Korean medicine and Sasang constitutional medicine

Domain XI · Traditional medicine & indigenous healing · Yi Je-ma · 1894 · Korea

What it is

Korean medicine (hanui-hak) is a codified, state-licensed medical system practised in South Korea by licensed Korean medicine doctors (KMDs), alongside conventional medicine in a dual licensing system. Sasang constitutional medicine (SCM) is a school within Korean medicine, systematised by Yi Je-ma…

Format

• Korean medicine itself has no "phases" for the psychotherapist to follow. The framework below is the psychotherapist's own course of work alongside Korean medicine.
• Context from Korean medicine practice. In a 2024 survey of KMDs, hwa-byung treatment typically lasted a median of 10 weeks and 18 sessions; acupuncture (95.4%) and herbal medicine (94.0%) were used by almost all respondents, while mind–body modalities and psychotherapy, though emphasised in the…

Who practises it, and how they are trained or regulated

• Version followed: Korean medicine as regulated in the Republic of Korea under the Medical Service Act (Act No. 14438 as listed by the Korea Legislation Research Institute) and Sasang constitutional medicine as set out in Yi Je-ma's (Lee Je-ma's) Dongui Suse Bowon (1894) and described by Korean academic Sasang medicine; hwa-byung care as described in the 2021 Korean medicine clinical practice guideline for hwa-byung;…
• What it is. Korean medicine (hanui-hak) is a codified, state-licensed medical system practised in South Korea by licensed Korean medicine doctors (KMDs), alongside conventional medicine in a dual licensing system. Sasang constitutional medicine (SCM) is a school within Korean medicine, systematised by Yi Je-ma in Dongui Suse Bowon (1894). It holds that every person belongs to one of four constitutions (Taeyang,…
• Core idea of change, as the system holds it. Within SCM, illness reflects the constitution's inherent imbalance pushed further by emotional excess and lifestyle; treatment aims to restore balance with constitution-specific herbs, diet and self-regulation. These are the system's own concepts, described here neither as established fact nor dismissed.

Evidence status, as the guide reports it

• Goals: deliver your own evidence-based psychotherapy (e.g. ACT, CBT, emotion-focused or interpersonal work) adapted to the client's model; coordinate with the KMD and prescriber with consent; review medicine/herb safety each time care changes.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• the client minimising symptoms as "just hwa-byung". Working: medical checks are done and documented.
• interpreters known to the family; small-community confidentiality. Working: the client corrects translations less often.
• attributing all change to one system to please a provider. Working: the client describes a combined plan in their own words.
• module fatigue; questions about religion feeling intrusive (explain why you ask). Working: new information changes the formulation or plan.
• domestic abuse or coercive control hidden as family conflict (assess privately); scapegoating. Working: family members use less blaming language.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.