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Sunday, October 19, 2014         

NEW YORK TIMES


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Stressed and depressed, Koreans avoid therapy

By MARK McDONALD

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SEOUL >> It can sometimes feel as if South Korea, overworked, overstressed and ever anxious, is on the verge of a national nervous breakdown, with a rising divorce rate, students who feel suffocated by academic pressures, a suicide rate among the highest in the world and a macho corporate culture that still encourages blackout drinking sessions after work.

More than 30 South Koreans kill themselves every day, and the suicides of entertainers, politicians, athletes and business leaders have become almost commonplace. And yet Koreans — while almost obsessively embracing Western innovations ranging from smartphones to the Internet to cosmetic surgery — have largely resisted Western psychotherapy for their growing anxieties, depression and stress.

“Talking openly about emotional problems is still taboo,” said Dr. Kim Hyong-soo, a psychologist and professor at Chosun University in Kwangju.

“With depression, the inclination for Koreans is to just bear with it and get over it,” he said. “If someone goes to a psychoanalyst, they know they’ll be stigmatized for the rest of their life. So they don’t go.”

Mental health experts said many troubled South Koreans seek help from private psychiatric clinics (and pay their bills in cash) so their government-insurance records do not carry the stigma of a “Code F,” signifying someone who has received reimbursement for such care.

Even when Koreans do seek out counseling, the learning curve can be steep.

A prominent psychiatrist in Seoul, Jin-seng Park, said it was not uncommon for some new patients to come to his office, talk over a problem for 40 minutes and then be shocked when they’re presented with a bill.

“They’ll say, ‘I have to pay? Just for talking? I can do that for free with my friend or my pastor,”’ Park said.

Meanwhile, the suicide rate in South Korea is nothing short of alarming, nearly three times higher than in the U.S. The rate here doubled in the decade between 1999 and 2009. Suicide pacts among strangers who meet online is a growing phenomenon.

“We have seen a rapid increase in depression, and I’d say 80 to 90 percent of our suicides are byproducts of depression,” Kim said. Government mental health clinics have proved effective in helping with basic family or marital problems, he said, “but they’re not getting at depression.”

“That issue is still very closed. We still conceal it.”

South Korean society has traditionally been underpinned by Buddhist and Confucian values, which emphasize diligence, stoicism and modesty. Individual concerns are secondary. Preserving dignity, or “face,” especially for the family, is paramount.

Some experts trace South Korea’s emotional malaise to the decline of these traditional values and the rise of the country as a modern industrial power, starting in the 1980s. South Korea, once even poorer than woeful North Korea, now boasts the world’s 13th-largest economy.

“As the society became more oriented toward materialism, people started to compare themselves,” Park said. “There’s a lot of competition now, even starting in childhood, and the goals of life have moved. We have a saying, ‘If one cousin buys land, the other cousin gets a stomachache.”’

With Confucian values on the wane, Koreans use a variety of ways — short of prescribed medications — to handle stress. Consulting shamans, outdoor exercise like golf and hiking, alcohol, organized religion, the Internet and travel are common outlets now. Shamans are still popular among Koreans, usually when they come down with the blues, an odd illness or a run of bad luck. Indeed, shamanism has made something of a comeback, with an estimated 300,000 shamans ministering to clients.

“More Koreans see fortunetellers than psychiatrists,” said Dr. Yoon Dae-hyun, a psychiatrist at Seoul National University Hospital. “Our biggest competitors are fortunetellers and room salons. They certainly make more money than us.”

Room salons are after-work clubs frequented by hard-drinking businessmen who select from a bevy of personal hostesses who ply them with expensive drinks and listen to their problems.

“Koreans are trying to find their own ‘package,’ their own set of remedies — and they’re doing this very intensely, of course,” said Dr. Oh Kyung-ja, a professor of clinical psychology at Yonsei University in Seoul. “They are desperately searching for things to do to divert themselves from stress. They just don’t have a good model.”






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