Taijin Kyofusho Disorder, The Fear Of Offending Others

Taijin Kyofusho disorder represents a very particular type of phobia. It is one in which a person fears offending another in some way, whether through words, a misplaced comment, a gesture or even with certain aspects of your body.

As impressive as this condition may seem, it is still a type of social anxiety described in diagnostic manuals.

It is very possible that, broadly speaking, this type of disorder is mainly associated with the Japanese personality.

As we all know, if there is one thing the Japanese are known for, it is their high sense of behavioral correctness, absolute respect for others, and such careful, minute courtesy in their daily treatment. However, it should be noted that this type of anxiety appears in any culture.

Behind Taijin Kyofusho ‘s disorder is insecurity. It is she who creates this almost delusional obsession with showing absolute perfection every time a person sees himself publicly exposed.

Their anxiety about looking the best, the best attitude, or the most developed treatment often leads to doubting everything they do and say.

Fear of blushing, of hesitating, of saying something unintelligent, and even fear of smelling bad at some point:  these are all small examples of the obsessions that make up the Taijin Kyofusho disorder .

Taijin Kyofusho Disorder : Characteristics and Treatment

Taijin Kyofusho Disorder translates as “ Interpersonal Relationship Fear Disorder ”. This type of social phobia was first described in Japan, and this is no accident.

In Japanese culture, the importance of the group in relation to the individual is often emphasized. Therefore, this recurrent anguish of offending others in some respect did not take long to be described and labeled.

As we indicated at the beginning, this type of phobia is not unique to the Japanese; however, for them it is a well-known psychiatric syndrome, whereas in the West we hardly talk about it.

Even so, it is included in the “Diagnostic and Statistical Manual of Mental Disorders” (DSM-5), but not with a category of its own, simply as “Other Specified Obsessive-Compulsive Disorders and Related Disorders”.

Let’s see what its most common features are:

Differences between Taijin Kyofusho Disorder and Social Phobia

Although many say that Taijin Kyofusho disorder is basically a type of social phobia, it should be noted that there are small nuances that make it unique.

• People with social phobia experience anguish, shame and anxiety when facing other people. However, patients with Taijin Kyofusho are afraid of embarrassing or creating discomfort for others by their presence.
• The basic problem is not how someone reacts to a given situation. The fear resides in “how those around me might react when I expose myself to them”.
• Another striking aspect is the emergence of obsessive-compulsive behaviors. In the scientific literature, we have the case of an American woman diagnosed with this disorder. The study, published at the University of Health Sciences in Chicago, describes how this patient had a particular obsession: looking at people’s genitals. He knew it would embarrass and upset them, and although he felt anguish about it, he couldn’t stop. These are details that show the complexity of this psychiatric condition.

Characteristics of Taijin Kyofusho

The Japanese diagnostic system states that this disorder can occur based on four very common subtypes, which shape a specific type of phobia. They are as follows:

• Sekimen-kyofu: Fear of blushing and that the other person is uncomfortable with it.
• Shubo-kyofu: Fear of upsetting others for not having an attractive body.
• Jiko-shisen-kyofu: anguish that others feel threatened or restless when observed.
• Jiko-shu-kyofu: Afraid of giving off a bad smell at some point.

On the other hand, in the West, the following aspects are also evaluated:

• Analyze whether these characteristics are stable or transient. It is known, for example, that these behaviors can appear in adolescence and disappear over time.

• Phobia degree.
• Appearance of delusional, obsessive-compulsive thoughts, etc.
• It is also common for this disorder to appear in patients with schizophrenia.

What types of treatment are there?

It should be noted that, from a cultural point of view, taijin kyofusho disorder is very interesting. We know that the first treatments for this condition appeared in 1910 at the hands of Dr. Shoma Morita. In their day, the therapeutic approach they used was as follows:

• Isolate the patient in specific facilities.
• Invite him to rest and relax.
• Write a diary.
• Doing manual tasks like gardening.
• Participate in classes taught by Dr. Morita.

From the 1930s onwards, this specialist changed his treatment in some aspects. He introduced group therapy as well as drug administration. Currently, Morita therapy is still used in Japan.

In the West, it should be noted that strategy varies greatly. The reason for this is that we do not recognize taijin kyofusho as a separate disorder, and it is treated in the same way as social phobia.

In general, exposure-based cognitive-behavioral therapy is used, in addition to working on aspects such as self-esteem and relaxation techniques.

However, everything depends on the uniqueness of each patient and the existence or not of other disorders. In any case, we are faced with a type of phobia that is much more familiar to the Japanese than most of us.