Autism in Korea and Seung-Hui Cho

Talk to the Chos is the title of an op-ed by Dave Cullen in today’s New York Times. Cullen, who is writing a book about the Columbine High killers, notes a sad—a terrible irony: Fourteen days before Seung-Hui Cho killed 32 people at Virginia Tech, “[a] judge ruled …… that depositions by the parents of the gunmen in the 1999 Columbine school shootings would remain sealed until 2027.” Cullen writes:

It would be tragic to also have to wait 28 years to hear from the family of Seung-Hui Cho, the killer at Virginia Tech. But the tense legal standoff that led to the Columbine ruling is likely to repeat itself in Virginia if we don’t quickly devise an alternative.

In the Columbine case, as in Virginia Tech, the killers’ families went into seclusion and released statements of regret and bewilderment. Parents of mass murderers have their own grieving to do. When the Chos resurface, a ravenous press corps will stalk them, and the public will be hungry for answers. The questions will grow increasingly belligerent and accusatory.

Cullen notes that Cho “demonstrated symptoms consistent with autism and Asperger’s syndrome, but these can also be signs of schizophrenia”; experts are “eager” to speak with his family, to “tease out the differences”: Had he experienced “psychotic episodes” earlier? If so, with what frequency and intensity? What kind of treatment was used, or not? As Cullen writes, “[a] deeper understanding of Mr. Cho’s pathway to murder can help us predict dangerous behavior and respond better to warning signs.”

What happened at Virginia Tech was terrible, inexcusable, unfathomable—-and that is why it is all the more important to try to understand, as futile and limited are efforts may be. The discussion here about Cho possibly being autistic has been going on for some days. It has not been an easy to discussion to follow, as a number of stereotypes about what autism is (an equation of autism with mental retardation, for instance) have surfaced, as well as some curious theories (connecting Cho’s violent behavior to mercury poisoning).

Many parents of autistic children reacted in horror to the suggestion that Cho may have been on the autism spectrum for fear that the public might start not only to connect autism with violence, but even to equate the two. I found this understandable but there is one aspect of Cho’s background that stands out equally to me and that, unlike an autism diagnosis, is simply obvious, and that resonates personally with me as an Asian American and the mother of an Asian American boy: Cho was Asian; more specifically, Cho was born in South Korea and emigrated with his family to the US when he was 8 years old. He was part of at least two cultures—South Korean and American, and also Asian American. In regard to the questions that Cullen raises about what we might learn from speaking to his parents, his sister, and family members—information that might help us to “predict dangerous behavior and respond better to warning signs”—I don’t see how we can overlook Cho’s background and, too, how autism is understood in South Korea.

The Korean word for autism is chapae and literally means “closed in on oneself.” It is formed from the Chinese character za, which means “by oneself,” and pae, meaning “closed.” Two chapters of Unstrange Minds: Remapping the World of Autism by Roy Richard Grinker are specifically about autism in South Korea. “Half Past Winter in South Korea” profiles Seung-Mee and her autistic daughter, Soo-Yong; and “Becoming Visible” notes how autism awareness and understanding are growing in South Korea and discusses a popular movie, Maraton, which was based on the true story of an autistic man, Bae Hyong-Jin, a marathon runner. Says Seung-Mee:

“You can’t escape being a victim…….

“I don’t like looking back to what could have been. This is my life. It’s like I’m always in the middle of winter. I can go forward to spring or I can go backwards to when everything started to go bad. It’s not spring yet, but maybe I’ll get there.” (pp. 230-231)

Michael Goldberg at Autism Bulletin included a note from Professor Grinker in a post on Unconfirmed Diagnosis in Virginia Tech Tragedy and I quote from it in part:

In Korea……. Autism is less stigmatizing than mental retardation but for autistic kids without mental retardation, autism is more stigmatizing for the family than the preferred diagnosis, Reactive Attachment Disorder (which, in cases where there is no demonstrable pathological care-taking environment, can be construed as a version of the refrigerator mother). Here is why autism is more difficult a category for the family as a whole.

In Korea, children American clinicians might diagnose with autism are often diagnosed with reactive attachment disorder (RAD). RAD is sometimes described pejoratively as “lack of love” (aejong kyolpip), a term that, for Koreans, conjures images of orphans craving affection and care. In Korea, RAD is thought to be a condition mimicking autism, caused by a mother’s absence of attachment to her son (this is the Korean version of the “refrigerator mother”). In fact, some clinicians in Korea even prefer to drop the word “reactive,” because, from their perspective, that word identifies the pathology in the child rather than the parent. By calling RAD simply “attachment disorder” (aechak changae), the blame can be more clearly placed on the mother.

RAD is a diagnosis that many parents prefer, even though it directly indicts the mother as a pathological caretaker. First, unlike autism, RAD or lack of love can be ameliorated by giving love; it’s not a permanent condition. An autism diagnosis, however, is seen as a statement that your child has no future. Autism, at least in Korea, is widely considered to be untreatable and many parents who try various therapies, like speech therapy, vitamin regimens, or herbal medicines, give up after a while if their child is not cured. The Seoul-based psychiatrist Dong-Ho Song, who is one of the best trained and busiest child psychiatrists in Seoul, and who is an important member of our Autism Speaks-funded project, had a patient who had been diagnosed with RAD first at the age 18 months and then subsequently by several other doctors throughout his early childhood. He was almost eleven when he came to Dr. Song and received his first diagnosis of autism. [Soo-Yong was originally diagnosed with RAD; doctors felt that her condition was due to neglect.]
……..
Now, as for the shooter at VTECH, Cho Seung-Hui, first, I am not a clinician, as you know. But second, as far as I know from reading the press, there is not much information on him as a child. It is unlikely he would have been diagnosed in Korea. In the U.S. it is also unlikely, if only because Korean-Americans are on the whole very reluctant to seek mental health care (since it is just so stigmatizing). Doctors I’ve interviewed (including Korean-American doctors) tell me that by the time someone gets to a mental health professional that person may be acutely mentally ill. Again, I am not a clinician, but I suppose it’s possible that some clinician somewhere could have at one time used the word autistic as an adjective to refer to — remember again that I am not a clinician — the flat affect and introverted personality of someone who would grow up to have schizophrenia. Remember that in the DSM I and DSM II “autism” was mentioned in the criteria for childhood onset schizophrenia. You can see the criteria on my website at unstrange.com.

To read the full text of Professor Grinker’s note, go to Autism Bulletin.

Seung-Mee, the South Korean mother quoted above, talks about being “always in the middle of winter.” She is able to work and to place Soo-Yong in a special needs daycare during the day, and to provide her with language therapy, music therapy, art therapy, and sports therapy, but does not feel she receives support from her husband or family. Going to a Methodist church has given her support and community, even though she is an agnostic.

I’m not going to speculate about what Cho’s mother, about what any of the mothers of those killed at Virgnia Tech, are feeling now. I’ll repeat the title of Dave Cullen’s New York Times op-ed: Talk to the Chos. There are so many questions here and a lot of work ahead of us to figure out the beginnings of something of an answer.