Letters from China

Psychoanalysis is a 19th century Viennese development of the Western mind. As it travelled to other countries and continents, it has been changed by the differing mentalities of place and time. Sometimes the changes were subtle, sometimes more radical. What can we expect now of the journey that psychoanalysis is beginning in China? China's philosophical and social systems are unlike those of the West, and unlike those of old China. We must expect that there will be change as it becomes a Chinese analysis, and in all likelihood that change will be more radical than the changes psychoanalytic theory and practice underwent in spreading from Austria and Europe to Great Britain and the Americas. China is a large and influential country and culture. We should expect that the Chinese experience of analysis is likely to change psychoanalysis itself. In the four “Letters from China” that follow, we can see the beginnings of such a process. In this collection, two recently graduated analysts from the United States recount the experience of their first encounters with colleagues in China, and two young Chinese women, one a psychiatric resident, one a recent PhD in psychology, tell of their exposure to and growing interest in analysis. We can see the beginnings of reciprocal influence of our cultures in these reports that speak of mutual curiosity, interest, and respect. But there is also a quality of puzzlement mixed in with the wonder as they approach these new experiences. It is a privilege to read these personal stories of our colleagues from East and West as they grapple with understanding how analytic ideas and psychoanalytic treatment will work in China. This would be my first voyage ever to the Orient so I wanted to make the most of it. As I imagined this unique opportunity, my mind transported me to the Great Wall, the Forbidden City, Tian'anmen Square, and the Bund, the architectural symbol of Shanghai's European past on the western bank of the Huangpu River. I was excited to experience firsthand the wonders of China's history, its peoples, and its cultures. I had no doubt that I was about to experience an amazing adventure, but little did I realize just how meaningful and transformative this journey would prove to be. In writing this letter, I hope to convey my newfound love for China and the Chinese peoples, and to express my thanks to all those who afforded me such memorable encounters. Looking back, I realize that my curiosity and interest in Chinese culture probably began when I was a little girl. I can remember meeting various visitors to our home in Canada, scientific colleagues and friends of my parents who were visiting from China. Reliably, they would gift us with extraordinary teas. It was rare though that I would actually participate in these tea-tasting ceremonies, which seemed then like a sophisticated grown up activity. Rather I loved to collect the tea canisters decorated with their brightly colored, intricate designs. Sometimes they even doubled as a good hiding place for my candy collection, a secret I treasured. Several years later, as an adolescent in the late 1970s, my respect and admiration for the Chinese peoples grew even further, when I attended Lester B. Pearson College of the Pacific, a United World College inspired by the late Canadian Prime Minister Pearson, where teenagers came to live and study with each other from all over the world, including China and other parts of Asia. In his Nobel Peace Lecture in 1957, Pearson said, “How can there by peace without understanding each other, and how can this be if they don't know each other?” About a decade later, the global community was riveted to the media reports of the 1989 massacres in Beijing's Tian'anmen Square. As a young adult, I felt particularly close in to the scenes of student protests and massacres, since fellow Pearson College alumni, Loreen Pindera, documented the daily stories as a radio reporter for the Canadian Broadcasting Corporation. So all these experiences fostered my interest in making it to the Orient, one day perhaps, but why now? Last fall, when I was a candidate of the International Institute of Psychoanalytic Training (IIPT) at the International Psychotherapy Institute, I was taken by the idea of attending the International Psychoanalytic Association (IPA), which was hosting the first-ever Asian Congress in Beijing from October 21–24, 2010. This conference entitled “Evolution and Change: Psychoanalysis in the Asian Context” would celebrate the 100th anniversary of the founding of the IPA by Freud, where psychoanalysts from East and West would come together, united by their shared passion and commitment to the growth of analysis in China. Before long, I had booked my ten-day tour that would begin with the IPA Congress in Beijing. Then I'd venture onwards to Shanghai to participate in sightseeing and visit the Shanghai Mental Health Center. Then I'd travel back to Beijing where I'd do more sightseeing, and ultimately, conclude my trip by touring and teaching at the Capital Medical University in Beijing. My friend and mentor, Maryland Pao, MD, a child psychiatrist who supervised me more than a decade ago at the Children's National Medical Center in Washington, DC, put me in touch with Dr Hong Xing Wang, Director of the 3 rd Department of Clinical Psychiatry at the Capital Medical University in Beijing, who in turn put me in touch with Drs Lin Yi and Jue Chen, psychiatrists working at the Shanghai Mental Health Center. These Chinese colleagues warmly welcomed me to meet with them, tour their hospitals, and teach them about psychotherapy. I was aware that many IPA members had been supervising and teaching psychoanalytic psychotherapy to teachers in China over the past 15 or so years. Close to home, I was inspired by IIPT faculty, Drs David and Jill Scharff who had been teaching and supervising extensively in China for many years. After much planning and many imaginary voyages, on October 20, 2010, I boarded my flight from Washington to Beijing. After a 13-hour flight, I dropped off my bags at the China People's Palace Hotel in Beijing. Moments later, I headed out again to find a cab that would take me to Peking University to hear Prof. Claudio Laks Eizirik, Former President of IPA, give the IPA pre-conference lecture on “Psychoanalysis and Culture: Contemporary Challenges.” Waves of fatigue quickly began to descend upon me, but I knew there was nowhere else that I would rather be. My taxi driver seemed to understand that I needed him to take me to Peking University. But that was all that we managed to communicate to each other. Curiously I felt happy for these feelings of disorientation, welcoming feelings of otherness as a minority in a culture that fascinated me so much. An eternity later, or so it seemed, my cab driver dropped me off seemingly in the middle of nowhere, a couple of miles from the School of Life Sciences where Dr Eizirik was speaking. Now, it was undeniable that I was a foreigner! Planted right in the heart of the Peking University campus, I was surrounded by the night-time student hustle and bustle, teenagers and young adults perched in twos aboard bikes made-for-one, lovers embracing nearby, and eager students racing on foot to their night classes. Phew! By some miracle, I found the lecture hall where I needed to be, and amazingly, I was on time! The venue was filled to capacity, overflowing in fact. There I found a seat amongst maybe 350 Chinese students, a foreigner amongst many enthusiasts sitting on the floor, many crouched in corners and wherever any place could be found. Excitement soon overcame my jet lag. Dr Eizirik gave an amazing lecture about the contemporary challenges we face in a globalized world, and the contributions that analysis can offer to understanding and responding to such cultural maladies as hatred, prejudice, and violence that are transmitted inter-generationally. At long last, I had arrived! The next day, the IPA Congress commenced in full gear. The Program Committee used an ingenious design to bring together speakers from Asia, Europe, and America. There were approximately 250 Chinese participants. For the next four days, I was immersed in the experience of this auspicious occasion. I felt privileged to take in many outstanding plenary sessions, lectures, workshops, and intercultural gatherings, and to sample native Chinese cuisine with people from all over the world. I particularly enjoyed a plenary given by Yang Yunping, of the IPA China Allied Center, entitled “A Challenge of Professional Identity for Chinese People in the Process of Learning and Practice,” chaired by Sverre Varvin, a Norwegian psychoanalyst. She discussed psychoanalytic ways of thinking about personal and professional identity, emphasizing the importance for the Chinese of developing their own local model of psychoanalysis that would be a good fit for Chinese culture and not simply an imported product from Western societies. I thought this was an important cautionary reminder to Westerners, lest we presume that our model of analysis be applicable wholesale within an Asian sociopolitical, historical, and cultural context. Speakers and participants, throughout the Congress, explored this theme of the universality versus the cultural relativism of psychoanalysis. I learned that psychoanalysis had been developing slowly in China between the 1950s and 1980s as Chinese therapists trained abroad. As a testament to the growth of this movement over the past 15 years, there are now nine Chinese candidates in training, all accomplished university teachers and/or psychiatrists, some of whom I had the pleasure to meet at a social gathering at Dazhaimen at the Xi Cui Road Restaurant. One of the Congress highlights was the intercultural gathering, known as “Coming Together in Beijing.” We met in groups of 20 for 90-minute sessions on two consecutive days. I felt right at home in these group sessions as this learning approach reminded me of the group affective learning model that was a distinctive feature of my training at the International Psychotherapy Institute. My group came from far and near, from such countries as Korea, India, Japan, Israel, India, Eastern Europe, and Taiwan, and co-led by Mira Erlich-Ginor from Israel and Dr Micky Bhatia from India, with translation by Wang Lanlan from China. At the start, our leaders remarked that the Chinese-speaking members were relatively quiet. But this palpable divide between East and West quickly gave way to a fervent intercultural dialogue when we all came together around the story of a Swedish adoption of a Chinese baby. We all marveled at how this mother-baby dyad had the power to help us transcend some of our cultural differences while revealing many others. Each group member related to different parts of this story and, in turn, to each other. For the remainder of my visit to China, I toured urban mental health centers in Shanghai and Beijing, namely the Shanghai Mental Health Center and the Capital Medical University's Third Department of Clinical Psychiatry. I enjoyed many interesting conversations with psychiatrists and a few child and adult patients. I was impressed by the work ethic of the psychiatrists who managed very large caseloads with skeleton staff. They wore many hats, employed not only as psychopharmacologists and therapists, but also as nurses and/or social workers. A young girl talked to me with the aid of her translator-psychiatrist about how far she was from her rural home, having been hospitalized two months ago. She seemed somewhat desperate to have me know that she felt unloved and rejected by her mother. On one of the adult inpatient units, a man spoke to me about his near conviction that something could be dangerously wrong with his gut. He realized that his wife and doctors thought otherwise, and told me how grateful he felt that his psychiatrist was willing to listen patiently to his story, day after day, week after week and month after month. My tour of Beijing's Capital Medical University concluded with my talk to graduate students in psychology and psychiatrists on “Psychoanalytic Thinking and Its Relevance to General Psychiatric Practice.” I developed the content of this talk by collaborating by email with Dr Hong Xing Wang over the preceding months, to learn the interests of the staff and students in his department. Some of the participants had attended the IPA Congress. I was impressed by the enthusiasm and seriousness of the participants, many of whom seemed already versed in psychoanalytic principles. Although they had a copy of my slide presentation, the students took photo after photo of the slides. I was unaccustomed to experiencing this dance of camera flashes going off, one after the other, which reminded me of a Western celebration when people light firecrackers. I felt a sense of elation and a strong intercultural connection with these people. It was truly an unforgettable experience! Now, many months later, I savor the Chinese teas that I have come to know, not only for the beautiful canisters but also for their splendid contents, which evoke in me wonderful memories of my encounters with these Chinese professionals. I feel I have arrived! Psychoanalysis had been a mysterious word for me. My first impression came from its appearance in several reviews of those incomprehensible films. I tried reading some Chinese translations of books of Freud and Jung during my early years in medical school, and it was there I started my exploration of the human mind. As an intern in adult psychiatry in my first year at Shanghai Mental Health Center, my experience was mainly in general psychiatry. I had basic training in clinical diagnosis and the use of medication. Problems of relapse and patients’ difficulties facing their families and surroundings caught my attention, and drove my interest further. At the same time, as a student of Professor Xiao Zeping, who has always been active in promoting psychoanalytic therapies in China, I participated in the organizational work of some workshops and conferences on this subject. The psychoanalytic vision of mental health problems attracted me, though it was still a vague concept for me. My second year of internship took place in Paris, organized by the university's exchange program. I arrived at the Jean-Martin Charcot Hospitalization Center, and started my internship in an adult psychiatry department in which systemic family therapy dominates clinical work. The multidisciplinary teamwork contrasted to how we had been working in China, because in Paris I was working with child psychiatrists, psychotherapists, specialists in psychosomatics, and other mental health colleagues. We had many discussions about psychopathological structure and the psychodynamics of the patients. I attended seminars for interns, including some by IPA Past President Daniel Widlocher and other psychoanalysts, participated in discussion groups with colleagues, read French classics of psychoanalytic psychopathology and started my own personal psychoanalysis. One year is not enough, but it opened my mind. These experiences impressed me professionally and culturally. They have served to remind me constantly to keep my eyes open in the years to come. After my internship in Paris, I came back to China and went to the IPA congress in Beijing where I translated for the workshop of Drs David Scharff and Janine Wanlass on Psychoanalytic Couple and Family Therapy. In 2011, I translated for several seminars of French psychoanalysts at Shanghai University. On these occasions, I met people of all ages from all over China who were experimenting with their clinical or consulting practices. Psychoanalysis was brought to China in the early 20th century, but its influence remained mainly in the field of literature, with no real influence on the general population. Today, with rapid socio-economic development in China, mental health problems are increasing at a remarkable rate. Now along comes a kind of “Freud Fever” in China. This feverish interest has aroused controversy in our hospitals. I have the impression that in China psychoanalysis is either deified or decried while mainly being widely misunderstood by the and by mental health workers. Although Shanghai Mental Health Center is relatively active in psychoanalytic and its leaders psychoanalytic very few psychiatrists are psychiatrists from or are even its practice in hospitals. Psychoanalytic a of our and there is no of the of analysis. Some Chinese psychiatrists that psychoanalysis is a kind of personal like a and that it is the scientific of our time. Some of them simply that its meet the of our daily work. It is relatively for the psychiatrists in this large psychiatric to use psychoanalysis as a But even as an understanding of psychopathological our Chinese are far with analysis to I in In clinical work is also more and more and many psychiatrists are to psychoanalysis as a they talk about analysis a because of psychopathology are But in China psychiatrists psychoanalysis in since been to it or it in China, it is as though we over a of psychoanalytic influence and headed for a new with rapid development of new and scientific We hear about psychoanalysis in our general psychiatry department. There are in for the the affective and the where we use and where psychoanalytic therapies are to clinical work and are there is still a long way to are trained in it is not to there are no working in the only now have slowly to with to problems of and It still that psychoanalysis is more hospitals. The psychoanalytic discussion group on the Chinese for and reviews and quickly its of people. There are discussions on Freud, and by young and workshops on no which are welcomed by therapists and the general It is known that psychoanalysis is not for but we can see there is a in China. I of the Chinese of only We grew up in a place where us changes and went several and the our parents the We are to be the new of hope and But that is not all that problems have to as our and and there are simply not ways for people to The of our parents and have their with no of a for professional They that should be to in to us of the no how much they The that has just to their now encounters difficulties from such as and social and from our We are for but are one of my for A young who just had her first child a few months ago was hospitalized for a of in our department of general adult psychiatry. her in with a about her In a family with her and I problems in the with her mother. many during the and the of the which she would not tell her because she that her have a without My was loved and by her beginning school, since parents had to work a After she to her home, her for including My this In the therapy while the talked my at her like a I her she only said, I I only had for one family because of other clinical work. We have no in the the family found a and will which is the after This family is a very good of the Chinese family These when to their There is no doubt that China is in of more and mental health In the between our relatively and the mental health of the I that psychoanalysis can find its A cultural but in my it is more an interesting to than it is a to the adoption of psychoanalytic ideas our work. I still remember the of a psychiatrist in who had been systemic family therapy for over some years of clinical just find out that don't always and then turn to In late October 2010, I to Beijing to at the first International Association in and to teach a on psychoanalytic couple therapy with David On in Beijing, I was by this of in the of the very old and the very A of a National of contemporary and of in all open the of the the of the Great Wall, and a Forbidden that and my Chinese spoke of old and new China, a theme that would my in my personal and my professional encounters. The IPA arrived in China, a an at theory to a from an culture. At it felt a like a where and to find a way to Each lecture was by translations on large in on one of the and in Chinese on the other. In the large the to a of the cultural to the and to the dance we the about the experience of the in this shared I was I did not to be as the and a in a country already by What did China from the IPA a or a What kind of dance could we translation read their as months and the the planning always and and found a seat at the This quickly for me, as my workshop on Psychoanalytic Couple and Family took an David Scharff and I our teaching together, but a travel on his me on my The was a of and local Chinese all on a young Chinese to help us our differences in and culture. her the changed the us to listen more to our for to to in the and to the group as a to teach the ideas rather than a the clinical a couple who different and on the As the couple they began to their and the ways they of the other. In a the this couple as our shared and began to the cultural I was as much as to the and of the Chinese and and for I was ideas such as found in and culture of ideas I was aware of the One and the to China. I had read about these and them discussed in As I attended the IPA conference and a couple for Chinese mental health by of Peking I realized the of my I had not the of these and on Chinese couple or family I was by and from Chinese colleagues who spoke of family with and In a family with just one it is more to I could see that the one child the of for two parents and four and being the only family to the this sense of is somewhat in Asian the One seemed to the or and and the or in or this is by a cultural and of families by the of the I learned that many parents were to work in the while their were in work a of or group versus a this cultural and our work with and families in China? In a I at the IPA I discussed a child who was of the a for her that her family would for the of her parents during her and for the affective her that she had and The Chinese with this little of their own personal and professional experiences with who an or Yang the for this to not just the story, but the little very important that her feelings be He wanted this girl to be to I was with the idea that she was for the many Chinese who the and seemed to understand the of this In the week the IPA David Scharff and I a on psychoanalytic couple treatment for Chinese mental health professionals. the of couple therapy and with the help of our Chinese we therapy sessions, one each day, with a Chinese the to and learn from this Although this couple was young to have the of and family in their couple I found about the between their and their as a and the wife was about the of her young from by attending for the first time. As the couple sessions we began to understand the of an from her own In her

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