Episode 3:
The importance of engaging in your own treatment

*The series is based on the real-life experience of Kim Nam-young, a JoongAng Ilbo reporter currently living with post-traumatic stress disorder (PTSD). The following articles are written from Kim’s first-person perspective.

To Readers

I have PTSD.

As a reporter on the social affairs desk, I covered the Itaewon disaster on Oct. 29, 2022. Since November of the following year, I have been receiving treatment regularly. I attend psychiatric counseling sessions and take medication every day.

I am only revealing the illness now, more than two years later, not because I have overcome it. This is not a story about recovery, but a record of living through the illness. To be honest, I still do not know when, or if, I will overcome it.

Instead, I want to talk about the time I have spent living alongside PTSD. Even now, I continue to work as a policy and social affairs reporter while exercising, traveling and going on with daily life.

If someone is hesitant to see a doctor, I hope this piece helps. I also hope we can become a society where people do not feel forced to hide emotional pain and trauma.

My very first visit

There is a chill in the waiting room. The psychiatrist sits expressionless, listening — at least in my eyes — half-heartedly to what I have to say. I leave the doctor's office holding a mysterious prescription with little explanation.

This is what I imagined before I ever stepped inside a psychiatric clinic.

The reality, however, was the complete opposite.

It was far warmer than I expected, and the doctor listened carefully to what I said. The explanation about the medication was so kind and easy to understand that I could have repeated it word for word to someone else.

My first psychiatric visit was on Nov. 9, 2022 — a turning point in my life.

The visit was for my PTSD from covering the Oct. 29 Itaewon disaster the same year.

Psychiatric treatment ultimately depends on one’s own agency. The same can be said of other forms of treatment, but mental health care tends to be more effective the more actively the patient engages with it. That does not mean I was willingly active from the start.

What happened during my first appointment

During my initial consultation, I underwent numerous tests, such as a heart rate variability (HRV) test, the Beck Depression Inventory, and the Beck Anxiety Inventory. These tests are widely used to objectively and scientifically assess levels of stress, depression and anxiety.

I think I received those tests on the first day of my visit because I had already explained that I was seeking treatment because of the Itaewon disaster.

The HRV test involved attaching clip-like sensors to my hands to measure my autonomic nervous system and heart activity. This is done because PTSD disrupts the balance of one's autonomic nervous system. The body continues reacting as if it is still in danger. My HRV test reflected exactly that.

My sympathetic nervous system was excessively activated. The results of the depression and anxiety tests were not much different.

After the tests, I sat down with a psychiatrist to review the results. I was asked questions like why I had come and what symptoms I had been experiencing. I explained that I worked as a reporter and had struggled psychologically after covering the scene of the Itaewon disaster.

After talking for around 10 minutes, I left the doctor’s with unexpected homework. I had to complete the Minnesota Multiphasic Personality Inventory (MMPI) and a sentence completion test before my next appointment.

The MMPI was like an aptitude or personality assessment. It is designed to evaluate personality traits and pathological conditions and contains more than 500 questions. Because there are so many questions, it is difficult to craft an idealized version of yourself through the answers.

The sentence completion test worked like this: a sentence beginning with “My family is...” would require me to complete it with my own words, such as “gets along well with each other.” The test naturally reveals a person’s inner thoughts and emotions.

At the time, I found it incredibly annoying. I worked on it little by little while doing my job, and it took me two or three days. Had I done it all at once, it probably would have taken two or three hours.

I asked the reason behind doing such tests at my follow-up appointment: “To find things that cannot be discovered through consultations alone,” the psychiatrist answered.

My second first visit

In truth, I had two “first visits.”

As I mentioned earlier, the first was on Nov. 9, 2022, about 10 days after the Itaewon disaster. The second came on Nov. 3, 2023, almost exactly a year later, because I had stopped treatment in between.

During my very first visits, I attended four sessions. The last was on Dec. 30, 2022. I stopped going because I did not want to continue.

“There are people in far worse condition than me who need treatment more,” I told myself repeatedly during the four sessions.

At the time, I did not think my symptoms were that severe — although looking back, they actually were.

There were people suffering more than I was, and I felt a sense of guilt, wondering whether I was taking away their chance to receive treatment.

I was neither a victim's family member nor a survivor. I had been closer to an observer.

I was afraid to even call myself a “PTSD patient.”

When I shared those thoughts, the psychiatrist ended the session by saying, “If you need help, you absolutely must come back.”

Then, around October 2023, the PTSD symptoms began to resurface, which started with flashbacks during a business trip flight.

Eventually, with the encouragement from those around me, I returned to see a doctor.

But because so much time had passed, I had to go through another initial consultation.

This time, I did not take the MMPI or sentence completion test. But I did undergo the heart rate variability test, the Beck depression and anxiety inventories and the Hamilton depression and anxiety scales.

After counseling, I received my first prescription for medication.

At the time, the thing I feared most was this: “What if this keeps happening every time?”

The key to treatment: me

Psychiatric treatment differs slightly from other forms of medical care as it strongly depends on the patient’s autonomy.

If you get an X-ray, for example, a lung problem may visibly appear on the scan. Psychiatry also relies on various tests, but if the patient does not speak honestly, it is difficult for the doctor to accurately understand the patient’s condition.

I was too late in realizing that. When I first visited my psychiatrist in 2022, I was overwhelmed with reporting on follow-ups on the Itaewon disaster, and I could not even find a reason within myself to continue treatment.

More than anything, it felt incredibly uncomfortable to reveal my most vulnerable state to a stranger. So I stayed silent.

But after I returned to treatment a year later, I gradually began to open up. For the first time since the incident, I was able to talk about what had happened at the disaster scene, when I felt overwhelmingly guilty and what emotions surfaced whenever I passed through Itaewon afterward.

Thoughts that had remained trapped in my head finally came out during consultations. I also honestly admitted that I could not sleep well and sometimes experienced hyperventilation.

As I built rapport with the psychiatrist, I began talking about everything.

I spoke about my job and complained about work. I talked about my hobbies like futsal and running. Once the barrier came down, I shared how much support I had received from my partner and that I had lately been thinking about what kinds of articles to write next.

Psychiatric treatment is a long journey. PTSD treatment, in particular, can take an extremely long time.

What I came to realize was that unless I took active steps toward healing, I would continue to live in pain. The person who can best help heal my wounded self is me. In other words, treatment requires agency, ownership and active participation.

Meeting the right doctor is also critically important.

“Like all relationships, the only way to know whether a doctor is right for you is to meet them in person,” said Na Hae-in, a psychiatrist and author of “A Guide to Using Psychiatry by a Specialist” (2024, translated).

Of course, there is no guarantee a doctor will suit you.

“When you are dissatisfied with treatment, the best thing to do is reflect on exactly what disappointed you and communicate those feelings to the doctor,” Na advised.

How to find a good psychiatrist

People often say the best clinic is the one closest to home because it is easier to visit frequently. But I think psychiatry is different.

If I had to choose between a convenient location and a good doctor, I would always choose the good doctor. In fact, the psychiatrist I currently visit is almost an hour away from my home. The commute itself exhausts me. Even so, I have no intention of leaving my current psychiatrist.

A good psychiatrist is ultimately a doctor who suits me well.

I have seen many people drift from doctor to doctor searching for such a person. A doctor who works well for someone else is not necessarily right for me. In that sense, it is like dating. Someone who seems wonderful to everyone else may not appeal to me at all.

Over two years of treatment, I met three psychiatrists. My current doctor suited me best. The other two were also excellent doctors, but their communication style did not feel comfortable for me.

A good psychiatrist is also someone who empathizes well.

Fortunately, my current psychiatrist understood the profession of journalism. Whenever I struggled because of a difficult reporting assignment, I felt tremendous relief and comfort knowing I was understood without needing lengthy explanations.

We even shared anger over people mocking the Itaewon disaster and the various forms of online harassment directed at reporters. I felt the doctor was on my side, which made it easier to be honest.

Another important quality is the ability to explain things clearly, especially when prescribing medication.

With psychiatric medication, patients should not blindly follow instructions. It is necessary to ask detailed questions about which medications you are taking, their effects and any side effects they may cause.

I, too, at first wondered, “Am I really allowed to ask all this?” But the answer is definitely yes.

For example, when changing my sleep medication, my psychiatrist even showed me charts explaining the effects and side effects of each type.

Then, I would share which medication I thought might suit me better, and the prescription was adjusted accordingly.

As time passed after my second first visit, I found myself able to open up about all kinds of emotions to the psychiatrist sitting across from me, and my symptoms gradually began to ease.

Outside the consultation room, however, things were different.

Some days, I drifted through life feeling numb. Other days, I had to battle emotions crushing my everyday life. Those, too, were remnants of PTSD.

The story continues to the third episode, "Episode 4: Working through the emotional aftermath as a survivor."

BY KIM NAM-YOUNG [[email protected]]