When the Kimura family moved here from Tokyo, their middle school-aged daughter missed her old friends. Midway into her first year in high school, she sTOPped going. Between 14 and 19, she barely left the house, and for one year hardly left her room, interacting only with her parents.
Now 33 and recovered, Ms. Kimura says she was “hikikomori.” That’s the name of a type of social withdrawal that can be so severe, people with it don’t leave their houses for years. It’s also what those who suffer from the condition are called.
The puzzling condition is often thought of as a Japanese phenomenon, affecting an estimated 500,000 to two million in Japan, according to projections from academic surveys. Published reports also have described cases in the U.S., Hong Kong and Spain, among other countries.
In Japan, hikikomori has been a household word since the 1990s, with many experts calling it one of the biggest social and health problems plaguing the country. Yet the causes and treatments of the condition—or even whether it’s a mental illness or not—remain poorly understood. And while the Japanese government has poured significant funds into helping hikikomori, treatment success rates remain low.
The condition illustrates the difficulty of defining mental illness and raises questions about the role society plays in shaping, allowing or even creating problematic behavior. Researchers in Fukuoka have set up an international collaboration to try to answer some of these questions.
Solving the hikikomori riddle has taken on greater urgency in recent years. Sufferers often are men in their 20s and 30s who would be in the workforce but instead are being supported largely by their parents. Government officials worry about who will take responsibility for long-term hikikomori when their parents retire or die.
Fukuoka, a city of 1.5 million 550 miles southwest of Tokyo, about four years ago opened a support center, which the Japanese government requires of every prefecture in the country. 福冈坐落于东京西南方1,500,550英里。大约四年前，根据日本政府对各县市的需要，福冈开设了一家“隐蔽年轻人”援助中心。
Called Yokayoka, which means, “It’s OK, don’t worry about it,” in the local dialect, the one-room support center is linked to a youth employment facility. The center primarily fields phone calls from hikikomori or, more often, their worried parents. It also offers support groups for hikikomori and their parents. However, only a small number of hikikomori actually show up at the center. Of those, a minority are treated successfully, staffers say.
援助中心名叫“Yokayoka”，当地方言的意思是“没事儿，别担忧”。这家援助中心只有一个单间，与一所年轻人就业机构相连。援助中心的主要工作 任务是接听“隐蔽年轻人”的电话，但来电的更多是忧心忡忡的爸爸妈妈。他们也为“隐蔽年轻人”及其爸爸妈妈成立了互助小组。但员工称，仅有少数“隐蔽年轻人”会来， 而他们中只有一小部分被成功治愈。
Takahiro Kato, a professor in the neuropsychiatry department at Kyushu University in Fukuoka, is working with the support center to study hikikomori in a more rigorous and systematic way. Dr. Kato and a team of Japanese and international collaborators that includes Alan Teo, a psychiatry professor at Oregon Health & Science University, want to better define what hikikomori is. They also hope to understand the social and biological underpinnings of the condition to improve treatments.
加藤贵裕（Takahiro Kato）是福冈九州大学神经精神学科的一名教授。他正与援助中心合作，用更严谨系统的办法对“隐蔽年轻人症候群”进行研究。加藤博士及其所属的一支包含日 本和国际专家在内的合作团队，正试图为“隐蔽年轻人症候群”下一个更为明确的概念。俄勒冈健康与科学大学神经病学教授张艾伦（Alan Teo）也是团队成员之一。该合作团队还期望知道这种病症的社会和生理原因，并改变治疗办法。
People who consider themselves hikikomori exhibit a wide range of symptoms, including depressive, autistic and obsessive-compulsive tendencies. A minority appear addicted to the Internet, says Dr. Kato, a 40-year-old psychiatrist.
Yossy, 31, came for a recent hikikomori support group. He says he didn’t leave his parents’ house for six months after harassment from his boss at his speech therapy internship led him to quit. After that, he did begin to visit friends occasionally and volunteer at a library. But after four years, he still hasn’t held a full-time job.
Hikikomori appears to be a condition distinct from other mental illnesses, Japanese experts say. Only about half of those with the condition would be diagnosed with a disorder in the U.S. psychiatric diagnostic manual commonly known as DSM-5, according to one survey of 4,134 Japanese residents published in Psychiatry Research in 2010. But large-scale survey data on hikikomori remains limited.
日本专家们觉得，“隐蔽年轻人症候群”好像有别于其他精神疾病。一项针对4134名日本居民的调查显示，仅有约一半的“隐蔽年轻人”符合美国精神病掌握 《精神障碍诊断与统计手册》（Diagnostic and Statistical Manual of Mental Disorders，俗称DSM-5）的诊断标准，会被诊断为精神障碍。调查结果发布在2010年的《神经病学研究》杂志上。但针对“隐蔽年轻人症候群”的 大规模调查数据仍然非常有限。
Japanese experts point to strict parenting practices and pressure that children feel to succeed as contributing factors. Yet hikikomori often live with their parents, and these parents can be soft in forcing their children to go to school or leave the home. They often bring trays of food to their bedroom doors.
Current thinking is that providing hikikomori with positive social interactions will help them reintegrate with the outside world. Michiko Asami, president of the nonprofit that runs Yokayoka, welcomes each hikikomori with a big smile and tries to initiate a nonjudgmental conversation. Sometimes they sit silently for multiple sessions or won’t look at her. Gradually, some do.
现在来看，为“隐蔽年轻人”提供积极的社会互动或有助于恢复他们与外面的联系。负责Yokayoka援助中心运作的非营利性机构主席浅海美智子 （Michiko Asami）笑容满面地欢迎每一位“隐蔽年轻人”的到来，她试图发起一次无偏见的对话。有时，“隐蔽年轻人们”会在小组交谈时静静地坐着，亦或根本不看她。渐 渐的，一些人开始参与进去。
social withdrawal: 社交退缩症