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INTRODUCTION

  1. Top of page
  2. INTRODUCTION
  3. MY JOURNEY TO THE ORIENT
  4. A PERSONAL VISION OF PSYCHOANALYSIS IN CHINA
  5. IMPRESSIONS FROM CHINA
  6. LETTER BY GAO JUN

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.

MY JOURNEY TO THE ORIENT

  1. Top of page
  2. INTRODUCTION
  3. MY JOURNEY TO THE ORIENT
  4. A PERSONAL VISION OF PSYCHOANALYSIS IN CHINA
  5. IMPRESSIONS FROM CHINA
  6. LETTER BY GAO JUN

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!

A PERSONAL VISION OF PSYCHOANALYSIS IN CHINA

  1. Top of page
  2. INTRODUCTION
  3. MY JOURNEY TO THE ORIENT
  4. A PERSONAL VISION OF PSYCHOANALYSIS IN CHINA
  5. IMPRESSIONS FROM CHINA
  6. LETTER BY GAO JUN

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 both the public and by mental health workers.

Although Shanghai Mental Health Center is relatively active in psychoanalytic psychotherapy, and its leaders promote psychoanalytic thought, very few psychiatrists are involved. Most psychiatrists stay away from psychoanalysis, or are even against its practice in hospitals. Psychoanalytic theories occupy a minimal part of our textbooks, and there is almost no recognition of the post-war developments of analysis. Some Chinese psychiatrists think that psychoanalysis is a kind of personal belief, almost like a religion, and that it is against the scientific orientation of our time. Some of them simply think that its efficiency doesn't meet the need of our daily work. It is relatively difficult for the psychiatrists in this large psychiatric hospital to use psychoanalysis as a therapeutic method. But even as an alternative understanding of psychopathological structure, our Chinese professionals are far less acquainted with analysis compared to what I saw in France. In France, clinical work is also more and more scientifically oriented, and many psychiatrists are opposed to psychoanalysis as a therapeutic method too. Nevertheless they talk about analysis a lot because psychoanalytical concepts of psychopathology are well known. But here in China psychiatrists seldom mention psychoanalysis in hospitals since they've never been exposed to it or understood what it is. Therefore in China, it is as though we jumped over a certain period of psychoanalytic influence and headed straight for a neurobiological new age, with rapid development of new drugs and scientific research. We seldom hear about psychoanalysis in our general psychiatry department. There are exceptions in specific departments, for instance the psychosomatic ward, the affective disorders ward, and the psychological consultation center, where we use psychotherapies and where psychoanalytic therapies are applied to clinical work and are often discussed. Nevertheless, there is still a long way to go. Few clinicians are well trained in psychotherapy; it is not easy to get supervision; there are no psychologists working in the wards. Furthermore, only now have things slowly begun to settle down with regard to problems of finance and policy.

It still seems that psychoanalysis is more popular outside hospitals. The psychoanalytic discussion group on Douban, the largest Chinese website for movies, books, and music reviews and discussion, quickly reached its limit of 5000 people. There are passionate discussions on Freud, Jung, and Lacan by young intellectuals. Seminars and workshops on psychoanalysis, no matter which theory, are welcomed by therapists and the general public.

It is well known that psychoanalysis is not suitable for everyone, but we can see there is a great need in China. I am part of the Chinese “post 1980s” generation of only children. We grew up in a place where everything surrounding us changes rapidly and continuously. Our grandparents went through several wars and the communist revolution, our parents through the Cultural Revolution period. We are assumed to be the new generation of hope and bliss. But that is not all that we're taking on. Many problems have begun to emerge as our society develops and changes, and there are simply not enough legitimate ways for people to seek help. The generations of our parents and grandparents have mostly maintained their traditional attitudes, with no awareness of a need for professional psychological support. They believe that secrets should be kept to themselves in order to protect us of the younger generation, no matter how much they suffer. The younger generation that has just begun to establish their lives now encounters difficulties both from outside – such as competition and social stress – and from inside our families. We are looking for help, but resources are limited.

Take one of my patients for example: A young lady who just had her first child born a few months ago was hospitalized for a state of delirium in our department of general adult psychiatry. Under heavy medication, her psychosis disappeared in three weeks, with a complete amnesia about her symptoms. In a family interview with her husband and mother, I discovered problems in the relationship with her mother. Her mother suffered many traumatic events during the 1960s and 1970s – the time of the Cultural Revolution – which she would not tell her daughter because she hoped that her daughter might have a “life without worry.” My patient was loved and raised by her maternal grandmother before beginning school, since both parents had to work a great deal. After she returned to her parents’ home, her mother arranged everything for her, including schools, university, profession, etc. My patient accepted this passively. In the therapy session, while the mother talked non-stop, my patient stared at her shoes like a child, saying nothing. When I asked her opinion she only said, “Yes, I understand.” I only had time for one family interview because of other clinical work. We have no psychologist in the ward. Luckily the family found a private psychologist and will continue therapy, which is rarely the case here after hospitalization. This family is a very good illustration of the Chinese one-child family pattern. These children often encounter great difficulty when attempting to confront their independence.

There is no doubt that China is in great need of more and better mental health care. In the gap between our relatively poor resources and the great mental health needs of the population, I believe that psychoanalysis can find its rightful place. A cultural difference certainly exists, but in my opinion it is more an interesting subject to discuss than it is a concrete obstacle to the adoption of psychoanalytic ideas into our work. I still remember the words of a senior psychiatrist colleague in France who had been practicing systemic family therapy for over ten years: “After some years of clinical practice, you just find out that things don't always work, and then you turn to psychoanalysis.”

IMPRESSIONS FROM CHINA

  1. Top of page
  2. INTRODUCTION
  3. MY JOURNEY TO THE ORIENT
  4. A PERSONAL VISION OF PSYCHOANALYSIS IN CHINA
  5. IMPRESSIONS FROM CHINA
  6. LETTER BY GAO JUN

In late October 2010, I traveled to Beijing to present at the first International Psychoanalytical Association (IPA) Conference in Asia and to teach a weeklong seminar on psychoanalytic couple therapy with David Scharff, MD. On arrival in Beijing, I was immediately struck by this city of stark contrasts, captured in the juxtaposition of the very old and the very new. A skyline of skyscrapers, a stunning National Theater of contemporary styled glass and metal artistry, hundreds of cars converging in huge traffic jams, all existed alongside creaking bicycles transporting wood bundles, open air markets the timeless multigenerational homes of the Hutong, the ancient majesty of the Great Wall, and a Forbidden City that once separated emperors and commoners. Even my Chinese translators spoke of old and new China, a theme that would pervade my visit, both in my personal travels and my professional encounters.

The IPA arrived in China, a “new” presence bringing an “old” (or at least established) theory to a “new” audience from an “old” culture. At first, it felt a bit like a junior high dance, where well-intended, excited, and interested parties try to find a way to mix. Each lecture was accompanied by projected written translations on large screens, in English on one side of the room and in Chinese on the other. In the large auditorium, the audience naturally gravitated toward “their” projected screen, clinging to familiar language, creating a physical representation of the cultural divide, “West” to the left and “East” to the right. Like awkward dance partners, we glanced across the room, curious about the experience of the “other” in this shared yet separate space. I was atypically self-conscious. I did not wish to be perceived as the arrogant and uninformed American tourist, imposing a brash agenda, another invader in a country already marked by traumatic history. What did China want from psychoanalysis? Was the IPA a foreign invader or a desired guest? What kind of dance could we really do?

To minimize translation difficulties, presenters read their papers as originally penned months earlier, reducing spontaneity and formalizing the proceedings. Fortunately, the best planning always goes slightly awry, and creativity, humor, and ingenuity found a seat at the IPA. This happened quickly for me, as my preconference workshop on Psychoanalytic Couple and Family Treatment took an unexpected turn. David Scharff and I planned our teaching together, but a travel delay on his part left me on my own. The class was a mixture of English-speaking international guests and local Chinese clinicians, all reliant on a competent, young Chinese psychiatrist, Qi Wei, to help us bridge our differences in language and culture. Despite her excellent translation, the language struggles fundamentally changed the workshop, forcing us to listen more carefully, to employ our unconscious for understanding, to attend to nonverbal communications in the videotaped case examples and to utilize the group as a whole to teach the ideas rather than a single presenter. Interestingly, the main clinical case example featured a couple who appeared dramatically different and mismatched on the surface. As the couple gained insight, they began to recognize their similarities and the ways they unconsciously held aspects of the other. In a parallel process, the class mirrored this couple dynamic, as our shared identifications and affects began to blur the cultural divide. I was as much learner as teacher, listening to the rhythm, sounds, and syntax of the Chinese language and considering both “old” and “new” contexts for concepts I was presenting. “Old” ideas such as projective identification found intuitive emotional resonance in “new” learners, and “new” culture specific applications of “old” ideas emerged.

Certainly, I was aware of the One Child Rule and the Cultural Revolution before coming to China. I had read about these concepts and heard them discussed in international forums. As I attended the IPA conference and later taught a weeklong couple seminar for Chinese mental health professionals (organized by Fang Xin of Peking University), I realized the limits of my “old” understanding. Surprisingly, I had not fully considered the impact of these events and policies on Chinese couple dynamics or family processes. Suddenly, I was inundated by responses and comments from Chinese colleagues who repeatedly spoke of common family struggles with separation and individuation. In a family with just one child, it is understandably more difficult to promote autonomy. I could see that the one child feels the weight of responsibility, caring for two parents and four grandparents, and being the only family representative to move into the future. While this sense of generational responsibility is somewhat inherent in Asian culture, the One Child Rule seemed to intensify the role restriction (i.e. son or daughter first; career and spouse second) and magnify the pride or despair in success or failure. Additionally, this separation/individuation issue is complicated by a cultural and generational history of families physically separated, often traumatically, by the policies of the Cultural Revolution. I learned that many parents were sent to work in the countryside, while their children were placed in geographically distant youth work camps, creating a type of peer-raised or group attachment versus a dyadic parent-child attachment.

How does this cultural history and context affect our work with couples and families in China? In a paper I presented at the IPA conference, I discussed a child who was afraid of the wind, a metaphor for her fear that her family would break up, for the stormy relationship of her parents during her conception, and for the affective storms inside her that she had difficulty expressing and understanding. The Chinese audience readily identified with this little girl, speaking of their own personal and professional experiences with children who carried an intergenerational conflict or message. Yang Fuzhong, the translator for this paper, commented, “I want to capture not just the story, but the little girl's feeling. It's very important that her feelings be heard.” He wanted this constricted, silenced girl to be able to speak. I was struck with the idea that she was “speaking” for the many young, mostly Chinese women who comprised the audience and seemed to intuitively understand the dynamic implications of this child's dilemma.

In the week following the IPA conference, David Scharff and I taught a five-day seminar on psychoanalytic couple treatment for Chinese mental health professionals. To illustrate the primary concepts of couple therapy and with the help of our Chinese translator, Gao Jun, we conducted five therapy sessions, one each day, with a Chinese couple, allowing the class to observe and learn from this vivid demonstration. Although this couple was too young to have directly experienced the Cultural Revolution, themes of loss, traumatic separation and family responsibility appeared in their couple dynamics. I found myself wondering about the interface between their parents’ histories and their struggles as a couple. Depressed and distressed, the wife (Ms C) was intensely worried about the safety of her young child, newly separated from Ms C by attending school for the first time. As the couple sessions progressed, we began to understand the dynamic origin of Ms C's fears, discovering an earlier traumatic, extended separation from her own parents. In essence, Ms C lost her mother who had been in conflict with her father and now was unable to advocate for her own child. Initially, the husband (Mr R) appeared less overtly troubled, announcing he was there to support his wife and to understand how to manage her emotional upsets. But further exploration of his childhood revealed that as the only son he carried the pressure of performing, caretaking, and producing. He was the country boy sent to the city for education, both an honor and a burden. He had no psychological space to “break down,” was ashamed of the tears his marital conflict invited. He carried a belief that he had failed in his caretaking role. I wondered if his achievements were a way of making up for something beyond his generation. In this couple, the containment function was fractured and splintered under the pressure of unresolved personal, intergenerational, and cultural traumas.

During the five therapy sessions, this couple worked hard to find connection and understanding, moving through painful material that evoked strong countertransference responses in David, myself, our able translator Gao Jun and the workshop participants. When the couple left the room and the workshop recommenced, the audience jumped to speak of their affective and somatic reactions to the couple work. I direct a graduate training program in the US, so I have considerable experience teaching introductory analytic concepts. Typically, students become distracted by the unfamiliar analytic terminology. What does Fairbairn mean by the anti-libidinal ego? What is part-object relating? Somehow, I doubt the terms are much clearer in Chinese. Whether the language differences forced us to a different place, or this group of Chinese learners were simply more attuned to emotional experience, or the affective potency of the couple moved us forward, I was struck by the linking capacity of the participants, their intuitive understanding of the unconscious processes and their ability to make use of countertransference material. I began to wonder how much of what we were bringing to China with psychoanalysis was actually “new.” Certainly, we were teaching unfamiliar technique to this group of participants, and presenting new topics not often discussed in China, even in clinical settings. This became blatantly evident as we described working with the couple's sexual relationship. Still, there was a sense of shared understanding I had not expected, particularly since I was so dependent on Gao Jun to translate every sentence spoken to me. By the end of two weeks in China, I could speak only two words of Chinese, but I felt less like the awkward, self-conscious foreigner at a junior high dance. Perhaps my language deficit helped me listen better and learn more.

When Charles Hanly, president of the IPA, talked about the “new” resources the IPA would bring to China, I found myself wondering how China will change psychoanalytic thinking. In other words, what “new” resources will China bring to our “old” theory? Perhaps because I was immersed in a culture so different from my own, I began thinking about how much culture influences clinical practice, how intergenerational conflicts and dynamics carry cultural traumas and the aspects of interpersonal and intrapersonal relating that transcend culture. I left China feeling very much like a “new” student of an “old” teacher, a teacher I would like to revisit.

LETTER BY GAO JUN

  1. Top of page
  2. INTRODUCTION
  3. MY JOURNEY TO THE ORIENT
  4. A PERSONAL VISION OF PSYCHOANALYSIS IN CHINA
  5. IMPRESSIONS FROM CHINA
  6. LETTER BY GAO JUN

When David Scharff asked me whether I would like to share my personal experiences of learning, translating, and practicing psychoanalytic psychotherapy, I had an immediate association, or, more precisely, a memory. Since this letter is meant to be personal, I would like to begin my letter with this memory and follow on with whatever may come to me.

It was in the October of 2008, at a seminar of an international congress for psychotherapy held in Beijing. Five or six psychoanalysts from different parts of the world were discussing their personal experiences of being an analyst. I was doing the simultaneous translation for Chinese participants. It was the most difficult translation I had and have ever done. Translating or interpreting psychoanalysis has always been a challenge for me, compared with other therapeutic approaches. But this was more than a challenge. It was mission impossible. The first speaker suggested that the discussion should be done by way of free association rather than as a structured presentation. He began to describe his practice on a particular day, associating from information from one of his patients to his personal thoughts and feelings. I grew more and more anxious, and even desperate. I could not make sense of what he was saying, nor was I able to anticipate what he was going to say because frequently there was no logic between two sentences, or even between the first and second half of the same sentence. The pressure built until a moment when I suddenly felt as if the cohesion of my mind broke. After that, I just translated whatever I heard and gave up wishing to understand what was going on. I could not evaluate my performance for I worked in a dreamlike fashion. But at least no one came to me to complain about the translation afterwards. Many of audience seemed to leave the presentation in a good humor. It will remain forever a mystery to me how the Chinese audience experienced those two hours.

This experience raises a larger question for me. How might it be possible for psychoanalysis to be translated into Chinese and understood by Chinese minds? It is always a mystery to me. Psychoanalysis is not my mother tongue, and just like a foreign language, it elicits ambivalent feelings in me, such as excitement, curiosity, admiration, suspicion, embarrassment, despair, love, and hate. It has been almost six years since I started my first formal training program in psychodynamic psychotherapy, the Sino-Norwegian Continuous Training Program in 2006. Today, I still find it difficult to say what psychoanalysis is. The term simply has too many meanings, covers too many contradictory theories from widely differing authors. As to the therapeutic skills, they are both difficult to understand and difficult to practice.

From the beginning, my experience has been somewhat chaotic. I frequently have sort of “as-if” feelings when learning and practicing psychoanalytic therapy. I am never sure whether my understanding of theories or skills is correct. I am amazed by what central concepts try to convey in the fullness of their meaning, such concepts as the unconscious, transference, countertransference, projective identification, and the internal dynamics of the human psyche. It is like the story of “Alice in Wonderland:” Everything in the wonderland of psychoanalysis is so absurd yet so real. It continues to fascinate and frustrate me.

Perhaps it would be better to add some information about my first formal encounter with psychoanalysis. When I started the training, I was 23-years-old, and in the first year of my graduate program in clinical psychology, with determination to be a skilled and effective helper, the excitement of “catching the big wave,” and equally strong self-doubts about whether I could survive in this field. Psychoanalysis and psychodynamic psychotherapy were absolutely “in fashion” then. The training programs in this approach were the best in China compared with other courses such as those in systematic or behavioral therapy. Most of the famous Chinese therapists seemed to claim to be “psychodynamically-oriented”. Moreover, with one exception, all the senior students in my program were trained mainly in this approach. Everyone around me was enthusiastic about psychoanalysis and psychodynamic psychotherapy. (In fact at that time, I could not tell the difference between psychoanalysis and psychodynamic psychotherapy.) I got the impression that it was the best theory for understanding human nature, and the best form of therapy for relieving people's suffering. I even heard remarks like, “Psychoanalysis has brought hope to China,” and, “Psychoanalysis will help our nation recover from the multiple traumas of the last century.” It sounded very ambitious, and since I was an ambitious young woman and was eager to find my own place in this world, I made the decision to be a psychodynamic therapist, though I really knew very little about psychoanalysis and psychodynamic therapy, and had no idea what I might encounter. I did not realize how serious this commitment would be or how hard the journey is.

My journey is far from complete. Nevertheless, I feel now I can describe it as a process of finding an omnipotent father figure, and of learning to mourn when that idealization inevitably fails. We are all struggling to recover from a century of multiple traumas in China. The sad thing is that because of these traumas, we lost connection with and confidence in our own culture and traditions. The rapid social and economic evolution of the last 30 years has not allowed enough psychological space for mourning. Chinese intellectuals have been trying to find something powerful, something from those Western “wonderlands,” to bring peace and happiness back to our ancient land. Psychoanalysis is one option. Can it succeed?

Since I do not know the answer, I will close with some associations to my question: I remember how in workshops or conferences when foreign trainers or analysts showed up, they were usually surrounded and admired by many Chinese participants. I was one of them. We all wanted our photos taken with them. There was never enough time for our questions. What is behind this eager admiration? I think there is our anxiety to get the “right” theory and the “right” skill from those foreign experts, as if they knew everything. Even when they said they did not know it all, more questions followed. It seemed to be so hard to believe they simply did not know everything!

I remembered once in a group supervision conducted by a German analyst, I presented a case that was extremely difficult for me. I desperately wanted his support and help. When he pointed out that I did not keep the setting, and that my inner analytic attitude had broken under pressure from the patient, I was so ashamed and helpless that I almost cried. I felt ashamed like a little girl who failed to live up to her father's expectations. I felt helpless and even a bit angry because I felt he did not give me enough emotional support. Nor did he give me any practical advice.

I remember once I served as the interpreter for an Australian cognitive psychotherapist, who drew a diagram to show the history of psychotherapy. When he said that psychoanalysis and psychodynamic therapy in general were declining, whereas CBT was the future of psychotherapy, I felt so sad and defeated that I had to suppress my disappointment to continue my work as translator.

I remember at the end of one long training course in psychodynamic therapy, a male colleague said to me in a rather sad tone that from now on he would try to accept that fact that psychoanalysis was not the key to all suffering and that our group teacher (a German analyst) was only mortal.

Finally, I remember two teachings, one psychoanalytic, one Chinese. Freud once said that the aim of psychoanalysis “is to replace neurotic misery with ordinary unhappiness.” A famous Chinese Taoist once said, “Once something happened and you don't know why it happened. That's life.” Both of these sayings speak for acceptance that despite all our efforts, suffering remains. The Taoist saying speaks merely of acceptance, but Freud's says that there are things we can do to improve our situation. That is not a magical outcome, but it seems to me it is worth working for.