Psychiatry and Chinese History ed. by Howard Chiang (review)

This enticing collection covers psychiatry and psychotherapy in or pertaining to China over a period of several centuries. The book aims to shed light on a number of corners of this vast field, rather than to present an integrated narrative. The body of the book is ten essays in four groups, on somewhat scattered topics. There are three essays on native Chinese concepts and practices during late Imperial times, three involving missionaries from the 1870s to the 1940s, three on institutions and ideas from the early twentieth century to the 1960s, and one on the recent mainland “psycho-boom.”

Brigid E. Vance begins the first set, describing a Ming manual on dispelling unwanted dreams. Its ideas are eclectic, but it emphasizes the eating of talismanic inscriptions—a kind of mentalized medicine. Hsiu-fen Chen looks at records of late Imperial talking cures applied to what were seen as imbalances among emotion–humors, each emotion having a special relation to each other. Treatment could talk through problems or simply report facts—or failing suitable facts, an elaborate temporary deception could reset the emotional joint. Chen analyzes the pitfalls of talk therapy to explain why drug therapy predominated. A case history from the early nineteenth century is the point of departure for Fabien Simonis’s erudite and elegant historical analysis of traditional concepts and vocabulary. Chinese psychology envisioned feelings and faculties very much in terms of fluids and organs, easily associating mental with physical disturbances—indeed, mental disturbances were long seen mainly as occasional symptoms of known physical ailments.

Starting the next group of essays, Peter Szto discusses an asylum complex built by a nineteenth-century missionary over the objections of his church superiors, modified from American models to suit local cultural and climatic needs. Zhiying Ma next looks at the rhetoric of Westerners’ institutional projects in China, arguing that their scientific and moral pretensions as they aimed at individualcentered treatments led them to promote a negative picture of a rival in caregiving, “the Chinese family.” The third essay in the missionary set looks at a more global phenomenon. When Western colonialists and missionaries stationed in tropical and other lands suffered depression, as they often did, it was usually classified as “neurasthenia” instead. The cause was debated. Was it culture, race, climate? Were the natives especially robust, or their societies especially deficient? Ideas shifted greatly over time, often reflecting Western interests. Wen-Ji Wang surveys the broad debate and a part of it focused on China.

The new quasi-public institutions for psychiatric care in the 1920s and 1930s were used for many purposes. As Hugh Shapiro details from case reports, women fleeing unwanted marriages were likely to be returned by their neighbors; but many sought and found refuge in psychiatric institutions. Toward the middle of the century, the development of theory and institutions for Chinese circumstances was led by Chinese psychiatrists in hospitals and academia, addressing each other and the educated public especially through the journal West Wind, until the 1949 revolution effectively suppressed approaches based on individual diagnosis rather than broad social aims. Geoffrey Blowers and Shelly Wang Xuelai tell the stories of four of the journal’s main contributors. Next, Harry Yi-jui Wu surveys a trove of case notes from a main Taiwan hospital covering the turbulent years 1946 to 1953, pointing especially to the differential recognition of psychological effects of war and social turmoil.

Finally, Hsuan-Ying Huang perceptively narrates and analyzes the mainland explosion in professional and amateur psychotherapy since the 1990s—the development of training courses, funding, legal infrastructure, and perhaps most remarkably a very popular television program consisting of brief one-shot therapy sessions with commentary.

Framing the ten essays are an introduction by Howard Chiang and a concluding review by Nancy N. Chen, each a valuable guide to themes and problematics binding the essays together.

Most of the book could benefit greatly from further...