I've been thinking about Evan Osnos's great piece in The New Yorker last week (sub. required) about the emergence of Freudian talk therapy in China.  Of course, it is important to keep in mind that only a very small group of people are embracing Freudian theory and practice (and doing it by skype!), thus we should not exaggerate its cultural significance.  But the discussion nascent Sino-Freudianism raises the larger issue of mental health and how the notion of the individual is socially constituted and reproduced in China.  

Osnos mentions a report last year from the British journal The Lancet:

…nearly one in five adults in China has a mental disorder, as defined by the Diagnostic and Statistical Manual of Mental Disorders, a figure that put China in the ranks of the most mentally ill countries in the world.  Scientists debated whether the estimate was too high, but other figures are beyond dispute: Suicide is the leading cause of death among young people.  Only one in twenty people witha mental disorder has ever seen a professional about it.

It turns out, according to the WHO, that the US has the highest rate of mental health disorders in the world.  And there are questions about whether the numbers in China reflect a true increase in actual mental illness or whether new diagnosis procedures are simply revealing something that has been there all along.  In either case, however, the same underlying point can be made: the very idea of "mental illness,' in its modern Freudian or non-Freudian terms, signifies a cultural shift in the way in which the individual is defined. 

An interesting article in the NYT last year argues that much of modern psychiatry is premised on American conceptions of normality and social life:

CROSS-CULTURAL psychiatrists have pointed out that the mental-health ideas we export to the world are rarely unadulterated scientific facts and never culturally neutral. “Western mental-health discourse introduces core components of Western culture, including a theory of human nature, a definition of personhood, a sense of time and memory and a source of moral authority. None of this is universal,” Derek Summerfield of the Institute of Psychiatry in London observes. He has also written: “The problem is the overall thrust that comes from being at the heart of the one globalizing culture. It is as if one version of human nature is being presented as definitive, and one set of ideas about pain and suffering. . . . There is no one definitive psychology.”

I would press this a bit further: there are also powerful economic and social and cultural incentives for embracing the assumptions of modern mental health discourse.  And we can see that at work in China today: a emphasis on individual work and achievement justifies entrepreneurial gains, making those who succeed in the new highly competitive market economy believe that they deserve the rewards they have reaped.  Of course on the other side those who fail to win out in the new economy come under tremendous pressure, perhaps contributing to depression or other mental disorders.  In other words, it is not just psychiatric ideas that are exported to the world, but the entire template of modern life.  I see this as more a matter of modernization than Westernization.

And that brings us back to Freud.  His is only one definition of mental illness, one that has lost much of its currency in the US.  But even if his views also fade in China, the broader social-psychological transformation of Chinese society will continue.  To return to the Osnos piece:

These days, the Chinese are increasingly willing to pay to talk.  Arthur Kleinman, a Harvard psychiatrist and China specialist, said, "This is radically distinctive from the past."  As he sees it, a mental shift has occurred, in "the very words used to talk about the self, which were always available to people if they wanted them, but were regarded as selfish and egocentric."…

The centrality and autonomy and potential of the individual, so important to the processes of modernization, would have been frowned upon by Confucius and his followers, seen as denying the social embeddedness of all persons.  But the Confucian view is being swept aside, not simply by Freud, who may well disappear himself, but by the economic and social and cultural dynamics of modern life.