Rubinstein2016 Article EmplottingHikikomoriJapanesePa

Cult Med Psychiatry (2016) 40:641–663
DOI 10.1007/s11013-016-9495-6
ORIGINAL PAPER
Emplotting Hikikomori: Japanese Parents’ Narratives
of Social Withdrawal
Ellen Rubinstein1
Published online: 4 May 2016
Springer Science+Business Media New York 2016
Abstract Hikikomori, often glossed as ‘‘social withdrawal,’’ emerged as a
sociomedical condition among Japanese youth at the end of the twentieth century, and it
continues to fascinate and concern the public. Explanatory frameworks for hikikomori
abound, with different stakeholders attributing it to individual psychopathology, poor
parenting, and/or a lack of social support structures. This article takes an interpretive
approach to hikikomori by exploring parents’ narrative constructions of hikikomori
children in support group meetings and in-depth interviews. I argue that some parents
were able to find hope in hikikomori by ‘emplotting’ their children’s experiences into a
larger narrative about onset, withdrawal, and recovery, which helped them remain
invested in the present by maintaining a sense of possibility about the future. Contrary
to literature that examines hikikomori as an epidemic of isolated individuals, I
demonstrate how parents play a key role in hikikomori through meaning-making
activities that have the potential to shape their children’s experiences of withdrawal.
Keywords Narrative Hope Psychiatry Hikikomori Social withdrawal Japan
Introduction
When Katoh-san (52) wakes up in the morning, there is a note on the kitchen
table from his younger son, Tomo, who is 21 years old. The note reads, ‘‘I want a
guitar string.’’ In the middle of the night Tomo sneaks downstairs to write notes
because he is unable to hold a real conversation with his parents. Katoh-san,
& Ellen Rubinstein
[email protected]
1
Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson
Medical School, 112 Paterson Street, #413, New Brunswick, NJ 08901, USA
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Tomo’s father, is a civil servant in Hokkaido. He, his wife (47), and his son live
together. In the summer of his first year of high school, Tomo dropped out, and soon
after he shut himself away in his room. ‘‘We haven’t had a meal together once in the
past four years,’’ his father says. Tomo hides in his room and avoids showing his
face. He carries his food to his room, locks the door behind him, and eats there. He
has been afraid of meeting people for the past four years and does not go outside.
He spends every night plucking at his guitar. At the end of last year, Tomo expressed
the wish to go outside. It seemed as though he wanted to rejoin society. But this, too,
he communicated in a note.
– Shiokura Yutaka, Asahi Shimbun [Newspaper], Japan (1997)1
In 1997, the journalist Shiokura Yutaka published a two-part series in Japan’s
second-largest newspaper on hikikomori: young adults, primarily male, who
withdraw from social activities and cease communicating with their families.2 The
series helped launch a public fascination with hikikomori, typified in the image of
the uncommunicative son whose doting mother leaves meals outside his bedroom
door (Jones 2006). Over the ensuing decades, hikikomori, as a symbol of individual,
family, and/or social pathology, has come to represent a generation of youth who are
either unable or unwilling to mature to become economically independent adults
and productive citizens.
Explanatory frameworks for hikikomori abound, with different stakeholders
attributing it to psychopathology (Kondo and others 2013; Teo 2010; Teo and Gaw
2010), poor parenting (Furlong 2008; Nakagaito 2004), and a lack of economic and
social support structures (Allison 2013; Genda 2007). The psychiatrist and hikikomori
expert Saitô Tamaki’s initial definition of hikikomori as ‘‘a problem that develops by the
time an individual is in his late twenties, [characterized by] at least six months of
withdrawal into the home and a continuing lack of social participation’’ (1998:25) laid
the groundwork for future government surveys and policies (Kôseirôdôshô 2003, 2010).
Although he is a psychiatrist, Saitô has always insisted that hikikomori is a condition
(jôtai), or a state of being, not a symptom of a psychiatric disorder (Saitô 2003). He
estimated there were one million hikikomori in the late 1990s, although a Cabinet survey
in 2010 revised that estimate to 700,000 hikikomori among youth between the ages of
fifteen and 34, a number that did not include ‘potential’ hikikomori, who are averse to
social relationships but have yet to withdraw completely (Naikakufu 2010).
This article takes an interpretive approach to hikikomori by exploring parents’
narrative constructions of their hikikomori children in support group meetings and
in-depth interviews. I argue that some parents found hope in hikikomori by
‘emplotting’ their children’s experiences into a narrative about hikikomori onset,
withdrawal, and recovery (Kaneko 2006b), thus embracing an alternative ‘narrative
time’ that restructured past experiences and future potential (Mattingly 1994, 1998,
2010). Parents contrasted the potential for recovery in hikikomori with the
chronicity of other psychological conditions, such as severe mental illness or
lifelong disability. Contrary to literature that examines hikikomori as an epidemic of
1
Translation by author. Japanese names are written in the order of family name followed by given name.
2
Hikikomori (‘‘withdrawal’’) can be used as either a noun or an adjective.
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isolated individuals, I demonstrate how parents play a key role in hikikomori
through meaning-making activities that have the potential to shape their children’s
experiences of withdrawal. These activities, I argue, hinge on the construction of
narrative time.
Constructing Narrative Time
Narrative has been identified as a fundamental organizing principle in making sense of
the world around us (Battersby 2005; Bruner 1991; Garro and Mattingly 2000;
Mattingly 1994). Particularly when the expected life course is disrupted, whether by
illness or some other form of trauma, narrative can be a significant way to bridge the
gaps between expectations and reality and create a sense of continuity despite changed
circumstances (Becker 1994; Bury 1982; Ezzy 2000; Frank 1995; Wentzell 2013).
A defining feature of narrative is plot, which links a series of events in a causal
‘narrative time’ that propels the narrative forward to its eventual resolution (Brooks
1984, qtd. in DelVecchio Good and others 1994). Mattingly (1994, 1998) has
written extensively about ‘emplotment’ in clinical encounters between occupational
therapists and their patients. Emplotment organizes scattered events into a story
with a plot; it creates narrative (or emplotted) time, an alternative temporal
landscape where actions and reactions build upon each other to reach a desired
conclusion. Narrative time stands in contrast to chronological time, which lacks
organizational structure; chronological time consists of ‘‘one thing after another’’
and fails to develop any sense of meaning (Mattingly 1994:812).
Narrative time has long been acknowledged as a significant component in stories
of illness and healing (e.g., Good 1994; Good and DelVecchio Good 1994;
Kleinman 1988; Mattingly and Garro 2000). Etiological narratives created from
personal experience and folk and biomedical knowledge can offer explanations as to
why disease or disability has occurred (Larsen 2004; Mathews and others 1994),
while ‘illness trajectories’ can set expectations for life after illness (Becker and
Kaufman 1995). Particularly when the master narrative of biomedical progress and
technology fails, such as when a disease proves unpredictable or incurable, patients
and clinicians employ narrative strategically to manage expectations and either
portend or foreclose future possibilities (Antelius 2007; Becker and Kaufman 1995;
DelVecchio Good and others 1994). While biomedical uncertainty can frustrate
patients who seek definitive answers (Becker and Kaufman 1995), it can also create
space for the unexpected to occur (Mattingly 1994, 1998, 2010). This space of
possibility, what Bruner (1986) has defined as the ‘‘subjunctive mode,’’ can
engender hope for the future.
Mattingly (1994, 1998) has argued the present is always infused with a desire for
the future, and that imagined future lends meaning to actions in the present (see also
Good 1994; Good and DelVecchio Good 1994; Novas 2006).3 Mattingly’s (2010)
3
For an extended discussion on the difference between hope and desire, see Crapanzano (2003).
Miyazaki’s (2006) response to Crapanzano explores hope within the context of neoliberalism and the
Japanese economy.
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work on a ‘‘narrative phenomenology of hope’’ draws together narrative, practice
theory, and hope to explore how hope is practiced in the everyday lives of
caregivers whose children suffer from chronic illnesses. In wedding the certainty of
narrative form with the improvisation of practice theory, Mattingly underscores how
unpredictable and uncertain life can be. A happy ending is not a given, and the
ability to hope for a future end to suffering takes work, a work that caregivers
perform everyday to ensure their children’s future.
I use parents’ narratives about hikikomori as evidence of that hopeful work. I
argue that parents use emplotment and narrative time to justify their continued
caregiving of their withdrawn children and maintain hope for the future. Identifying
their children as hikikomori and emplotting individual suffering into a larger
narrative about Japanese society lent their children’s behavior a cultural logic and
suggested ways that parents might end hikikomori. This framing of hikikomori
required interpreting it as an important developmental stage that transformed both
parents and sufferers into new selves with the ability to critique the mainstream
institutions of family, school, and work. I turn to these institutions in more detail in
the following section.
Postwar Japan as Narrative
The hikikomori phenomenon materialized against the backdrop of a culturally
familiar narrative of postwar Japan and the emergence of the new middle class,
which became iconic of the postwar Japanese lifestyle (Bestor 1989; Kelly 1986;
Vogel 1963). A mainstream consciousness, disseminated through the institutions of
family, school, and work, regulated life experiences for a majority of the population
and promulgated a restricted idea of what constituted normalcy in both aspirations
and statistics (Kelly 1993). The significance of these standardizing and structuring
institutions was that they created in the public imaginary a tantalizing narrative of a
successful life course that inculcated normative goals and values (Kelly 2002). In
postwar education and occupation, individuals advanced along a standardized life
course with their age cohort, and where they failed to advance, they became keenly
aware that they had fallen behind their peers (Rohlen 1974, 1983). Ideological
adherence to the proper life course continues to dictate the divide between normalcy
and deviance. The hikikomori descriptor therefore indicates problems with an
individual’s social development, problems that prevent him or her from assuming an
expected social role (Borovoy 2008). Attention has focused particularly on male
hikikomori; as the traditional primary wage earners within the family, men’s retreat
from social and economic spheres portends a more severe crisis than the retreat of
women, whose non-participation in the workforce can still be justified by recourse
to traditional ideas about bridal training within the home.
Borovoy (2008) has described hikikomori as the consequence of a socially
sanctioned ‘‘politics of inclusion,’’ where an emphasis on equality and shared values
means a lack of alternatives for those who do not fit within the mainstream. Those
who cannot conform ‘‘drop out’’ of social activities to regain their psychological
strength before attempting reintegration (see also Lock 1986, 1988a). Allison (2013)
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has analyzed the breakdown of the key identity-forming institutions of family,
school, and work in what she terms ‘‘liquefied Japan,’’ where the solidity of these
postwar structures has melted into a fluid instability. She argues that this instability,
and the anxiety it provokes, has produced a sense of precarity, a term that
encapsulates the alienation, isolation, uncertainty, and lack of hope that she sees as
characteristic of contemporary Japan. Allison extends her analysis of precarity into
the social realm, identifying a ‘‘social precarity,’’ or a feeling of disconnectedness
from one’s fellow citizens, a ‘‘dis-belonging’’ that hikikomori, in their retreat from
social space, embody (Allison 2013:85).
The structurally deterministic argument that Allison details, where the very
conditions that enabled Japan’s postwar success ultimately resulted in national
breakdown, was a common theme in the hikikomori discourse. As social
commentary, hikikomori could be construed as a result of economic circumstances
that leave young adults with limited options (Furlong 2008). Particularly during the
recession of the 1990s, young adults who floundered on the proper life course
became targets of criticism for not advancing to the adult roles of white-collar
salarymen and wives and mothers, instead appearing to shirk adulthood in favor of
lingering in quasi- or full dependence on their parents (Cook 2013; Genda 2007;
Yamada 1999). As Horiguchi (2012) has argued, hikikomori gained public traction
within a particular ‘‘ecological niche’’ (Hacking 1998) that has shifted over the
years to encourage public policy focus on a variety of youth-related problems,
including school refusal (tôkôkyohi, futôkô), children’s physical abuse of parents,
and otaku subculture. While hikikomori is a condition that has captivated the public
only recently, there is widespread belief that the groundwork was laid decades
earlier (see Goodman and others 2012).
Indeed, the nuclear family, composed of a ‘‘ricewinner husband, homemaker
housewife, and two samurai-student children’’ (Kelly 1986:604), has been a target for
critics since it replaced the three-generational household in the postwar era, a symbol
both of modernization and of the loss of traditional values (Lock 1986, 1987, 1988a,
1988b). While husbands worked to provide for the family, wives managed the
household and raised the children, which included discipline and early moral training
(Bernstein 1983; Imamura 1987). Women were the primary caregivers, and the ideal
mother was one who displayed an all-encompassing devotion to her children,
especially her sons, because her devotion catapulted them toward mainstream success
(Allison 1991). In a country where the health of the family has long symbolized the
health of the nation (Kelly and White 2006), and where the mother–child relationship
is a defining feature of the family (Lock 1987, 1988b), hikikomori could be read as an
incisive critique against both familial and societal relations. Bound up in the cultural
symbolism of the mother (Doi 1973) and postwar beliefs about parenting, it was easy
to fault mothers for failing to raise socially responsible citizens (Horiguchi 2011).
Hikikomori remains an amorphous concept that works as a diagnostic but not a
diagnosis, hovering somewhere between social deviance and psychological
sickness, as psychiatrists, policymakers, journalists, and others continue to debate
its meaning. In arguing for a hopeful reading of hikikomori, this article examines
how national anxiety and instability can also be read as sites of productive
uncertainty. That is, the very condition of unknowing enabled some parents to
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imagine a different future, one that did not look so bleak. Such imaginings emerged
in the narratives parents told within the hikikomori support community.
Research Conditions
The research for this article took place over fourteen months in Tokyo and its
environs in 2010-11 and was part of a larger project that compared the separate yet
interrelated communities that have developed around hikikomori and mental illness
(Rubinstein 2012). I began my research with my own biomedical prejudice,
believing that hikikomori functioned as a ‘disguised diagnosis,’ or a euphemistic
label that allowed parents to ignore their children’s psychiatric symptoms and avoid
the stigma of associating with psychiatrists (see, e.g., Munakata 1989). My first
contacts in the field were psychiatrists and, through them, a support group for
families and their mentally ill kin. The members of this group introduced me to their
acquaintances in other support groups, one of which was the Hikikomori Discussion
Group (HDG) that I detail below.
I found initial agreement with my perspective on hikikomori among certain
psychiatrists and mental illness support groups; indeed, there is a large body of
biomedical literature debating the relative merits of ‘hikikomori’ as a diagnostic
category and its relevance to other cultural settings (e.g., Kato and others 2011;
Tateno and others 2012). As I became more acquainted with parents, hikikomori,
and treatment providers (both lay and professional) at hikikomori-related events,
however, I realized hikikomori was a far more nuanced concept than I had
anticipated, and mere medicalization did an injustice to the interpretations parents
and others offered. I met parents who had taken their children to psychiatrists and
whose children had been diagnosed with psychiatric disorders, yet who continued to
identify their children as ‘hikikomori’ for reasons beyond a desire to avoid stigma.
This made me wonder about the symbolic work hikikomori did for parents.
In pursuing the answer to that question, I regularly attended hikikomori-related
support groups and public lectures, some of which were organized by parents and
others by mental healthcare professionals. The sheer breadth of hikikomori-related
activities was impressive, and different groups offered different conceptualizations
of hikikomori, with some more or less sympathetic to psychiatric interpretations and
treatment paradigms. Other groups worked hard to divorce hikikomori from the
language of psychiatry and often pointed to psychiatry’s inability to understand,
much less treat, hikikomori’s suffering.
Throughout the course of my research, I conducted over fifty interviews in the
overlapping hikikomori and mental illness communities with parents, children,
hikikomori-related program staff (among whom were many former hikikomori),
self-described hikikomori, and psychiatrists who did and did not specialize in
treating hikikomori. My interviewees primarily broke down into two generational
cohorts: parents and psychiatrists in their fifties and sixties, and hikikomori and
support staff in their twenties and thirties. I mainly interviewed mothers, as they
were the primary caregivers. Despite the preponderance of mothers, fathers were
often support group leaders. Rarely did I see both parents attend group meetings
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together, and in only two cases did I interview husband and wife together. My
interviewees came from a self-selecting population who chose to identify as part of
their respective communities, and therefore my research is limited only to the most
vocal and active parents. They are not a representative population, as people
introduced me to like-minded individuals; still, they do much to illustrate the issues
facing both older and younger generations of Japanese who are beholden to the
postwar ideal of the mainstream middle class while also acknowledging that it no
longer suffices as a symbol of a shared national reality.
Narratives are dynamic entities, intersubjectively constructed by storyteller and
audience (DelVecchio Good and others 1994; Good and DelVecchio Good 1994),
and support group discussions provided shared context for the individual stories I
collected from parents. Although the chronological series of events of which parents
spoke did not change, the meanings they ascribed to these events were in constant
negotiation. In piecing together the comments they made in groups and the stories
they told in interviews, I began to see how parents constructed narrative time to
maintain hope for their children’s future. The narratives I detail below cannot be
considered ‘complete’ or ‘unedited’ accounts of the past but are rather the result of
parents’ interactions with one another and their interactions with me during our
interviews (Hydén 1995). Many of these parents were familiar with researchers—
Japanese and foreign journalists, psychiatrists, academics, parents, and hikikomori
have published widely on the hikikomori phenomenon—so when I showed up, I was
simply another researcher, although an American one who spoke Japanese, which
made me more exotic. My American identity meant there were always implicit (and
often explicit) Eastern-Western cultural stereotypes to contend with, although I tried
to challenge my interlocutors’ assumptions by refusing to acknowledge hikikomori
as ‘uniquely Japanese’ (cf. Zielenziger 2006). As much as I pushed back against
culturally deterministic arguments, however, they formed a crucial part of nearly all
of my interviewees’ narratives.
The parents with whom I interacted the most attended so many different events
that they had become seasoned storytellers, but each meeting, each interaction,
offered grounds for new iterations. Because I engaged with them in a variety of
hikikomori-related settings, I had the opportunity to observe how their narratives
developed over time and in different contexts, shedding light on how their
interpretations could and did change throughout their experience with their
hikikomori children. Like the hikikomori phenomenon itself, there were no
certainties, but there were multiple interpretive possibilities.
The Hikikomori Discussion Group
The monthly Hikikomori Discussion Group (HDG) meetings consisted mainly of
parents and individuals who identified with the label of hikikomori, along with a
few students and researchers like myself. Meetings were held in a community
center’s bland linoleum room of long white tables, uncomfortable plastic chairs, and
a rolling whiteboard, and always followed the same pattern: first, a large group
discussion in one big circle, followed by a fifteen-minute break, during which we
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rearranged the tables into small clusters that seated five or six people. One of the
organizers always emailed the group beforehand to announce the topic of that
month’s meeting, which, more often than not, was ‘free talk,’ a freestyle discussion
beginning with brief self-introductions that segued into regular members expounding on familiar themes. Unlike the structured support groups I attended, where
meetings consisted of illness narratives in the guise of self-introductions, the HDG
seemed to be a group of individuals who enjoyed thinking aloud together about
ways to change Japanese society, while also seeking ways to change their own
situations. As Horiguchi (2011) and Kawanishi (2006) have noted, support groups
can provide an alternative source of community for families of hikikomori and
mentally ill kin. This particular group had been in existence for several years, and
the regulars knew one another’s stories. Many of them also participated in a reading
group where they discussed the latest hikikomori literature by popular and academic
authors alike.
The HDG was particularly wedded to a non-pathological interpretation of
hikikomori, and although members acknowledged the existence of mental illness
among hikikomori, particularly in the form of ‘neurotic’ symptoms like compulsive
hand-washing, they did not believe in a causal link between psychopathology and
hikikomori. Rather, they advocated for hikikomori as a legitimate social identity,
one the government could validate by instituting a system of basic income, or
economic welfare for all; this would presumably free people to do whatever they
wanted, whether that meant staying at home all day or working a regular job. No
longer would hikikomori feel guilty because they would be supplied with their own
spending money, and no longer would parents worry over how their children would
survive without them. This was a fantasy, of course, and no one in the HDG
expected it would happen, but it represented one possible way to provide for
hikikomori without stigmatizing them further.
Neither parents nor hikikomori ever claimed the hikikomori experience itself was
pleasant, but there were parents in the HDG who read into hikikomori a significance
that transformed it from social failure to profound psychological experience. One
night during the group’s post-meeting gathering at a local fast food restaurant, a
middle-aged male hikikomori became drunk and raucous. He burped loudly,
insisted he was still sober, and proclaimed he had the psychological age (seishin
nenrei) of a fifteen-year-old boy. The group leader, a mother in her early sixties
whose gray hair was dyed with a dusting of rose blush, protested. Hikikomori, she
said, actually have a higher psychological age than their peers because they spend
so much time thinking about life.4 Framed in this light, hikikomori were wise
beyond their years, performing the difficult psychological work of self-discovery
that it took others a lifetime to achieve. Sometimes the hikikomori period acquired
the mystical qualities of a religious experience. A 60-year-old mother whose
29-year-old son had been a hikikomori in his third year of junior high school told
me that hikikomori emerge after their period of withdrawal having experienced
4
Although I digitally recorded formal interviews, I did not record discussion group meetings or social
outings. I therefore use different textual formats to represent different types of speech and interpretation
(see Davis 2012). Dialogue quoted verbatim and translated from the Japanese is presented in quotation
marks and block quotes. Non-verbatim dialogue captured in extensive fieldnotes is presented in italics.
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something akin to spiritual enlightenment (satori). Now emplotted as a psychological journey, hikikomori was not simply a passive reaction to a pathological society
but had the potential to be a volitional act of self-discovery.
Not all parents were capable of emplotting hikikomori or maintaining a sense of
narrative time, especially when the hikikomori period dragged on for years or
decades without any signs of change. These parents experienced the failure of
emplotment, and their narratives came to a ‘‘standstill’’ (Kohn 2000) in which they
stopped imagining a future beyond their children’s present circumstances. Although
they were able to narrativize the onset of hikikomori, offering an emplotted
explanation as to why their children had become withdrawn, they were unable to
move the narrative beyond the present inertia. The only possible future was more of
the same, as the 66-year-old mother of an apartment-bound 36-year-old son told me:
I don’t know if there will be any improvement. He might just get older….
There’s nothing more I can think of that I can do on my own initiative. … He
goes to the bathroom by himself, he eats meals by himself, he goes shopping
by himself. That’s good, I think. I try to look at it in that light. That’s the only
way I can think about it—but if I think this way, things will never get any
better.
Antelius (2007) has argued that a lack of future possibilities necessitates the
creation of meaning located in the present, without the temporal forward projection
characteristic of narratives. Yet, if one cannot move beyond the present, then the
future becomes ‘‘the simple accumulation of multiple instances of the present’’
(Miyazaki 2006:157). For this mother, who was not an HDG member, the future of
her hikikomori son was simply the passage of time marked only by his increasing
biological age. Narrative time had failed to overcome the limitations of chronological time; it had stalled at the point where her son was able to perform basic
human functions, but not much more. She alluded to the moral imperative to hope,
suggesting that her inability to do so might prevent her son from future
improvement—but hope was proving difficult to sustain. The resignation expressed
in her comment is what those parents who created more hopeful narratives of
hikikomori fought against, as I illustrate in the following two sections.
KAWANO-SAN: Variations on Emplotment
Kawano-san was the feisty 57-year-old mother of a 22-year-old hikikomori son who
first introduced me to the HDG.5 She stood fewer than five feet tall, with glasses and
shoulder-length black hair she wore with bangs, which gave her an almost girlish
appearance. She was thick in her midsection, which she covered with knee-length
shirts and sweaters. We met outside a Tokyo train station on a Saturday afternoon in
May and together walked to the community center to meet the group.
5
All names are pseudonyms. -san is a respectful title that is equivalent to the English ‘‘Mr./Miss/Ms./
Mrs.’’
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Many of the HDG parents, including Kawano-san, also participated in school
refusal (futôkô) support groups, which meant Japan’s educational system was a
popular topic for criticism. A mother commented at one meeting that the problem
with Japanese schools was that everyone had to be the same, like soldiers in an
army, or else they would be punished. Kawano-san piped up to say she had a clear
memory of her son as a third-year student in elementary school. He and his
classmates were supposed to go swimming for gym class, but it was cold, and her
son refused to jump in the pool, even when his teacher demanded he join his peers.
School, she concluded, is all about preparing children to be hard-working company
employees who follow orders. A different mother replied, That’s exactly the type of
adult you don’t want. You want adults who are willing to speak their mind and
provide new opinions.
Kawano-san then told us about the ‘‘ideal child’’ (risô na kodomo) that every
teacher desired (cf. White and LeVine 1986). The ideal child was lively and
cheerful, spoke in a loud and confident voice, and addressed people in appropriately
respectful language. A lot of value was placed on these traits, she said, and there
was no recognition that other types of personalities existed. Her son, for example,
was lively when he was with his friends, but he was quiet in class, so his teachers
had not liked him. To demonstrate the problem with this limited worldview,
Kawano-san opened up her folding fan, first to its full width, but, deciding this was
too big, closed it until only one-quarter of the fan showed, like a slice of cake. This,
she said, tracing the edges of the slice, is your frame (waku). If you fall within the
frame, you’re okay. But if you don’t—and here she tapped the table next to the fan—
you’re in trouble.
Kawano-san’s son fell outside the frame. She said he had struggled in his last two
years of elementary school with a teacher who preferred ‘‘child-like children’’
(kodomo rashii kodomo) to more mature children like her son, who liked to think
about things and raise questions. He entered junior high school, but his attendance
soon became sporadic as he complained of headaches, stomachaches, and fever. As
his absences mounted, his homeroom teacher visited the Kawano household to
speak with both mother and son:
The teacher told him it was okay for him to be late to school, so he should still
come.… But of course, for my son, showing up late after the class had already
started was embarrassing and uncomfortable, so he spent the next three years
not going to school at all.
When her son left school, Kawano-san joined a parents’ support group that
taught her about educational opportunities outside of mainstream schooling. She
hired a 20-year-old university student to tutor her son at home, and the two
became friends, sometimes studying and sometimes playing video games. Even
without junior high school, she believed her son could advance with his agemates, and she contrasted her acceptance of her son’s school refusal with her
husband’s initial dismay.
My husband did not accept this at all. At first he was extremely pessimistic. He
grieved. He suffered. ‘‘My son can’t even go to junior high school?’’ he said.
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‘‘His life is over.’’ I tried to encourage him by saying, ‘‘That’s not the case at
all. Even if he doesn’t go to junior high school, there are still plenty of other
ways to live. It’ll be okay.’’
Kawano-san’s optimism seemed justified when, at the age of sixteen, the son
began studying for his high school equivalency degree and decided he wanted to
prepare for the national university entrance exams. He entered an entrance exam
preparatory school and made friends, enjoying bowling and dinner outings and even
a trip to Tokyo Disneyland. At the age of eighteen, he and his friends took the
entrance exams. He failed and planned to spend another year studying, which is not
unusual in Japan, ‘‘but then he became unsure of which university he wanted to
attend,’’ Kawano-san said. ‘‘Studying lost meaning for him, so he quit. Since then,
he’s led his life at home (jitaku de seikatsu shite imasu).’’
When we first spoke, Kawano-san was adamant that her son simply preferred,
but did not need, to remain at home. She had found receipts for Tokyo bookstores
and music stores in his room, so she knew he went out during the day while she
worked; he also took the family dogs for daily walks around the neighborhood. She
said he was wrestling with finding his place in the world, but once he did, he would
become a full-fledged member of society. Remaining at home while he took the
time to think about life made sense in the context of his personality and the social
pressure to conform to a prescribed norm. I suggested that even in this context, not
participating in everyday society might make his life feel unsatisfying, but Kawanosan was more circumspect.
Being out in the world doesn’t guarantee you satisfaction. You have to decide
to some extent that things are good enough. For example, you’re not one
hundred percent satisfied, but maybe sixty or seventy percent. The other thirty
percent or so you think, Well, there’s nothing I can do about that, and so you
go on with your life.
Kawano-san might as well have been describing her contrasting experiences with
her two children, her twin emotions of satisfaction and resignation. Her son was not
the first child in the family to stop attending school. Her daughter, who was four
years older, had been a school refuser in her first year of high school, although she
later enrolled in a correspondence school and earned her high school equivalency
degree. She took the university entrance exams, matriculated at a four-year
university, and, along with her classmates, found a job upon graduation. She had her
own apartment and did not require her parents’ financial support. She was single
while I was in Japan but became engaged the following year.
Despite her period of school refusal, Kawano-san’s daughter had made her own
way back to the standardized life course and had become a socially responsible
adult. Given her daughter’s experience, Kawano-san had no reason to believe her
son’s experience would be any different. He, too, would find his way back to the
mainstream, as evinced by his friendship with the tutor and his enrollment at the
exam school. But upon failing the university entrance exams, he had begun to slide
into the hikikomori lifestyle. He and the tutor, who now worked as an accountant,
no longer communicated, and Kawano-san believed this was because her son felt he
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had not lived up to the tutor’s expectations: taking the national entrance exams and
matriculating at a university. ‘‘The tutor told my son to give him a call when he was
at university, and they could go out drinking together,’’ she said. But the son never
went to university and thus never called.
It was another eight months before Kawano-san and I sat down for a follow-up
interview, despite frequent email contact and monthly HDG meetings. Her
perspective on hikikomori within her household seemed to have shifted from
hikikomori as an alternative developmental stage to hikikomori as a sign of troubled
family relations. She had also begun to wonder if her son might have some kind of
disability (shôgai), although of what, she was unsure. She called him a not-quitehikikomori (chûtohanpa no hikikomori), as if he were caught somewhere among the
vagaries of psychological experiences. ‘‘I just never thought things would stay the
same all this time,’’ she said.
When her son first became a school refuser, Kawano-san said, she had thought it
was a stage that would soon pass, and once it did, he would continue on the usual
track of school, work, and marriage. With her daughter’s school refusal narrative as
a model, Kawano-san had assumed the situation would eventually resolve itself. But
that was not what had happened.
Kaneko (2006b) has identified a three-part structural pattern in the narratives that
‘recovered’ hikikomori recount for a public audience: a pre-hikikomori period, the
hikikomori experience, and the process of recovery. Kawano-san modified her
narrative to fit this pattern by classifying the entirety of her son’s experience over
the past decade as hikikomori, even though he had only more recently begun to
engage in the typical hikikomori behavior of remaining at home and occupying
himself with video games and comics. In collapsing the distinctions between types
of social non-participation, she prevented her son’s story from becoming a narrative
of degeneration, of a withdrawal from social life that had become more pronounced
over the years. She equated his early years of school refusal and friendship with his
tutor with his later years of more protracted withdrawal as a way of flattening out
the highs and lows of his experience. In this sense, Kawano-san was un-emplotting
her son’s story, attempting to remove a sense of intentionality from her son’s actions
so that each stage was merely another episode within the broader context of the
hikikomori period. By grouping everything under one stage of experience, she
concurrently emplotted her son’s actions into the larger three-part narrative and
paved the way for the next stage: the process of recovery.
Kawano-san engaged in ‘‘active waiting’’ (Han 2011) and used narrative time to
create a space for her son to solve his existential dilemma. Narrative time could be
generous, as it included the fiction that the sort of life her son wanted would still be
attainable once he was no longer a hikikomori. But narrative time could not be taken
out of the context of chronological time, and as Kawano-san’s son aged and failed to
advance through the normative life stages, his options for the future became more
limited.
Kawano-san confronted the inherent contradiction in her active waiting at every
group meeting. ‘‘You can’t solve any problems in the discussion group,’’ she told
me at our first interview, ‘‘but you can see all sorts of people there, some who are
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653
working, some who are still at home. Whatever they’re doing, they find a way to
exist.’’
The self-identified hikikomori who attended the meetings were, for Kawano-san,
the embodiment of alternative plots her son’s story might take. Different narrators
contributed different perspectives to hikikomori stories, and the multiplicity of
voices further demonstrated the range of possible futures (see Good and DelVecchio
Good 1994). Whether or not they had ‘recovered’ from hikikomori—that is,
whether or not they were able to resume their proper social roles as students or
financially independent adults (Kaneko 2006a)—was a separate matter. They were
at least present at meetings, and their ability to participate to varying degrees in a
public setting was a more immediate goal for her son.
Another possibility, however, was the one she broached at our second interview,
her suggestion that her son might have some kind of disability. In speaking of her
son as a hikikomori, Kawano-san implied that his withdrawal was only temporary, a
brief (albeit longer than expected) pause while he decided what role he wanted to
play in society. Disability meant a chronic condition, and by raising the issue she
suggested her son’s narrative might not end with complete social reintegration, and
that, in fact, the underlying cause of his withdrawal might extend indefinitely into
the future. It bespoke a change in how she conceptualized her son, now imagined as
someone who might not have the capabilities to succeed. At the same time, she
subscribed to the idea that her son’s upbringing might have some relation to his
current withdrawal, and if she made an active attempt to change the home
environment, it could lead her son to change his behavior.
Kawano-san expressed an uncertain hope in hikikomori. Hikikomori was a more
promising condition than a disability because of its potential abatement, but her
son’s prolonged hikikomori experience cast doubt on the plausibility of her
narrative. She spoke in vague terms of a damaged relationship between herself, her
husband, and her son, intimating that this damage, unspecified though it was, had
enabled his hikikomori period to continue for so long. She wondered aloud how to
make amends. Her son’s twenty-third birthday was only a few months away by the
time of our second interview, and she wanted the family (her husband, her daughter,
and herself) to write him birthday notes, just small things like, ‘‘Happy birthday!’’
and ‘‘Thanks for walking the dogs everyday!’’ This was not common practice in
Japan, she said, but it might make him feel more appreciated. It might even
encourage him to join family life again.
WATANABE-SAN: The Failure of Biomedicine
Watanabe-san, whom I met at the HDG, looked like the typical salaryman. He was
68 years old, a thin man with a bald pate, who always wore a white dress shirt and
gray slacks. He carried a well-worn black briefcase from which he pulled sheaves of
blank paper to write on while we spoke. He wrote slowly at first, careful to draw his
Japanese characters so that I could read them, but the more enthusiastic he became,
the more he scrawled, circling words again and again and stabbing his pen into the
paper until it was covered with ink splotches.
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Nothing made Watanabe-san more enthusiastic than criticizing Japan, a right he
felt he had earned by following the normative middle-class life course, which he
itemized as ‘‘good middle school, good high school, good university, good
company, good bride, good marriage, good grandchildren.’’ He was now retired and
worked part-time while receiving his pension.
Watanabe-san’s 35-year-old hikikomori son was the middle child, sandwiched
between two brothers. Watanabe-san insisted there had been nothing exceptional
about their childhood. The son had advanced through junior high and high school,
stumbling briefly in his first year of high school with an overly strict teacher. In his
third and final year of high school, he began missing the morning train for his
commute.
At that time, but now, too, the dream is to raise a child who goes to a good
[secondary] school, a good college, joins a good company, and makes a good
match in marriage. Do you understand what that means, the meaning of good
(ii)? The school is one that makes your child study hard so that he can enter a
prestigious university. … My son commuted 1.5 hours each way to get to his
school. But then he became a ‘‘drop out’’ [said in English] and fell behind
everyone else.
When the son stopped attending school, he became a hikikomori, spending his
days at home watching television and not venturing out unless forced by his parents.
Watanabe-san and his wife believed they had caused their son’s withdrawal, so they
visited Tomita Fujiya, a counselor who specialized in hikikomori and who first
wrote about hikikomori in the early 1990s, years before the psychiatrist Tamaki
Saitô (1998) published his definitive text. Tomita (1992) emphasized the need for
better communication between parents and children. According to Watanabe-san,
Tomita told them their son had withdrawn in reaction to their pressuring him to
study hard and attend only the most prestigious schools. Watanabe-san used an
analogy to explain this to me. ‘‘When you pickle vegetables, you take raw
vegetables, add salt, and squeeze them down into a bowl so they become tender,’’ he
began. The pickling process is aided by a stone weight called omoishi that sits on the
bowl’s cover. It is this weight that helps squeeze any remaining liquid out of the
vegetables. ‘‘You squeeze, squeeze, squeeeeeze—and that’s what happens to
children. They feel squeezed by all of the pressure.’’ Thus, to help their son, the
Watanabes were told to stop pressuring him:
Tomita-san’s advice to us about how to guide our son was for us to put as little
pressure on him as possible, to let him be free. The weight would lift from
him, and gradually he would begin to feel as though he could do whatever he
wanted. At first it felt like Tomita-san was saying that because of the pressure
we’d put on our son, he’d turned out to be like this. His mother felt guilty
because Tomita-san said she’d pushed our son too hard. I participated, too, so
as a parent I felt the same way. It depends on the household, but there are a lot
of cases where it’s only the mother who’s held responsible for her children,
and the father isn’t involved. But both of us went to see Tomita-san.
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655
Even without parental pressure, the son’s mood darkened over the ensuing
months until he became so depressed that Watanabe-san encouraged him to see a
doctor. The son responded by attempting to drown himself in a nearby lake. His
behavior grew increasingly bizarre. One day neighbors found him naked and
shivering in a parking garage. Another day he stood outside the nearest train station
in the rain, clothed this time but without an umbrella or shoes. Soon after, he slit his
wrists, which landed him in the psychiatric emergency room, where he was
diagnosed with schizophrenia. He was nineteen.
Hospitalization, with attendant medication, seemed to help, and the son’s
condition began to improve. He managed to attend school for one semester, at first
commuting to and from the hospital, before it proved too taxing. He officially
dropped out of high school, but the following year he expressed an interest in
studying for the university entrance exams. Although he passed the exams and
started at university, he began to experience violent episodes, provoking physical
altercations seemingly without cause. He took a leave of absence from school and
attempted a variety of part-time jobs, never for more than a few days or weeks. In
his mid-twenties he turned his violent impulses against his father.
His violence landed him back in the hospital, an unfortunate pattern that
continued to the present. Although the son’s symptoms had lessened over the years,
and he was now mostly stable, there were still outbursts severe enough that he had
to be hospitalized. For Watanabe-san, the hospital was not a place of healing. ‘‘It’s
not hospitalization,’’ he said. ‘‘It’s a place of internment (shûyôjo). The hospital is a
place that holds him when he’s violent. It doesn’t cure him.’’
The lack of cure was Watanabe-san’s greatest complaint about psychiatry, and
his poor experiences with mental health care professionals, including a well-known
counselor who had fallen asleep during a session with him and his wife, had only
deepened his bitterness. Psychiatry had failed to cure his son, and what use was
biomedicine if it had no cure for disease? Watanabe-san understood his son’s
medication to do nothing other than lessen the severity of his symptoms, and for
him, whatever recovery there might be in the future would not, could not, come
from psychiatry. Where other parents had found ways to contest psychiatric practice
through multifamily support groups in the mental illness community (Rubinstein,
n.d.), Watanabe-san had avoided these groups, believing them to represent a type of
resignation he was not willing to accept.
A real schizophrenia group spends a lot of time thinking about the disability
pension and the kind of lives their children can have with it. They’ve given up
on the idea of their children going out into the world and living independently.
My wife and I couldn’t think that way. We didn’t want to think that way.
Watanabe-san did not deny his son’s psychopathology, but he used the
hikikomori concept to speak about his son in what Bruner (1986) has called the
‘‘subjunctive mode,’’ a narrative technique that enabled him to imagine alternatives
to a life of chronic impairment and a disability pension. The biomedical narrative of
progress had proved incompatible with the reality of his son’s condition;
schizophrenia remained foreign, unknowable, and unconquerable. Hikikomori, by
comparison, had a cultural logic to it, and Watanabe-san drew on the familiar
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narrative of postwar Japan’s rapid modernization and loss of traditional values to
explain the existence of hikikomori. He was passionate in his criticism of
contemporary social pressures, and he mourned what he saw as a loss of empathy
among his countrymen.
Bosses should be understanding and should tell you to take some time off if
you’re emotionally drained. Neighbors should be kind to one another. Like
someone saying, ‘‘Here, I made this and thought of you. I’d like to give it to
you.’’ This is the type of relationship that developed outside of central Tokyo
long ago. The neighborhoods in central Tokyo, inside the [circular] Yamanote
train line, are the opposite.… They’ve lost their concern for one another.
Watanabe-san thus doubly emplotted his son’s experience. One emplotment
focused on the broader social context in which hikikomori had emerged and
demonstrated how individuals like his son were victims of socio-historical
circumstance. The other emplotment shifted focus away from his son as
psychiatrically ill and instead emphasized his hikikomori attributes, which meant
there was still hope for the future. Watanabe-san attended hikikomori support
groups that stressed behavioral interventions, and he actively sought information
about how to make his son’s life better.
I want to get any kind of useful information. ‘Useful’ means it will bring about
a cure (naosete iku) for hikikomori. Good information. ‘‘This is where you can
find a good doctor. There’s this book. There’s that book. There’s this kind of
medication.’’ That kind of information.
Although his language was inflected with the biomedical model of disease,
Watanabe-san made it clear that psychiatry was unable to offer these interventions
in any meaningful way. He therefore turned to the hikikomori support community,
participating in at least three groups that I knew of, including the HDG. He invited
me once to another group run by a large and energetic man in his late thirties who
had created an overseas therapy program to cure hikikomori. He had no professional
mental health credentials, but had done a few months of shadowing at psychiatric
treatment centers, had studied anthropology at university, and had lived in several
Asian countries throughout his life. His theory was that the totality of Japanese life
caused some individuals to become hikikomori, so rehabilitating them required
something as drastic as removal to a foreign country, where their inability to follow
Japanese social norms could not be judged, and where they would be free to develop
their own sense of self. I asked Watanabe-san why parents were willing to trust
someone like this man, whose expertise was based on his personal opinions.
Watanabe-san replied by quoting Deng Xiaoping: ‘‘It doesn’t matter if the cat is
black or white. As long as it catches mice, it’s a good cat.’’
Although Watanabe-san had no definitive answers for hikikomori, the hikikomori
concept at least offered a range of possible interpretations and interventions, and he
was willing to explore them all. This was in contrast to psychiatry’s limited
purview, where hospitalization (‘‘internment’’) and medication represented the only
two available options. His disillusionment with psychiatry was not without cause, as
parents in both the hikikomori and mental illness communities expressed their
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frustration at psychiatry’s continued emphasis on hospitalization and medication
over outpatient care and rehabilitation. Watanabe-san had found that, compared to
psychiatry, in the hikikomori community meant there was always another strategy
to try. It was this endless potential that kept Watanabe-san engaged in the
hikikomori community; to do otherwise would be to resign himself to a narrative
standstill and a lack of hope for his son’s future.
Conclusion
Narrative can be a powerful strategy for making meaning and creating a sense of
continuity when life disruption occurs. Hikikomori is a disruption that affects the
entire family and threatens the continuation of the family line; writ large, it
threatens the existence of the nation. It is a condition without easy explanations, and
parents found ways to cope with the unknown by narrativizing their experiences in
supportive communities. In eschewing pathological interpretations of their
children’s conditions, parents sought hope outside of biomedicine by creating their
own community of resources and experts.
As Horiguchi writes in her study of family groups for hikikomori, narratives from
hikikomori and their families are ‘‘personal life stories, each of which is one version
of an attempt to retrospectively describe what happened’’ (2011:220). Drawing from
narrative theory, I have taken this observation one step further to suggest that these
narratives are full of both ‘past talk’ and ‘future talk’ in that they reveal not only
parents’ understandings of the events leading up to their children’s hikikomori
period but also their tentative expectations for the future. I have suggested that
emplotting the hikikomori experience motivated parents to continue engaging with
their children in the present, even as their children shunned all social interaction,
because hikikomori had the potential to abate in the future. It lacked the incurability
of a psychiatric disorder, as Watanabe-san believed, and it did not imply chronic
disability, as Kawano-san feared. Rather, there was a possible, if uncertain,
resolution, a narrative denouement that at its best could lead to transformational
change for both children and parents.
When parents imbued the hikikomori experience with meaning, they created a
narrative space where hikikomori sufferers became a valuable resource, enabling
the sufferers to favorably compare their current circumstances to their prehikikomori lives. Hikikomori were empowered to create ‘‘radicalized selves’’
(Clarke and James 2003) with new values by claiming hikikomori as a social
identity. They no longer dwelled on their failure to achieve the mainstream ideal but
instead parlayed their hikikomori experience into a profession, finding work as
support program staff, presenting at symposia, and allowing journalists and
researchers to interview them. Parents who believed in the significance of
hikikomori, who emplotted hikikomori in a narrative of social and psychological
development, validated these new selves by treating the hikikomori as experts, as
they were the only ones who could truly understand the hikikomori condition. These
‘professional’ hikikomori, in turn, embodied one narrative possibility for their
children’s future.
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Hikikomori as symbolic capital could hold transformative power not only for the
withdrawn individual but also for parents, which enabled parents to emplot their
own lives along with their children’s (Landsman 2003). These were parents in their
fifties and sixties who had come of age in the postwar era and were beholden to the
myth of the mainstream middle class until their children’s deviation from the norm
had forced them to reevaluate their priorities. In critiquing Japanese society through
hikikomori, then, parents made claims to newly enlightened selves who had
sloughed off the false consciousness of the masses and were now able to understand
there were many ways of being in the world beyond the prescriptions of the postwar
mainstream. The HDG leader said it had been hard for her when her son had first
stopped attending school, but ultimately his actions had allowed her to open her
mind to new possibilities. ‘‘Thanks to my son (okagesama de),’’ she said at a
meeting after-party at the bar across the street, ‘‘I am a changed person.’’ This was a
positive development that spoke not only to her new social awareness but also to an
enhanced ability to support her son’s psychological needs. Hikikomori as
transformative event for both children and their parents was one narrative
construction of hikikomori, one that HDG members whose children were no longer
hikikomori could model for those parents who were still coping with their children’s
withdrawal.
When children withdrew into their homes, they removed themselves not only
from the constraints of social and developmental time (Kaneko 2006b), but also
from the temporality of the nation. Parents’ stories thus served the additional
function of drawing their children back into the national narrative of postwar Japan.
Like Watanabe-san, some parents created narratives around hikikomori that
contextualized their children’s behavior in terms of a familiar national critique
about postwar prosperity followed by economic recession and the breakdown of
traditional social ties. By linking their children’s experiences to these larger
narratives, parents inserted their children back into the sociocultural fabric, creating
a discursive social space for them that contrasted with the asociality of their
behavior. Rather than speaking of their children as non-participants in Japanese
society, parents demonstrated how hikikomori could be interpreted as an alternative,
if not necessarily desirable, form of participation.
In engaging with the concept of hikikomori intellectually as well as experientially, parents began to imagine alternative possibilities for social relationships, both
within their own households and within society at large. While prior scholarship on
hikikomori has emphasized the separation of hikikomori from social life (e.g.,
Allison 2013; Borovoy 2008; Horiguchi 2012), I have shown how hikikomori can
also be construed as a thoroughly social activity, one intertwined with parental
caregiving strategies and supportive communities of care. As Kleinman and
Kleinman (1996) have noted, suffering of any kind is intersubjective, experienced in
and through social interactions, including those within the family (see also Garro
and Yarris 2009). Hikikomori represents more than ‘‘bare life’’ within the home
(Allison 2013); rather, parents and other members of the hikikomori community,
including many self-identified hikikomori, are engaging in creative social work that
directly affects home life. Parents’ narrative interpretations of hikikomori hint at
what this work looks like and suggest ways they are trying to
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reconfigure relationships beyond the mainstream ideals. Further study can reveal
how these reconfigurations are enacted in everyday life.
Acknowledgments I would like to thank Alessandro Angelini, Elif Babul, Nicholas J. K. Breitborde,
Benjamin F. Crabtree, Jenna Howard, William W. Kelly, Nicole Labruto, Aubrey Moe, Karen Nakamura,
and especially Joshua H. Roth, in addition to the anonymous reviewers, for reading and commenting on
earlier versions of this paper. I would also like to thank Erika Kido-Kumah and Toko Shiiki for
transcription and translation assistance. This study was funded by the Japan-U.S. Educational
Commission (Fulbright IIE) Dissertation Research Fellowship, Yale University’s Whitney and Betty
MacMillan Center for International and Area Studies Dissertation Grant, and Yale University’s Council
on East Asian Studies Dissertation Research Grant.
Compliance with Ethical Standards
Conflict of Interest Ellen Rubinstein declares that she has no conflict of interest.
Ethical Approval All procedures performed in studies involving human participants were in accordance
with the ethical standards of Yale University’s Institutional Review Board (IRB Protocol #: 0909005658).
References
Allison, Anne
1991 Japanese Mothers and Obentos: The Lunch-Box as Ideological State Apparatus. Anthropological
Quarterly 64(4): 195–208.
2013 Precarious Japan. Durham: Duke University Press.
Antelius, Eleonor
2007 The Meaning of the Present: Hope and Foreclosure in Narrations about People with Severe Brain
Damage. Medical Anthropology Quarterly 21(3): 324–342.
Battersby, James L.
2005 Narrativity, Self, and Self-Representation. Narrative 14(1): 27–44.
Becker, Gay
1994 Metaphors in Disrupted Lives: Infertility and Cultural Constructions of Continuity. Medical
Anthropology Quarterly 8(4): 383–410.
Becker, Gay, and Sharon R. Kaufman
1995 Managing an Uncertain Illness Trajectory in Old Age: Patients’ and Physicians’ Views of Stroke.
Medical Anthropology Quarterly 9(2): 165–187.
Bestor, Theodore C.
1989 Neighborhood Tokyo. Stanford: Stanford University Press.
Borovoy, Amy
2008 Japan’s Hidden Youths: Mainstreaming the Emotionally Distressed in Japan. Culture, Medicine
and Psychiatry 32(4): 552–576.
Brooks, Peter
1984 Reading for the Plot: Design and Intention in Narrative. New York: Vintage Books.
Bruner, Jerome
1986 Actual Minds, Possible Worlds. Cambridge: Harvard University Press.
1991 The Narrative Construction of Reality. Critical Inquiry 18(1): 1–21.
Bury, Michael
1982 Chronic Illness as Biographical Disruption. Sociology of Health & Illness 4(2): 167–182.
Clarke, Juanne N., and Susan James
2003 The Radicalized Self: The Impact on the Self of the Contested Nature of the Diagnosis of
Chronic Fatigue Syndrome. Social Science & Medicine 57: 1387–1395.
123
660
Cult Med Psychiatry (2016) 40:641–663
Cook, Emma E.
2013 Expectations of Failure: Maturity and Masculinity for Freeters in Contemporary Japan. Social
Science Japan Journal 16(1): 29–43.
Crapanzano, Vincent
2003 Reflections on Hope as a Category of Social and Psychological Analysis. Cultural Anthropology
18(1): 3–32.
Davis, Elizabeth Anne
2012 Bad Souls: Madness and Responsibility in Modern Greece. Durham: Duke University Press.
DelVecchio Good, Mary-Jo, Tsunetsugu Munakata, Yasuki Kobayashi, Cheryl Mattingly, and Byron J.
Good
1994 Oncology and Narrative Time. Social Science & Medicine 38(6): 855–862.
Doi, Takeo
1973 The Anatomy of Dependence. New York: Kodansha International.
Ezzy, Douglas
2000 Illness Narratives: Time, Hope and HIV. Social Science & Medicine 50(5): 605–617.
Frank, Arthur
1995 The Wounded Storyteller. Chicago: University of Chicago Press.
Furlong, Andy
2008 The Japanese Hikikomori Phenomenon: Acute Social Withdrawal Among Young People.
Sociological Review 56(2): 309–325.
Garro, Linda C., and Cheryl Mattingly
2000 Narrative as Construct and Construction. In Narrative and the Cultural Construction of Illness
and Healing. C. Mattingly and L.C. Garro, eds., pp. 1–49. Berkeley: University of California
Press.
Garro, Linda C., and Kristin E. Yarris
2009 ‘‘A Massive Long Way’’: Interconnecting Histories, a ‘‘Special Child,’’ ADHD, and Everyday
Family Lives. Culture, Medicine and Psychiatry 33: 559–607.
Genda, Yuji
2007 Jobless Youths and the NEET Problem in Japan. Social Science Japan Journal 10(1): 23–40.
Good, Byron
1994 The Narrative Representation of Illness. In Medicine, Rationality, and Experience: An
Anthropological Perspective. pp. 135–165. Cambridge: Cambridge University Press.
Good, Byron, and Mary-Jo DelVecchio Good
1994 In the Subjunctive Mode: Epilepsy Narratives in Turkey. Social Science & Medicine 38(6): 835–
842.
Goodman, Roger, Yuki Imoto, and Tuukka H. I Toivonen, eds.
2012 A Sociology of Japanese Youth: From Returnees to NEETs. London: Routledge.
Hacking, Ian
1998 Mad Travelers: Reflections on the Reality of Transient Mental Illnesses. Charlottesville, Va.:
University Press of Virginia.
Han, Clara
2011 Symptoms of Another Life: Time, Possibility, and Domestic Relations in Chile’s Credit
Economy. Cultural Anthropology 26(1): 7–32.
Horiguchi, Sachiko
2011 Coping with Hikikomori: Socially Withdrawn Youth and the Japanese Family. In Home and
Family in Japan: Continuity and Transformation. R. Ronald and A. Alexy, eds., pp. 216–235.
New York: Routledge.
2012 Hikikomori: How Private Isolation Caught the Public Eye. In A Sociology of Japanese Youth:
From Returnees to NEETs. R. Goodman, Y. Imoto, and T. Toivonen, eds., pp. 122–138. London:
Routledge.
Hydén, Lars-Christer
1995 The Rhetoric of Recovery and Change. Culture, Medicine and Psychiatry 19: 73–90.
Jones, Maggie
2006 Shutting Themselves In. Jan. 15, 2006, The New York Times Magazine, www.nytimes.com/
2006/01/15/magazine15japanese.htmlpagewanted=1&incamp=article_popular_1, accessed Jan.
15, 2006.
123
Cult Med Psychiatry (2016) 40:641–663
661
Kaneko, Sachiko
2006a Hikikomori and Cultural Debates about Japanese Personhood: An Anthropological Study of
Japan’s So-called ‘Socially Withdrawn Youth’, D.Phil. dissertation, Department of Social and
Cultural Anthropology, Oxford University.
Kaneko, Sachiko
2006b Japan’s ‘Socially Withdrawn Youths’ and Times Constraints in Japanese Society: Management
and Conceptualization of Time in a Support Group for ‘Hikikomori’. Time & Society 15(2/3):
233–249.
Kato, Takahiro A., Masaru Tateno, Naotaka Shinfuku, Daisuke Fujisawa, Alan R. Teo, Norman Sartorius,
Tsuyoshi Akiyama, Tetsuya Ishida, Tae Young Choi, Yatan Pal Singh Balhara, Ryohei Matsumoto,
Wakako Umene-Nakano, Yota Fujimura, Anne Wand, Jane Pei-Chen Chang, Rita Yuan-Feng Chang,
Behrang Shadloo, Helal Uddin Ahmed, Tiraya Lerthattasilp, and Shigenobu Kanba
2011 Does the ‘Hikikomori’ Syndrome of Social Withdrawal Exist Outside Japan? A Preliminary
International Investigation. Social Psychiatry and Psychiatric Epidemiology 47: 1061–1075.
Kawanishi, Yuko
2006 Families Coping with Mental Illness: Stories from the US and Japan. New York: Routledge.
Kelly, William W.
1986 Rationalization and Nostalgia: Cultural Dynamics of New Middle-Class Japan. American
Ethnologist 13(4): 603–618.
1993 Finding a Place in Metropolitan Japan: Ideologies, Institutions, and Everyday Life. In Postwar
Japan as History. A. Gordon, ed., pp. 189–217. Berkeley: University of California Press.
2002 At the Limits of New Middle Class Japan: Beyond ‘Mainstream Consciousness’. In Social
Contracts Under Stress: The Middle Dlasses of America, Europe, and Japan at the Turn of the
Century. O. Zunz, L.J. Schoppa, and N. Hiwatari, eds., pp. 232–254. New York: Russell Sage
Foundation.
Kelly, William W., and Merry I. White
2006 Students, Slackers, Singles, Seniors, and Strangers: Transforming a Family-Nation. In Beyond
Japan: The Dynamics of East Asian Regionalism. P.J. Katzenstein and T. Shiraishi, eds., pp. 63–
82. Ithaca: Cornell University Press.
Kleinman, Arthur
1988 The Illness Narratives: Suffering, Healing, and the Human Condition. New York: Basic Books.
Kleinman, Arthur, and Joan Kleinman
1996 The Appeal of Experience; the Dismay of Images: Cultural Appropriations of Suffering in our
Times. Daedalus 125(1): 1–23.
Kondo, Naoji, Motohiro Sakai, Yasukazu Kuroda, Yoshikazu Kiyota, Yuji Kitabata, and Mie Kurosawa
2013 General Condition of Hikikomori (Prolonged Social Withdrawal) in Japan: Psychiatric Diagnosis
and Outcome in Mental Health Welfare Centres. International Journal of Social Psychiatry 59(1):
79–86.
Kôseirôdôshô (Ministry of Health, Labour and Welfare)
2003 Jûdai/nijûdai o Chûshin toshita ‘‘Hikikomori’’ o Meguru: Chı̂ki Seishin Hoken Katsudô
Gaidorain. [Guidelines for Community Health Interventions with a Focus on Hikikomori in
their Teens and Twenties]. July 28, 2003, http://www.mhlw.go.jp/topics/2003/07/tp0728-1.html,
accessed Mar. 17, 2010.
Kôseirôdôshô (Ministry of Health, Labour and Welfare)
2010 Hikikomori no Hyôka/Shien ni kansuru Gaidorain [Guidelines for the Evaluation and Support of
Hikikomori]. May 20, 2010, http://www.mhlw.go.jp/stf/houdou/2r98520000006i6f.html, accessed
May 30, 2010.
Landsman, Gail
2003 Emplotting Children’s Lives: Developmental Delay vs. Disability. Social Science & Medicine
56: 1947–1960.
Larsen, John Aggergaard
2004 Finding Meaning in First Episode Psychosis: Experience, Agency, and the Cultural Repertoire.
Medical Anthropology Quarterly 18(4): 447–471.
Lock, Margaret M.
1986 Plea for Acceptance: School Refusal Syndrome in Japan. Social Science & Medicine 23(2): 99–
112.
1987 Protests of a Good Wife and Wise Mother: The Medicalization of Distress in Japan. In Health,
123
662
Cult Med Psychiatry (2016) 40:641–663
Illness, and Medical Care in Japan: Cultural and Social Dimensions. E. Norbeck and M.M. Lock,
eds., pp. 130–157. Honolulu: University of Hawaii Press.
1988a A Nation at Risk: Interpretations of School Refusal in Japan. In Biomedicine Examined. M.
Lock and D. Gordon, eds., pp. 391–414. Norwell, MA: Kluwer Academic Publishers.
1988b New Japanese Mythologies: Faltering Discipline and the Ailing Housewife. American
Ethnologist 15(1):43–61
Mathews, Holly F., Donald R. Lannin, and James P. Mitchell
1994 Coming to Terms with Advanced Breast Cancer: Black Women’s Narratives from Eastern North
Carolina. Social Science & Medicine 38(6): 789–800.
Mattingly, Cheryl
1994 The Concept of Therapeutic ‘‘Emplotment’’. Social Science & Medicine 38(6): 811–822.
1998 Healing Dramas and Clinical Plots. Cambridge: Cambridge University Press.
2010 The Paradox of Hope: Journeys through a Clinical Borderland. Berkeley: University of
California Press.
Mattingly, Cheryl, and Linda C Garro
2000 Narrative and the Cultural Construction of Illness and Healing. Berkeley: University of
California Press.
Miyazaki, Hirokazu
2006 Economy of Dreams: Hope in Global Capitalism and Its Critiques. Cultural Anthropology 21(2):
147–172.
Munakata, Tsunetsugu
1989 The Socio-cultural Significance of the Diagnostic Label ‘Neurasthenia’ in Japan’s Mental Health
Care System. Culture, Medicine and Psychiatry 13(2): 203–213.
Naikakufu (Cabinet Office)
2010 Wakamono no Ishiki ni kansuru Chôsa (Hikikomori ni kansuru Jittai Chôsa). [A Report on a
Survey of Youth Consciousness: A Hikikomori Field Survey]. July 2010, http://www8.cao.go.jp/
youth/kenkyu/hikikomori/pdf_index.html, accessed July 2010.
Nakagaito, Masakazu
2004 Hikikomori o Umu Shakai. [A Society that Generates Social Withdrawal]. Japanese Journal of
Addiction & Family 21(1):17-26.
Novas, Carlos
2006 The Political Economy of Hope: Patients’ Organizations, Science and Biovalue. BioSocieties 1:
289–305.
Rohlen, Thomas P.
1974 For Harmony and Strength: Japanese White-Collar Organization in Anthropological Perspective.
Berkeley: University of California Press.
1983 Japan’s High Schools. Berkeley: University of California Press.
Rubinstein, Ellen
n.d. Negotiating Psychiatry: Biomedical and Experiential Discourses in a Japanese Multifamily Support
Group. Unpublished manuscript.
2012 Diagnosing Deviance: Schizophrenia and Social Withdrawal in Contemporary Japan. Ph.D.
dissertation, Department of Anthropology, Yale University.
Saitô, Tamaki
1998 Shakaiteki Hikikomori: Owaranai Shishunki [Social Withdrawal: Adolescence without End].
Tokyo: PHP.
2003 Hikikomori Bunkaron [Cultural Theory of Hikikomori]. Tokyo: Kinokuniya Shoten.
Shiokura, Yutaka
1997 Shakai ni Derarenai (Hito to Ikitai Hikikomoru Wakamonotachi) [Unable to Enter Society
(Withdrawn Youths who Long to Live with Others)]. Feb. 5, 1997, Asahi Shimbun, accessed Nov.
10, 2007.
Tateno, Masaru, Tae Woo Park, Takahiro A. Kato, Wakako Umene-Nakano, and Toshikazu Saito
2012 Hikikomori as a Possible Clinical Term in Psychiatry: A Questionnaire Survey. BMC Psychiatry
12: 169–175.
Teo, Alan R.
2010 A New Form of Social Withdrawal in Japan: A Review of Hikikomori. International Journal of
Social Psychiatry 56(2): 178–185.
123
Cult Med Psychiatry (2016) 40:641–663
663
Teo, Alan R., and Albert C. Gaw
2010 Hikikomori, a Japanese Culture-Bound Syndrome of Social Withdrawal? A Proposal for DSM-5.
Journal of Nervous and Mental Disorders 198: 444–449.
Tomita, Fujiya
1992 Hikikomori kara no Tabidachi. [Departure from Hikikomori]. Tokyo: Heart Publishing.
Vogel, Ezra F.
1963 Japan’s New Middle Class: The Salary Man and his Family in a Tokyo Suburb. Berkeley:
University of California Press.
Wentzell, Emily
2013 Change and the Construction of Gendered Selfhood among Mexican Men Experiencing Erectile
Difficulty. Ethos 41(1): 24–45.
White, Merry I., and Robert A. LeVine
1986 What is an Ii Ko (Good Child)? In Child Development and Education in Japan. H. Stevenson, H.
Azuma, and K. Hakuta, eds., pp. 55–62. New York: W. H. Freeman and Company.
Yamada, Masahiro
1999 Parasaito Shinguru no Jidai. [The Age of the Parasite Single]. Tokyo: Chûkô Shinsho.
123