Hikikomori: Japan’s Name for a Global Crisis

The young man smiled shyly at me from across the computer screen. Let’s call him Hiro. For years, he’d lived alone, a recluse behind a closed door.

“I’ve never been good at participating in society,” he told me, “and my relationships at school didn’t go well, and eventually I became futoko [stopped going to school]. I became hikikomori when I was in my third year of middle school.”

What did that first day look like, I asked him, when you didn’t go to school?

Hiro glanced at his hands, which he had been wringing since our conversation began. “I felt a strong sense of guilt,” he said. “I felt like I was a bad person for not going to school, and that wasn’t just the first day, but also as I became an adult. There was a pervasive sense of guilt for staying home all the time.” He paused for a moment. “I’m doing better now.”

Hikikomori — acute social withdrawal — is a Japanese term that descibes both a condition and an identity. Afflicted individuals retreat like hermits into their homes or bedroom, shutting themselves away from the world for months or years at a time. Hiro is now in recovery, but many hikikomori are not so lucky. As his story made clear, the syndrome can be cruelly self-perpetuating: Feelings of inadequacy lead to withdrawal, which reinforces feelings of inadequacy.

Reports of social withdrawal date back to the 1970s, but the term hikikomori was popularized in 1998 when a leading psychiatrist, Dr. Saito Tamaki, wrote a book of the same name. I had the privilege of meeting Dr. Saito and Hiro in July 2018, as I was researching how stakeholders and change-makers in Japan are combating social isolation and building belonging.

The Japanese Ministry of Health, Labour, and Welfare has defined hikikomori as “a situation where a person without psychosis is withdrawn into his/her home for more than six months and does not participate in society such as attending school and/or work.” While the syndrome’s manifestation is clear, its root cause is hard to pin down. Experts have pointed to possible factors from autism to anxiety; bullying to problems in school; poor interpersonal skills to an inability to get a job; overbearing parental pressure to overindulgent parental coddling. Debates persist over whether hikikomori is a distinct psychiatric disorder. Some observers say it’s not a psychological condition at all.

What cannot be disputed, however, is the pervasiveness of the condition. Estimates of sufferers in Japan range from 541,000 to well over a million — and the inherent challenge of identifying people who have withdrawn from society means many hikikomori are going unseen and aging behind closed doors. Despite the popular perception of hikikomori as young people in their teens or twenties, many are in their 40s or even older. Female hikikomori are at special risk of invisible isolation, as Japanese gender roles make it culturally acceptable for women to stay at home.

Some have argued that hikikomori’s prevalence in Japan derives from the country’s cultural context. Young Japanese who struggle to excel in school or to find employment (especially young men) may self-stigmatize and withdraw, rather than persist as “non-fitting” members of a society whose expectations they cannot meet. Others suggest the conformist nature of Japanese society can be stifling, leaving no room for individuals who march to the beat of their own drum.

And yet, social withdrawal is hardly exclusive to Japan. Cases have been reported from countries as varied as France, Korea, and Oman. Psychiatrists surveyed from Australia, Bangladesh, India, Iran, Japan, Korea, Taiwan, Thailand, and the United States indicated that hikikomori syndrome is seen in their countries.

Indeed, in my conversations with Japanese hikikomori experts from the medical, public, and nonprofit sectors, and with a number of recovering hikikomori themselves, I felt that I was hearing themes I could have heard in any country or context — themes that emerge wherever social isolation, and its cruel cousins shame and stigma, have taken hold.

That is why, even though hikikomori may be particularly associated with Japan, the overarching issue I see is the global problem of social isolation. Likewise, the efforts under way in Japan to address the hikikomori crisis have lessons we can apply more broadly to efforts to build belonging worldwide.

Many features of hikikomoris’ struggles, from bullying to social anxiety to feelings of inadequacy, are familiar to people of all ages and backgrounds, all around the globe. This is especially true when it comes to mental health challenges, and the stigma that often accompanies them. UNICEF estimates that one in five adolescents will face a mental health disorder each year. Globally, some 300 million people suffer from depression. And many experts believe that the majority of hikikomori carry some form of psychiatric disorder or mental disability — yet Japanese sufferers and their families often wait years to seek help from a medical expert or specialist, and even then, it is seen as less “embarrassing” to be termed hikikomori than to be diagnosed with mental illness.

I believe the destigmatization of mental illness is one of the social justice imperatives of our time. To help hikikomori — and so many others who struggle with isolation — cross the threshold back into society, we have to recognize that mental and emotional barriers are just as powerful as physical barriers. Well-intentioned observers might ask, “If someone is feeling isolated, why don’t they just get out there?” But to hikikomori, and so many others who struggle with isolation, stigma and shame can make the door out of the bedroom seem more like a brick wall.

In Japan, the hikikomori challenge is often framed in economic terms, given the lost productivity that hundreds of thousands of shut-ins represent. But for an isolated person, young or old, in Japan or anywhere else, the biggest hurdle may not be the act of finding a job but emerging into a society that has left them feeling “less-than.”

Moreover, parents and family members may face brick walls of their own. As much as they want to support their loved ones, they are susceptible to societal pressures themselves — the embarrassment of not fitting in; the shame of appearing like a failure; the stigma of a mental health challenge in the family.

In Japan, for example, I learned of self-described hikikomori “treatment centers” known for abusive rehabilitation practices. Some of these centers charge tens of thousands of dollars for their services, or bring hikikomori in against their will, literally kicking down the bedroom door. Not surprisingly, as I learned from several young individuals who had fled one such place, these centers, instead of helping hikikomori, can actually inflict more trauma.

Fortunately, far better programs exist to build pathways out of even the most extreme forms of isolation. And as I saw in Japan, while there is no all-purpose, silver bullet solution, there are ways for individuals, organizations, and institutions to contribute at every level.

Governments can take the lead in collecting and sharing data, which validates the fact that a problem exists, and can mobilize resources to address it. According to Kouichi Murata, an employee I interviewed from Japan’s Ministry of Health, Labor, and Welfare, the government has collected data on hikikomori and, since 2009, has been providing financial support to hikikomori support centers at the prefectural and city level — nearly 70 such centers so far. These centers serve as a first point of contact, fielding calls from distraught parents, hosting support groups, and connecting hikikomori and their families with help.

Researchers can help advance awareness and understanding of what isolated people are going through; and this, in turn, can lay the groundwork for more targeted and effective interventions. U.S. expert Dr. Alan R. Teo, working with colleagues at Kyushu University in Japan, recruited close to 400 participants across Japan to design and develop a standardized, cross-national tool to reliably assess and measure hikikomori. Their paper, published in June 2018, concluded that the resulting 25-item Hikikomori Questionnaire “possesses robust psychometric properties and diagnostic accuracy” — and thus can be a useful tool for better detecting, evaluating, and assisting people at risk.

Private sector and civic leaders can be critical allies as well. One of the most inspiring initiatives I saw in Japan is a new social enterprise called Mecha Koma, a web design company launched in 2017 that employs around 20 hikikomori. When I met with Mecha Koma’s visionary founder Kei Sato, he excitedly described how he is creating an atmosphere where hikikomori can build confidence through work — and, insodoing, fuel healing and an empowering sense of purpose.

“When you’re taking that first step, the important thing is just to provide that space for [hikikomori] to come together, and to not deny anyone, to welcome everybody,” Sato explained, emphatically repeating his one rule: “Do not deny.” The power of Sato’s acceptance, encouragement, and affirmation was palpable in his words and his enthusiasm. “[Hikikomori] might have different values and opinions and worldviews,” he told me, “but none of that is to be denied, because they’ve lived their whole lives being denied and having this idea reinforced that they’re no good, that they won’t amount to anything in life.”

Mecha Koma is thoughtful and creative in its approach, tailoring the work to the style, abilities, and self-esteem needs of the hikikomori themselves. As Sato told me, “The way we do that is by breaking down the work into discrete pieces, and highlighting the sense of accomplishment and achievement that comes with finishing even a very minor task that’s been assigned to them.” To that end, employees are paid by the piece, ensuring steady recognition and reward.

Eventually, as they are able to perform and complete tasks, they rediscover their own potential and value, and their self-stigma dissolves. I was moved to learn that one successful young employee was now referring others to the program, too.

To me, what makes Mecha Koma so special is that not only does the organization understand that all of us want to have meaningful work and to be part of society, but it also has steps to bring people there. Rather than projecting blame or shame onto the person who is isolated, Mecha Koma says, “We see potential.” That’s what’s transformative. That creates the conditions that build confidence: the willingness to reach out to someone who is isolated and to say, “I see you and I believe in you.”

Indeed, an isolated person can be his or her own bridge to belonging for someone else. In Japan, I was moved to learn about the newspaper Hikikomori Shimbun, created and run by current and former hikikomori to put their experience out in the open. Not only does the publication give them a platform for sharing and self-expression, it provides an outlet for mutual support, recognition, and self-empowerment.

As founding editor Naohiro Kimura told Public Radio International’s The World,“If people are lonely, if they’re suffering, it’s really important to reach out and communicate with other people; that’s how you start to heal.”