Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Gunma Hospital, Gunma, Japan.
J Clin Psychol. 2021 Aug;77(8):1851-1864. doi: 10.1002/jclp.23216. Epub 2021 Jul 14.
Hikikomori, a severe form of social withdrawal, is a condition characterized by the avoidance of social participation and staying at home for more than 6 months. Hikikomori was initially reported in Japan in the 1990s and is now observed worldwide. Here, we introduce specialized psychodynamic group psychotherapy for persons with hikikomori, and illustrate the case of an adult male with schizoaffective disorder. In the present report, the patient initiated an unreasonably difficult job-hunting process, became unwell, and was hospitalized. He began to participate in group psychotherapy as a place of belonging and gradually increased his social interactions. We also consider the specific difficulties exhibited by people with hikikomori, especially focusing on the avoidance around assuming responsibility for decisions and extreme dichotomous thinking. Additionally, we discuss the benefits of dealing with these difficulties in a group structure and propose the applicability of group psychotherapy in therapeutic interventions for persons with hikikomori.
蛰居现象，一种严重的社交回避，其特征是避免社交参与并在家中呆超过 6 个月。蛰居现象最初于 20 世纪 90 年代在日本报道，现在在全世界都有观察到。在这里，我们介绍一种针对蛰居者的专业精神动力学团体心理疗法，并举例说明一位患有精神分裂情感障碍的成年男性的情况。在本报告中，患者开始了一个不合理的困难求职过程，变得不适，并住院治疗。他开始将团体心理治疗作为归属的地方，并逐渐增加他的社交互动。我们还考虑了蛰居者表现出的具体困难，特别是在回避承担决策责任和极端二分思维方面。此外，我们讨论了在团体结构中处理这些困难的好处，并提出了团体心理疗法在治疗蛰居者方面的适用性。
