DISPATCH
TOKYO Public health experts concerned about hikikomori
apans Coming-of-Age Day is sup-
J posed to celebrate the entrance into
society of a new wave of adults, but it
has recently become the focus of con-
cern about a generation that is increas-
ingly seen as pathologically withdrawn.
True to its reputation as the most
colourful day in the Japanese social
calendar, the festival earlier this year
saw hundreds of thousands of young
men and women dressed in bright silk
kimonos and slick suits for ceremonies
to mark their passage into adulthood.
But many of the festivities were
overshadowed by a stronger than usual
security presence after disruptions last
year grabbed front-page headlines and
prompted a prolonged bout of hand-
wringing about the unwillingness of
20-year-oldsthe age at which it
becomes legal to drink, smoke, and
voteto behave and accept the
responsibilities of an adult. These con-
cerns have focused on a seemingly new
psychiatric phenomenon: hikikomori
(acute social withdrawal). The term,
coined by psychiatrists, has risen to
prominence in the past 3 years along
with a series of savage crimes done by
young recluses.
Research into the lifestyle of the per- anything that might suggest disfunc-
petrators showed that their hermetic
way of lifeshut up for months on
end in their rooms with little more
than a computer or a video game for
companywas far from exceptional.
News reports sug-
gest that up to
1 million young The extremes of dropping
Japanese are just dead or dropping out are not
as reclusive. And necessarily contradictory
psychiatrists argue
that this is not so
much a lifestyle choice as a sickness
that afflicts a generation that has been
made vulnerable by affluence and
technological advances.
For the moment, the term is
undoubtedly used more by the media
than by the medical community. The
definition of the ailment remains
sketchy, estimates of the scale of the
problem are based largely on guess-
work, and research is only just begin-
ning. But that has not stopped the
government from taking the issue seri-
ously enough to launch studies into
the problem, which began last year.
Specialist psychiatric centres have
been established and there is a
plethora of websites offering advice.
In its first study of the phenomenon
released in April last year, the govern-
ment defined hikikomori as anyone
who has completely withdrawn from
society for more than 6 months. The
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study reported that 6151 cases had
presented at public health centres dur-
ing the previous 12 months.
Most of those affected were young.
About 40% were aged between 16 and
25 years. Another 21% were aged
between 25 and 30 years. One in four
had felt symptoms for at least
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Young adults may need to get out more
5 years. Nearly 8% said they had with-
drawn from society for a decade or
longer. The figures may represent only
the tip of the iceberg because hikiko-
mori are by definition reluctant to seek
treatment and their families are often
unwilling to request counselling for
tionality.
Tamaki Saito, the psychiatrist who
coined the term hikikomori, says the
government needs to take
a systematic approach to defining and
dealing with this
illness. That will
not be easy as the
symptoms are
hard to pin down.
Although they
bear similarities
to agoraphobia, depression, and other
forms of mental illness, specialists say
there are important differences.
Sufferers behave normally unless
they are placed in a stressful situa-
tion, said Hiromi Shiraishi of the
Tokyo Institute of Psychiatry. There
are also many unanswered questions
about the possibility of a link to violent
behaviour. In the past year, newspa-
pers have been filled with stories of
reclusive teenagers suddenly turning
on their parents, teachers, or class-
matesat times with murderous
consequences. But the postings on
websites suggest that the alienation
associated with hikikomori manifests
itself more in lethargy than in violence.
While a clear definition remains elu-
sive, there is broad agreement that this
illness is a product of the affluence,
technology, and convenience of mod-
ern Japanese life. Many hikikomori
spend most of their waking hours on
the internet or playing video games,
while snacking on food and drink
delivered to their homes. In the past,
such unproductive behaviour for those
of working age would have prompted
many to be kicked out of their houses,
but todays Japan is so rich that mil-
lions of parents are happy to allow
their children to remain at home until
their thirtiesa trend that has
prompted the widely used expression
parasite singles.
Others see the pressure to conform
in Japan as the cause. Here you have
to be like other people and if you
arent then you feel a sense of loss, of
shame, so you withdraw, Sadatsugu
Kudo, who works at a centre for
hikikomori, told reporters.
It is not easy, however, to reconcile
this problem with the current genera-
tion of young Japanese, whoon the
surface at leastappear anything but
withdrawn. They are travelling over-
seas in record numbers, packing night-
clubs in Tokyo, and sporting some of
the worlds most outrageous fashions.
As is often the case with issues of
mental health, this begs the question
of whether the problem lies with the
observed or the observers. Or to put it
another way, perhaps the anxiety
about the escapism and withdrawal of
young Japanese is as much a reflection
of the insecurities of a society that is
ageing faster than any other. Such is
the speed of the demographic shift in
Japan, that people currently in their
twenties face a huge burden later in life
to provide for the health, pension, and
welfare needs of their parents.
Viewed in this light, it is perhaps no
coincidence that the two new social ill-
nesses that have come out of Japan in
recent years are both related to work.
10 years ago, at the height of Japans
economic powers, there was a sudden
rush of concern about karoshi (death
by overwork) that suggested the coun-
try was labouring itself to an early
grave. Now, after a decade of eco-
nomic stagnation, all the attention is
on hikikomori, which suggests that the
country is becoming apathetic.
The extremes of dropping dead or
dropping out are not necessarily con-
tradictory. And both may yet prove to
be symptoms not just of Japan, but of
all modern societies. But it is hard to
escape the conclusion that these ill-
nesses reflect at least as much on
Japanese society as on the individuals
concerned.
Jonathan Watts
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