Tuesday, January 04, 2011
Freud in China New Yorker
Dispatches by Evan Osnos.« China on the Couch Main January 4, 2011
Americanitis vs. Chinitis
Posted by Evan Osnos
Becoming a richer, more powerful country has rarely been relaxing. In the magazine this week, I write about the advent of a new era of psychology in China, which reflects the mounting pressures on ordinary citizens in an age of prosperity. There is precedent here. In 1881, at the height of the American industrial revolution, New York doctor George Beard published “American Nervousness,” about the fraying effects of modern life. Every person was born with a limited supply of nervous energy, Beard wrote, and depleting it in the hustle of modern civilization led to “neurasthenia,” a mix of fatigue and confusion named after the Greek for “tired nerves.” Neurasthenia rapidly became a household word in America, a fashionable affliction that carried the air of sophistication and striving. Its famous sufferers included Theodore Roosevelt, Jane Addams, and William James, who popularized its nickname, “Americanitis.” In 1925, a doctor estimated that a quarter of a million people were dying before the age of fifty every year because of “the hurry, bustle and incessant drive of the American temperament.” The Rexall drug company patented “Americanitis Elixir” for the “man of business, weakened by the strain of your duties.”
Neurasthenia eventually lost favor among American psychiatrists—Sigmund Freud, among others, redirected the study of the mind toward the inner workings, not the outer pressures—and it was ultimately sidelined from American diagnostic manuals. But one of the only places in the world where Americanitis maintained a foothold well into the nineteen-nineties was China. It was an easy fit for China because it echoed traditional medical concepts of qi, the vital life force, and it allowed patients to avoid the stigma of mental illness by describing their symptoms as fatigue, headache, or other physical sensations. When Arthur Kleinman, the Harvard psychiatrist and China expert, studied a hospital in Hunan province in the early eighties—the first frantic moments of China’s economic rise—he found that the most common diagnosis at the hospital was none other than neurasthenia. China, in other words, had come down with an acute case of Americanitis.
These days, Americanitis has fallen out of use again; Chinese doctors are far more likely to apply more familiar diagnoses, such as depression and chronic fatigue syndrome. But there many questions about China’s mental-health future that have yet to be settled. Some things worth exploring:
• Kleinman, of Harvard, is tracking whether the sheer speed and scale of China’s economic improvements will spare the country the full traumatic effects of its political upheavals. He’ll be writing about that soon, but, in the meantime, “Rethinking Psychiatry” remains the classic look at the impact of culture on the treatment of the mind.
• In the book “Crazy Like Us,” Ethan Watters argues that the West is exporting a one-size-fits-all approach to mental illness. He draws on the good work of Professor Sing Lee of the Chinese University of Hong Kong. Lee has tracked various ways in which China’s changes have been reflected in the minds of its people, including, as he described to me recently, the peculiar case of “Traveling Psychosis,” which produced a string of violent outbursts aboard Chinese trains in the eighties and nineties. The attackers were overwhelmingly young, first-time travelers en route to China’s booming coastal factory towns, without the money to pay for seats. After two or three days of standing in the aisles or toilets, on trains packed to the hilt with two or three times the legal limits, the young travelers began to wound and kill each other. As soon as they were removed from trains, the attackers often went right back to normal. “Traveling Psychosis” is rarely, if ever, found outside China, but as Sing Lee reminded me, it echoed the experience of nineteenth-century America, when the sudden new experience of the railroads left people addled by the experience.
KeywordsArthur Kleinman; China; Ethan Watters; Sing Lee; mental health; psychiatry; traveling psychosis
Read more http://www.newyorker.com/online/blogs/evanosnos/2011/01/americanitis-vs-chinitis.html#ixzz1A68ctaKg
Americanitis vs. Chinitis
Posted by Evan Osnos
Becoming a richer, more powerful country has rarely been relaxing. In the magazine this week, I write about the advent of a new era of psychology in China, which reflects the mounting pressures on ordinary citizens in an age of prosperity. There is precedent here. In 1881, at the height of the American industrial revolution, New York doctor George Beard published “American Nervousness,” about the fraying effects of modern life. Every person was born with a limited supply of nervous energy, Beard wrote, and depleting it in the hustle of modern civilization led to “neurasthenia,” a mix of fatigue and confusion named after the Greek for “tired nerves.” Neurasthenia rapidly became a household word in America, a fashionable affliction that carried the air of sophistication and striving. Its famous sufferers included Theodore Roosevelt, Jane Addams, and William James, who popularized its nickname, “Americanitis.” In 1925, a doctor estimated that a quarter of a million people were dying before the age of fifty every year because of “the hurry, bustle and incessant drive of the American temperament.” The Rexall drug company patented “Americanitis Elixir” for the “man of business, weakened by the strain of your duties.”
Neurasthenia eventually lost favor among American psychiatrists—Sigmund Freud, among others, redirected the study of the mind toward the inner workings, not the outer pressures—and it was ultimately sidelined from American diagnostic manuals. But one of the only places in the world where Americanitis maintained a foothold well into the nineteen-nineties was China. It was an easy fit for China because it echoed traditional medical concepts of qi, the vital life force, and it allowed patients to avoid the stigma of mental illness by describing their symptoms as fatigue, headache, or other physical sensations. When Arthur Kleinman, the Harvard psychiatrist and China expert, studied a hospital in Hunan province in the early eighties—the first frantic moments of China’s economic rise—he found that the most common diagnosis at the hospital was none other than neurasthenia. China, in other words, had come down with an acute case of Americanitis.
These days, Americanitis has fallen out of use again; Chinese doctors are far more likely to apply more familiar diagnoses, such as depression and chronic fatigue syndrome. But there many questions about China’s mental-health future that have yet to be settled. Some things worth exploring:
• Kleinman, of Harvard, is tracking whether the sheer speed and scale of China’s economic improvements will spare the country the full traumatic effects of its political upheavals. He’ll be writing about that soon, but, in the meantime, “Rethinking Psychiatry” remains the classic look at the impact of culture on the treatment of the mind.
• In the book “Crazy Like Us,” Ethan Watters argues that the West is exporting a one-size-fits-all approach to mental illness. He draws on the good work of Professor Sing Lee of the Chinese University of Hong Kong. Lee has tracked various ways in which China’s changes have been reflected in the minds of its people, including, as he described to me recently, the peculiar case of “Traveling Psychosis,” which produced a string of violent outbursts aboard Chinese trains in the eighties and nineties. The attackers were overwhelmingly young, first-time travelers en route to China’s booming coastal factory towns, without the money to pay for seats. After two or three days of standing in the aisles or toilets, on trains packed to the hilt with two or three times the legal limits, the young travelers began to wound and kill each other. As soon as they were removed from trains, the attackers often went right back to normal. “Traveling Psychosis” is rarely, if ever, found outside China, but as Sing Lee reminded me, it echoed the experience of nineteenth-century America, when the sudden new experience of the railroads left people addled by the experience.
KeywordsArthur Kleinman; China; Ethan Watters; Sing Lee; mental health; psychiatry; traveling psychosis
Read more http://www.newyorker.com/online/blogs/evanosnos/2011/01/americanitis-vs-chinitis.html#ixzz1A68ctaKg
# posted by Lamb Mouton @ 5:51 PM 
