사회공포증의 임상고찰(4) - 가해의식을 동반한 아형 -

A Clinical Study of Social Phobia (4 ) — Social Phobia Accompanied with Ideas of Hanning Others —

The authors examined the clinical manifestations of 246 patients who had been diagnosed with Social Phobia and received group therapy at Koryo General Hospital, Seoul, from Mar. 1983 to Apr. 1990. Among them, We observed 81 patients with ideas o f harming others caused by their physical defects. They believed they had overt physical defects that made others unpleasant. They claim they recognize this intuitively by the way other people taek, qesture and look away when they are with the patient. They firmly believed that they harm others, thus feel guilty. It is for this reason that they have to avoid interpersonal relationship. This type of Social Phobia has never appeared on the western literature ; in fact, DSMIII- Rcriteria can hardly explain this special type. We present it as one of the subtypes of Social Phobia, which have been frequently reported in Japan and Korea. We’ve discussed cultural aspects of this interesting subtype “Regard for others” in the Confucian culture may play an important role for this. Along with this, Korean’s mentality on Groupism, Hwa(peace in harmony), Chaemyun(face saving) and NoonchiCeye-reading) are also considered in producing this type of Social Phobia. The ways that cause harm in others are • by their gaze(63.0%), emitting odo r(l4 .8% ), tensing up(8.6% ), facial expression(8.6%), blushing (2 .5 %), swallowing(1.2%) and breathing sound (l.2% ). Surprisingly, 21 patients(25.9%) believed their symptom is infecting the others. Therapeutically, group therapy was efficient and cognitive reconstruction was a turning point in the treatment process. Though, more cross cultural studies are needed, we can reasonably say that this subtype of Social Phobia is culture related syndrome in the Far East with Confucian culture