Recasting Therapeutic Models of Care Before and During the Pandemic

The deep impacts of China’s economic reforms at a “breathless” pace over the past three decades have wrought profound economic and social transformations. Mental health concerns continue to illuminate the intersections of selfhood, social life, and state governance in postsocialist China. This timely monograph examines the “inner revolution” taking place across 21st century China via the recent growth in psychotherapeutic practices and cultures. While anxiety might be a global condition of the 21st century, Zhang argues that the category and range of experiences can be read as part of the affective landscape of contemporary China. Through the lenses of anxiety and distress for a range of actors, readers may understand how psychological counseling became the platform for managing wellbeing and the indigenization of therapeutic interventions.

Zhang highlights how psychotherapy might be made uniquely Chinese through the engagement of bentuhua– “the creative ‘fitting’” or “culturing” of practices such that they become localized as part of everyday contexts. In many ways, this ethnography follows up on some of the social and cultural dynamics that contributed to the popularity of Chinese breathing, self-cultivation, and healing practices during the late 1980s referred to as qigong fever. Zhang illuminates how therapeutic models of care may become recast with multiple inflections of cultural meaning and ethics that include familial and social networks, Zen Buddhism and Daoism, socialist thought work and other interpretative models. Her examination of branding further offers wonderful insights on how a therapeutic model no longer in use elsewhere, can become bundled as a relevant business model for franchises.

Reading this book both prior to the COVID-19 pandemic and then re-reading it during the ongoing global public health moment has facilitated different insights. My initial reading queried whether the utilization of psychological counseling and language beyond the clinic in work contexts might help to de-medicalize the work of therapy or would the incorporation of such techniques instead enable the full engagement of mind/body into the post-socialist work context. Zhang’s examination of military, police, and state enterprise uses of psychological counseling for screening suggests how such practices might extend the medical/clinical gaze into different spaces. Rather than assume top-down hierarchical engagements, however, she suggests that the implementation of psychology and psychotherapy reflect certain notions of guan’ai or therapeutic governance and care that may transcend institutions. Zhang offers the thoughtful insight by a fellow sand play therapy workshop participant, who happens to be a police detective, on two notions of self (ziwo) – one that is embedded within social relations while the other is detached from family, kin, or networks. Together the two versions complete the sense of being human for him.

As COVID-19 cases rise worldwide, access to mental health care is understood to be all the more critical as essential forms of care and recovery. With these frameworks, it is possible to comprehend the embrace of psychology and psychotherapy in China over the past decade as the profound journeys of ordinary persons seeking lifelines to address deeply felt concerns and create breathing spaces.

Nancy N. Chen is Professor of Anthropology at the University of California at Santa Cruz. She is the author of Breathing Spaces: Qigong, Psychiatry, and Healing in China (2003) and Food, Medicine, and the Quest for Good Health(2008). She is also co-editor of four book volumes: Bioinsecurity and Vulnerability (2014) with Lesley A. Sharp; Asian Biotech: Ethics and Communities of Fate (2010) with Aihwa Ong; Bodies in the Making: Transgressions and Transformation (2006) with Helene Moglen; and China Urban: Ethnographies of Contemporary Culture (2001) with Constance Clark, Suzanne Gottschang, and Lyn Jeffery. She received the SMA Medical Anthropology Student Association (MASA) Graduate Mentorship Award in 2020.