User:JCChavers/practice

Definition
Shin-byung( 신병 ) the culture-bound syndrome is a Korean folklore representative of the process of a shamanic initiation.

Symptoms
Development of shin-byung begins with a sudden onset of physical discomforts (general weakness, dizziness, fear, loss of appetite, insomnia, and gastrointestinal problems). An altered state of consciousness experienced reflects the disassociation phase ultimately allowing the ancestral spirit (shin) possession (byung) for those called to serve. The phenomenon of the occurrence of individual spirit possession is not locally seen as pathological but as divine.Shin-byung is believed to include three shamanic initiation phases. During the first phase, the individual experiences anxiety and body aches. These symptoms can last from a few weeks to years. The second phase, also known as the trance phase, is when dissociation presents. The individual experiences nightmares and hallucinations during which spirits attempt to enter the body. The experiences during this stage are often very disturbing and may cause the individual to seek help. During the final phase, Possession of the individual occurs resulting in a display of multiple personalities. This phase continues until the spirit's personality dominates the individual's consciousness and behaviors. The final phase of co-existence is said to be inevitable or fatal.

Three predominant phases of shamanic initiation

 * 1.Body aches and anxiety develop


 * 2.Experience of trance and dissociation


 * 3.Final possession phase occurs with onset of multiple personalities

Korean
A polytheistic form of animism (shamanism), which involves finding a spiritual presence in everything living and nonliving is thought to control people's lives. The value system in a Koreans culture historically emphasizes the family and group harmony confucianism more than that of the individual. Indigenous world views of shamanism has been passed down from ancestors for some 2000 years. Shin-byung symptoms were caused by haan-laden are believed to be dead ancestors in pursuit of possession and ultimately consciousness control. Once patient has recognized Shin-byung, accepted, and metaphysically been resurrected; a cure of said shin-byung symptoms occurs.

Western
Shin-byung is considered aculture-bound syndrome in the DSM IVbecause it is almost specifically recognized in one culture. The particular symptoms, course, and social response to the "illness" are very often influenced by factors associated within the Korean culture. Western medicine is commonly based on research, scientific evidence and discoveries. Beliefs and understanding about culture bound syndromes like shin-byung varies but current research supported by DSM IV revisions improves communication and care. Strategies for cure improve with awareness of cultural and diversity.

Physicians have recognized similarities in shin-byung with that of patients suffering from schizophrenia, depression, and dissociation personality disorder.

Assessment
In the primary care setting of Western physicians, both diagnosis and recognition of mental illness within Asian culture are difficult. Although health practices of the Korean culture commonly includes rituals of a shamanic practitioner for  patient, clarity of such from psychosis or various culture bounds syndrome require distinction for treatment. Haan is a Korean word describing accumulated and unresolved feelings of resentment, anger, and grief over experiences of victimization or oppression. Prevalence among Korean culture is the frequency of presenting with somatic complaints subsequent to repression. The Cultural Formulation aids in cultural identity of patient experiencing shin-byung; culture-bound syndrome. Health practices of the Korean culture commonly includes a collaboration of a shamanic practitioner to treat psychosis.

]]

Case Study
Anna, a 27 year old single Korean female presents with multiple afflictions including history of physical, emotional, and sexual abuse. For Anna there was an underlying foundation of anxiety and other various complications including depression and suicide having grown up in a dysfunctional family environment. She was initially disturbed by back complaints followed by vivid disturbing dreams. Anna was at a glamorous, colorful dance, where she suddenly found herself surrounded by dead people in one dream. In another, she was falling forever into the earth and was accosted by a guardian of the underworld offering help. The most disturbing was a series of recurrent dreams in which Anna was told by a strange old woman to be her disciple. Anna would awaken from these dreams feeling as if “someone was strangling me.” She had difficulty breathing, and felt that some kind of ki (energy or spirit) had entered her body. Anna could not tell where this ki came from or whose it was, only that it belonged to someone else. Anna and her sister met with a Shaman to initiate a goot process and Anna decided to comply with her ancestors summoning to participate in ritual shamanic process.