Comment: China's psycho-boom

A ‘psycho-boom’ is sweeping through China, challenging long-held stigmas about ‘personal problems’ and mental health, reports Belinda Cranston.

The Chinese are wary of discussing their problems out loud – signs of personal weaknesses and disorders of the mind carry a strong social stigma.

It’s interesting then, that the reality television show Psychological Sessions has been captivating audiences across the People’s Republic of China since 2004.

Aired on state-owned television, the show typically involves an individual pouring their troubles out to a host, while a well-respected psychologist looks on. Sometimes, the individual’s partner or family is present.

Music and a short video clip portraying aspects of their life is thrown in, then the psychologist demonstrates ‘some very masterful technique’ while interpreting the problem.

All within 20 minutes.

Dr Hsuan-Ying Huang, from the Australian Centre on China in the World at the ANU College of Asia and the Pacific, has watched hundreds of the shows ahead of researching a ‘psycho-boom’ that has hit China.

He has also noted the increased availability of personal development books in the Communist state, along with a deluge of short courses in psychotherapy offered by privately run colleges.

“A couple of decades ago, before China opened itself to the West, it was unthinkable for the Communist state to recognise mental illnesses as a social issue,” says Huang, who has degrees in clinical medicine, psychiatry and medical anthropology from National Taiwan University, National Taiwan University Hospital and Harvard University.

As he explains, it’s a far cry from the days of China’s Cultural Revolution, when from the mid-1960s to the mid-1970s, those who practiced psychiatry were persecuted, while ‘the whole discipline of psychology was exterminated’, leaving a generation gap of psychiatrists and psychologists.

Along with its extraordinary economic growth and natural disasters, like the 2008 Sichuan earthquake, the East Asian state has become aware of modern-day stresses and the need for treatment.

The government is responding by pursuing Western uses of psychotherapy – the treatment of mental and emotional disorders through the use of psychological techniques.

Jumping on the bandwagon of the ‘psycho-boom,’ are a slew of privately run colleges offering short courses in psychotherapy – a bone of contention for Huang.

He says it is one thing to be interested in the intricacies of the mind - but another for colleges to claim courses can prepare people to work as mental health practitioners.

“These courses are more appropriate for people wanting to explore their interests, rather than fulfil the requirements of a certain career,” says Huang.

Teachers running such courses, which can be as short as two days long, are usually famous psychotherapists based at universities and teaching hospitals.

“It’s a nice little earner outside their usual job,” says Huang.

For those working as self-employed psychotherapists, opening a practice is “as easy as opening a noodle shop,” Huang says.

Many remain in business for a short time only – some struggle to find clients, others find their passion is short lived.

“It’s not like in the West, where therapy is a career. If you spend many years studying, then set up a private practice, you are likely to stick with that for a long period of time,” Huang says.

Legislation passed in China in late 2012 is aimed at addressing a lack of adequate mental health care services.

Huang says it remains to be seen whether the new mental health law will stipulate and regulate qualifications and training needed to work as a psychotherapist in China.

“Because many practicing as therapists do not have rigorous, long-term training,” he says.

“They are registered as various kinds of business entities.”

In instances where therapists are suitably qualified, attracting clients still has a long way to go.

Unlike in Western societies, where making appointments is the norm, unpredictable work situations means Chinese citizens prefer walk-in clinics for medical attention.

“The notion of making an appointment ahead of actual treatment is actually quite weird for a lot of people,” says Huang.

“Many people think, ‘I have this issue, I want to talk to you. I will talk to you for the whole afternoon, because I have time today’.”

According to Huang, they are also of the mindset that clients, rather than practitioners, should call the shots.

“People think, ‘I am the one that pays. Why do I have to conform to your principles? Why every week? Why every Tuesday?’”

Those who work in with the system do find satisfaction, Huang says.

“They learn more about themselves. They learn how to appreciate and deal with interpersonal relationships better.”

Despite a lack of professionally qualified practitioners, he is quietly optimistic knowledge will improve.

“There is a substantial group of people who are committed to psychotherapy training and practice, and they are making great progress.”

In the meantime, therapists from many Western countries are providing services for Chinese patients over the Web via Skype.

Huang believes the China American Psychoanalytic Alliance is the largest, most organised group to do so.

Chinese therapists are also using the web to reach patients - in many instances their services are offered for free.

“Once they have enough patients, they will start charging,” Huang says.

For everyone else, there’s always reality television.

This article is from the Australian National University’s College of Asia and the Pacific

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