Compassion and the 'right to cry' in coping with loss

This South Korean drama is about a marriage in crisis, between a high-flying conglomerate heiress (Hong Hae-in, played by Kim Ji Won) and a smart and kind lawyer from the countryside (Baek Hyun Woo, played by Kim Soo Hyun). In the first episode, we (and Hyun Woo) learn that Hae-in has a rare brain tumour. While watching the drama, I enjoyed reflecting on my own experiences, as a Stage 2 Trainee Health Psychologist, of working with people with severe and chronic health conditions .

Firstly, I thought the series was a realistic portrayal of how waiting is excruciating. When being asked to wait for her condition to get better before receiving treatments, Hong Hae-in said 'Why do they all want me to wait? Why do they talk as if time is on my side? I don't have time.' From noticing bodily changes, requesting health examinations, receiving the diagnosis, being put on the waiting list for treatments and further check-ups, to follow-up care and recovery, waiting is key in living with physical health difficulties. Waiting is closely linked to a fear of uncertainty: 'Will I ever be able to live normally again?' I learned about the concept of Wellbeing Tower from my placement at a cancer support centre. Kyle Wehmanen and colleagues imagine our wellbeing as the Jenga Tower, with every life stress removing one block from the tower. We can add blocks to our wellbeing tower by engaging in health behaviours such as diet, regular exercise, self-care and stress management.

In fact, Hong Hae-in initially tells her husband that she does not trust the diagnosis, because 'I have never drunk soda in my entire life. Have you ever seen me eaten instant or junk food? Do you think I enjoy drinking vegetable juice and watching what I eat? I meditated in the morning and did yoga at night for my stress. I watched my breathing if there was no oxygen concentrator.' It was refreshing to hear health behaviours being mentioned explicitly in a K-drama, and to watch a character who is highly aware of what she does and how that can affect her health.

In real life though, there are many factors that affect our health behaviours, such as culture, access to healthy food and green spaces, and our financial means, and the process could involve more automatic action rather than rational and conscious choices. Phillippa Lally and colleagues have modelled how habits are formed in the real world, showing that some behaviours are more easily established than others depending on the level of difficulty and effort required for that behaviour. I found it easier to form a habit of flossing and drinking lukewarm water before breakfast than getting to sleep before 9 pm and exercising every morning. The literature on health behaviour change is rich, and some techniques may work for some people but not everyone. However, I have found these three techniques most useful: restructuring the environment (placing the floss next to the toothbrush), psychoeducation on the consequences of undesirable behaviour (screen use before bedtime and increased wakefulness), and self-monitoring (keeping a sleep diary).

The series goes on to portray different manifestations of grief through a series of losses. There is no right or wrong way to grieve. During the grief journey, guilt may be another feeling that the patients and their family members experience, which could be effectively addressed by self-compassion practice and pacing. Interestingly, I have seen many K-dramas where the characters suggest breaking up after receiving a terminal illness diagnosis. What I find unique about Hong Hae-in and Baek Hyun-woo's relationship is that Hong Hae-in confides in Baek Hyun-woo immediately after receiving the diagnosis. He has been the only person she trusts and relies on during this journey. Initially, she resists being vulnerable and asks him not to treat her like a patient. However, vulnerability leads to compassion and Hyun-woo gradually feels empathetic and understands the rapid worsening of Hae-in's health condition.

Before accepting her symptoms, Hae-in starts feeling empathetic to other people. According to Kristin Neff, 'common humanity', or viewing one's suffering as part of the larger human experience, is a key part of self-compassion. Hae-in also tries to support other people by offering financial support, which reminds me of Paul Gilbert's styling of compassion as 'a sensitivity to suffering in self and others with a commitment to try to alleviate and prevent it'. From those beginnings of saying 'I don't have the right to cry', it makes me happy to see Hong Hae-in developing more compassion for her experiences.

Uyen Phan Hong (Rose) Le is a Health Psychologist in Training at Glasgow Caledonian University

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References

Gilbert, P. (2014). The origins and nature of compassion focused therapy. British journal of clinical psychology, 53(1), 6-41

Lally, P., Van Jaarsveld, C. H., Potts, H. W., & Wardle, J. (2010). How are habits formed: Modelling habit formation in the real world. European journal of social psychology, 40(6), 998-1009.

Neff, K. D. (2003). Self-Compassion: An Alternative Conceptualization of a Healthy Attitude Toward Oneself. Self and Identity, 2(2), 85–101. https://doi.org/10.1080/15298860309032

Wehmanen, K. W., Cottet-Puinel, F. E., Hampton, T. C., Hamlin, G. T., Wedig, I. J., & Elmer, S. J. (2023). Impact of health behaviors on community well-being and resilience: teaching K-12 students with Jenga!. Advances in physiology education, 47(2), 361-365.