Tag: Hikikomori

Silent Distress in Adolescence: A Seminar by Anna Maria Speranza

Fiorenzo Ranieri

On 10 October 2026, as part of the training activities organised by the Martha Harris Association for Psychoanalytic Psychotherapy with Children and Adolescents (Associazione Martha Harris di Psicoterapia Psicoanalitica per l’Infanzia e l’Adolescenza), Professor Anna Maria Speranza gave a seminar devoted to silent distress in adolescence.

This article offers a reworking of the material presented and discussed by the speaker, preserving its theoretical perspective, principal clinical references, and implications for psychopathological assessment. It is not a transcript of the seminar, but a considered reconstruction of its main themes, organised in a discursive form to facilitate reading and consultation.

The seminar addressed a question of particular clinical importance: how can we recognise and understand forms of adolescent suffering that may remain unnoticed for a long time because they do not manifest themselves through overtly conflictual or transgressive behaviour?

Distress That Goes Unnoticed

Continue reading Silent Distress in Adolescence: A Seminar by Anna Maria Speranza

The Hikikomori Body

Fiorenzo Ranieri

Paper presented at the conference “Solitude and Relationships”, organised by the Order of Psychologists of Tuscany on 22–23 January 2026 (proceedings available at:

https://www.fondazionepsicologi.it/quaderni/solitudine-e-relazioni-volume-2/)

Introduction

This contribution offers some reflections on the relationship that adolescents and young adults living in voluntary social withdrawal — commonly referred to in the literature as hikikomori — have with their own bodies. These observations draw on my clinical experience and on findings from the scientific literature. Further valuable insights emerged from the annual seminar The Hikikomori Phenomenon – A Psychoanalytic Perspective on Psychic and Social Withdrawal Across the Life Cycle, organised by the Martha Harris Study Centre in Florence and co-led with Dr Miriam Monticelli.

When we meet adolescents and young adults in social withdrawal, what strikes us is not only their absence from the world, but also a particular mode of bodily presence. The body is there — yet somehow withdrawn, suspended, as though it needed to pass unnoticed. Continue reading The Hikikomori Body

The Denied Body: Clinical and Countertransference Dynamics in Hikikomori Withdrawal

Fiorenzo Ranieri

The article “The Denied Body: Clinical and Countertransference Dynamics in Hikikomori Withdrawal” was published in the March 2026 issue of the Journal of Child Psychotherapy.

Abstract

Social withdrawal, known as hikikomori, represents a complex clinical condition in which the body is often silenced and withdrawn from relational exchange. This paper explores the role of the bodily dimension in psychoanalytic psychotherapy with adolescents and young adults, with particular attention to the therapist’s countertransference reactions. The concept of psychic retreat is used to understand how the body becomes the main vehicle for non-symbolisable communications. Starting from the premise that enactment is the language of the retreat, clinical vignettes illustrate how this process can become a transformative moment when recognised and worked through within the analytic field. The containing function allows the transformation of what has been evacuated into the body into shareable thoughts, thereby reopening a relational space. The paper emphasises the importance of keeping the patient’s body alive in the therapist’s mind, to give meaning to what cannot be said and to restore the possibility of connection with the Other.

Keywords:

Hikikomori; body and psychotherapy; psychic retreat; countertransference; enactment

Ranieri, F. (2026). The denied body: clinical and countertransference dynamics in hikikomori withdrawal. Journal of Child Psychotherapy, 1–16. https://doi.org/10.1080/0075417X.2026.2639574

Indirect Psychotherapy With Parents of Adolescents and Young Adults With Hikikomori

Fiorenzo Ranieri

The journal Psicologia Clinica dello Sviluppo (Il Mulino) published the article “Indirect Psychotherapy With Parents of Adolescents and Young Adults With Hikikomori” in its first issue of 2026 (available in Early Access at the following link: [link]). The pre-print version submitted for peer review is reproduced below.

Abstract:

This article presents a psychodynamic approach to working with families of adolescents and young adults experiencing hikikomori, a specific form of extreme social withdrawal. Young individuals with hikikomori present sensitive challenges for mental health professionals, particularly when they refuse direct contact with clinicians. In such cases, therapeutic work with the parents often becomes the only feasible intervention. The method of indirect psychotherapy is a parent-focused intervention that respects the adolescent’s refusal of treatment while aiming to redefine relational dynamics within the family system. This process seeks to establish an alliance with the parents and gradually engage them in confronting the often idealized yet emotionally neglected internal object of the “child.” When effective, this approach can catalyze meaningful changes in the family and, indirectly, in the adolescent. The article concludes with the presentation of several clinical vignettes.

Keywords: indirect psychotherapy, parent-focused intervention, hikikomori, psychodynamic therapy, psychic retreats Continue reading Indirect Psychotherapy With Parents of Adolescents and Young Adults With Hikikomori

Two Psychoanalytic Perspectives on Hikikomori: The Theses of Mohr and Urani

Fiorenzo Ranieri

Recently, I came across two interesting doctoral theses submitted at the Tavistock & Portman NHS Foundation Trust: Shut in and cut off? by Petra A. M. Mohr (2019) and Socially withdrawn young people by Margherita Urani (2023). Both studies offer an in-depth psychoanalytic perspective on voluntary self-seclusion, drawing on interviews with child and adolescent psychotherapists who have worked directly with hikikomori patients. The two theses provide a rich source of information about patients’ behaviours, experiences and mental processes. The therapists interviewed describe their clinical experiences, the patients’ subjective states, and the complex countertransference dynamics that emerge in therapeutic work.

Continue reading Two Psychoanalytic Perspectives on Hikikomori: The Theses of Mohr and Urani

Michele Cocchi’s “Good” Video Games: the Novel US

Fiorenzo Ranieri

US is a novel about young people, taking us straight into that other adolescence: the difficult one, with Gordian knots to untangle, arduous paths to trace and identities to construct. Its author, Michele Cocchi, portrays it by exploring the life of Tommaso, a boy who has been living shut away in his room for more than a year. No school, no going out with friends, and relationships with his parents reduced to a minimum. Tommaso is a hikikomori: he has withdrawn from the world, seeking refuge in an isolation that, although suffocating, seems to him the only way of managing anxieties and fears that are difficult to define but capable of invading every aspect of his existence.

Around him is a family that, despite all its fragilities, never ceases to be there. An imperfect but real family, reflecting the dynamics of many families dealing with a child’s social withdrawal. The only passions he has left are NBA basketball and, above all, video games.

The turning point comes with US, an online multiplayer video game in which players, divided into teams of three, are bound together by a profound constraint: every individual mistake has consequences for the entire group. The missions, set against complex and dramatic historical backgrounds, offer no easy choices, forcing participants to confront moral dilemmas and their own vulnerability. US is not merely a game: it is an experience that puts players to the test and prompts them to question themselves.

In the virtual world, Tommaso becomes Logan and finds in Rin and Hud two teammates with whom, despite never seeing one another, he builds authentic bonds. The rules of the game prevent them from revealing their identities, yet it is precisely this anonymity that allows the three young people to open up to one another, becoming mutual points of reference during an adolescence marked by isolation.

Cocchi’s novel, written by the Pistoia psychotherapist who died prematurely in 2022, tells the story of the protagonist’s journey of growth. Continue reading Michele Cocchi’s “Good” Video Games: the Novel US

Hikikomori – Il re escluso [The Excluded King]

Fiorenzo Ranieri

The human condition of adolescents and young adults, children and adults experiencing psychic and social withdrawal — the condition of hikikomori — has been portrayed by various artists. To mention just a couple of examples that I have personally appreciated, there is the play Hikikomori by Holger Schober, directed by Vincenzo Picone, and the fine novel Us by my friend and colleague Michele Cocchi, who sadly passed away recently, published by Fandango in 2020. Continue reading Hikikomori – Il re escluso [The Excluded King]

Seeking the origins of psychic and social withdrawals

Fiorenzo Ranieri

The article “Seeking the origins of psychic and social withdrawals: warning signs in the observations of young children”, co-authored with Miriam Monticelli, has been published in Infant Observation – International Journal of Infant Observation and Its Applications.

Read the full article:

(https://www.tandfonline.com/doi/full/10.1080/13698036.2023.2290290 ).

“The authors hypothesize that the child’s psychic withdrawal is a potential precursor to the social withdrawal called ‘hikikomori’, a phenomenon frequently observed among adolescents and young adults. They also hypothesize a continuum between psychic withdrawal, social withdrawal and the ‘psychic retreats’ by John Steiner. The authors investigate very early psychic withdrawal and its potential link to the development of social withdrawal. Two observations collected using the Infant Observation and Young Child Observation method provided essential support. Children with premonitory signs of psychic withdrawal observed when they were very young were contacted years later for new observations. The aim was to test the hypothesis that the mental and social functioning mechanisms observed were maintained over time, hindering the children’s lines of development. In both cases, it is shown that over the years, precursor signs of mental withdrawal can be traced in the non-spontaneous modes of interaction with peers, with an adaptation to the environment that, especially in a child, seems to rely on the family context and home to avoid contact with others. The article provides clues as to how psychic withdrawal fuels social withdrawal and can contribute to the construction of internal personality organizations that lead to self-reclusion called hikikomori”.

Keywords

Psychic withdrawal; social withdrawal; psychic retreat; hikikomori; Infant Observation; Young Child Observation

Contact the authors for further information