Shut in and cut off? An exploration of internal and external relationship dynamics of adolescents and young adults who are socially withdrawn and isolated in their homes

Mohr, Petra A M (2021) Shut in and cut off? An exploration of internal and external relationship dynamics of adolescents and young adults who are socially withdrawn and isolated in their homes. Professional Doctorate thesis, Tavistock and Portman NHS Foundation Trust/University of East London. Full text available

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Abstract

The aim of this research was to learn more about adolescents and young adults who withdraw into their rooms, and who are isolated from society. I wanted to investigate whether ‘Hikikomori’, a phenomenon found in Japan of people shutting themselves away in their rooms for months and years, without attending education, training or work, was relevant in Britain. Data was gathered by a two-staged method: an audit conducted at a young people’s mental health clinic, and semi-structured interviews with child psychotherapists and a psychiatrist who had clinical experience of working with severely withdrawn young people. The audit was analysed using descriptive statistics. The key findings of the audit were that 16% of overall referrals showed Hikikomori presentations of being shut away in their room for several months or more, and a further 13% were social isolated and at risk of Hikikomori. The audit further showed that such withdrawn young people showed a higher engagement in psychotherapy compared to overall referrals. It also showed there are some characteristics that are common amongst the withdrawn group, in particular excessive computer use, experiences of bullying, and fears that others would attack, control or humiliate them. The interviews were analysed using Thematic Analysis, which identified four overarching themes of ‘being stuck’, ‘relationship to the outside world’, ‘boundaries’ and ‘therapy, change and endings’. Their subordinate themes are explored within psychoanalytic theories on adolescence, and concepts such as ‘psychic retreats’ and ‘pathological defence systems’, as well as psychoanalytic investigations of the impact of the internet, leading to a consideration of the internal objects and the inter-relationship dynamics present within severe withdrawn states. The findings of the audit and the interview study were compared with each other and put in the context of other research findings. The implications of the findings are considered and recommendations made.

Item Type: Thesis (Professional Doctorate)
Additional Information: Thesis submitted in partial fulfilment of the requirements of the Tavistock and Portman NHS Foundation Trust and the University of East London for the degree of Professional Doctorate in Child and Adolescent Psychoanalytic Psychotherapy.
Uncontrolled Keywords: Professional Doctorate in Child and Adolescent Psychoanalytic Psychotherapy
Subjects: Children, Young People and Developmental Pyschology > Adolescents- Psychology
Children, Young People and Developmental Pyschology > Adolescents - Psychotherapy
Disabilities & Disorders (mental & physical) > Mental Disorders
Research, Tests, Assessments > Psychotherapy Research
Department/People: Children, Young Adult and Family Services
Research
URI: http://repository.tavistockandportman.ac.uk/id/eprint/2524

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