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Mental Health and Social Withdrawal in Contemporary Japan; Beyond

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Mental Health and Social Withdrawal in Contemporary Japan; Beyond (タイトル・クレジット表記 日/英) «修 復 の モ ニ ュ メ ン ト「 ド ア 」» 渡辺 篤 2016–2020年 写 真 ：井 上 圭 佑 © Atsushi Watanabe 2020 MONUMENT OF RECOVERY “The Door” Atsushi Watanabe Photo by Keisuke Inoue © Atsushi Watanabe 2020 Mental Health and Social Withdrawal in Contemporary Japan This book examines the phenomenon of social withdrawal in Japan, which ranges from school nonattendance to extreme forms of isolation and confine- ment, known as hikikomori. Based on extensive original research, including interview research with a range of practitioners involved in dealing with the phenomenon, the book outlines how hikikomori expresses itself, how it is treated and dealt with, and how it has been perceived and regarded in Japan over time. The author, a clinical psychologist with extensive experience of prac- tice, argues that the phenomenon although socially unacceptable is not homog- enous and can be viewed not as a mental disorder, but as an idiom of distress, a passive and effective way of resisting the many great pressures of Japanese schooling and society more widely. Nicolas Tajan is a program-specific associate professor in the Graduate School of Human and Environmental Studies at Kyoto University, Japan. BK-TandF-TAJAN_9780815365747-200257-FM.indd 1 09/11/20 1:29 PM Japan Anthropology Workshop Series Series editor: Joy Hendry, Oxford Brookes University Editorial Board: Pamela Asquith, University of Alberta Eyal Ben Ari, Kinneret Academic College, Sea of Galilee Christoph Brumann, Max Planck Institute for Social Anthropology, Munich Henry Johnson, Otago University Hirochika Nakamaki, the Suita City Museum Founder Member of the Editorial Board: Jan van Bremen, University of Leiden The Japanese Family Touch, Intimacy and Feeling Diana Tahhan Happiness and the Good Life in Japan Edited by Wolfram Manzenreiter and Barbara Holthus Religion in Japanese Daily Life David C. Lewis Escaping Japan Reflections on Estrangement and Exile in the Twenty-First Century Edited by Blai Guarné and Paul Hansen Women Managers in Neoliberal Japan Gender, Precarious Labour and Everyday Lives Swee-Lin Ho Global Coffee and Cultural Change in Modern Japan Helena Grinshpun Inside a Japanese Sharehouse Caitlin Meagher Mental Health and Social Withdrawal in Contemporary Japan Nicolas Tajan For a full list of available titles please visit: www.routledge.com/Japan- Anthropology-Workshop-Series/book-series/SE0627 BK-TandF-TAJAN_9780815365747-200257-FM.indd 2 09/11/20 1:29 PM Mental Health and Social Withdrawal in Contemporary Japan Beyond the Hikikomori Spectrum Nicolas Tajan BK-TandF-TAJAN_9780815365747-200257-FM.indd 3 09/11/20 1:29 PM First published 2021 by Routledge 2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN and by Routledge 52 Vanderbilt Avenue, New York, NY 10017 Routledge is an imprint of the Taylor & Francis Group, an informa business © 2021 Nicolas Tajan The right of Nicolas Tajan to be identified as author of this work has been asserted by him in accordance with Sections 77 and 78 of the Copyright, Designs and Patents Act 1988. The Open Access version of this book, available at www.taylorfrancis.com, has been made available under a Creative Commons Attribution-Non Commercial-No Derivatives 4.0 license. Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. British Library Cataloguing-in-Publication Data A catalog record for this book is available from the British Library Library of Congress Cataloging-in-Publication Data A catalog record has been requested for this book ISBN: 978-0-8153-6574-7 (hbk) ISBN: 978-1-351-26080-0 (ebk) Typeset in Times New Roman by KnowledgeWorks Global Ltd. BK-TandF-TAJAN_9780815365747-200257-FM.indd 4 09/11/20 1:29 PM Contents Preface vi Acknowledgements viii Introduction: Step aside, intersections, minor roads xi 1 School nonattendance created the need for clinical psychologists 1 2 The resistance to students’ psychological care 32 3 Is social withdrawal a mental disorder? 59 4 Mental health surveys on hikikomori 88 5 NPO support toward hikikomori youths 117 6 Hikikomori subjects’ narratives 151 7 Beyond the hikikomori spectrum 186 8 Conclusions: Social isolation, biopower, and the end of the clinic 219 Index 243 BK-TandF-TAJAN_9780815365747-200257-FM.indd 5 09/11/20 1:29 PM Preface “Hikikomori phenomenon, far from being homogeneous, begins to appear as it really is: the history of a myriad of singular subjects who, despite them- selves, draw attention to their absence while making social renunciation an idiom that is deeply subjective and eminently social.” This quotation encap- sulates some of the central issues of this fascinating and important work. Nicolas Tajan is not an anthropologist but a clinical psychologist who was brought by his topic of inquiry to act and proceed in his research more and more like an anthropologist. As the above mentioned sentence indi- cates hikikomori is not a psychiatric category – showing this is one of the central aims of the book – the term refers to “the history of myriad singu- lar subjects” rather than to an ailment with clear characteristic traits. The point is not merely that this failure at being a homogeneous set of indi- viduals or psychological characteristics reflects the difference between the method of the psychiatrist, who sees instances of particular diseases and categorizes them as depression or bipolar disorder, and that of the anthro- pologist, who seeks to encounter others as they are in their diversity, rather than to categorize them. The point rather is that the reason why hikikomori escapes psychiatric categorization is neither because these categories do not constitute knowledge nor because it is true that all medical categories sub- sume under a single term myriad singular subjects, but because hikikomori fails to become an object of psychiatric knowledge. It is not a mental disease but a psychosocial phenomenon. The hikikomori does not ask anything from the psychiatrist, or the medical profession in general, or from any others in particular actually: hiding, shut in a room in a house that he or she rarely leaves. There is a paradox here in viewing these persons as “patients”. How do you meet someone who does not want to meet anyone? What if you succeed, is the person you met a hikikomori or not hikikomori anymore? This desire for isolation and loneliness, which Tajan describes as an “idiom of distress,” is eminently social and challenges the health professions. Here are persons who do not ask for help, do not come forward with their complaints, and therefore are only made into “patients” by others. Which happens only some- times, when they are not hidden from view by the family from (and within) BK-TandF-TAJAN_9780815365747-200257-FM.indd 6 09/11/20 1:29 PM Preface vii which they are hiding. In either case, they do not seek help, for whatever reason they have renounced asking. The clinic has always been about responding to the patient’s demand, even if in many cases, this meant reinterpreting it in a different way. Medical and psychiatric categories are tools that help the specialist endowed with knowl- edge, called upon because of that knowledge, to respond to the patient’s demands. Hence the need for a different method and approach when the person’s way to ‘address’ others is silence, isolation, social renunciation; one that is not, or at least that is less, predicated on a hierarchical relation of knowledge and thus closer to that of anthropologists. Clinical psycholo- gists interested in hikikomori have to do fieldwork. They cannot remain in their office waiting for the patients to come. They must go to them. This profoundly changes the relationship and indicates that these individuals in distress are not like those who can be analyzed, and disciplined through the use of psychiatric categories. In what ways are they different? This is what this book describes with finesse and attention and tries to interpret in a larger social and historical context. The hikikomori phenomenon, according to Tajan, makes visible an ongo- ing process of social transformations of which it is part. One that is par- ticularly visible in Japan, but that is also present in many places across the world. It concerns the place of medical professions in contemporary post- modern societies, the way individuals attempt to make themselves into sub- jects, their refusal of current mental health practices, and it questions the place and role of anthropological knowledge in this changing world. Paul Dumouchel BK-TandF-TAJAN_9780815365747-200257-FM.indd 7 09/11/20 1:29 PM Acknowledgements Before beginning this book, I had the privilege of completing my Ph.D. in psychopathology at the University of Toulouse in 2014 under the exceptional supervision of Marie-Jean Sauret and Pierre-Henri Castel. In France, most of those who are interested in Lacanian psychoanalysis know Marie-Jean Sauret for his unique style that combines kindness, humor, firmness, and a sincere involvement in political matters. It is still a surprise for both of us that his legacy continues in Japan where I work now as an associate profes- sor and a psychoanalyst. And, I honestly do not have enough words to say how privileged I feel to have met one of the most prolific thinkers in con- temporary France: Pierre-Henri Castel. Since our first contact in September 2009, I owe him the freedom I took to allow myself to adopt an approach that is at the crossroads of Lacanian psychoanalysis, clinical psychopathol- ogy, history of psychiatry, and the anthropology of mental health. I would also like to express my gratitude to Tsuiki Kosuke for allowing me to work from April of 2011 to March of 2017 in the Institute for Research in Humanities at Kyoto University.
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