Bentuhua: Culturing Psychotherapy in Postsocialist China

The breathless pace of market reform in China has brought about profound ruptures in socioeconomic structures and increased mental distress in the population. In this context, more middle-class urbanites are turning to nascent psychological counseling to grapple with their problems. This article examines how Chinese psychotherapists attempt to “culture” or indigenize (bentuhua) three imported psychotherapy models in order to fit their clients’ expectations, desires, and sensibilities: the Satir family therapy, cognitive behavioral therapy, and sandplay therapy. It addresses three interrelated questions: What is the role of culture in adopting, translating, and recasting psychotherapy in contemporary China? How is cultural difference understood and mobilized by therapists in the therapeutic encounter? What kind of distinct therapeutic relationship is emerging in postsocialist China? Data presented here are drawn from my semistructured interviews and extensive participant observation at various counseling offices and psychotherapy workshops in the city of Kunming. My ethnographic account suggests that it is through constant dialog, translation, and re-articulation between multiple regimes of knowledge, cultural values, and social practices that a new form of talk therapy with “Chinese characteristics” is emerging. Finally, I reflect upon what this dialogic process of transformation means for psychotherapy as a form of globally circulating knowledge/practice.     

Constructions dans l’analyse: le transfert comme construction d’un espace porteur et comme reconstruction

The author argues that Binswanger’s daseinsanalyse is far from contradicting what Freud established in the field of analytical therapy. On the contrary, it enriches psychotherapy by making explicit what it is capable of constructing. This paper focuses on the transferential aspect of this construction. Übertragung, or transference, calls upon the world of the patient, its emotional space inhabited by the patient’s body and the bodies of others. This world, along with its underlying dramatics, not only requires recognition, but also carriage (Tragung) to the analyst’s side, at least if the analyst is to succeed in revealing the unconscious part of this world to foster its transformation rather than repetitions of the mechanisms that freeze it. The author reflects on the “gestation” and “carriage” metaphors to show how therapeutically effective the “carrier-experienced space” can be.     

At the Margins of Moral Personhood

In this article I examine the proposition that severe cognitive disability is an impediment to moral personhood. Moral personhood, as I understand it here, is articulated in the work of Jeff McMahan as that which confers a special moral status on a person. I rehearse the metaphysical arguments about the nature of personhood that ground McMahan’s claims regarding the moral status of the “congenitally severely mentally retarded” (CSMR for short). These claims, I argue, rest on the view that only intrinsic psychological capacities are relevant to moral personhood: that is, that relational properties are generally not relevant. In addition, McMahan depends on an argument that species membership is irrelevant for moral consideration and a contention that privileging species membership is equivalent to a virulent nationalism (these will be discussed below). In consequence, the CSMR are excluded from moral personhood and their deaths are less significant as their killing is less wrong than that of persons. To throw doubt on McMahan’s conclusions about the moral status and wrongness of killing the CSMR I question the exclusive use of intrinsic properties in the metaphysics of personhood, the dismissal of the moral importance of species membership, and the example of virulent nationalism as an apt analogy. I also have a lot to say about McMahan’s empirical assumptions about the CSMR.     

Where Empathy in Psychotherapy Originated: C. Rogers,His Psychoanalytic Predecessors and Followers

This article presents a historical-psychological analysis of how the concept of empathy appeared and became established in psychotherapy. It examines in detail the early psychoanalytic approaches of S. Ferenczi and O. Rank and their possible influence on C. Rogers’s laying the groundwork for the role of empathy. For the first time in Russian psychology, the article illuminates certain aspects of the biographies of Rogers and H. Kohut as the founders of new schools in psychotherapy, of which empathy is the paramount feature. Kohut’s self-psychology is analyzed from the standpoint of his postulation of the “threefold” status of empathy as a method of psychology, a tool of the analyst, and the subject of a universal requirement of development. It briefly considers the development of the views of Rogers and Kohut in the latest “experiential” schools in the person-centered approach and intersubjective psychoanalysis.     

Ou en sont les therapies psychosexuelles?

Sex therapy was born in 1970 with the publication of Masters and Johnson’s landmark book “Human Sexual Inadequacy”. Since then it has evolved under the influences of social changes, medical technological developments, advances psychotherapy and an alteration in the awareness of sexual problems. However, there has been no fundamental change in psychosexual therapy technique during the past decade. On the other hand, as with psychotherapy, techniques have diversified and become more refined and adapted to specific conditions and patients, and we have a better understanding of their mode of action. During the coming years it will be most important to achieve a greater compliance of more patients in following recommended treatment by improvising the collaboration between sex therapists with diverse specialities to provide a thorough evaluation of each patient.     

Prayer,Silence, and Psychotherapy

A new interpretation of L.S. Vygotsky's “The Tragedy of Hamlet, the Prince of Denmark” and his little-known publication “Traurnye stroki-Den' 9 ava.” An essential question (object) of these texts is the secret of genuine human overcoming of suffering. This is also the main problem of psychotherapy. Vygotsky's answer has both psychological and religious sgnificance: the experience of a tragedy is mediated by prayer. Vygotsky's idea creates the basis for religiously oriented, “synergetic” psychotherapy where the main process will be spiritual, including prayer.     

Coexperiencing Psychotherapy as a Psychotechnical System

The main challenge of contemporary psychology is to fill the increasing split between research psychology and psychological practice. A creative response to this challenge is found in a general methodological approach, which L.S. Vygotsky called the “philosophy of practice” or “psychotechnics.” This article describes a psychotechnical system called “coexperiencing psychotherapy.” This psychotechnical system combines science, practice, and education. From the perspective of general psychological theory the article describes a model of an “integral unit of psychological analysis,” in which the main general psychological categories (activity, set, relationship, and communication) are synthesized. In addition, the article presents a theoretical interpretation of experiencing (perezhivanie) as a productive meaning-generating activity. Finally, conceptual models of levels, registers, and structures of consciousness are proposed. From a psychotherapeutic practice perspective, a system of a “psychotechnical unit” of the psychotherapeutic process and structure of situation is given. The general method of coexperiencing psychotherapy is “understanding.” The educational dimension of the psychotechnical system remains outside the scope of the current article.     

Anaphylactic shock and lethal anaphylaxis caused by compound amino acid solution, a nutritional treatment widely used in China

Compound amino acid solution (CAAS) is a large class of solution of amino acids’ mixture and was widely used in China. Its extensive nutritional treatment was accompanied by a substantial incidence of adverse reactions, especially life-threatening anaphylaxis. However, the adverse reactions were reported in isolated case reports only, and the reasons behind this needed further investigation. The Chinese language papers were searched from China National Knowledge Infrastructure and Wanfang database published in China from 1985 to 2010. The search terms “anaphylactic”, “anaphylaxis”, “allergic”, “allergy”, “shock”, and “adverse reaction” combined with the term “amino acid” were used. Totally 71 episodes of anaphylactic shock and seven deaths in 38 articles were analyzed. Chest distress and cool extremities were the most common clinical manifestations. Almost all patients suffered from significant hypotension. The vast majority of patients were not found to be allergic to certain substances. CAAS was inappropriately administrated in more than one-third of patients. The life-threatening anaphylaxis was prominently prevalent in pregnant women, the elderly and patients with hypersensitivity such as asthma, and patients without medicinal indication. Innovation of processing technique and establishment of more strict supervision system are an urgent need for CAAS to control its production quality and thus improve its safety in China.     

The Tipping of the Big Stone—And Life itself. Obesity,Moral Work and Responsive Selves Over Time

Why is “everything I know is the right thing to do a million miles removed from what I do in reality?” This question posed by Rita, my main interlocutor and friend in a fieldwork that started in 2001–2003 and was taken up again in 2014–2015, opens up an exploration of moral work and moral selves in the context of the obesity epidemic and weight loss processes. I address these questions through the notion of “moral laboratories” taking up Mattingly’s argument that moral cultivation over time cannot be disconnected from a notion of self. Mattingly has consistently argued for a biographical and narrative self, which is processual and created in community. Along these lines, and by recourse to the German philosopher Bernhard Waldenfels’ phenomenology, I will propose the notion of a responsive self. The responsive self highlights the eventness of ongoing experimentation against the odds and captures equally pathic and agentive dimensions of a self that both persists and is transformed over time.     

虫草文化及科学史

根据考古和史料证据推断,人们对虫草的认识有着5 000多年的历史,涉及文化、艺术、历史、哲学、宗教、习俗、医药及生物科学等方面。根据各阶段的特点可分为崇拜时代、本草时代、描述时代和分子时代。(1)崇拜时代(红山文化-神农本草经问世)：中国考古发掘出众多玉蚕和玉琀蝉,反映在远古时期对虫草的蒙昧认识以原始的轮回崇拜为特点。至今中外仍遗留着一些古代虫草崇拜的习俗。(2)本草时代(《神农本草经》问世-1818年虫草属建立)：古代苏美尔人可能使用过一种虫草入药;而中国人2 000年来一直使用白僵蚕、蝉花和冬虫夏草等入药。此时期物化观念对东西方都有较大影响,对于虫草东西方均有“动物化植物”“竹根化蝉”“虫草互变”等认知,反映了物化论的深刻影响。(3)描述时代(1818年-20世纪末)：1818年Fries建立虫草属,揭开虫草菌科学发展300年的篇章。物化论逐渐被近代科学取代;庞大的虫草家族逐渐形成。欧洲和日本流行虫草绘画,加快了虫草知识的普及。19世纪后期兴起利用虫草菌防治害虫,并在20世纪中期形成规模较大的真菌杀虫剂产业。中国将虫草用于食品和药品的古老传统得以传承并发展,在20世纪后期形成较大产业;但欧美各国发展较慢。(4)分子时代(21世纪初以来)：在现代生物科学和技术的带动和支撑下,虫草研究从上世纪末开始进入分子时代。生物药物素研究缓慢进展,而虫草的多基因系统发育、虫草侵染昆虫的分子致病机制以及以基因组学引领的组学研究则快速进展。国际和国内学术交流活跃,对于弘扬虫草文化起到有力的促进作用。     

Beyond Participation: Politics,Incommensurability and the Emergence of Mental Health Service Users’ Activism in Chile

Although the organisation of mental health service users and ex-users in Latin America is a recent and under-researched phenomenon, global calls for their involvement in policy have penetrated national agendas, shaping definitions and expectations about their role in mental health systems. In this context, how such groups react to these expectations and define their own goals, strategies and partnerships can reveal the specificity of the “user movement” in Chile and Latin America. This study draws on Jacques Rancière’s theorisation of “police order” and “politics” to understand the emergence of users’ collective identity and activism, highlighting the role of practices of disengagement and rejection. It is based on interviews and participant observation with a collective of users, ex-users and professionals in Chile. The findings show how the group’s aims and self-understandings evolved through hesitations and reflexive engagements with the legal system, the mental health system, and wider society. The notion of a “politics of incommensurability” is proposed to thread together a reflexive rejection of external expectations and definitions and the development of a sense of being “outside” of the intelligibility of the mental health system and its frameworks of observation and proximity. This incommensurability problematises a technical definition of users’ presence and influence and the generalisation of abstract parameters of engagement, calling for approaches that address how these groups constitute themselves meaningfully in specific situations.     

Untamed <Emphasis Type="Italic">Jianghu</Emphasis> or Emerging Profession: Diagnosing the Psycho-Boom amid China’s Mental Health Legislation

This article focuses on the psychotherapy debate in China that was triggered by the country’s mental health legislation. Seeing the release of the draft Mental Health Law in 2011 as a “diagnostic event” (Moore in Am Ethnol 14(4):727–736, 1987), I examine the debate in order to unravel the underlying logic and ongoing dynamics of the psycho-boom that has become a conspicuous trend in urban China since the early 2000s. Drawing on my fieldwork in Beijing and Shanghai, I use the two keywords of the debate—“jianghu” (literally “rivers and lakes”), an indigenous term that evokes an untamed realm, and “profession,” a foreign concept whose translation requires re-translation—to organize my delineation of its contours. I describe how anticipation of state regulation prompted fears and discontents as well as critical reflections and actions that aimed to transform the field into a profession. The efforts to mark out a professional core against the backdrop of unruly jianghu further faced the challenge of an alternative vision that saw popularization as an equally noble cause. The Mental Health Law came into effect in 2013; ultimately, however, it did not introduce substantive regulation. Finally, I discuss the implications of this debate and the prospects of the psycho-boom.     

Le psychothérapeute psychanalyste « à <Emphasis Type="Italic">l’école de la phénoménologie</Emphasis> »

The mixing of psychoanalysis and phenomenology fosters the development of psychotherapy, psychoanalysis drawing on phenomenology to offer a method of studying and understanding the human being; this creates a genuine form of “anthropology”. Phenomenology’s contributions to psychoanalysis revolve around the three notions of épochè, the understanding of others and transference. On the one hand, épochè (a suspension of natural states of mind, obviousness and knowledge; an eidetic reduction; and an opening to the world and others) ensures better comprehension (“to take with yourself”) of others and their existential projects. On the other hand, épochè prevents falling into the transference and countertransference traps and sets the distance necessary for the hermeneutic act, that is, the interpretation of what is no longer there, what is absent, yet said and indicated by language in psychoanalytic therapy. Through its humanist, anthropological perspective and its overall understanding of the human being, phenomenology leads the way to rethinking clinical psychotherapy to create a more unified discipline.     

L’intersubjectif et l’intrasubjectif dans l’expérience de souffrance. Un regard psychanalytique

Psychoanalysis characterises subjectivity as a notion based on the “plurality of psychologically troubled persons”, revealed, for instance, in dreams. The author takes a closer look at a number of Freud’s dream analyses and argues that, in working with the dream, subjects often eject one of their psychologically troubled persons (often the “suffering child”) out of themselves, projecting the person into the Other. As a result, an intersubjective space is created, which is required to receive the divisions originating from the intrasubjective space. Freud’s 1895 Project, however, goes farther: the evacuation of the “disparate part” of the child to the Other grants access to logical and rational judgement, guaranteeing a child’s psychological life a fictional stability (the “Thing” or the “ego”). Freud adds that this process is possible if a Nebenmensch — or “fellow creature” — is present and has the quality of a “helping person” capable of receiving the child’s suffering cry. These two lines of thought, together, help clarify the intersubjective position underlying the analytical work: a tentative encounter between the patient’s distress and the analyst’s presence. Free-floating attention will enable the analyst to receive and hear this distress and ease the patient’s recovery of his or her intrasubjective space.     

Consuming “the unfortunate”: the violence of philanthropy in a contemporary Chinese state-run orphanage

Following the Tocquevillian tradition and driven by a neoliberal concern, many China scholars interpret the rise of philanthropy in contemporary China as a sign of the growing “civil society” that will help to democratize the country and improve its citizens’ social well-being. However, this paper shows that philanthropy in the Chinese context works to reproduce social inequalities between philanthropists and the subjects they claim to help. My ethnography focuses on philanthropic activities in a state-run orphanage in southeastern China. In these activities, characterized primarily by donations and volunteer work, middle- and upper-class philanthropists label orphans as “the unfortunate” or even “the abnormal unfortunate” to create a clear-cut “they/unfortunate–we/fortunate” dichotomy that stigmatizes these children. Furthermore, they utilize this dichotomy as a tool to transmit class consciousness to their own children, “touristify” the orphanage, and even exploit the orphans for marketing or commercial purposes. The pragmatic rationale reflected in these representations and practices also provides an alternative to the current anthropological studies on humanitarianism, which have mostly focused on religious, ethical and moral motivations among philanthropic agencies.     

Literature and patent analysis of the cloning and identification of human functional genes in China

The Human Genome Project was launched at the end of the 1980s. Since then, the cloning and identification of functional genes has been a major focus of research across the world. In China too, the potentially profound impact of such studies on the life sciences and on human health was realized, and relevant studies were initiated in the 1990s. To advance China’s involvement in the Human Genome Project, in the mid-1990s, Committee of Experts in Biology from National High Technology Research and Development Program of China (863 Program) proposed the “two 1%” goal. This goal envisaged China contributing 1% of the total sequencing work, and cloning and identifying 1% of the total human functional genes. Over the past 20 years, tremendous achievement has been accomplished by Chinese scientists. It is well known that scientists in China finished the 1% of sequencing work of the Human Genome Project, whereas, there is no comprehensive report about “whether China had finished cloning and identifying 1% of human functional genes”. In the present study, the GenBank database at the National Center of Biotechnology Information, the PubMed search tool, and the patent database of the State Intellectual Property Office, China, were used to retrieve entries based on two screening standards: (i) Were the newly cloned and identified genes first reported by Chinese scientists? (ii) Were the Chinese scientists awarded the gene sequence patent? Entries were retrieved from the databases up to the cut-off date of 30 June 2011 and the obtained data were analyzed further. The results showed that 589 new human functional genes were first reported by Chinese scientists and 159 gene sequences were patented (http://gene.fudan.sh.cn/introduction/database/chinagene/chinagene.html). This study systematically summarizes China’s contributions to human functional genomics research and answers the question “has China finished cloning and identifying 1% of human functional genes?” in the affirmative.     

Depression, Constraint, and the Liver: (Dis)assembling the Treatment of Emotion-Related Disorders in Chinese Medicine

Traditional Chinese medicine (TCM) is today practiced worldwide, rivaling biomedicine in terms of its globalization. One of the most common TCM diagnoses is “Liver qi constraint,” which, in turn, is commonly treated by an herbal formula dating back to the 10th century. In everyday TCM practice, biomedical disease categories such as depression or anxiety and popular disease categories such as stress are often conflated with the Chinese medical notion of constraint. Medical anthropologists, meanwhile, argue that constraint reveals to us a distinctive aesthetics of constructing body/persons in Chinese culture, while psychologists seek to define constraint as a distinctive psychiatric disorder distinctive from depression and anxiety. All of these actors agree in defining constraint as a concept dating back two thousand years to the very origins of Chinese medicine. This article disassembles the articulations by means of which these different facts about constraint are constructed. It shows how ideas about constraint as a disorder caused by the penetration of external pathogens into the body were gradually transformed from the eleventh century onward into constraint as an emotion-related disorder, while treatment strategies were adjusted to match perceptions about body/self that developed among the gentry elite of southeast China in late imperial China.     

中国植物激素研究: 过去、现在和未来

为了迎接2006年10月在北京召开的“植物激素与绿色革命”香山会议, 使其更具影响力, 本刊组织了一期“植物激素专辑”。本文作为此专辑的序言, 对我国在该领域研究作了概述和评论, 以帮助读者全面地了解我国在该领域的研究历史、现状和未来发展趋势。本文回顾了中国植物激素研究在二十世纪八十年代之前的工作发展历程中的重要成果, 主要集中在生理学研究方面的成果。随着植物分子遗传学技术与原理的不断成熟以及我国经济的飞速发展, 特别是研究队伍的迅速成长, 我国科学家近年来在植物激素代谢调控、转运及激素信号转导等领域取得了重要进展, 特别是激素受体基因分离鉴定、激素控制株型以及激素间的相互作用等方面取得的突破性进展。基于国际植物激素总体研究前沿和我国优势领域, 我们展望提出了我国在植物激素研究领域的未来发展方向与趋势。     

Reflechi twòp—Thinking Too Much: Description of a Cultural Syndrome in Haiti’s Central Plateau

A rich Haitian ethnopsychology has been described, detailing concepts of personhood, explanatory models of illness, and links between mind and body. However, little research has engaged explicitly with mental illness, and that which does focuses on the Kreyòl term fou (madness), a term that psychiatrists associate with schizophrenia and other psychoses. More work is needed to characterize potential forms of mild-to-moderate mental illness. Idioms of distress provide a promising avenue for exploring common mental disorders. Working in Haiti’s Central Plateau, we aimed to identify idioms of distress that represent cultural syndromes. We used ethnographic and epidemiologic methods to explore the idiom of distress reflechi twòp (thinking too much). This syndrome is characterized by troubled rumination at the intersection of sadness, severe mental disorder, suicide, and social and structural hardship. Persons with “thinking too much” have greater scores on the Beck Depression Inventory and Beck Anxiety Inventory. “Thinking too much” is associated with 8 times greater odds of suicidal ideation. Untreated “thinking too much” is sometimes perceived to lead to psychosis. Recognizing and understanding “thinking too much” may allow early clinical recognition and interventions to reduce long-term psychosocial suffering in Haiti’s Central Plateau.