Presentation Information
[SY-60-04]Shame and the Unbearable Self:
Psychoanalytic Reflections on Suicidality in the Korean Context
*In-Soo Lee (Korean Psychoanalytic Center(Korea))
Keywords:
Suicide,Shame,Cofucianism,Korean Culture
South Korea, despite its rapid modernization and global cultural influence, continues to experience the highest suicide rates among OECD nations. This paradox reveals a cultural psyche shaped by Confucian hierarchies, repression of aggression, and a pervasive culture of shame. This paper explores how internalized shame and narcissistic dynamics contribute to suicidality in the Korean context. Using a detailed clinical case of a 23-year-old woman with chronic suicidal ideation, I examine how unbearable self-states are formed when perfectionistic ideals collide with deep fears of being a burden, failing to meet ego ideals, or violating cultural taboos. The patient’s apparent “shamelessness” masked a profound narcissistic defense against shame, which, when accessed, opened new therapeutic possibilities. Her suicidal fantasies functioned as omnipotent escape mechanisms, preserving a fragile grandiose self against perceived psychic annihilation. Through psychoanalytic work, she gradually began to accept the reality of human limitations, moving beyond a dichotomous, perfectionistic worldview and softening narcissistic defenses. This presentation argues that shame in Korean culture is intensified by collective identity, intergenerational trauma, and the cultural imperative to maintain emotional restraint and social conformity. These dynamics can hinder emotional development and lead to a split between the actual and idealized self. The psychoanalytic process must account for this heightened shame sensitivity by providing empathic attunement and a secure therapeutic space. Doing so allows the dissociated grandiose self to evolve into a more integrated, realistic ideal self—thereby reducing the patient’s vulnerability to narcissistic collapse and suicidality. This paper offers a culturally grounded psychoanalytic framework for understanding and treating suicidality in Korea, where shame, rather than guilt, often dominates the emotional landscape.