The Tapping Evidence Base
Trauma (other) · Anxiety · Multiple Conditions

Effectiveness of psychotherapy for Hwa-Byung: A systematic review of interventional studies

Kwon, C. Y., Lee, B. · Medicine · 2025

Systematic review📚 9 studies reviewed⚖️ vs. waitlist or before-after comparisonsModerate rigor✓ Source-checked📍 South Korea
In plain English. Hwa-Byung is a Korean condition rooted in suppressed anger that shows up as physical and emotional symptoms. This review pooled nine studies of six different therapies, one of which was EFT, and found that most approaches, including tapping, meaningfully eased Hwa-Byung symptoms. The reviewers were candid that the studies generally lacked strong control groups, so the evidence is suggestive rather than airtight.

What they found

9
studies reviewed

Nine studies (7 controlled trials) of six intervention types, including emotional freedom technique, were reviewed; most interventions significantly improved Hwa-Byung symptoms versus waitlist or pre-post comparison, though methodological limitations including lack of appropriate control groups were noted.

How the study worked

Who took partpatients with Hwa-Byung (a Korean culture-bound anger-suppression syndrome)
What they didThis systematic review gathered and appraised the body of published studies against a defined method.
Compared withwaitlist or before-after comparisons
Measured withHwa-Byung Scale, state anger, state anxiety

💡 Where this could help

Picture someone carrying decades of suppressed anger that has turned into chest tightness and physical illness — common in Hwa-Byung but recognizable anywhere anger gets pushed down instead of processed. If tapping's showing here continues to hold, it could offer a gentle, self-taught way to release that pressure on one's own schedule, for free, without needing to sit across from a therapist and put words to it.

🔬 What to study next

Hwa-Byung is anger that gets pushed down until it becomes physical illness, so the most interesting next step is measuring that physical toll directly — blood pressure reactivity, cortisol, or muscle tension (EMG) before and after tapping, to see if calming the felt anger also eases its bodily signature. A trial with a credible active control, plus testing whether this pattern holds for anger-suppression syndromes outside Korea, would tell us whether this is a culturally specific finding or a broader one about suppressed emotion generally.

The full record

DesignSystematic review
Participants9 studies pooled
Populationpatients with Hwa-Byung (a Korean culture-bound anger-suppression syndrome)
Comparison groupwaitlist or before-after comparisons
Outcome measuresHwa-Byung Scale, state anger, state anxiety
JournalMedicine
Year2025
CountrySouth Korea
LanguageEnglish
MethodEFT / tapping
Publication typeReview or meta-analysis
Verification✓ Confirmed against the primary source

Read the original study →

Cite this study

APA

Kwon, C. Y., & Lee, B. (2025). Effectiveness of psychotherapy for Hwa-Byung: A systematic review of interventional studies. Medicine. https://doi.org/10.1097/MD.0000000000041315

This record is part of the Tapping Evidence Base — an openly-sourced, fully-referenced directory of the research on EFT/tapping. Explore more studies on Trauma (other) · Anxiety

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THE TAPPING EVIDENCE BASE Trauma (other) 9 studies pooled WHAT THEY FOUND Nine studies (7 controlled trials) of sixintervention types, including emotionalfreedom technique, were reviewed… Systematic review · 9 studies Kwon · 2025 · evidence.thetappingsolution.com