Fear of Interpersonal Relations




Taijin Kyofusho (TK) can be translated as fear (kyofu) of interpersonal relations (taijin) disorder (sho) (Takahishi, 1989)


Though little known in the West, TK has been recognised in Japanese diagnostic systems for almost a century and has been thought to be an Asian variant of social anxiety that is uniquely situated within that cultural context. Thus, it's not surprising that it has often been discussed in terms of individualism and collectivism. For instance, it is widely held that individualistic cultures emphasise independence and individual success. Thus, Western conceptualisations of social anxiety tend to have an egocentric focus (i.e., fear of embarrassing oneself) versus collectivist cultures, which place more emphasis on the group and group harmony/cohesion and may focus social fears on offending or upsetting others (a core feature of TK).


TK has been described as an "altruistic phobia" given that the individual is fearful of making others uncomfortable. Some researchers have dichotomised TK into

  • nonoffensive (or "sensitive") type

  • offensive type

The sensitive type is very similar to Western Social Anxiety Disorder (SAD) - fears tend to be egocentric in nature and are focused on embarrassment arising from social/performance situations and the sufferer's putative shortcoming or physical manifestations of anxiety. Conversely, offensive TK is characterised by allocentric fears i.e. the individual, fears that he/she will cause others to suffer offense, displeasure, or embarrassment.


TK Subtypes Based on the Focus of Fears


Subcategories of TK include:

  • fear of blushing (sekimen-kyofu)

  • fear of a deformed body (shubo-kyofu)

  • fear of eye contact (jiko-shisen-kyofu) *In a slightly different interpretation, Lee and Oh (1999) noted that there may be a belief that one's eyes are too sharp or hostile and therefore, cause distress to others. This type of fear can also be subdivided into a fear of offending through one's side gaze or by staring at valuables (i.e. watches, jewellery) and/ or defective body parts.*

  • fear of one's own body odour (jiko-shu-kyofu)

In terms of etiology, a number of theories have been proposed which includes temperament, neurobiology, and family/cultural factors. Original formulations attributed TK to temperamental predispositions toward hypochondria and certain environmental experiences. These factors led TK individuals to overinterpret events, fear interpersonal situations, focus excessive attention on bodily sensations.


Treatment options include various psychopharmacological and psychotherapeutic interventions. The main psychotherapeutic approaches for TK have been group therapy, psychoanalysis, cognitive behavioural therapies, and Morita therapy - a culturally indigenous form of psychotherapy where treatment took place over the course of 40 days in inpatient hospitalisation settings. Today, Morita therapy is employed in outpatient settings for a variety of mental disorders.




Reference: Work by B. A. Sharpless


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