La conduite Hikikomori qualifie un retrait au domicile primaire. Elle survient chez des sujets dont le tableau clinique témoigne de souffrances narcissico-identitaires organisées autour de clivages précoces. Les processus intellectuels et affectifs fonctionnent indépendamment, ce dont l’expression langagière témoigne. Les mots n’appellent pas d’images, ils se diluent dans d’abstraites généralités ou dans des énoncés factuels, sans que l’émotion les colore. Ces sujets instaurent une coupure avec le monde réel extérieur, comme pour retrouver un intérieur qui leur soit propre, à la frontière définitivement établie, en dur. Ils tentent une forme d’affirmation subjective en rejetant le dehors, mais le font en silence, pacifiquement, sans haine perceptible. Comment venir en aide à ces singuliers patients qui généralement ne formulent ni désir ni demande ? La première tâche du thérapeute est de parvenir à les rencontrer, parfois initialement au domicile. Lorsqu’un cadre de psychothérapie peut se mettre en place, ajusté au plus près des contraintes et résistances du patient, il va s’agir d’entreprendre un laborieux travail de reliaison entre les mots et les affects qui risque d’exposer à l’expression d’une violence verbale débridée, utilisant volontiers comme support les phénomènes culturels. L’actualité du monde s’offre comme médiation et canalise cette émergence pulsionnelle brute. Cette matière, culturelle au sens large, prend une place déterminante dans l’économie psychique des hikikomoris. Elle tient lieu d’extériorité et s’y déchargent les tensions au travers des mots, au fur et à mesure que ceux-ci sont pulsionnellement réinvestis. La visée du processus thérapeutique est d’accompagner la transformation de cette violence en une agressivité adressée, subjectivante, amorce d’une liaison libidinale s’opposant aux effets du clivage intrapsychique.

In 1962, when Hanna Arendt proposed the concept of the banality of evil, Pierre Marty and Michel de M’Uzan for their part described operative thought. These two notions were developed in totally unrelated fields: that of war criminals on the one hand and that of patients undergoing consultation for psychosomatic illness on the other. However, they are related in the idea of an elaborative deficiency, an inability to think in the first person singular, in short, a subjective void. In order for this to happen, the developing subject begins to differentiate between his interior and the external real world that he rejects. In this operation of judgment, he learns how to deal with negation, the symbol of which becomes the condition of independence of thought, at the root of the subject. When this process fails, it will be necessary to look outside the libidinal potentialities which have not been constituted within by conforming to ambient values, for example, by the investment of perceptual reality and of the concrete world, as well. Hikikomoris patients fall within this spectrum of disorders, which René Roussillon describes, from a transnosographic perspective, as narcissistic identity suffering. An early division of the ego, established in an insufficiently adjusted primary object relationship, is regularly described as the source of these difficulties. Intellectual and affective processes are separated without further functional communication, as evidenced by language expression. Words do not call for images, they are diluted in abstract generalities or in factual statements, without emotion ever coloring them. The particularity of hikikomoris patients in this range of disorders is that they have cut themselves off from the real outside world, as if to find an interior of their own, at the definitively established border between the two. And if they do attempt a form of subjective affirmation by rejecting the outside world, it is in silence, peacefully, without perceptible hatred. How can we help these singular patients who generally formulate neither desire nor requests (the latter, on the other hand, coming strongly from an exhausted entourage, even desperate in the face of so much immobility that nothing seems able to rectify)? The first task of the therapist is to manage to meet them, sometimes initially at home. When a psychotherapy framework can be set up, adjusted as closely as possible to the constraints and resistance of the patient, it will be a question of helping him to restore meaning to his words, to embody a language that seems disaffected, free of emotion. The laborious work of linking words and affects risks exposing the therapist to the expression of unbridled verbal violence, against “shrinks” and all those who disturb, before the culture and current affairs of the world can offer themselves as mediation that channels this raw instinctual emergence. The confinement to home is usually punctuated by a large consumption of videos, anonymous exchanges on social media, and a thirst for a wide range of information. This matter, cultural in the broad sense, plays a decisive role in the psychic economy of the hikikomori patient. It replaces exteriority and tensions are relieved through words, as they are instinctually reinvested. The aim of the therapeutic process is to accompany the transformation of this violence into an addressed, subjectivizing aggressiveness, the beginning of a libidinal link opposing the effects of intra-psychic cleavage.