Phobias Types Taijin Kyofusho: Japanese Social Phobia By Lisa Fritscher Lisa Fritscher is a freelance writer and editor with a deep interest in phobias and other mental health topics. Learn about our editorial process Lisa Fritscher Medically reviewed by Medically reviewed by Daniel B. Block, MD on October 16, 2020 twitter linkedin Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania. Learn about our Review Board Daniel B. Block, MD on October 16, 2020 Print eli_asenova/E+/Getty Images Translated as "the disorder of fear," taijin kyofusho, or TKS, is a specific, culturally bound, Japanese form of social phobia anxiety disorder. This fear occurs in about 10 to 20 percent of Japanese people and is more common in men than women. By contrast, anxiety disorders are significantly more prevalent in women than men. Overview Japanese culture stresses the good of the group over the desires of the individual. Therefore, if you have this phobia, you might be intensely fearful that your body's appearance or functioning is offensive or displeasing to others. Some Japanese people with taijin kyofusho particularly focus on odors, others on the way that they move, and still others on their body shape or aesthetics. The fear can also be of aspects of your mind rather than your physical body. You might be afraid that your attitude, behaviors, beliefs, or thoughts are different than those of your peers. Taijin kyofusho is listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) under 300.2(F42) Other Specified Obsessive Compulsive and Related Disorders. Symptoms Taijin kyofusho and social phobia, or social anxiety disorder, have similar symptoms. Common symptoms include: Blushing Inappropriate eye contact Shaking Difficulty speaking Sweating Gastrointestinal distress A strong desire to flee the situation Patients with either phobia simultaneously crave and fear interpersonal interactions, and may gradually become more and more withdrawn in an effort to avoid their fearful reactions. How It Differs From Social Phobia The crucial difference between taijin kyofusho and social phobia is subtle. Commonly in the West, people with social phobia are afraid of experiencing embarrassment in front of others, while Japanese people with taijin kyofusho are afraid of embarrassing others by being in their presence. In keeping with cultural expectations, the basis of social phobia is on the sufferer's individual reactions, while the basis of taijin kyofusho is on the sufferer's perception of the reactions of the group. Subtypes The Japanese diagnostic system divides taijin kyofusho into four specific subtypes. Each subtype is similar to a specific phobia: Sekimen-kyofu is a fear of blushing. Shubo-kyofu is a fear of a deformed body. Jiko-shisen-kyofu is a fear of one's own glance. Jiko-shu-kyofu is a fear of body odor. Severity 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, most common type, often begins before the age of 30 Delusional: The sufferer obsesses over a particular personal flaw of the body or mind that may periodically change Phobic with schizophrenia: This is a separate and more complicated disorder. In this case, taijin kyofusho is part of the sufferer's schizophrenic reactions, not a simple phobia Treatment In the Western world, clinicians don't recognize taijin kyofusho as a separate disorder and usually treat it the same way as social phobia. Japanese clinicians frequently use Morita therapy. Developed in the 1910s, traditional Morita therapy is a highly regimented progression that helps the patient learn to accept and redirect his thoughts. Stage one is bed rest in total isolation, stages two and three focus on work, and only stage four includes what Westerners think of as therapeutic techniques such as talk therapy. Today, Japanese clinicians modify Morita therapy for outpatient or group settings, but the basic principles remain the same. Like Western psychiatrists, Japanese doctors sometimes prescribe medications as an adjunct to therapy. Was this page helpful? Thanks for your feedback! Ever wonder what your personality type means? Sign up to find out more in our Healthy Mind newsletter. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Nakagami Y, Ii T, Russ TC, Marques JG, Riese F, Sönmez E, Hopwood M, et al. Taijin kyofusho: A culture‐bound diagnosis discussed by Japanese and international early career psychiatrists. Psychiatry Clin. Neurosci. 2017;71(2):146. doi:10.1111/pcn.12482 Park SC, Kim YK. Anxiety Disorders in the DSM-5: Changes, Controversies, and Future Directions. Adv Exp Med Biol. 2020;1191:187-196. doi:10.1007/978-981-32-9705-0_12 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM–5). Fifth edition. Arlington, Va.: American Psychiatric Association; 2013. Tei S, Kauppi JP, Jankowski KF, et al. Brain and behavioral alterations in subjects with social anxiety dominated by empathic embarrassment. Proc Natl Acad Sci U S A. 2020;117(8):4385–4391. doi:10.1073/pnas.1918081117 Arimitsu K, Hitokoto H, Kind S, Hofmann SG. Differences in Compassion, Well-being, and Social Anxiety between Japan and the USA. Mindfulness (N Y). 2019;10(5):854–862. doi:10.1007/s12671-018-1045-6 Iwata Y, Suzuki K, Takei N, et al. Jiko-shisen-kyofu (fear of one's own glance), but not taijin-kyofusho (fear of interpersonal relations), is an east Asian culture-related specific syndrome. Aust N Z J Psychiatry. 2011;45(2):148-152. doi:10.3109/00048674.2010.534068 Hofmann SG, Hinton DE. Cross-cultural aspects of anxiety disorders. Curr Psychiatry Rep. 2014;16(6):450. doi:10.1007/s11920-014-0450-3 Wu H, Yu D, He Y, Wang J, Xiao Z, Li C. Morita therapy for anxiety disorders in adults. Cochrane Database of Systematic Reviews. 2015;(2):Art. No.:CD008619. doi:10.1002/14651858.CD008619.pub2 Additional Reading Essau CA, Sasagawa S, Ishikawa S, Okajima I, O'Callaghan J, Bray D. A Japanese form of social anxiety (taijin kyofusho): frequency and correlates in two generations of the same family. Int J Soc Psychiatry. 2012;58(6):635-642. doi:10.1177/0020764011421099 Hofmann SG, Anu Asnaani MA, Hinton DE. Cultural aspects in social anxiety and social anxiety disorder. Depress Anxiety. 2010;27(12):1117–1127. doi:10.1002/da.20759 Sasaki J, Wada K, Tanno Y. Understanding egorrhea from cultural-clinical psychology. Front Psychol. 2013;4:894. doi:10.3389/fpsyg.2013.00894