Introduction

The term hikikomori has been introduced relatively recently. The late 1990s saw the first use of the phrase shakaiteki hikikomori to describe social withdrawal (Saito, 1998) as a result of certain characteristics being recognised in Japan that distinguish this phenomenon from other mental states. The characterisation of the disorder is attributed to Tamaki Saitō, a Japanese psychiatrist, who described hikikomori as a state of social withdrawal involving not going to work or school for more than six months except for occasional outings, and not communicating with people except for family members (Saito, 1998).

The phenomenon, which has since been increasingly reported in Japanese scientific literature, can be summarised as abnormal avoidance of interpersonal contact (Tateno, Park, Kato, Umene-Nakano, Saito, 2012). Hikikomori is sometimes combined with another concept: futōkō. This phenomenon refers to people who have been out of school for a long time (Lozano). Much more commonly, hikikomori is described as a separate phenomenon and is used to classify, according to the original translation, social withdrawal that may even be considered pathological (Kato, Kanba, Teo, 2020).

However, the term can now be used to describe both a condition and a person. It is therefore also used to characterise a person who experiences a state of social isolation and withdrawal. Such an individual may be entirely socially excluded, avoiding interaction with other people, unable to work or study, often living with their parents (Teo, Gaw, 2010). The totality of characteristics typical for this phenomenon causes difficulties in defining it correctly due to the still discernible links with other conditions, such as psychosis, schizophrenia or Internet addiction (Strip, Thibault, Beauchamp-Chatel, Kisely, 2016). This can make it difficult to diagnose hikikomori and conduct research into the phenomenon. Physical isolation is a central, though not the only feature of hikikomori, i.e. most often staying at home (Roza, Spritzer, Gadelha, Passos, 2020). In 2003, the Ministry of Health, Labour and Welfare in Japan proposed criteria to facilitate the diagnosis of hikikomori, including the disappearance of social relationships, lack of diagnosed other mental disorders, and lack of interest in work. It was specified that, similar to the definition proposed by Saitō, symptoms should persist for at least six months (Ministry of Health, Labour and Welfare, 2003). However, research shows that the question of symptom duration remains debatable even among the various medical professions (Tateno et al., 2012). A tool frequently used in diagnosing hikikomori is the hikikomori test, referred to as the HQ-25, which a person can complete on their own.

The questionnaire consists of 25 questions that aim to determine a person’s level of socialisation, isolation and the emotional support they receive (Teo, 2023). The study is considered psychometrically sound and valued for its diagnostic accuracy. At the same time, the need for further study of the properties of this test and its ability to make diagnoses is identified (Teo et al., 2018). Hikikomori is a concept that has emerged from analyses in Asian countries, particularly Japan, which results in differences in diagnosing (or lack of diagnosis) between countries (Stip et al., 2016). This may lead to limited research opportunities outside Asia. However, more and more research has been focused on describing the phenomenon in various other parts of the world. When analysing the available literature, it is therefore important to bear in mind possible discrepancies in how hikikomori is defined by various authors, both because of the meaning of the concept and through differences in sampling.

As interest in hikikomori grew, more and more new studies describing the complexity of the phenomenon began to emerge. It proved to be important to identify the causes of hikikomori in a society. Studies of hikikomori in Italy have identified the feeling of being judged as one of the main reasons for this, particularly because of appearance (Esposito, Addeo, D’Auria, Lenzi, 2023). Other reasons include the desire to escape social pressures or expectations (Esposito et al., 2023), the rejection of established patterns of behaviour and the sense of needing to meet society’s (including cultural) demands (Uchida, Norasakkunkit, 2015), abnormalities in the child’s relationship with the parents such as overprotection and oppression at home (Kobayashi, Yoshida, Noguchi, Tuchiya, Ito, 2003). The problem is also linked to peer relationships at school, as well as Internet or computer game addiction (Adamski, 2018). It can therefore be seen that this contemporary problem, which is affecting more and more people, can undoubtedly be greatly influenced by new technologies. Understanding the relationship between hikikomori and technologies is made more difficult by the complexity of the phenomenon and the fact that contemporary technologies are very popular. One should also note the important role that new technologies played during the pandemic period, not only in the lives of the hikikomori, but also in society as a whole, as manifested, among other things, by the increased use of the Internet in all age groups (Kovačić Petrović, Peraica, Kozarić-Kovačić, Palavra, 2022). An escape to the virtual world, characteristic of hikikomori, is becoming a widespread trend and because of this, there is a blurring of the line between Internet addicts and hikikomori.

Technology is believed to have a significantly detrimental effect on hikikomori and can potentially do more harm than realistically help. However, many studies also focus on the positive aspects of using the Internet, which would allow symptomatic treatment of this type of social withdrawal. In the face of a dynamically changing reality, it is extremely important to carry out research into the impact of these changes on society. This is because in-depth analyses allow for a better understanding of man’s relationship with the modern world around him.

Materials and methods

A literature review was conducted in order to analyse possible links between hikikomori and technologies. In order to gather an adequate number of studies, the Google Scholar tool was used, as well as keywords related to the topic under discussion, such as: hikikomori, technology, therapy, Pokémon GO, Internet, and their compounds and English equivalents. A selection of articles was then made in terms of the two most common contexts: negative impact (e.g. relationship to addiction) and positive impact (e.g. use in therapies).

Technology as a therapy tool

However, one must also bear in mind the positive impact that technologies can have on hikikomori (Park, 2021). This issue is only discussed to a limited extent in the literature. However, one notes the rapid development of games and communication tools available through computers and telephones, in which high hopes are placed for improving the situation of some hikikomori. It is pointed out though that many hikikomori individuals may prefer treatment methods based on face-to-face contact with another human being (Castelpietra, Nicotra, Leo, 2021). In addition to activities linking new technologies to classic solutions, it is also possible to identify non-obvious ones, one of which is the Pokémon GO, a game developed by Niantic in 2016 (Khamzina, Parab, An, Bullard, Grigsby-Toussaint, 2020). The title is an AR (Augmented Reality) game that combines elements of the real world with the digital world. In this particular case, users are urged to leave the house to catch Pokémon, which affects the movement of one’s character. Studies have shown that using the game significantly increases the number of steps walked. However, the figure was not considered clinically significant (Khamzina et al., 2020). The production used simple mechanisms such as character development or growing your collection of the titular Pokémon. In addition, sound and graphics techniques have been used that mimicked and extended the real world (Kato et al., 2019). It is pointed out that Niantic’s production encouraged people with hikikomori to leave their home to spend time in a completely different way. Isolated people were deciding to leave home of their own free will and without external pressures (Tan, Ondrus, Kato, Tan, 2020). Objects in play such as Pokéstop and Pokégym could act as important meeting places leading to socialisation (Hussain, 2018). The product was expected to improve the situation at least minimally (Tan et al., 2020) but, after a prolonged period of use, Pokémon GO was becoming unattractive and tedious despite continuous improvements and additions. The positive influence of the Pokémon GO app is, therefore, transient in nature but offers hope for use in the early stages of hikikomori (Kato et al., 2019). However, this does not completely rule out the possibility of using games to improve the functioning of hikikomori. Researchers are in favour of the creation of special places in therapeutic centres where people will have the opportunity to play games that are cooperative and require interaction with other users (Wong et al., 2019). The element that distinguishes this approach from others is the treatment of games as an additional part of the therapies taking place in the centres rather than their essential part. This also reduces one of the main problems faced by games like Pokemon GO, i.e. security issues. Not being able to leave the room while playing minimises the risk of serious accidents that may have occurred through carelessness while walking (Hussain, 2018).

Another method under consideration is a therapy using pet-like robots (Kato et al., 2019). According to many researchers, one of the most significant problems of hikikomori is the difficulty and aversion to direct human contact. As a result, the use of robots programmed to mimic emotions and respond to feelings in the best possible way has begun to be explored. This method has been used in many other therapies for a variety of conditions, including people with hikikomori. The robots were intended to reduce reluctance to come into contact with people and help with socialisation. The idea was that contact with a robotic animal would not only allow a hikikomori to become accustomed to relationships but would also combat the problem of loneliness. One of the more famous productions was the Aibo dog produced by Sony (Sarkar, 2020). However, it is worth mentioning that the use of technology to combat other problems has aroused mixed feelings (Kumazaki, 2018). On the other hand, it has been proven that the use of social robots and the allocation of AI-based allies in games improved the mood of MOBA users (Wang, Dai, Chen, Wang, Hoorn, 2023). This offers hope for the creation of games with a more positive atmosphere and a focus on human-computer relationships as a form of combating negative emotions.

In addition to the direct use of app and robot functionality, the positive impact of contact-based hikikomori treatment methods has been demonstrated. Through the C-BED method, i.e. a learning process based on the sharing of experiences by people in similar situations through online dialogues, people have an opportunity to exchange impressions and opinions around the clock. The equality of all individuals and free contact with the organisers lead to the opening up of new possibilities and perspectives for the reproduction of interpersonal relationships, and the use of supplementary videos and audio files in learning further enhances the attractiveness of this type of solution (Yokoyama, Kawasaki, Mitsumiya, Xu, 2019).

In addition to the opportunities offered by new technologies in the treatment of hikikomori, attention is drawn to the fact that there have been some changes in the provision of online services due to the presence of hikikomori who represent a market niche for some sellers. In addition, they can become a target group for sites offering remote work, encouraging the possibility to stay at home (Correy, 2012). However, there is a lack of scientific literature extensively discussing this state of affairs and how actions on the part of companies affect the way hikikomori function or their treatment process.

Discussion

The phenomenon of hikikomori is becoming widespread around the world and is affecting more and more people, even the youngest ones. The problem that used to be identified only with Japan once often entails other mental health problems and can be confused with other conditions. Sometimes characteristics such as isolation, excessive use of the Internet or leaving home rarely are not initially associated with illness. For this reason, among others, the Ministry of Health, Labour and Welfare in Japan has detailed the characteristics of hikikomori with terms such as: no diagnosed other mental illness, not going to work or school and pathological avoidance of contact with others. The reasons for this phenomenon are mainly found in situations that are strongly linked to the socio-cultural plane, for example concerning relationships with parents, behavioural patterns and societal expectations. However, the full list of causes is not known. In Japan, a collectivist approach to work or school prevails, social expectations are high and the individualistic approach is limited in favour of society as a whole.

The naming of hikikomori as a phenomenon is relatively recent and, as a result, the number of studies on the subject is low, particularly when it comes to research on the connections with new technologies. However, the number of studies is expected to increase in the near future both due to the interest in the phenomenon in various countries around the world and the dynamic technology development. Due to the constant changes in digital reality, problems of definition have also moved into the Internet arena, so that the blurry definitional boundaries in describing hikikomori should not only be expanded to include the context of Internet addiction but also narrowed due to the possibility of hikikomori using digital reality in a way that contradicts the accepted definition. This raises problems in diagnosing, learning about and describing the phenomenon. Many authors undertake to explore the relationship between hikikomori and addiction, usually without specifying the direction of the outcome.

Because of the tendency towards addiction, teenagers and adults may prefer to spend time online, primarily due to the anonymity that gives them freedom of action and due to the feeling of being invisible to others. There is also the avoidance of being judged by others, which is linked to the anonymity mentioned earlier, or the ability to identify with other people as the hikikomori may experience a sense of closeness and notice similarities with other users. This makes the powerful medium of the Internet the ideal place for such people. Creating an online self has become an integral part of the lives of socially withdrawn people. Many computer games offer the possibility to create your own avatar. The creation of a new, idealised version of oneself by a hikikomori can be a response to imperfections and a chance to fix one’s life at least in the virtual world. However, it is important to bear in mind that technology itself is not the ultimate cause of such behaviour; it is merely a tool in dealing with one’s problems. On the one hand, this leads to an exacerbation of the typical, well-known problems associated with device misuse, such as ignoring basic needs and tasks, isolation, avoidance of contact or sleep disorders. On the other hand, the perception of a strong interest in the Internet by hikikomori makes it possible to consider its therapeutic applications.

In contrast, the technologies themselves are seen as the solution to the problem of hikikomori. This may sound paradoxical in light of the fact that it leads to addiction but the example of the Pokémon GO game reinforces the belief in the great potential and value of new technological solutions for therapeutic purposes. The product used a number of interesting and, above all, transparent principles. Elements of the game such as PokéGyms and PokéStops even encouraged people to visit different locations, which inevitably involved the need to leave one’s home. Ultimately, this could have led to interactions with other people who appeared at the same time. This simple mechanic has motivated huge numbers of people, including hikikomori, to get out of their homes to explore. Of course, people have lost interest in the game after prolonged use. Looking at it from another angle though, the short-lived nature of the app is worth noting. Other treatments for hikikomori include therapy with the use of a robotic pet, such as the Aibo dog by Sony. Such solutions have been tested on people with autism or dementia among others. Their disadvantage, like in the case of Pokémon GO, was their short-lived nature, with prolonged use causing discomfort to the patient. They did, however, have some advantages: they were an excellent method for socially withdrawn people to renew social contacts and an opportunity to become accustomed to someone’s presence or to learn how to respond to emotions. The authors of the study point out that despite the limited impact of the Pokémon GO game on improving hikikomori functioning, there are growing hopes for AR games that combine the real world and the virtual one. However, the market for this type of games is still a niche, and considerations of game use are often based on speculation. There is no denying that these solutions, as well as robots, help to offset some of the symptoms of hikikomori: they can build new relationships, encourage people to get out of their homes or share their opinions with others. Each of the aforementioned attempts at treating hikikomori, even if its effectiveness is low, allows for a better exploration of digital reality processes and offers hope for the further development of technology-based therapies. A key idea may be to use technology as only a certain part of centre-based therapy in view of the still insufficiently researched and documented impact of technological solutions on hikikomori.

Conclusions

The aim of this review was to present the relationship between hikikomori and new technologies. The unresolved issue of setting sharp boundaries for the definition of the concept leads to difficulties in conducting research and separating hikikomori from Internet addiction, as well as in determining the direction of the outcome of the two conditions. Hikikomori encounter common problems of the excessive use of the Internet in the virtual space, but certain behaviours demonstrate therapeutic potential. However, due to the rapid waning of interest in games and robots, they represent a short-term solution. Scientific literature focused on this topic is currently scarce. Newer research would allow consideration of treatments for hikikomori based on ever-evolving technologies.