Paper Heart
CW: suicide, mental illness The lifetime prevalence of mental health disorders in South Korea is one out of every three people, slightly higher than the world average of one in four. In light of the high profile celebrity suicides in 2019, I decided that I wanted to know more about the state of mental health care in South Korea. In doing my research, I learned much more about the mental health care system in South Korea and the types of care that are available to South Korean citizens. However, there was a dearth of information regarding the care available for the non-Korean speaking, expat community in South Korea. So how do therapists in South Korea work with the multifaceted and deeply cultural mental health issues that foreigners experience here? This was the question that guided my search as someone who has dealt with anxiety since college and has peers who have experienced various forms of mental illness. I sought out Dr. Ebesutani to hear more about his experience working with the English-speaking foreigner population in South Korea. Dr. Chad Ebesutani is a US and South Korea Licensed Psychologist and Director of the Seoul Counseling Center. The Seoul Counseling Center—with locations in both Sinsa-dong (Gangnam) and Pyeongtaek (near the Camp Humphreys US Army Base)—is a space for English-speaking expats, international students, Korean Americans, and army personnel and families to receive counseling from certified South Korean and American therapists. Dr. Ebesutani is also an Associate Professor of psychology at Duksung Women’s University, where he runs a Child Psychology Research Lab focusing on evidence-based treatments and the assessment of mental health skills usage among both clinical and non-clinical populations. I started off our time together by asking Dr. Ebesutani about the most common mental health issues/disorders that he encounters among his foreigner clients. He stated that depression and anxiety are the most common disorders. With South Korea having the highest suicide rate of all OECD (Organization for Economic Co-operation and Development) countries, this observation was not surprising even among the foreigner population. He noted that social anxiety and panic disorder were also common problems he encountered at his center. I recalled a time when I used to suffer panic attacks in college as a result of my uncertain academic future. I would wake up in the middle of the night, heart thumping so hard that I could feel it in my ears. Social anxiety is also a condition I deal with on a day-to-day basis here even as a Korean American—so this observation was, again, not surprising to me. I wondered how foreigners, who often have left a significant part of their support systems back in their home country, work through such problems. But there were two additional issues that Dr. Ebesutani raised that I had not expected: societal integration challenges and alcohol abuse. According to the Journal of Korean Medical Science, South Korea is home to the highest prevalence of alcohol abuse/alcohol dependence among OECD countries, with approximately 7% of the population suffering from this disorder. These two problems often strongly impacting the expat life in South Korea is noteworthy, as often in South Korean workplace culture, alcohol is the gateway to inclusion in the greater workplace ecosystem through what is known as ‘hwe-sik’ (회식), the South Korean after-work company dinner. Dr. Ebesutani and the psychologists at his clinic work with many Korean American clients. Korean Americans in Korea belong to a unique niche of people who straddle the line between belonging and alienation. And it is not surprising that Korean Americans also deal with issues of societal integration. Dr. Ebesutani noted that lack of comfort with the Korean language was often the issue that prevented this population from feeling like they are truly “Korean.” Ultimately, this issue boils down to the issue of identity and feelings of isolation from one’s community. As a Korean American, I empathized deeply with what Dr. Ebesutani’s Korean American clients were feeling. I came to Korea hoping that by being here and integrating into the social fabric of my home country, I could feel more “Korean.” And after a year and a half of being here and working on my Korean as well as my mannerisms, I have integrated somewhat. But as a Korean American, that is not enough. Korean people asking me where I’m from, innocent comments from teachers about how well I eat the food, and the phrase “You’re so American” all contribute to the separation of Koreans and Americans. This idea of isolation from community as a Korean American in South Korea may seem paradoxical at first. However, unlike “proper” non-Korean foreigners, Korean Americans are often met with criticisms along the lines of “You’re Korean, so why can’t you…?”. As long as you look Korean or reveal that you are part Korean, there is a certain expectation that Korean people have of you even if you have never engaged with the culture for various reasons; meanwhile, our non-Korean foreigner counterparts are given praise by local Koreans for their smallest dip into Korean culture. Our hyphenated identities often create conflicts within ourselves regarding our sense of belonging and identity as Korean people. The mental health issues that people face in South Korea, just like anywhere else in the world, are embedded in culture and require a nuanced understanding in order to address. The South Korean government has been slowly but surely developing its response to mental illness in the past 20 years. The Mental Health Act of 1995 in South Korea and its subsequent revision in the 2016 Act on the Improvement of Mental Health and the Support for Welfare Services for Mental Patients (AMSW), are two of the most prominent government initiatives to promote the welfare of people suffering from mental illness. However, Dr. Ebesutani informed me that these Acts were created primarily to care for individuals with serious mental illnesses (SMI), such as those with schizophrenia, severe bipolar disorder and severe major depression who experience substantial impairment to their daily functioning.
Syllable
I asked my mother the Korean word for nectarine and she told me 천도복숭아, heavenly peach. And I recognized the angel there, though she wouldn’t have believed I knew her. I had heard her on the phone one room over, unripe and glorious like a child playacting stone fruit, head held between summer-bare knees acting out being eaten remaining whole. By Sarah Berg
Waygukin Gothic
Photo by La Toya Crittenden Mirror The grant year is going okay, you will say if anyone asks. The only thing is that the cool girls live in your building. These are the students you want to love, but whose withholding glares bring you slam-back to when you were fourteen and covered in acne and painfully out of place in your own body. Have teens always been this put-together, always this beautiful and seemingly unflustered? You duck your head as you see them in the mornings, walking to school arm-in-arm, their sneakers gleaming white, the keychains on their backpacks jangling almost tauntingly. During class, if they become distracted, you sometimes confiscate the makeup mirrors that sit on the corner of each desk. You hope that you do this because of your desire to better their education, and not because some small, irascible part of you resents them for doing a better cat-eye eyeliner than you ever could—at an age when you once wore fishnet gloves and purple skinny jeans, and straightened your greasy bangs to a crisp. Again, one of these students raises her eyebrows as you take her mirror and place it on your own desk. Very well. Let the teens be teens. It must be for their own good—you think, rather austerely, rather plaintively. The lesson goes otherwise smoothly. You reach the final stage of the class where they break into pairs for an independent activity. You take a seat at your desk, take a breath, congratulate yourself for another trainwreck-free thirty minutes. The students are hard at work and not likely to see, so you allow yourself a single glance into the confiscated makeup mirror. When you glance into the glassy surface, there is movement. Like a fish under dark water. Something is moving. You blink, but you haven’t imagined it—a shadowy figure stares back out at you, its eyes pale and mournful. It takes a second, but somehow, you know—it’s you—from another dimension, the other universe where you were acne-free by age fourteen and avoided a goth phase and made all the right friends and never developed the complex of someone living day-to-day, running from something maybe nonexistent, maybe self-created. “All the wrong choices you’ve made,” the figure groans. “I have helpfully outlined them for you in a decision tree.” The figure rifles around in its pockets, produces a folded note, and holds it up to the surface of the mirror. You hesitate, but when you touch the mirror, your hand sinks through the glass like it’s warm water. You want to ask the alternate-you—why now? Aren’t you now millions and millions of miles away from those wrong choices? Wasn’t that the point? You want to ask, but when you look in the mirror it’s your own reflection staring back. And the folded note, upon opening, is nothing more than a worn piece of blank paper. Daily News On the walk home to your apartment building, you decide to turn the news notifications off on your phone. You’re in a new country, after all, and it’s only right that you give 100% to this experience. You subscribe to The Korea Times but delete the rest, muttering the word “experience” over and over under your breath as the apps tremble with fear and disappear in a puff. This time of day, you always hope to see your favorite stray cat who sometimes stretches himself out in the yellowing grass in front of your apartment. “Hi baby,” you coo to him, crouching down and scratching him under the chin. He closes his eyes contentedly, raises his head. People pass by and give you confused, slightly disgusted glances. You stiffen. You understand your kinship with this stray marks you as even more strange and clueless, even more out of place. Your host mom has warned you about stray cats and disease and you know she’s right, but in this strange new state of again being someone’s child, someone who must learn from the very beginning of things like a newborn, you allow yourself some moments of childish rebellion. “You’re a good baby,” you tell him, because he is a good baby. You stroke the matted fur along the ridge of his spine, and then notice something strange—a piece of paper tied around the base of his tail. “What’s this?” you ask him. He lies still as you untie the string and unfold the piece of paper. It’s a headline, a notification. ARE YOU PAYING ATTENTION? 10 THINGS TO KNOW ABOUT THE CLIMATE SUMMIT. You look down at the cat. He gazes back unflinchingly, eyes round and ancient as the moon. Future Tense Your students are improving. You had reservations about how effective you would be, a first-time teacher with no worldly experience, but you’re proud of how well they (and by extension, you) are doing. Today, your lesson is on the language of dates and times. When it comes time for speaking practice, a supernatural quiet falls over the room as each student gets to her feet and stands beside her desk. In unison, in a deep and hellish voice that belongs to no thirteen-year-olds of this world, the class predicts in perfect English future tense the exact time and date you are to die. Fish Prince It’s one of those winter days where the sun is nearly set by 5pm. You stand on the steps of your school and watch it sink into the city spread out before you, an egg yolk breaking into the apartments and slope-roofed houses, convenience stores and government buildings, the port crowded with fishing boats and the sea beyond that. Today, you are walking towards the park next to the port when you hear a panicked voice, hoarse and distant: “Excuse me!” You freeze, turn around. Nothing appears out of the ordinary: a woman with her dog, a mother and father walking with their son between them, three old men sitting on a bench pouring each other paper cups of makgeolli.