When young Chinese medical student Zhang Yin first started college, it was astoundingly lonely for him, so he turned to a counsellor for help in combatting depression. Soon, Zhang became fascinated by the idea of therapy, and is currently researching stress and depression at Changsha University, with ambitions to train as an existential therapist.
Zhang’s enthusiasm for talk therapy reflects a wider surge in interest, as China’s citizens look for meaning beyond their endless quest for prosperity. Since the collapse of Maoism, the Chinese have been searching for something more than just material that fits into long-term happiness, according to ethnographer Huang Hsuan-ying. Others suggest that this desire is sharpened by the traumas of China’s modern history, characterised by war, famine and cultural revolution.
Psychology isn’t really new to China; back in the 20s, Freud’s work was translated into Chinese, although this initial flurry of interest was soon suppressed. Mao banned psychology and psychiatry followed a mostly medicalised model. Desperate gaps remain in mental health services in China, particularly in the countryside. There are currently just 20,000 psychiatrists in China, a frustratingly small number for the most populous country in the world. Evidence from other countries suggests that China will need an additional 100,000 psychiatrists to properly meet their country’s needs. Even if there are 400,000 psychological counsellors registered with the country’s ministry of labour, many believe that the licence is too easy to obtain.
Nowadays, public interest in psychology is matched by official recognition; last year, China passed its first mental health law after planning it out for 27 years. It acknowledges the role of psychotherapy, introducing a framework for its practise. Practitioners say that patients often report problems such as stomach ache or insomnia, and may expect drug-based treatments, even when they acknowledge psychological causes. Younger, better-educated people tend to be more open to the idea of therapy rather than drugs. According to Zhang, his parents don’t even understand what psychotherapy is.
Various cultural changes are helping psychotherapy flourish in China, with many in the generation taking an interest. At the International Federation for Psychotherapy’s conference in Shanghai this summer, Chinese speakers ranged over subjects such as psychocardiology and psychoanalysis to the application of standardised rating scales in treating children with ADHD. At times, the event had the air of a fan convention as younger people rushed up after talks to take pictures with the speakers.
Many people in China train to become psychologists but never become professionals, or just abandon the work soon after they being. Fees for public work are low, and while private sessions can command 10 times that, building a stable client base is extremely difficult. The problems sometimes reflect prosaic cultural differences, such as an incomprehension of formal aspects of western practise. Others see unexpected alignments and convergences between aspects of traditional Chinese thought, such as Daoism, and psychotherapy.