W3 Activity: Hwa-byung and Korean Women

Hwa-byung, or anger/fire disease, occurs in Korean middle aged women who are dealing with problematic familial relationships or being treated poorly or unfairly and is often a result of repressing anger and frustration from a situation. An article in Health Care for Women International states that, “Hwa differs from Western conceptualizations of anger because it implies the accumulation of a range of emotions such as frustration, anxiety, anger, apprehension, and disappointment for an extended period of time in conjunction with physical manifestations (Min, Lee, Kang, & Lee, 1987; Park, Kim, Kang, & Kim, 2001).” It is believed that due to the nature of the Korean culture to endure and not outwardly express displeasure or frustration and the importance placed on familial ties, experiencing trauma or discord within the family can lead to heightened emotional states, outbursts, anger, and physical discomfort.

In 2012 when this study was published, it is believed that hwa-byung impacted about 5% of the Korean population, focusing in on those who experience low socioeconomic status, low education levels, and stuck in stereotypical gender roles. Although these are common factors, there are many others that can contribute to experiencing hwa-byung. Many women who experience hwa-byung either seek out traditional treatment or Western medicine. Depending on the journal, results of whether the women sought out traditional or Western treatment depended on where the women themselves were located, either within Korea or elsewhere. Some patients sought out Christian faith healing and shamanic methods. Because “hwa-byung is closely related to an oppressive environment, many treatment methods including psychotherapy, drug treatment, family therapy and community approaches have been suggested (Min et al., 1989; Kang & Lee, 1998). It is also necessary for psychiatrists to enrich their treatment strategies with teachings from traditional and religious healing methods.”  

Some Korean female immigrants to America also suffer from this illness. Psychiatric treatment, similar to how one would work with those who have depression or anxiety, proves to be effective. Desire to find an effective treatment for those who suffer from hwa-byung has been on-going since the 1970s and, much like anxiety and depression, it is still not entirely clear as to what the most effective treatment of this would be.

Kim, Eunha, Ingrid Hogge, Peter Ji, Young R. Shim, and Catherine Lothspeich. “Hwa-Byung Among Middle-Aged Korean Women: Family Relationships, Gender-Role Attitudes, and Self-Esteem.” Health Care for Women International 35, no. 5 (2013): 495-511. doi:10.1080/07399332.2012.740114.
Suh, Soyoung. “Stories to Be Told: Korean Doctors Between Hwa-Byung (Fire-Illness) and Depression, 1970–2011.” Culture, Medicine, and Psychiatry 37, no. 1 (March 2013): 81–104. doi:10.1007/s11013-012-9291-x.
Sung Kil Min. “Hwabyung in Korea: Culture and Dynamic Analysis.” World Cultural Psychiatry Research Review 4, no. 1 (January 2009): 12–21.
Lee, Jieun, Amy Wachholtz, and Keum-Hyeong Choi. “A Review of the Korean Cultural Syndrome Hwa-Byung: Suggestions for Theory and Intervention.” J. Asia Pac. Couns. Journal of Asia Pacific Counseling 4, no. 1 (2014): 49-64. doi:10.18401/2014.4.1.4.

2 thoughts on “W3 Activity: Hwa-byung and Korean Women

  1. In class, we learned that culture could be defined by a set of values, customs, beliefs, rituals and ideas of a particular group. I believe that Hwa-Byung is a cultural phenomenon due to the unique circumstances of those who tend to be diagnosed. In the United States, I think that this would be diagnosed as a generalized anxiety disorder or depression, due to the mental health components of it. The reason I believe that it is culture specific is because I come from a South Asian culture and due to the communal nature of our culture, we tend to put a higher emphasis on the importance of the community over individual self. There is also a concept of not airing your dirty laundry. For that reason, I believe that the culture can create unique issues when it comes to mental health and seeking help.
    The communal component was evident in this post. I liked how you discussed that treatment often utilized ‘family therapy and community approaches’ . I think for the reasons I have outlined and for the evidence provided in the blog a culturally competent approach to treatment is the most beneficial route for those suffering from this disorder.

  2. Hey Linsey,
    I just read your post about Hwa-byung. I found it very interesting, especially in the way that this syndrome pertains to aspects of Korean culture. Culture is an ever-changing, nearly impossible to define concept that appears within groups of as a result of both that group’s environment and the most common thought currents that make up its society. These currents are made up of expectations for how the people that make up a society should behave and how they should not behave.
    In this particular case, I believe that the syndrome can be considered culture-related. Because the syndrome is based on the way that Korean society functions in how people deal with disappointment, and most likely how women are expected to deal with disappointment and grief, this syndrome is related specifically to Korean culture. It is important, as you mentioned, to recognize similar syndromes in other cultures because it helps to clarify this one in this culture specifically as a culture-bound syndrome. For example, this syndrome occurs as a result of family-related stress, something that is incredibly important in collectivist cultures.
    In individualist cultures, this kind of phenomena might be given less importance or treated as a simple emotional problems connected to other psychological disorders instead of given weight as a culture-bound syndrome. For this reason, it is important to recognize the validity that must come along with culture-bound syndromes regardless of the lack of information that we have about them.
    Thanks for your post,
    Julia

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