The cases of young Italian boys are recent who decide to retire at home and close any relationship with the outside world.
Parallel the word has also spread in the Italian lexicon Hikikomori which contains an aura of mystery and exotic nebulosity. This term was born in Japan during the 80s, spreading in the rest of the world.
The first description of this phenomenon was reported by the Japanese psychologist Tomita during the late 1970s. The word Hikikomori It derives from the verb hikikomorou which can be translated as “to withdraw itself in a closed place”, “retire in themselves”. In fact, this is the heart ofHikikomori: a conscious choice to withdraw from society and the obligations it imposes.
Each country has translated the term differently, social withdrawal In Italy, Claustration in France, Neets (Not in Employment, Education or Training) in England, but everyone underlines the behavioral component of this phenomenon, that is, the voluntary interruption of relations with other human beings.
According to the Japanese ministry of Health Labor and Welfare (MHLW) condition of hikikomori mainly affects teenagers and adults under 30 years and is characterized by a period of social withdrawal which lasts on average 3 years with a large margin of variability (months or years).
It is important to underline how on a symptomatological level, American psychiatrists Teo and Gaw consider discriminating to hypothesize the presence of Hikikomori The following characteristics:
- A lifestyle centered on the house (more often one room).
- Lack of interests for school or work.
- At least 6 months of duration.
- People who despite being withdrawn continue to maintain social relationships are excluded.
- People with other pathologies such as schizophrenia, mental disability or other psychiatric disorders are excluded.
The latter point is particularly important to read what is still the most heated debate about theHikikomori: pathology or cultural expression of a malaise? The discussion is open.
Some scholars have proposed to divide the phenomenon ofHikikomori In two types: Primary hikikomori for those people who do not present comorbilities with other psychiatric pathologies; Secondary hikikomori For those who are also affected by another pathology (e.g. depression, anxiety, schizophrenia).
Other authors, on the contrary, believe that theHikikomori be it itself a psychiatric disorder. On the other hand, the latest version of the diagnostic and statistical manual of mental disorders (DSM 5) does not mention theHikikomoriwhile in the previous one (DSM IV-TR) this was identified as a syndrome linked to culture, that is, a set of symptoms, expression of a malaise, specific for the Japanese context. What has been said expresses well the difficulty of labeling a phenomenon whose boundaries have yet to be clarified.
Beyond the attempts, although necessary, of categorization, more and more authors believe theHikikomori An epidemic phenomenon that concerns millions of young people, despite reliable estimates are difficult to obtain given the high number of “submerged” cases that do not come to the observation of professionals.
It is assumed that in Japan the prevalence during the life of theHikikomori both 1.2% and that the phenomenon is now of global scope since cases such as Korea, China, USA, Spain and Southern Italy have been detected. Faced with this rapid diffusion, it appears spontaneous to question what the causes that contribute to the phenomenon of hikikomori.
Although there is no unanimous consent in the literature, it is possible to identify some risk factors that contribute to theHikikomori: the greater impact of hikikomori among male teenagers seems to be connected to a specific form of anxiety towards entry, typical of adult life, in a society characterized by high levels of competitiveness; where the weak is labeled as a loser and rejected by the company itself.
Rather than taking the risk of not finding people with people with Hikikomori They prefer to avoid potential failure by retiring at home. Thus we create a state that in psychology is called Helplessness, that is, a lack of trust in the possibility of receiving an external help that, in turn, strengthens the social withdrawal. In this situation, a family structure seems to be grafted that promotes the closure towards the outside and the autarchy of relationships.
It is no coincidence that the appearance of the former Hikikomori It took place in the 70s, a period in which the Japanese social landscape underwent profound changes. Following the Second World War, the traditional Japanese family model, based on the enlarged family, suffered a profound crisis. It passed to a western model in which the father remained for the most of the time away from home and the mother became responsible for the education of the son.
The relationship of dependence that naturally characterizes the mother-child relationship is reinforced and the mothers are socially encouraged to become overprotective and manage the son in an controlling way. The young man therefore decides to manage the anxiety generated by not being able to find a place in society through a voluntary retreat in the house (more often in the room) obtaining, at least initially, a tacit reinforcement from family members. The family system transmits the idea of a bad and dangerous world to the boy where only the house is a safe place.
It seems that in this dynamic the point of contact between Japan and Italy resides. In fact some cases of Hikikomori They were detected in southern Italy where the family model has more similarities with the Japanese one. Far from grossotype grossotypes there is actually a similarity between Italian and Japanese culture. It concerns the trend of families to retain and encourage the stay of the young man within the family unit. In this sense, similarly to what is happening in Japan, the psychological distress would find manifestation in the forced car-report.
If on the one hand the family appears to be an agent at least of maintenance of the Hikikomoriit should be noted that another key factor is the victim of bullying during the school period. Suffering bullying increases the feeling of not having the tools to defend itself from an aggressive and competitive society.
The young Hikikomori He feels he does not possess communication skills to affirm himself in society and, at the same time, perceives social pressures to build a future. The consequence of this dilemma is the loss of push towards the relational aspects and the withdrawal in a safe port as its room.
Finally, a last factor taken into consideration by the literature on theHikikomori It is the relationship with new technologies. Second Kato and collaborators, the New technologies they could strengthen the social withdrawal as they would offer linear and understandable virtual worlds in the eyes of the teenager. The rules in these worlds are clear, explicit, likely and, above all, easily accessible rewards.
In the real world, on the contrary, the objectives are more nuanced, the complex rules and the frustration of one’s own objectives very likely. To survive, flexibility and courage is required to expose yourself to failure and shame. The problem, also present when it comes to treatment, therefore lies in the ego -inticity of the social withdrawal: there is a loss of motivation in facing a complex world with continuous change rules and for which there is no instruction manual. However, it is necessary to underline that the link between Hikikomori And the Internet is still to be clarified.
No correlations have emerged between the use of the computer and the onset of Hikikomori. However, the rapid evolution of communication devices seems to be able to contribute to a certain extent to the maintenance of the social withdrawal As well as associating a set of other pathologies (internet addiction, dependence on social networks, game addiction). And, however, new technologies and more generally the web must not be demonized as they are an important resource to try a first contact with these people.
The difficulties of defining the phenomenon have not allowed to structure intervention protocols universally recognized. In Japan, the Ministry of Health has developed some guidelines that include four phases for the Treatment of the Hikikomori:
- Support the family and get contact with the young man;
- Offer individual support to the boy;
- Include the patient in a therapeutic group in order to develop social skills;
- Exercise the skills acquired in real situations.
If the family taking charge becomes an essential step for the Treatment of the Hikikomorion the intervention side on the individual, a certain ineffectiveness of the pharmacological therapies was found. The only exception seem to be anti-depressive, in particular paroxetine, which showed some results in cases where obsessive thoughts are present. However, it is to be underlined how the data are very scarce to date and, therefore, how premature to draw conclusions.
The currently most useful approach seems to be a combined intervention of psychotherapy and drugs. As regards psychotherapeutic interventions, those with cognitive-behavioral orientation are the most used. According to literature, given the phenomenological similarity between Hikikomori And social anxiety disorder, mainly behavioral group interventions seem to give the best results. These interventions base their effectiveness on techniques of progressive exposure to situations considered threatening by the person with Hikikomori.
The group is used as a safe place to exercise and improve its own social skillsoften rusty from the long period of inactivity, receiving unconditional acceptance and support. As mentioned, however, the first and most difficult step remains to be able to establish a first contact with the young man, for this purpose new technologies such as e-mails, Facebook and Skype can be used.
Summarizing, theHikikomori It is a phenomenon with clear psychological and social roots with still shaded outlines. Risk factors to develop Hikikomori They are: the male sex as among the boys the onset of hikikomori is 4 times greater than the girls; The firstborn since it is on the first -born male who concentrated expectations with respect to the good name of the family; The young age since the debut usually takes place between 19 and 27 years with 23% of cases in the first year of lower middle schools; The medium-high social class with the presence of graduate parents and having been a victim of school bullying.
As much as structured interventions have not yet been developed, the recent attention to the phenomenon is certainly to be encouraged in the hope that this facilitates the awareness of a problem that affects millions of young people.
