This article by Dr. Luke Kim is part of a series designed to teach families about Korean culture. For a listing of all the articles in the series, click here.
From a clinical point of view, haan is considered as a causative factor in the development of a Korean culture-bound psychiatric syndrome called "Hwa-byung." Hwa-byung literally means "fire (Hwa) disease (Byung)," or "anger disease." The syndrome manifests in the mixture of clinical depression, anxiety and somatic symptoms characterized by the presence of a "lump" and pressure in the throat or chest. The syndrome is most common among women, especially married women who are beyond the middle age and of low social class standing.
According to Sung Kil Min's survey of 100 Hwa-byung patient seen at the Yonsei University Hospital Outpatient Clinic, Seoul, Korea, the symptoms most frequently complained of were: oppressive and heavy feelings in the chest, a feeling of a mass in the chest or abdomen; a feeling of something hot and pushing in the chest; a sensation of heat in the body; feelings of something boiling up, or burning inside. Other physical symptoms include: headaches, palpitation, indigestion, etc. Generally the patients complained of physical symptoms, but when they were asked of emotional symptoms, they mentioned frequently: sadness, pessimistic view, loss of interest, temper, startle, nervousness, and even suicidal thoughts. Other emotions include: rage, hate, resentment, frustration, mortification, regret and shame.
Hwa-byung has been known in Korea as a folk medical term for a long time. Interestingly, Korean immigrant patients who were seen at clinics in Los Angeles manifested symptoms of Hwa-byung. It was Keh-Ming Lin of UCLA who first reported in an English language psychiatric journal citing 3 Korean Hwa-byung cases in 1983. Subsequently several research articles appeared in the American journals, which has aroused an interest in the syndrome among mental health professionals.