorder, we must treat them for that
disorder
even if their condition also involves hikikomori. Established therapies can be used
to treat the regular disorder.
However, in cases of primary hikikomori we need to consider new methods that are
suited to its pathology.
Case description
The patient�s mother first came to our office and explained that her son had
refused to work for 2 years after
graduating from university, even though he had a good
academic record and was always kind and gentle in his
dealings with others. After 6 months of counselling the
mother, the patient himself came to our office. He was 25
years of age. He complained that he would like to have
a job and lead an ordinary life, but was unable to do so.
In discussing his past, we discovered that he was good
academically and even leader of the student representative committee in elementary
school. In high school, he
joined the volleyball club, but soon quit in anger because
he felt that the team selection procedures were unfair.
He subsequently lost motivation to attend school and
dropped out. After 3 years, he entered university via the
special university entrance qualification system. He was
able to adjust to university life. After graduating from university he obtained a
regular company job. He attended
the company training course where he met many fellowemployees for the first time.
However, he soon became
exhausted from the effort to maintain good relationships
with them. Additionally, he was disappointed by his perceived inability to relate
well with others and felt that he
would not be able to manage his job. He feared entering adult society. As a
consequence, he was unable to
report for work on the first day and continued to remain
FIgure 2.
Classification of hikikomori. Classificazione di �hikikomori�.
195
The phenomenon of �hikikomori� (social withdrawal) and the socio-cultural situation
in Japan today
As long as they feel unable to seek pleasure and adopt a
behavioural principle of avoiding unpleasantness, it will
be difficult for them to work and live in society.
relationship between hikikomori
and Japanese culture
While five psychological features were presented, primary hikikomori is thought to
have a low level of pathology. Therefore, to understand this phenomenon requires
understanding not only of individual pathology, but also
consideration of background socio-cultural factors. In
this final section, the views of other authors are summarized and our opinions on
hikikomori are considered
from three perspectives.
Views of other authors
As mentioned above, hikikomori is thought to have been
a problem within Japanese society since 1990. It must be
recognized that this phenomenon is rooted in the interrelations between youth and
society. In considering the
factors that contribute to hikikomori, one may look to
certain characteristics and pathologies of Japanese society over the past two
decades.
Allison wrote Millenial Monsters 23 after staying in Japan for a year from 1999
and studying youth culture in
contemporary Japan. In that book, she states that hikikomori is an event that
occurs as a result of the post-war
education-obsessed society, which forces children into a
single set of values. There are several commentaries from
other countries concerning the relationship between the
education system in Japan and hikikomori. Borovoy 24
wrote that all children are made to follow the same path
based on standardized education, while Furlong 25 also
pointed out the relationship between hikikomori and the
rigid educational system. He states that both parents and
children emphasize academic success and do not look
for other options, thinking that academic success will
lead to solid employment. In reality, however, the hikikomori phenomenon did not
occur in the 1970s and 1980s
when the education system in Japan was more rigid than
today and the �education society� in which academic results led reliably to
employment was unchallenged. This
�education society� began to change in the 1990s when
hikikomori first appeared and academic success no longer guaranteed solid
employment or a happy life.
Allison 23 and Nomura 26 referred to the relationship
between hikikomori and the IT revolution. However,
the hikikomori phenomenon first appeared in the early
1990s, while Internet usage only reached 60% in 2001.
Therefore, it is clear that the hikikomori phenomenon
preceded general Internet usage. In our experience, it is
not universal for hikikomori (especially young adults over
30 years old) to have such a preferred private world of
being absorbed in the Internet or home movies.
Considering the time gaps, neither the education system
nor the IT revolution should be regarded as direct causes
of the hikikomori phenomenon. What changes in society,
An ideal self image originating in the desires
of others rather than in one�s own desire
This following of �the envisioned ideal path,� which is
the ideal of the self that they have had since childhood,
is not an ideal they have cultivated themselves based on
their own desires or a passionate ideal in which they have
invested emotional energy based on their own longing.
Rather, it is an ideal that originated in the opinions of others. In other words,
they create their ideal image based
on others� expectations and are unable to hold onto their
own goals or ideals. As a result, a strong desire to work
toward those ideals does not arise in them.
Preserving the ideal image of the �expected� self
As they continue to live as hikikomori, the fact that they
are not following their envisioned path becomes a more
serious problem within them. If they had struggled and
lost, they could have created a new awareness of themselves from the pain of that
defeat, and faced the task of
seeking a new path. Instead, the gap between their ideal
self and actual self becomes even larger. Nevertheless,
they still cherish the fantasy of rejoining their imagined
ideal path, rather than starting from the place they are at
now. While recognizing that they have strayed from that
path, they continue to want to show others their envisioned ideal self.
Parents� investment in the ideal self of the child
The involvement of parents is an important point that
must not be ignored in considering the psychological
trends of primary hikikomori youth. The parents continue
to invest in the ideal image of their child, even after he
has grown up and become hikikomori. As therapists, we
often hear parents speak proudly of the excellence or
goodness of their hikikomori child, believing that he can
still achieve something in the future. The parents not only
support their child financially, but also may contribute to
his holding on to the past ideal image through their psychological investment.
In a previous paper 11, we discussed in detail the family
features of primary hikikomori (social withdrawal).
Avoidant behaviour to maintain the positive opinion
of others
Hikikomori avoid things that would threaten the �envisioned self� or �ideal self�.
They avoid situations in which
they may be asked by others about their present circumstances, and avoid thinking
about starting again from their
present state. Their principles of behaviour are centred on
protecting the ideal self by avoiding such situations. If they
held a strong ideal, born of their own desires, they would
probably not adopt such a pattern of avoidancy. Additionally, they do not feel a
particular desire to achieve something or to immerse themselves in something
pleasurable.
While this may not be to the extent of a complete lack of
pleasure, as expressed by the term anhedonia, it may indicate their basic inability
to seek pleasure of some kind.
196
M. Suwa, K. Suzuki
At the time of socialization, it is usual for adolescents
to resist authority or to sometimes display violence as a
result of their conflicts. The way in which Japanese youth
express their resistance is changing with time. In Mita�s
�time of ideals�, youth conflict was manifested by the formation of gangs of
hoodlums or yakuza, drop-outs from
society. In the �time of dreams�, young people rejected
American capitalism and resisted the order of politics,
and their violent campus activism and embrace of communism held sway in Japanese
society. In the �time of
fiction�, the target of youth resistance narrowed from society at large to those in
closer proximity, such as parents
or teachers. Those youth became involved in domestic
violence, school violence, or �bosozoku� motorcycle
gangs, disrupting traffic and disturbing neighbourhoods.
Next, in the �time of impossible�, when the object of resistance such as the
transcendental other crumbled away,
the energy to express one�s resistance externally may
have been internalized through the action of hikikomori.
The action of hikikomori serves not only to protect one�s
present condition, but also results in injury of self through
internal acting out at the time of initiation or socialization. Therefore, in this
light, hikikomori can be seen as
a state of contradiction between protecting oneself and
injuring oneself.
Changes in communication
The form taken in interpersonal relations among Japanese, which has been called
conformism, has changed
greatly in recent years. Such conformism was maintained
by the local community, relatives, and company organization in which relationships
were formed similar to a
family. However, after the �time of dreams� period, the
importance of the local community, relatives and the
company was diminished. While conformism has declined in Japanese society,
individualism has not yet taken root. Toivonen 29 indicated that hikikomori youth
can
be viewed as disempowered victims of the reaction to
globalization in conformist society. Both Takeda 30 and
Allison 23 suggested that this new kind of relationship
among Japanese, replacing conformism, can be identified as �orphanism�, whereas
Miyadai 31 used the term
�synchronal communication�.
Takeda 30 wrote that a new individualism has been
formed amid the rapid changes in Japanese society, leading to a social situation in
which there is no orientation
towards belonging to groups. This new individualism is
oriented toward both physical and mental isolation, the
�orphanism� mentioned above. This term �orphanism� is
a new word coined from �kojin� in Japanese (an individual) and �koji� in Japanese
(an orphan). Allison noted that
orphanism can often be observed as behaviour on trains,
and that hikikomori is one manifestation of orphanism.
Certainly, disinterest in others who are physically present
in close proximity, and who at the same time have an
obsessive focus on a distant person or information via
mobile phone, e-mail or the Internet, is the current social
attitude of Japanese, especially youth. An example is the
then, have influenced this phenomenon? We will focus
on 3 specific areas of change: changes in the social foundation, changes in
communication, and changes in the
labour system.
Social changes in general � �Beyond reality�
Based on our clinical experience and observations of changes in neurotic patients,
changes among criminal youth and
changing family problems, we sense that from around 1990
Japan�s social foundations have been undergoing considerable change. The basis of
social norms, or the standards underpinning society, have changed fundamentally.
The sociologist Mita 27 divided the period after World War
II into 3 parts using the following terms to indicate opposite of reality; the
�time of ideals�, the �time of dreams�
and the �time of fiction�. The �time of ideals� refers to
the period of pre-rapid economic growth from 1945 to
1960, the �time of dreams� relates to the period of rapid
economic growth from 1960 to the mid-1970s, and the
�time of fiction� characterizes the period of post-rapid
economic growth from the mid-1970s. In the so-called
�time of ideals�, Japanese people worked hard to achieve
post-war rehabilitation, seeking material wealth while
idealizing American �freedom� and economic success.
In the �time of dreams�, Japanese were confident of a
hopeful future and that their dreams would be realized.
Japanese society underwent tremendous change during
this period. Due to the breakdown of agricultural collaboration and the rapid
development of industry, family relationships, male-female relationships, the lives
of
women, the lives of men, the raising of children, the formation of personality and
aims in life � all changed dramatically. Each of Mita�s 3 divisions, however,
becomes
progressively unrealistic and the possibility of realization
increasingly remote. In the concept of �fiction�, there is
absolutely no intention of anything ever becoming real.
Osawa 28 explained that the mentality of the �time of fiction� is �characterized
by an attitude whereby reality is
viewed as one type of fiction, structured and framed by
words and symbols so that reality is reduced to something relative�. The fact that
youth in the late 1970s and
early 1980s were called �Shin-jinrui� (New Human Beings), who viewed everyday life
as little more than fiction,
reflects the character of that period. After that, a group of
youth called �Otaku� emerged who placed �anime� and
the virtual world above reality.
Osawa 28 suggested that the �time of fiction� gave way to
the �time of impossible� in the mid-1990s. In this society,
what he termed �the agency of a third person� diminished. This so-called �third
person� is the transcendental
other who alone can judge the appropriateness of social
standards. Without the instance of a third person, there
is no one to guarantee absolute social norms or standards and individuals are
forced to choose by themselves.
Nothing is dependent on fate in this society.
Encountering a transcendental other is what socializes
youth. This transcendental other might exist in the form
of authority figures, organizations, rules or even disasters.
197
The phenomenon of �hikikomori� (social withdrawal) and the socio-cultural situation
in Japan today
pan experienced unprecedented economic growth after
1960 until the sudden economic collapse around 1990.
These rapidly-changing economic circumstances were
unique to Japan, and are likely to have had a strong effect
on the young people who grew from children to adults
during this period.
The percentage of workers engaged in manufacturing has
been steadily decreasing in Japan. In 1975, the rate was
over 25%, while in 1998 it was under 20% and in 2010
it had fallen to 16.8%. At the same time, there has been
a rapid increase in tertiary industry workers, currently accounting for 70% of the
workforce. Therefore, most young
people today aim for employment with a company in the
fields of information/telecommunication, finance or marketing. The employment
environment has also become
harsher since the so-called �bubble economy� burst in
the early 1990s. It is not difficult to imagine that to be
hired and continue working in tertiary industry requires
higher levels of interpersonal skills and greater survival
power than ever before.
Significantly, the number of irregular employees has increased rapidly since the
early 1990s. In 1991, it rose
to 19.8%, by 2000 it had reached 26% and in 2010 had
climbed to 34.4%. Since the mid-1990s, the number of
insecure young employees who frequently change their
irregular positions, so-called �freeters�, has been increasing, as has the number
of hikikomori. The labour problem
affecting these youth, who are termed �precariart�***, has
become one of the major social issues that Japan faces
today. In such an environment, one can easily imagine
the hurdles that must be overcome in order to re-enter
society once a young person has gotten off the employment track.
Conclusions
In this paper, we:
� introduced the hikikomori phenomenon in Japan;
reviewed a number of studies about hikikomori and
identified the characteristics of the phenomenon;
� discussed the psychological features of primary
hikikomori;
� examined the impact of contemporary Japanese society on youth today.
The social problem of hikikomori experienced in Japan
in the past two decades has also been reported in several other developed countries
18-22. Might this become a
worldwide problem? In the US, after 9/11 and the recent
Lehman shock, young people appear to have greater difficulty entering society and
maintaining life on their own.
In European countries, youth unemployment is rising and
young people are also experiencing many problems in
times of economic austerity. Therefore, we need to conmany young women who do their
makeup on the train.
They are totally indifferent to other passengers and put
on eyeliner and apply mascara as if they were at home.
Miyadai 32 stated that in this phenomenon �changes of
environment such as increased social mobility make
�commitment� disappear�. As a result of this increased
mobility and developments in communication media,
close proximity and continuity (personal history) are no
longer important for personal communication in today�s
Japanese lifestyle. Face-to-face communication is becoming less common, and on-line
communication is generally considered more important. The concept of �off-line
meeting�**, now commonly used among young Japanese,
may be considered clearly describing their form of existence in which indirect
online communication takes precedence over actual relationships. Attaching little
importance to one�s immediate society, isolating oneself from
both family and local community and placing priority on
interactions in a preferred private world, has come to be
the way of life among many Japanese youth.
Miyadai 31 observed that, in the past, personal communication in which there was a
mutual acceptance or understanding of emotional experience existed not only
among family and close friends, but also extended to
one�s larger group affiliations, such as one�s company or
race. He also noted that Western �civil society�, which is
based on the assumption that people with different values
and norms defer to a universal rule or principle, has not
been realized in Japan. The art of social intercourse in
which one forms a relationship with someone totally unknown, through a process of
sounding out and gradually
becoming closer, is the essence of such a civil society. In
Miyadai�s opinion, therefore, since Japanese people can
no longer easily trust others or feel the support of their
group, they have adopted what he calls �synchronal communication�. In this form of
communication people do
not connect through emotional relationships, but rather
by having similar tastes or interests in order to feel at ease.
Hikikomori youth usually cut off their personal relationships with friends at the
time they leave their school or
job. This exacerbates their internal conflict. They do not
belong to any organizations and have no interests in
which to concentrate their attention. Thus, hikikomori
youth have neither personal communication supported
by some kind of group affiliation, nor synchronal communication supported by a
sharing of similar interests.
We differ from Allison in that we believe hikikomori are
unable to adopt an orphanistic lifestyle in which societal
norms are neglected or adopt a form of synchronal communication.
Changes in the labour system
Let us next consider the labour environment in Japan. Ja-
** This term is used in Internet communication. At first, members of a specific
site meet and chat online. Then, at some later date,
they may meet in person. Such face-to-face meetings are called �off-kai� or �off-
line meeting�.
*** The term �precariart� is a combination of the words precarious and proletariat.
198
M. Suwa, K. Suzuki
Giornale Italiano di Psicopatologia 2010;16:157-64.
15 Park KS, Kim JY, Cho CB. Prevalence of Internet addiction
and correlations with family factors among South Korean
adolescents. Adolescence 2008;43:895-909.
16 Kim H. Internet addiction and hikikomori. Human Mind
2005;123:93-9 (in Japanese).
17 Bynner J, Parsons S. Social exclusion and transition from
school to work: the case of young people not in education,
employment, or training (NEET). Journal of Vocational Behavior 2002;60:289-309
18 Sakamoto N, Martin RG, Kumano H, et al. Hikikomori, is it
a culture-reactive or culture-bound syndrome? Nidotherapy
and a clinical vignette from Oman. Int J Psychiatry Med
2005;35:191-8.
19 Garcia-Campayo J, Alda M, Sobradiel N, et al. A case report
of hikikomori in Spain. Med Clin (Barc) 2007;129:318-9 (in
Spanish).
20 Malagon A, Alvaro P, C�rcoles D, et al. �Hikikomori�: a new
diagnosis or a syndrome associated with a psychiatric diagnosis? Int J Soc
Psychiatry 2010;56:558-9.
21 Mangiarotti A. I giovani che si autorecludono: il mondo esterno
� solo sul computer. Il Corriere della Sera 2009, 11th, Feb.
22 Kato TA, Tateno M, Shinfuku N. Does �hikikomori� syndrome
of social withdrawal exist outside Japan? A preliminary international
investigation. Soc Psychiatry Psychiatr Epidemiol
2012;47:1061-75.
23 Allison A. Millennial Japan. Intimate Alienation and New
Age Intimacies, Millennial Monsters. California: University
of California Press 2006.
24 Borovoy A. Japan�s hidden youths: mainstreaming the
emotionally distressed in Japan. Cult Med Psychiatry
2008;32:552-76.
25 Furlong A. The Japanese hikikomori phenomenon: acute social withdrawal among
young people. Sociological Review
2008;56:309-25.
26 Nomura Y, Aoki S. Recent problem in adolescent psychiatry.
Igaku no Ayumi 2006;217:929-34 (in Japanese).
27 Mita M. Shakai-gaku Nyumon. Tokyo: Iwanami Shin-syo
2006 (in Japanese).
28 Ohsawa M. Fukanousei no Jidai. Tokyo: Iwanami Shin-syo
2008 (in Japanese).
29 Toivonen T, Norasakkunkit V, Uchida Y. Unable to conform, unwilling to rebel?
Youth, culture, and motivation in
globalizing Japan. Front Psychol 2011 Sep 13;2:207. doi:
10.3389/fpsyg.2011.00207.
30 Takeda T. Ko to Shuudann no aida wo yurageru Infura wo.
Nikkei Design 1998;2:38-43.
31 Miyadai S. Seifuku-syoujo tachi no sentaku. Tokyo: Koudansya 1996 (in Japanese).
32 Miyadai S. Nippon no nanten. Tokyo: Gentoh sha shin-syo
2009 (in Japanese).
sider the possibility that the hikikomori phenomenon
which emerged in Japan in the 1990s might be the first
sign of a larger disturbance in modern society in general.
references
1 Suwa M, Suzuki K. The concept of �Hikikomori� in mass
media and psychiatry. Japanese Journal of Adolescent Psychiatry 2006;16:61-74 (in
Japanese).
2 Suwa M, Suzuki K. Psychopathological features of �primary social withdrawal�.
Psychiatria et neurologia Japonica
2002;104:1228-41 (in Japanese).
3 Saito T. Present state of �Hikikomori�. Kokoro no Rinsho
Arakaruto (Clinical Psychiatry a la Carte) 2001;20:162-5 (in
Japanese).
4 Ito J, Yoshida M, Kobayashi K, et al. Report of investigation
into the actual condition among consultations about social withdrawal (hikikomori).
Guideline from the Ministry
of Health and Labor 2003 (in Japanese). http://www.mhlw.
go.jp/topics/2003/07/tp0728-1f.html
5 Koyama A, Miyake Y, Kawakami N, et al. Lifetime prevalence, psychiatric
comorbidity and demographic correlates
of �hikikomori� in a community population in Japan. Psychiatry Res 2010;176:69-74.
6 Kondo N, Sakai M, KurodaY, et al. General condition of
hikikomori (prolonged social withdrawal) in Japan: psychiatric diagnosis and
outcome in mental health welfare centers. Int J Soc Psychiatry 2013;59:79-86.
7 Kondo N. Social withdrawal in the adolescent and young
adult. Psychiatria et neurologia Japonica 2001;103:556-65
(in Japanese).
8 Kinugasa T. Young adults and withdrawing. Japanese Journal of
Clinical Psychiatry 1998;(Special issue):147-52 (in Japanese).
9 Nakamura K, Kitanishi K, Masumo H. et al. Taijin kyofusho
cases characterized by avoidant and withdrawal tendencies.
Japanese Journal of Psychopathology 1995;16:249-59 (in
Japanese).
10 Kondo N, Kobayashi M. Social withdrawal and pervasive
developmental disorders. Japanese Journal of Clinical Psychiatry 2008;37:1565-9 (in
Japanese).
11 Suwa M, Suzuki K, Hara K. et al. Family features in primary
social withdrawal among young adults. Psychiatry Clin Neurosci 2003;57:586-94.
12 Saito T, Nakai H, Aoki S. Concerning �Hikikomori(social
withdrawal)� � Topos of adolescent mind. Kokoro no Rinsho
Arakaruto (Clinical Psychiatry a la Carte) 2001;20:166-83
(in Japanese).
13 Watts J. Public health experts concerned about �hikikomori�.
Lancet 2002;359:1131.
14 Aguglia E, Signorelli MS, Pollicino C. et al. Hikikomori phenomenon: cultural
bound or emergent psychopatholoy?