title: [On the edge of the public space--an existentialistic contribution to the understanding and treatment of people with hikikomori].
abstract: The author attempted to elucidate some core psychological features of people with hikikomori (psycho-social withdrawal). He drew special attention to the agency seken, a unique Japanese concept which implicitly determines which social behaviors and conditions are orthodox and desirable from a public and interpersonal point of view. He analyzed the psychological attitude of people with hikikomori towards this agency, presenting several cases in which their psychological characteristics were explicitly manifested. The persons in the presented cases had a fundamental difficulty in being integrated into the public, for example, as an official full-time employee in companies. They also harbored a characteristic psychological attitude toward seken. They developed a delicate insight that seken is not a substantial agency but a pretended consensus. Nevertheless, they also felt an intensive pressure from this agency and were powerless to deal with it. The above-mentioned psychological characteristics do not explain all types of cases with hikikomori. The author also presented a case in which a taijin-kyofu (social anxiety) feature played a dominant role. The patient in this case gradually narrowed the social domain in which he was involved to preserve his narcissistic perfect self and was gradually dragged into the state of hikikomori. Then the author presented the view which contrasts a public aspect of encounter with its singular, private and existential aspect. Although our behavior and encounter in general can be articulated from public points of view, it can be assumed that there is a singular encounter between each individual and "objects" or "others" prior to the articulation. In the author's view, an individual captured in this singular encounter is an existential being. People with hikikomori appear to have difficulties in overcoming the point where this singular and public aspect intersect. He also suggested that one possible trajectory of recovering from the hikikomori state is to cultivate interpersonal tolerance and power in the public domain, maintaining a singular relation with others on the edge of public space. The author also took the opportunity to mention the debate over whether hikikomori is a culture-dependent syndrome or a pathological state whose worldwide manifestation is now beginning to be recognized. In his view, there is a subtle but great difference between the concept "seken" of Japanese origin and the concept "public" of Western origin. This difference may color the fundamental Japanese mentality, foster the incidence rates of hikikomori and determine the characteristics of its clinical manifestation in Japan.
authors.affiliation: Center of the Student Counseling/Department of Psychopathology and Psychotherapy, Graduate School of the Faculty of Medicine, Nagoya University.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Tsuda
mesh_terms: D000328:Adult; D032882:Comprehension; D003469:Culture; D006801:Humans; D038622:Internationality; D007564:Japan; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D012931:Social Environment; D012934:Social Isolation / Q000523:psychology*; D013577:Syndrome