In reading this exquisitely beautiful book by Li Zhang, on the emergence of a new psychotherapeutic space in China, I was deeply struck by her notion of the “inner revolution.” This is an evocative term that not only points to the fundamental revolutions that the Chinese state has gone through over the course of a century, but also the ways in which citizens have experienced, adopted, and transformed themselves. As psychiatric experts of wars and natural disasters know all too well, the true effect of such collective psychological suffering is belated, felt only after a certain time has passed (this might include the current pandemic: Zeavin 2020). Such trauma often remains long unexpressed, unknown (even to those who experience it), and thus unshared. And it is the collective, often generational, nature of the trauma that Chinese are now seeming to confront in their ardent exploration of their inner selves in this “inner revolution.”
The inner revolution has taken place in the context of the tremendous changes that Chinese psychiatry has gone through over half a century. Recently, Stefan Ecks, Harry Wu and I worked on a project to compare psychiatric attitudes toward depression in Myanmar, China, and Japan. We were particularly struck by the fundamental shifts in China: from Soviet-era psychiatry (when it was denounced as a bourgeois pseudoscience), to the state campaign to reexamine the Cultural Revolution (which encouraged people to share their stories of sociopolitical suffering using the psychiatric idiom of “neurasthenia”), to the current commercialization of psychological care and people’s embracing of anything psychologically-therapeutic. Anxious China is unique in that Li provides a testimonial on some of these historical events via her own experience of growing up with families deeply affected by the Cultural Revolution, who witnessed the rise of the neurasthenia discourse firsthand. As a native anthropologist who routinely goes home to investigate and participate in the current psy fever, Li is able to weave together different perspectives across generations and across different strata of society while being firmly grounded in a local sense of place, her own hometown. She thus gives us rare and invaluable insight into how Chinese have survived these tremendous historical transformations over the years and how they are now beginning to explore their effects on their psyche.
This gives Li’s book a special strength as she investigates the emergent psychological space with genuine curiosity about the potential that these new forms of care of the self might have. In so doing, she does justice to the main source of her conceptual inspiration, which is Foucault’s work on the care and the technologies of the self. His later work was notable for its shift in tone from his investigations of oppressive means of governance to the study of self-care that ancient philosophers adopted for themselves in their search for truth. Zhang’s account of people searching for ways to interpret their lives radiates with the same sense of hopefulness, optimism, and creative energy. In parallel with their Japanese counterparts, Chinese psychiatrists and psychotherapists draw on rich cultural traditions of introspection and self-cultivation such as meditation, breathing exercises, calligraphy, and copy-printing of sacred texts, among others (the rather curious fascination with Jungian psychology is another common trait between Chinese and Japanese milieu that merits further examination). These “indigenous” forms of psychological care have apparently survived despite decades of political turbulence, where people’s interiority was often thoroughly and sometimes brutally interrogated, scrutinized and modified through “thought education” and other forms of political censorship, persuasion and coercion. Their passion for a sense of liberty and self-knowledge is profoundly moving, particularly as Li is able to go beyond stereotypical analysis by drawing out surprisingly tender, self-agonizing and self-transformative narratives from different classes of people, including a housewife, an entrepreneur, a solider, and a police officer. This reminds me once again the power of ethnographic encounters in exploring interiority well beyond cultural stereotypes at the crossroads of anthropology and psychotherapy, as we have learned from the classics like Vincent Crapanzano (1985)’s Tuhami.
While Li’s account focuses on the emergent aspects of a tenderly creative, innovative, and optimistic space for introspection, I wonder how this coexists—or works against—the increasing digital surveillance that China seems to champion. How does this new psychological space stand in relation to the new digital space of surveillance of the population? Does the first represent the sense of interiority, depth and wholeness, whereas the latter is something assembled through the datafication of personal traits, movements, and utterances (cf. Greene 2020, Lupton 2020)? Does this psychotherapeutic space have the potential of developing into an independent space of private reflection, a kind of secret interiority that nurtures critical perspectives? Or does it simply become a platform of producing socially adaptive and well-adjusted self-entrepreneurs, individuals for whom self-cultivation is merely a means of self-promotion and social advancement? Will this psychological space be further incorporated into surveillance of the collective psyche, similar to what Li describes when pointing out the parallels between cognitive behavioral therapy (CBT) and the Communist Party’s method of thought-correction? In one of the book’s many fascinating details, Li illuminates a phenomenon where people go looking for a license to practice as a psychotherapist with the aim of naked self-advancement, but end up inadvertently gaining so much more, as they come away with a sense of genuine curiosity and desire for self-cultivation and enlightenment. This is the duality of psychological care that increasingly theorists of digital therapy point to, where remote therapy is opening up surprisingly intimate spaces, even as it creates ambiguities about the nature (and ownership) of one’s inner life (Zeavin 2020; cf. Kitanaka 2015). How might Chinese, who have been so adept at cultivating techniques of protecting the sense of their inner selves despite political turbulence, adopt and shape this new psychological space?
Junko Kitanaka is Professor of Medical Anthropology in the Department of Human Sciences at Keio University in Tokyo. She received an MA at the University of Chicago and a PhD from the Depts. of Anthropology and Social Studies of Medicine at McGill University. Her book Depression in Japan: Psychiatric Cures for a Society in Distress received the Francis Hsu Prize from the Society for East Asian Anthropology in 2013 and has been translated into French. She has served on the Board of the Society for Medical Anthropology and numerous editorial boards including Cultural Anthropology. She is currently working on a new project on the medicalization of the lifecycle.
Note: The research was funded by Kakenhi 19K01205.
Works Cited:
Crapanzano, Vincent. (1985) Tuhami, Portrait of a Moroccan. Chicago: University of Chicago Press, 1985.
Greene Jeremy, A, Lea AS. Digital futures past: The long arc of big data in medicine. New England Journal of Medicine 381(5): 480-485, 2020.
Kitanaka, Junko. The Rebirth of Secrets and the New Care of the Self in Depressed Japan. Current Anthropology 56(12): S251-S262, 2015.
Lupton, Deborah. Data Selves: More-than-human Perspectives. Cambridge, UK: Polity Press, 2020.
Zeavin, Hannah. 2020. The Third Choice: Suicide Hotlines, Psychiatry, and the Police. Somatosphere. http://somatosphere.net/2020/the-third-choice-suicide-hotlines-psychiatry-and-the-police.html/ (accessed November 12, 2020).