• Journal of Hospice and Palliative Care
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• v.8 no.2
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• pp.143-151
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• 2005

Purpose: Bereavement Memorial Service has been held every year by the hospice team at St. Vincent's Hospital for the purpose of supporting the bereaved family who feel grief and mourning. The purpose of this study is to find out the attitude of the bereaved attending at bereavement memorial service (BMS) and to find out the areas needing improvements to set up better memorial service. Methods: Hospice team sent invitation card to 180 families of patients who admitted and passed away at hospice ward Nov., 2003${\sim}$Oct., 2004. Among them 22 families attended the BMS meeting, which was held on 26th Nov., 2004. The researcher collected data from 22 families with 'Questionnaire' survey. Except identifying data and 2 dichotomy questions, we used open-ended questionnaire. 1 researcher conducted a telephone interview survey in 18 families who couldn't attend at BMS meeting. Results: The median age was 56 (range $16{\sim}19$) and there were 37 females and 3 males. They were patient's wife (22), mother (4), husband (5), daughter (4), mother-in-law (1), siblings (1), brothers wife (1). Duration after bereavement, $1{\sim}3$ months (17) was the highest frequency. 36 families agreed 'the dead experienced the death with dignity'. The reason of agreement to the death with dignity was 'the patient died in preparation' (16). 'the patient died in well-being condition spiritually' (9), 'the patient died in comfort physically (7). 4. persons thought the dead died with indignity. The bereaved defined 'the death with dignity' as follows: 'acceptance of death & death in spiritual well-being' (9), 'death in physical comfort condition' (7), 'the death in psycho-social well-being' (3), non-respondents (10). Most families (21) were still in difficulty to overcome bereavement grief. The answer regarding the method to overcome the difficulty was 'with spiritual sublimation' (13), 'with devotion of oneself in daily life' (10), 'with devotion to mourning as it is' (3). With regard to their attitude to invitation, 'having joy and thanks from hospice team' (21), 'grief' (4), 'suffering' (4). Toward the existence of hesitation about attendance at BMS meeting, the result as follows. Nonexistence of hesitation respondent (34), existence respondent (6), the reason for hesitation was various; 'the meeting reminds me of the suffering times', 'the meeting makes me to recall, and it will be likely to cry', and so on. The needs and feelings to memorial service meeting were various; 'it was meaningful time', 'it was good to recall about the dead', 'more meeting annually' and so on. In respect of the most difficulty after bereavement, in attendant family, 'depression' (10) was the highest frequency, whereas, in non-attendant family, the most difficult thing was 'financial problem/role difficulty (6). Conclusion: This study shows the rate of attendance was high in bereaved whose bereavement duration $1{\sim}3$ month. Most of bereaved were still suffering from bereavement grief within 1 year. Although most families didn't hesitate and felt positive mood to invitation, the rate of attendance was low. Comparing with two groups between attendant family and non-attendant, the latter felt more difficulty in 'financial problem/role difficulty, on the other hand, the former felt difficulty in 'depression'. Hereafter, the additional study about the factor relating to these attitude and needs of the bereaved relating to memorial service will be necessary.

• Sim-seong Yeon-gu
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• v.38 no.1
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• pp.1-44
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• 2023

Hexagram Bi (比 ䷇ 8) is one of the hexagrams comprised of one-unbroken line and five-broken lines. The hexagrams of one-unbroken and five-broken lines symbolize the relationship and dynamics between one yang-consciousness and the five-yin unconsciousness. The hexagram of one-unbroken line and five-broken lines has six different images depending on the position of the one unbroken line from the beginning line to the top line. In terms of psychology, this means that the position change of one yang line in relation to five yin lines may symbolize the function of consciousness which clarifies and determines the content of the psyche. In addition, the flow of psychic energy can be examined through the process of one unbroken line's movement. In other words, the psychic contents of the beginning line of hexagram Bok (復 ䷗ 24), which is the beginning of the hexagram of one-unbroken line and five-broken lines, proceed sequentially, and then arrive at the process of the last sixth, hexagram Bak (剝 ䷖ 23) through the fifth, the hexagram Bi (8). That is, it can be said that the content of the hexagram and the line determined according to the position of one unbroken line show a certain psychic flow. As a result, the first hexagram Bok (復 ䷗ 24), after recovering and starting newly, means the beginning of consciousness. After that the process of proceeding with the second, third, and fourth lines represents the flow of consciousness. And in the fifth place, the fifth line of hexagram Bi, it reaches its peak and is placed in the optimal state of consciousness because of its right and centered position at this hexagram Bi. Like nature, the psyche gradually enters the path of decline from the highest state, which leads to the last sixth, the top line of hexagram Bak. However, the top line of the hexagram Bak, where everything falls off, contains the content of starting again in its top line. It is the beginning line of hexagram Bok to inherit this. This means the circumambulation of the psyche that changes from a psychologically difficult state of depression to a stage of recovery. There is a stage that must be passed in this circulation process, and that is the hexagram Gon (坤 ䷁ 2). October(tenth month)'s hexagram Gon is placed between hexagram Bak, the ninth month of the lunar calendar, and hexagram Bok, the eleventh month of the lunar calendar. This represents that the flow of recovery must go through a maternal process of hexagram Gon. The retreat to the psychological uterus is inevitable in regenerating the psyche. This process flows from the hexagram Bak and through hexagram Gon to the hexagram Bok. At this situation the hexagram Gon acts the absolutely necessary role. In addition, the main body of the hexagrams of one-unbroken and five-broken lines, including the Bi hexagram, is also the Gon hexagram composed of six-broken lines. In other words, all six hexagrams of one-unbroken and five-broken lines have a certain relationship with the Gon hexagram, and it would be meaningful to look at the correlation between the unbroken lines of the hexagrams of one-unbroken and five-broken lines and the corresponding broken lines of the hexagram Gon. This can be said to be the dynamics of the maternal unconscious connected to the state of consciousness in six forms. Therefore, each hexagram of one-unbroken and five-broken lines symbolizes the expression of the integration the mother archetype with the consciousness. Revealing this well is the meaning of the hexagram of one-unbroken and five-broken lines. Its hexagram image consists of a combination of Gon (☷), which symbolizes the mother, and the thunder (☳) the eldest son, the water (☵) the middle son and the mountain (☶) the third son. As a result, the hexagram Bok (復 ䷗ 24), Sa (師 ䷆ 7), Gyeom (謙 ䷠ 15), Ye (豫 ䷏ 16), Bi (比 ䷇ 8) and Bak (剝 ䷖ 23) are sequentially created in the order of the unbroken line. This is symbolically the evolutionary process of consciousness. In this way, the hexagrams of one-unbroken and five-broken lines, which mean the conjunction of mother and son, represent the advancing relationship between the maternal unconscious and consciousness. In addition, the relationship with the mother according to the position of the son is related to the dynamics of mother archetype to the attitude of consciousness. The psychological meaning can be deduced from the flow of six lines of hexagrams of one-unbroken and five-broken lines. And the state in which the activation of the consciousness is at its peak is the fifth line of the hexagram Bi, and comparing it with the contents of the corresponding fifth line of hexagram Gon not only can find the state and meaning of the conjunction of consciousness and the maternal unconscious, but the entire flow can be compared to the individuation process.

• Journal of Yeungnam Medical Science
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• v.5 no.2
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• pp.141-150
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• 1988

The authors studied the mental health status of the 1989 freshmen of Yeungnam University using the psychotic scale of Derogatis SCL-90, Zung anxiety and depression scale and MMPI from January 1988 to February 1988. The subjects of this study were contained 3792 students(l206 female, 2586 male). 392 students(10.3%), out of all respondents were screened to fall on high score ranges. The authors performed a second test to 156(39.8% 47 female(30.1%), 109 male(69.9%)) of the high-scored in oder to clarify their mental health status and analyze various psychosocial factors; using MMPI. The MMPI results were categorized with Lachar's classification. The results were as follows. : 1. By the MMPI scores, 24 respondents(15.4%) had neurotic trends, 20(12.8%) had psychotic trends and 7(4.5%) had trends of behavior disorder. It was about 1.4% of all 3792 freshmen. 2. On the close examination of the MMPI, 8 respondents were diagnosed for affect disorder, 6 for anxiety disorder, 9 for schizophrenia and 3 for personality disorder. It was 0.7% of all freshmen. 3. On the analysis of the psychosocial factors, the schizophrenic scores were high in the case of unsatisfy infamily atmosphere, unsatisfy in marital intimacy of parents, serious in conflicts between father and I, and serious in conflicts between mother and I. 4. The hypochondriacal scores were high in the case of weak in physical condition, having hospitalization experience and physical illness.

• Journal of Oriental Neuropsychiatry
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• v.21 no.4
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• pp.219-231
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• 2010

Objectives : School refusal is usually considered as individual's behavioral problem. These days. however. the adolescents' school refusal needs some kind of medical approaches because it is related to mental disorder of the adolescents. Due to too much pressure and stress from the competition between classmates and from good performance in school. the number of adolescents who refuse to go to school is increasing. Despite this circumstance. school refusal is neither regarded as a single independent disorder nor endorsed as an officially classified disease. which makes difficult to conduct research on this issue and to establish standardized treatment for it. In addition. there is a lack of research on this topic. especially in oriental medicine. so there is no a case report or study on school refusal. This study is trying to comment on school refusal from the perspective of oriental medicine. Methods : We tried to examine the effect of oriental medicine treatment for school refusal with four adolescent cases. The patients commonly have at least more than one mental disorder (including depression disorder. anxiety disorder. and anorexia nervosa). have some problem with the relationship with their family. in particular with mother. do not have father or not be loved by their father. and have irregular eating habits. Thus. we diagnosed them as qi transforming into fire (氣鬱化矢) spleen-stomach deficiency cold (脾胃虛寒) and heart blood deficiency (心血虛) due to stress from the family issues and unhealthy eating habits. The patients received supportive therapy. family therapy. etc among many oriental mental treatments and their progress had been observed through hospitalization and outpatient treatment. Results : All four cases were reported positive progress on their symptoms and started coming back to school. We also examined whether they were well fitting into the school while they received outpatient treatment. and the results show that all four patients continue to settle down in normal school life. Conclusions : This study closely reviewed the mental disorder of school refusal cases and showed that the Oriental medical treatment was effective in helping the patients come back to school. More future research is required to better treatment for school refusal cases in oriental medicine.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.10 no.2
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• pp.145-157
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• 1999

This study was performed by the children and adolescents who were abused or neglected physically, emotionally that were selected in child & adolescents psychiatric ward. We investigated the number of these case in admitted children & adolescents, and also observed characteristics of symptoms, developmental history, characteristics of abuse style, characteristics of abusers, family dynamics and psychopathology. We hypothesized that all kinds of abuse will influnced to emotional, behavioral problems, developmental courses on victims, interactive effects on family dynamics and psychopathology. That subjects were 22 persons of victims who be determined by clinical observation and clinical note. The results of the study were as follows：1) Demographic characteristics of victims：ratio of sex was 1：6.3(male：female), mean age was $11.1{\pm}2.5$. According to birth order, lst was 12(54.5%), 2nd was 5(23%), 3rd was 2(9%) and only child was 3(13.5%). 2) Characteristics of family：According to socioeconomic status, middle to high class was 3(13.5%), middle one was 9(41.% ), middle to low one was 9(41%), low one was 1(0.5%). according to number of family, under the 3 person was 3(13.5%), 4-5 was 17(77.5%), 6-7 was 2(9%). according to marital status of parents, divorce or seperation were 5(23%), remarriage 2(9%), severe marital discord was 19(86.5%). In father, antisocial behavior was 7(32%), alcohol dependence was 10(45.5%). In mother, alcohol abuse was 5(23%), depression was 17(77.3%), history of psychiatric management was 6(27%). 3) Characteristics of abuse：Physical abuse was 18(81.8%), physical and emotional abuse and neglect were 4(18.2%). according to onset of abuse, before 3 years was 15(54.5%), 3-6 years was 5(27.5%), schooler was 1(15%). Only father offender was 2(19%), only mother offender was 8(35.4%), both offender was 8(35.4%), accompaning with spouse abuse was 7(27%), and accompaning with other sibling abuse was 4(18.2%). 4) General characteristics and developmental history of victims：Unwanted baby was 12(54.5%), developmental delay before abuse was9(41%), comorbid developmental disorder was 15(68%). there were 6(27.5%) who didn‘t show definite sign of developmental delay before abuse. 5) Main diagnosis and comorbid diagnosis：According to main diagnosis, conduct disorder 6(27.3%), borderline child 5(23%), depression4(18%), attention deficit hyperactivity disorder(ADHD) 4(18%), pervasive developmental disorder not otherwise specified 2(9%), selective mutism 1(5%). According to comorbid diagnosis, ADHD, borderline intelligence, mental retardation, learning disorder, developmental language disorder, oppositional defiant disorder, chronic tic disorder, functional enuresis and encoporesis, anxiety disorder, dissociative disorder, personality disorder due to medical condition. 5) Course of treatment：A mean duration of admission was $2.4{\pm}1.5$ months. 11(15%) showed improvement of symtoms, however 11(50%) was not changed of symtoms.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.6 no.1
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• pp.74-89
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• 1995

Selective mutism is a childhood condition defined by persisten failure to speak in specific social situation when speaking is expected, dispite preserved ability to comprehend spoken language and speak. Present study is to investigate clinical characteristics, treatment method and outcome of 23 children who were diagnosed as selective mutism by DSM-IV criteria at the child psychiatry ouptatient department of SNUH. The results were as follows : 1) The Sex ratio was 1: 4.8, female dominant Mear age of onset was 33 years old and mean age of first referral was 7.7 years old. 2) 22% of subjects had perinatal problem such as low birth weight, preterm birth, 26% of the subjects have history of delayed language development. There are subjects who had been separated with mam caretaker before 3 years old(26%) and who experienced physical or psychological trauma before 3 years old(26%). A few subjects had enurests(30%) and encoprests(4%). 3) Many subjects(65%) had symbiotic relationship with their mother. These families consist of dominant, verbally aggressive mother and passive father. Parents of 39% of all subjects were judged to have definite psychopathology(social phobic, depression, hysterical trait or alcohol problem) 26% of all subject, were reported physically abused. 4) The personality trait of the subjects were frequently described as follows(in order of frequency) ; Shy(100%), anxious(83%), stubborn(83%)m rigid and tense posture(78%), immature(65%) overdependent(65%), irritable(52%), manipulative(39%), depressive(39%). 5) The mean performance IQ of 16 subjects by KEDI-WISC was 88.3 Among them, the subjects with IQ below 69 were seven and those with IQ above 70 were nine. When comparing these two group(Mental retardation group vs Normal IQ group), we could find some difference in language development, personality trait, family dynamics and treatment outcome. 6) Among several treatment methods for selective mutism, play therapy was the most frequently used method(65%). Other commonly used treatment methods were pharmacotherapy(21%), behavioral therapy(8%), combined therapy(play therapy+pharmacotherapy+family therapy+behavioral therapy)(12%), 7) Regarding the outcome of treatment 8.6% was evaluated as Excellent, 30.4% as Good, 52% as Fair, 8.7% as Poor at the tinic of treatment. At follow up interview 21.7% was evaluated Excellent, 13% as Good, 21.7% as Fair, 34.8% as Poor. 8) We classified all subjects by Havden's 4 subtype. Symbiotic mutism was most common(65%) and other subtypes are Speech phobic mutism(8.6), Reactive mutism(13%) and Passive-aggressive mutism(30%).