The term hikikomori describes a specific form of social withdrawal that can be observed in children, adolescents, and young adults. Epidemiological research studies have shown that this condition is comorbid with a psychopathological disorder only in 50% of all cases. Many young people in a state of withdrawal do not show symptoms ascribable to already known diagnostic parameters. The authors, psychologist, and psychiatrist at the UFSMIA (Functional Mental Health Unit for Children and Adolescents) in Arezzo, illustrate the current debate on the hikikomori phenomenon from a number of viewpoints: psychiatric, sociological, anthropological, and psychological. On the basis of a clinical case discussed at length in this paper, the authors define their viewpoints and the strategies initiated at the Mental Health Unit in the presence of a patient displaying a state of acute social withdrawal. The multiple actions taken by the UFSMIA are combined according to the concept of modularity. Clinical experiences collected allow the definition of therapeutic protocols useful for the treatment of hikikomori adolescents. The overall objective is to promote the autonomy of the adolescent, as well as the reinforcement of his/her identity and personal resources, as well as the non-traumatic re-entry into the social context.
IntroductionThe Japanese Saito coined the term “hikikomori” to define an extreme form of social withdrawal, particularly present in Japan (1998). In the West there is an increasing frequency of adolescents hikikomori.Objectives and AimsThe UFSMIA Arezzo has received a number of requests to take care of adolescents bearing strong similarities to hikikomori teenagers or “on the way of the social withdrawal”. These admissions have led to an epidemiological study in order to quantify these behaviors among very young teenagers in a Italian town.MethodsThe research used a questionnaire addressed to the coordinator teachers of the middle schools of Arezzo (2694 students). The questionnaire collected information on the single student absent from school for more than 40 days asking reasons for the absence.ResultsAbsents from school for more than 40 days not for an illness were 27. The average age was 14,5 years, 59,3% males, 40,7% females. The 66,6% of the students repeated one or more times a year of school. The teachers do not know the reasons for the absences for 29,6% of students but for 51,9% they indicate psychological problems as the main reason of the absences. The 40,7% of students showed difficulty waking up, leaving home, coming to school, difficulty in relating to others and low self-esteem. These signs could bring to identify hikikomori subjects.ConclusionsThe research shows that the school is not able to recognize a student hikikomori, but it can provide valuable informations to identify a teenager with social withdrawal.
A hikikomori is a child, an adolescent or a young adult who voluntarily retreats into his own home for long periods, not showing evident signs of psychological distress or overt mental disorder. This phenomenon was first described in Japan, but several research studies show that it is spreading in many countries around the world. The author hypothesizes that the decision to become a hikikomori is made by the person in an attempt to find a solution to difficulties in relationships with himself and with others. The choice of reclusion rapidly becomes a trap: in this condition the individual is imprisoned in complex functions of the mind which curb and restrict independence and personal autonomy. This is owing to the fact that, with the withdrawal, a pathological personality organization, formed during the years of early infancy, gradually takes control of the internal world, pushing towards anti‐developmental mental states and behaviours. The paper continues with some reflections on individual treatment with psychoanalytic psychotherapy of adolescents and young adults in a state of acute social withdrawal. The reference model used is John Steiner's notion of ‘psychic retreat’. A description of a four‐year treatment completes the paper, allowing for further clinical reflections.
Introduction"Hikikomori” is known since the 80s and was described by Saito in 1998 as a different clinical picture from any current diagnostic category, being social withdrawal the most important aspect. Young hikikomoris, more than a million in Japan (Teo2010), withdraw in their room for at least six months, interrupting communication with the outside world. This picture was described by many international scholars (Watts 2002; Zielenzinger 2008; Teo 2010; Piotti et al.2014). Part of international literature, after DSMIV-TR, defined hikikomori as a culture-bound syndrome (Agugliaetal.,2010). However, recently similar cases were described in different contexts, both in Asia and Western world (Kato et al.,2012), highlighting peculiar clinical signs influenced by the context, although maintaining a common matrix referred to Saito framework.AimsThis literature review aims to gather descriptions of hikikomori in different cultures, to identify cross-cultural variables on which the phenomenon is based and to analyse any differences in clinical manifestations.MethodsEighty-two articles which contained ‘hikikomori” in the title or abstract were reviewed and searched using online databases (PsycINFO, PubMed, googleschoolar)ResultsThe scientific literature was divided by year of publication and by three phases:1. The articles are mostly Japanese2. Western articles, referring to Japanese contexts3. The Hikikomoriconcept isclosely related tosocial withdrawal (sources from many countries).ConclusionThe literature shows a tendency to consider hikikomori a phenomenon which exceeds cultural context (although influenced by it), rather than a culturally characterized syndrome.
IntroductionSocial withdrawal is a potential signals of distress and mental illness such as psychosis, mood disorders, anxiety (Kirkcaldy & Siefen, 2012). The term 'hikikomori” defines a particular form of social withdrawal recognized in Japan at the end of the last century (Saito, 1998). At the moment in all the west world (United States, France, United Kingdom, Spain, Italy) there is an increasing frequency of adolescents and young people who show symptoms of hikikomori like a life style centered on the own home and refusal of the school.Objectives and AimsRequests to take care of social withdrawal teenagers (hikikomori) are increasing. This work describes two cases in treatment of early adolescents.MethodsAuthors analyse the terapeutic steps of the clinical treatment of two very young teenegers arrived to the Public Health Service because their extreme social withdrawal. The work focusses the attention on the relationship with the patients, the families and the social context.ResultsThe two cases show that the treatment of hikikomori sindrome is complex. A single type of approach (e.g. individual psychoterapy or family therapy) is not sufficient. Combining different patterns it is possible to create a network of treatments able to promote the resources of subject and of his/her familiar and social context.ConclusionsResults underline the necessity of increasing the clinical knowledges on the social withdrawal sindrome and creating new protocols useful for the treatment.
Extreme Risk Seeking Addiction (ERSA) is a behavioural addiction manifested as a repeated voluntary search for risk. This article introduces some theoretical reference points to discuss a clinical case study, a once-weekly psychotherapy which extended over more than ten years.The model followed assumes that ERSA is due to the feelings of excitement and 'narrow escape' which, if reiterated, bring about the construction of a pathological organization, a psychic retreat in Steiner's terms. This organization is a part of the self which is tyrannical and falsely protective, and is able to create illusory feelings of invulnerability and all-powerfulness. Psychotherapy can offer a benevolent interaction which is sufficiently in tune with the ERSA-affected person to be able to favour self-reflective experiences promoting the mentalization of affect and, more generally, the skills which make it possible to recognize emotions in the self and in others, and to manage emotional states within relationships effectively and competently.
Distribution électronique Cairn.info pour De Boeck Supérieur. © De Boeck Supérieur. Tous droits réservés pour tous pays.La reproduction ou représentation de cet article, notamment par photocopie, n'est autorisée que dans les limites des conditions générales d'utilisation du site ou, le cas échéant, des conditions générales de la licence souscrite par votre établissement. Toute autre reproduction ou représentation, en tout ou partie, sous quelque forme et de quelque manière que ce soit, est interdite sauf accord préalable et écrit de l'éditeur, en dehors des cas prévus par la législation en vigueur en France. Il est précisé que son stockage dans une base de données est également interdit.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.