Korean Women do not Suffer from Addictions… Or do they?

Korean Women do not Suffer from Addictions… Or do they?

I am a recovered alcohol user. After battling a severe, decades-long addiction that had me visiting therapists, doctors, and treatment centers throughout Toronto, I came to a startling realization…  There were no Korean women in therapy for addictions.  I was the only one. It was almost as if they do not exist in the world of substance use or addictions. Are Korean women impervious or super-resilient to stress? Do they not suffer from mental health or addictions concerns? Or is something else going on? An examination of Korean societal values, immigration factors, and gender-based variables can provide insight into this phenomenon.

Unsplash

Korean Society

South Korean culture is permeated with the portrayal of respect, patriarchy, and filial piety. The visual representation of members of society are paramount, where any individual suffering or distraction from positive depictions of oneself are to remain hidden. McCurry (2019) stated that Koreans view individuals with mental health concerns as “failures of moral character”. Psychological problems are viewed as shameful personality flaws that must be repressed or resolved internally (Lee et al., 2014). Thus in South Korea, the internalization of stressors has become the accepted norm and the sharing of mental health concerns is avoided.

Korean society is highly permissive of public drinking behaviours such as binge-drinking and visible drunkenness. Business meetings, family functions and even ancestor worship ceremonies involve alcohol. Pouring-for-each-other and pouring-for-elders’ traditions reinforce the ritualized nature and importance of sharing alcohol with others. Korean society’s endorsement of alcohol-drinking behaviour combined with the concealing of mental health concerns interact to exacerbate potential addiction concerns.

Immigration

Korean immigrants are likely to undergo stress and life-changing events that can compound existing mental health issues, such as language barriers, isolation, trauma over leaving their homeland, etc. They may not be aware of available treatment options and may not wish to divulge their concerns to others, particularly with non-Korean speaking therapists.  These factors combine with the stigma of seeking help for mental health concerns and interact to limit access to healthcare. Immigrant women arrive in Canada with embedded patriarchal values where they are expected to value the well-being of their husbands and children above their own desires, despite migration out of South Korea (Choi et al., 2014).  Moreover, it has been found that Korean immigrant women experience greater difficulties with acculturation than Korean men (Kim & Chen, 2011), which unfortunately can compound existing stress and lead to addictive behaviours.

Gender variations have been identified in the risk factors for alcohol use (Lee & Chung, 2020), the experiences of stigma associated with addiction (Becker, 2016), and trajectories for recovery (Abreu Minero et al., 2022).  A study by Kim (2009) asked Korean Canadian immigrants their reasons for engaging in alcohol use, and found that the men touted an important connection between socializing and alcohol consumption. Korean immigrant women also imbibed at social functions, but additionally engaged in alone at-home drinking to ease emotional and psychological concerns (Kim, 2009). Emotion-coping drinking practices were further exacerbated by women’s English-language proficiency, length of residence, immigration-related stressors, and alcohol consumption by male partners (Lee, 2022).

Although clinical research has typically focused on the male gender, efforts to address gender disparities have brought much-welcomed insights. Studies have found that females in recovery benefit from treatment programs geared towards mental health and relationships, while males have benefited from focusing on interactions between addiction(s) and physical health (Abreu Minero et al., 2022).  Niv & Hser (2007) found positive results for treatment use as well as addiction outcomes in all-female groups when compared with mixed-gender groups. Moreover, a study by Lee et al. (2022) in South Korea found that women attending a day treatment program for alcohol use disorder scored significantly higher in continuous abstinence rates (78.9%) after treatment than control groups (9.5%), which is an indication that gender-oriented alcohol treatment programs can be both positive and effective interventions.

Conclusion

As one who has gone through the long process of alcohol recovery, including many attempts, failures, loss of friends, missing work, stigma and shame, it is difficult to quantify the effects of these unintended consequences of addiction. What initiates as light-hearted social drinking or stress release can develop into unplanned dependency, as biological neural receptors readjust and configure to require more alcohol in order to maintain their current state.  Stigma can be severely shocking and hurtful, as previous friends and family members’ initial concerns turn to accusations and apparent hatred. Stigmatization may be a contributing factor to South Korea ranking first in the world for suicide for the past two years (Kim, 2022). Therefore, attention to mental health and addictions must not be ignored despite rapid gains in South Korean popularity, food, and music.  Repressed internalization of problems should not be promoted and can be extremely detrimental. Koreans DO suffer from mental health concerns, and Korean women ARE affected by addictions. Culturally-sensitive and gender-configured approaches are warranted in order to treat mental health concerns and addictions, and improve the quality of life for all Korean-Canadians.

References

Abreu Minero, V., Best, D., Brown, L., Patton, D., & Vanderplasschen, W. (2022). Differences in

addiction and recovery gains according to gender - gender barriers and specific

differences in overall strengths growth. Substance Abuse Treatment, Prevention, and

Policy: 17(1):21. doi: 10.1186/s13011-022-00444-8

Becker J. B. (2016). Sex differences in addiction. Dialogues in Clinical Neuroscience, 18(4),

395-402. https://doi.org/10.31887/DCNS.2016.18.4/jbecker

Choi, J., Kushner, K.E., Mill, J. & Lai, D. (2014). The Experience of Korean immigrant women

adjusting to Canadian society. Journal of Cross Cultural Gerontology, 29, 277-297.

https://doi.org/10.1007/s10823-014-9235-8

Kim, S. (2022, September 26). Korea's suicide rate rises, remains the highest in the world.

https://www.bloomberg.com/news/articles/2022-09-27/korea-s-suicide-rate-rises-remains-highest-in-developed-world?leadSource=uverify%20wall

Kim, W. (2009). Drinking culture of elderly Korean immigrants in Canada: A focus group

study. Journal of Cross-Cultural Gerontology, 24(4), 339-353.

https://doi.org/10.1007/s10823-009-9104-z

Lee, E. (2022). Factors predicting the use of different coping strategies among Korean immigrant

women in the United States. International Journal of Intercultural Relations, 88, 57-65. https://doi.org/10.1016/j.ijintrel.2022.03.006

Lee, S.Y. & Chung, J. (2020).  Risk factors of binge drinking in adults across gender and age

groups.  Journal of Addictions Nursing, 31:4, E27-E37.

Lee, I., Lee, M., & Choi, S. S. (2022). Therapeutic community-oriented day treatment program for

Korean women with alcohol use disorder: a non-randomized pilot feasibility trial. Addiction

Science & Clinical Practice, 17(1), 14. https://doi.org/10.1186/s13722-022-00297-3

Lee, J., Wachholtz, A., & Choi, K. H. (2014). A Review of the Korean cultural syndrome

hwa-byung: Suggestions for theory and intervention. Asia T'aep'yongyang Sangdam

Yon'gu, 4(1), 49. ttps://doi.org/10.18401/2014.4.1.4

McCurry, J. (2019, December 2). Deaths of K-pop stars put focus on mental health taboos in

South Korea. The Guardian (online).

https://www.theguardian.com/world/2019/dec/02/deaths-of-k-pop-stars-put-focus-on-mental-health-taboos-in-south-korea

Niv, N., & Hser, Y.-I. (2007). Women-only and mixed-gender drug abuse treatment programs: Service needs, utilization and outcomes. Drug and Alcohol Dependence, 87(2), 194–201.