Hikikomori: Adolescence without End by Tamaki Saito

In the Brothers Grimm tale, Rapunzel was shut away in a tower, while in Charlotte Brontë’s most famous work, Mrs Rochester was locked away in Thornfield Hall, hidden from the eyes of Jane Eyre. The common theme is that the two women see hardly anyone for a very long time and are cut off from society. Tamaki Saitō’s book is also about people who are locked away from society. The only difference is that Hikikomori: Adolescence without End is the story of real people, and there are 700,000 of them in Japan - only a little short of 1 per cent of its entire population.

In English, hikikomori may be translated as “social withdrawal”. Saitō, a Japanese psychiatrist, describes it as a state in which a person confines himself to his own room or home and does not participate in society for six months or longer. To be hikikomori, he asserts, this behaviour cannot have another psychological problem as its principal source.

Saitō says the condition was widely ignored in Japan until this book was published, in its original Japanese-language version, in 1998. It would go on to fuel huge media and social attention to hikikomori and provoke no small amount of controversy. Saitō has since become a television celebrity and a highly influential figure in Japanese psychiatry.

Drawing on his clinical experience, Saitō describes what it is like to be in a state of hikikomori, how it develops, and how it affects the life and mental health of the individual and his or her family. He also describes how he has helped a number of patients “recover”, with the support of their families.

So is hikikomori a new mental disorder, or a symptom of other psychiatric conditions? Many people with hikikomori are known to have other psychiatric conditions such as schizophrenia, anxiety and obsessive- compulsive disorder. However, Saitō argues that a substantial proportion of these psychiatric conditions are secondary to hikikomori, not its cause. Nevertheless, he strongly opposes categorising hikikomori as a psychiatric diagnosis on its own, possibly because of the stigma sometimes associated with “mental illness” in Japan.

Another key debate about hikikomori is whether it exists only in Japan or whether it is a global phenomenon. Some researchers strongly believe that it is a Japanese culture-bound syndrome. Others, including Saitō, contend that it can be found in any country experiencing the rapid change in social and familial structure that follows industrialisation. For example, a recent study led by Japanese psychiatrists found that their peers in many countries, including Australia, India and the US, have come across cases that match the definition of hikikomori. Needless to say, this area will benefit greatly from further scientific investigation.

Saitō’s book also provides a unique insight into the Japanese psyche - how the Japanese perceive family, school, adolescence, adulthood, gender and society. Perhaps that is why it has been translated by a scholar of modern Japanese literature and not by an expert in psychology or psychiatry. It appears that some of the scientific and clinical details might have been lost in translation, but this doesn’t stop this English translation conveying the passion of the author and the startling reality of hikikomori cases. The translator also sticks to the Japanese domestic style of name order, with the surname being followed by the first name. I found this choice slightly confusing, especially when those names are mixed with non-Japanese names, which are spelled the other way around.