Although often bearing strong similarities to agoraphobia and social phobia, this phenomenon does not fit comfortably within any established formal diagnostic category. Nor should it, in my view. We have defined quite enough aspects of human experience as diseases, thank you very much.
The lack of a diagnostic label, however, has meant that different practitioners and researchers have observed and reported on the phenomenon almost independently of one another. Consequently, we have multiple accounts from different countries from different perspectives that are relatively untainted by preconceived notions imposed by the early investigators.
Shoshanna Campbell, helping out at Changeways Clinic for the past few months, has been looking through some of the research for this talk. She has unearthed papers on the topic from cultures all over the world. In Great Britain, for example, the term most often used is NEET – Not in Employment, Education, or Training.
The largest literature, however, comes from Japan, where these young men are known as hikikomori. Nowhere on Earth has the problem penetrated popular culture like it has in Japan, where estimates have been made that there are an estimated 700,000 young people living these sharply restricted lifestyles. (Estimates for the incidence of issues related to mental health are almost always exaggerated, so it’s best to take these numbers with a grain of salt.)
Hikikomori regularly appear in the news and other media in Japan. In 2002, Tatsuhiko Takimoto published a novel with hikikomori characters, Welcome to the NHK, that was subsequently made first into a manga series and then into an anime television series.
Although I’m not generally an anime fan, I’ve spent part of the past week going through this series (available in a dubbed edition in North America). I have repeatedly been struck by the insights in the series and how closely the experiences of the characters mimic those of clients I have seen in therapy.
These individuals inevitably feel alone and unique. Because they know almost no one, they meet few who are similar to them. I’ve thought often while viewing Welcome to the NHK that I wish my clients could watch the series. Most would be astonished to find aspects of their own lives played out on screen, appearing within the setting of a Tokyo apartment block.
The series begins by introducing us to Tatsuhiro Sato, a 22-year-old who dropped out of college four years before the series begins after suffering what seems to have been a severe panic attack. He has lived ever since inside his tiny one-room Tokyo apartment, imagining that the NHK (Japan’s real-life public broadcaster, but within the context of the series a more wide-ranging organization) is behind a national conspiracy to create hikikomori by producing addictive programming – a delusion that persists and reappears when he is under stress. He rages against his next-door neighbor who blares theme music from an anime series apparently designed for young girls.
The neighbor turns out to be his old school friend Yamazaki, who would be hikikomori himself if he did not have to get out for classes at a school for game designers. A mysterious girl, Misaki, recruits Sato into her “project,” which is to cure a hikikomori with a mix of Freud, Jung, and exposure-like excursions into the outside world. Along the way we encounter suicide clubs, multi-level marketing schemes, polypharmacy, internet pornography addiction, and “girl games” designed to appeal to dateless young men.
The two young men become inspired to create the girl game to beat all girl games, using their ability to understand the longing and isolation of the players of such things as their trump card. I found myself concerned at this point, given the American imperative that any such quest must pay off with wild success in the end, thus countering any shred of realism in the plot up until that point. But Welcome to the NHK has bigger fish to fry, and chooses instead to side with a more sobering reality. The resolution they seek is a relinquishment of narcissistic self-aggrandizing fantasy and a coming to terms with the real world.
Episode 1, the link to which is below, gives something of the flavour of the series, though the conspiracy element quickly fades to the background in subsequent episodes only to recur in snippets. Watching the series should probably come with Continuing Education credits for professionals, given that it constitutes a virtual seminar on the inside world of the problem. At least some episodes are available on YouTube, and the full series is available on DVD (e.g., at Amazon).
Why might Welcome to the NHK be useful for western clinicians?
Attend any North American seminar on an established phenomenon, and it will tend to resemble other local examinations of the same problem. Attend three seminars and you can sleep through the fourth: Nothing new will be said.
But view a phenomenon from the perspective of another culture, and the focus will be on elements that you have not seen highlighted in programs from your own culture. As a result, it is often possible to learn more from programs from another culture than those from your own – even if you’re not trying to cultivate your cross-cultural sensitivity.
Welcome to the NHK is a terrific introduction to NEETs, Hikikomori, Lost Boys, and the Failure to Launch phenomenon – both for professionals and for those currently stuck in such lives. The series includes difficult elements (including recurrent references to suicide), so it’s best not prescribed unless the prescriber has first watched it in its entirety. Luckily, that’s not hard to do.
Frankly, I’m surprised the English-language distributor, Funimation Entertainment, hasn’t targeted the clinical market, given that the product they are sitting on is so completely suited to it.
I have now launched a YouTube VLog on psychological topics called How to be Miserable, with new posts every Tuesday and occasional Thursdays! Come take a visit and see what you think. Consider subscribing (just press the big red SUBSCRIBE button on the page) to ensure that new videos appear in your YouTube feed. One of the primary topics will be the Hikikomori phenomenon. Here's the intro video:
What if one wants to overcome this tendency? One strategy is to seek the assistance of a qualified psychotherapist - preferably one trained in cognitive behavior therapy.
In addition, our clinic has developed a cognitive behavioral guide to self-care for depression. The strategies for working with depression and those for establishing one's adult life are extremely similar. Though not a substitute for professional face-to-face care, UnDoing Depression may be a useful adjunct to your efforts. The preview is below. For 50% off the regular fee of $140 USD, use coupon code “changeways70” when you visit our host site, here.
We also have courses for professionals and for the public entitled What Is Depression, What Causes Depression, Diagnosing Depression, Cognitive Behavioral Group Treatment of Depression, How to Buy Happiness, and Breathing Made Easy. For the full list with previews and substantial discounts, visit us at the Courses page of the Changeways Clinic website.