Taijin kyofusho in Japan and South Korea

The CBS I chose to research is Taijin kyofusho. Taijin kyofusho or TKS, is a cultural variation of social anxiety.  TKS is a clinical syndrome that is most prevalent in Japan and South Korea.  The syndrome, which translates as “fear of interpersonal relations”, can be divided into two subtypes.  The first is the neurotic subtype and the second is the offensive subtype. The first subtype can be divided into a classical type and an avoidant type.  The classical type is the fear of being negatively judged due to physical signs of anxiety and feelings of shame due to anxiety.  The physical signs that they fear of being judged for can include sweating and tremors.

The second subtype, the offensive subtype, is what distinguishes TKS from the typical social anxiety disorder (SAD).  The offensive subtype is comprised of two factors.  As stated in the article I read, the factors are “a belief that one’s self or one’s behavior is flawed, inappropriate or offensive in someway and a fear that these flawed social presentations will offend others”.  The symptoms that are associated with this subtype further distinguish this disorder.  Individuals within this subtype report symptoms that are considered delusional according to the DSM system.  These symptoms are all fears.  They include fear of body odor and intestinal gas, fear of having stiff facial expression, fear of staring at and making eye contact with others, fear of a deformed body and fear of blushing.

Culturally speaking, this offensive subtype of TKS is mostly present in Asian cultures but studies have shown other cultures as having symptoms associated with the offensive subtype.  It was reported that there was an African-American women who had a fear of offending others by staring at their genital region in social situations.

Treatment of TKS can be done through Morita Therapy.  Morita Therapy was developed in the 1910s.  The goal of this therapy is to restore the mind to before the patient was caught up in their social fears.  Morita Therapy was originally characterized by rest and discipline.  It is now, however, done on an outpatient basis and in groups.


Marques, L and Robinaugh,D. Cross-Cultural Variations in the Prevalence and Presentation of Anxiety Disorders.  Expert Review of Neurotherapeutics.  Pp 313-322.  Feb 2011.


Maeda, F and Nathan, J. Understanding Taijin Kyofusho, Through its Treatment, Morita Therapy. Journal of Psychosomatic Research, Vol. 46, No. 6.  Pp 525–530. 1999



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