Theodore Jun Yoo's It's Madness: The Politics of Mental Health in Colonial Korea begins with alarming statistics. While South Korea boasts an enviable developmental trajectory to join the Organisation for Economic Co-operation and Development, the club of the world's wealthiest nations, it has the highest suicide rate among them. Some attribute these stark numbers to the extreme, high-stress environment of South Korea, with intense pressure to attain a narrow definition of success, exacerbated by a decreasing social safety net.
It's Madness illuminates a syncretic history of mental illness in Korea. It is a complex story in which age-old practices co-existed with modern science and medical technologies, throughout an era of tumultuous entry into modernity as a colony. This pioneering study reveals the period of Japanese colonization of Korea (1910–45) as a crucial moment of how mental health came to be categorized, treated, managed, and understood in Korea. It's Madness glimpses the little-examined transnational history of mental health in colonial modern Korea in its encounter with internal and external practices and their legacies.
Following the likes of Michel Foucault, Karen Nakamura, and Yi Bu-yeong, Yoo stresses being mindful of “the cultural specificity of psychiatric categories.” What was considered “normal” was challenged and changed drastically at various transitional moments. Varied responses from divergent sectors reveal a society struggling to adapt to old and new ways of managing behaviors deemed “unusual, frightening, or bizarre” (pp. 9–10).
Chapter 1, “Forms of Madness,” offers a cross-section of coexisting temporalities of how “madness” or “mental disturbance” was understood or represented from neo-Confucian dynastic annals to the governmentality of a modern colonial apparatus. It traces competing orders from shamanism and other localized beliefs, to adaptations of Chinese medicine, to inventions in Korean traditional medicine, at the cusp of the entry of missionaries and Western medicine with the rise of Japanese colonial rule. Shamanism is an illuminating case in that descriptions must be culled from extant sources that were extremely biased against such practices of the common people, such as the records of neo-Confucian elites, Japanese colonial ethnographers, Western missionaries, and medical establishments. Despite predominantly derogatory representations in the written records about allegedly primitive cultural practices of Korean commoners, especially women, Yoo suggests that these rituals offered relief to the oppressed.
Chapter 2, “Madness Is…,” offers insights into the rise of modern psychiatry as an institution. Here, too, we see cultural clashes among multiple competing actors, whose records reveal biases and accomplishments on the road to the institutionalization of psychiatry. Gleaning various sources (e.g., hospital statistics, missionary field reports, Government-General annual reports, literary texts, and sensational newspaper reportage), we glimpse a society in flux. According to one daily, it appeared that madness, “once the domain of the philosopher, had become the domain of scientists, who were now engaged in numerous treatment experiments” (p. 57), with many mentally ill becoming incarcerated.
Sensational stories tapped people's curiosity and trepidation toward emerging institutions, such as the first Western-style psychiatric facility. The facility was established by the colonial government and housed within the stone structures of the Government-General building, and reports likened its intimidating barred windows to “a zoo or a prison.” Yoo observes that two competing models became influential in the genealogy of psychiatric institutions: Western missionary doctors, who arrived in the country in the 1880s, and Japanese authorities, who arrived after 1876, initially to treat the Japanese military stationed there. By the 1920s, each school of thought had established its own brand of psychiatric institutions with differing treatments for the mentally afflicted.
A missionary doctor, for example, combined Christianity-based healing practices with science. Western missionaries' claims to have ousted “primitive” shamanistic practices often downplayed their own turn to exorcism rituals in their healing practices, as Sung Deok Oak noted. State-sponsored Japanese doctors implemented the German model, focusing instead on a “biological approach” of lab-based treatments of the “diseased brain.” Yoo notes a trend away from a patient-centered approach toward a focus on research and experimentation-centered approaches: “Over time, the humane approach disappeared completely, replaced by the relentless research agendas of faculty and staff” (p. 71). This chapter also documents the proximity between institutions of medicine and criminology. It further describes discriminatory practices in colonial education that segregated training for Japanese and Korean medical students, engendering differences in the quality and quantity of Korean doctors of psychiatry.
Chapter 3, “A Touch of Madness: The Cultural Politics of Emotion,” builds on scholarship on emotion and culture to examine Korea's “emotional regime,” its “conflicting emotional ideals, norms, and rituals.” Yoo notes that “Korean emotional constructs such as jeong (affective bonds), shame and chemyeon (social face), nunchi (the subtle art of gauging another's mood), and han (intense suppressed anger)” are rooted in Korean culture, but were transformed by neo-Confucianization during the Chosŏn dynasty that imposed stricter social hierarchies. Further transformations in Korea's “emotional regime” came with new understandings about the individual's place in society, accompanied by the simultaneous industrialization and urbanization of the Korean landscape with the rise of modern bourgeois culture, all under Japanese colonial subjection (p. 78).
Chapter 4, “Madness as a Social Epidemic,” explores modern medical discourses around mental illness and its links to criminology. Diagnostic advancements in the scientific and governmental realms galvanized the medical community, law enforcement, and the press to label, quarantine, and police mental ailments as a growing social concern (p. 111). Similarly, new discourses on mental illness revealed alarmist social prejudices and stigmatization in new ways through sensationalized coverage. Suicide was also seen as a growing social epidemic at this time.
The conclusion, “A Method to the Madness,” recaps broader themes. The chapter analyzes how a gruesome mystery behind the discovery of a decapitated corpse was reported through contending and converging discourses in medicine, criminology, and the media. This perplexing case illustrates how a modern colonial society struggled to understand changing social symptoms and norms.
It's Madness is a timely study of a neglected topic in Korean, comparative East Asian, and trans-Pacific histories. Acknowledging methodological challenges of limited and scattered archival resources, one hopes that this study paves the way for further studies that explore this fascinating and little-understood topic. This book is important reading for East Asian histories, the history of science and medicine, transnational histories of Christian missionaries, and comparative postcolonial and empire studies.
