Taijin Kyofusho (translation: the disorder of fear of interpersonal relations) is a neurotic culture bound/ culture-related syndrome in Japan where a person feels extreme social-phobia that is associated with their appearance. This fear is related to a feeling of guilt towards the body, and is biologically based within the experience of fear and anxiety. One is afraid of a certain aspect of their appearance offending others, and because of this one may go into social isolation in order to avoid these extreme feelings of guilt. This condition can take on many forms for an individual. For example one may fear certain biological processes of their body (e.g. blushing, sweating, farting, odor, etc). The most common symptom is the fear of being stared or being caught starring at another. In essence, making eye contact with others is extremely terrifying, and will leave one feeling shame or guilt. The fear can also be localized – one may be ashamed of a certain aspect of the body – on the eyes, mouth, knees, etc. The reason for this feeling of shame and embarrassment (also known as Haji in Japanese) is derived from the fear of making others feel uncomfortable. In the article Shame and Guilt: A psychosocial View of the Japanese self, the aspects of shame and guilt within Japanese culture are considered a crucial part in the development of Taijin Kyofusho. Within Japanese culture, shame and embarrassment are combined into the word Haji because of how connected they are. For example, overexposure of oneself will make one feel Haji, but further one may feel guilt for this overexposure because they feel it has made others uncomfortable. In order to avoid hurting others with their appearance people with Taijin Kyofusho avoid social situations. All of this is associated with the Japanese cultural emphasis on the presentation of the outer-self. In many aspects of Japanese culture there is a precise script for what is acceptable and unacceptable. For example, the Japanese tea ceremony is a performance, there is a script one is to follow, and if one deters for the script or messes up, that individual will experience Haji. It is consider that because the Japanese culture expresses an extreme concern with this performance of the outer-self, that people develop Taijin Kyofusho. In order to counteract this societal pressure, the Japanese have time set for private space. Here, often in an inebriated setting, people join with close friends, schoolmates, or family and let out everything that has been bottled up. This is a very therapeutic time to release Haji. However, if someone is not regularly releasing these feelings, neuroticism may take over. The person may even become so overwhelmed with how their appearance affects others that they can be driven toward self-harm and suicide. In cases like these, therapy is seen as a positive way to address the symptoms of Taijin Kyofusho. Further, having a supportive family and people to talk to can help a person address issues, express fear, and relieve themselves of extreme feelings of shame, embarrassment, and guilt towards their appearance.
Lebra, Taki S. “Shame and Guilt: A Psychocultural View of the Japanese Self.” Ethos 11, no. 3 (1983): 192-209. http://www.jstor.org/stable/639973?origin=JSTOR-pdf.