Kill Me, Heal Me Episode 7: Boundaries

Kill Me, Heal Me delivers great story-telling in episode 7. I could also probably use some psychotherapy for having liked it so much. Even before episode 8 makes it into subtitles, I have to write something about how this show is flirting with unethical medicine.

Oh Ri-Jin is training to be a psychiatrist. She’s still in her residency so she isn’t fully licensed in her specialty. Nevertheless, she’s in a profession that forbids her to be friends or lovers with someone who is also her patient.

At the end of episode 7, she accepts Cha Do-Hyun’s offer to work for him as his “secret doctor.” I cheered inside, and then groaned. Somehow this show tricked me into being happy about a terrible breach of professional ethics. How did they do that?

Perhaps by having Ji Sung break my heart every time he’s on screen.

kill me heal me episode 7 rooftop large optFor a hundred years, mental health professionals have known that the “therapeutic relationship” is purposefully unbalanced. The professional helps. The patient takes help.

Interactions that don’t follow the therapeutic model are boundary crossings—possibly even boundary violations, which are a breach of professional ethics. If you live in a small town, for instance, you may run into your therapist at the grocery store, a benign “boundary crossing.”

A crossing becomes a violation if it’s repeated and involves a power imbalance. The most outrageous example of a professional boundary violation is sex between therapist and patient. But there are other ways to have a dual relationship. What if you’re a lawyer and your therapist asks you for legal advice? The therapist has violated professional ethics. It’s a conflict of interest.

In 1912, Freud himself wrote

I cannot advise my colleagues too urgently to model themselves during psychoanalytic treatment on the surgeon, who puts aside all his feelings, even as human sympathy, and concentrates his mental forces on the single aim of performing the operation as skillfully as possible. 

Freud was a smart observer of humankind, even if his ideas on the causes of mental illness are outdated. When he found his colleagues giving therapy to friends and family members, he immediately understood the problem. By definition, a therapist can’t be the patient’s friend.

The people who train to be therapists and counselors are often friendly people, however, so part of professional training is learning to make rational decisions about how much friendliness to extend to a patient. Some boundaries would strike people in other professions as odd. A dentist might not hesitate to hire a former patient as an office assistant, but a therapist should never hire a former patient.

Avoiding dual relationships protects not only the patient from exploitation but also protects the therapist from clients’ emotions. Patients with emotional trauma may relive their most difficult emotions while they work with a therapist. They can grow angry or demanding or fall in love with a therapist. Good boundaries create safety for patients and counselors.

And although these guidelines come from psychotherapy, they apply to other kinds of therapy as well. Cognitive-behavioral therapy is short-term and doesn’t involve talking about the past, but it still relies on a professional therapeutic relationship.

These are good professional reasons why Oh Ri-Jin should immediately leave Seoul for the training opportunity at Johns Hopkins.

The script of Kill Me, Heal Me creates suspense over her decision without ever mentioning professional ethics. The central issue of episode 7 is, “Will Oh Ri-Jin overcome Cha Do-Hyun’s noble and idiotic attempt to send her away?”

That’s a less interesting conflict than the one front and center in my mind: “Will Oh Ri-Jin violate professional ethics and stay to help Cha Do-Hyun?” I’m rooting for her to leave. I’m grateful that Dr. Seok Ho-Pil tells Ri-Jin she isn’t responsible for Cha Do-Hyun and she should go to the States.

But then the director cuts over to scenes with Cha Do-Hyun and makes me desperately sad for him. I finish these scenes hoping for Oh Ri-Jin to stay. Please? Pretty please?

When Dr. Seok tells Do-Hyun it’s wrong to endanger Oh Ri-Jin by continuing to see her, Do-Hyun is like the human embodiment of loneliness. When Oh Ri-Jin shows up at the end of the episode, I’m jumping up and down in emotionally conflicted glee.

kill me heal me episode 7 rooftop message large optKill Me, Heal Me bypasses my rational objections to Oh Ri-Jin and Cha Do-Hyun’s relationship by tapping directly into my most irrational emotions. Damn you, show!

Like many women, I’m a sucker for the story formula in which a woman sacrifices herself to save a man from suffering. I may disapprove of the cultural expectation that women should put men’s needs ahead of their own, but I still can’t resist the classic romances containing this narrative. I must have read Jane Eyre and Rebecca at least a dozen times as a teenager. Both novels are complex psychological stories but do include a dose of self-sacrifice.

Something about the self-sacrifice narrative is ingrained (too deeply) in human culture. And this narrative meshes well with a story about mental illness like Kill Me, Heal Me.

In fact, self-sacrifice or masochism is actually the most common reason for female therapists to violate boundaries with male patients. Occasionally, therapists who are highly ethical and talented may become “unable to set limits on the patient” and grow personally or romantically involved with their most challenging clients.

But fiction doesn’t have to imagine a world where everything is perfect. One reason I still find Jane Eyre and Rebecca brilliant as novels is that the authors recognized the problems of self-sacrifice as well. The novels show the attraction and perils of an unbalanced relationship.

Jane Eyre and Rebecca both end with destructive house fires that burn away what remains from the heroes’ dark past lives. The heroines find love, but that love is inextricable from loss. And depending on how you read the novels, you can walk away optimistic or pessimistic about whether happiness is even possible for heterosexual couples.

We have yet to discover the Jane Eyre or Rebecca of K-dramas—K-dramas don’t like to question the narrative that “love conquers all”—but smart script-writers can’t completely ignore the internal contradictions of human beings. Cha Do-Hyun would like to feel less isolated, but since meeting Oh Ri-Jin, his alter-egos have caused increasing trouble for him. Oh Ri-Jin would like to help Do-Hyun, but knows he’s emotionally attached to her and that it’s unprofessional for her to work for him—hence her lie to her family that she’s going to Johns Hopkins.

(Local affairs tangent: subtitlers occasionally seem confused whether it’s John Hopkins or Johns Hopkins. The university’s founder was in fact named Johns Hopkins. His personal name was an ancestor’s family name. Common naming practice around here.)

Love doesn’t conquer all. It can totally undermine therapy, for instance. But the script has Oh Ri-Jin insist to Cha Do-Hyun that she isn’t qualified to treat him in a professional sense and that she can only help his alter-egos negotiate with each other. So even though he originally asked her to work for him as a doctor, she’s refusing a formal therapeutic relationship.

But because he’s confessed he has complicated emotions about her, they are entering into a relationship—of some kind. Is she a professional friend now? It’s a curious variation on K-drama’s beloved contract dating trope and risks perpetuating the idea that therapists are simply “paid friends.” Many Americans have this misconception and I would guess Koreans do as well.

But the ambiguity of their relationship will make for great dramatic tension. And the Beauty and the Beast metaphor invites us to think about this relationship as an encounter between two archetypes, not a medical drama.

kill me heal me episode 7 rooftop message heal me large optKill Me, Heal Me is most compelling when it fudges the medical details and focuses on big melodramatic gestures, like Oh Ri-Jin’s repainting of the rooftop where she interrupts Yo-Sub’s suicide. When she reclaims the cold industrial space by altering Yo-Sub’s spray painted “Kill Me” to say “Heal Me,” it doesn’t just explain the show’s title. It also suggests the way mental health is determined by how we write and rewrite memories and thoughts.

Scenes like that pull me in so deeply that I completely forget this is an ambiguous relationship with potential to harm both of them. I wish Oh Ri-Jin would state categorically that she can’t provide professional help, even if she’s there to encourage Cha Do-Hyun as a friend would.

But Kill Me, Heal Me operates in a more fantastical world than It’s Okay, That’s Love, which approached professional ethics with heart-breaking realism. Kill Me, Heal Me is a little bit camp, a little bit fairy tale, and plenty endearing. As long as it’s on the screen, it totally overrides my rational objections—though I may regret it later. What can I say? This is one of my own psychological weaknesses: I can’t resist a good-looking man crying.

Help! What should we make of the “secret doctor” storyline?

 

6 thoughts on “Kill Me, Heal Me Episode 7: Boundaries

  1. Dear Odessa, Thanks for the reference to my blog, Moments of Change and the thought that “Good boundaries create safety for patients and counselors.” Perhaps the screen is a little like therapy. It is a place where it is safe to think and feel things that aren’t so simple in real life. When the boundaries of the screen or the counseling room are strong, we are free to experience the full strength and passion of wish and need without practical concern for consequences. That is a great luxury. Jeffery Smith MD (blog.psytx.com)

    • Thank you, Dr. Smith, for saying it much better than I could! And thanks for sharing your experiences and knowledge on the web. The web needs more such writing to make tricky topics accessible. Good therapists save lives just as medications do–but they don’t always get as much credit.

  2. Thanks for this sobering dose of reality about psychiatry. I agree with everything you said. There is a reason why firm boundaries are established in certain professional relationships. But I have a question… can a psychiatrist and a person with mental illness who are not doctor and patient, be friends? Have a non-professional relationship? A cardiac surgeon can have friends who have heart problems. He will not perform surgery on them, but might at least nudge them to get treatment. Can that analogy be applied here? That fat dude is still the actual doctor for CDH I hope and not Ri Jin. I also think because this show doesn’t take itself too seriously all the tropes work!

    • I love that Dr. Scofield/Seok Ho Pil is in there. He’s like a stand-in for me when I have brief moments of thinking about this realistically. He’ll make sure everyone’s okay. But it’s true that psychiatrists are friends with people with MI all the time and vice versa. In fact, people who are comfortable talking about psychology gravitate to each other, so sometimes psychiatrists and “patients” are close friends. Pretty normal. And to make life more complicated and wonderful, I know people who have been on both sides–working full-time helping people one day, living as a patient in a mental hospital the next. A friend of mine has some crazy stories about running into former patients and colleagues when she herself was a patient for a time. If I could write fiction, I’d make up a romantic comedy based on those scenarios.

      The key to KMHM working is that it doesn’t take itself seriously. I mentally file “dubious psychiatry” with the other crazy K-drama tropes like “contracts are a good way to date” and “vomiting is a good way to meet people.” But I do wonder why K-drama writers like stories with doctors in love with their Own Patients. It’s not hard to tell a story of doctors in love with Other People’s Patients, and avoid the whole issue. But then, one of the things that keeps me watching K-dramas is that they’re so uninterested in reality!

  3. This was a really good analysis of episode 7. I had wondered a little bit about the ethical violations that their blurred relationship would make. However it never stayed too long in my mind. The show makes us root for them to the extent that we don’t care about these questions. But I was thinking, perhaps this will add to the conflict later. I’m still holding my teddy bear wondering how their fluffy time together will get ruined by the next half of the show. K-dramaland rules dictate that after, say ep 10 -12, it will all goes downhill.

    • Thanks for reading, camwill! Like some other K-dramas I love, KMHM taps into that awesome fantasy of soul mates. Even if in the real world I would consider this relationship kinda messed up, I’m loving it so much. I’m totally eating up that idea that CDH and ORJ are Everything to each other. But I’m so worried about all the suffering to come! Because of ep 8, I think CDH can’t keep his condition a secret much longer.

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