China (International Dictionary of Psychoanalysis)

Unlike in Japan and Korea, psychoanalysis in China has had a relatively checkered history. Freud's ideas achieved some notoriety in the 1920s during a period of significant social and political reform but were otherwise not taken seriously until the 1930s when the first translations began to appear. To this day, only a handful of Freud's works have been translated into Chinese.

Early translations resulted in some distortions of the original ideas for several reasons. There has been a tendency for translators to directly borrow the Japanese terminology as the two languages share a common writing system in kanjiharacters, even though the same characters may mean different things in the two languages. This has produced occasional errors, as, for example, with China's initial use of the Japanese term muisiki for "Unconscious", which literally means, in Chinese, "without consciousness."

More systematic distortions were also evident. There was concern in some quarters that Freud's theory, which appeared to grant primacy to a free-reigning sexuality, could be construed as a threat to the stability of family relations. Some interpretations of the Oedipus complex were desexualised, emphasizing a social component. The female author Yonqin, writing in 1930 about Freud's theory of hysteria (and omitting all references to infantile sexuality), stated that the condition arises out of conflict between social pressure and the "biological instinct for satisfaction and fulfilment." A motive for translating Freud, in one translator's eyes, was to forewarn a general public of the dangers of taking Freud too seriously (Zhang, 1989).

By contrast, very serious attempts have been made to rethink the oedipal myth in terms of culturally prevalent myths. In China the myth of Hsueh Jen Keui tells of a soldier of the Tang dynasty who kills his own son in ignorance of the kinship tie, preserving the authority of the father; some commentators have held that this becomes an exemplar of the Confucian ethic of filial piety (Zhang, 1989).

Sometimes translations of psychoanalytic and scientific articles based upon primary sources were written with a clear political purpose. The May Fourth movement of 1919 had heralded a brief renaissance in which there had been increasing call from intellectuals to modernize China and shake off certain feudalistic practices and "superstitions." Freudian notions of sexual tension in families proved compelling to those calling for social reform. Freudian ideas could be claimed to be useful because of their allegiance to biology, medicine and education.

As several commentators have amply documented, psychiatry, as a separate discipline, was in its infancy in China before 1949. There was a home for the mentally ill in Canton which opened in 1898 run by an American missionary doctor. Before that there appears to have been little in the way of psychiatric services. By the time the Communist Party came to power a small number of psychiatric hospitals appeared in the major cities where foreign influence was quite high. The most significant was the Peking Union Medical College which launched the first full-scale academic program in 1932 with new initiatives in teaching and practice involving the disciplines of sociology and social work.

However, psychoanalysis as therapy has not easily taken root in China. This is because, it has been argued, there has been no tradition of expressiveness in the doctor-patient relationship and the doctor in a traditional Chinese setting adopts an authoritarian attitude towards patients. Before WWII there had been only one Chinese psychoanalyst, Bingham Dai, who trained under Harry Stack Sullivan and taught psychotherapy at Peking Municipal Psychopathic Hospital (allied to the Peking Union Medical College) from 1935-39. While he was of the view that, but for the Japanese invasion, psychoanalysis might have taken root in China, he downplayed the theoretical importance Freud attached to the instinctual impulses, claiming that Chinese clinicians emphasised interpersonal relations, and gave more attention to helping their patients tackle the problems of being human (Blowers, 2004).

One should also note that Chinese typically present psychological problems as somatic complaints and have deeply ingrained philosophical systems of thought for which traditional practices such as worshipping of ancestors and visits to the temple to seek one's fortune serve in times of distress.

These practices have been understood by Unschuld (1980, cited in Gerlach, 1995) as embodying a "Medicine of parallels," evolving out of Confucianism, Taoism and Buddhism in which "visible and invisible occurrences in the internal and external worlds of the human being (e.g. emotions, internal organs, climatic conditions, elements) are allocated to particular series of parallels and are mutually dependent on each other. Thus the dividing lines between internal and external, mind and body, are removed and a change in one link in the series of parallels will directly affect the others" (Gerlach, p. 94). These systems of thought have also been influenced by turbulent political events. After the founding of the People's Republic of China (PRC) in 1949, the Communist government severed all ties with non-Communist countries. Attention became focused on Russia. In the early part of its first decade, all psychological work in the PRC was based upon Russian psychology and followed Pavlov's work very closely. When this model proved less than satisfactory for explaining all psychological phenomena, there then followed two very difficult periods in which psychology was criticised and eventually shut down along with many other disciplines in the second of these periods that became known as the "Proletariat or Cultural Revolution". Only since 1978 has psychology emerged with a new agenda, largely free of previous political constraints.

During the 1980s visiting psychoanalysts to China (Joseph, 1987) formed the impression that, insofar as psychotherapeutic methods are applied, they are oriented to behavioral therapy or use supportive techniques. They argued, however, that this circumstance maybe connected with traditional Chinese cultural patterns, which discourage both disclosure and communication about one's own feelings and thoughts to strangers and openness to sexual desires. Insight-oriented psychotherapies face obstacles both in the traditional pattern of Chinese thought and in conflicts leading to feelings of shame more than guilt. However, there have been substantive changes since the 1980s, both in the doctor-patient relationship and in the status of psychoanalytically oriented psychotherapy, in several of China's key cities.

In spite of there being no analysts in the early years of the PRC, by the 1990s things began to change. The German-Chinese Academy for Psychotherapy (GCAP), comprising German family therapists, behavioral therapists, and psychoanalysts under its president, Margarethe Haass-Wiesegart, initiated a range of training programs covering behavioural, systemic and psychoanalytic trends. From 1997-1999 they began a continuous training program of six-week courses in Kunming, Beijing, Shanghai, Wuhan, and Chengdu; the curriculum consisted of psychoanalytically oriented psychotherapy. The analysts involved in this training were Antje Haag, Margarethe Berger and Alf Gerlach, the latter having first lectured in China in the 1980s. A second program was initiated in 2000 in Shanghai and Hefei.

Since 1995 the IPA has also begun reaching out to China, organising a committee for Asia, with China represented by Argentinean-trained Teresa Yuan, of Chinese descent. She began training programs at Beijing Anding Psychiatric Hospital, attended by professionals from universities in Beijing and other Chinese cities. Psychoanalytic psychotherapy has been taught in a variety of psychiatric settings in the above mentioned cities, as well as in Xian, Guangzhou, Nanjing and Hong Kong. Huo Datong, a Chinese analyst trained with a Lacanian orientation in France, recently founded a psychoanalytic center in Chengdu (Yuan, 2000).

Although these developments signal a promising outlook for psychoanalytic methods and their application in China, the range and complexity of Freud's ideas may not be fully appreciated unless and until translation revisions and translation of more of his works are undertaken, clinical psychology gets more firmly established, and the therapeutic context is expanded to encompass thorough education on a range of treatments and the possibilities of the individual psychotherapeutic scheme.

GEOFFREY H. BLOWERS AND TERESA YUAN