한국인의 정신치료유형 및 ASC상태에 관한 사회심리학적 고찰

Abstract

[한글]

現代醫學은 주로 自然科學的 方面으로 發展해온 나머지 人間의 精神的 側面을 疎忽히 해왔다고 할 수 있다. 豫防醫學敎室의 한 프로젝트에서 著者가 接見한 農村住民들이 Illness Behavior는 일반적인 病院利用度와 다른 樣相을 나타냈었다. 人間의 理性的 思考로서

他人의 行動 및 社會現象이 明確하게 理解되지 않는 境遇, 非科學的이라는 斷點을 내리는 傾向이 있는데, 非合理的으로 보이는 社會現象일지라도 그러한 現象을 惹起시키는 力動(dynamics)을 찾아 봐야 된다는 생각을 여러 學者들이 披瀝해왔다.

本硏究는 精神疾患 患者 및 呪術者의 意識狀態를 疾病의 範疇로서의 文脈은 물론, 最近 心理學에서 頭되고 있는 人間意識의 한 paradigm (Kuhn, 1970)으로서의 ASC(Altered States of Consciousness) 現象을 精神治療 類型에 따라 考察하고자 한다.

硏究方法으로는 文獻考察, 僞裝入院을 통한 參與觀察 및 자유로운 面接形式을 竝行했다. 僞裝入院은 虛無妄想, 實存的 不安 및 生의 無意味를 呼訴하여, A病院은 躁鬱病, B病院은 精神分裂症 妄想形으로 診斷을 받아 入院 되었고, 退院은 두 病院 전부 自退(self-discharge)를 하였다.

硏究對象 機關으로 서울, 京畿道 및 忠淸道에 位置한 敎育病院 精神科 2개소와 일반 精神病院 1개소, 民間 精神療法機關 6개소를 選擇하여 關係者 및 患者들과의 자유로운 面談 및 그들의 心理機 , 態度 및 行動을 參與 觀察하였다.

分析方法은 社會福祉機關 關係者 8人, 7人의 shaman, 新興敎主 5人, 多數의 精神科 患者와의 面談 및 參與觀察을 통해 募集된 기존의 理論과를 比較 考察하였다.

精神病院 特徵은 繼續的 構造(hierachial structure)로서 精神科 要員은 否定的 態度(negative attitude)를 보여 주었고, 藥物療法으로 ASC經驗을 抑制하는 精神病院에서 患者들의 ASC狀態의 區別은 民間療法에서 보다 容易하지 않았다. 民間療法의 調査結果는, 巫

俗治療의 機制를 逃避와 投射로 보고 있는데, 著者가 參觀한 각종굿, 信仰療法을 綜合해본 바에 의하면 個人에게 미치는 結果(individual consequences)에 따라 解放과 洞察의 機制로 볼 수 있었다.

[영문]

There is a lot of psychotherapeutic virtues in shaman's rituals in Korea. The author tried to compare the shamanistic state of consciousness in terms of mechanism, psychodynamism & their cultural connotation regarding Korean personality with patient's Altered State of Consciousness in Psychiatric hospital. A comprehension of ASC states offers a much wider view the range of human potentialities and the vast wealth of unexplored inner experiences. The aim of this study is as follows.

1. To compare the result of Rosenhan's psychiatric experiment in U.S.A. with that of author's in Korea.

2. To compare the patient's ASC state in psychiatric hospital with folk psychiatry.

3. To evaluate the mechanism & the psychodynamism of shamanism in Korea.

Materials used in this study were collected from the field survey by way of participant-observation & free interview with the shamans, faith healers, both patients in mental hospitals & folk psychiatry.

The pseudopatient, an author who employed pseudonym was in medical profession alleged another occupation in order to avoid the special attentions that might be accorded by staff, as a matter of courtesy or caution, to ailing collegues. In order to generalized the findings, admission into a variety of hospitals was sought. The three hospitals in the sample were located in Seoul and Kyongi Province. Two were research-oriented, others not. Two had good staff-patient ratios, others were quite understaffed. Only one was a strictly private hospital.

The pseudopatient arrived at the outpatient department of Neuro Psychiatry complaining that she had been hearing voices, asked what the voices said. She replied that they were often unclear, but as for as she would tell they said "empty", "hollow", and "panic." The choice of these symptoms was occasioned by their apparent similarity to existential symptoms that was asserted ontological insecurity by R.D. Laing, ennui, malaise & mal de siecle by Erich Fromm, and meaninglessness of man's life by Viktor E Frankl. Such symtoms are alleged to arise from painful concerns about the perceived meaninglessness of one's life.

Immediately upon admission to the psychiatric ward, the pseudopatient ceased simulating any symptoms of abnormality. The author have observed the attitude of mental profession & patient's ASC state in psychiatric hospital. Also the author

hold an interview with professional shamans, family shamans & faith healers of new religion.

The results & conclusions obtained from the experiment were as follows.

1. There is no difference in the result of Rosenhan's psychiatric hospital experiment and that of author's.

2. It is more difficult to find out ASC experience in psychiatric hospital which directed primarily at eliminating the ASC phenomena through pharmacological intervention analogous to administering an antidote for ingested toxins than folk psychiatry.

3. Consequently, shamanism can be understand as anxiety relieving cultural system even though the shamanism itself like a cultural complex. There are double aspects in shamanistic functioning; one is negative aspect in terms of projective approach, the other is a positive aspect in terms of humanistic attitude & psychotherapeutic virtues lie, liberation & insight function.