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

Theodore Yoo’s book purports to be a study of the politics of mental health in colonial Korea, but he delivers much more in this fascinating study. I finished the book with a deeper appreciation of traditional Korean views on mental illness as they evolved in the first half of the twentieth century. Yoo presents his subject as a palimpsest, a layering of different approaches to and ideas about mental illness in Korea. By accretion, these layers ultimately create the complicated field of attitudes toward mental illness that remain visible in contemporary Korean life.

The introduction offers a fascinating discussion of contemporary Koreans’ apparently anachronistic view on mental dysfunction. South Korea carries one of the highest rates of suicide in the modern world, a fact that belies its fabulous economic success over the last half century. Yoo describes compellingly how traditional views of mental illness remain tenacious, disruptive, and conflictive, and how they bleed though the layers of “modern” medicalized language systems and ideologies that took hold in Korea during the twentieth century. These traditional views posit that mental maladies are culturally bound to frayed and disrupted personal relationships or result from spiritual and moral failings in the individual—hence the continued reluctance of Koreans to turn to Western models of psychotherapy or other medical interventions. What emerges in the subsequent four chapters is a detailed exposition of the different layers. It provides, in a sense, a genealogy of how madness has been viewed in traditional Korea: how first missionaries and later the Japanese brought psychiatric concepts of treatment to the colony after 1910 and how this Japanese model evolved from a treatment-centered orientation to acquire a pedagogical and research emphasis. The latter emphasis led to isolation and incarceration for those individuals judged dangerously or criminally insane in the later half of the colonial period.

Chapter 1, “Forms of Madness,” examines traditional approaches to mental illness rooted in the interplay between indigenous shamanic beliefs and imported Chinese medical practices. For the most part, shamans dealt with mental illness as externally generated by malevolent spirits. Their goal therefore was to expel these external influences in order to restore the patient to mental health. While shamans were marginalized during the Chosŏn period, they remained readily available and often consulted in this realm of human disturbance. Korean traditional medicine, on the other hand, evolved from the very early importation of Chinese practices. It approached mental illness as a symptom of imbalanced bodily forces; rebalancing was prescribed for the restoration of mental health. The chapter is rife with detailed case studies and examples. It could stand alone as a short compendium of traditional approaches to mental health.

Chapter 2, “Madness Is...,” discusses the introduction of American and Japanese psychiatric traditions to Korea, the establishment of the first mental hospitals, and the ultimate evolution of medicalized techniques for treating the mentally ill during the colonial period. Western medical training began in the first missionary hospitals and expanded during the colonial period, particularly after the establishment of the faculty of medicine within the new Keijō Imperial University after 1926. Yoo traces the different approaches of missionary and Japanese doctors and examines Korean attitudes toward the mentally ill and their treatment. Ultimately, therapeutic interventions for the chronically ill were passed over, and a pedagogical research orientation took over the larger colonial institutions.

Chapter 3, “A Touch of Madness: The Cultural Politics of Emotion,” examines mental illness through literary and legal representations of the emotions. This discussion is a particularly fascinating investigation of Korean emotional constructs, such as affective bonds (chŏng 情), shame and social face (ch’emyŏn 體面), tact (nunchi 눈치), and emotional suffering (han 恨). The meanings of these constructs began to shift under the influence of modernity, colonialism, and the rise of bourgeois culture. To my knowledge, this chapter is the first attempt to develop an explanation of emotions within a specific...