In recent decades, clinicians and researchers have become increasingly aware of a form of extreme social withdrawal lasting at least six months, known as hikikomori [ 1 ]. The term was coined in the late 1990s by Japanese psychiatrist Saitō Tamaki to describe individuals who withdraw almost entirely from social life, isolating themselves within their home – often in a single room – refusing school or work, and avoiding face-to-face relationships. While some remain connected t