I wonder about a convergence of autism and trauma with the Hikikimori. I dont claim to be a cultural expert for the Japanese but I picked up on the shame people had around non-conformity. The third criteria of distress and social impairment needs to be seen through a cultural lense. Japanese culture is more collectivist so the parents distress may be an indication of the social impairment of the child. In recent years I've started using trauma informed care in restrictive eaters who have sensory issues. There is a lot of ND people who fit into this. Its often the first time these people have had a clinician see them as someone who has experienced difficulty in life rather than a "problem".
The topic is becoming more widely considered because it's not really restricted to Japan. Practitioners around the world are seeing the same thing. There are specific aspects within each culture, including Japan, but the more general trend of young adults finding it difficult to launch is very common. Social awkwardness is frequently self-reported and high-functioning autism is frequently diagnosed or "flash-diagnosed" by practitioners, though social anxiety and awkwardness are often equally the product of inexperience in real-world social settings. Isolate long enough and most people lag in developing social skills or lose some of the skills they once had. HFAutism may increase the likelihood of the problem, but does not constitute the problem itself.
I would strongly recommend this recent video by Meeka le Fay which I believe addresses some significant problems with how we understand (and misunderstand) _Hikikomori_ in the west. It directly addresses the issues of neuro divergence and trauma you raise as well as a crucial factor few of us seem to be aware of (I most certainly wasn't); or at least goes unmentioned in most English-language discourse, and apparently all but denied in Japanese discourse. In his video Dr Paterson rightly drew attention to the importance of making sure we have our definitions in order and also to the fact that this is not a social phenomena unique to Japan. Therefore, if we are going to adopt the Japanese term into English-language discourse it is incumbent upon us to do so with an understanding of the behaviour it designates in the particular social and historical context it emerged from. If we neglect to do this, we risk sowing confusion in the very act of seeking better understanding. ruclips.net/video/pCFWl6C-pFE/видео.htmlsi=VkW4Qdtf2xH53OwW
This topic is very close to me because I'm desperate to help a relative. Also, I want to comment that the restricted lives women have been forced to lead in certain times and places led them to have distress, and this was used to criticize women in general.
The historic and, to an extent, current treatment of women in many societies can definitely be a factor. That said, in culture after culture it is overwhelmingly males who find themselves in this situation - 60 to 80% by most estimates. True, it seems, in NAm, Europe, UK, Japan (where I am headed as I write this, hoping to learn more about the situation there), and other locales.
I agree with your reservations, and additionally I believe it would further misdirect the population of people who should presently be dx’d with avoidant personality disorder and treated along those lines. AvPD is not well researched and may be discovered to be flawed in the future, but making up a new ‘social isolation disorder’ would reset the entire playing field and add a schism.
I think we need to have a definition of a problem before we can study it properly. No point in doing research on it if we mean one group of people in Portland and another in Milan. But I do have concerns about overpathologization. Regarding avoidant personality disorder, I think it's useful to remember that APD is simply a label for a specific set of behaviours - it tells us nothing about origins, little about treatment, nothing about prognosis. We diagnose it based on a person's actions, then we say their actions are the result of the diagnosis: A classic example of circular reasoning. Defining a behavioural approach as a mental disorder, in my experience, isn't very helpful. Many people simply say "oh, I've learned I have APD and that's why I avoid all the time." The diagnosis becomes a way of bolstering the very behaviour that constitutes the diagnosis. Diagnosis seems like it would be helpful, but in many instances causes more problems than it solves, creating a myth-story that perpetuates the problem. I absolutely support the work of Teo et al and think that having this definition is a very good idea. We have to be able to describe what we're talking about. I think the team working on diagnostic criteria are fully cognizant of the problems of diagnosis (and don't need my two cents, frankly), but see that a) without borders we don't get a body of data, and b) it really IS a problem that is about as disabling as mental health challenges get (see the upcoming video in 2 weeks for more on that).
All true, and especially true that many “disorders” shouldn’t be these iron bars people get locked behind since they’re just descriptors. I just hesitate to hop on another one after seeing so much fundamental misuse!
Welcome to the NHK.
I wonder about a convergence of autism and trauma with the Hikikimori.
I dont claim to be a cultural expert for the Japanese but I picked up on the shame people had around non-conformity.
The third criteria of distress and social impairment needs to be seen through a cultural lense. Japanese culture is more collectivist so the parents distress may be an indication of the social impairment of the child.
In recent years I've started using trauma informed care in restrictive eaters who have sensory issues. There is a lot of ND people who fit into this. Its often the first time these people have had a clinician see them as someone who has experienced difficulty in life rather than a "problem".
The topic is becoming more widely considered because it's not really restricted to Japan. Practitioners around the world are seeing the same thing. There are specific aspects within each culture, including Japan, but the more general trend of young adults finding it difficult to launch is very common.
Social awkwardness is frequently self-reported and high-functioning autism is frequently diagnosed or "flash-diagnosed" by practitioners, though social anxiety and awkwardness are often equally the product of inexperience in real-world social settings. Isolate long enough and most people lag in developing social skills or lose some of the skills they once had. HFAutism may increase the likelihood of the problem, but does not constitute the problem itself.
I would strongly recommend this recent video by Meeka le Fay which I believe addresses some significant problems with how we understand (and misunderstand) _Hikikomori_ in the west. It directly addresses the issues of neuro divergence and trauma you raise as well as a crucial factor few of us seem to be aware of (I most certainly wasn't); or at least goes unmentioned in most English-language discourse, and apparently all but denied in Japanese discourse. In his video Dr Paterson rightly drew attention to the importance of making sure we have our definitions in order and also to the fact that this is not a social phenomena unique to Japan. Therefore, if we are going to adopt the Japanese term into English-language discourse it is incumbent upon us to do so with an understanding of the behaviour it designates in the particular social and historical context it emerged from. If we neglect to do this, we risk sowing confusion in the very act of seeking better understanding. ruclips.net/video/pCFWl6C-pFE/видео.htmlsi=VkW4Qdtf2xH53OwW
Living with an autistic sibling certainly hasn't helped with successful launching, forming normal social behaviours etc. If that's what you're asking.
This topic is very close to me because I'm desperate to help a relative. Also, I want to comment that the restricted lives women have been forced to lead in certain times and places led them to have distress, and this was used to criticize women in general.
The historic and, to an extent, current treatment of women in many societies can definitely be a factor. That said, in culture after culture it is overwhelmingly males who find themselves in this situation - 60 to 80% by most estimates. True, it seems, in NAm, Europe, UK, Japan (where I am headed as I write this, hoping to learn more about the situation there), and other locales.
I agree with your reservations, and additionally I believe it would further misdirect the population of people who should presently be dx’d with avoidant personality disorder and treated along those lines. AvPD is not well researched and may be discovered to be flawed in the future, but making up a new ‘social isolation disorder’ would reset the entire playing field and add a schism.
I think we need to have a definition of a problem before we can study it properly. No point in doing research on it if we mean one group of people in Portland and another in Milan. But I do have concerns about overpathologization. Regarding avoidant personality disorder, I think it's useful to remember that APD is simply a label for a specific set of behaviours - it tells us nothing about origins, little about treatment, nothing about prognosis. We diagnose it based on a person's actions, then we say their actions are the result of the diagnosis: A classic example of circular reasoning. Defining a behavioural approach as a mental disorder, in my experience, isn't very helpful. Many people simply say "oh, I've learned I have APD and that's why I avoid all the time." The diagnosis becomes a way of bolstering the very behaviour that constitutes the diagnosis. Diagnosis seems like it would be helpful, but in many instances causes more problems than it solves, creating a myth-story that perpetuates the problem.
I absolutely support the work of Teo et al and think that having this definition is a very good idea. We have to be able to describe what we're talking about. I think the team working on diagnostic criteria are fully cognizant of the problems of diagnosis (and don't need my two cents, frankly), but see that a) without borders we don't get a body of data, and b) it really IS a problem that is about as disabling as mental health challenges get (see the upcoming video in 2 weeks for more on that).
All true, and especially true that many “disorders” shouldn’t be these iron bars people get locked behind since they’re just descriptors. I just hesitate to hop on another one after seeing so much fundamental misuse!
OMG OMORI reference???
OMORI IRL??