A Philip E. Lilienthal Book in Asian Studies. Oakland, CA: University of California Press, 2016. xii, 225 pp. (Illustrations.) US$65.00, cloth. ISBN 978-0-520-28930-7.
Theodore Jun Yoo offers some staggering statistics to introduce his history of mental illness in Korea: among Republic of Korea (ROK) citizens today, just over one in four (27.6 percent) experience multiple mental health problems over their lifetime. At 29.1 per 1000 people the ROK’s suicide rate tops the list of OECD countries (3). Despite this near-crisis situation, the topic has received minimal consideration in Korean academic literature. Yoo attempts to fill this void by tracing the history of mental illness, the care Korean practitioners have offered patients, and general attitudes that Korean society has harboured toward those afflicted with mental disabilities. His subtitle is modest. He covers ground beyond simply the “colonial period,” and presents a well-researched and carefully articulated review of his topic that crosses traditional time periods to consider pre-colonial Chosŏn history as well.
Korea’s baptism to modern psychiatry occurred soon after Japan’s Meiji government saddled the kingdom with the Kanghwa Treaty in 1876, and after Japanese medical practitioners armed with the latest research from Europe began crossing over to the peninsula primarily to care for Japanese military personnel (54). Mental illness had long been recognized as a problem in Korea, but its medical practitioners relied on more traditional treatment approaches. Among these were female shamans who, believing that “human problems [were] caused by [external] disturbances in the cosmic world,” performed the dramatic gut ceremony that incorporated “frenzied dancing, lively music, and food” to win over the spirit’s favour (21, 22). A second option was traditional Chinese medicine, which later in the Chosŏn period displayed a distinct Korean identity. This approach sought to balance the “complex network of internal and external forces” to return the patient to mental stability (27). Towards the latter half of the dynasty, as Neo-Confucianism dug its roots deeper into Korean society, the mental patient came to be ostracized, rather than treated, to hide family shame (42).
The transition to modern psychiatric practices received its biggest boost with the arrival of Western missionaries, and particularly Dr. Horace Allen, who received King Kojong’s blessing to open the Kwanghyewŏn (Royal) Hospital in 1885. In addition to attending to physical ailments, the hospital gained notoriety as a center for the care of “diseases of the nervous system” (51). The hospital eventually opened a medical school that trained Koreans in modern psychiatric practices. Materials documenting the approaches that doctors employed to treat patients at the newly opened Severance Hospital, however, are apparently scarce, if not non-existent. Yoo describes early Western practices as an intersection between medical treatment and missionary work. Similar to shamanist practices, they also saw the cause of the patient’s mental illness as external, the work of demons who needed to be exorcised before the patient could be properly healed (54). After annexation, Korean psychiatric practices divided. Practitioners at the Severance Hospital, then under the directorship of Charles McLaren, adopted a more “humanistic” approach to mental care and Japanese practitioners at the government general hospital affiliated with Keijō Imperial University advanced a German-centred clinical approach.
Following the survey of Korea’s history of mental treatment during late Chosŏn and the colonial period, drawing primarily on print culture, Yoo offers interesting insights into societal changes in Korean perception of mental illness. Here his focus is on its “medicalization and criminalization” (111). Suicide provides one example. Perceptions on this act have gone through a most interesting transition from late Chosŏn to the period of colonial rule, as it had in Japan from Edo up through the Pacific War years. In the earlier period, Korean commoner suicide, when it received attention, was seen as indignation over failure or wrongful accusation, or as a means of preserving personal or family honour (122). It was only later that suicide came to be connected to mental illness, particularly as an “out” for those whose means of life were insufficient for paying the hefty costs that the Japanese administration levied on patients who required institutional care. While the Korean press treated rises in suicide rates as a “tragic by-product of colonialism and flawed modernity,” the colonial government likened it to a similar phenomenon experienced by Japanese, as an inevitable “price to pay to become ‘modern’” (140).
It’s Madness is a well-crafted, but disturbing, monograph that introduces a complex issue that has received insufficient treatment in contemporary colonial literature in general, much less in Korean historiography. Yoo’s time frame, from late Chosŏn through the colonial period, coincides with revolutionary changes in the way people viewed the mind. His description of this period in Korea suggests a trajectory of similarity between practices occurring at the forefront of psychiatry as to how the mind was to be studied, as well as how the mentally challenged patient was to be treated. Appending a brief introduction to the changes that were occurring primarily in Europe would have provided important contextualized background for Korean psychiatry history, while offering clues as to the influences that enlightened the thinking of such people as Horace Allen, who entered Korea just two years before Sigmund Freud started his practice, and Charles McLaren, who commenced employment at Severance Hospital during the height of (Carl) Jungian psychology. (Yoo does offer a short footnote regarding this latter connection on page 167.) That said, It’s Madness should gain consideration as an important read for students of colonial studies. It belongs on the bookshelf of all dedicated Korean studies scholars.
Mark Caprio
Rikkyo University, Tokyo, Japan
pp. 840-841