![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
(1) "Indeed, the publication of this book caused a surge of media attention and launched Saitō to a position as the foremost expert in Japan on youth culture and the problem of withdrawal, in particular. His clear, easily understandable description, as well as his urgent insistence that withdrawal is a growing problem that threatens to reach epidemic proportions, made him a media sensation. Popular journals began requesting articles from him, and he became a frequent speaker on television. Since then, he has availed himself of this media attention to spread knowledge about the condition and to make the word hikikomori (withdrawal) known throughout the nation. It was largely due to Saitō's success in the media that this word burst into popular circulation and appeared on the lips of journalists, writers, and critics throughout the nation. In short, this book and Saitō's subsequent work and media appearances brought a condition that had been hidden in back rooms and apartments throughout Japan - a silent epidemic of suffering - to the attention of the public."
(2) "A large number of cases involve people who are introverted to begin with - often the types who are considered 'good' boys and girls and who 'don't require much looking after.' Most do not go through a rebellious phase, and in fact, many have an overly methodical quality to their personality that can develop into obsessive-compulsive disorder, such as the obsession for checking meaningless details. This does not mean, however, that all children who shut themselves away display these sorts of tendencies. It is not unusual to find seemingly 'ordinary' people who happen to hit a stumbling block in life, become so depressed that their personality seems to change altogether, and shut themselves away from society. Some of these people were outgoing through middle school; some even served as their class representatives at school. Some were good at sports through high school and were able to express their opinions without any trouble. I think it is a special characteristic of hikikomori cases that there is not one fixed personality trait that manifests itself in every single case."
(3) "Once people enter into a state of withdrawal, they hardly go outside; instead, they sleep during the day and are active at night, avoid their families, and tend to coop themselves up in their own rooms. Their sense of self-pride, concerns about their appearance, and the deteriorating relationship with their own family cause them concern and mental discord, sometimes even leading to angry, violent fits or even attempted suicide. In some cases, hikikomori cases display symptoms such as obsessive-compulsive disorder or anthropophobia. These symptoms only prolong the state of withdrawal even further and create a vicious circle that is increasingly difficult to escape from. In this way, the stubborn state of apathy and of withdrawal grows even longer. The period of withdrawal can last from a few months to years. One of the longest cases I have seen involved a young man who sut himself away for well over a decade. As the symptoms progress and extend over an increasingly long period of time, it simply seems to others that the person is being lazy and acting lethargic, but often, there are deep conflicts and strong, fretful feelings hidden below the surface. *As evidence, one can see that the majority of people in withdrawal do not experience boredom, even though they spend their days not doing anything.* Their minds appear to be occupied, not giving them the psychological room to feel bored." // This is definitely not NPD, as it is common for them to feel bored.
(4) "Men are overwhelmingly more likely to experience withdrawal.
The percentage of elder sons is especially high.
The average age at which the problem first arose was 15.5 years old.
The most common trigger intiating the withdrawal was 'skipping school,' seen in 68.8 percent of the cases."
(5) "In the shadows of the 'elite' kids who skip school - those students who do manage to pull themselves up by the bootstraps and participate in society - there seem to be a large number of kids who start out skipping school, then find themselves unable to go out in society, even though they feel constant irritation at themselves because of their social paralysis."
(6) "Of course, it is also wrong to say that there is no connection whatsoever between skipping school and social withdrawal - it is clear as day that a certain portion of the people who stop attending school end up in an extended period of truancy and eventually withdraw from society."
(7) "The withdrawn state always involves problems carried over from adolescence. What I am trying to say is that after one has achieved a high level of social maturation, then it is rare for a person to slip into a state of social withdrawal. At least, I do not know of any such cases."
(8) "In addition, there were respondents who said, 'I cannot get on a train or a bus because I am concerned about other people looking at me.' There were many others who said they had a strong aversion to other people entering their homes so they would hide or do other things when people came to visit. There were even respondents who would refuse to answer the telephone."
(9) "One also often sees symptoms of dismorphophobia, the fear that one's own appearance is ugly, even though in most cases outsiders probably would not agree. There are cases where people in withdrawal become so hung up on their unique features that they stop interacting with others, saying things like 'my nose is crooked,' 'my hair is too thin,' 'I've got too many zits,' or 'I'm too fat.'"// This seems to happen, I think, because there is someone that has undue influence over their mind, and that person wants them to believe that they are ugly, or does think this about them, even if that is not actually true. This happened to me, when I was in social withdrawal. I hate them.
(10) "For instance, there have been cases when patients who were in an extended period of social withdrawal were unable to stop their obsessive-compulsive behaviors and were hospitalized, but immediately afterward, the symptoms of obsessive-compulsive behavior disappeared. This leads me to believe that the obsessive-compulsive symptoms associated with withdrawal are slightly different than what one finds in the obsessive-compulsive nervous disorder itself."
(11) "It is quite common that hikikomori are so overly fond of order that, ironically, they end up becoming disorderly or living in messy, unclean rooms." // I did not have this issue in social withdrawal, but did, before and after.
(12) "Eighty-one percent of the respondents said that they had a tendency to reverse their sleeping hours, thus reversing night and day."
(13) "It goes without saying, but people in withdrawal hate for others from outside the immediate family - relatives and other people - to enter the house."
(14) "Waking up one's mother in the middle of the night and wanting to talk on and on for a long period of time can be seen as another sign of regression." // Sometimes, but not often. I didn't do this, at all, until we moved into the house in Del Valle, though.
(15) "If regression is taking a step down on the ladder of development and returning to a less mature state, a large number of people regress to become 'good children' and do not go through a rebellious stage. What I am trying to say is that violent outbursts at home do not necessarily come about simply because a person returns to a less mature state. Instead, violent outbursts are another symptom that one finds among certain people in regression." // I didn't become violent, at all, when in social withdrawal.
(16) "Emotional instability, especially feelings of depression, is a relatively common symptom among people in withdrawal. According to the survey, 31 percent of the respondents reported experiencing chronic changes in their emotional state. The percentage of respondents experiencing depression was 59 percent, if one includes mild cases."
(17) "Many hikikomori patients, however, still are undergoing internal conflict, thinking they would like 'to do whatever it takes to make a new start,' and 'the sooner, the better.' However, because they do not feel that they have much time or space to carry this out, these thoughts do not transfer into hope, and unfortunately for them, these feelings just transform into irritation and despair."
(18) "Another symptom one finds among withdrawn patients is an obsessive concern about their own health. They might become obsessed with the questions 'Am I sick?' or 'Am I going to become sick?' even when they are not manifesting any illness at all. Sixty percent of respondents reported some sort of 'mental symptoms,' including hypersensitivity to their own health."
(19) "What about the number of children in the families? Eighty-five percent of the respondents came from a family with more than two children, including the patient himself or herself, and 60 percent were the oldest child - well over half. Of the total percentage, 49 percent of the respondents were first-born sons as well as the oldest child overall. Of course, not all first-born sons were the oldest child in the family, so if one were to look at just the ratio of the withdrawn patients who were first sons, the number is over half of all respondents. As a result, we can see that my earlier statements that men are more likely to experience withdrawal and the percentage of eldest sons is especially high are not ungrounded."
(20) "In response to the question about what the trigger was to send them into a state of social withdrawal, the highest number of respondents stated that the reason was 'unclear' (39 percent of respondents). The next highest responses were 'problems related to people other than family' (38 percent), 'discouraging experiences having to do with academics' (18 percent), and 'changes in the school environment' (10 percent)." // I have no idea what the trigger was, so I am among the 39 percent.
(21) "When we asked respondents when their symptoms first appeared, the most common response was the 'first year of high school' at 23 percent, while the next most common response was 'the second year of middle school.'"
(22) "It seems that one reason people in withdrawal have difficulty recuperating on their own is that they do not have any meaningful contact with others. What I am trying to say is the very fact of being in a state of withdrawal is itself traumatic in its effects."
(23) This does not sound like a reliable method for detecting a case of SZ: "I learned an interesting technique to distinguish psychogenic withdrawal from schizophrenia from the psychiatrist Dr. Kasugai Takehiko. He suggests having the therapist write a letter or memo, and then sending it to the family to give to the patient. If the patient takes it in hand and reads it, then the illness is likely psychogenic withdrawal, but if he or she shows no interest in it whatsoever, then one should suspect that the patient is suffering from schizophrenia. Based on my own clinical experience, this has proved an extremely helpful technique. In most cases of social withdrawal, it may seem that hikikomori patients are avoiding the rest of the world, but in reality, they have an earnest desire for contact with other people. In most cases of schizophrenia, however, the patient is trying to completely avoid all contact with others or has no interest in them whatsoever. These guidelines for differentiation may not be 100 percent accurate, but I still believe that they can be quite helpful in clinical situations."
(24) "They are not unaware that there is something wrong with them. They are sensitive to relations with others, and they can be severely hurt when someone scolds them or rejects them. They have a tendency to avoid all situations except those in which they know they will certainly be accepted."
(25) "Still, the distinction is not simple to make. I have often seen that as patients in a typical state of social withdrawal progress in their treatment, they gradually begin to develop borderline characteristics. It is especially common for this kind of change to occur when they are in the hospital undergoing treatment. It is difficult to determine beforehand exactly which sort of patients will undergo that sort of transformation, as one does not know until commencing treatment."
(26) "In a report published by Murakami Yasuhiko from Nagoya University, he reported that among people suffering adolescent delusional disorders, he found 'a sense of being incomplete,' a desire 'to start over,' and 'thoughts of magical disconnection' (majutsu-teki tanraku shikō), such as the belief that one could go back in time and do things over. Also, there is a tendency for patients to rebel against the thoughts they believe others have of them. These characteristics also appear with social withdrawal. 'Adolescent delusional disorder' seems to have much in common with social withdrawal."
(27) "There are some other characteristics that the DSM-IV raises as signs of schizoid personality disorder but that differ from the signs seen in typical cases of social withdrawal. I have listed those below.
3. Appears indifferent to the praise or criticism of others.
4. Neither desires nor enjoys social relationships.
If anything, these two points show tendencies opposite to those in cases of social withdrawal. People in withdrawal want to be praised more than usual and tend to be excessively sensitive to criticism. In short, people in withdrawal typically harbor a strong desire for relationships with others."
(28) "Dr. Isaac Marks, who works in England and has written about the subject of withdrawal, stated that this sort of problem is not all uncommon in England and understands it as a sort of general fear of society. Dr. Marks also comments that in the United States, withdrawal patients would probably be diagnosed as having avoidant personality disorder."
(29) "When we put together these opinions we see that the majority of the cases that I have been calling 'social withdrawal' are classified either as 'social phobia' or 'avoidant personality disorder.' If we set up the presupposition that this might be something else, then certainly we may probably begin to see new possibilities for treatment."
(30) "For people in a state of withdrawal, the routes between the 'individual and family' and the 'individual and society' are completely shut down. As a result, the only thread of hope lies in getting the family to cooperate. In reality, it is often the case that treatment that involves earning the understanding and cooperation of the family can allow the person to recover. In most cases, however, there is a vicious circle at work in the relationship with the family, and the situation just gets worse and worse."
(31) "It is precisely because I think it is a bad idea for the family to handle it themselves that I emphasize so strongly that people in a chronic hikikomori state do not get better through individual effort, scolding, and encouragement from the family. When one is dealing with long-term withdrawal, there are limits to the efforts that both the individual and the family can make, no matter how hard they try." // Why did the 2016 election's aftermath enable me to work? Why did SZ entirely destroy my social withdrawal issue?
(32) "Nonetheless, it goes without saying that there are a number of things that family members can do that are not helpful: using parental authority in a one-sided way to try to force the child to change, adopting an overly emotional attitude, refusing to listen to the child's opinions, and getting violent in order to make him or her obey. These techniques will only be traumatic to the person in withdrawal. Even if it looks like these techniques help get a person back 'on the right track,' they only delay a proper resolution to the problem, and it is only a matter of time before the person has a 'relapse.'"
(33) "In general, young people who are in a state of withdrawal are extremely frightened of being hurt. That is because they know all too well that even a single careless statement can make them feel as if their entire existence has been negated. Of course, we must show an appropriate amount of respect for those fears. However, it is also true that as long as they stay cooped up in withdrawal, they will not experience any psychological growth. No doubt the reason is already clear. In a life of withdrawal, individuals have no more contact with others, and therefore it is impossible for them to heal from the traumas they have experienced, even when those traumas are indeed real. To put it another way, the image they have of others is stuck - they perceive others as threatening beings that will simply bring about more pain." // Not true of me. I will, also, note that psychological growth can definitely be experienced, while in isolation, also. You do not need other people to experience psychological growth.
(34) "In the eyes of people who have withdrawn from the world, their families are not 'other.' People in withdrawal seem to see their families almost as if they were a part of their own bodies." // This is not true of me. Is this true of the families of hikikomori more than it is ever true of the hikikomori themselves? How often are the family members of hikikomori narcissists? How often are the narcissists with undue influence people outside the family? How often do narcissists outside the family influence both the hikikomori, and their family members in extreme malice?
(35) "The reason that they might engage in violent fits in the household is that they treat family members as if they were a part of their own selves and fail to recognize them as independent people." // Is this actually true, when reversed? For such hikikomori, is violence triggered by their families not recognizing *them* as independent people? I didn't have violent fits myself, and I had no trouble recognizing the independence of other people. Instead, others may have viewed me, not as an independent person, but as an extension of themselves, and someone to be controlled by them. They seem like this, now, and I have SZ.
(36) "According to psychoanalytic theory, love has its fundamental roots in self-love. One cannot love others more than one loves oneself. Those who insist they can are narcissists lacking self-awareness. That is what psychoanalysis teaches us. Love for the family is similar. If anything, the fact that it is sometimes difficult to distinguish between love and self-love means that we should pay more attention to love within the family. *Often, love within the family is linked with a desire to possess other people and control them, and this becomes the reason for occasional outbursts of virulent criticism.* Later, I discuss violent outbursts in the household, but those too are a product of love. After a violent rage, sometimes the parties will apologize profusely to one another; the child will try to show his or her thoughtfulness, and the mother will hold the child in an embrace that goes on and on - it seems that the thing that lies behind such tragic forms of 'love' is a loss of distance and control."// Often? Is this common in Japan?
(37) "The more efforts the mother makes, the more hikikomori individuals feel that they are weaklings who cannot exist without their own mother. They realize they do not know how to function if their mother were to abandon them. I have heard patients in their twenties and thirties say this over and over again."
(38) "What I am trying to say is that in order to maintain this thing known as self-love, it is necessary to have what I call 'the mirror of the other.' The best possible situation is that one preserves one's love for oneself by loving other people or by receiving the love of others." // This is not necessary.
(39) "Young people who are in a withdrawn state, however, do not have that sort of mirror. All they have is an empty mirror that never reflects anything but their own face. That kind of mirror is not helpful producing an objective view of the self. No sooner do they see an omnipotent image of themselves - a self that seems brimming with power and possibility - than that image suddenly disappears, only to be replaced by a miserable image of themselves as people who have no value and no reason to live. Their mirrors produce only extremely unstable, warped images of themselves. In other words, it is necessary to use the 'power' of someone outside the family to stabilize their 'mirrors' and maintain a healthy (and by that I mean 'stable') sense of self-love." // I do not relate to this. Is Saitō a narcissist? Is this common in Japan?
-
(40) "The next thing to deal with is how to get the family system and the individual system to work together. The big question is this: in what way can the individual and the family restore a point of connection? To put it concretely, this is the stage at which conversations between the individual and family become possible and the family works to establish a closer, more candid exchange with the hikikomori child. In my experience, this is the stage that is most difficult and that takes the greatest amount of time. Children in a chronic state of withdrawal avoid even having to see the members of their family. Sometimes they do not speak at all and convey their thoughts by writing them on notes. Still, treatment will not progress properly if the family tries to skip this stage, no matter how deep the state of isolation. Conversely, the care we pay to this stage greatly determines the future progress of healing. That is how important this stage is. The reason this stage is so difficult goes beyond the fact that the individual and the family. In receiving therapy, differences between the value systems of the various members of the family become an issue, along with the friction those differences cause. For instance, one often sees cases where the mother is the only one who is zealous about the treatment while the father and siblings do not show much interest, thus inviting the criticism that they are 'lazy.' Of course, there are also cases where the roles are reversed." // ?
(41) "I explained before that yelling and trying to scold a person into action are harmful, but what people think of as 'well-reasoned arguments' are also not very helpful. Here are several of the kinds of arguments I am talking about. 'You've got a responsibility to go out and work once you're past twenty.' *'People who don't work don't deserve to eat.'* 'We've spoiled you so that's why you turned out this way. We're not spoiling you anymore.' 'You're at the age where you can earn your own money, so we're not giving you any more allowance.' 'Unless we treat you strictly, you're never going to make anything of yourself.' *All of these kind of things one would expect upright and decent people to say.* None of these arguments is completely off the mark. These words are correct - too correct perhaps - and in reality, all they do is make the person in withdrawal more embarrassed and wound him or her all the more." // Saitō reveals his bad character, here.
(42) "Almost everyone grows unhappy when others begin lecturing them about what they already know, and it makes them want to argue back. People in withdrawal also feel anxiety about the future and regret their current situation but simply do not know how to fix it. They are not spending their time just lounging carefree around the house, doing whatever they feel like. They are disappointed in themselves but also feel unable to go out into society. Before anything else can be done, it is important for the family to understand that and show sympathy."
43) "However, it is also necessary to realize that 'lending an ear' and letting someone 'twist you around their thumb' are two entirely different things. This may seem obvious, but there is often a tendency to mix these two things up. For instance, there are instances when a person in withdrawal gets so angry that he or she starts demanding an apology and perhaps even financial compensation. As a fundamental rule, the family should not give in to such demans. It is my supposition that such demands are usually leveled at families who are not willing to be bothered with the complaints of their child. The reason that people in withdrawal start resorting to strong language, wanting apologies or financial compensation, is so the family will listen to their complaints. What is important in the end is that the child feels 'my family has lent me their ear and listened to my feelings.' If it is posdible to get the withdrawn child to feel that way, then sometimes the grudges and demands will gradually trail off, even if the family does nothing else." // Saitō does not want the grievances of the hikikomori to be addressed by their family, and he discourages them from taking the hikikomori seriously. He suggests that they listen to the hikikomori, or give them the impression that they care only enough so that they shut up, and do not press for concrete action from the family beyond that.
(44) "It may not be possible to tell from appearances alone, but hikikomori children are extremely sensitive to the changes in their families. They will certainly notice if their families begin reacting to them differently. That does not mean, however, they will immediately change in response to their families' wishes. If anything, they tend to look on rather coldly, trying to gauge how serious the family is about engaging with them and whether the family will behave in a fickle manner. When the family gives up on their efforts (usually after a concerted effort to start them), it is equivalent to the family saying, 'We've given up on you again.'"
(45) "Earlier in this book, I stated that approximately half of all people in withdrawal have extremely impoverished levels of conversation with their own family. I touched on this earlier, but in such cases, the first priority is to help reestablish conversation betwen the child and their family. In this section, I talk about concrete techniques for doing so. If the child in withdrawal has stopped speaking, it is not uncommon even in families where there is some level of communication. Nonetheless, even if the child manages to avoid his or her family altogether, there is no question that the child is secretely holding his or her breath and watching the family, never missing a thing. If the parents suddenly start talking to him or her, the child will of course notice immediately."
(46) "Of course, the withdrawn child will probably ignore these greetings, and at times he or she might even act annoyed; however, greetings never hurt anyone. It might seem a bit forced, but being careful to use these greetings at every opportunity is the first step. And it will seem tedious, but once the family has started using these greetings, the family should be sure not to let them die off and disappear. There are cases when the child in withdrawal will say something to the family, even though the family has been saying nothing more than the usual greetings. This is a valuable opportunity to start a conversation, so the family should be sure not to let it slip by. The family should take every opportunity to get the child to speak, even if the conversation is not about anything of any importance. Even if the conversation is not really much of a conversation at all, the more opportunities there are for interaction, the more likely the withdrawn child will be to let his or her guard down with the family. If the child does not respond with even a single word of greeting, try using notes as well, but keep up with the greetings. As with the greetings, the content of the notes does not have to be anything important." // Mom.
(47) "If it is still not possible to have a proper conversation, it is essential to show the maximum possible respect for the child's privacy. For that reason, it is best to speak to the child from outside the door without opening it."
(48) "Once a sufficient level of communication has been established, I believe it is important to make it clear exactly how much the child needs for living expenses. By this, I am referring to the total amount of money the child will spend on things that he or she likes, on things related to hobbies, on fashion, and on other things. To put it in a different way, I am referring to everything other than food and shelter. It is best for the family first to clarify the total amount those things would cost, then provide for those things in the form of an allowance of an agreed-on amount. Often, when families actually sit down to ask withdrawn children how much they need, they will often respond with an amount that is unexpectedly and perhaps even unreasonably low. That reaction can be seen as a reflection of the child's inferiority complex or perhaps their gnawing sense that they have no real excuse for their actions. In my therapeutic experiences, I do not remember ever encountering a case in which the family gave their child the chance to determine an allowance, and the child responded with an absurdly large amount of money." // This seems like supporting evidence for my belief that hikikomori are unduly subject to the will of others, like their parents, so they end up only asking for what their parents are willing to give them, which is not much.
(49) "I often hear complaints that children in withdrawal 'do nothing but watch TV cooped up in their own rooms' or 'are always playing video games.' There is a tendency to think badly of people who demonstrate the otaku-like, autistic tendency to show enthusiasm for only the things that interest them. There is an assumption that this tendency is necessarily pathological; however, in the case of withdrawal, it is, if anything, desirable that the person maintains an interest in society, even if it is only through the screen of a television. There is a strong-rooted assumption out there that if people get completely infatuated with television or spending time on the computer, it will only become harder for them to deal with the rest of the world, but that assumption os completely without foundation. Rather than jump the gun and act as if there were a crisis, it is better for the parents to spend time with the child and try to have fun. Just the very act of enjoying something together to represents an excellent act of communication."
(50) "The foremost reason is that it is difficult to link the feelings of apathy and withdrawal to a specific diagnosis. Hikikomori patients do not demonstrate the same clear signs of abnormality as a schizophrenic, and the conflicts that they experience are right on the borderline separating normal experience from the pathological, so typically, they do not express a strong desire on their own part to undergo treatment. Because of this, people think that they are being 'lazy' when they are beginning to slip into withdrawal. In fact, it is not just ordinary people who say such things. It is not unheard-of for psychiatrists to say 'they don't have a psychological illness so just leave them alone' or 'they're just being lazy, so maybe you should give them some physical work or something to do.'"
(51) "As the state of withdrawal grows increasingly prolonged, parents will likely retire and start living off their pensions. If the hikikomori state continues, then the parents may die while their child is still at home. Aging and death are hard facts for the parents, and no one can do anything to stop them. When the child in withdrawal reaches the 'milestone' of age thirty, the parents should take the initiative and make a concerted effort to help their child recognize these facts. The family should not hide anything; they should convey to their child the financial outlook of the entire family. This probably involves creating a will and testament rhat expresses their hopes for their child and shows their concern for his or her future."
--
End of entry.
(2) "A large number of cases involve people who are introverted to begin with - often the types who are considered 'good' boys and girls and who 'don't require much looking after.' Most do not go through a rebellious phase, and in fact, many have an overly methodical quality to their personality that can develop into obsessive-compulsive disorder, such as the obsession for checking meaningless details. This does not mean, however, that all children who shut themselves away display these sorts of tendencies. It is not unusual to find seemingly 'ordinary' people who happen to hit a stumbling block in life, become so depressed that their personality seems to change altogether, and shut themselves away from society. Some of these people were outgoing through middle school; some even served as their class representatives at school. Some were good at sports through high school and were able to express their opinions without any trouble. I think it is a special characteristic of hikikomori cases that there is not one fixed personality trait that manifests itself in every single case."
(3) "Once people enter into a state of withdrawal, they hardly go outside; instead, they sleep during the day and are active at night, avoid their families, and tend to coop themselves up in their own rooms. Their sense of self-pride, concerns about their appearance, and the deteriorating relationship with their own family cause them concern and mental discord, sometimes even leading to angry, violent fits or even attempted suicide. In some cases, hikikomori cases display symptoms such as obsessive-compulsive disorder or anthropophobia. These symptoms only prolong the state of withdrawal even further and create a vicious circle that is increasingly difficult to escape from. In this way, the stubborn state of apathy and of withdrawal grows even longer. The period of withdrawal can last from a few months to years. One of the longest cases I have seen involved a young man who sut himself away for well over a decade. As the symptoms progress and extend over an increasingly long period of time, it simply seems to others that the person is being lazy and acting lethargic, but often, there are deep conflicts and strong, fretful feelings hidden below the surface. *As evidence, one can see that the majority of people in withdrawal do not experience boredom, even though they spend their days not doing anything.* Their minds appear to be occupied, not giving them the psychological room to feel bored." // This is definitely not NPD, as it is common for them to feel bored.
(4) "Men are overwhelmingly more likely to experience withdrawal.
The percentage of elder sons is especially high.
The average age at which the problem first arose was 15.5 years old.
The most common trigger intiating the withdrawal was 'skipping school,' seen in 68.8 percent of the cases."
(5) "In the shadows of the 'elite' kids who skip school - those students who do manage to pull themselves up by the bootstraps and participate in society - there seem to be a large number of kids who start out skipping school, then find themselves unable to go out in society, even though they feel constant irritation at themselves because of their social paralysis."
(6) "Of course, it is also wrong to say that there is no connection whatsoever between skipping school and social withdrawal - it is clear as day that a certain portion of the people who stop attending school end up in an extended period of truancy and eventually withdraw from society."
(7) "The withdrawn state always involves problems carried over from adolescence. What I am trying to say is that after one has achieved a high level of social maturation, then it is rare for a person to slip into a state of social withdrawal. At least, I do not know of any such cases."
(8) "In addition, there were respondents who said, 'I cannot get on a train or a bus because I am concerned about other people looking at me.' There were many others who said they had a strong aversion to other people entering their homes so they would hide or do other things when people came to visit. There were even respondents who would refuse to answer the telephone."
(9) "One also often sees symptoms of dismorphophobia, the fear that one's own appearance is ugly, even though in most cases outsiders probably would not agree. There are cases where people in withdrawal become so hung up on their unique features that they stop interacting with others, saying things like 'my nose is crooked,' 'my hair is too thin,' 'I've got too many zits,' or 'I'm too fat.'"// This seems to happen, I think, because there is someone that has undue influence over their mind, and that person wants them to believe that they are ugly, or does think this about them, even if that is not actually true. This happened to me, when I was in social withdrawal. I hate them.
(10) "For instance, there have been cases when patients who were in an extended period of social withdrawal were unable to stop their obsessive-compulsive behaviors and were hospitalized, but immediately afterward, the symptoms of obsessive-compulsive behavior disappeared. This leads me to believe that the obsessive-compulsive symptoms associated with withdrawal are slightly different than what one finds in the obsessive-compulsive nervous disorder itself."
(11) "It is quite common that hikikomori are so overly fond of order that, ironically, they end up becoming disorderly or living in messy, unclean rooms." // I did not have this issue in social withdrawal, but did, before and after.
(12) "Eighty-one percent of the respondents said that they had a tendency to reverse their sleeping hours, thus reversing night and day."
(13) "It goes without saying, but people in withdrawal hate for others from outside the immediate family - relatives and other people - to enter the house."
(14) "Waking up one's mother in the middle of the night and wanting to talk on and on for a long period of time can be seen as another sign of regression." // Sometimes, but not often. I didn't do this, at all, until we moved into the house in Del Valle, though.
(15) "If regression is taking a step down on the ladder of development and returning to a less mature state, a large number of people regress to become 'good children' and do not go through a rebellious stage. What I am trying to say is that violent outbursts at home do not necessarily come about simply because a person returns to a less mature state. Instead, violent outbursts are another symptom that one finds among certain people in regression." // I didn't become violent, at all, when in social withdrawal.
(16) "Emotional instability, especially feelings of depression, is a relatively common symptom among people in withdrawal. According to the survey, 31 percent of the respondents reported experiencing chronic changes in their emotional state. The percentage of respondents experiencing depression was 59 percent, if one includes mild cases."
(17) "Many hikikomori patients, however, still are undergoing internal conflict, thinking they would like 'to do whatever it takes to make a new start,' and 'the sooner, the better.' However, because they do not feel that they have much time or space to carry this out, these thoughts do not transfer into hope, and unfortunately for them, these feelings just transform into irritation and despair."
(18) "Another symptom one finds among withdrawn patients is an obsessive concern about their own health. They might become obsessed with the questions 'Am I sick?' or 'Am I going to become sick?' even when they are not manifesting any illness at all. Sixty percent of respondents reported some sort of 'mental symptoms,' including hypersensitivity to their own health."
(19) "What about the number of children in the families? Eighty-five percent of the respondents came from a family with more than two children, including the patient himself or herself, and 60 percent were the oldest child - well over half. Of the total percentage, 49 percent of the respondents were first-born sons as well as the oldest child overall. Of course, not all first-born sons were the oldest child in the family, so if one were to look at just the ratio of the withdrawn patients who were first sons, the number is over half of all respondents. As a result, we can see that my earlier statements that men are more likely to experience withdrawal and the percentage of eldest sons is especially high are not ungrounded."
(20) "In response to the question about what the trigger was to send them into a state of social withdrawal, the highest number of respondents stated that the reason was 'unclear' (39 percent of respondents). The next highest responses were 'problems related to people other than family' (38 percent), 'discouraging experiences having to do with academics' (18 percent), and 'changes in the school environment' (10 percent)." // I have no idea what the trigger was, so I am among the 39 percent.
(21) "When we asked respondents when their symptoms first appeared, the most common response was the 'first year of high school' at 23 percent, while the next most common response was 'the second year of middle school.'"
(22) "It seems that one reason people in withdrawal have difficulty recuperating on their own is that they do not have any meaningful contact with others. What I am trying to say is the very fact of being in a state of withdrawal is itself traumatic in its effects."
(23) This does not sound like a reliable method for detecting a case of SZ: "I learned an interesting technique to distinguish psychogenic withdrawal from schizophrenia from the psychiatrist Dr. Kasugai Takehiko. He suggests having the therapist write a letter or memo, and then sending it to the family to give to the patient. If the patient takes it in hand and reads it, then the illness is likely psychogenic withdrawal, but if he or she shows no interest in it whatsoever, then one should suspect that the patient is suffering from schizophrenia. Based on my own clinical experience, this has proved an extremely helpful technique. In most cases of social withdrawal, it may seem that hikikomori patients are avoiding the rest of the world, but in reality, they have an earnest desire for contact with other people. In most cases of schizophrenia, however, the patient is trying to completely avoid all contact with others or has no interest in them whatsoever. These guidelines for differentiation may not be 100 percent accurate, but I still believe that they can be quite helpful in clinical situations."
(24) "They are not unaware that there is something wrong with them. They are sensitive to relations with others, and they can be severely hurt when someone scolds them or rejects them. They have a tendency to avoid all situations except those in which they know they will certainly be accepted."
(25) "Still, the distinction is not simple to make. I have often seen that as patients in a typical state of social withdrawal progress in their treatment, they gradually begin to develop borderline characteristics. It is especially common for this kind of change to occur when they are in the hospital undergoing treatment. It is difficult to determine beforehand exactly which sort of patients will undergo that sort of transformation, as one does not know until commencing treatment."
(26) "In a report published by Murakami Yasuhiko from Nagoya University, he reported that among people suffering adolescent delusional disorders, he found 'a sense of being incomplete,' a desire 'to start over,' and 'thoughts of magical disconnection' (majutsu-teki tanraku shikō), such as the belief that one could go back in time and do things over. Also, there is a tendency for patients to rebel against the thoughts they believe others have of them. These characteristics also appear with social withdrawal. 'Adolescent delusional disorder' seems to have much in common with social withdrawal."
(27) "There are some other characteristics that the DSM-IV raises as signs of schizoid personality disorder but that differ from the signs seen in typical cases of social withdrawal. I have listed those below.
3. Appears indifferent to the praise or criticism of others.
4. Neither desires nor enjoys social relationships.
If anything, these two points show tendencies opposite to those in cases of social withdrawal. People in withdrawal want to be praised more than usual and tend to be excessively sensitive to criticism. In short, people in withdrawal typically harbor a strong desire for relationships with others."
(28) "Dr. Isaac Marks, who works in England and has written about the subject of withdrawal, stated that this sort of problem is not all uncommon in England and understands it as a sort of general fear of society. Dr. Marks also comments that in the United States, withdrawal patients would probably be diagnosed as having avoidant personality disorder."
(29) "When we put together these opinions we see that the majority of the cases that I have been calling 'social withdrawal' are classified either as 'social phobia' or 'avoidant personality disorder.' If we set up the presupposition that this might be something else, then certainly we may probably begin to see new possibilities for treatment."
(30) "For people in a state of withdrawal, the routes between the 'individual and family' and the 'individual and society' are completely shut down. As a result, the only thread of hope lies in getting the family to cooperate. In reality, it is often the case that treatment that involves earning the understanding and cooperation of the family can allow the person to recover. In most cases, however, there is a vicious circle at work in the relationship with the family, and the situation just gets worse and worse."
(31) "It is precisely because I think it is a bad idea for the family to handle it themselves that I emphasize so strongly that people in a chronic hikikomori state do not get better through individual effort, scolding, and encouragement from the family. When one is dealing with long-term withdrawal, there are limits to the efforts that both the individual and the family can make, no matter how hard they try." // Why did the 2016 election's aftermath enable me to work? Why did SZ entirely destroy my social withdrawal issue?
(32) "Nonetheless, it goes without saying that there are a number of things that family members can do that are not helpful: using parental authority in a one-sided way to try to force the child to change, adopting an overly emotional attitude, refusing to listen to the child's opinions, and getting violent in order to make him or her obey. These techniques will only be traumatic to the person in withdrawal. Even if it looks like these techniques help get a person back 'on the right track,' they only delay a proper resolution to the problem, and it is only a matter of time before the person has a 'relapse.'"
(33) "In general, young people who are in a state of withdrawal are extremely frightened of being hurt. That is because they know all too well that even a single careless statement can make them feel as if their entire existence has been negated. Of course, we must show an appropriate amount of respect for those fears. However, it is also true that as long as they stay cooped up in withdrawal, they will not experience any psychological growth. No doubt the reason is already clear. In a life of withdrawal, individuals have no more contact with others, and therefore it is impossible for them to heal from the traumas they have experienced, even when those traumas are indeed real. To put it another way, the image they have of others is stuck - they perceive others as threatening beings that will simply bring about more pain." // Not true of me. I will, also, note that psychological growth can definitely be experienced, while in isolation, also. You do not need other people to experience psychological growth.
(34) "In the eyes of people who have withdrawn from the world, their families are not 'other.' People in withdrawal seem to see their families almost as if they were a part of their own bodies." // This is not true of me. Is this true of the families of hikikomori more than it is ever true of the hikikomori themselves? How often are the family members of hikikomori narcissists? How often are the narcissists with undue influence people outside the family? How often do narcissists outside the family influence both the hikikomori, and their family members in extreme malice?
(35) "The reason that they might engage in violent fits in the household is that they treat family members as if they were a part of their own selves and fail to recognize them as independent people." // Is this actually true, when reversed? For such hikikomori, is violence triggered by their families not recognizing *them* as independent people? I didn't have violent fits myself, and I had no trouble recognizing the independence of other people. Instead, others may have viewed me, not as an independent person, but as an extension of themselves, and someone to be controlled by them. They seem like this, now, and I have SZ.
(36) "According to psychoanalytic theory, love has its fundamental roots in self-love. One cannot love others more than one loves oneself. Those who insist they can are narcissists lacking self-awareness. That is what psychoanalysis teaches us. Love for the family is similar. If anything, the fact that it is sometimes difficult to distinguish between love and self-love means that we should pay more attention to love within the family. *Often, love within the family is linked with a desire to possess other people and control them, and this becomes the reason for occasional outbursts of virulent criticism.* Later, I discuss violent outbursts in the household, but those too are a product of love. After a violent rage, sometimes the parties will apologize profusely to one another; the child will try to show his or her thoughtfulness, and the mother will hold the child in an embrace that goes on and on - it seems that the thing that lies behind such tragic forms of 'love' is a loss of distance and control."// Often? Is this common in Japan?
(37) "The more efforts the mother makes, the more hikikomori individuals feel that they are weaklings who cannot exist without their own mother. They realize they do not know how to function if their mother were to abandon them. I have heard patients in their twenties and thirties say this over and over again."
(38) "What I am trying to say is that in order to maintain this thing known as self-love, it is necessary to have what I call 'the mirror of the other.' The best possible situation is that one preserves one's love for oneself by loving other people or by receiving the love of others." // This is not necessary.
(39) "Young people who are in a withdrawn state, however, do not have that sort of mirror. All they have is an empty mirror that never reflects anything but their own face. That kind of mirror is not helpful producing an objective view of the self. No sooner do they see an omnipotent image of themselves - a self that seems brimming with power and possibility - than that image suddenly disappears, only to be replaced by a miserable image of themselves as people who have no value and no reason to live. Their mirrors produce only extremely unstable, warped images of themselves. In other words, it is necessary to use the 'power' of someone outside the family to stabilize their 'mirrors' and maintain a healthy (and by that I mean 'stable') sense of self-love." // I do not relate to this. Is Saitō a narcissist? Is this common in Japan?
-
(40) "The next thing to deal with is how to get the family system and the individual system to work together. The big question is this: in what way can the individual and the family restore a point of connection? To put it concretely, this is the stage at which conversations between the individual and family become possible and the family works to establish a closer, more candid exchange with the hikikomori child. In my experience, this is the stage that is most difficult and that takes the greatest amount of time. Children in a chronic state of withdrawal avoid even having to see the members of their family. Sometimes they do not speak at all and convey their thoughts by writing them on notes. Still, treatment will not progress properly if the family tries to skip this stage, no matter how deep the state of isolation. Conversely, the care we pay to this stage greatly determines the future progress of healing. That is how important this stage is. The reason this stage is so difficult goes beyond the fact that the individual and the family. In receiving therapy, differences between the value systems of the various members of the family become an issue, along with the friction those differences cause. For instance, one often sees cases where the mother is the only one who is zealous about the treatment while the father and siblings do not show much interest, thus inviting the criticism that they are 'lazy.' Of course, there are also cases where the roles are reversed." // ?
(41) "I explained before that yelling and trying to scold a person into action are harmful, but what people think of as 'well-reasoned arguments' are also not very helpful. Here are several of the kinds of arguments I am talking about. 'You've got a responsibility to go out and work once you're past twenty.' *'People who don't work don't deserve to eat.'* 'We've spoiled you so that's why you turned out this way. We're not spoiling you anymore.' 'You're at the age where you can earn your own money, so we're not giving you any more allowance.' 'Unless we treat you strictly, you're never going to make anything of yourself.' *All of these kind of things one would expect upright and decent people to say.* None of these arguments is completely off the mark. These words are correct - too correct perhaps - and in reality, all they do is make the person in withdrawal more embarrassed and wound him or her all the more." // Saitō reveals his bad character, here.
(42) "Almost everyone grows unhappy when others begin lecturing them about what they already know, and it makes them want to argue back. People in withdrawal also feel anxiety about the future and regret their current situation but simply do not know how to fix it. They are not spending their time just lounging carefree around the house, doing whatever they feel like. They are disappointed in themselves but also feel unable to go out into society. Before anything else can be done, it is important for the family to understand that and show sympathy."
43) "However, it is also necessary to realize that 'lending an ear' and letting someone 'twist you around their thumb' are two entirely different things. This may seem obvious, but there is often a tendency to mix these two things up. For instance, there are instances when a person in withdrawal gets so angry that he or she starts demanding an apology and perhaps even financial compensation. As a fundamental rule, the family should not give in to such demans. It is my supposition that such demands are usually leveled at families who are not willing to be bothered with the complaints of their child. The reason that people in withdrawal start resorting to strong language, wanting apologies or financial compensation, is so the family will listen to their complaints. What is important in the end is that the child feels 'my family has lent me their ear and listened to my feelings.' If it is posdible to get the withdrawn child to feel that way, then sometimes the grudges and demands will gradually trail off, even if the family does nothing else." // Saitō does not want the grievances of the hikikomori to be addressed by their family, and he discourages them from taking the hikikomori seriously. He suggests that they listen to the hikikomori, or give them the impression that they care only enough so that they shut up, and do not press for concrete action from the family beyond that.
(44) "It may not be possible to tell from appearances alone, but hikikomori children are extremely sensitive to the changes in their families. They will certainly notice if their families begin reacting to them differently. That does not mean, however, they will immediately change in response to their families' wishes. If anything, they tend to look on rather coldly, trying to gauge how serious the family is about engaging with them and whether the family will behave in a fickle manner. When the family gives up on their efforts (usually after a concerted effort to start them), it is equivalent to the family saying, 'We've given up on you again.'"
(45) "Earlier in this book, I stated that approximately half of all people in withdrawal have extremely impoverished levels of conversation with their own family. I touched on this earlier, but in such cases, the first priority is to help reestablish conversation betwen the child and their family. In this section, I talk about concrete techniques for doing so. If the child in withdrawal has stopped speaking, it is not uncommon even in families where there is some level of communication. Nonetheless, even if the child manages to avoid his or her family altogether, there is no question that the child is secretely holding his or her breath and watching the family, never missing a thing. If the parents suddenly start talking to him or her, the child will of course notice immediately."
(46) "Of course, the withdrawn child will probably ignore these greetings, and at times he or she might even act annoyed; however, greetings never hurt anyone. It might seem a bit forced, but being careful to use these greetings at every opportunity is the first step. And it will seem tedious, but once the family has started using these greetings, the family should be sure not to let them die off and disappear. There are cases when the child in withdrawal will say something to the family, even though the family has been saying nothing more than the usual greetings. This is a valuable opportunity to start a conversation, so the family should be sure not to let it slip by. The family should take every opportunity to get the child to speak, even if the conversation is not about anything of any importance. Even if the conversation is not really much of a conversation at all, the more opportunities there are for interaction, the more likely the withdrawn child will be to let his or her guard down with the family. If the child does not respond with even a single word of greeting, try using notes as well, but keep up with the greetings. As with the greetings, the content of the notes does not have to be anything important." // Mom.
(47) "If it is still not possible to have a proper conversation, it is essential to show the maximum possible respect for the child's privacy. For that reason, it is best to speak to the child from outside the door without opening it."
(48) "Once a sufficient level of communication has been established, I believe it is important to make it clear exactly how much the child needs for living expenses. By this, I am referring to the total amount of money the child will spend on things that he or she likes, on things related to hobbies, on fashion, and on other things. To put it in a different way, I am referring to everything other than food and shelter. It is best for the family first to clarify the total amount those things would cost, then provide for those things in the form of an allowance of an agreed-on amount. Often, when families actually sit down to ask withdrawn children how much they need, they will often respond with an amount that is unexpectedly and perhaps even unreasonably low. That reaction can be seen as a reflection of the child's inferiority complex or perhaps their gnawing sense that they have no real excuse for their actions. In my therapeutic experiences, I do not remember ever encountering a case in which the family gave their child the chance to determine an allowance, and the child responded with an absurdly large amount of money." // This seems like supporting evidence for my belief that hikikomori are unduly subject to the will of others, like their parents, so they end up only asking for what their parents are willing to give them, which is not much.
(49) "I often hear complaints that children in withdrawal 'do nothing but watch TV cooped up in their own rooms' or 'are always playing video games.' There is a tendency to think badly of people who demonstrate the otaku-like, autistic tendency to show enthusiasm for only the things that interest them. There is an assumption that this tendency is necessarily pathological; however, in the case of withdrawal, it is, if anything, desirable that the person maintains an interest in society, even if it is only through the screen of a television. There is a strong-rooted assumption out there that if people get completely infatuated with television or spending time on the computer, it will only become harder for them to deal with the rest of the world, but that assumption os completely without foundation. Rather than jump the gun and act as if there were a crisis, it is better for the parents to spend time with the child and try to have fun. Just the very act of enjoying something together to represents an excellent act of communication."
(50) "The foremost reason is that it is difficult to link the feelings of apathy and withdrawal to a specific diagnosis. Hikikomori patients do not demonstrate the same clear signs of abnormality as a schizophrenic, and the conflicts that they experience are right on the borderline separating normal experience from the pathological, so typically, they do not express a strong desire on their own part to undergo treatment. Because of this, people think that they are being 'lazy' when they are beginning to slip into withdrawal. In fact, it is not just ordinary people who say such things. It is not unheard-of for psychiatrists to say 'they don't have a psychological illness so just leave them alone' or 'they're just being lazy, so maybe you should give them some physical work or something to do.'"
(51) "As the state of withdrawal grows increasingly prolonged, parents will likely retire and start living off their pensions. If the hikikomori state continues, then the parents may die while their child is still at home. Aging and death are hard facts for the parents, and no one can do anything to stop them. When the child in withdrawal reaches the 'milestone' of age thirty, the parents should take the initiative and make a concerted effort to help their child recognize these facts. The family should not hide anything; they should convey to their child the financial outlook of the entire family. This probably involves creating a will and testament rhat expresses their hopes for their child and shows their concern for his or her future."
--
End of entry.
