In his contribution to The New York Times Op-Ed column, Korean novelist Kim Young-ha writes: “[Suicide is] the No.1 cause of death for people [in South Korea] between the ages of 10 and 30. For people in their 40s, suicide is the second most common cause of death, after cancer. Among the older generations, the numbers are even more bleak.” Kim notes that about 60% of the people who attempt suicide suffer from depression, a disorder found in most industrialized capitalist economies. The rate of suicide in South Korea has risen by 219% between 2000 and 2012. Suicide currently ranks as the second cause of death in the country, just behind cancer. Kim claims that one common reason why South Koreans avoid treatment for depression is that they generally perceive it as a form of weakness or an ailment that plagues only the feeble-minded. The same article quotes Yonsei Severance Hospital psychiatry professor Kim Eo-su: “One out of three depression patients stops mid-treatment. One of the biggest issues is that many patients think they can overcome depression on their own through a religious life or through exercise.” But exactly what religions did most of the patients turn to when they stopped treatment midway?
South Korea's population is currently divided into four major religious groups: Catholics, Protestants, Buddhists, and the nonreligious. According to a census conducted by KBS, the number of Buddhists has decreased since the 1990s, while Protestants and Catholics have steadily increased to form a Christian majority. Those who identify as nonreligious rank second, followed by Buddhists.
South Korea has a centuries-long relationship with Shamanism, Confucianism, and Buddhism. These early spiritual roots existed in South Korea prior to the twentieth century Joseon Dynasty, the Japanese Occupation, modernization and westernization, the Korean War, and the flourish of European and American Christian missionaries. Historically, Christianity is still relatively new to the country, just as adopting Eastern religion into Western clinical psychology is considerably new here in the States where it is most commonly linked to Jon Kabat-Zinn and his program established in 1979. There is also the earlier example of D.T. Suzuki’s Introduction to Zen Buddhism, published in Germany in 1939 with a mildly xenophobic preface written by Carl Gustav Jung and reprinted into English about ten years later. Some of the Buddhist practices encouraged by clinical psychologists have been adopted by U.S. marines to help deal with PTSD and other combat related stresses with positive results.
South Korea’s struggle with suicide, depression, and the lack of trust in protocol to manage these issues is not new. The country’s general resistance to psychological treatment has been critiqued for years. Some in South Korea find the idea of paying to talk to someone about their problems absurd. According to Mark McDonald, Korean patients will give the excuse that they can just as easily go to their friends or pastor with their problems and be heard for free, so why pay? Patients are unwilling to seek reimbursement for psychological treatments covered by health insurance due to fear of stigmatization. The notion of pulling oneself up by his or her bootstraps is commonplace not just in South Korea but also in many other capitalist societies. McDonald offers a typical Western criticism of how South Korea is victimized by its own tradition of Buddhism and Confucianism, which he claims lead to a paralyzing "stoicism and modesty." He fails to offer any answer to the essential question of how to encourage patients to trust clinics and recognize the validity of psychiatry.
I am a Korean-American immigrant (1.5 generation) raised by converted Protestants. My parents were generally not religious, but mildly affiliated with Buddhism until 1995 when my father converted to Christianity following a DWI incident. Since the age of 18, I seceded from the church completely in order to seek a religion that wasn't passed down to me from my parents. I turned to Christianity again to help me cope with anxiety and suicidal thoughts after a traumatic event when I was 20. But being at a church only worsened my condition. My prayers for recovery from depression went unanswered and my anxiety did not dissipate. I abandoned my faith because I wasn’t finding answers to my problems. Soon thereafter I sought therapy at my university’s counseling program. The guided meditations and one-on-one sessions with a professional were immensely helpful and dramatically improved my health in a matter of weeks, whereas my earlier Christian life did not bring about such results.
I feel comfortable with Buddhism even though I don't identify as a Buddhist. Many of its practices of inward reflection and mindfulness are things I’ve learned from cognitive behavioral therapists here in the U.S., although their foundations lie in the Eastern religious practices and teachings that South Korea is increasingly abandoning. My mental clarity increased since those sessions, and my overall outlook on the world and my own life improved. I was able to obtain very basic tools to help me cope during times of difficulty, especially in sessions where my therapist specialized in mindfulness techniques. The practicality and simplicity of these treatments are preferable to the Christian doctrine of my earlier life. I can practice meditation on my own without the help of another. Acknowledging the present moment and simply knowing that I am capable of breathing is empowering, whereas making pleas with an outside force to better my condition only led to frustration. With that said, I am not suggesting that mindfulness and meditation are the ultimate answers for people in South Korea who deal with depression or suicidal thoughts. As Alexandra Morris’s article suggests, these tools are not the sole solutions to psychological disorders. Mindfulness or medication, or a combination of both can be the most effective treatment. It all depends on the patient and what his or her diagnosis and needs are. If clinical psychological treatment is being resisted by a significant population of the mentally ill in a country where people are increasingly turning to western religions, a less threatening resource of traditional coping practices is incredibly close at hand.
South Korea is currently facing a massive challenge following the Sewol sinking. The Vice Principal who survived the tragedy recently committed suicide. Psychiatrist Jeong Hye-shin says that the PTSD affecting the victims and the grieving nation has the potential to be as scarring as the trauma caused by the Korean War. The need for psychological care is crucial now more than ever. If the resistance to psychological treatment due to fear of stigmatization is keeping the mentally ill from getting help, then perhaps a return to more familiar roots with simple Buddhist exercises such as breathing, mindfulness, meditation can help. Being in the present moment to allow thoughts and feelings to occur allows the self a chance to accept them and begin the stages of processing trauma. Rather than pushing psychological treatment on those who resist it, how about encouraging patients to return to some of the country’s more familiar roots?
Grace Jung is a New York based writer, translator and film producer. Her essays and e-books have been published by Thought Catalog, and her novel Deli Ideology is forthcoming from the same publisher. Her short fiction has been published by The Cortland Review and Molotov Cocktail. Her translation of Lee Cheong-jun's novella Worm Story will be released by Merwin Asia Publishing. She is currently producing a documentary entitled A-Town Boyz. She is a former Fulbright scholar.