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By William Kremer and Claudia Hammond BBC World Service
As many as a million young people in Japan are thought to remain holed up in
their homes - sometimes for decades at a time. Why?
For Hide, the problems started when he gave up school.
"I started to blame myself and my parents also blamed me for not going to
school. The pressure started to build up," he says.
"Then, gradually, I became afraid to go out and fearful of meeting people. And
then I couldn't get out of my house."
Gradually, Hide relinquished all communication with friends and eventually, his
parents. To avoid seeing them he slept through the day and sat up all night,
watching TV.
"I had all kinds of negative emotions inside me," he says. "The desire to go
outside, anger towards society and my parents, sadness about having this
condition, fear about what would happen in the future, and jealousy towards the
people who were leading normal lives."
Hide had become "withdrawn" or hikikomori.
In Japan, hikikomori, a term that's also used to describe the young people who
withdraw, is a word that everyone knows.
Tamaki Saito was a newly qualified psychiatrist when, in the early 1990s, he
was struck by the number of parents who sought his help with children who had
quit school and hidden themselves away for months and sometimes years at a
time. These young people were often from middle-class families, they were
almost always male, and the average age for their withdrawal was 15.
It might sound like straightforward teenage laziness. Why not stay in your room
while your parents wait on you? But Saito says sufferers are paralysed by
profound social fears.
"They are tormented in the mind," he says. "They want to go out in the world,
they want to make friends or lovers, but they can't."
Symptoms vary between patients. For some, violent outbursts alternate with
infantile behaviour such as pawing at the mother's body. Other patients might
be obsessive, paranoid and depressed.
Otaku v hikikomori
A man looking at some adult manga comics
An overlapping group of people with the hikikomori, otaku are "geeks" or
"nerds"
They are known for their obsessions, especially manga cartoons and anime
"Otaku" is the formal word for "you" in Japanese - it's thought that the term
came about from the tendency of socially awkward manga fans to use over-formal
language
In press coverage, both otaku and hikikomori have been linked with serious sex
crimes
When Saito began his research, social withdrawal was not unknown, but it was
treated by doctors as a symptom of other underlying problems rather than a
pattern of behaviour requiring special treatment.
Since he drew attention to the phenomenon, it is thought the numbers of
hikikomori have increased. A conservative estimate of the number of people now
affected is 200,000, but a 2010 survey for the Japanese Cabinet Office came
back with a much higher figure - 700,000. Since sufferers are by definition
hidden away, Saito himself places the figure higher still, at around one
million.
The average age of hikikomori also seems to have risen over the last two
decades. Before it was 21 - now it is 32.
So why do they withdraw?
The trigger for a boy retreating to his bedroom might be comparatively slight -
poor grades or a broken heart, for example - but the withdrawal itself can
become a source of trauma. And powerful social forces can conspire to keep him
there.
One such force is sekentei, a person's reputation in the community and the
pressure he or she feels to impress others. The longer hikikomori remain apart
from society, the more aware they become of their social failure. They lose
whatever self-esteem and confidence they had and the prospect of leaving home
becomes ever more terrifying.
Parents are also conscious of their social standing and frequently wait for
months before seeking professional help.
A comic strip from Welcome to NHK! Welcome to NHK! was a novel, comic book and
cartoon that focused on the life of a hikikomori
A second social factor is the amae - dependence - that characterises Japanese
family relationships. Young women traditionally live with their parents until
marriage - men may never move out of the family home. Even though about half of
hikikomori are violent towards their parents, for most families it would be
unthinkable to throw them out.
But in exchange for decades of support for their children, parents expect them
to show respect and fulfil their role in society of getting a job.
Matsu became hikikomori after he fell out with his parents about his career and
university course.
What about the girls?
An unhappy Asian girl
Hikikomori are seen as predominantly male - Tamaki Saito says males occupy 70%-
80% of the group
However, an internet survey by NHK found just 53% to be male
Andy Furlong at the University of Glasgow speculates that female withdrawal
into the home seems so natural to Japanese society that women hikikomori may
remain unreported
"I was very well mentally, but my parents pushed me the way I didn't want to
go," he says. "My father is an artist and he runs his own business - he wanted
me to do the same." But Matsu wanted to become a computer programmer in a large
firm - one of corporate Japan's army of "salarymen".
"But my father said: 'In the future there won't be a society like that.' He
said: 'Don't become a salaryman.'"
Like many hikikomori, Matsu was the eldest son and felt the full weight of
parental expectation. He grew furious when he saw his younger brother doing
what he wanted. "I became violent and had to live separately from my family,"
he says.
One way to interpret Matsu's story is see him as being at the faultline of a
cultural shift in Japan.
"Traditionally, Japanese psychology was thought to be group-oriented - Japanese
people do not want to stand out in a group," says Yuriko Suzuki, a psychologist
at the National Institute for Mental Health in Tokyo. "But I think especially
for the younger generation, they want more individualised or personalised care
and attention. I think we are in a mixed state."
But even hikikomori who desperately want to fulfil their parents' plans for
them may find themselves frustrated.
Andy Furlong, an academic at the University of Glasgow specialising in the
transition from education to work, connects the growth of the hikikomori
phenomenon with the popping of the 1980s "bubble economy" and the onset of
Japan's recession of the 1990s.
It was at this point that the conveyor belt of good school grades leading to
good university places leading to jobs-for-life broke down. A generation of
Japanese were faced with the insecurity of short-term, part-time work.
And it came with stigma, not sympathy.
Job-hopping Japanese were called "freeters" - a combination of the word
"freelance" and the German word for "to work", arbeiter. In political
discussion, freeters were frequently bundled together with "neets" - an adopted
British acronym meaning "not in education, employment or training". Neets,
freeters, hikikomori - these were ways of describing the good-for-nothing
younger generation, parasites on the flagging Japanese economy. The older
generation, who graduated and slotted into steady careers in the 1960s and
1970s, could not relate to them.
Japanese men celebrating with fists in the air University graduates at a
job-hunting fair in February... but freeters, neets and hikikomori find
themselves on the periphery of Japan's labour market
"The opportunities have changed fundamentally," says Furlong. "I don't think
the families always know how to handle that."
A common reaction is for parents to treat their recalcitrant son with anger, to
lecture them and make them feel guilty for bringing shame on the family. The
risk here is that - as with Hide - communication with parents may break down
altogether. But some parents have been driven to extreme measures.
For a time one company operating in Nagoya could be hired by parents to burst
into their children's rooms, give them a big dressing down, and forcibly drag
them away to a dormitory to learn the error of their ways.
Kazuhiko Saito, the director of the psychiatry department at Kohnodai Hospital
in Chiba, says that sudden interventions - even by healthcare professionals -
can prove disastrous.
"In many cases, the patient becomes violent towards the staff or the parents in
front of the counsellors, or after the counsellors have left," he says.
Kazuhiko Saito is in favour of healthcare professionals visiting hikikomori,
but he says they must be fully briefed on the patient, who must know in advance
that they are coming.
Hikikomori - just a Japanese thing?
A man and his son arguing
Hikikomori has entered the Oxford English Dictionary as "In Japan: abnormal
avoidance of social contact"
But Saito Tamaki believes it is also a problem in Korea and Italy
After a 2002 BBC documentary, Saito received a flurry of emails from British
parents who said their children were in a similar condition
Andy Furlong points out that young people in Western societies frequently "take
time out" in gap years or have "false starts" on careers or courses without
attracting stigma
He adds that the preconditions for a hikikomori-like problem are falling into
place in Europe, with 50% youth unemployment in some countries, forcing young
people to continue living at home
In any case, the do-nothing approach has been shown not to work. Tamaki Saito
likens the hikikomori state to alcoholism, in that it is impossible to give up
without a support network.
His approach is to begin with "reorganising" the relationship between the
patient and his parents, arming desperate mothers and fathers with strategies
to restart communication with their children. When the patient is well enough
to come to the clinic in person he can be treated with drugs and therapy. Group
therapy is a relatively new concept to Japanese psychology, but self-help
groups have become a key way of drawing hikikomori into wider society.
For both Hide and Matsu, the journey to recovery was helped by visiting a
charity-run youth club in Tokyo known as an ibasho - a safe place for visitors
to start reintroducing themselves to society.
Both men have made progress in their relationships with their parents. Matsu
has been for a job interview as a computer programmer, and Hide has a part-time
job. He thinks that by starting to talk again with his parents, the whole
family has been able to move on.
"They thought about their way of life in the past and in the future," he says.
"I think that before - even though they were out working - their mental
attitude was just like a hikikomori, but now they're more open and honest with
themselves. So as their child I'm very happy to see them change."
Many parents of hikikomori visit the ibasho even though their children may
never be well enough to come with them.
Yoshiko's son withdrew from society very gradually when he was 22.
At first he would go out to buy shopping, but she observes ruefully that
internet shopping means this is no longer necessary and he no longer leaves the
house. He is now 50 years old.
"I think my son is losing the power or desire to do what he wants to do," she
says. "Maybe he used to have something he wanted to do but I think I ruined
it."