Hwa-byung: symptoms, causes and treatment of this cultural syndrome

Let us look at the characteristics of hwa-byung, a cultural syndrome that occurs in Korean people.

There are several mental disorders that have been classified as "cultural syndromes", which are psychosomatic syndromes that have been detected in some specific cultures or societies, such as amok, which originated in Indonesia; koro, from China; or hwa-byung, from Korea, which is the one we are going to talk about in this article.

The syndrome known as hwa-byung is a somatization disorder related to the difficulty that some people have in managing the states of anger that they have come to feel in the face of injustices, so that by repressing their feelings they can suffer physical and psychological symptoms (e.g., sadness, frustration or notable tiredness, among others).

In this article we will explain what is hwa-byung syndrome, what are its possible causes and whether there is any treatment.What are its possible causes and if there is any treatment.

Hwa-byung: What does this cultural syndrome consist of?

Hwa-byung, also referred to as wool-hwa-byung (Hwabyeong or Hwapyŏng), is a somatization disorder originating in Korea and closely linked to its culture..

This can develop when a person is not able to manage the anger felt in situations that he/she considers to be unjust, thus repression of their emotions will eventually trigger the development of this syndrome and a series of psychological and physical symptoms that are closely linked to it. that are closely linked to it (e.g., feelings of frustration, sadness, insomnia, fatigue, headache, etc.).

This syndrome can be found in different international diagnostic manuals on mental disorders such as the DSM or the ICD, among others, in the section dedicated to cultural syndromes, where other syndromes or mental disorders that are closely linked to the culture where they were discovered are found; although in recent years they have been gradually arousing greater interest on the part of researchers and health professionals around various parts of the world.

Both hwa-byung and the other cultural syndromes have been slow to be investigated by the international scientific community; however, they have been gaining importance in recent decades due to the growth of cultural diversity in Western countries, as is the case of the United States, a country where it is very important to study cultural syndromes such as hwa-byung, since it is estimated that among its population there are more than 2 million people of Korean origin.

• You may be interested in, "What is Cultural Psychology?"

Most characteristic symptoms of hwa-byung

Among the detected and diagnosed cases of hwa-byung, a series of symptoms associated with this syndrome have been found. symptoms associated with this syndrome when it develops in people over a prolonged period of time, giving rise to a series of symptoms associated with hwa-byung.The most characteristic symptoms of hwa-byung syndrome are the following:

• Feelings of frustration and constant anger (the most characteristic symptoms).
• Feelings of helplessness and melancholy.
• Sleeping difficulties or insomnia.
• Noticeable lack of energy or fatigue.
• Hypervigilance for fear of suffering something bad.
• Frequent headaches (cephaleas) and muscular pains.
• Dizziness.
• Noticeable lack of appetite.
• Tachycardia.
• Digestive problems.
• Feelings of restlessness.
• sensation of heat
• Tightness in the chest.
• Dry mouth and breathing difficulties.

As we have seen, there are numerous physical and psychological symptoms that can develop when suffering from hwabyung syndrome, which has aroused the interest of several researchers, leading to an increase in the number of studies on the subject. This has facilitated the detection of a greater number of cases, so that this has also given rise to more research about possible treatments in order to alleviate the symptoms..

It should be noted that in a study on hwa-byung, in which a series of brain scans were performed, they found a series of measurable traces in the brain as a consequence of having suffered this syndrome, among which the following could be observed lower levels of activity in brain areas directly involved in impulse and emotion control..

Causes

Research estimates that hwa-byung may affect as many as 10,000 people in South Korea each year. The average profile of a person suffering from this syndrome is a middle-aged woman and older with a low socioeconomic status.

On the other hand, they were able to observe that it was frequent that this syndrome began to develop in complicated moments in the life of these people, such as a divorce process, marital problems or conflicts with other members of their family. complicated moments in the life of these people, such as a divorce process, marital problems or conflicts with other members of their family..

The predisposition to suffer from the hwa-byung syndrome due to the fact that it is not very socially accepted to externalize emotions, so it is this tendency to internalize what can predispose and facilitate the triggering of this syndrome, as well as favoring its maintenance over time. Likewise, this tendency to internalize emotions may predispose and facilitate the triggering of the syndrome, this tendency to internalize emotions may make it difficult to seek psychological help..

The hwa-byung syndrome is a rather complex mental disorder that could be caused by various psychosocial factors. Moreover, as previously mentioned, it is a Korean cultural syndrome, and more specifically, it is linked to South Korea, as no data are shown for North Korea.

In Western culture the symptoms that are part of the hwa-byung syndrome could fit with some mood disorder, with components of anxiety, depression, stress, etc. It should be noted that this syndrome has a high comorbidity with disorders related to anger, with major depressive disorder and also with generalized anxiety disorder..

Treatment

Since its discovery, hwa-byung syndrome has been treated mainly from the medical model, because although patients suffering from this syndrome are aware of its psychogenic origin, they do not usually seek help from a psychologist or psychiatrist because in their culture, as is still the case in much of the world today, there is a certain reluctance among the general population to seek such help because it is considered not yet fully socially accepted.

Therefore, it is more common for them to seek medical treatment for the physical symptoms related to hwa-byung syndrome (e.g. fatigue, muscle aches, headaches, etc.).

On the other hand, to treat the psychological symptoms of hwa-byung syndrome, other alternatives to hwa-byung syndrome are often used. syndrome, alternatives to psychological therapy that are more deeply rooted and socially acceptable within the Korean culture are often used.In some cases, Koreans have chosen to seek the help of shamans.

In research conducted with Koreans in relation to the mental health problems they may suffer, it was found that when they have a problem at the psychological level they tend to deal with it by seeking informal help from close relatives and friends, rather than seeking help from mental health professionals, the latter option being considered as a last resort.

However, in recent years, however, the demand for psychological help from professionals has been on the rise.As a result, cases of hwa-byung syndrome have already been treated through different psychological treatments such as cognitive therapy, supportive therapies following a psychodynamic approach and also psychological therapies based on mindfulness-based stress reduction programs, the latter showing positive and encouraging results with regard to the reduction of hwa-byung symptoms.

It is worth noting that in 2006 a study was published that showed promising results regarding the use of an MMP scale for the reduction of hwa-byung symptoms. the use of an MMPI-2 scale, a tool that has been widely used in the past.a tool that has been widely used to assess personality and psychopathology, and which in this case was designed to assess the characteristics of hwa-byung. This scale analyzed important components related to this syndrome such as Gastrointestinal symptoms, anger, feelings of hopelessness and general health.

However, although the results obtained with the adaptation of an MMPI-2 scale to assess hwa-byung were encouraging, more clinical studies are needed to further validate this scale.