Transforming Emotions with Chinese Medicine: An Ethnographic Account from Contemporary China (review)

This is a wonderful little book and an amazing achievement. In fewer than 150 pages, the author provides a detailed analysis of the embodiment of emotion in Chinese culture, discusses Chinese medical approaches to the understanding and treatment of disordered emotions, and presents a novel methodology for studying Chinese medicine in practice. She succeeds in weaving together the different strands of her inquiry into one coherent account that moves in successive steps from the macro level of cultural aesthetics to the micro level of clinical interaction, while tying it all to wider debates in an interdisciplinary matrix that encompasses the phenomenology of the body, the history and anthropology of Chinese medicine, and conversation analysis. All of this, finally, is delivered in easily accessible language that provides a wide audience with access to complex thematics without surrendering intellectual rigor or its appeal to more specialist readers.

The topic on which the author’s various inquiries are centered is qingzhi bing, a group of disorders attributed by Chinese medicine to disordered emotions and believed to be treatable by its therapeutic arsenal. Writing for an audience that can be assumed to view emotional disorders predominantly through the framework of biomedicine and Western psychotherapy, and that will be generally unfamiliar with the Chinese medicine and its complex history, the author’s first task consists of preparing the terrain for a discussion in which qingzhi bing and their treatment by Chinese medicine make sense in their own terms. Zhang devotes four chapters, roughly half of the entire book, to this effort.

Chapter 1 introduces readers to the topic of the book and situates it within wider debates in medical anthropology and transcultural psychology. Chapter 2 presents an overview of Chinese medicine as a living and transforming tradition and the problems associated with its continued existence in a modern biomedically dominated society. Chapter 3 moves to a phenomenologically oriented exploration of how Chinese people in their everyday lives experience their body-person (shenti) within processes of “world making” (i.e., health) and their breakdown (i.e., disease). Three key aspects of illness experience are elaborated. These encompass blocked circulation (butong), lack of moderation (shidu), and loss of harmony (weihe). Healing is thus the activity of attuning (tiaohe) these processes to a more normal state. The roles that emotions play in these processes, and how they are sensed, described, and integrated into a medical practice that concerns itself with understanding and regulating processes, constitutes the topic of chapter 4.

The remainder of the book is devoted to exploring in considerable detail how Chinese medicine in contemporary China diagnoses and treats emotional disorders. Chapter 5 lays out the understanding of emotional disorders in contemporary Chinese medicine textbooks and their integration into overarching modalities of practice such as “differentiating patterns and determining therapies” (bianzheng lunzhi). In chapter 6, the author uses a case history approach, drawing on participant observation in a Beijing clinic, to elucidate how these general principles are translated into everyday clinical practice. Chapter 7, finally, is a detailed microanalysis of the activity of attuning (tiaohe). Employing methodologies developed in conversation analysis, the author is able to show how physician and patient negotiate within the course of a clinical encounter the meaning of illness, its categorization within the discourse of Chinese medicine, and thus, a path to effective treatment. With some justification this is presented as a method for shedding light on how practice-oriented Chinese medicine actually works “in practice.”

If there is one criticism I have of this book besides the somewhat slipshod editing (numerous spelling mistakes, missing references in the bibliography, etc.), it is its tendency not to question the self-presentations of contemporary Chinese medicine. Why, for instance, does the liver system dominate the contemporary discourse on emotional disorders in Chinese medicine in just...