The Empty Hearts and Kinship Correlates of China’s Psy Fever

In her new book Anxious China, Li Zhang documents the rise of “psy fever” in the 21st-century China, as manifested in the widespread use of psychotherapeutic knowledge and techniques by the country’s middle-class citizens to understand and remake themselves. Traversing diverse spaces ranging from clinics to companies, from universities to militaries, Zhang shows us that psychotherapies, though imported from Western countries, have undergone much “culturing” or bentuhua by adopting the language of Chinese philosophies, invoking key social relationships such as family ties, and addressing people’s deep anxieties amid rapid social change. As such, they allow people to disentangle themselves from and re-embed themselves in the social, to search for happiness and a secularized spirituality, while also enabling and transforming the post-socialist state’s governance. This is a fascinating book, and I would like to offer some thoughts as a partial insider and as a researcher of related phenomena.

I studied psychology for my undergraduate degree at a top Chinese university during the mid-2000s, right around the time when the psy fever took shape. I had chosen psychology with the naive imagination that it would help me find meanings of life. However, the psychology I was taught fashioned itself as a cognitive science, which allowed for the management of thoughts and emotions, but which largely stayed clear from discussions of meaning. (The disappointment led me to philosophy for my double major and to anthropology for my Ph.D.) Therefore, I found myself nodding vigorously to Zhang’s argument that the versions of happiness as articulated by therapeutic discussions in China “are oriented toward how to foster a sense of feeling good (often fleeting), but lack a further attempt to search for deeper meaning or self-empowerment crucial to the cultivation of a long-lasting form of well-being” (148). In other words, the scientifically-looking psychology/psychotherapy might be empty-hearted.

Interestingly, in recent years, quite a few Chinese psychotherapists have become vocal cultural critics. For example, Dr. Xu Kaiwen has famously asserted that many Chinese youths suffer from an “empty-heart illness” or kongxinbing because they lack guiding values of life. I thus wondered whether Xu or any of the therapists studied by Zhang has attempted to fill the void, what meanings and values they use for the filling, and how those attempts are received by the public. I am also curious about how the therapists’ approaches to meaning are affected by their positions in the ideological state apparatus, especially under the Xi Jinping regime which seeks to reclaim certain socialist values, as well as how the quest of meaning (or the lack thereof) shapes psychology as a scientific discipline and as a tool for governance in China.

As an anthropologist, I have spent the last decade studying something complementary to the psy fever: the largely institution-based care and management of people diagnosed with serious mental illnesses, a group that is still heavily stigmatized. My fieldwork shows that the family—both as an idea and as a set of relationships—is routinely mobilized by professionals and state officials to justify and enact psychiatric interventions, and that these processes in turn have transformed actual family lives and intimate ethics. In other words, the state’s mental health governance has its kinship correlates (Ma 2020).

I was thus particularly drawn to the various ways in which the family shows up in Zhang’s ethnography: therapies that center the role of the family in shaping the person—such as the Satir family therapy—tend to be successful in China because they resonate with Confucian and popular understandings (52); in fact, therapeutic techniques that were initially designed for families—such as family sculpting and restructuring—have been adapted for use on other social roles, like company employees and schoolteachers (100). Moreover, some people turn to psychotherapy because they are frustrated by family conflicts and fragilities (115); yet, despite the family’s importance, most therapists can only work with the individual, and they find it hard to get other family members involved (83). These intricacies prompt me to ask: how do psychotherapists theorize the family as a symbol of the Chinese culture? Given the uneven access that therapists have to different family members’ time (and minds), how do therapies transform family relations? Do these transformations fall along particular gender and generational lines? How does the generalized use of family-based therapeutic techniques and languages shape people’s senses of social belonging and, perhaps indirectly, their political imaginations? All in all, how might the inner revolution, psychosociality, and therapeutic governance that come with the psy fever be mediated by family?

Of course, each set of questions probably deserves a book in its own right, and this is exactly the power of Zhang’s book: its multi-layered approach is combined with a meticulous attention to ethnographic details; its generous understanding of the nascent field goes hand in hand with a sharp cultural critique; all these make the book a wellspring of inspirations for students and scholars of global psy fevers.

Zhiying Ma is Assistant Professor at the Crown Family School of Social Work, Policy, and Practice, University of Chicago. She is a cultural and medical anthropologist and a scholar of disability studies. She is writing a book on how psychiatry and law shape families’ involvement in the care and management of persons with serious mental illnesses in China.

Work Cited:

Ma, Zhiying (2020). “Biopolitical Paternalism and Its Maternal Supplements: Kinship Correlates of Community Mental Health Governance in China.” Cultural Anthropology35(2): 290-316.


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