A Window into Hikikomori, an Increasingly Global Syndrome of Shutting Out Society (1.5 CEs)

This case discussion presents a classic case of hikikomori in a male adolescent in Japan. The first presenter will describe hikikomori, a phenomenon and syndrome once unique to Japan, but increasingly found worldwide. It is a condition whereby an individual becomes an extreme recluse. Individuals with hikikomori often experience severe interpersonal distress, resulting in significant or sometimes a complete shutting out of relationships with others. In Japan, hikikomori has become a critical social issue, currently affecting an estimated 1 million adolescents and adults. Understandably, the nature of this condition makes it difficult for the people affected to seek mental health services, making this syndrome difficult to treat. While hikikomori is viewed to be more socially acceptable than a psychological diagnosis, the utilization of mental health services to treat it remains low. For those with hikikomori, part of the issue might be the nature of social disengagement. It is suspected that a sense of shame, which is already challenging in countries such as Japan, might be the underlying force preventing individuals and their families from seeking help. The second presenter will present the case of an adolescent male with hikikomori, including a review of assessment findings from the Rorschach, MMPI, WAIS, Wartegg and Adult Attachment Projective. The third presenter will explain the shame dynamics present in the Thurston Cradock Test of Shame (TCTS) protocols of the adolescent and his parents, and will address the impact of shame on this family’s struggle with hikikomori. A question and answer period will follow, to address the unique challenges of shame and this syndrome in Japan, as well as in other cultures.

Chair

Julie Cradock O'Leary | Private Practice

Discussant

Leighko Toyoshima Yap | Private Practice 

Goals & Objectives

1. Describe the characteristics of hikikomori
2. Describe the connections between hikikomori and shame. 
3. Discuss family and cultural dynamics that can influence hikikomori symptoms.