Lifestyle - As stress grows,modern chinese turn to Western psychotherapy

Dune Lawrence

BEIJING: When Li Xianyun began working as a psychiatrist at Hui Long Guan Hospital in Beijing in 1991, she did not discuss her job in public. People thought it was strange, she says, and they assumed she worked in an insane asylum. Now, those she meets are eager to learn more about her profession.

"If I tell them I'm a psychiatrist and talk about my job, they show their admiration," said Li, 40. "They want my suggestion on how to raise children and how to deal with all kinds of difficulties."

In the past 30 years, China's Communist system of government-assigned jobs and apartments has become a capitalist free-for-all, with cutthroat competition for education and work and a widening gap between rich and poor. To cope with the stress, some people are turning to a Western tool: psychotherapy.

This is a radical shift in a nation where focus on the individual was discouraged by both socialist ideology and traditional culture.

"There are great changes happening in Chinese society, and people are more open and pay more attention to their inner mind," says Zheng Yu, a therapist in Chengdu, about 1,500 kilometers, or 930 miles, southwest of Beijing.

Job pressures may be a contributing factor. Fifty-one percent of Chinese respondents to a survey by Hudson Highland Group reported higher work stress than a year ago. It is the second consecutive year in which China has registered the highest stress levels in Asia, the recruitment firm, based in New York, said in a report in October.

"When some people get rich, they say, 'I'm successful, but I'm still unhappy,"' said Kathy Li, 37, who quit working in media in 2005 to start her own counseling business in Beijing. "People are realizing more and more what can make them happy is not from the outside world but from the inside."

The May earthquake in Sichuan Province, which killed an estimated 87,500 people, has added to the demand for psychotherapy. Government officials called for help from specialists in other countries to treat the psychological, as well as physical, trauma from the disaster.

The need for outside assistance exposed the shortage of resources in China. The country has only 30,000 professional therapists and counselors in a population of 1.3 billion. World Health Organization figures show 1.3 psychiatrists for every 100,000 people in China, compared with 13.7 per 100,000 in the United States.

"You can see there's a big gap," Kathy Li said.

International cooperation is providing opportunities for training. The nonprofit China American Psychoanalytic Alliance has enrolled 57 Chinese in a two-year program taught by Americans using Internet telephone service.

American therapists are also providing training through the Beijing Suicide Research and Prevention Center, where Li Xianyun, the psychiatrist, works.

Psychotherapy, which gained an entry in China with the country's first psychology institute in 1917, was disparaged as unscientific after the Communists took power in 1949. It was banned during the Cultural Revolution of Mao Zedong, which ended in 1976.

China's traditional culture values "saving face," which means emphasizing the positive and addressing embarrassing issues obliquely. This approach conflicts with the process of openly discussing problems that is inherent to most psychotherapy.

Custom also emphasizes individual contributions to the group, especially the family, rather than self-fulfillment. The Communist era only deepened that idea, promoting love of the party and country over personal relationships.

Kathy Li said she did not receive any psychotherapy training in medical school. She uses counseling with many of her clients, partly because the Chinese also have a cultural aversion to drugs.

"People tell me, 'I don't want to take medication; drugs have significant side effects,"' she said.

Four days a week, Zheng Yu, the Chengdu therapist, lies down on a couch in his office and uses Skype to call his psychoanalyst 12 time zones away in New York, a routine he began in 2005. Zheng, 38, is oriented toward psychoanalysis, which was developed by Sigmund Freud a century ago in Vienna.

He says Freud's theory of family dynamics - based symbolically on the Greek myth of Oedipus, who killed his father and married his mother - dovetails with the problems of his Chinese clients who are only-children struggling to gain independence from overprotective parents.

The current global financial crisis may raise pressure on China's economy - and increase potential demand for therapy - if a slowdown in U.S. and European consumer spending has repercussions in the export-dependent country.

As more Chinese turn to counseling, Li Xianyun worries that people may develop overblown expectations.

Many now "treat psychotherapy as some miracle," she says. They will need to understand it is more like medical science: "Psychotherapy cannot resolve every problem."