Hikikomori Phenomenon in Japan

Hikikomori or ひきこもり in Japanese, a term coined by psychiatrist, Saito Tamaki, means to be “pulled inward.” The Japanese Ministry of Health, Labour and Welfare describes this term as an acute social withdrawal that has occurred in Japanese society within the last two decades. According to reports made by the Japanese government in 2016, 1.5 million Japanese people are hikikomoris in which 540,000 are between the ages of 15 to 39. This means that 1 in every 100 Japanese people are living in isolation by severing contact with the outside world, aside from limited interaction with family, and refusing to leave their bedrooms. This social condition is found more commonly in men, but in recent years, more women have become hikikomoris. In addition, while we will be focusing primarily on the youth, it is important to mention that this acute social withdrawal affects all ages. To be considered a hikikomori, one must be isolated for at least six months, although they often remain in solitude for much longer such as two to four years. Hikikomori can be traced back to the 1990s, but this social phenomenon began to emerge more prominently in around 2000, but has not been diagnosed as a psychiatric disorder due to insufficient research. However, it is considered a culture-bound syndrome insofar as this state of social withdrawal is said to be a uniquely Japanese problem. This public mental health concern is kept relatively hidden in the face of Japan’s very polished image and is seen as a taboo subject in which discussions about encouraging treatment or therapy are not often had. The hikikomori reveals darker implications of Japan as it is rooted in cultural and societal peculiarities including great pressure to conform, high standards of educational success, and strained family dynamics, resulting in an alarming increase of social recluses.

Stigmatization of Mental Health

Many aspects of hikikomori are misunderstood not only by foreigners but also by many Japanese, and this can be correlated with the stigmatization that surrounds mental health in Japan. When it comes to mental illness, it is commonly believed that the person's psychosocial factors are to blame, such as weakness of personality, rather than biological factors. Japan has the fourteenth highest suicide rate in the world, given that people, especially the youth, with severe depression avoid seeking help in fear of being ostracized and have very limited resources to turn to as a result of structural barriers with mental health services. Even if provided with resources, many Japanese still avoid seeking treatment or therapy because of low perceived need and a common desire to handle the problem on their own. It is a common stereotype in Japan that hikikomoris are "work-shy slackers" who rely on welfare and choose to be lazy by staying in their rooms playing video games. This harmful portrayal of hikikomori refuses to acknowledge that this social condition is a legitimate mental health concern, and instead puts blame on the individual. Perception of health and illness, as discussed in this course, is largely influenced by culture and because understanding of mental health in Japan is grounded in cultural shame and intolerance, many hikikomoris report feeling extremely lonely, pushing them into isolation.

Reasons for Isolation

Conformity

In Japan, there is a well known saying that translates to "the nail that sticks out gets hammered down," which encapsulates the absolute conformity that is strived for in this country. This juxtaposes the strong sentiments of individuality expressed in the West because in Japan, the desire is to be like everyone else. There are certain expectations and behaviours that must be followed in order to be accepted by others and anyone who fails to do so is quickly labelled an outcast. Therefore, many hikikomori feel as though they do not fit in despite wanting to and this fear of being shunned by their community makes it difficult to want to leave the house. It is easier to withdraw from society completely than face rejection in the outside world.

Another aspect of conformity is how Japanese people measure their worth primarily in terms of how they are perceived by others. Self-image is carefully constructed and personal issues are disguised instead of treated because of this obsession with how one is publicly viewed. Some families who have a hikikomori in their family go to great lengths to keep this a secret in order to spare themselves the humiliation of being judged by others in their social groups. This is harmful because it makes this person feel like a great embarrassment not only in their family, but in society. Therefore, family therapy is very common as part of the recovery process for a hikikomori.

Family

In many Japanese families, the father is a workaholic and almost never home, while the overbearing mother spends all her time raising her children. Some people who have become hikikomoris express how their strained or abusive parental relationships was a large factor that drove them into voluntary confinement. For example, a Japanese documentary called "Hikikomori Loveless: What Causes Young Japanese Hermits to Give Up on Real Life," follows the story of a hikikomori named Ito, who was verbally and physically abused by his parents growing up. In a society where a child's success in the future is largely determined by their academic performance, Ito's mother would lash out at him when he fell short of such expectations. Ito claims that his mother now pretends to have memory lapses to avoid addressing his abusive upbringing and has never admitted to mistreating her son. Ito has spent many months locked in his bedroom playing video games, listening to music, and browsing the internet. The only interaction he has with another person is with his mother, but their conversations are very limited. Ito's story is one of many which reveals that traumatic childhood experiences can be linked to mental health concerns, and without proper help, can lead to situations of self-imposed confinement.

Education

Japanese students are put into highly pressurized learning environments because an entrance exam before applying to universities is the sole determinant of a successful career in the future. This puts many students under unbearable stress and some are driven to the point of complete burn out or withdrawal. This immense pressure to succeed is correlated to a deterioration of physical and mental health. On top of this pressure to excel, many students have to face the disappointment from their parents if they fail to meet their expected standards. For some, school becomes too distressing, which triggers an acute social withdrawal.

Bullying

Many hikikomoris experienced merciless bullying when attending school. In Japan, most cases of bullying involves a group of students inflicting unrelenting psychological (and sometimes physical) torment on a single victim.  These victims usually do not "fit in" and go against expected conformity that is engrained into these children's minds at a young age. Bullying becomes a group phenomenon with very little intervention by teachers who are not trained to identify these signs of severe mistreatment. With no one to turn to for help, many find safety within their own bedroom, but never receive proper treatment to help themselves properly recover from the psychological traumas that can arise from bullying.

Cram Schools

At a very young age, some Japanese parents place their children into an after-school program called cram school which typically runs for a few days and the students sleep overnight at the school. The children are taught by an elite group of teachers and they must follow a vigorous routine of studying for up to thirteen hours, taking an exam at the end of the day, going to bed, then repeating this cycle very early the next morning. Cram schools are meant to provide additional preparation and put these children at an intellectual advantage in hopes that they will do better in their college entrance exams. This type of institution demonstrates the pressure that is placed on these children at a young age and in some cases, it creates hostility between children and their parents, or with the education system. Furthermore, cram schools have been regarded by some as educational abuse and received criticism for the potential violation of a child's rights. There is a lack of research that explores the ethics of cram schools considering that educational abuse is not covered by the law in Japan; however, it should be noted that some hikikomori become socially withdrawn after being forced into these intense learning environments.

Gender Differences

The population of hikikomori is mainly men, despite the growing number of women becoming socially withdrawn. The reason for this ties with the idea that hikikomori is not only a mental health concern, but also a result of societal pressures and influences. In Japan, high gender inequality still persists especially in the workforce and stereotypical gender roles continue to lay the foundation of society in which the husband is expected to be the breadwinner with a stable job while the wife stays at home to take care of the children and perform household duties. Construction of masculinity in Japan revolves around this expectation that the man will have a successful career to provide for his family and failing to fulfil this duty is an attack on his manhood. This pressure to succeed begins very early in their academics and many fear that they will not meet this cultural expectation. From a heteronormative perspective, a man failing to have an honourable career in Japan is also in connection with the difficulty of finding romantic relationships with women because these men are seen as less worthy. Therefore, James Roberson, a cultural anthropologist at Tokyo Jogakkan College, explains that hikikomori is a resistance to this pressure of being successful and the idea of what it means to be a man. On the other hand, for Japanese women, their career does not define whether they are an acceptable member of society to the same degree that it does for men, which can help explain why more men are hikikomoris compared to women.

Reintegration

Treatment and Therapy

Hikikomori has received increased public attention, yet an effective clinical approach and strategy of treatment is still underdeveloped. However, current treatment involves a combination of psychotherapy and psychopharmacology. Many parents seek help by visiting psychiatrists, psychologists, or self-help groups for families of hikikomori because they are at a loss with how they can help their children recover and assimilate back into society. In addition, exposure treatment to gradually increase social contact, family therapy, and psychotherapy focused on childhood trauma are the several types of therapy being implemented into hikikomori treatment. For those who are complete recluses, the first step usually involves frequent home visits in order to encourage a hikikomori to leave their room.

Jogging Therapy

A research study conducted by Masaki Nishida et al. from Jichi Medical University, determined that jogging is an effective form of therapy for hikkimoris who suffer from symptoms of depression and anxiety but also low self-esteem. This study followed the progress of a twenty-year-old Japanese male partaking in exercise therapy after being hospitalized for treatment due to his severe social withdrawal. He was asked to jog for thirty minutes, three times a week for three months. As a result of this routinely exercise, his social withdrawal improved tremendously in addition to his pharmacotherapy. Although the medication helped to alleviate some of his depressive symptoms, the case report demonstrates that jogging therapy was beneficial for boosting his self-confidence because it strengthened his resilience and stimulated certain neural networks in the brain.

Support Groups

Support groups have found some success with helping recluses reintegrate themselves back into society through strategic practices such as creating a trusting environment where they are not labelled as "patients" and motivating them to gradually participate in social activities. Hikikomoris who attend support groups have also reportedly shown increased self-confidence.

Hikikomori News

A great example of a support system is Hikikomori News which is a bi-monthly newspaper that began in 2016, and is written for Japan's community of social recluses. The creator, Naohiro Kimura, who was an on and off hikikomori for ten years himself, hopes to achieve a sense of solidarity and mutual understanding through his newspaper and his goal is to encourage other hikikomoris to step out. This newspaper organization holds meetings where hikikomoris get together to have an open conversation, forming a close community. The writers at the newspaper make an effort to change the Japanese public's perception of hikikomori by showcasing that this social condition can come in many different forms, and that the stereotype of a young male confined to his bedroom, playing video games with zero contact with the outside world is not a representative one. In addition, other types of media such as social media has allowed for hikikomoris across Japan to form friendships and find comfort in knowing that they are not alone. With that being said, the narrative of hikikomori has long been misrepresented through public scrutiny in Japan, thus, Hikikomori News has provided a platform where they are finally given a voice, and a chance to reframe their story.