Hikikomori: a systemic-relational analysis.

Over the past 40 years, Japan has spread a definite condition: hikikomori. The term derives from hiku, "pull back", and komoru, "island", and describes a form of voluntary social withdrawal that involves adolescents. These subjects avoid social commitment, school education and friendships with an associated digital dependence. The causes identified depend on a cultural/educational and family system in which individual identity is subordinated to social identity, causing isolation. Early identification of hikikomori and above all its differentiation from other syndromes appears necessary to avoid inadequate diagnosis and interventions. This study stems from the intention to outline the phenomenon starting with the presentation of the characteristics of the phenomenon, focusing on possible causes and risk factors, then explain the psychological therapy based on the systemic-relational approach. A clinical case will be presented according to principles of the systemic-relational intervention. The subject, with a psychopathological diagnosis that can be linked to hikikomori and digital dependence, showed a dysfunctional family structure that has been treated by family psychotherapy. At the follow-up visit the patient showed new interpersonal skills by improving management and problem-solving skills.