It’s Madness: The Politics of Mental Health in Colonial Korea by Theodore Jun Yoo (review)

In this richly detailed account of mental illness and its attendant politics in Korea, Theodore Jun Yoo follows his well-received first book, on gender and politics, with a second volume focusing on Korea under Japanese occupation.¹ He writes that his central task in the current book is “to trace the ‘genealogy of madness’ by analyzing how Korean society sought to make sense of behaviors that were unusual, frightening, or bizarre” (p. 10). While two of the four main chapters deal specifically with the colonial era, in keeping with his primary purpose of locating secular trends and changes in the identification, treatment, and management of the mentally ill in Korea, Yoo in fact covers a much more expansive time frame, devoting his entire first chapter and the first half of his third chapter to the second half of the Joseon (Chosǒn) Dynasty (1392–1910). The result of this widened temporal lens can be seen in contrast with more typical studies of modern psychiatry that posit a teleological transition from the premodern era, characterized by the prevalence of shaman-mediated exorcism, to the period of (colonial) modernity in which medical authorities, armed with biomedical nosologies and enabled by bureaucratic apparatuses, defined and enforced normality for modern subjects. Yoo instead presents a narrative driven by the concept “palimpsest,” borrowed from literary theorist Sarah Dillon (p. 160, n. 12), which helps him to emphasize the multilayered nature of the formation of modern discourses on madness in Korea. In other words, Yoo sees in colonial Korea not a clean slate created by the triumphant rise to dominance of modern psychiatry, but “an amalgam of ideas from traditional Korean folk culture, Chinese traditional medicine, and modern psychiatry” (p. 11) that was bequeathed to postcolonial Korea more or less in toto.

As Yoo details in the first chapter of the book, two disparate ideas on mental illness prevailed in Korea before the introduction of modern psychiatry in the early twentieth century. One was shamanism, which “viewed patients’ unresolved grudges or misfortune, or their possession by spirits, as the cause of mental afflictions” and whose remedies involved sacrificial rituals to soothe perturbed spirits or drive away evil ones through exorcism—a practice that was often violent and at times even fatal (p. 44). By the end of the Joseon period, however, “there was a slow shift from the personal, spirit-centered approach of shamanism . . . to naturalistic medical methods that focused on the processes of somatization” (p. 41). At the center of this addition of a new layer to the palimpsest was the sophistication of Korean medicine, which systemized both the etiology and the treatments found in traditional Chinese medicine. For practitioners of Korean medicine such as Heo Jun (1539–1615), mental illness was merely a symptom reflecting an imbalance in the body, just as human emotions were linked to specific organs. Any medical intervention in this tradition was therefore designed to restore the balance of bodily energies and organs.

While a group of progressive Korean scholars began to discuss Western psychiatric institutions as early as the 1880s as part of their vision for a sweeping reform movement in the spirit of enlightenment, the real occasion for the introduction of modern psychiatry came with the formal colonization of the peninsula in 1910, as elaborated in chapter 2. According to Yoo, two largely unrelated (or even oppositional) strands of psychiatry took root in colonial Korea. On the one hand, there was the Christianity-inspired, habilitation-focused approach adopted by Charles Inglis McLaren (1882–1957), a missionary doctor at the Severance Union Hospital in Korea from 1923, who “attempted to offer his patients both spiritual and psychological solutions, modeling his approach on Jesus’s own treatment of the ill and downtrodden” (p. 61). Standing in contrast to this “spiritualized psychotherapy” was what Yoo calls “a German-style approach to psychiatry, including its emphasis on diagnostic nosology and its...