Hikikomori- The

Japanese way of
loneliness

Kornel Nawrocki
 Introduction
Since contemporarily the public attention is brought to problems such as global
warming, covid pandemic or political tension, people have tendency of overlooking fringe
issue. For instance, the phenomenon of Hikikomori would not be recognizable for the
majority of people, as it can be considered as a local problem, originated in Japan. However,
I would like to explain, how that problem may affect some people, even from our
environment and through this discourse, spotlight the depth of problem of social withdrawal.
Considering most of its roots, characteristic of behaviour of diseased person and advisable
ways aiming to help them. Finally, I would like to feature, which actions are organised to cure
that problem.

What is hikikomori
Hikikomori is a Japanese term, actually it is abbreviation from shakaiteki hikikomori
which shakai means ‘society’ and teki is a suffix added to create an adjective, and hikikomori
is translated as ‘withdrawal’. Therefore, in this essay, terms (social) withdrawal and
hikikomori are used interchangeably. It is it is difficult to define what exactly hikikomori is,
whereas it has not been diagnosed as a disease until the late 90’s. However, recently the
unison appears among psychiatrists and hikikomori can be described as a “form of
pathological social withdrawal or social isolation whose essential feature is physical isolation
in one’s home”. 1
Major contribution to development the concept of hikikomori had Saito Tamaki,
currently a professor in University of Tsukuba, specialist in adolescent psychiatry. Between
1983 and 1988, he conducted research on patients who did not leave their homes or left them
for an extended period of time. He is one of the first people who observed this phenomenon;
he introduced and popularized the term hikikomori, and he continues his activities for this
until now.
Because of socio-cultural differences, in Japanese society psychiatry has not been
developed for a long time, which up to now has implications for contemporary inhabitants in
Japan. Kawai Hayao played a significant role, both for the recognition (certification of clinical
psychologists), and development (creation of the school counsellor system) of clinical
psychologists in the late 1990s, and the 2000s.
Meanwhile Tamaki pursued to spotlight the issue of hikikomori and bring it to public
attention as it was very little-known problem, often underestimated by most of Japanese
people and finally provoke a public debate among psychologist, counsellors, and psychiatrists
to improve the situation of withdrawn people and enhance their role in society. Although it
an enormous amount of work and a long time to bear fruit, which has paid off in the long
term, as it will be discussed later.
According to medical diagnose, hikikomori begins with a period of withdrawal that
prolongs for more than 6 months, when person is unable to function in society. Social
withdrawal, in majority, affects adolescent people who are vulnerable for excessive pressure
of environment and other social factor which are in some part related to Japanese culture.
Thus, most cases are men (80%), since in Japanese culture, men are overburdened with
expectations from society. Furthermore, those cases include in large part oldest sons, what is
based on the expectations of that person (as a future head of household). In average, the age
of first symptoms appearance is 15.5-year-old and average time elapsed between first
symptoms occur and the treatment is taken is 4.5 years. Admittedly it is not recommended
to keep the withdrawal on for a such a long time, though the problem of hikikomori is widely

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ignored and in most cases first attempts for treatment are taken too late. That affects the
treatment extending it. Longest reported period of withdrawal was 168 months (over 14
years).
For most people from western world, it can be though to understand, why since the
problem is pervasive, it is hardly ever to receive a help and overcome this disease. In Japan,
even families who are extremely modern, forward-thinking and participate actively in society
tend not to speak up when it comes to talking about their own child being in a state of
withdrawal. In some cases, parents try to avoid the problem of hikikomori pretending it does
not affect their families, which makes child even more withdrawn from both society and
family.
As in 90’s when the problem was spotlighted for the first time, it was admitted that it
affects youth and young adults. It is true, but the fact remains that Hikikomori appear to be
growing older. According to the survey2, the average age of hikikomori now has reached 32.6
years of age. It is associated with the extreme cases of long-term withdrawal for over a decade.
In respect of Hikikomori’s extent, it can be recognized as a social phenomenon affecting the
entire Japanese nation. To make matters worse, many Japanese people reject the existence
of that disease or qualify their symptoms as sort of weakness. It leads to vicious circle of
society avoiding a visible problem, and people left without any help.

Is it mental disorder?
If we tried to think, why social withdrawal is a such underestimated problem, we
would come to conclusion that it is not considered as an illness in the full sense. Hikikomori
has not been defined as a particular disease. It is a particular state that develops in
conjunction with certain environmental factors (that occur especially in japan). However, it
can be changed by taking treatment, improving relation with nuclear family and surrounding
environment. Social isolation, which is one of the symptoms of social withdrawal is caused by
mental distress. When the person isolates more, they experience more mental distress which
discourage them to reestablish connection with environment. This vicious cycle demotes
many people with severe mental illness to a life of social segregation and isolation.
From a psychiatric point of view, social withdrawal is one of the possible symptoms
among neurasthenic or nervous-tempered individuals (or being labelled by psychiatrists).
Moreover, comparing to typical defined mental objects e.g., menopause, depression,
schizophrenia, and disability, hikikomori is neither medical nor well defined. This
phenomenon of hikikomori as an arguable and ill-defined medical object, despite its high
reach, make it extremely difficult to produce a consistent monograph on the subject. So far,
the most crucial thesis about hikikomori which has been written is “Adolescence without end”
by Saito Tamaki3, which brought many significant information used in this essay.
Simultaneously the dramatic increase in developmental disorders, autism and school
nonattendance is observed. Other factor of Hikikomori development, next to mentioned
above, is stereotype of Japanese students overburdened with peer pressure, stress
accompanying entrance exams, to high school, university etc.
Altogether, it is significant to understand social withdrawal as a pathological system
that involves both society and family as well. Hikikomori is not a disease entity (defined for
example as schizophrenia), but a psychological disorder with a social background.

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 Analysis of withdrawn person
For many people, unfamiliar with issue of hikikomori it would perceive withdrawn
people as lazy and uneager to return to society feeling comfortable isolated from other
people. Nonetheless is more complicated and not everything is so obvious.
Whist the average length of time for the period of withdrawal, according to the survey,
was thirty-nine months (3 years and 3 months), it can prolong in some cases to over a decade.
During the time of isolation, one is vulnerable for many actions that are likely to extend the
period of withdrawal. Person in withdrawal hardly leaves their house or even their room. They
prefer to coop themselves up instead of exposing themselves to unpleasant things. Only slip
out to the bathroom, assured before they would not face anyone. In extreme cases withdrawn
person is unable to consume food with their family and ask them to leave the meals in front
of the door of their room.
In most cases people suffering from hikikomori have reversed cycle of day and night.
They stay active during the night, playing games, watching anime, reading manga’s or surfing
the internet, while sleeping during the day. It helps them to avoid eventual encounter with
other household members.
It may not seem obvious, but hikikomori do not experience a boredom even though
they spend most of time doing nothing. Their minds appear to be occupied, not giving them
the psychological space to feel boredom.
The average family environment is middle class or above and there were relatively few
families where the parents were divorced. It is tough to imagine that issue affects mainly
wealthy people, which is rather uncommon comparing to other contemporary problems like
poverty, depression etc. The stereotype adolescent teenager, who belongs to thriving family,
is being pushed by the parents, peers and teachers for better results and is forced to avoid
any failures. It leads to mental exhaustion and feeling of inability for prospering in society and
it follows the school nonattendance which is the first major symptom of hikikomori. In survey,
90% of hikikomori cases went through period of skipping school but skipping school does not
immediately lead to social withdrawal.
Another unobvious thing is that hikikomori do not chose on their own to keep living
apart from society. They are willing to escape from their withdrawal more than anyone else
is, but they are unable to do so, thus they stay withdrawn for such a long time. It requires the
great workload to overcome that mental state. The major difference between depression and
hikikomori is that, whilst the people with depression are left without any willingness to live,
the hikikomori are still eager to overcome their situation, but in both cases, it is extremely
tough to get over it. One of a factors of vicious circle of hikikomori is that people in withdrawn
state are constantly criticized by society, as they are not able to meet social norms. People
think that since Hikimori are able to function in society (e.g., attend school or get a job), they
are just idle and do not deserve any kind of help.
However, as it was mentioned before that average age of starting social withdrawal is
15.5-year-old, hikikomori in the vast majority affects adolescent people. After one has
achieved high level of social maturation, along with age, then it is rare for person to enrol into
state of social withdrawal.
According to Saito Tamaki’s survey, other triggers which sent people into a state of
social withdrawal are unclear (39%), problems related to people other than family (38%),
discouraging experiences having to do with academics (18%), changes in the school
environment (10%). Thus, it can be concluded that the origin of hikikomori is in relationship
with people and environment rather than in one’s health.

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 Even though it would seem that withdrawn human beings are prospering well despite
cooping themselves up, they still suffer from many mental disturbances. For instance, they
perceive majority of people as bringing potential threat to them, thus rejecting any help from
others. Furthermore, they are extremely vulnerable for being hurt and are afraid of possibility
of it. Particularly critic towards them.
Most of hikikomori affected people have hardly any acquaintances because of
spending most of the time within their home, hence household is the only place they belong
to, and thereby have any bond with. It leads to either escaping from any sort of contact with
immediate family or excessive attachment to them. Which takes different forms in behaviour.
In extreme cases, withdrawn person might engage in violent fits in the household, as it treats
family members as if they were a part of their own selves and fail to recognize them as
independent people. Sometimes it leads to greater violent outbursts when withdrawal person
abuse on other family members. Another form of violence of people with hikikomori
syndrome, is having too close bond with mother and becoming dependent from her
completely, engaging her to pay most of attention to withdrawn child. At that time, one tends
to think that “they would not know what to do if they had lost their mother. What is more,
hikikomori tend to have feeling that everyone around is observing them, (neighbours
particularly), which is an often excuse not to leave a house, whilst arguing with family.
Even if parents think that child is avoiding the outside world on purpose, it is likely
they are wrong. As the matter of fact, withdrawn children often share the same set of value
with parent, more than the family ever realize, hence they aware of their situation and
worried.
As it was mentioned before, withdrawn people are more vulnerable for negative
emotions and actions towards them. Thus, they feel extremely uncomfortable when it comes
to talking about things which triggered them to shut up. They also feel anxiety about their
future and regret their situation, but simply do not know how to fix it. They feel
disappointment about their situation, but also feel inability to go outside. However, despite
their efforts to return to society, in most cases they forget about any joy which they
experience in tome prior to withdrawal. When the period of withdrawal prolongs for a longer
period of time, additional symptoms may occur. One of the most seemingly visible is
impoverished ability to conversate, caused by limited contact with other human beings.
Nearly half of people in advanced stage of withdrawal is affected by this issue even with their
own family.
Broadly speaking, people in social withdrawal suffer as much as people with other
ailments even though hikikomori is not defined as a particular disease. Hikikomori is caused
partly by other mental issues, that origins in a personhood, which will be discussed below.

Psychological origin
There is an element of truth in the thesis that development of hikikomori comes from
environment to which one belongs to. Undue pressure and steep expectations impact the
mind of adolescent human being. Furthermore, those children are left without any mental
health, as weakness in Japanese society is perceived as pathetic and unbearable. According
to Tamaki, there are many withdrawn teenagers in Japan who does not seem to suffer from
any major mental disturbance, whilst suffering invisibly seemingly. As it was mentioned
before, majority of withdrawn people are men, especially oldest sons, but obviously they are
some cases involving women. However, when women begin to withdraw from society, their
behaviour tends not to last for an extended period of time.

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 Social withdrawal is a symptom that accompanies various other mental conditions.
Accordingly, psychiatrists tend to diagnose hikikomori as the accompanying of other mental
issue such as a strong fear of others (antrophobia) or having obsessive-compulsive disorder
(according to survey, 53% of hikikomori cases also experience that kind of disorders, those
people are obsessed with cleanness of other household members, but their rooms are
cluttered), Insomnia (68% required sleep-inducing drugs, 81% have reversed cycle of a day),
Regression (it is a mechanism arising from withdrawal state, related to excessive bond to
mother mentioned before. Instead of illness, 44% have involved "instability with family
members", after a long period of time spent in home, according to Saito Tamaki. People with
this syndrome have tendencies of behaving infantile and selfish as they gradually lose their
contact with society), refusal to eat or overeating, addition to intoxicants (such as painkillers
or cough suppressants).

Other psychological ailments that can accompany social withdrawal are:

schizophrenia (but withdrawn does not experience hallucinations and similar symptoms but
in both diseases one is isolated from environment and lost the contact with society, in
hikikomori cases it is easier to reestablish connection with outside world), apathy (when the
individual avoid competitive situation which causes the difficulty to develop one’s identity),
avoidant personality disorder, borderline personality disorder and the most significant,
depression. The last one ailment occurs when patient does not seek for help from anyone. It
is likely for one to develop depressive state as a secondary disorder, which compound their
mental state. While staying cooped up in a room it often leads one to loss of willingness to
live or suicidal thoughts. Withdrawn adolescent also experience feelings of isolation,
emptiness, or despair.
All secondary symptoms are making withdrawn person ever more unwilling to return
to society. To make matters worse majority of symptoms will not disappear without receiving
sort of treatment and participating in society.
Compared with ordinary diseases within the body, when individual grows sick, their
bodies will react naturally including immune responding to overcome a disease. However, in
case of withdrawal, the unhealth state does not decline but it makes the situation worse
and even prolonging it. People suffering from hikikomori do not lose their contact entirely,
but rather do not find themselves in situation where all channels for communication are cut
off completely.
Even though one’s symptoms are not getting worse, they still find themselves in a
need to continue withdrawal. The reason why the state of withdrawal last for such a long
time (contemporarily it often prolongs for over a decade) may have origin in unfavoured
attitude of Japanese society towards hikikomori in which both sides neither does cooperate
nor understand each other. It leads to the development the vicious circle of hikikomori that
escalates the phenomenon on a large scale. It can be described in the following steps. Firstly,
the individual receives unbearable pressure from society which leads to frustration. Secondly,
it avoids their problems and shut themselves in and refuse to contact the outside world. Then
it develops the state of hikikomori, whilst family become anxious about the mental state of
withdrawn member and pressure on them to go outside. Afterwards, it makes individual even
more anxious and uneager to return to society. Hence it is extremely hard both for family
members and withdrawn individual to manage to reestablish communication between
themselves. The recommended method how to conduct that therapy will be described
afterwards.

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 Fortunately, according to newest observations, psychiatrists agree that the adolescent
mindset lasts until the one reaches the age of thirty, and then it is more likely to manage to
return to society. Despite the psychological origin, the cultural factors exist and have a great
influence in the development of Hikikomori, and they will be elaborated further.

Cultural Origin
Similarly, another crucial factor which has contributed to development of hikikomori
is Japanese society. If one wondered whether issue of social withdrawal is strongly associated
with Far East culture, the answer is yes. Throughout last century, specific features have
developed in Japanese society that make life in Japan very difficult, especially for working
men. In Japan, duty of obedience and devotion to superior is deeply rooted in culture of Land
of Rising Sun. Like in medieval Japan the warrior was obligated to absolute submission to his
feudal lord, contemporarily the employee is expected to consecrate his private life for
additional work, which leads to numerous overtimes spent in a workplace and limited contact
with family, which is related to problem of hikikomori, as it will be further elaborated later.
Beginning with early childhood, Japanese mothers tend to spoil their children trying
to guarantee them everything possible. Thereby they act relatively selfish, as they satisfy
themselves with the fact that they treat their children the best. Insofar as that does not
prepare the child to prosper in society with rife difficulties. Once it enrols into primary school,
comes the shock to reality. From this point forward, the child finds the life extremely tough
to manage, and it requires several years to settle into functioning customarily. Along with
passing years, the school environment put more pressure on a pupil, (including social
expectation to try harder, curriculum, having multiple talents etc.) It is socially acclaimed to
enrol children to extracurricular activities such as sports (kendo, baseball, martial arts), music
(playing violin, piano) and cram schools after ordinary school where pupils prepare for exams
and take tutoring. In consequence all children experience chronic exhaustion back to early
childhood, minority of them does not manage that life path and begin to avoid their problems,
for instance by school nonattendance which can be considered as an early stage of hikikomori.
Moreover, in Japanese culture, weakness and disability is negatively perceived and socially
excluded, hence it is favourable to phenomena such as hikikomori or depression.

Whilst the period of schooling comes to end, the student struggles with entrance
exams for university. Among Japanese it is intensely admirable to attend the one of top
universities such as University of Tokyo or University of Waseda. It is since during job
interviews, the name of graduated school matters more than owned abilities and skills. After
one land a job position it will come up through the ranks, increasing its salary, until
retirements. In Japan it is highly common to remain in the same company until retirement.
Since post-war period, in Japanese work environment certain expectations have been formed
towards workers. It is widely desirable to sacrifice private life to spend most of one’s time in
a workplace with colleagues. In some cases, overworking until night hours contributes to
some mental problems, which may threaten one’s life. The specific term was formed, Karoshi
means the death from overworking. Interestingly it has some correlation with heart problems
but is mainly caused due to chronic stress and excessive agitation. In 2011, over 2,700 people
have died due to that disease.

As long as that working model wad profitable and was contributing to economic
growth, no one has perceived it as pathological and spotlighted its drawbacks. Nonetheless,

6
it has changed in the early 90’s. So far, Japanese economy and society had been advancing
rapidly and Japan was expected to surpass the USA. Nevertheless, in 1990 the property
bubble has burst, which later contributed to the economic downturn and visible slowdown in
development. Consequently, an economic crisis that left many people entering the labour
market jobless. It affected those people’s mind and pushed many of them into mental health
problems such as depression or hikikomori. Furthermore, during 90's there were insufficient
number of psychiatric clinic and psychotherapists to treat hikikomori. Thus, many adolescent
people, disillusioned with promises about decent job perspectives have been rejected and
society. Part of them have shut themselves in their house or committed suicide. Additionally,
many elder people underestimated their problems as they have been growing up during the
times of welfare when everything was open-access, and now perceived those people are lazy
and incompetent to find job. Collectivistic societies assume that one who does not work,
does not deserve to eat, hence disabled person, both physically and mentally. Unfortunately,
Japan has that way of social thinking. Therefore, he problem of hikikomori has been
accumulating for a long time, as all sufferers are left without any prospect of support.
In fine, most hikikomori cases come from well-educated parents. It is common to find
households where father is engaged into his job and neglects relationship with family and
when overbeating mother who pushes her children to work as hard as they can. Furthermore,
social withdrawal seems to appear in the most average Japanese families, hence that problem
is deeply linked to some pathology in contemporary Japan

Can we consider Hikikomori as a substantial threat?

If one wondered, whether Hikikomori is affecting them, the obvious answer would be
“no”. Even though the problem of social withdrawal is strongly related to Japanese culture, it
can be observed in countries like South Korea, Taiwan, Singapore, or Sweden. In Korea around
300 000 people suffer from hikikomori. However, in Korea there is system of requirement for
young men to spend part of their lives on military service. Moreover, problem of withdrawn
youth is correlated with addiction to online games, when teenagers trying to escape from
harmful reality, cooping themselves up in their rooms and spend day and night on playing
video games (e.g., League of Legends).
It may not be apparent that, likewise Asia area. that issue has impact also on
Scandinavia. That may be rooted in cultural origins, particularly Protestantism. Similar to
Japanese culture, including the one mentioned above, a collectivist mindset prevails that
obliges everyone to work. Moreover, both these countries are relatively wealthy, so the basic
human’s needs will always be provided. Therefore, many adolescent individuals lose their
willingness as they cannot feel neither fulfillness nor satisfaction. Specific Japanese term
“Ikigai” was created. It is combination of what one loves, what one is good at, what the world
needs and what one can be paid for. In highly developed countries, loss of ikigai can be
observed, as people could not find themselves suitable to anything, and spend their time for
wasting away.
Resemblant to hikikomori term of „NEET” was created to describe youth and young
adults who are not able to either live on their own or find a job. That phenomenon notably
influences English adolescents. It is strongly correlated with lack of possibility to achieve any
crucial success. It affects people in poverty who do not have chance for social advancement,
unlike hikikomori which affects wealthy people with mental burnout or exhaustion.
Fortunately, it is not likely for worldwide epidemic of hikikomori, as it a product of
certain social factors and is deeply rooted in Japanese culture. The major difference between

7
Japanese and western mindset is that in western part of world, the individuality is highly
desirable and required on labour market, whilst in Japan is socially demanded to follow the
environment and not to stand out. Regardless, In Japan, the hikikomori phenomenon affects
hundreds of thousands of individuals: between 696,000 and 541,000 aged 15–39 and 613,000
aged 40–64, but that survey did not include adults, hence the amount of total people is likely
to be much higher. Nonetheless In 2020, the hikikomori population aged 15–64 is roughly
estimated to be around 1,154,000 people nationwide. Social withdrawal situations gradually
increased since the 1990s, until they became a “social problem” (shakai mondai) in the early
2000s and a global issue in the 2010s.
To makes matters worse, in 2000, over 1 million of Japanese suffered from depression
(in country with population of 127 million). Meanwhile the Japanese government is not able
to help the inpatients, as their country is struggling with severer issues such as economic
recession and aging population. It is estimated, that until 2050, Japanese is going to lose 1/3
of their population. Thereby problem of social withdrawal is avoided for over 20 years. The
japan is also struggling with “Parasite singles” - unmarried people who continue to live in their
familial household even after graduate, relying on their parents for the basic conditions of
their existence, but have not achieve a state of social withdrawal, this problem translates into
a demographic disaster.
To summarize, they are few countries that reported hikikomori cases, as it is problem
directly linked with Japanese environment and is not likely to spread on the entire world.
However, in Japan that problem is threatening to all society and cannot longer be avoided.
Accordingly, Saito Tamaki, in his book “Adolescence without end” described how to deal with
withdrawal individual from your own environment, as it will be discussed followingly.

How to deal with hikikomori?

One thing that is sure about dealing with social withdrawal is that by the time the
patients are brought in for consolations, they are already in bad state in most cases. Average
length of time elapsed between beginning of withdrawal and first clinical treatment was 23
months, thus it is necessary to diagnose as soon as possible as it goes worse with time.
Thereby, to prevent the development of hikikomori, the treatment is obligatory. Overall
treatment includes 2 major steps: firstly, restore the point of connection between individual
and family, secondly restore the connection between individual and society.
Family ‘s engagement is crucial during treatment because they are only people who can make
one receive treatment, without them, one can literally lost all connection with society without
possibility to come back
Firstly, it necessary to accept that the person in withdrawal needs some sort of help,
protection, and treatment. Parents should not accept withdrawn child denial for help, even if
rejection from child is a common thing. Hence, initially parents should pursue gaining a trust
of their child. Nevertheless, that stage is the most difficult as teenagers in withdrawal tend to
avoid seeing other family members, let alone getting in touch with them. It is absolutely
necessary for family members to understand, that their child is suffering from a disease and
needs a proper help, although it is extremely tough in Japanese culture accept the fact of
being weak in some way. Even if the withdrawn one hesitates from making a conversation, it
is recommended to make them aware of their existence (and thereby importance) for
instance by making greetings to child (but without expecting a response), then trying to
initiate small talk about for example weather or their mood, and subsequently make one
engage child into responding to banal questions (e.g., what do you want to eat). If that goes

8
well, parents should attempt encouraging child to start a conversation on their own, the
family is simply aware of appropriate means of handling the situation,
then it is possible to significantly alleviate the suffering of the child. However, whist having a
conversation with child, one should not expect them to take anything for granted, eventually
if them do not understand the context or stutter to talk, give a child the further explanation
and give a hint how to respond.
Nevertheless, if a withdrawn child keeps rejecting help, it is forbidden to push on them,
it takes appropriate period of time to give desirable results. While talking with child, there are
some things recommended to avoid talking about such topics as school, work, peer, marriage,
any other expectation or even future. Particularly parent must not mention the trigger which
sent one into a withdrawal state. It is also forbidden to say withdrawn one that they are
"selfish", "spoiled" "self-centred", or anything that could one feel uncomfortable. Although
parents should not overreact or at let child know about parents’ dismay because excessive
pressure does not encourage child to reopen for connection with the society. If the
reestablishing the relation with a child brings a fruition, child may give hints with hidden
messages, thus parent should pay attention to everything one says. As it was prior mentioned,
Japanese fathers tend to escape from their problems and spend most of their time with
colleagues. Therefore, they neglect the relationship with family, especially with a withdrawn
child, however this is not the way how to solve a problem, and it is advisable for father to
start carrying attention about his child.
When it comes to mother, withdrawn youth tend to feel strong allegiance to their
mother. When it occurs, it is necessary to make them aware that mother is independent being
and create awareness that they live regardless from her. What is more, if child start to give
their parents trust, they will show kind of grudge and clearly manifest it, for instance by
confessing to them, that they are responsible for their mental state, and it is their fault.
Sometimes, it is true that excessive expectations from parents translate to mental breakdown,
but it should be obvious for parents not to take everything one say for serious, but simply
draw a conclusion and keep carrying about their child.
If the child’s relation with a household seems to improve, and withdrawn one is eager to
receive help, it is recommended to come to the child to about importance of a problem in
way that could slightly encourage one to start a treatment, as it is necessary to return to
functioning in society having re-established connection with family. However, it still requires
a proper moment to tell a child to start taking counselling
As it is quite rare for child to persistently resist from starting a therapy, in minor cases
one starts to throw a temper tantrum when parents start to initiate the treatment (as a
personal refusal) but after starting the treatment such symptoms will not continue for long.
When it prolongs, it may turn into domestic violence. When child behaves abusive towards
other family members, it is extremely necessary to take a refuge, due to the fact it is the best
way to solve that kind of problem even though it is time intensive. Whilst taking refuge
outside the home, it is necessary to consider following facts:
• Parents should consult with therapist about way of leaving the home, prior to that
action
• The immediate trigger for leaving the home should be a violence outburst.
• Parents have to leave the house on the same day the violence is taking place

• Parents should call the child on the same day afterwards leaving and assure the child
they will stay in touch with them, and they return the home when violence will stop


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 • Parents should not get blackmailed by the child, even though one may beg them for
comeback
• Parents should say they will not come back until child will take a treatment, and not
even consider a comeback until the child’s violence will decline
• Parents should contact child periodically for maximum 5 minutes and hang up always
when the conversation exceeds that time in order to make the child disciplined
• Parents should stay in touch with therapist during entire refuge

• Prior to comeback, it is advisable to initiate a few meetings with child to assure if one
behaves properly towards them.
• It is expected that the refuge will take certain period of time (between one and several
months)
Since parents and the child have reestablish the point of connection, parents must make
child to start a treatment.
In case when the withdrawn one does not make problems with starting a therapy, it
is significantly easier to develop a relationship of deep trust with a doctor, which is the most
important thing for patient. However, parents also should have reliance on child’s therapist
as if psychotherapist explains clearly how they should go about dealing one’s issue,
then situation becomes more stable for the family, who now have confidence their child is
receiving professional support. Although Parents have major contribution to disengaging their
child from hikikomori syndrome, thus if they will not cooperate and act cooperatively, it is not
possible to expect sufficient recovery.
Throughout therapy, one is given by therapist to help understanding to vital things:
social withdrawal is not easy to cure if treatment will take certain time and dedication it is
going to work out and make the withdrawn one return to society. Regardless of that, it
necessary to let the patient overly attach to therapist and remain role bounds, and it is
forbidden particularly to create romantic relationship with therapist. There again, when the
treatment goes off with effectively, the following phase is to encourage relations with outside
world, for instance by initiated meeting with other people struggling with similar problems,
but for such appointments it is recommended to choose place where people would cut off
from external incentives and focus on communicating with other people, whilst having a
psychological supervision on standby. Regarding therapist, there are many who consider that
social withdrawal should not be used as a diagnosis by medical psychologists, instead,
psychologist should be providing diagnoses based on the other symptoms that accompany
withdrawal.
When the treatment is coming to end, the child should be once more capable of
functioning in society and manage to prosper in their ordinary environment, likewise one was
in prior-withdrawn state.
In brief, although hikikomori is also an ailment, it requires extremely different
approaches for treatment, comparing with physical diseases. However, the period of
treatment, may be fair longer and engaging the whole family, as they are obligated to help a
withdrawn child in order to help them in returning to society. Still, it involves medical
treatment. Nevertheless, there is not sufficient psychotherapists in Japan to handle all
hikikomori individuals. Below, it will be elaborated, what Japan does to treat hikikomori
leastwise.

Which steps are taken to treat Hikikomori?

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Following the economy collapse in early 90’s, the great number of unemployed young people
have been pushed into mental burnouts or ailments and loss of willingness to live.
Nevertheless, on that time, the Japanese psychiatry has barely existed, thus those people
could not seek for any help. On this account, in 1991 the Japanese ministry of health and
welfare started a programme called "Model project of countermeasures for the welfare of
withdrawn and truant children", which aimed to supply a counselling supervision for
adolescents. However, people older than 18 years old were excluded from treatment, thereby
majority of hikikomori cases, (estimate 90% of cases), as meanwhile it was thought that
problem of hikikomori affects merely youth. Moreover, along with time elapsing and aging of
Japanese population, hikikomori become even older and contemporarily the average of
withdrawn one was 31 in 2011, hence nowadays it may be much higher.
In 1992, whilst discovering the scale of the problem Saito Tamaki, conducted the
survey about proposal activities to help in returning to society. Accordingly, discussed before,
psychiatric day-care facilities (56%), a part time job (53%), an acquaintance or relative's
workplace (33%), an organization for people with similar hobbies (25%), workplace for people
with psychiatric disorders (22%). Therefore, back to that time, people were aware of eventual
possibilities to help hikikomori. However, avoidance of that issue led withdrawn one into
worse state. Hence it was necessary to create public awareness of that ailment, in order to
enhance the situation of hikikomori. Regarding to that, in 1997, Ishida Ira published a novel
Ikebukuro West Gate Park (IWGP), in which he introduced a hikikomori character. It is the first
successful novel featuring a hikikomori character. His six volumes were extremely popular,
adapted to a TV drama, a manga, and an anime in 2020.
In 2003, anime called “Welcome to NHK” was broadcasted, directed by Yūsuke
Yamamoto, it was the first popular depiction of such problem as TV show. Of the more
significant works, it is worth mentioning the film Tokyo! By Bo Joon Ho, which one of
segments pictures the lifestyle of men in 30’s who keeps living in a small flat apart from
society. That film brought worldwide attention and was acclaimed by critics. In 2006 Michael
Zielenziger’s book Shutting out the sun4 was published. That was the first major book to
introduce the lives of hikikomori to the 11English-speaking world.
In 2003 NHK started a year-long “hikikomori support campaign”. It created a website
to provide support and network prepared special programs about hikikomori and meanwhile
Ministry of Health, Labour and Welfare published the finalized version of hikikomori
guidelines following pieces of advice recommended prior, by Saito Tamaki.
After 20 years of first publication “Adolescence without end” by Saito Tamaki in 1998,
people across the world are much more aware of hikikomori phenomenon than 2 decades
ago. It can be considered as a good sign, as it was the main aim of Tamaki according to his
book. In 2019, he held a press briefing at the Foreign Press Centre Japan on the subject
of hikikomori5. In view of their rising age, he recommended practical advice to parents with
older hikikomori, such as drawing up a lifetime financial plan for them, so they will be able to
get by after the parents are gone. He also recommended that parents should not fear
embarrassment or be concerned about appearances as they look at the options, including
disability pensions or other forms of public assistance for their children.
In the late 90’s, people sought many possibilities in developing IT technology, chiefly
in concept of personal computers. So did Tamaki, who expected help for hikikomori brought
with the internet, as metaphorically “window for world”, that could be initial point of
connection with society to reestablish firstly. However, he could not predict that internet in
future will one be used as a tool for communication among individual human beings. Albeit it

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gives them chance to exchange the experiences and facilitate supporting each other.
Since 2020, the entire world population have been affected by quarantine, primarily
by social isolation and so do hikikomori. Based on prior outbreaks (e.g., SARS, MERS, etc.),
studies have shown that quarantined individuals, due to increased loneliness, have
heightened stress-related mental disturbances. Hence, considering all social challenges, it
may be considered that all people are brought to express likewise hikikomori whilst lockdown.
Although it is not permanent situation and is not likely to bring all people in the withdrawn
state, but the fact remains that phenomenon of hikikomori may occur more often, even in
western world6.
When it comes to Japan, people who do experience mental disturbances there
generally view seeking the help of a psychiatrist as shameful or a reason for them to be
socially shunned. Fortunately, experts predict an increased focus on issues related to mental
health, affected particularly youth, for instance hikikomori through effective telemedicine
services to either the affected individual or their respective family unit. Hence it can be
expected that situation of hikikomori is on way to improve, what finally will affect adolescent
youth positively.

Words for the future

As discussed before, ultimately people have started recognizing hikikomori as problem need
to be treated instead of fad. Although, this situation is not possible to work itself out and
requires engaging from all society to yield. If the awareness of the problem will be raised
enough, psychiatric medicine should deal with social withdrawal and focus more on that issue.
It is recommended to develop public health sector that could help adolescent people with
mental ailments.
In addition, the government should create a possibility for meetings of parents of
withdrawn children where they could share their experience, outside the internet. However,
due to contemporary chronic problems in Japan it is not plausible that the government would
arrange such activities. To make matters worse, aftermath pandemic one can be sure that the
amount of hikikomori will increase. Hence, we all should at least accept reality of social
withdrawal and never deny that kind of issues, since there is not sufficient help for people
with those disease in Japan, and the only thing left is our own personal support and not avoid
the problem of Hikikomori

Acknowledgements
Firstly, I would like to express my special thankfulness to Miss Monika Szyszka, for
supervising and guiding me throughout all process of creation of this essay. Secondly, I would
like to thank Julia Placzyńska and Magdalena Styś for their contribution to development of
the idea for that discourse.

Bibliography
1. Tajan., N., 2021. Mental Health and Social Withdrawal in Contemporary Japan: Beyond the
Hikikomori Spectrum. Routledge.

2. Tamaki, S., 2022. Video report: Middle-aged Hikikomori (Prof. Tamaki SAITO, Tsukuba Univ.) | 公益
財団法人フォーリン・プレスセンター（FPCJ）. [online] 公益財団法人フォーリン・プレスセンター

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（FPCJ） | 「日本の今」を、世界のメディアへ。取材と広報を支援する情報発信サイト. Available
at: <https://fpcj.jp/en/worldnews-en/briefings-en/p=73828/> [Accessed 1 January 2022].

3. Saitō Tamaki., n.d. Hikikomori : Adolescence without End. London: University of Minnesota
Press.

4. Zielenziger, M., 2009. Shutting Out the Sun. new york: Vintage.

5. NHK WORLD. 2022. Japan's 'Hikikomori' are growing older | NHK WORLD-JAPAN News. [online]
Available at: <https://www3.nhk.or.jp/nhkworld/en/news/backstories/464/> [Accessed 1 February
2022].

6. NHK WORLD. 2022. Japan's struggle with an aging and shrinking population | NHK WORLD-JAPAN
News. [online] Available at: <https://www3.nhk.or.jp/nhkworld/en/news/backstories/391/>
[Accessed 28 February 2022].

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