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ISSN : 2233-6710(Print)
ISSN : 2384-2121(Online)
Journal of Asia Pacific Counseling Vol.1 No.2 pp.123-137

Culturally Competent Counseling for Culture-Bound Syndrome of Hwa-byung: A Case Study of a Korean American Woman

Caleb Kim, Kyung-Mee Choi

Loyola University Chicago
University of St. Francis
Received May 1, 2011, Revision received July 17, 2011, Accepted July 26, 2011


Hwa-byung, literally “anger illness,” is recognized as a Korean culture-bound syndrome listed in the DSM-IV. Often times,hwa-byung occurs in middle-aged Korean women in response to repressed, life-long, multi-layered emotions, namely han.Hwa-byung and han are also prevalent in Korean American women because of acculturation difficulties, clashing genderroles, and racial discrimination while living in the U.S. As a consequence, Korean women with hwa-byung exhibit one ormore psycho-behavioral-somatic symptoms such as anxiety, depression, and/or headaches. However, there are few studiesof Korean American women’s hwa-byung and its treatment process in counseling practice. Illustrating the case of a KoreanAmerican woman, this study demonstrates how this individual develops and exhibits the hwa-byung syndrome anddisentangles her repressed multi-layered emotions through hanpuri, which is a traditional healing process in Korea. Fromthis case illustration, counselors may gain insight into culturally competent counseling practices with reference to Koreancultural values.