Medical Anthropology

Cross-Cultural Studies in Health and Illness

ISSN: 0145-9740 (Print) 1545-5882 (Online) Journal homepage: http://www.tandfonline.com/loi/gmea20

Cultivating the Therapeutic Self in China

Li Zhang

To cite this article: Li Zhang (2018) Cultivating the Therapeutic Self in China, Medical
Anthropology, 37:1, 45-58, DOI: 10.1080/01459740.2017.1317769

To link to this article: https://doi.org/10.1080/01459740.2017.1317769

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MEDICAL ANTHROPOLOGY
2018, VOL. 37, NO. 1, 45–58
https://doi.org/10.1080/01459740.2017.1317769

Cultivating the Therapeutic Self in China

Li Zhang
Department of Anthropology, University of California at Davis, Davis, California, USA

ABSTRACT KEYWORDS
Facing intensified market competition and rapid social change, many China; emotion; middle-class;
Chinese are experiencing increased mental distress. In this article, I examine psychotherapy; self-work;
how psychological training and interventions play a vital part in cultivating sociality
a new self among urban middle-classes. I ask how the Chinese notion, ziwo
(self), is turned into an object of intense inquiry and how therapeutic
techniques are deployed for self-development. The new forms of the self,
however, continue to intersect with and complicate the existing social
nexus, cultural sensibilities, and notions of personhood. My ethnography
explores how this therapeutic work contributes to intricate forms of sub-
ject-making that challenge such conceptual binaries as the private versus
social self, the inner versus outer life, and psychological versus social
problems. Thus, what is emerging is not a usual “neoliberalism” story of
self-advancement, but a more complicated picture based on assemblages.

As many urban Chinese are accumulating material wealth and building up their private “paradises”
in gated communities, they begin to realize that such gains do not necessarily endow them with a
deeper sense of fulfillment and happiness. Faced with increasing market competition, rapid social
changes, and pressure to become “successful” (chenggong), many are experiencing varying degrees of
mental and psychological distress. Although it is hard to identify a direct causal relationship between
recent societal transformations and the rising popularity of psychological care and mental health,
this is the broader context in which a new counseling movement is unfolding in contemporary
China. A therapeutic language of personal emotions, self-fulfillment, and self-mastery, along with a
medicalized language of managing anxiety (jiaoluzheng), depression (yiyuzheng), and stress (yali), is
being introduced to Chinese society, reshaping the way the self and the psyche are conceived. This
phenomenon raises important questions of how Chinese people cultivate well-being, endure distress,
and conceptualize selfhood when family bonds and social ties become increasingly fragile in
postsocialist times.
From 2010 to 2016 (a total of 15 months), I took several field trips back to the city of Kunming in
southwestern China to conduct ethnographic research in order to understand how this new “psy
fever” is transforming selfhood, quality of life, and techniques of governing in urban areas.1 I was
affiliated with the Yunnan Provincial Health Education Institute’s counseling center as well as two
private counseling firms. Using snowballing method, I was able to interview many therapists and
counseling trainees, observe some private therapy sessions, and participate in a number of therapist
training workshops in Kunming.2
In this article, I examine how psychological training and therapeutic interventions play a vital part
in the Chinese urban middle-class project of self-making.3 I explore how the Chinese notion, ziwo, is
turned into an object of intense inquiry and how various therapeutic projects are used to achieve
self-development and personal fulfillment in the current context.4 I show too that newly crafted
forms of the self (including both self-healing and healing by others) through using psychotherapeutic

CONTACT Li Zhang lizhang@ucdavis.edu Department of Anthropology, University of California at Davis, Davis, CA 95616, USA.
Color versions of one or more of the figures in the article can be found online at www.tandfonline.com/gmea.
© 2017 Taylor & Francis
46 L. ZHANG

techniques continue to intersect with and complicate the existing social nexus, cultural sensibilities,
and local notions of personhood. Thus, a therapeutic self is at the same time a social self and a
reflexive self. This reflexive quality and healing effect through psychological exploration is a distinct
feature integrated into contemporary self-care.
My ethnography focuses on how the therapeutic work contributes to intricate forms of subject-
making that challenge such conceptual binaries as the private versus social self, the inner versus
outer life, psychological versus social problems. While this new regime of the self is becoming a
profitable industry and bears certain key neoliberal traits (such as promoting self-governing and self-
reliance), it dovetails with the postreform state’s project of building a “harmonious society” that
underscores social harmony and conflict reduction.5 Therefore, what is emerging here is not a usual
“neoliberalism” story of self-advancement but a more complicated picture based on assemblages. In
this context, I suggest that such self-practices, while very much influenced by global psychother-
apeutics, are still rooted in Chinese history and culture and can have important political implications
for Chinese society in face of soaring inequality and growing social insecurity.

Therapeutic technologies of the self

Therapeutic interventions have a significant impact on the conceptions of personhood and selfhood,
identity formation, and the politics of citizenship (see Dumit 2003; Jenkins and Barrett 2004; Kirmayer
and Raikhel 2009; Pandolfo 2000; Petryna 2003). Recent studies on Russia also suggest that psychological
work has become an important part of a larger project to refashion postsocialist subjectivities and class
formation (Matza 2009, 2012; see also Raikhel 2006). What intrigues me most here is how the micro-
process of therapeutic self-work actually takes place in a specific cultural context in face of rapid social
change. In this regard, Lawrence Kirmayer’s work (2007) provides a useful starting point to think about
the interplay between psychotherapeutic techniques and cultural concepts of the person across different
time and place. In other words, cultivating a therapeutic self is always deeply embedded in a specific
historical, cultural, and political nexus. Analytically, my approach is largely influenced by Nikolas Rose’s
notion (1985) of “the psychological complex” by which psychological, social, and political domains
intersect. Rose (1985; see also Cruikshank 1996) demonstrates how psychotherapies offer a technical
means to reform the self and promote a mode of governance premised on self-management.6 Yet, as he
shows, “the self” is not pre-given; instead, it is formed through social recognition. Thus, self-cultivation is
a changing process shaped by negotiating with social expectations, duties, and norms (Rose 1990:218). In
China today, this negotiation is complicated by at least three sets of expectations, norms, and ethics that
are in constant interaction with one another to shape the making and remaking of the self: traditional,
socialist, and neoliberal.
In this article, I seek to address the following specific questions: First, why is the self granted
extraordinary salience among the middle-class in China today? Second, what specific projects of self-
development and self-care are emerging in the wake of mass psy education, training, and counseling?
Third, what technologies of the self are fashioned at the crossroads of different forms of knowledge
and sociality? By “technologies of the self,” I borrow Foucault’s definition to refer to practices that
permit individuals to effect by their own means or with the help of others a certain number of operations on
their own bodies and souls, thoughts, conduct, and way of being, so as to transform I themselves in order to
attain a certain state of happiness, purity, wisdom, perfection, or immortality (1988:18).

While urban Chinese mobilize diverse practices as technologies of the self today, I focus on the
incorporation of psychotherapeutic means for self-care and self-improvement and explore their
social and political ramifications.
The question of selfhood and self-cultivation has a long genealogy in Chinese history. Space does
not allow me to launch a detailed discussion here, but it is worth pointing out some important
continuities and discontinuities in the way the self is conceived and nurtured. For example, the
concern with self-improvement has long been an important element in Confucianism. A central
 MEDICAL ANTHROPOLOGY 47

Confucian notion, xiusheng (cultivating one’s moral character through embodiment), suggests that
the self, which includes both the body and the soul, is an object that can be worked on and improved
over time. Yet, the ethical self is not isolated or abstract but is embedded in multiple social layers and
manifested through bodily conduct. Further, the Confucian discourses on self-cultivation in the past
had a clear class and gender dimension: this life-long project was primarily for elite men.
Under Maoist socialism, concern for selfhood was largely eclipsed by concern for collective well-
being and the party-state’s projects. This did not mean that the self ceased to exist; rather, the
exploration of the self was largely folded into revolutionary causes, collective production, and nation
building. In the post-Mao era, serious inquiries of the self re-emerged in the realm of literature and
literary criticism. It then resurged in the new waves of popular psy fever and recent revitalization of
Confucianism in China. The emphasis now is on the understanding and mastery of the self through
what is deemed as “modern” and “scientific” psychological methods, and the possibility of combin-
ing these with traditional cultural practices. Moreover, the ability to examine and manage the self is
becoming a new criterion for assessing one’s worth in an emerging therapeutic culture.7
Yet, the reconfigurations of selfhood should not be read as the rise of an individualistic self
against a collectively oriented self. It has been widely acknowledged that Chinese notions of
personhood are deeply embedded in larger social relationships including the family, kin, neighbor-
hoods, and work units (Pellow 1996; Tu 1985; Yan 1996; Yang 1994). The production of persons is
realized in a relational process by constantly creating and maintaining social ties as well as cultivat-
ing socially acceptable behaviors. Over the past two decades, this socially embedded selfhood has
been undergoing profound transformations (Liu 2002; Yan 2010). It would be a mistake though to
assume that recent changes indicate a move toward a discrete self detached from the social.
Ethnographic evidence suggests that the search for ziwo and personal happiness in contemporary
China is very much entangled with social obligations, socialist ethics, and certain cultural values
(Engebretsen 2009; Rofel 2007; Yang 2015; Zhang 2010).8 As Nikolas Rose has reminded us in a
different context, “our contemporary regime of the self is not ‘antisocial’. It construes the ‘relation-
ships’ of the self with lovers, family, children, friends, and colleagues as central both to personal
happiness and social efficacy” (1996:159). In China, the way “psychologization” takes place is
distinctly embedded in the familial and other social processes. Anthropologist Andrew Kipnis
(2012) has rightly argued that the “rise” of individualism today in China is more of a psychological
problematic than a social fact. For him, the psyche is not a socially isolated site but a domain where
conflicting feelings, expectations, and discourse manifest. But more importantly, below, based on the
ethnography I argue not simply that the self is simultaneously individual and social; rather, I
demonstrate how a dual ongoing process of what I call “disentangling” and “re-embedding” of the
self works and how these two processes can form a useful analytical framework for better under-
standing the remaking of the middle-class self in contemporary China.
Some scholars have adopted the notion of “the divided self” to describe the fragmented and
complex nature of the self for Chinese today (Kleinman et al. 2011). I propose to move beyond this
divide by unraveling the constant articulation and re-articulation of the self and the social. To do so,
we need to probe ethnographically how some Chinese people experience the psychologization of the
self and negotiate the tensions that arise in this process. Understanding such intimate experiences
and personal struggles will enable us to better grasp the extent and cultural meanings of China’s
broader social transformations. Further, it will shed new light on how a set of global therapeutic
knowledges and techniques articulates with culturally situated people and reshapes their conceptua-
lization of the self and its social embeddedness. This is a complex, dialogic process involving
negotiation, alterity, and friction.

Embracing xinli re
Since the 1990s, a new xinli re (“psy fever”) or what Kleinman (2010) calls “psycho-bloom” has been
sweeping Chinese cities. Elsewhere (Zhang 2014, 2015b), I have offered more detailed accounts of
48 L. ZHANG

this new phenomenon (ranging from learning psychology, mental hygiene education, group therapy,
to private counseling) and its social and cultural context (see also Huang 2014). This is a stark
contrast to the time under Mao’s regime when research and teaching of psychology was largely
suspended and mental illness was regarded simply as a result of wrong political thinking. Psychiatry,
often involving hospitalization and the use of electric shock therapy, was limited to treating acute
psychosis. Today in the midst of a thriving therapeutic culture, various work units such as schools,
enterprises, the police, and the military are increasingly keen to incorporate modern psychological
techniques to reform their employees for better management. Many younger people are also
interested in how to recast themselves as new and happier persons by using professional psycholo-
gical techniques or various self-help methods.9 As Huang puts it, “‘the psychological’ (xinli) has
recently become an indispensable dimension of individual and interpersonal experience in urban
China” (2014:183).
The Chinese state has played an important role in the rise of this psy fever. First, the state-run
Central Chinese Television Station launched a widely watched late-night show called “Psychological
Consultation” (xinli fangtan) in 2005. This has played a critical role in popularizing psychological
counseling and reducing the stigmas attached to emotional disorders and help-seeking. Second, and
more importantly, the state launched a national certification program in 2003, through which young
urbanites of diverse backgrounds can complete required training courses within two or three
months, pass the exam, and obtain counseling licenses. A typical prep program offers classes on
Basic Psychology, Developmental Psychology, Social Psychology, Child Psychology, Criminal
Psychology, and Counseling Theories and Methods. By now, more than one hundred thousand
people have been certified through this speedy assembly-line-like program, but it is estimated that
less than 10 percent of them go into private practice or become mental health professionals.
Why do so many people flock to counseling training yet so few become full-time therapists or use
it in treating mental illness? What do they hope to gain from such seemingly “impractical” training?
The answer partly lies in the growing desire among middle-class Chinese to reconfigure the self and
its relationship with the social nexus in order to realize self-actualization and the dream of the good
life. With the influx of all things psychological from overseas, attending to one’s psyche and emotion
becomes a new tool for achieving effective self-management, among not only urban professionals but
also marginal groups (see Yang 2013a, 2013b; Zhang 2014). This broad application of psychology
and counseling in the social realm is a distinct feature of how globally circulating psychotherapy is
embraced in China.

“Doing self-work”
In a warm summer afternoon, through the introduction of a mutual friend, I met Ms. Zhu Ling, a
part-time therapist in her early forties, at a tea house near Green Lake in Kunming. She had a college
degree and held a well-respected position in a provincial government agency. For her, entering the
psy field was accidental, yet it became a long journey of self-discovery and self-healing that
profoundly altered her life. As we were enjoying a cup of green tea, she began to tell me about
her encounter of psychology, counseling, and personal transformations:
About seven years ago, one day as I was reading a newspaper, I saw an advertisement on psychotherapist
training classes offered by the provincial health bureau. I had no idea that there existed such a field and
occupation. I had always liked to listen to my friends’ problems, but did not know how to help them. So I
thought I would enroll in the program and learn something to help my friends. The classes lasted for three
months, mostly on the weekends and in the evenings. I passed the certificate exam easily. But in this process I
began to realize that I was deeply troubled by many unresolved issues and I myself needed help.

The program Zhu Ling enrolled was typical — it packed in many topics in a short period. At that
time, she was facing a set of misfortunes and challenges. Her father had fallen ill two years earlier
and was bed-ridden at home; her daughter was born with Down syndrome; her husband’s private
 MEDICAL ANTHROPOLOGY 49

firm went into bankruptcy. She felt as if “the sky was suddenly going to collapse,” yet she tried to
bottle up the distress and confusion inside her by keeping herself busy. In studying psychological
theories and counseling, she came to realize that she must first “do her own homework” by allowing
herself to explore who she was and what she wanted, and by taking the opportunity to cleanse
(qingli) her mind. After careful consideration, she made a bold decision. She hired a live-in domestic
worker to take care of her daughter and father and left home with a backpack and embarked on a
two-year journey to Tibet. The choice of her destination was not accidental. Tibet, in many people’s
imagination, stands for a place of unworldliness and purity. She described this journey as a spiritual,
physical, and psychological expedition. The goal was to disentangle herself temporarily from the web
of family and other social relations and obligations in order to reclaim a serene and resilient self,
capable of accepting life as is. Using Rose’s language, it was to reshape “its relations with others so
that it will best fulfill its own destiny” (1996:159). She explained to me the importance of prioritizing
self-care and mental clarity: “No therapist can heal others if she cannot heal herself first. Her mind
must be like a body of lucid and tranquil water in order to reflect upon others’ life and help them
untie the knots of the soul.” The language she used throughout the interview was imbued with the
ethos of Zen Buddhism that stresses mindfulness, clarity, and tranquility.10 It also echoes a popular
method of self-inquiry created by a contemporary American self-help writer Byron Katie, known as
“The Work” (Katie and Mitchell 2002).
Zhu Ling’s story is a narrative of self-care and self-development widely shared by others drawn to
counseling. During my research, again and again, informants recounted moments of self-enlight-
enment brought by their work on the self during their encounter with psychology and therapy. They
eagerly explained to me how they found clarity in their mind, how their depression was lifted, how
their anxiety decreased, and how their troubled souls began to find new hope. They attributed these
positive changes to therapeutic work on the self and saw it as a pivotal project that could generate
healing, personal growth, and happiness.
It is important to point out that such self-work for many Chinese often involves both psychother-
apeutic efforts and regimented physical activities. As one self-fashioned counselor and educator told
me, his project of self-discovery and struggle with depression consisted of two essential and
intertwined parts — participation in psychotherapy training and a daily long-distance walk. He
recalled:

I have been walking some twenty kilometers every day between my home and work for several years. By now if
you calculate the total distance of my walking, I could have walked from Kunming to Beijing. This journey
along with my therapeutic experience has not only strengthened my physical body but, more importantly,
transformed my psyche. I am a much happier and composed person now in comparison with the disturbed and
confused me eight years ago.

The belief that physical well-being and mental well-being cannot be separated reflects a common
view among many therapists and ordinary people in China. Rather than focusing on the notion of
somatization, as Arthur Kleinman discussed several decades ago (1979, 1986), urban Chinese
increasingly emphasize the mutually constitutive processes of the physical and the mental, the
body and the mind (see Zhang 2007).11
Barbara Ehrenreich, an American popular writer, once depicted the “new psychology” that gained
wide popularity in the 1970s America as “both an industry and a kind of secular religion, enlisting
hundreds of thousands of middle-class Americans in the project of self-improvement through
psychological growth” (1983:91). This observation is very telling about what is happening in
China. While the teaching of “self-growth” and “self-development” is becoming a popular profitable
industry catered to middle-class professionals and youth in Chinese cities today, it also carries a
flavor of religious zeal in pursuit of self-salvation. This industry, capable of combining therapeutics,
secular religious spirit, and business operation, is expanding rapidly. Advertisements on workshops
focusing on how to foster an enhanced, therapeutic self by psy experts are mushrooming: “Self-
Loving, Self-Care: A Balanced Development,” “Unpacking Self-Growth,” “Encountering the
50 L. ZHANG

Unknown Self,” and so on. One workshop claims its aim is to “help you unearth the inner-self
strength, pursue the happiness brought by the growth of the soul, and greatly improve your
personality so that you can live a life with a brand new, authentic self.” The ultimate goal is not
treating mental or psychological illness but helping cultivate a better self in order to truly live the
“good life.”
Although “psy fever” foregrounds self-queries and self-improvement, an ultimate aim is to create
an enhanced self able to handle family and social relationships better and thus live a happy and
successful life. After the long journey, Zhu Ling eventually returned home and found herself in a
strong position to take care of her family and work responsibilities. She felt less frustrated and burnt
out and gained more inner strength to handle stresses. She told me that going away for two years was
worth it for her own healing and rejuvenation. In other words, the new self is not an assertion of
individualism but a refashioning of a person who is better at managing one’s own emotions and the
social nexus. I call these two simultaneous processes “disentangling” and “re-embedding,” as I now
explore.

Disentangling and re-embedding

On a July morning in 2010, I was sitting in a small conference room with three men and five women,
all in their late 20s or 30s, at a three-day intense workshop on sand play therapy organized by a local
training center called Xinshi (“a space of the heart”). This was created by a private vocational school
specialized in training young people for obtaining various kinds of certificates. It also provides
postexam, advanced training for those who have obtained their certificates. The young men and
women in the workshop had recently passed the counseling certificate examination after taking prep
classes there for two months. During the self-introduction, I learned that all of them held regular
jobs — three school teachers, one policeman, two state agency employees, and two private firm
employees.
During a long break, we engaged in an animated conversation. I asked why they were there
and what they hoped to achieve through the therapy program. I quickly learned that most of
them sought psy training as a form of self-development and self-help to improve their life and
work. Xiao Wang, a female middle school teacher, spoke first:
For me studying psychology and counseling is a way of understanding myself and my own issues better so that I
can understand the social world around me better. I discovered this field by accident but fell in love with it
quickly because it helps me see myself with clarity. Prior to that I was in a state of chaos (huntun).

Financial consideration however was also a factor. Even though the fees for enrolling in the classes
and exam are not small (around 3000–4000 yuan per person, which is about two months’ salary of
an average wage earner in Kunming), my interlocutors reasoned that they could master the tools of
solving one’s own problems and gain a deeper understanding of oneself through systematic learning.
This was cheaper than paying for professional counseling at the rate of 300–400 yuan per hour.
Then our conversation turned to the question of ziwo. The Chinese word, ziwo, can be
roughly translated into “self” or “selfhood,” but it can imply at least two layers of meanings —
dawo (the big self) and xiao wo (the small self). And the small self is always embedded on the big
self. In other words, there is no purely private self without any social embeddedness. I asked
them to explain what ziwo meant to them and how their understandings might have changed
over time. The first person who responded was Wan Qing, a divorced mother in her mid 30s
with an eight-year-old daughter. She used to work for a real estate firm selling new housing units.
Although her income was very good, the work was highly demanding. After she divorced four
years ago, she decided to quit the real estate job to spend more time with her daughter. She
implied that she had saved enough money to live on for a while. Two years ago, she started an
afterschool care program helping eight children with their lunch and homework. This is a
popular practice in urban China today due to parents’ busy work schedule. The home care
 MEDICAL ANTHROPOLOGY 51

brought in some income while still allowing her to take care of her daughter. The reason why she
was studying psychology and counseling was to “help myself and guide my child to grow better.”
She did not hesitate to articulate her understanding of ziwo:
Ziwo is like a circle demarcating the boundary between one’s own self and others. Within the line, one must
love and accept oneself. Outside the line, one must respect, understand, and appreciate others. I try to teach my
eight year old daughter how to draw this line and respect the boundary. For example, she likes to go through
my purse for fun. So I tell her that the purse is my private belonging and she must get my approval before
handling it. She must know the boundary between ziwo and others. This is the first step toward personal
growth.

Wan Qing’s view of the self as a demarcated entity was intriguing; most people I met did not
speak in these terms. Rather, people tended to relate the notion of the self to the broad family and
social relationships. Wan Qing also placed great importance on the self/other boundary. For her,
studying psychological counseling was the most effective way of deepening self-understanding and
improving social relationships with others.
Wan’s emphasis on a private self formed a sharp contrast with another trainee, Lu Minxin, a 25-
year-old temporary junior high school teacher and a former army soldier. Within the workshop, Lu
was the one most concerned about social acceptance. He passionately declared:
Anyone who enters the world must be recognized and accepted by society. Only when the society acknowledges
me, there can exist the self. If you are not connected with the society and people around you, how can you have
a true ziwo?

He admitted that he had recently become more drawn to a psychological exploration of the self and
his emotions, despite that focusing on one’s own feelings and reflecting one’s own inner experiences,
as usually required as part of the learning, was often unsettling. He said:
I came from a mountainous village in Guizhou Province. My family was poor and I did not have much
education. In the military, I always felt inferior to others as if my brain was empty. So I tried to follow the
orders and win the recognition and approval of the people around me. I tried not to think about myself or how
I felt. When I first began studying psychological counseling, my goal was to obtain the skills to help my students
and improve my teaching. But soon I realized that I wanted to understand my feelings and myself even though
the concept of ziwo is quite new to me.

Lu Minxin found it difficult to talk about his personal feelings at the workshop. He constantly
referred to how he might be viewed and judged by his fellow soldiers and co-workers and was
disturbed by his uncertainty of whether his behaviors would be accepted by others. Throughout the
three-day workshop, he was particularly sensitive of how we might judge him and his answers. He
reminded me of my parents’ generation that grew up under socialism and largely sought social
conformity. Further, because he came from a poor rural family and was quite aware of the long
existing rural-urban hierarchy in which he inhabited, he felt a sense of inferiority. Yet, part of him
wanted to explore a dormant realm inside him. He hoped that cultivating self-awareness and self-
efficacy would enable him to craft a new kind of person capable of engaging the social world and
becoming more confident. Therefore, he was experiencing a great deal of inner struggle.
Feng Gang, a 33-year-old city police officer, was shy, with a touch of melancholia. We first met at
the workshop and later became good friends because we shared a special moment when I was
assigned as his therapist in one simulated sand play therapy session. I did not know before the
session that he was experiencing a great deal of confusion and anxiety caused by tensions with his
boss and his family.
The sandbox arrangement he created was telling (see Figure 1). It was a desert scene, with a red
snake stranded in the sand. Nearby there was a cluster of green cactus and a jade horn. It took him
20 minutes to put them together, and then he was silent for five minutes. Finally, he murmured: “I
feel that the snake is very lonely and stuck there. It is trying to move toward the green plants —
perhaps an oasis in the dessert. But it is very tired and will probably never get there.” At that time, I
did not know much about his personal circumstance, but I could sense a great deal of emotion and
52 L. ZHANG

Figure 1. Sand play arrangement by Feng Gang.

tension. I asked: “Does this scene speak to your current situation?” He nodded and tears came rolling
down. He took a piece of tissue to wipe his eyes and then said slowly: “This snake is just like me. I
never had a chance to look at myself like this before.” He continued to weep and stare at the snake.
I later learned that he was a plain-clothed policeman responsible for apprehending pocket-pickers
on city buses. His work was highly demanding and sometimes dangerous, yet his supervisor did not
trust him and accused him of slacking off. He felt stressed and resentful. When he began to take
counseling classes in his spare time, his parents-in-law—who lived with his family — questioned why
he was studying psychology and complained frequently. His wife, a full-time office worker, was
supportive but also needed his help in taking care of their newborn baby.

I come home after work feeling exhausted, but I am expected to help my wife wash baby diapers and do
housework. My parents-in-law think I am just lazy if I need some rest. They also believed that studying
psychological counseling is impractical, a waste of time. I am under so much pressure at work and at home.
And I do not have a moment for myself. I am stuck and feeling very lonely.

Feng Gang commented that he cherished the moments he had crafted for himself to look deeper
into his own psyche and emotion. He attributed these moments to his study of psychology and
counseling. Attending to his anguish and opening up his feelings to others in the therapeutic setting
was a first step toward healing, even though the experience was painful. As a police officer, he was
expected to be strong and not to talk about his feelings, but the therapy training gave him a safe
space to explore his inner fears and desires. He was able to be reflexive while reaching out for help
from the mentor and fellow trainees. At the end of our session, he told me that the green plants he
had placed in the sand box represented hope and faith: “I am not sure where it is yet, but I have a
feeling that I have begun to see sparks of faith in this rather despaired situation. And that is why I
keep crawling like that snake.” Later, he continued:

Ziwo has two layers of meanings. One is dangxia de wo (the self that is living in this moment) and it is deeply
embedded in the complex nexus of family, kin, and society. The other is the primeval self detached from reality,
which can only emerge from time to time when I am alone in meditation. I am longing for the disentangled self,
but at the same time I cannot abandon the socially embedded self because both together make me human.
 MEDICAL ANTHROPOLOGY 53

This is a powerful statement that highlights the complexity of the self as relational and dynamic,
constantly being constituted and reconstituted through different layers of sociality and desire. Two
years later, I revisited him and found his personal situation had improved greatly. He had continued
to study counseling in his spare time and to engage in the self-cultivation project. But he no longer
retreated; rather, he was actively engaged in his family’s and other social activities: “I have learned to
adjust my mindset constantly, which helps enhance my family and work relations. Even though I
cannot change the reality, I am much better at seeing different options and deciding how to
respond.” When he felt more confident and at ease in dealing with others, he was more willing to
be an active participant in the social world. He also began to volunteer at a small private counseling
center to offer free psychological service to troubled primary and high school students.
These three cases illustrate heterogeneous ways of conceiving the self that have emerged through
therapeutic work in contemporary urban China. Wan Qing stressed the importance of a private self
and maintaining a boundary between public and private, yet she was also aware that the formation of
this private self was relational and could not be isolated from the social world. Lu Minxin advocated
a mode of selfhood as one deeply rooted in and shaped by interpersonal dynamics and social norms.
Disentangling the self from others, even for a moment, was unsettling for him. Feng Gang’s notion
of self-work was more complex. First, it required the act of disentanglement so that the inner self
could find a space of healing and regain clarity and strength.
Yet the work does not stop here; the new self cultivated by psychotherapeutic experiences needs
to be re-embedded in the social world. Recall that the woman, Zhu Ling, who left for Tibet, also
came back to her social world after her extended journey. She told me that she felt like a new person
and was happier and more effective at home and at work: “Once in a while, I also disentangle myself
from the busy world around me, but not necessarily to be away physically. Now I can do it mentally
or through meditation.” From this perspective, the self and the social, the inner (nei) and the outer
(wai) constitute a dialogic relationship that strengthens one another.12 Yet, all of these people had
some faith in psychological work, seeing it as an effective tool of enhancing the self. Thus, self-
efficacy and social efficacy become one and the same project, with promises to bring happiness,
success, and fulfillment. Many informants I spoke with echoed this view, as they witnessed ther-
apeutic work on the self leading to positive effects on their family and social life.

Conclusion
For many urban Chinese professionals, ziwo is increasingly an object that one can work on, adjust,
and improve with psychotherapeutic techniques. The relationship between the self and the layered
social nexus remains a key problematic. I have identified a distinct dual process of “disentangling”
and “re-embedding” as central to the working of this new therapeutic self. Yet, much of the focus on
the social here is on the intersubjective, and on one’s relationship with family members, friends, co-
workers, and others in social networks. In contrast, they were less focused on broader social
processes, which many deemed as beyond their control. As Jie Yang (2015:84) points out, this
innovative therapeutic approach can end up bypassing current social and economic factors that
cause many people distress.
Three important features about this emerging therapeutic culture of the self are worth noting.
First, multiple notions of selfhood — traditional, socialist, and neoliberal — exist and are entangled.
Individuals must navigate this plurality and try to make sense of the different forms of the self that
coexist but are often in tension with one another. Therapeutic engagement with self-work is
becoming an important tool for enhancing one’s ziwo jiazhi (self-worth) and well-being. While in
the earlier reform years (1980s–90s) material wealth was the prominent marker, today health and
well-being are important registers (see Farquhar and Zhang 2012).13 A recent article in China’s
popular Sina Blog site, widely circulated among some middle-class professionals, put it boldly:
“Willing to receive psychological counseling is a sign or indicator of self-confidence and affluence.”
54 L. ZHANG

This article claims that almost every middle-class American has a therapist, and this is one of the
secrets of their success.14
Second, life stories and personal narratives of feelings are essential in the cultivation of a new
therapeutic self and personal growth. As Bradley Lewis puts it, “these culturally located ‘self’ stories
and the priorities within those stories combine with other cultural stories to scaffold our narrative
identity and provide us with a compass for living” (2013:398). A common theme that emerged in the
narratives I collected is that individuals often started to engage in psychotherapeutic work out of
curiosity or the desire to help others, and then discovered that they need to do self-work. Talk
therapy training, as conducted in China (mostly in small groups), offers a unique opportunity for
participants to share self-stories and experiment in self-remaking. Here the emphasis is not to treat
mental illness but to enhance well-being and the quality of everyday life.15
Third, this regime of self-work is shaped by class and gender. The primary consumers of this new
industry are members of the urban middle-classes. The working-class, the poor, those on the
margins of the society, are largely excluded, lacking the time and money (and perhaps interest) to
embrace these therapeutic experiments of self-actualization.16 Women make up nearly 80 percent of
the participants at the self-growth workshops and psy training classes I attended; Chinese therapists
who I interviewed also reported a majority of women. This may be due to ideas that women are
primarily responsible for taking care of familial relationships and engaging in emotional labor. But
urban Chinese women now have the possibility of acquiring a professional toolbox to take charge of
their affective relationships. For many of them, this change is simultaneously powerful and demand-
ing, hopeful and stressful. At the same time, this gender imbalance does not mean that men have
fewer psychological conflicts or need less help. Many therapists feel that it is imperative to break
down cultural barriers and gender bias to include more men in this new therapeutic realm.
While this new therapeutic culture provides a unique and safe space for self-exploration and self-healing,
its impact goes far beyond the personal realm. Nikolas Rose (1996) has reminded us that the regime of an
enterprising self is itself a central feature of contemporary governmentality and an indispensable compo-
nent of neoliberal political programs in advanced capitalist societies. While my research shows that this
culture of self-engagement is emerging outside of liberal Euro-American societies, it clearly takes a distinct
form in a context that has its own deep cultural and historical understandings about what it means to
cultivate oneself. Here what we see is a blend of new and old, foreign and local narratives of soul searching
and self-discovery, rather than a simple storyline of neoliberal takeover in self-care.
This new self-work dovetails with the postsocialist politics of reshaping persons and society. A
core element in the official project of building “a harmonious socialist society” is a higher degree of
stability and contentment among citizens. In this context, the Chinese state and social scientists have
come to embrace “positive psychology,” a distinct branch of psychology developed by Martin
Seligman (1991, 2002) and others. Despite critiques of positive psychology by scholars like Louise
Sundararajan (2005) for its lack of a moral map and reluctance to tackle structural problems, such
self-work is regarded by many Chinese experts to have the potential to contribute to broader social
interventions by improving citizens’ emotional outlook and fostering a sense of satisfaction (see
Zhang 2015b). With the help of psy experts, Chinese people are told, it is possible to turn social
problems and suffering into a technical matter of sound personal choice and self-management.17 At
this stage, it is unclear whether psychotherapeutic work will generate a stronger sense of individual
autonomy and well-being among some people or help accommodate the existing sociopolitical
system through bypassing questions of social conflict and inequality.18

Notes
1. The very language of re (fever) indicates a reminiscence of the past socialist mass movements, in which people
could easily get lost in “blindly” following the trend.
2. My larger project explores three sets of major issues: the changing technologies of the self, the relationship
between culture and psychotherapy, and the intersection between emerging therapeutic governing and
 MEDICAL ANTHROPOLOGY 55

postsocialist governing. For more detailed account of my fieldsite selection and methods used for this project,
see Zhang (2014).
3. The new middle-class is an emergent, fragmented, and amorphous social group, which can be largely defined
through their home ownership and consumption practices. However, this is a relational and fluid category
without any fixed boundaries. For more detailed discussion on the middle class, see my book In Search of
Paradise (2010) and The Global Middle Classes (Heiman et al. 2012).
4. The reconfiguration of the self takes place in a variety forms and domains (see Zhang and Ong 2008), but the
therapeutic turn is relatively new and unique in that it focuses on the possibility of healing with the help of psy
experts.
5. In another article (Zhang 2015b), I explicitly address the relationship between therapeutic works and modes of
governing and state efforts to incorporate positive psychology in the management of the military, the police,
and state enterprises.
6. Rose’s analysis builds on Foucault’s (2006) notion of the generalization of psychiatric power beyond mental
illness.
7. Goldstein (2005), in analyzing the post-revolutionary self in France, argues that in granting the self a central
place in ranking people, a new structuring principle was provided for the society to replace the old corporate
order abolished by the revolution.
8. In her study of people diagnosed with bipolar disorder in China, Ng (2009) points to the rise of a multifaceted
individualism by analyzing generational difference in the location of agency. By contrast, Yan (2010) has argued
that the individualization of Chinese society is the antithesis of individualism (see also Beck 1992). He insists
that the two concepts are very different: Individualism refers to a personal attitude or preference; individualiza-
tion alludes to a macro-sociological phenomenon, which may or may not result in changes in personal
attitudes.
9. Such popular self-help projects are sometimes lumped in the genre of “xinling jitang” (the chicken soup for the
soul); this framing is less stigmatized and more accessible (see Bunkenborg 2014; Zhang 2014).
10. A famous Zen Buddhist expression of a high state of being is xin ru mingjingtai: when one’s heart is as lucid as
a dustless mirror, one will be able to see things clearly and comprehend life.
11. Zhiying Ma (2012) argues that despite the influence of the holistic language of Chinese medicine, psychiatric
discourse in China still largely produces a separation between the body and the mind, the biological and the
sociopolitical. However, in the counseling world, this is not quite the case; there is much more fusion effort.
12. See also Pritzker’s (2016) analysis of inner child emotion pedagogies in China, which reveals how Chinese
people have a distinct understanding of an intricate relationship between the inner and outer self.
13. This search for the good life in my view is very different from what Zhang et al. (2011) call “the quest for an
adequate life” based on the notion of minsheng (livelihood of the people). For the middle-class Chinese, the
notion of the good life promises much more than an adequate life (see Borovoy and Zhang 2016).
14. This article appears in http://blog.sina.com.cn/u/3164664704, September 18, 2014.
15. Talk therapy is used by mental health professionals in the medical setting, but the general trend is that many
people embrace the mass training programs for purposes other than medical treatment (see Huang 2014).
Concerns about mental illness rarely enter such training sessions, in contrast to hospital settings.
16. Jie Yang’s recent research shows that the urban poor are also drawn into what she calls “the psycho-politics”
that attempts to turn them into happy subjects who can realize their own potential (2013a, 2013b). This
psychologization project is primarily a government-initiated process, which is quite different from the middle-
class project of the self I examine here. The latter is largely grass-roots initiated and profit driven.
17. The Psychiatric Society shows that psychiatry and its allied activities (such as psychoanalysis, group therapy, and
counseling) have always had important political and social implications. One of its explicit tasks is to help
achieve consensus and social integration through controlling and standardizing human beings (Castel et al.
1982:xxii).
18. This is a key question posed by journalist Evan Osnos (2011) in thinking about the relationship between
psychoanalysis and an authoritarian state.

Acknowledgments
My deepest gratitude goes to the psychotherapists, their clients, and other informants in Kunming for their generosity,
insights, and patience. I am grateful for the generous financial support from the John Simon Guggenheim Memorial
Foundation, the National Science Foundation, the School for Advanced Research, and several UC Davis Faculty
Research Grants. Earlier versions of this article were presented at the Center for Asian Studies at Stanford University,
the Department of Anthropology at Duke University, the Department of Sociology and Anthropology at Peking
University, Gender and Women Studies at Emory University, the IBF at Uppsala University in Sweden, and the
Department of Anthropology at University of Cologne in Germany. I thank all the participants at these events for their
comments and insights. At the School for Advanced Research Short Seminar on “Question the Global in Global
56 L. ZHANG

Psychiatry,” I received incredibly helpful critique and suggestions from the participants, which reshaped the final
version of this article. The three anonymous reviewers also offered extremely valuable and incisive comments and
suggestions, most of which have been incorporated into my revision. Finally, I am deeply grateful for the journal
editor, Lenore Manderson, for her enthusiasm in my work and the entire special issue, and for her guidance, insights,
and patience.

Funding
My research for this project was supported by a fellowship from the John Simon Guggenheim Memorial Foundation, a
grant from the Cultural Anthropology Section of the National Science Foundation, and the UC Davis Faculty Research
Grants.

Notes on contributor
Li Zhang is professor of Anthropology and vice dean for Social Sciences at the University of California-Davis and the
past president of the Society of East Asian Anthropology (2013–15). Her current project explores an emerging
psychological counseling movement in urban China and how it reshapes Chinese people’s understandings of selfhood,
well-being, and post-socialist governing. She is the author of two award-winning books: Strangers in the City and In
Search of Paradise.

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