A Response Letter

Dear Interlocutors:

I am too inspired by the letter form to communicate directly with you all, as Tomas has done. I find this format more intimate, candid, and effective.

As I write this response, the world is deep in the frightening pandemic as COVID-19 infection and death cases continue to climb rapidly. Even though the vaccines are on the way, which gives us a glimpse of hope, the widespread uncertainty and suffering caused by COVID-19 is unlikely to end soon. Meanwhile, the United States is facing unprecedented political turmoil in the aftermath of violent Trump supporters storming Capitol Hill and assaulting democracy. In such turbulent and desolate times, it is not exaggerating to say that anxiety—the theme of my book—captures not only the mood of China but also the general state of being of the contemporary world at this moment. How to live through such an unsettling and difficult time? How to take care of our individual and collective well-being? How to find hope and resilience in the midst of political, economic, and public health crises? These questions become even more pressing for all of us to ponder and grapple with.

Let me first express my profound gratitude for your careful reading of my book and your deep and constructive engagement with my work. It is most gratifying to see how my research has sparked new questions, curiosity, debates, and creative interpretations among you. Obviously, I cannot address all of your good questions and insights in this short letter, but I would like to respond to one or two issues from each of you (in random order) that resonate with me in the deepest way or ignite my further thinking.

Tomas: I so appreciate that you took the time to write to me even when you were in the middle of your own grieving for the loss of your father. And I am so happy to know that my own story echoed with your personal experience and somehow reached you beyond the level of intellectual exchange. Needless to say, Anxious China is a very personal project to me. From the very beginning I hoped that I would be able to integrate some of my own encounters and family experiences with troubled moods in the writing, and share with readers my journey to search for healing, meaning, and well-being. I am well aware that such self-disclosure (especially on mental health) carries certain risk. But I also know that it can be very helpful to many readers. In the end, I found that this is one of the most gratifying parts of my fieldwork and writing. Through my own struggle with anguish and loss, I have found a more candid and authentic way to connect with not only the people who appear in my book but also numerous readers who are drawn to the human dimension (as the case with you). I am also very delighted to see that you appreciate my effort to resist all sorts of binaries because this effort is not merely an intellectual exercise but reflects what the therapists and clients I studied attempt to do. Such bricolage and boundary-crossing efforts in my view are what make the Chinese psy practice fascinating and distinct.

Junko: I love your interpretation and reflection on my key notion of “inner revolution” by situating it in the broader historical context of China, especially against the backdrop of the traumatic socialist years. I also appreciate your comparative insights by bringing in your rich research on Japanese psychiatry. It is always so rewarding to compare notes with you about our findings on Japan and China over the years because of the many striking similarities found between the two societies. Here I would like to address your question about what the newly emerging psychotherapeutic space can do for Chinese people. Although I will not rule out the possibility that some people might nurture critical perspectives on life and even challenge the status quo through therapeutic work, my sense is that the overwhelming trend points to the emergence of self-adjusted individuals who aspire to live a more balanced life, find some happiness and meaning in a fiercely competitive society. In recent years, there has emerged a popular term called neijuan (involution) in the Chinese news media to describe a mode of existence facing most Chinese today, especially the younger generations: They are locked in a life marked by relentless competition without a sense of purpose or meaning, yet they are not allowed to exit or unable to escape. In such an involution or impasse, the new psychosocial space can perhaps provide a refuge, but I am not optimistic about its potential for fostering macro-level societal transformations.

Rebecca: I am grateful that you have raised a fundamental question concerning many researchers in the field of psychotherapeutics, which I did not ask explicitly in the book: Are new psy practices and the remaking of the subject we witness in China politically conservative or liberatory? You rightly point out that the foundation of this question is based on a binary distinction itself that is problematic. This brings us back to an important observation made by Tomas about my intention to move beyond dichotomous thinking. In the case of China (and I imagine the same elsewhere), the answer to your question is not black and white or clear cut. Perhaps, my answer to Junko’s question above also speak to this question partially. There is liberatory potential in the new psychotherapeutic practices but this interpretation depends on a radical re-conceptualization of what constitutes “politics” or the “political.” Is the remaking of the self in everyday life outside the traditional or socialist box liberatory or revolutionary? To me, the answer is yes because it constitutes a quiet inner revolution by engendering a deep level yet subtle social transformation. What is happening in China, as you point out, is not a one-way Western colonization of the Chinese mind and way of life, but instead a dialogic process in which new meanings and self are created by people based on their history, social condition, and aspiration for a better future.

Zhiying: As you have noted, you and I have long been working on two different yet related domains in the Chinese mental health field—psychological and psychiatric interventions. I enjoy reading your works because they provide rich and insightful accounts of the psychiatric world that I want to learn more. I very much agree with you on the persistent tension between the popular desire to search for meanings of life and the discipline of psychology as a scientific field devoid of the means to address heart/emotion related issues. In recent years, in addition to the widely found “empty heart illness” you mentioned, there has emerged another rubric of “sang culture” (closely related to the neijuan culture) to convey the mood of these young people (born in the 1990s and 2000s) who are facing staggering pressure to work hard to succeed and bear an overwhelming feeling of fatigue and dispirited. As a Chinese researcher Liu Xinting explains, “the basic meaning of sang is to lose something through death, and hence it is associated with mourning and related moods of dejection and depression.” Psychological counseling as practiced outside the hospital and academia seems to be partially fulfilling this growing need among the younger generations yet has a lot of limits as my book shows. I also appreciate your attention to the centrality of the family (a strong focus of your own research) in Chinese psychotherapeutic work and the many good questions you raised about how the family mediates gender and generational relations, therapeutic practice, and politics. This is an important area that I touched upon but deserves more systematic analysis and further theorization in my future research.

Dominique: Thank you for your thoughtful engagement with my book, especially with one of the core concepts, “therapeutic governing,” and the complex role of grassroots counselors by bringing in your own research insights on Brazil. Let me briefly respond to your two potential inroads. First, the claim that grassroots counselors are “unqualified” is a complicated one. On the one hand, there are indeed some or even many Chinese therapists who are inadequately trained and act like swindlers by cheating their clients and getting paid without being able to provide helpful service. Note that psychological counseling is a poorly regulated new field in China. On the other, you rightly point out the unequal power relations that give the authority and those with institutional backing the power to define who is qualified. Some of the grassroots therapists I met might have less formal education and credential but are at the frontline of doing much needed good work. Second, your point about dialogic work at a meso-level is well taken. Like Brazil, there are also numerous sites (such as those psy training workshops I described) where dialogic praxis takes place in China where new meanings and imaginings are enacted. It would have been a very productive lens to analyze in greater detail some of these local encounters.

Nancy: I am so glad that you brought up the impact of COVID-19 on Chinese society and how this horrendous pandemic might have affected the psyche and mental well-being of Chinese people. This seems to be a perfect place to wrap up my response letter. My book was published in August 2020 in the midst of the pandemic, but the research and writing were done way before the arrival of COVID-19. Therefore, I did not have the chance to reflect on the relationship between anxiety, the role of psychotherapy and the pandemic. By now, ample evidence shows however that the pandemic has taken a significant toll on the mental condition of Chinese people. There has been a rapid rise of anxiety, depression, and other forms of distress across different social strata in China over the past twelve months. The pandemic has intensified the need for psychotherapeutic help in the population and also exposed the dire condition of mental and psychological services. When many distressed people urgently seek “lifelines” (using your word) to address their concerns and anguish, they realize that help is not there and there is a long way to go in order to find well-trained and trusted therapists and doctors. Perhaps, one silver lining of the pandemic is that it makes people realize clearly that mental distress is more widespread and needs to be confronted and destigmatized.

Once again, thank you all for the stimulating comments and questions. I see this forum as the beginning of a highly productive conversation and hope to continue this dialogue with you and Somatosphere readers in the future.

Warm wishes,


Li Zhang (Ph.D. Cornell 1998) is Professor of Anthropology at the University of California-Davis. She is the author of two award-winning books: Strangers in the City (Stanford 2001) and In Search of Paradise (Cornell 2010), and the co-editor of Privatizing China, Socialism from Afar (Cornell 2008) and Can Science and Technology Save China? (Cornell 2019). Her most recent book is Anxious China: Inner Revolution and Politics of Psychotherapy (UC Press 2020).