Rec: Li Zhang’s ‘Anxious China’

Welcome to the first in a potential blog series that may or may not actually become a blog series because I never seem to be able to get beyond single posts. In this would-be series, loosely titled “Recs,” I make recs (ie “recommendations”) and do some thinking in relation to them.

The inaugural “Rec” is this interview I listened to with Professor of Anthropology Li Zhang about her book Anxious China: Inner Revolution and Politics of Psychotherapy. You can listen below. Unfortunately there’s no transcription, but that’s why I’m here!:

Li Zhang speaks with Suvi Rautio on the New Books Network about her book
Anxious China: Inner Revolution and the Politics of Psychotherapy

Before getting into it, I’d like to do a bit of bitching: one of the things that bothers me most about American and British coverage of China is the way in which China is depicted as this big hulking monster, as if a) that weren’t an extension of Yellow Peril sentiments and b) there weren’t 1.4 billion actual flesh-and-bone people living inside the purported monster. I’m not saying that the Chinese government doesn’t commit atrocities or exert undue influence on the populace, but I think in many Americans’ eyes, “China,” “the CCP (Chinese Communist Party),” and “the Chinese people” are all interchangeable. The fact that different people living in the same country can exist and think differently from each other is something that Americans—progressive and conservative alike—seem to understand with respect to America but cannot seem to fathom for a scary foreign nation like China. The fact that it’s an Asian nation and that Americans do not know what to do with Asians or how to process our varied human existences in the US or abroad, only furthers the dehumanizing practice of replacing the actual people of China with the West’s notion of China.

This is something I was reminded of in listening to Li Zhang’s New Books Network interview for Anxious China: Inner Revolution and Politics of Psychotherapy (University of California Press 2020). We hear so much about “the rise of China” or “the threat of China” in relation to its turbo-charged economic development over the past few decades. But how often do we consider the psychological ramifications of that hyper-capitalist transformation on its people? I hear stories from folks in the country about the dangerous, high-stress conditions that Chinese delivery workers are subjected to; the pressures facing migratory workers to earn enough for their rural families who they only see but once a year; the insane housing market and the expectation that a young man have a home ready for his wife-to-be in order to be marriageable; and a ton more. All of this has led many Chinese middle class citizens to seek psychological treatment in unprecedented numbers. In Anxious China then, Zhang charts the importation, popularization, and indigenization of “modern” ie “Western” psychology and psychotherapy (with no value marker as to whether that’s a good or a bad thing).

Full disclosure: I’m just going off the interview and haven’t actually read the book yet, and I still have a lot to learn about Chinese philosophers, traditional medicine, spirituality, and cultural concepts that have informed the Chinese understanding of what we today call “psychology/心理学.” That said, it sounds like Zhang helpfully starts the book by situating psychotherapy within the context of mental health care in modern China starting in the late 19th century. One of the examples she gives of how psychology came to China is in the work of modern psych “pioneer” Yan Yongjing. Yan translated Western psychological concepts into Chinese and in the process emphasized studying the heart and spirit, which were central to Chinese medicinal traditions.

Zhang also talks about the impact of Maoism on Chinese citizens’ psyches and how people dealt with it. The Cultural Revolution was a time when folks were told, “Who needs the psychologist when one has the party?” So to talk about their mental conditions, people tended toward somaticization. In other words, they might’ve expressed something like mental distress in terms of, say, digestive issues, rather than reveal their mental/emotional struggles, for fear of being labelled a crazy person (疯子). This kind of somaticization was partly a function of stigma around mental health issues, available language, and sociocultural values of the time. I wouldn’t be surprised if it was also partly a function of the fact that Chinese medicine doesn’t think of the mind and body as separate the way Western medicine does.

In the years since then, starting around the time of Deng Xiaoping, Western psychology, and psychotherapy specifically, has started gaining popularity in the country. Interestingly, it sounds like there’s a process of indigenization happening, as a way to make psychotherapy make more sense in the Chinese context. Zhang looks specifically at three popular modes of psychotherapy that have undergone indigenization (本土化)and why they appeal to Chinese practitioners and clients. Those modes are:

1) Satya family therapy, which believes that individual issues are never actually individual but rather are a function of the family system. So rather than just the one family member getting treatment, the whole family unit undergoes treatment. This model has appealed to people because of the importance of the family unit in Chinese society.

2) Cognitive Behavioral Therapy (CBT), which looks to change patients’ cognitive outlooks in order to facilitate desired behavioral changes. Zhang argues that aside from the things that have made CBT popular in the West (the fact that insurance companies like it, that it promises concrete outcomes in minimal time, etc), it has also been popular in the Chinese context because of its connection to socialist thoughtwork—ie work typically done by party cadres to persuade people of socialist/party ideals. Apparently, it’s something of a trend for CBT practitioners to have previously been socialist thoughtworkers. Many of these practitioners are able to successfully get through to patients, because they’re able to use the listening and persuasive skills necessary to thoughtwork, to instead persuade their clients of certain cognitive changes. So there’s a relationship between CBT as a form and socialist thoughtwork as a form (as opposed to the content of either practice).

3) Jungian sandplay therapy, which is only mentioned briefly in the interview, but Zhang says that Jung was deeply influenced by what he called “Eastern culture”—namely Chinese and Indian traditions. I assume then that there are elements of Chinese culture embedded within this therapeutic method that resonate with patients who find it helpful.

In listening to all of this, there was a part of me that wondered whether, to borrow from Audre Lorde, the master’s tools can truly dismantle the master’s house, even if those tools are being molded to fit the culture. I wonder what it means that the West has hijacked so many of “the East”’s tools—various aspects of Buddhism (hello, mindfulness), the construction of Dialectical Behavioral Therapy (DBT), yoga, acupuncture/cupping/guasha (which was taken and re-branded in the West as the Graston Technique), breathwork, and so much more. Which, I’m not saying these modes of wisdom shouldn’t be shared or practiced by people outside of those traditions, though it sucks to see a lot of them get perverted and commodified, but clearly, whatever Westerners had been doing to address their anxieties and illnesses–which I think are often related to the pressures of capitalism and our war economy–just wasn’t cutting it. Yet despite all that, China has turned to the West for answers. I know that the marketing of these psychotherapies in China is also a reason for their rise, but I also imagine that it goes deeper than that.

I think there’s some dismissal or forgetting of indigenous ways of knowing here. Which I think might in part be related to the Cultural Revolution and the wiping out of the Four Olds (old ideas, old culture, old habits, and old customs). I bet that the still-present inferiority complex that took root during China’s century of humiliation that today masquerades as a superiority complex, also has something to do with it. I can’t tell you how many times I’ve heard relatives talk about how China is still “落后”—behind, backwards, regressive—as if advancement were measured solely by degree of industrialization and economic growth. Which isn’t to discount the fact that a lot of people really have experienced an improvement in quality of life that is tied to China’s economic development, but it also can’t be understated how much has gotten sacrificed along the way. I think there’s something more spiritual and ancestral to be reclaimed. I hope that one day, those paths to healing will be embraced just as much as psychotherapy has been, if not more.

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