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韓國人 精神治療에 關한 硏究

Research on Psychotherapy of Korean Patients

최신의학 1970년 13권 9호 p.52 ~ 76
이동식,
소속 상세정보
이동식 (  ) - 서울대학교 학생지도 연구소 동북 신경정신과 병원

Abstract


The author attempted to establish the firm ground for the development of psychotherapy on the Korean soil. First He did this on the basis of his own 17 years of psychotherapeutic experiences in Korea (except for 5 years abroad); second, by examining the Korean personality and culture; third, by examining´ and comparing the common elements between the goals and philosophy of psychotherapy in the West and the goals and philosophy of Tao in the East (Buddhism, Confucianism, Taoism, Chundoism).
He at first reviewed the scanty literature on psychotherapy in contemporary Korea. Then he presented his own therapy cases: 6 cases of brief psychotherapy, 3 cases of long term intensive psychotherapy lasting 6 years. with 600 hours for the two, one conjoint therapy of a childhood schizophrenic, 2 cases of family therapy and three groups of group therapy.
He also discussed the total 117 cases of psychotherapeutic experience out of which 86 are male and 31 are female. Forty three males and 9 females are schizophrenic, 31 males and 16 females are neurotic. Thirty one males and 12 females belong to the age group of 19-25yrs., 22 males and 2 females to the 26-30 group, 15 males and 12 females to that of 31-40yrs. Ten males received therapy of 1-2 years, 11 males 2-5 years, 6 males over 6 years. Only 2 females received 1-2 years of psychotherapy. As to the efficacy of the therapy, 22(19%) showed no improvement, 37(31. 6%) showed symptomatic improvement, 53(45.3%) showed improvement in symptoms with partial personality change, 5(4.3%) showed definite reconstruction of personality.
Forty five percent of the patients are students mostly of the college level. Among males next are the employees of the private company, business-men, teachers, professors and physicians. Among female patients 15 are housewives and 10 are students. Eighty one (69. 2%) are college students or graduates, only one case of the illiterate.
tis to the referral sources, 33.3% from psychiatrists, 23. 1% from physicians, 9.4% from counselors and´ psychologists, 14.3% from patients.
Among long term cases 80% are between the ages of 19 and 40. Most of the cases lasting over 3 years or more schizophrenic and borderline. As to the medication 66.7% received no medication, 25% received medication, 8% received medication at the beginning and then tapered off.
The author also discussed the personality and culture of Korea, which some Korean psychotherapists consider as hindering psychotherapy in Korea. In the traditional Korean culture, Korean personality has deep concern over others´ needs, feelings and welfare, non-verbally-oriented and relationship-oriented, which is favorable for receiving and learning psychotherapy. He defined the traditional Korean culture as family-oriented, sympathy-oriented, humane relationship culture, which is different from Western culture which could be labeled as verbally-oriented alienating culture.
He also showed the roots of psychotherapy in the traditional Tao and Oriental medicine. In Oriental medicine the highest goal of the old sacred physician is to prevent disease by tendering or healing the mind by cultivating Tao. There is also the technique of psychotherapy based upon the psychodynamic theory of interrelationships between different emotions.
The goal of Tao is to become God, that is, cultivating and maturing of man´s potentiality. In Buddhism one become buddha by returning to one´s original nature. In Confucianism one become sacred man. In Taoism one become true man or god-man. In Chundoism man is equal to Heaven (God). Becoming one´s original nature is equal to individuation, self-realization, self-actualization in the Western psychotherapy.
The Western existentialists, psychoanalysts and psychotherapists maintain that one cannot free himself from normal, existential, ontological anxiety by psychoanalysis or by any means, whereas in Tao especially in Suhn(Zen) Buddhismeven this normal, existential anxiety can be abolished by overcoming the life and death mind.
In Buddhism 57,51 or 4 stages of enlightenment are differentiated. This can be compared with Rogers´ scale for the measurement of process in psychotherapy. Searching for Bull Pictures on the walls of Buddhist temple depict the process of enlightenment and psychotherapy very succinctly in thlauthor´s opinion. The search for the bull is equal to the search for the nuclear emotions motivating one´s personality, behavior and thoughts. Catching, reining and taming the bull mean grasping, holding without repressing, controlling and resolving the nuclear feelings. Freeing the bull means finally freeing oneself from these major motivations.
From the above the author maintains that the traditional Korean personality and culture are very much favorable for receiving and learning or teaching psychotherapy. There is not much hindrance different from the Western countries except for the lack of funds for the therapy of the most Korean patients, scarcity of adequate therapists and absence of organizational activities.
The author´s experience is quite in contradistinction to the view of the Japanese psychiatrists and analysts that the Japanese patients are not amenable to psychoanalysis or long term intensive psychotherapy. He also feels that what the Korean therapists should learn from the West is the technique rather than the philosophy of psychotherapy and also feels that much can be learned from studying and practicing Tao especially Suhn(Zen) Buddhism by both the Eastern and Western psychotherapists.

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