[Health Column] The Little Hero Within Us

In last year's disaster escape movie Exit, the protagonist is a young unemployed man named Yongnam (played by Jo Jung-suk). After graduating from college, he has been failing to find a job for several years and is treated coldly at home. One day, during his mother's 70th birthday party, a toxic gas spreads, causing chaos in the area. Yongnam uses all his physical strength and skills to cleverly lead his family to escape. As shown in this film, ordinary citizens become heroes in times of disaster. Medical staff fighting the novel coronavirus disease (COVID-19), volunteers, public officials, and countless donors?these are the small heroes of our time who act for others rather than themselves.

The act of helping others over oneself is called altruism. It is one of the mature defense mechanisms. According to psychoanalytic theory, our ego strives to manage anxiety and restore mental calmness. This effort is called a defense mechanism, which mostly operates at an unconscious level, making it difficult to consciously recognize the specific process. Defense mechanisms can be understood as ways our mind unconsciously protects itself from pain and distress.

Defense mechanisms are classified into several levels. The first is pathological defense mechanisms, which include conversion and denial. Conversion refers to the transformation of mental content rejected by consciousness into physical symptoms. For example, a daughter-in-law who cannot release her anger after being scolded by her mother-in-law may experience paralysis in her hand. Denial is an unconscious attempt to reject the meaning of a specific event. It is an effort to protect oneself from anxiety or unpleasant feelings by avoiding painful reality. The second level is immature defense mechanisms, such as projection and regression. Projection is a mental process of transferring unacceptable impulses or thoughts to the external world. By projecting unbearable aggressive feelings onto others, one perceives oneself as being treated aggressively by others. Regression is a psychological process of reverting to a less mature stage of mental functioning when facing an unbearable reality.

The third level is neurotic defense mechanisms, including repression and rationalization. Repression involves locking away painful content from consciousness into the unconscious. Selective amnesia is an example. Rationalization appears in Aesop's fable "The Fox and the Grapes." The fox, having given up on picking grapes, does not admit its incompetence and instead excuses itself by saying, "Those grapes are sour and cannot be eaten," which is merely a self-justification that distorts reality. Finally, examples of mature defense mechanisms include altruism and humor.

We are currently enduring difficult and bleak times, so much so that we cannot see an "exit" or escape route. In such times, we need the small heroes around us and the small hero within ourselves. These heroes are indeed appearing. Medical staff caring for COVID-19 patients, dedicated public officials at quarantine sites, countless volunteers, and those of us who support them with words and hearts. Ordinary citizens who send their reserved masks, necessary daily supplies, and food to COVID-19 treatment sites; the story of a basic livelihood security recipient who donated the cancellation refund of their cancer insurance to a community center for the residents of Daegu and Gyeongbuk, who are fighting a desperate battle... All are heroes of this era armed with altruism. Now, it is time for the hero within me to respond.

Seongwon Noh, Professor, Department of Psychiatry, Hanyang University Hospital