Taijin Kyofusho: A Culture-Bound Social Phobia

Translated as "the disorder of fear," taijin kyofusho, or TKS, is a specific, culturally bound, Japanese form of social phobia characterized by a fear that one's appearance or functioning is offensive or displeasing to others. It shares similarities with social phobia (social anxiety disorder) and is often mistaken for it.

Symptoms of Taijin Kyofusho

The symptoms of taijin kyofusho are similar to those of social phobia, including:

• A strong desire to flee the situation
• Blushing
• Difficulty speaking
• Gastrointestinal distress
• Inappropriate eye contact
• Shaking
• Sweating

Additionally, people with taijin kyofusho may experience:

• A fear of being a burden to others
• A fear of being laughed at or ridiculed
• A fear of making others feel uncomfortable
• A fear of appearing unattractive or unpleasant

Diagnosis of Taijin Kyofusho

To diagnose taijin kyofusho, a mental health professional will ask questions about the duration, severity, and nature of symptoms. They may also conduct a physical exam and perform lab tests to rule out other conditions that might be causing the symptoms.

The crucial difference between taijin kyofusho and non-culturally bound social anxiety disorder is subtle. People with social anxiety disorder are afraid of experiencing embarrassment in front of others, while people with taijin kyofusho are afraid of embarrassing others by being in their presence.

In keeping with cultural expectations, the basis of social anxiety disorder is on the individual's reactions, while the basis of taijin kyofusho is on the individual's perception of the reactions of the group.

Types of Taijin Kyofusho

The Japanese diagnostic system divides taijin kyofusho into four specific subtypes, each similar to a specific phobia:

• Sekimen-kyofu: Fear of blushing
• Shubo-kyofu: Fear of a deformed body
• Jiko-shisen-kyofu: Fear of one's gaze
• Jiko-shu-kyofu: Fear of body odor

Severity of Taijin Kyofusho

Japanese psychology also recognizes four types of taijin kyofusho based on severity:

• Transient: Short-term, moderately severe, most common in teens
• Phobic: Chronic, moderate to severe, begins before age 30
• Delusional: Obsession over a particular flaw that may change
• Phobic with schizophrenia: Separate disorder, taijin kyofusho as part of schizophrenic reactions

Causes of Taijin Kyofusho

The exact causes of taijin kyofusho are unknown, but several factors may contribute:

• Behavioral inhibition: Tendency to withdraw or experience distress in unfamiliar situations
• Difficult or traumatic social experiences: Being shamed or embarrassed socially
• Collectivist culture: Emphasis on the group over the individual, as seen in Japanese/Korean cultures

Impact of Taijin Kyofusho

Taijin kyofusho can have a significant impact on a person's life, causing:

• Emotional distress, fear, and shame
• Avoidance of social situations
• Difficulty maintaining relationships
• Feelings of isolation and loneliness
• Increased risk of depression and anxiety disorders

Treatment Options for Taijin Kyofusho

Treatment for taijin kyofusho typically involves medication and therapy:

• Medications: Anti- anxiety medications, antidepressants, beta-blockers
• Psychotherapy: Cognitive-behavioral therapy (CBT), exposure therapy, Morita therapy

Coping With Taijin Kyofusho

In addition to professional treatment, coping strategies may help manage anxiety:

• Relaxation techniques: Deep breathing, progressive muscle relaxation
• Self-care: Adequate sleep, healthy diet, regular exercise, avoiding excessive caffeine
• Social skills practice: Spending time with friends, joining support groups, attending group therapy

Seeking professional help and utilizing self-help strategies can significantly improve the quality of life for individuals with taijin kyofusho.