:Hikikomori

The Japanese Ministry of Health, Labour, and Welfare defines hikikomori as a condition in which the affected individuals refuse to leave their parents' house, do not work or go to school, and isolate themselves from society and family in a single room for a period exceeding six months.{{sfn|Itou|2003}} The psychiatrist Tamaki Saitō defines hikikomori as "a state that has become a problem by the late twenties, that involves cooping oneself up in one's own home and not participating in society for six months or longer, but that does not seem to have another psychological problem as its principal source".{{sfn|Saitō|2012}}

More recently,{{when|date=February 2024}} researchers have developed more specific criteria to more accurately identify hikikomori. During a diagnostic interview, trained clinicians evaluate for:{{sfnm |1a1=Teo |1a2=Gaw |1y=2010 |2a1=Teo |2a2=Stufflebam |2a3=Saha |2a4=Fetters |2y=2015 |2p=182}}

1. spending most of the day and nearly every day confined to home,
2. marked and persistent avoidance of social situations, and social relationships,
3. social withdrawal symptoms causing significant functional impairment,
4. duration exceeding six months,
5. no apparent physical or mental etiology to account for the social withdrawal symptoms.

The psychiatrist Alan Teo first characterized hikikomori in Japan as modern-day hermits, while the literary and communication scholar Flavio Rizzo similarly described hikikomori as "post-modern hermits" whose solitude stems from ancestral desires for withdrawal.{{cite web |last=Rizzo |first=Flavio |date=14 June 2016 |title=Hikikomori: The Postmodern Hermits of Japan |url=http://www.warscapes.com/opinion/hikikomori-postmodern-hermits-japan |website=Warscapes |access-date=17 June 2016 |archive-url=https://web.archive.org/web/20160619040744/http://www.warscapes.com/opinion/hikikomori-postmodern-hermits-japan |archive-date=19 June 2016 |url-status=live }}

While the degree of the phenomenon varies on an individual basis, in the most extreme cases, some people remain in isolation for years or even decades. Often hikikomori start out as school refusers, or {{Nihongo|futōkō|不登校}} in Japanese (an older term is {{Nihongo|tōkōkyohi|登校拒否}}).

Hikikomori has been defined by a Japanese expert group as having the following characteristics:{{cite journal |last=Stip |first=Emmanuel |date=3 March 2016 |title=Internet Addiction, Hikikomori Syndrome, and the Prodromal Phase of Psychosis|journal=Frontiers in Psychiatry |volume=7 |page=6 |doi=10.3389/fpsyt.2016.00006 |pmid=26973544|pmc=4776119 |doi-access=free }}

1. Spending most of the time at home
2. No interest in going to school or working
3. Persistence of withdrawal for more than 6 months
4. Exclusion of schizophrenia, intellectual disability, and bipolar disorder
5. Exclusion of those who maintain personal relationships (e.g., friendships)

While many people feel the pressures of the outside world, hikikomori react by complete social withdrawal. In some more severe cases, they isolate themselves in their bedrooms for months or years at a time.{{sfn|Teo|2013}} They usually have few or no friends. In interviews with current or recovering hikikomori, media reports and documentaries have captured the strong levels of psychological distress and fear felt by these individuals.{{cite web|url=http://fusion.net/video/568756/hikikomori-japans-lost-generation-of-digital-age-hermits/|title=Hikikomori: Japan's Lost Generation of Digital Age Hermits|work=Fusion |access-date=11 May 2017|archive-url=https://web.archive.org/web/20170512232053/http://fusion.net/video/568756/hikikomori-japans-lost-generation-of-digital-age-hermits/|archive-date=12 May 2017|url-status=live}}

While hikikomori favor indoor activities, some venture outdoors occasionally.{{cite web|url=http://vickery.dk/hikikomori|archive-url=https://web.archive.org/web/20050208025913/http://vickery.dk/hikikomori|archive-date=February 8, 2005|title=Articles|website=vickery.dk}} The withdrawal from society usually starts gradually. Affected people may appear unhappy, lose their friends, become insecure and shy, and talk less.

According to Japanese government figures released in 2010, there were at that time 700,000 individuals living as hikikomori within Japan, with an average age of 31.{{cite news |last=Hoffman |first=Michael |date=9 October 2011 |title=Nonprofits in Japan help 'shut-ins' get out into the open |url=http://www.japantimes.co.jp/news/2011/10/09/national/media-national/nonprofits-in-japan-help-shut-ins-get-out-into-the-open/ |newspaper=The Japan Times Online |access-date=24 July 2014 |archive-url=https://web.archive.org/web/20140728175648/http://www.japantimes.co.jp/news/2011/10/09/national/media-national/nonprofits-in-japan-help-shut-ins-get-out-into-the-open/ |archive-date=28 July 2014 |url-status=live }} (The population of Japan in 2014 was 127.3 million.) Still, the numbers vary widely among experts. These included the hikikomori who were at that time in their 40s and had spent 20 years in isolation. This group is generally referred to as the "first-generation hikikomori". There is concern about their reintegration into society in what is known as "the 2030 Problem", when they will be in their 60s and their parents begin to die. Additionally, the government estimates that 1.55 million people are on the verge of becoming hikikomori. Tamaki Saitō, who first coined the phrase, originally estimated that there may be over one million hikikomori in Japan, although this was not based on national survey data. Nonetheless, considering that hikikomori adolescents are hidden away and their parents are often reluctant to talk about the problem, it is extremely difficult to gauge the number accurately.{{sfn|Saitō|1998}}

A 2015 Cabinet Office survey estimated that 541,000 recluses aged 15 to 39 existed. In 2019, another survey showed that there are roughly 613,000 people aged 40 to 64 that fall into the category of "adult hikikomori", which Japan's welfare minister Takumi Nemoto referred to as a "new social issue".

While the terminology hikikomori is of Japanese origin, the phenomenon is not unique to Japan. There have been cases found in the United States,{{Cite web|last=Chen|first=Carol W. Berman, Xi|date=2022-01-19|title=COVID Threatens to Bring a Wave of Hikikomori to America|url=https://www.scientificamerican.com/article/covid-threatens-to-bring-a-wave-of-hikikomori-to-america/|access-date=2022-01-23|website=Scientific American|language=en}} the United Kingdom, Poland,{{Cite web |last=Cyrny |first=Wiktor |date=2019-01-06 |title=Ola nie wychodzi z pokoju odkąd skończyła 21 lat. Kim są polscy Hikikomori? |url=https://www.newsweek.pl/polska/spoleczenstwo/zamknieci-przed-swiatem-kim-sa-polscy-hikikomori/5bhhkfr |access-date=2025-02-11 |website=Newsweek |language=pl}} Oman,{{cite journal | last1=Sakamoto | first1=Noriyuki | last2=Martin | first2=Rodger G. | last3=Kumano | first3=Hiroaki | last4=Kuboki | first4=Tomifusa | last5=Al-Adawi | first5=Samir | title=Hikikomori, is it a Culture-Reactive or Culture-Bound Syndrome? Nidotherapy and a Clinical Vignette from Oman | journal=The International Journal of Psychiatry in Medicine | volume=35 | issue=2 | date=2005 | issn=0091-2174 | doi=10.2190/7WEQ-216D-TVNH-PQJ1 | pages=191–198| pmid=16240975 }} Spain,{{cite journal |last1=Malagón-Amor |first1=Ángeles |last2=Córcoles-Martínez |first2=David |last3=Martín-López |first3=Luis M |last4=Pérez-Solà |first4=Víctor |date=2015 |title=Hikikomori in Spain: A descriptive study |journal=International Journal of Social Psychiatry |volume=61 |issue=5 |pages=475–483 |doi=10.1177/0020764014553003 |pmid=25303955 |s2cid=27277596}} Germany,{{Cite web |title=Ein rein japanisches Phänomen? |url=https://www.goethe.de/ins/jp/de/kul/sup/mag/20720273.html |access-date=2023-04-26 |website=@GI_weltweit |language=de}} Italy, India,{{Cite web |last=Kumar |first=Sheila |date=2020-03-15 |title=Pulling inwards: The modern-day hermits |url=https://www.newindianexpress.com/magazine/voices/2020/Mar/15/pulling-inwards-the-modern-day-hermits-2115951.html |access-date=2024-06-01 |website=The New Indian Express |language=en}} Sweden, Brazil,{{cite journal |last1= Roza |first1= Thiago |last2= Kessler |first2= Felix |last3= Passos |first3= Ives |date= 24 August 2022 |title= Hikikomori in Brazil: Context, clinical characteristics, and challenges |url= https://journals.sagepub.com/doi/10.1177/00207640221120363 |journal= International Journal of Social Psychiatry |volume= 69 |issue= 4 |pages= 1059–1061|doi= 10.1177/00207640221120363 |pmid= 36003018 |access-date= 7 August 2024}} China,{{cite journal |last1=Hu |first1=Xinyue |last2=Fan |first2=Danhua |last3=Shao |first3=Yang |title=Social Withdrawal (Hikikomori) Conditions in China: A Cross-Sectional Online Survey |journal=Frontiers in Psychology |date=14 March 2022 |volume=13 |doi=10.3389/fpsyg.2022.826945 |doi-access=free |pmid=35360625 |pmc=8963962 }} Hong Kong, Taiwan, Singapore,{{Cite news |last=Ang |first=Shermaine |date=2024-05-04 |title='I gave up on my life': She didn't leave home for a year, played games all day |url=https://www.straitstimes.com/singapore/i-gave-up-on-my-life-she-didn-t-leave-home-for-a-year-played-games-all-day |access-date=2024-05-06 |work=The Straits Times |language=en |issn=0585-3923}} South Korea, France,{{cite news |last=Gozlan |first=Marc |date=9 June 2012 |title=Des cas d'hikikomori en France |url=http://www.lemonde.fr/sciences/article/2012/06/07/des-cas-d-hikikomori-en-france_1714707_1650684.html |url-status=live |archive-url=https://web.archive.org/web/20150403221427/http://www.lemonde.fr/sciences/article/2012/06/07/des-cas-d-hikikomori-en-france_1714707_1650684.html |archive-date=3 April 2015 |access-date=7 June 2017 |newspaper=Le Monde |page=3 |language=fr}}Australia,{{Cite news |title=‘Hikikomori’: Condition of being confined to home for years |url=https://www.news.com.au/lifestyle/real-life/true-stories/hikikomori-condition-of-being-confined-to-home-for-years/news-story/1aa3a1da48636b0636324988285097aa}} and Russia.{{sfn|Teo|2013}}{{Cite journal|last1=Kato|first1=Takahiro A.|last2=Kanba|first2=Shigenobu|last3=Teo|first3=Alan R.|date=2018|title=Hikikomori: experience in Japan and international relevance|journal=World Psychiatry|volume=17|issue=1|pages=105–106|doi=10.1002/wps.20497|pmc=5775123|pmid=29352535}}{{cite news |last1=McLeod |first1=Hamish J. |last2=Rooksby |first2=Maki |last3=Furuhashi |first3=Tadaaki |title=Hikikomori: understanding the people who choose to live in extreme isolation |url=https://theconversation.com/hikikomori-understanding-the-people-who-choose-to-live-in-extreme-isolation-148482 |access-date=2 November 2020 |work=The Conversation |date=29 October 2020 |language=en}}{{cite journal |last=Андрей Голубь |title=Тяжелая жизнь хикикомори в России |url=https://dailymoscow.ru/vladivostok/32133-tyazelaya-zizn-xikikomori-v-rossii |access-date=13 November 2023 |journal=Daily Moscow |date=21 December 2015 |language=ru}}

Hikikomori is similar to the social withdrawal exhibited by some people with autism spectrum disorder. This has led some psychiatrists to suggest that hikikomori may be affected by autism spectrum disorder and other disorders that affect social integration, but that their disorders are altered from their typical Western presentation because of Japanese sociocultural pressures.{{cite web |last=Kary |first=Tiffany |year=2003 |title=Total Eclipse of the Son: Why are Millions of Japanese Youths Hiding from Friends and Family? |url=http://psychologytoday.com/articles/pto-2550.html |work=Psychology Today |access-date=13 October 2007 }} Suwa and Hara (2007) discovered that 5 of 27 cases of hikikomori had a high-functioning pervasive developmental disorder (HPDD), and 12 more had other disorders or mental diseases (6 cases of personality disorders, 3 cases of obsessive-compulsive disorder, 2 cases of depression, 1 case of slight intellectual impairment); 10 out of 27 had primary hikikomori. The researchers used a vignette to illustrate the difference between primary hikikomori (without any obvious mental disorder) and hikikomori with HPDD or other disorder.{{sfn|Suwa|Hara|2007}} Alan Teo and colleagues conducted detailed diagnostic evaluations of 22 individuals with hikikomori and found that while the majority of cases fulfilled criteria for multiple psychiatric conditions, about 1 in 5 cases were primary hikikomori.{{sfn|Teo|Stufflebam|Saha|Fetters|2015|p=182}} To date, however, hikikomori is not included in the DSM-5 (The Diagnostic and Statistical Manual of Mental Disorders), due to insufficient data.{{Cite journal|last1=Berman|first1=Naomi|last2=Rizzo|first2=Flavio|date=2018-11-09|title=Unlocking Hikikomori: an interdisciplinary approach|url=http://dx.doi.org/10.1080/13676261.2018.1544416|journal=Journal of Youth Studies|volume=22|issue=6|pages=791–806|doi=10.1080/13676261.2018.1544416|s2cid=150209926|issn=1367-6261}}

According to Michael Zielenziger's book Shutting Out the Sun: How Japan Created Its Own Lost Generation, the syndrome is more closely related to posttraumatic stress disorder. The author claimed that the hikikomori interviewed for the book had discovered independent thinking and a sense of self that the current Japanese environment could not accommodate.{{sfn|Zielenziger|2006}}

The syndrome also closely parallels the terms avoidant personality disorder, schizoid personality disorder, schizotypal personality disorder, agoraphobia, and social anxiety disorder (also known as "social phobia").

Sometimes referred to as a social problem in Japanese discourse, hikikomori has a number of possible contributing factors. Alan Teo has summarized a number of potential cultural features that may contribute to its predominance in Japan. These include tendencies toward conformity and collectivism, overprotective parenting, and particularities of the educational, housing, and economic systems.{{sfn|Teo|Stufflebam|Kato|2014}}

Severe social withdrawal in Japan appears to affect men and women equally. However, because of differing social expectations for maturing boys and girls, the most widely reported cases of hikikomori are from middle- and upper-middle-class families; sons, typically their eldest, refuse to leave the home, often after experiencing one or more traumatic episodes of social or academic failure.

In The Anatomy of Dependence, Takeo Doi identifies the symptoms of hikikomori, and explains its prevalence as originating in the Japanese psychological construct of amae (in Freudian terms, "passive object love", typically of the kind between mother and infant).{{sfn|Doi|1973}} Other Japanese commentators such as academic Shinji Miyadai and novelist Ryū Murakami, have also offered analysis of the hikikomori phenomenon, and find distinct causal relationships with the modern Japanese social conditions of anomie, amae, and atrophying paternal influence in nuclear family child pedagogy. Young adults may feel overwhelmed by modern Japanese society, or be unable to fulfill their expected social roles as they have not yet formulated a sense of personal honne and tatemae – one's "true self" and one's "public façade" – necessary to cope with the paradoxes of adulthood.

The dominant nexus of hikikomori centres on the transformation from youth to the responsibilities and expectations of adult life. Indications are that advanced industrialized societies such as modern Japan fail to provide sufficient meaningful transformation rituals for promoting certain susceptible types of youth into mature roles. As do many societies, Japan exerts a great deal of pressure on adolescents to be successful and perpetuate the existing social status quo. A traditionally strong emphasis on complex social conduct, rigid hierarchies, and the resulting, potentially intimidating, multitude of social expectations, responsibilities, and duties in Japanese society contribute to this pressure on young adults.{{sfn|Rohlen|1989}} Historically, Confucian teachings de-emphasizing the individual and favouring a conformist stance to ensure social harmony in a rigidly hierarchical society have shaped much of East Asia, possibly explaining the emergence of the hikikomori phenomenon in other East Asian countries.

In general, the prevalence of hikikomori tendencies in Japan may be encouraged and facilitated by three primary factors:

1. Middle class affluence in a post-industrial society such as Japan allows parents to support and feed an adult child in the home indefinitely. Lower-income families do not have hikikomori children because a socially withdrawing youth is forced to work outside the home.{{cite book | last1=Kudō | first1=Sadaji | last2=Saitō | first2=Tamaki | trans-title=Argument! Hikikomori |title=激論!ひきこもり | publisher=ポット出版 [Studio Pot] | publication-place=Tokyo | date=September 2001 | isbn=4-939015-10-6 | oclc=152683407 | language=ja}}
2. The inability of Japanese parents to recognize and act upon the youth's slide into isolation; soft parenting; or codependency between mother and son, known as amae in Japanese.{{cite book |last=Kudō |first=Sadatsugu |date=October 2001 |trans-title=Hey Hikikomori! It's Time, Let's Go Out |place=Tokyo |title=おーぃ、ひきこもり そろそろ外へ出てみようぜ—タメ塾の本 |publisher=ポット出版 [Studio Pot] |isbn=4-939015-10-6 |language=ja}}
3. A decade of flat economic indicators{{when|date=February 2024}} and a shaky job market in Japan makes the pre-existing system requiring years of competitive schooling for elite jobs appear like a pointless effort to many.{{sfn|Okano|Tsuchiya|1999}}

Although the connection between modern communication technologies (such as the Internet, social media, and video games) and the phenomenon is not conclusively established, those technologies are considered at least an exacerbating factor that can deepen and nurture withdrawal.{{Cite news |last=Gent |first=Edd |title=The plight of Japan's modern hermits |website=BBC News |date=2019-01-29 |url=http://www.bbc.com/future/story/20190129-the-plight-of-japans-modern-hermits |access-date=2019-03-29 |archive-url=https://web.archive.org/web/20190329180920/http://www.bbc.com/future/story/20190129-the-plight-of-japans-modern-hermits |archive-date=29 March 2019 |url-status=live }}{{Cite web |title=The Hikikomori Phenomenon – Is Information Technology Really To Blame? |url=https://www.forbesindia.com/article/essec-business-school/the-hikikomori-phenomenon-is-information-technology-really-to-blame/87909/1 |access-date=2024-06-01 |website=Forbes India |language=en}} Previous studies of hikikomori in South Korea and Spain found that some of them showed signs of Internet addiction, though researchers do not consider this to be the main issue. However, according to associate professor of psychiatry at Kyushu University in Fukuoka, Takahiro Kato, video games and social media have reduced the amount of time that people spent outside and in social environments that require direct face to face interaction. The emergence of mobile phones and then smartphones may also have deepened the issue, given that people can continue their addiction to gaming and online surfing anywhere, even in bed.{{Cite web |title="Hikikomori": Social Recluses in the Shadows of an Aging Japan |website=nippon.com |date=2017-07-19 |url=https://www.nippon.com/en/currents/d00332/hikikomori-social-recluses-in-the-shadows-of-an-aging-japan.html |access-date=2019-03-29 |archive-url=https://web.archive.org/web/20190306175157/https://www.nippon.com/en/currents/d00332/hikikomori-social-recluses-in-the-shadows-of-an-aging-japan.html |archive-date=6 March 2019 |url-status=live }}

{{See also|Kyōiku mama}}

The Japanese education system puts great demands upon youth. There is high competition to pass entrance exams into the next tier of education in what could be termed a rigid pass-or-fail ideology, which could induce a high level of stress. Echoing the traditional Confucian values of society, the educational system is viewed as playing an important part in society's overall productivity and success.{{sfn|Rohlen|1992}}

In this social frame, students often face significant pressure from parents and society in general to conform to its dictates and doctrines.{{sfn|Rohlen|1996}} These doctrines, while part of modern Japanese society, are increasingly being rejected by Japanese youth in varying ways such as hikikomori, freeter, NEET (Not currently engaged in Employment, Education, or Training), and parasite singles. The term "Hodo-Hodo zoku" (the "So-So tribe") applies to younger workers who refuse promotion to minimize stress and maximize free time.{{Citation needed|date=May 2021}}

Beginning in the 1960s, the pressure on Japanese youth to succeed began successively earlier in their lives, sometimes starting before pre-school, where even toddlers had to compete through an entrance exam for the privilege of attending one of the best pre-schools. This was said to prepare children for the entrance exam of the best kindergarten, which in turn prepared the child for the entrance exam of the best elementary school, junior high school, high school, and eventually for their university entrance exam.{{sfn|M. White|1987}} Many adolescents take one year off after high school to study exclusively for the university entrance exam, and are known as ronin.{{sfn|Tsukada|1991}} More prestigious universities have more difficult exams. The most prestigious university with the most difficult exam is the University of Tokyo.

Since 1996, the Japanese Ministry of Education has taken steps to address this 'pressure-cooker' educational environment and instill greater creative thought in Japanese youth by significantly relaxing the school schedule from six-day weeks to five-day weeks and dropping two subjects from the daily schedule, with new academic curricula more comparable to Western educational models. However, Japanese parents are sending their children to private cram schools, known as juku, to 'make up' for lost time.

After graduating from high school or university, Japanese youth also have to face a very difficult job market in Japan, often finding only part-time employment and ending up as freeters with little income, unable to start a family.Yoshimoto, K, and Japan Institute of Labor. 1996. "High School and Initial Career of Graduates." JIL Report No. 89.

Another source of pressure is from their co-students, who may harass and bully (ijime) some students for a variety of reasons, including physical appearance, wealth, or educational or athletic performance. Refusal to participate in society makes hikikomori an extreme subset of a much larger group of younger Japanese that includes freeters.{{cite magazine |last=Jones |first=Maggie |url=https://www.nytimes.com/2006/01/15/magazine/15japanese.html |title=Shutting Themselves In |date=15 January 2006 |magazine=The New York Times Magazine |access-date=11 March 2016 |archive-url=https://web.archive.org/web/20160406003446/http://www.nytimes.com/2006/01/15/magazine/15japanese.html |archive-date=6 April 2016 |url-status=live }}{{cite news |url=http://news.bbc.co.uk/2/hi/programmes/correspondent/2334893.stm |title=BBC NEWS – Programmes – Correspondent – Japan: The Missing Million |access-date=11 March 2016 |date=2002-10-20 |archive-url=https://web.archive.org/web/20160311142505/http://news.bbc.co.uk/2/hi/programmes/correspondent/2334893.stm |archive-date=11 March 2016 |url-status=live }}

Some organizations, such as the non-profit Japanese organization NPO lila, have been trying to combat the financial burden the hikikomori phenomenon has had on Japan's economy.{{cite web |url=http://www.npo-lila.com/ |title=NPO法人 楽の会リーラ |website=NPO lila |access-date=18 June 2013 |url-status=dead |archive-url=https://web.archive.org/web/20130622221856/http://npo-lila.com/ |archive-date=22 June 2013 |language=ja |df=dmy-all }} The Japanese CD and DVD producer Avex Group produces DVDs of live-action women staring into a camera to help hikikomori learn to cope with eye contact and long spans of human interaction. The goal is to ultimately help hikikomori reintegrate into society by personal choice, thereby realizing an economic contribution and reducing the financial burden on parents or guardians.{{Cite web|url=http://kumalanguage.com/hikikomori-japans-social-ghosts/|title=Hikikomori – Japan's Social Ghosts – Kuma Language Services|date=18 July 2016|language=en-US|access-date=11 August 2016|archive-url=https://web.archive.org/web/20160829062346/http://kumalanguage.com/hikikomori-japans-social-ghosts/|archive-date=29 August 2016|url-status=dead}}

The "80–50 problem" refers to hikikomori children from earlier days now entering their 50s, as their parents, on whom they rely, enter their 80s.{{cite web|url=https://japantoday.com/category/features/kuchikomi/the-8050-problem|title=The '8050 problem' – 'hikikomori' people entering 50s as parents on whom they rely enter their 80s|work=Japan Today|date=14 November 2018}} It was first described in Japanese publications and media in the late 2010s.

In 2019, Japanese psychiatrist Tamaki Saitō held a press briefing at the Foreign Press Center Japan on the subject of hikikomori. 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. Tamaki emphasized the necessity for families in these situations to plan ahead; he argued that the Japanese government failed to see the urgency of the problem and demonstrated no motion toward developing substantive policies or systems like special safety nets related to the ageing group of hikikomori.{{cite web|url=https://www.nippon.com/en/japan-topics/c05008/japan%E2%80%99s-hikikomori-population-could-top-10-million.html|title=Japan's 'Hikikomori' Population Could Top 10 Million|publisher=nippon.com|date=17 September 2019}}

When it comes to psychosocial support, it is hard for therapists to attain direct access to hikikomori;{{Cite journal|last1=Nonaka|first1=Shunsuke|last2=Shimada|first2=Hironori|last3=Sakai|first3=Motohiro|date=2020-01-16|title=Family Behavioral Repertoires and Family Interaction Influence the Adaptive Behaviors of Individuals With Hikikomori|journal=Frontiers in Psychiatry|volume=10|page=977|doi=10.3389/fpsyt.2019.00977|issn=1664-0640|pmc=6976530|pmid=32009999|doi-access=free}} research to find different and effective treatment plans to aid hikikomori has been ongoing. One such treatment plan is focused on the families of hikikomori. Such focus primarily includes educational intervention programs (e.g. lectures, role-play, etc.) that are geared towards reducing any averse stigma that family members have towards psychiatric disorders like hikikomori.{{Cite journal|last1=Kato|first1=Takahiro A.|last2=Sartorius|first2=Norman|last3=Shinfuku|first3=Naotaka|date=2020-07-27|title=Forced social isolation due to COVID-19 and consequent mental health problems: Lessons from hikikomori|journal=Psychiatry and Clinical Neurosciences|volume=74|issue=9|pages=506–507|doi=10.1111/pcn.13112|pmid=32654336|pmc=7404367|issn=1323-1316|doi-access=free}} These educational programs are derived from other established family support programs, specifically Mental Health First Aid (MHFA) and Community Reinforcement and Family Training (CRAFT).{{Cite journal|last1=Kubo|first1=Hiroaki|last2=Urata|first2=Hiromi|last3=Sakai|first3=Motohiro|last4=Nonaka|first4=Shunsuke|last5=Saito|first5=Kazuhiko|last6=Tateno|first6=Masaru|last7=Kobara|first7=Keiji|last8=Hashimoto|first8=Naoki|last9=Fujisawa|first9=Daisuke|last10=Suzuki|first10=Yuriko|last11=Otsuka|first11=Kotaro|date=2020-01-09|title=Development of 5-day hikikomori intervention program for family members: A single-arm pilot trial|journal=Heliyon|volume=6|issue=1|pages=e03011|doi=10.1016/j.heliyon.2019.e03011|doi-access=free |issn=2405-8440|pmc=6953643|pmid=31938741|bibcode=2020Heliy...603011K }} CRAFT specifically trains family members to express positive and functional communication, whereas MHFA provides skills to support hikikomori with depression/suicidal-like behaviour. Studies so far that have modified the family unit's behavioral response to a hikikomori has yielded positive results, indicating that family behavior is essential for recovery; however, further research is still needed.

Although there has been a primary emphasis on educating family members, there are also therapy programs for the hikikomori themselves to participate in, like exercise therapy. The individual psychotherapy methods that are being stressed in current research are primarily directed towards cultivating self-confidence within the hikikomori.{{Cite journal|last1=Nishida|first1=Masaki|last2=Kikuchi|first2=Senichiro|last3=Fukuda|first3=Kazuhito|last4=Kato|first4=Satoshi|date=2016-04-29|title=Jogging Therapy for Hikikomori Social Withdrawal and Increased Cerebral Hemodynamics: A Case Report|journal=Clinical Practice and Epidemiology in Mental Health |volume=12|pages=38–42|doi=10.2174/1745017901612010038|issn=1745-0179|pmc=4894832|pmid=27346999}} However, studies have indicated that effective treatment of hikikomori requires a multifaceted approach rather than the utilization of one individual approach, such as individual psychotherapy or family therapy.{{Cite journal|last1=Ranieri|first1=F.|last2=Andreoli|first2=M.|last3=Bellagamba|first3=E.|last4=Franchi|first4=E.|last5=Mancini|first5=F.|last6=Pitti|first6=L.|last7=Sfameni|first7=S.|last8=Stoppielli|first8=M.|date=March 2015|title=Early Adolescence in Social Withdrawal: Two Hikikomori in Treatment|url=http://dx.doi.org/10.1016/s0924-9338(15)30941-x|journal=European Psychiatry|volume=30|pages=1198|doi=10.1016/s0924-9338(15)30941-x|s2cid=143201325|issn=0924-9338}}{{Cite journal|last=Wong|first=Paul W.C.|date=December 2020|title=Potential changes to the hikikimori phenomenon in the wake of the Covid-19 pandemic|url= |journal=Asian Journal of Psychiatry|volume=54|pages=102288|doi=10.1016/j.ajp.2020.102288|pmid=32682300|issn=1876-2018|pmc=7352106}}

In South Korea hikikomori in low income families can get up to ₩650,000 (equivalent to $490 or £390) as a monthly living allowance.{{cite news |last1= Kim |first1= Hyunjung |last2= Ng |first2= Kelly |date= 23 May 2023 |title= Hikikomori: Why S Korea is paying young recluses to leave home |url= https://www.bbc.co.uk/news/world-asia-65554271 |work= BBC News |access-date= 7 August 2024}} They can also apply for subsidies for various services, including (but not limited to) health, education, counselling, legal services, and cultural activities. This is in order to attempt to recover the daily lives of the hikikomori and attempt to reintegrate them into society.

A "rental sister" is a system whereby hikikomori are regularly visited and encouraged to try and leave their bedrooms and integrate back into society.{{cite news |date= 16 October 2018 |title= BBC World Hacks: 'Rental Sisters' for Japan's Reclusive Young Men |url= https://www.bbc.co.uk/mediacentre/proginfo/2018/42/bbc-world-hacks |work= BBC |access-date=7 August 2024}} This can come through various methods, such as talking through a door or eating out, among other methods.

Based on prior outbreaks (e.g. SARS and MERS), studies have shown that due to increased loneliness, quarantined individuals have heightened stress-related mental disturbances. Considering that political, social, or economical challenges already bring people to express hikikomori-like behavior, researchers theorize that since all the aforementioned factors are by-products of a pandemic, a hikikomori phenomenon may become more common in a post-pandemic world. In fact, people who do experience mental disturbances in Japan generally view seeking the help of a psychiatrist as shameful or a reason for them to be socially shunned. Experts predict an increase in focus on issues such as the mental health problems now affecting youth, and specifically through effective telemedicine services to either the affected individual or their respective family unit.{{Cite journal|last1=Rooksby|first1=Maki|last2=Furuhashi|first2=Tadaaki|last3=McLeod|first3=Hamish J.|date=2020-09-15|title=Hikikomori: a hidden mental health need following the COVID −19 pandemic|journal=World Psychiatry|volume=19|issue=3|pages=399–400|doi=10.1002/wps.20804|pmid=32931118|pmc=7491622|issn=1723-8617|doi-access=free}}

Furthermore, with hikikomori becoming more prevalent amid a pandemic, experts theorize that it will bring out more empathy and constructive attention towards the issue.

{{div col}}

• Acedia
• Asociality
• Avolition
• Fushūgaku
• School refusal
• Herbivore men
• Jōhatsu
• Monasticism
• Recluse literature
• Tang ping
• Tokyo!, 2008 movie in three parts, the third part of which, Shaking Tokyo, shows the life of a hikikomori
• Welcome to the N.H.K., a Japanese novel, manga, and anime series about a young man who is a hikikomori

{{div end}}

{{Reflist|22em}}

{{refbegin|35em|indent=yes}}

• {{cite journal

|last1=Amendola

|first1=Simone

|title=Clarifying the position of hikikomori in mental health: Is hikikomori a variant of already-known mental health disorders? A review of the literature |journal=Journal of Pacific Rim Psychology

|date=2024

|volume=18

|doi=10.1177/18344909241274808

|doi-access=free

}}

• {{cite book

|last=Doi

|first=Takeo

|author-link=Takeo Doi

|year=1973

|title=The Anatomy of Dependence

|translator-last=Bester

|translator-first=John

|location=Tokyo

|publisher=Kodansha

|title-link=The Anatomy of Dependence

}}

• {{cite book

|last=Itou

|first=Junichirou

|year=2003

|title=Guideline on Mental Health Activities in Communities for Social Withdrawal

|language=ja

|location=Tokyo

|publisher=Ministry of Health, Labor, and Welfare

}}

• {{cite book

|author=Japan. Ministry of Health, Labour and Welfare

|year=2006

|title=White Paper on Labour and Economy 2006: Diversification of Employment and Working Life

|translator=((the Japan Institute for Labour Policy and Training))

|publisher=Ministry of Health, Labour, and Welfare

|ref={{sfnref|Japan|2006}}

}}

• {{cite book

|last1=Mathews

|first1=Gordon

|last2=White

|first2=Bruce

|year=2004

|title=Japan's Changing Generations: Are Young People Creating a New Society?

|location=London

|publisher=Routledge Courzon

|isbn=978-0-415-32227-0

|ref={{sfnref|Mathews|B. White|2004}}

}}

• {{cite book

|last1=Okano

|first1=Kaori

|last2=Tsuchiya

|first2=Motonori

|year=1999

|title=Education in Contemporary Japan: Inequality and Diversity

|series=Contemporary Japanese Society

|location=Cambridge, England

|publisher=Cambridge University Press

|isbn=978-0-521-62686-6

}}

• {{cite journal

|last=Rohlen

|first=Thomas P.

|year=1989

|title=Order in Japanese Society: Attachment, Authority, and Routine

|journal=Journal of Japanese Studies

|volume=15

|issue=1

|pages=5–40

|issn=0095-6848

|doi=10.2307/132406

|jstor=132406

}}

• {{cite book

|last=Rohlen

|first=Thomas P.

|author-mask={{long dash}}

|year=1992

|chapter=Learning: The Mobilization of Knowledge in the Japanese Political Economy

|editor1-last=Kumon

|editor1-first=Sumpei

|editor2-last=Rosovsky

|editor2-first=Henry

|title=The Political Economy of Japan. Volume 3: Cultural and Social Dynamics

|location=Stanford, California

|publisher=Stanford University Press

|pages=321–363

|isbn=978-0-8047-1992-6

}}

• {{cite book

|last=Rohlen

|first=Thomas P.

|author-mask={{long dash}}

|year=1996

|chapter=Building Character

|title=Teaching and Learning in Japan

|editor1-last=Rohlen

|editor1-first=Thomas P.

|editor2-last=Le Tendre

|editor2-first=Gerald K.

|location=Cambridge, England

|publisher=Cambridge University Press

|pages=50–74

|isbn=978-0-521-49587-5

}}

• {{cite book

|last=Saitō

|first=Tamaki

|author-link=Tamaki Saitō

|year=1998

|title=Hikikomori kyūshutsu manyuaru

|language=ja

|trans-title=How to Rescue Your Child from "Hikikomori"

|location=Tokyo

|publisher=PHP Kenkyūjo

}}

• {{cite book

|last=Saitō

|first=Tamaki

|author-link=Tamaki Saitō

|author-mask={{long dash}}

|year=2012

|title=Social Withdrawal: Adolescence without End

|translator-last=Angles

|translator-first=Jeffrey

|translator-link=Jeffrey Angles

|location=Minneapolis, Minnesota

|publisher=University of Minnesota Press

}}

• {{cite journal

|last1=Suwa

|first1=Mami

|last2=Hara

|first2=Koichi

|year=2007

|title={{'}}Hikikomori{{'}} among Young Adults in Japan: The Importance of Differential Diagnosis between Primary Hikikomori and Hikikomori with High-functioning Pervasive Developmental Disorders

|url=http://aska-r.aasa.ac.jp/dspace/bitstream/10638/956/1/0026-003-200703-094-101.pdf

|journal=医療福祉研究 [Medical and Welfare Research]

|volume=3

|pages=94–101

|issn=1349-7863

|access-date=7 September 2017

|archive-url=https://web.archive.org/web/20130929091438/http://aska-r.aasa.ac.jp/dspace/bitstream/10638/956/1/0026-003-200703-094-101.pdf

|archive-date=29 September 2013

|url-status=dead

}}

• {{cite journal

|last1=Takefuji

|first1=Yoshiyasu

|title=Review of hikikomori: A global health issue, identification and treatment

|journal=Asian Journal of Psychiatry

|date=2023

|volume=84

|pages=103596

|doi=10.1016/j.ajp.2023.103596

|pmid=37099923

}}

• {{cite journal

|last=Teo

|first=Alan R.

|year=2013

|title=Social Isolation Associated with Depression: A Case Report of Hikikomori

|journal=International Journal of Social Psychiatry

|volume=59

|issue=4

|pages=339–341

|doi=10.1177/0020764012437128

|pmc=4886854

|pmid=22408115

}}

• {{cite journal

|last1=Teo

|first1=Alan R.

|last2=Gaw

|first2=Albert

|year=2010

|title=Hikikomori, a Japanese Culture-Bound Syndrome of Social Withdrawal? A Proposal for DSM-5

|journal=Journal of Nervous and Mental Disease

|volume=198

|issue=6

|pages=444–449

|doi=10.1097/NMD.0b013e3181e086b1

|pmid=20531124

|pmc=4912003

}}

• {{cite book

|last1=Teo

|first1=Alan R.

|last2=Stufflebam

|first2=Kyle W.

|last3=Kato

|first3=Takahiro A.

|year=2014

|chapter=The Intersection of Culture and Solitude: The Hikikomori Phenomenon in Japan

|editor1-last=Coplan

|editor1-first=Robert J.

|editor2-last=Bowker

|editor2-first=Julie C.

|title=The Handbook of Solitude: Psychological Perspectives on Social Isolation, Social Withdrawal, and Being Alone

|publisher=Wiley-Blackwell

|pages=445–460

|isbn=978-1-118-42736-1

}}

• {{cite journal

|last1=Teo

|first1=Alan R.

|last2=Stufflebam

|first2=Kyle

|last3=Saha

|first3=Somnath

|last4=Fetters

|first4=Michael D.

|last5=Tateno

|first5=Masaru

|last6=Kanba

|first6=Shigenobu

|last7=Kato

|first7=Takahiro A.

|year=2015

|title=Psychopathology Associated with Social Withdrawal: Idiopathic and Comorbid Presentations

|journal=Psychiatry Research

|volume=228

|issue=1

|pages=182–183

|issn=0165-1781

|pmid=25977071

|doi=10.1016/j.psychres.2015.04.033

|s2cid=8011082

}}

• {{cite book

|last=Tsukada

|first=Mamoru

|year=1991

|title=Yobiko Life: A Study of the Legitimation Process of Social Stratification in Japan

|location=Berkeley, California

|publisher=University of California

|isbn=978-1-55729-031-1

}}

• {{cite book

|last=White

|first=Merry

|year=1987

|title=The Japanese Educational Challenge

|location=New York

|publisher=The Free Press

|isbn=978-4-7700-1373-6

|ref={{sfnref|M. White|1987}}

}}

• {{cite book

|last=Zielenziger

|first=Michael

|author-link=Michael Zielenziger

|year=2006

|title=Shutting Out the Sun: How Japan Created Its Own Lost Generation

|location=New York

|publisher=Vintage Books

|publication-date=2007

|isbn=978-1-4000-7779-3

}}

{{refend}}

{{refbegin|35em|indent=yes}}

• {{cite book

|year=2012

|editor1-last=Goodman

|editor1-first=Roger

|editor2-last=Imoto

|editor2-first=Yuki

|editor3-last=Toivonen

|editor3-first=Tuukka

|title=A Sociology of Japanese Youth: From Returnees to NEETs

|series=Nissan Institute/Routledge Japanese Studies Series

|volume=83

|location=Abingdon, England

|publisher=Routledge

|isbn=978-0-415-66926-9

}}

• {{cite book

|last=Kuhn

|first=Kevin

|year=2012

|title=Hikikomori

|language=de

|location=Berlin

|publisher=Berlin Verlag

|isbn=978-3-8270-1116-9

}}

• {{cite journal

|last1=Toivonen

|first1=Tuukka

|last2=Norasakkunkit

|first2=Vinai

|last3=Uchida

|first3=Yukiko

|year=2011

|title=Unable to Conform, Unwilling to Rebel? Youth, Culture, and Motivation in Globalizing Japan

|journal=Frontiers in Psychology

|volume=2

|issue=207

|pages=207

|issn=1664-1078

|pmc=3171786

|doi=10.3389/fpsyg.2011.00207

|doi-access=free

|pmid=21949510

}}

{{refend}}

; Media

• {{cite web|url=https://www.youtube.com/watch?v=oFgWy2ifX5s| archive-url=https://ghostarchive.org/varchive/youtube/20211117/oFgWy2ifX5s| archive-date=2021-11-17 | url-status=live|title=Japan's modern-day hermits: The world of hikikomori |publisher=France 24|date=2019-01-18}}{{cbignore}}

{{Commons category}}

• {{Cite web |title='Rental sisters' for Japan's Reclusive Young Men |url=https://www.bbc.co.uk/programmes/p06nxz78 |work=People Fixing the World |date=16 October 2018 |publisher=BBC World Service |language=en-GB |access-date=2018-10-19}}
• {{Cite web |last=Butet-roch |first=Laurence |date=14 February 2018 |title=Pictures Reveal the Isolated Lives of Japan's Social Recluses |url=https://www.nationalgeographic.com/photography/proof/2018/february/japan-hikikomori-isolation-society/ |archive-url=https://web.archive.org/web/20181213194115/https://www.nationalgeographic.com/photography/proof/2018/february/japan-hikikomori-isolation-society/ |archive-date=2018-12-13 |website=National Geographic |others=Photographer: Maika Elan |access-date=2019-04-13}}

{{Japan topics}}

{{Japanese social terms}}

{{Young adult development}}

{{Authority control}}

Category:Academic pressure in East Asian culture

Category:Autism spectrum disorders

Category:Demographics of Japan

Category:Economy of Japan

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Category:Culture of Japan

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Category:Society of Japan

Category:Words and phrases describing personality