Tuesday, October 12, 2010

Psychoanalysis in China

A headline in yesterday's Washington Post caught my eye - "Freud coming into fashion in China." Until I saw the article, I'd never used "China" and "Freud" as part of the same sentence!

Through the article I learned about the China American Psychoanalytic Alliance (CAPA). Nine years ago, Dr. Elise Snyder, in her late 60s at the time, gave a paper about psychoanalysis in Beijing. She was startled at how interested young psychiatrists, psychologists and social workers were in learning about psychoanalysis. On returning home she formed CAPA, which has developed a remarkable training program for mental health clinicians in China.

In 1986, on my only trip to China, the psychiatrists I met were organically-minded, and showed little interest in psychoanalysis. It was only their politeness that kept them from describing it as a symptom of western decadence. But with the enormous social changes associated with rapid economic growth, internal migration, and a growing middle class, the anxiety and depression previously seen as western decadence have become part of Chinese life, and interest in the psychological aspects of human function has burgeoned. Incidents of suicides among workers in the economic zone and kindergarten killings have led the government to take more interest in developing access to mental health treatment.

CAPA has established a two year psychotherapy training program in which teachers in the U.S. treat the training participants via Skype and conduct supervision the same way. Faculty members travel to China for face-to-face meetings with the students and their patients. The first class will graduate in Beijing on October 24.

The CAPA program will give a window onto complex ethical questions. Freudian psychology is highly individualistic. Therapy centers on the patient's fears and desires. Societal expectations are seen through the lens of the individual psyche. Despite the extraordinary changes since Mao's death in 1976, however, China is still an authoritarian society. Challenging the state is not welcome. If psychotherapy led to intense questioning of the political structure it could create significant danger to the individual, and could lead to discrediting of the Freudian venture itself.

At a CAPA gathering in New York in January the topic of the main panel will be "Ethical Problems in Teaching and Treating in China," presented by two students in the China program. I hope it will be the start of an extensive piece of intercultural ethical inquiry. There would be much to learn from a dialogue between Freud and Mao!

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