Current Anthropology Volume 59, Number 5, October 2018 000

“Officials’ Heartache”
Depression, Bureaucracy, and Therapeutic Governance in China

by Jie Yang

This article offers an anthropological approach to the study of therapeutic governance that emphasizes the role of experts
in psychosocial programs by focusing on nonexpertise diagnosis and those subject to psy power. I examine the informal
diagnosis of depression for Chinese government officials who have committed suicide and the experiences of those
subject to such diagnosis. By pathologizing those officials as psychomedically depressed, Chinese media and the gov-
ernment implicitly cultivate an ideal subject for the state’s autocratic bureaucracy, one who is rational, masterful, and
psychologically healthy and who promotes social harmony and self-actualizes through public service. This biomedical
approach turns bureaucratic politics into mental health management as it implements new forms of regulation and
control through psychological care and permissive empathy. I demonstrate that while resonating with reductive Western
therapeutic governance, which replaces substantial social, economic, and political progress with psychosocial practices,
the Chinese mode of therapeutic governance diverges from its Western counterpart by de-emphasizing psy expertise and
varying according to groups. It is a devolved exercise of power manifest in mass adherence to China’s political project of
social harmony and stigma, invoking informal diagnosis and drawing on both Western and local healing practices.

In Chinese media, all petitioners are mentally ill; all officials
who committed suicide suffered depression. (Popular saying)
While those above are sick, why must those at the bottom be
fed with medicine? (Popular saying)
Were they [officials who committed suicide] not dead, their
superiors couldn’t sleep well! (Anonymous web user)
On February 27, 2013, Ke Jianguo, director of the Anti-
Corruption Bureau in Chongzhou, Sichuan Province, was found
dead after “falling” from a building. An investigation immedi-
ately ruled out foul play and determined his death to be a case of
suicide following a period of “depression” (Qi 2013).1 The sui-
cide rate among Chinese officials has recently been on the rise.2
While real numbers are hard to determine, suicide appears to
plague officialdom at all ranks, from cabinet-level dignitaries to
township officers and from government party chiefs to officials
in charge of finance, taxation, and public security.3 Most victims
are men between the ages of 40 and 60. Authorities quickly at-
tribute their deaths to a handful of medical conditions: qi benren
yali guo da (personally experienced excessive pressure), jingshen
fudan guozhong (excessive stress), jiaolu (anxiety), and, most
often, yiyu zheng (depression). Media reports of suicides some-
times include brief interviews with colleagues or family mem-
bers of the deceased that reveal personal details about the in-
Jie Yang is an Associate Professor of Anthropology in the Department
of Sociology and Anthropology at Simon Fraser University (8888 Uni-
versity Drive, Burnaby, British Columbia V5A 1S6, Canada [jie_yang@
sfu.ca]). This paper was submitted 6 I 17, accepted 9 IX 17, and elec-
tronically published 14 IX 18.
dividual, for instance, that he suffered from “insomnia,” “a bad
mood,” or “low spirits,” highlighting the death as the outcome
of private, psychological issues. These reports invariably describe
these officials as dedicated public servants with promising po-
litical prospects who were, unfortunately, susceptible to psy-
chological dysfunctions (e.g., uncontrollable impulses), a char-
acterization that serves to homogenize them and to advance
a linear relationship between stress, depression, and suicide.
Such homogenization and pathologization delegitimize the de-
ceased as rational political actors and implicitly promote an
ideal opposite: a subject who is rational, masterful, and psy-
chologically healthy. In general, these media reports describe
1. Chinese media repeat official accounts because of restrictions on in-
dependent inquiry. For a Chinese-language summary of data on officials’
suicides, see http://star.news.sohu.com/20150729/n417764418.shtml. For
media reports of officials’ suicides since 2009, see http://www.peacehall
.com/hot/guanyuanzisha.shtml. In 2012, the media reported 48 abnormal
deaths among officials; 29 were described as suffering from depression, one
from anxiety neurosis, and six from moodiness and frequent insomnia
(Beijing Youth Newspaper 2015).
2. Chinese authorities began to show concern about the mental health of
public servants in 2009, when 13 government officials reportedly commit
suicide. Since 2011, lectures and training sessions addressing this issue have
been organized at all levels of government, and psychologists have been
invited to develop psychological evaluations for candidates seeking to enter
public service (Beijing Youth Newspaper 2015).
3. According to government figures, 112 Chinese officials committed
suicide between August 2003 and April 2014 (Liu 2014). This appears to
reflect dramatic underreporting. According to nongovernmental estimates,
during the first half of 2013, 6,526 Chinese public servants went missing,
8,371 escaped overseas, and 1,252 committed suicide (Qi 2013).

q 2018 by The Wenner-Gren Foundation for Anthropological Research. All rights reserved. 0011-3204/2018/5905-00XX$10.00. DOI: 10.1086/699860

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 000
public servants collectively as a group at high risk for depres-
sion and suicide and recommend greater availability of thera-
peutic services (Beijing Youth Newspaper 2015; Fang, Yun, and
Zhang 2011).
However, the reports never include the voices of medical
authorities, including psychiatrists. Employers and government
investigators “diagnose” these individuals with depression, an-
xiety, or other psychological disorders after death and without
recourse to experts. The presence of psychotropic drugs such
as estazolam and oryzanol in the offices or cars of the deceased
seems to corroborate the informal diagnoses (Fang, Yun, and
Zhang 2011; He 2011; Huang 2011; Liu 2014). Yet these drugs
are prescribed for a variety of conditions, not just depression.
Outspoken supporters of the state echo the media’s verdict. Qi
Xingfa, a well-known political scientist at Northeast China Nor-
mal University, has asserted that the majority of officials’ sui-
cides are indeed attributable to youyu xing zisha (suicide caused
by biomedical depression; see Wang 2015).
To me, this standard narrative does not ring true. From my
first exposure to the phenomenon of guan xinbing in 2009, I
have suspected that disease cannot fully account for depression
and suicide among Chinese public servants. The term guan
xinbing, while pronounced like the term for coronary heart
disease, translates, in its current popular usage, as “officials’
heartache.” It first appeared in the public discourse in a 2011
novel entitled Guan Xinbing, by Ding Zhikuo, depicting China’s
delicate and tangled bureaucratic politics. Later that year, it also
appeared in a news article published in Nanfang Zhoumo ad-
dressing officials’ psychological disorders and moral confusion
(Fang, Yun, and Zhang 2011). On baike.com (a Chinese site
similar to Wikipedia), guan xinbing is defined as more related
to problems in psychological and spiritual realms than material
reality. In Chinese, “psychology” is literally translated as “the
study of the heart’s reasoning,” reflecting the place of the heart
in Chinese culture as the center of cognition, virtue, and bodily
sensation. Guan xinbing thus refers, in recent years, to both
physical and psychological elements of officials’ bewilderment
and discomfort. It is implicitly treated as a complex of diseases,
feelings, distresses, or moral concerns.
In summer 2009, I was invited to tea by a former classmate of
mine in Zhangqiu, Shandong Province, who is now a middle-
ranking official. Aware of my research into mental health, he
confided that he suffered from insomnia (shimian), burning
heart (xinjiao), and uncomfortable feelings overwhelming his
heart (xinli nanshou). He asked me to refer him to a psychiatrist
in Beijing, which I did, but he preferred to see someone who
worked at a comprehensive hospital rather than a mental hos-
pital, hoping to avoid revealing his illness through telltale hos-
pital receipts, which he believed could jeopardize his career. He
said his distress stemmed mostly from competition and tangled
relationships at work.4 However, when I reviewed media re-
4. Officials below the rank of director feel greater stress than higher-ups,
as they see fewer opportunities for promotion or psychological counseling
(Beijing Youth Newspaper 2015).
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Current Anthropology Volume 59, Number 5, October 2018
ports of suicides among people like him, I found that they did
not mention the social aspects of distress but were presented
entirely through the lens of biomedicine. Their emotional tone
was one of defeat: a disease (predominantly depression) had
afflicted a promising individual and resulted in loss of life. The
evidence to support this diagnosis was slim, but the message
was firm.
In this article, I explore the discrepancies between state
media accounts of officials’ depression and those of officials
themselves and show how these discrepancies reveal a Chinese
mode of “therapeutic governance”—control through psycho-
social or biomedical interventions, where power is exercised
through therapeutic activities. The study is based on ethno-
graphic field research undertaken during the summers of 2009–
2011 and 2013, focused on the social and political context of
these informal diagnoses. I conducted in-depth, semistructured
interviews with 26 public servants in Zhangqiu, Shandong
Province, a locality representative of many Chinese small-to-
medium-sized cities in terms of its bureaucratic practices. Pub-
lic servants were identified through snowball sampling, and I
also observed six routine meetings at two government agencies
in Zhangqiu and interviewed 15 psychiatrists on their under-
standings of mental health among public-servant patients in
both Beijing and Zhangqiu. Since 2009, I have also followed
media reports (on TV and online) of suicides by officials (mind-
ful that media in China remain subject to state censorship).
My research shows that the informal diagnosis of mental ill-
ness by media and government actors, based on a popular
biomedical understanding of mental illness, strategically steers
the discussion of suicide away from worsening problems in the
bureaucracy. As such, informal, nonexpertise diagnosis consti-
tutes an important feature of therapeutic governance in China
today, which addresses complex social, economic, and political
issues as private psychological or medical issues. I found that
several interrelated factors contribute to informal diagnoses as
well as to the discrepancies between views of officials’ depres-
sion and suicide. These factors include the contradictions and
qian guize (hidden rules) embedded in Chinese bureaucracy,
the intensified pressure for promotion, and the government’s
strategic propagation of a particular psychological rhetoric,
that is, “psychologization” as a central mechanism of thera-
peutic governance—the use of the idea of disease or illness to
make sense of conditions and experiences that are social and
cultural—in its attempts to control an increasingly privatized
but still “socialist” country. As my school friend’s experience
attests, guan xinbing is widespread among lower-ranking offi-
cials in Zhangqiu. Their “heartache” speaks to shifts in ethics,
subjectivity, and governance in China as much as it does to
biomedical depression.
The state pathologizes officials’ suicides in a process that
simultaneously constructs a psychologically conscious subject
who can process change, endure pressure, and actualize her- or
himself by serving the public. However, the means of pathol-
ogization diverges from that described in the Western litera-
ture on therapeutic governance (Miller and Rose 1994, 2008;
Yang “Officials’ Heartache”
Nolan 1998; Polsky 1991; Pupavac 2001, 2005). That literature
refers to an increasing integration of the ideas, languages, and
practices of therapeutic expertise into governance, replacing
substantial social, economic, and political progress with psy-
chosocial intervention. Conversely, in China, therapeutic gov-
ernance often occurs without recourse to experts; Chinese ther-
apeutic governance—operating through permissive empathy
constructed between the state-therapist and the (dead) people-
client, between higher-ups and subordinates, and between in-
dividuals—constitutes a kind of intrusive care. Such care is
imposed and irrelevant to the source of the problems that cause
depression or suicide among officials. It is not surprising that
officials are diagnosed after death. The range of acceptable dis-
course and practices is restricted, and responses to complex
sociopolitical issues are reduced to mental health management.
Specifically, the Chinese state smooths over contradictions in
the expectations for public servants with Western ideas of psy-
chology and individualism to ensure the continued operation of
an autocratic state in a market economy.
Psychological Imaginary and Depression in China
Through analysis of the voices and experiences of public ser-
vants in Zhangqiu, I review the meanings and effects of depres-
sion in current-day China to show that there is no valid reason
for the government to restrict its investigation of official suicides
to the biomedical realm. It does so for tactical purposes, tapping
into a popular psychomedical imaginary (of depression) to steer
public discussion away from problems in the bureaucracy or in
society more generally, and in the process promoting a psy-
chologically healthy subject who is able to manage his or her
emotions and internal life.
As Foucault (1976) suggests, both the form and etiology of
madness must not be sought in either the body or the psyche
but in the history of their discursive construction. Similarly, I
contextualize the notion of depression in both the global and
the Chinese settings. Around the world, work-related depres-
sion today is viewed as a form of social pathology. Most re-
search asserts that a purported rise in workplace depression is
an effect of neoliberalization, which destroys traditional work
culture (see, e.g., Moerland 2009 on this effect in France; Molé
2012, for an account of “mobbing” as a workplace coercion
pathology caused by neoliberal labor policies in Italy; and Ki-
tanaka 2015 on workplace depression in Japan as constituted
by new “caring” forms of neoliberal surveillance and control).
However, in China, according to my public-servant informants,
the main cause of depression in bureaucratic settings is qian
guize, hidden rules that have shaped China’s bureaucracy since
ancient times (Wu 2001).
Depression—translated in Chinese as yiyu, youyu, yumen,
or yiyuzheng—is treated as either a heart emotion or an illness
category. It is associated with a variety of symptoms. While it
can be somatized as “headache,” “congested chest,” “blocked
throat,” and so on, yiyu also refers to a range of emotional and
psychological phenomena, including feeling gloomy, low spir-
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000
ited, or conflicted and experiencing insomnia, obsessive think-
ing, oversensitivity, or suicidal thoughts (see Dere et al. 2013 on
the use of both somatic and psychological terms by Chinese
patients). For most people, yiyu is a part of everyday life, some-
thing that can happen to anyone at any time. The solution is to
see it as a part of life or to simply ignore the symptoms through
pretended muddledness (nande hutu). In the discourse of offi-
cials’ suicides, “depression” becomes a buzzword that makes
things visible and believable or a watchword that makes people
act in certain ways. It provides unifying principles of the situ-
ation and of the group, mobilizing signs to constitute the sit-
uation or the group.
In China, mental health issues have long been a matter of
secrecy and shame. Psychological distress is often attributed to
personal weakness or foreign influence. Such views may derive
from Mao’s era, when mental illness was stigmatized as an atti-
tude problem caused by ill-advised ideological positions based
on bourgeois capitalism or as “thought diseases” resulting from
diminished revolutionary zeal (Munro 2002). Suicide in all set-
tings has unique personal, social, and political dimensions. For
example, while in Christian contexts, suicide may be viewed as
a mortal sin, resulting in condemnation or family shame, in
China, suicide can figure as an act of preservation of “face” and
family status or as a form of resistance (Chan and Pun 2010;
Pearson and Liu 2002; Wu 2010).
Into this Chinese cultural landscape has come a global dis-
course on mental illness. The interaction between biomedi-
cine and traditional Chinese medicine has been asymmetrical:
Chinese medicine has been transformed by biomedicine more
than the reverse (Scheid 2007). People raised in the Chinese
medical tradition now also have words to name biomedical
disease categories. For Chinese psychiatrists, depression has re-
placed the former diagnosis of neurasthenia (shenjing shuairuo),
which was widespread in China until the 1980s (Kleinman
1986; Lee 2011). Depression is now referred to as lanse bingdu
(“blue virus”) and is considered the second-most widespread
condition causing death, exceeded only by heart disease.5 In
addition, the state media constantly reports on new conditions
that, although linked with the ubiquitous stress associated with
socioeconomic dislocation, are often psychologized (e.g., as “un-
employment complex syndrome”). Since the mid-1990s, with
China’s economic restructuring, the psychologization of dis-
tress of all kinds has been pervasive. At the same time, discourses
on mood and emotion have spread, particularly in big cities, and
psychological self-help literature and biographical confessional
talk shows have become popular (Yang 2013). All of these outlets
trade widely in psychological jargon, which has entered public
parlance.
In this context, those in charge of a local television station
in Zhangqiu, where Xiao, one of my informants, works, had no
5. See the 2009 Chinese TV series Xifu (Daughter-in-Law) on depres-
sion as the “blue virus.” The series depicts the social, familial, and political
factors associated with depression through the struggles of a mother-in-law
and daughter-in-law.
 000
trouble employing psychomedical terms to describe his behav-
ior. Xiao was well known locally for his “mental illness,” which
began several years ago when he was the preferred candidate for
a prestigious training opportunity that hinted at eventual pro-
motion. However, at the last moment, the directors of the tele-
vision station chose one of his colleagues instead. Xiao was so
outraged that, one day, when the colleague visited his office, he
poured tea on the man’s head. Xiao’s superior asked him to apol-
ogize, but Xiao refused, explaining that he had simply defended
himself from attack. After interviewing witnesses, superiors di-
agnosed Xiao as having symptoms of schizophrenia and pathol-
ogized him as unable to function. Xiao was furious about his lost
opportunity:“Icouldn’tcopewiththatpsychologicalimbalanceor
containmy‘fire.’Evennow,wheneverthinkingofthatunfairness,I
am enraged . . . . Just because they have power, they humiliated
me that way?” Over time, Xiao was largely marginalized at his
workplace. Several informants related similar stories and, like
Xiao, treated episodes that others had deemed pathological
as, rather, strong emotional responses to unjust bureaucratic
practices, suggesting a sociomoral view of distress. But they also
described negative behaviors and feelings in terms that over-
lapped with the jargon of pseudodiagnosis used by superiors. In
this way, officials appeared both to repeat and resist the imag-
inary of mental illness promoted in therapeutic governance.
These diverse uses of “depression” echo what Byron J. Good
(1977) suggests—that certain terms used in everyday language
to depict bodily conditions do not specify clusters of symptoms.
Rather, they capture syndromes of common experiences—sets
of words, experiences, and feelings that typically run together
for members of a society. For Good, experiences of physical
sensations, moral order, and social events are inseparable. “De-
pression” appears to be such a syndrome among Chinese offi-
cials. However, diverging from Good’s model, in which socially
bound illness experiences can be articulated, many officials I
interviewed acknowledged that they felt yiyu but struggled to
describe symptoms. Their experiences defied semantic repre-
sentation; they were felt.
While public servants may experience depression through a
multiplicity of meanings and effects, the government skips over
complexity in favor of biomedical parlance. Media represen-
tations of officials succumbing to depression actually give shape
to an inverted subjectivity: one that could withstand the very
pressures officials succumb to. To understand this divergence,
I turn to the mode of governing that underlines it and to the
unique process of psychologization and subject formation in
China today.
Psychologization and Therapeutic Governance
China’s Psychoboom
In China, the gradual depoliticization of social life and growing
emphasis on the self in the reform era has been accompanied
by a process of psychologization (see Kipnis 2012; Kleinman
et al. 2011; Yang 2013; cf. Gordo and De Vos 2010; Rose 1996),
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Current Anthropology Volume 59, Number 5, October 2018
which is medicalization in the realm of mental health. The
literature on medicalization (Conrad 1992; Furedi 2004; Lock
and Nguyen 2010; Zola 1972) and the medicalization of de-
pression (Hirshbein 2009; Kitanaka 2012, 2015; Neitzke 2016;
Rose and Abi-Rached 2013) shows how disease categories re-
cast personal and social problems as medical or psychological
conditions, involving processes of pathologization, biologiza-
tion, and individualization.
The trend toward psychologization has been tracked in West-
ern liberal societies (Kitanaka 2012, 2015; Martin 2007; Mills
2015), but, as Greg Eghigian (2004) points out, this trend also
flourished in communist societies, such as East Germany in
the 1960s and 1970s. Studying the role of (forensic) psychology
in preventing youth crimes in East Germany, Eghigian (2004)
argues that while the agendas and methods of policy makers,
researchers, and psychologists cross-pollinated, prompting a
psycho-pedagogical turn in delinquency, this development was
not a departure from authoritarian rule but rather “an exten-
sion of the socialist utopian project” (184). In recent years in
Russia, psychologists have offered “psychological education”
to children of the elite, which Matza (2012) argues is both a
form of neoliberal subjectivation and a post-Soviet project for
progressive sociopolitical reform. In both Russia and East Ger-
many, psychology and psy experts, including psychologists, psy-
chiatrists, counselors, and social workers, as appendages to
power, have served the shifting needs of governments and
nation-building projects. In China, the popularization of psy-
chological labels and psychological modes of thinking has led to
the emergence of a “psychoboom”—a notable increase in the
use of psychology, psychometrics, and psychotherapy in social
life (Kleinman 2010; see also Huang 2014; Yang 2013; Zhang
2014). Such widespread deployment of psychological knowledge
and concepts has given rise to overpsychologization among
the public, producing new mental “diseases,” increasing de-
mand for psychotherapeutic services, and fostering a mental
health industry. In this context, people engage in mutual diag-
nosis, create (pseudo)diseases, and seek solace in self-help and
therapy in an attempt to fill the moral and emotional vac-
uum created by the decline of communism and the unleashing
of market forces (Bell 2008).
In China, these developments are partly enabled by a ther-
apeutic ethos that increasingly pervades Chinese modes of gov-
ernance, resulting in a combination of the governmental and
the ethical. Vanessa Pupavac (2001, 2005), studying the influ-
ence of social psychology on international development and
humanitarian aid to populations in the global South, defines
therapeutic governance as management of the psychology of
populations, a mode of control through psychosocial inter-
ventions that mitigates social risk. For Pupavac (2005), the risk-
management approach to social policy builds on a perception
of general crisis—social, moral, and emotional—following dis-
illusionment with the postwar Keynesian welfare state model.
Therapeutic governance thus links psychosocial well-being with
security, with policy orienting away from development and so-
Yang “Officials’ Heartache”
cial progress toward soft security, including survival strategies
and emotional adjustment (Pupavac 2005).
Within this view, an individual’s emotional state and psy-
chological well-being are no longer just a personal matter but
also a kind of potential, with either positive or negative social
implications, requiring management. This mode of therapeutic
governance resonates with Foucault’s conceptualization of gov-
ernmentality, which relies on practices of observing, monitor-
ing, shaping, or controlling behavior in a way that is “think-
able and practicable both to its practitioners and to those upon
whom it is practiced” (Gordon 1991:3–4). Underpinning this
control are the assumptions that therapeutic methods can im-
prove psychological health, that doing so is part of good gov-
ernance, and that it is in the government’s best interest to
protect and improve individual psychological well-being.
Pupavac’s conceptualization of therapeutic governance res-
onates with the notions of “therapeutic authority” (Miller and
Rose 1994, 2008) and of the “therapeutic state” (Nolan 1998;
Polsky 1991; Szasz 1963). These concepts may differ in their
empirical analysis, but they tend to emphasize the significance
of psy experts and expertise in governing social, economic, and
political issues. Conversely, in China, therapeutic governance
de-emphasizes psy expertise and varies according to groups
(Yang 2015; Zhang 2015). While resonating with Western ther-
apeutic governance, which is reductive, replacing substantial
social, economic, and political progress with psychosocial prac-
tices, it diverges from its Western counterparts mainly in four
ways.
First, therapeutic governing in China dovetails closely with
state interests. As part of its political project of constructing a
“harmonious society,” the government tends to focus on ex-
pediency in treating cases of open distress in the populace and
limits scrutiny of social, economic, or political processes that
may contribute to such distress. Media and government rep-
resentations of biomedical depression as the default cause of
officials’ suicides rather than problematic bureaucracy illustrate
this tendency.6 “Caring” for the people’s psychological well-
being also resonates with the government’s invocation of the
Confucian doctrine of minben, in which benefiting the people
is presumably the moral aim of government and what keeps
rulers in power (Bell 2015). Likewise, therapeutic efforts appear
to constitute xianneng zhengzhi, a “political meritocracy” that
relies on governance by morally superior and capable leaders
(Bell 2015). Psychological “care” thus highlights the role of the
state as the people’s “guardian,” part of the party’s “guardian
6. The suicides of rural migrant workers at Foxconn in China in 2010
are a case of something else: protest against a state-promoted global labor
regime that denies workers’ rights (Chan and Pun 2010). While factory
management blamed the suicides on “personal matters,” workers were
clearly made desperate by growth that depended on their low wages. Chi-
nese officials are positioned differently, enmeshed in, suffering from, but
also benefiting from a state bureaucracy they find stressful. Their suicides
do not result primarily from exploitation.
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000
discourse,” contributing to its political legitimacy (Shi and Lu
2010).
Second, therapeutic governance is facilitated by stigma. In-
formal diagnosis of mental distress in China has real conse-
quences for those who are “diagnosed” (e.g., Xiao), partly be-
cause of the strong stigma attached to mental illness. Stigma
thus constitutes an informal mode of control and governing.
Also, the biomedical view of mental distress promoted by Chi-
nese media and the government reinforces the stigma of men-
tal illness as only a private matter and intensifies control over
the individual.
Third, while the management of officials’ suicides invokes
therapeutic expertise (biomedicine), Chinese therapeutic gov-
ernance also draws on social and cultural practices of healing,
including renqing (compassion), “scar” literature, and “speak-
ing bitterness” (see Yang 2015).7 For example, the tone of me-
dia representations of officials’ suicides and the termination of
corruption investigations because of their deaths manifests
renqing (e.g., compassion for the dead: sizhe wei da [“the dead
must be respected”]) in the Chinese context. As a result, this
mode of power is made up of a loosely connected set of ex-
pertise, representations, and governing technologies, exercised
by both governmental and nongovernmental agencies, includ-
ing individuals, and is thus hegemonic.
Fourth, Chinese therapeutic governance does not represent
individuals as being as entirely vulnerable as those depicted in
its Western counterpart, who require expert supervision (see
Furedi 2004). In the Confucian tradition, suffering has a pos-
itive dimension and can prepare people for success (see Yang
2017a). Chinese officials are seen as part of the solution, not
the problem: they strive toward success. When they commit
suicide, media reports often demonstrate how great politi-
cal prospects were taken over by psychological impulses. Chi-
nese psy experts and expertise can thus be dispensable, as elab-
orated below.
Nonexpertise
Indeed, while the literature on Western therapeutic gover-
nance focuses on the role of psy experts in international devel-
opment (Pupavac 2001, 2005), governmentality (Matza 2012;
Miller and Rose 1994, 2008; Rose 1996), and the therapeutic
state (Nolan 1998; Polsky 1991; Szasz 1963), the Chinese mode
of therapeutic governance can operate through informal patho-
logization and diagnosis by government agencies, media, and
even the public and by tapping into popular psychological imag-
inaries. That is, in China, nonmedical entities have the power
to assess mental illness in various contexts, including offi-
cials’ suicides (Chen 2010). News reports about such suicides
use language like “anxiety,” “stress,” “depression,” and “psychi-
7. Scar literature is a literary genre emerging in late 1970s depicting
the sufferings of Chinese cadres and intellectuals during the Cultural
Revolution that was considered by some to be therapeutic.
 000
atric disease” without substantiation from psychiatrists or other
medical authorities. As evidenced by the case of Xiao, employ-
ers, colleagues, and family members make assertions of mental
health on their own, bypassing medical authorities, with real
consequences for employees.
Such informal diagnoses are also used in appointing Chinese
officials and determining whether they are qualified for certain
posts. For example, Shao Jingjun (2016), a specialist researcher
at the Central Disciplinary Committee of the Chinese Com-
munist Party, attributes rampant corruption among Chinese
officials partly to mental illness, which he defines without in-
voking medical expertise. According to Shao, jealousy, violence,
revenge, stubbornness, self-aggrandizement, narcissism, depen-
dence, indifference, flattery, and habitual lying are psycholog-
ical illnesses that must be precluded in leaders. Those who suffer
these “diseases” must receive medical treatment or be dismissed.
Nonexpert diagnosis of mental illness has also been extended
to media representations of members of vulnerable groups who
exercise retaliatory violence or commit public “crimes” (Zhao
2008), permeates social programs targeting the unemployed and
urban poor (Yang 2015), and manifests in new mental “ill-
nesses” proliferating in everyday discourse (Yang 2017b).
Nonmedical assessments may be partly driven by the lin-
gering impact of the Maoist view of mental illness as an ideo-
logical pathology and partly by the capricious power of the
party state. It may also derive from the long-standing focus
on self-cultivation in Chinese society, an orientation that has
recently been encouraged by the government as a way to cope
with reduced state welfare support (see Farquhar and Zhang
2012). There is a sense that everyone can become a health
“expert” and take care of him- or herself. The blurred distinc-
tion between non-expert-led psychologization and expert-led
therapeutic management resonates with an anthropological ap-
proach to expertise that treats experts “not solely as rationalist
creatures of expertise but rather as desiring, relating, doubt-
ing, anxious, contentious, affective—in other words, as human
subjects” (Boyer 2008:38). These doubting or affective “experts”
contribute to overpsychologization and the growing mental
health industry in China.
Anthropological Approaches to Therapeutic Governance
In Western studies of therapeutic governance, the emphasis on
the power of experts and expertise over those who are subject
to psy power fails to demonstrate the effects of psychologiza-
tion on individuals and elides the agency and contestation of
those subject to psy expertise. This elision limits us from fully
revealing the degree of the intrusiveness of Western biomedi-
cine into individual bodies and subjectivities or delivering a
more nuanced critique of therapeutic governance. It may also
foreclose alternative, indigenous sources of healing and com-
munal practices of coping with the consequences of violence
or socioeconomic dislocations that cause mental distress.
Here I want to diverge from this Western framework by
considering the role of culture and phenomenology in the study
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of therapeutic governance. Specifically, I emphasize the im-
portance of theoretically and methodologically focusing on in-
dividual voices and lived experiences with psy power. Mark
Nichter (2010) argues that we can only understand illnesses
or distress in terms of the broader culture of a certain society,
sensible as an “idiom of distress.” That is, expressions of distress
may be drawn from a number of culturally and personally avail-
able meaning complexes, though Nichter (2010) cautions against
using such interpretations to deem illnesses less serious than
diseases attributed to biological causes. The notion of idioms of
distress provides a promising venue for exploring psychologi-
cal or mental disorders.
Alternatively, by paying attention to individual lived expe-
rience, we may define mental illness or distress as “syndromes”
of common experiences (Good 1977) or as socially conditioned
responses to stress. Stress responses are socially constructed and
regulated by social norms (Cloward and Piven 1979). To un-
derstand “deviant” behaviors and feelings, we need to under-
stand the cognitive, moral, and bodily frameworks through
which people process stress.
In China, therapeutic governance is both part of the post-
socialist transformation and a response to the widespread stress
and disorientation resulting from privatization and marketi-
zation since the mid-1990s. The decline of communism and
dismantling of the work-unit system as a primary source of
emotional and material support have been experienced by many
as a crisis of identity, morality, and community. Uncertainty
and stress about the rules and norms governing life create a
demand for psychological answers. The therapeutic paradigm
has become integral to relationships between state institutions
and citizens, forging new points of contact with the public
(through the psychoboom), redefining political authority, and
diverging from more overt political control.8 According to Tal-
cott Parsons (1965), therapy provides access to individual sub-
jectivities without much resistance. Rather than judge people’s
behaviors, therapists empathize and can establish a sense of
“permissiveness” (Parsons 1965:317), because suffering is the
key link between therapist and client. Unlike forms of social
control based on threat, therapy works indirectly via permis-
sive empathy, through which therapists gain privileged access
to clients’ subjectivity.
As a form of governing that ostensibly disavows control,
therapeutic governance taps into individual emotion and psy-
chology while eschewing social issues or matters of policy.
As Eva Moskowitz (2001) noted in her study of the history
8. Both Chinese media and experts describe a countrywide crisis in
mental health. A survey conducted in 2009 shows that more than 100 million
Chinese suffer from some form of mental illness (Chen 2010). Approxi-
mately 90 million people now suffer from depression (Beijing Youth News-
paper 2015). The suicide rate is 22 or 23 per 100,000 people, far exceeding
the world average of 13. Depression reportedly increases the likelihood of
suicide twentyfold, and about 15% of people with “chronic depression”
commit suicide (Dubois 2013).
Yang “Officials’ Heartache”
of therapeutic culture in the United States, an obsession with
feelings in the 1970s helped establish a new framework in which
social problems were viewed from a psychological perspective.
Similarly, Elisabeth Lasch-Quinn (2001) observes that thera-
peutics emphasize managing attitudes rather than tackling in-
equality. Therapeutic governance is not confined to changing
outward conduct. It can target the very nature and develop-
ment of personality by nurturing psychological functionalism
(Pupavac 2001). The focus on individuals’ internal lives and
self-care in China resonates with its recent emphasis on the self
in its effort to relieve the government of responsibility for the
individual, which helps it enact a neoliberal market economy.
In this context, the Chinese government treats psychology
as a tool for building idealistic or utopian situations that par-
allel or identify with long-standing “socialist” ideals (social har-
mony), bridging past, present, and even future forms of gover-
nance. Framed as providing practical modes of understanding
and acting, psychology affects how people imagine who they
are and what they might become (by reconciling them to their
inner beings and reconfiguring interpersonal relationships).
By popularizing psychological knowledge, the government and
the public may invest it with ideological and ethical contents,
potentially turning this knowledge into a mechanism of so-
cial control.
A New Language
Since Mao’s era, exploring the inner self has been an important
constituent of identity and politics in China. During the Cul-
tural Revolution (1966–1976), citizens were mobilized to spy on
one another and report ideas that were politically “incorrect.”
People were forced to use set formulae and fixed expressions
from Mao’s works to frame their consciousness through “lin-
guistic engineering” (Ji 2004). To some extent, the widespread
psychological discourse today provides people with a new lan-
guage to make sense of their experiences (with socioeconomic
dislocation), for example, through informal and mutual diag-
nosis. But the current situation differs from the systematic dis-
semination of Maoist ideologies in that today’s psychological
discourses include a variety of rhetoric, appeal to feelings, and
are imbued with a logic of self-help adapted from both the
West and the Chinese tradition of self-cultivation. While state
efforts to shape people’s hearts and minds continue through, for
example, media censorship of the content of communication
(by stipulating biomedical depression as the cause of officials’
suicides), in a reversal of the Maoist condemnation of self-
centeredness, current psychologization encourages individu-
als to retreat to their private and internal lives. By turning
inward and celebrating self-care, the therapeutic accommo-
dates moral disorientation and the weakening of communal
solidarity. Stress and social deviance are now pathologized or
psychologized rather than politicized as in Mao’s era.
In the case of officials’ suicides, the emphasis on biomedical
causes reduces the complexity of these officials/subjects to bare
life, recasting their social existence as only a biological life form
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000
(Agamben 1998). Their relationship to power was made re-
ducible to therapeutic activities. In the following discussion,
I sketch the social and political backdrop of the therapeutic
approach to officials’ suicides in China. Rather than empha-
sizing the power of psy professionals, I focus on the embodied
and affective experience of Chinese public servants, represen-
tatives of the state vis-à-vis ordinary people, and subjects of
both state rules and hidden rules (as embodied by supervisors).
That is, they both suffer from and contribute to this form of
therapeutic governance. By demonstrating the complex sub-
jectivities of public servants and the sociopolitical factors as-
sociated with their distress, I critique the homogenizing and
reductive aspects of Chinese therapeutic governance.
Qian Guize and Autocratic Bureaucracy
In The Three Spirits of the Academy (1926), Lu Xun wrote that
the Chinese people were literally dying to become government
officials. He was not far off, by many accounts. Chinese culture
has long been heavily invested in officialdom, and people’s ob-
session with becoming an official is called guan yin (officialdom
addiction). Historically, one used every possible means to attain
an official position, including destroying rivals and currying
favor with those in authority. In Zhangqiu, the wife of a public
servant complained to me that after her husband was promoted
to section chief, his lifestyle changed. He often returned home
late and drunk after attending social dinners, part of his con-
stant networking as he chased further promotion. As her hus-
band told me, “You have to obey others if you have no offi-
cial power, whereas others have to obey you when you are in
power. The problem is that even if you are in power, you still
have to obey others who hold greater power than you.”
Many of my informants are fixated on promotion; it is a
source of anxiety and distress due to complex bureaucratic prac-
tices, especially qian guize (Tatlow 2012; Wu 2001). A phrase
coined by Chinese journalist-turned-historian Wu Si (2001),
“qian guize” refers to hidden rules that attach to, complement,
bypass, or twist the operation of formal, established rules in
Chinese institutions. These rules constitute informal codes of
behavior that range from prescriptions for proper demeanor,
to minor rule bending, to more serious transgressions aimed
at amassing wealth and benefits, including particularistic
factionalism, nepotism, flattery, and bribery. Hidden rules de-
fine one’s access to resources, including career advancement
and pay raises. Qian guize underpin what amounts to auto-
cracy—the idiosyncratic rule of individuals rather than the
predictable rule of law.
Other recent research supports my informants’ contention
that qian guize in bureaucratic contexts are the main trigger
of guan xinbing, officials’ heartache (He 2011). A 2009 survey
conducted by Renmin Luntan, an offshoot of People’s Daily,
showed that, of 5,800 officials, more than 64% believed that
work pressure is mainly due to the impact of qian guize on one’s
prospects (Fang, Yun, and Zhang 2011; Liu 2014). However,
what these hidden rules are and how they work have not been
 000
studied systematically. By their very nature, they are elusive and
highly contextual; their fluidity and uncertainty can consume
people cognitively and affectively, turning officials into, in their
own words, “patients of power” and triggering anxiety, distress,
and even suicide.
Qian guize typically follow powerful individuals’ self-interests;
“insiders” (senior officials) become de facto rule makers and
implementers. In the absence of strong checks and balances
in China’s one-party rule, the cost of breaching established
laws and following one’s own rules is generally low. This lack of
accountability can transform public power—delegated through
formal rules and institutional mechanisms to serve state inter-
ests—into private power for individual agendas. Once an of-
ficial becomes an insider, he then spares no effort to maximize
economic and social benefits. In an officialdom dominated
by qian guize, bureaucracy, patriarchy, personal attachment,
and personality cults characterize interpersonal relationships.
(Most officials are men; another article is needed to analyze
women and qian guize.) Activities flow from the personal pref-
erences of insiders. Leaders tend to prefer subservient rather
than competent subordinates. Those who are reluctant to give
up pride and character to curry favor with higher-ups are mar-
ginalized. Such “reverse elimination” (ni taotai) causes distress
among officials (see Wu 2001). Those who do not submit are
often given “smaller shoes” (xiaoxie) to wear; they are inten-
tionally made uncomfortable or demoted.9
Qian guize include both direct and indirect modes by which
superiors exercise power over employees, such as gei lianse kan
(giving people dirty looks or glaring) or assigning tasks that
feili bu taohao (require tremendous effort but back people into
a corner). Superiors tinker with workplace practices to maxi-
mize their power and bully subordinates or peers. Subordi-
nates are subjected to humiliation and degradation. In general,
qian guize create subjects who oscillate between formal and
informal rules, public and private arenas, words said and un-
said, and potential and manifest power. A desire for security
and protection may lead public servants to cultivate paternal-
istic relations with superiors and seek to become “insiders”
themselves, all the while anticipating precariousness, uncer-
tainty, and flux. Qian guize construct a kind of intersubjectivity
based on volatile interdependency. Most of my informants see
their colleagues as neither friends nor enemies but rather as
people who can become either at any moment in response to
shifting interests. People see others as extensions of themselves,
using them or bypassing them to achieve their own goals.
In Zhangqiu, among the most explicit qian guize are those
allegedly imposed by the networks of at least seven powerful
9. Officials in Zhangqiu recounted many examples of “smaller shoes”:
making a fuss over trivial matters; highlighting subordinates’ weaknesses
by deliberately assigning them challenging jobs; and creating strife by
intentionally assigning disobedient subordinates to work with acrimo-
nious colleagues.
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Current Anthropology Volume 59, Number 5, October 2018
families. Members of these families hold key positions in gov-
ernment and financial institutions, and connections to them
can increase one’s chances of promotion. An informant sur-
named Lin is deputy director of the tax bureau in Zhangqiu.
When his former director was relocated to another city, Lin was
confident that he would be promoted to director, a belief con-
firmed by a famous guniang (folk healer-cum-fortune-teller,
whom officials there consult seeking psychological relief and
insight into their careers). When the exiting director announced
that, in fact, another deputy director would replace him, Lin
was so shocked that his hair turned gray overnight. He felt
“ashamed” and “betrayed,” he told me, given that the party
committee had hinted he would be chosen. The deputy director
who got the job, however, has a powerful uncle in the provincial
government whose networks overlap with those of the seven
families in Zhangqiu. As a folk saying circulated in Zhangqiu
puts it, “Chao zhong wu ren mo zuo guan” (Without powerful
connections in the government, one should not become an
official).
Most of my informants indicated that navigating qian guize
requires an “embodied understanding” (tihui); they must be
able to read fluctuating meanings of body language such as
a look, a wink, or a pat on one’s shoulder, depending on con-
text. Important information may be expressed in a pause in
conversation, requiring subordinates to fill in the silence with
proper words or actions. Failure to understand this physical
aspect of qian guize leads to unwanted consequences. One of-
ficial in charge of the road system in Zhangqiu explained, using
the English word “depressed”:
You have to interpret [the indirect messages of superiors]
accurately and speak accordingly. Every day, you walk in half-
steps and talk in half-sentences to be safe and not to offend
superiors. You walk on thin ice; if not careful, you will fall into
deep waters. . . . No matter how healthy you are, you will
sooner or later become depressed; it’s so important to twist
yourself to fit the system.
Yet, for all the efforts it involves and the high cost to officials’
mental health, following qian guize does not always equal suc-
cess. This is reflected in the situation of my informant Chen.
Chen was relocated in 2013 to a position that was equal in rank
to his previous one but in which he lacked power to allocate
resources. His wife indicated that whenever Chen watched his
superior on the local television news, he would clench his teeth
and fists, saying, “I will kill him—kill all those in his clique.”
His rage resembles the effects of what Molé (2012:39) describes
as “mobbing,” workplace harassment by superiors in Italy
dubbed a “life-death crisis” by its victims. Chen’s wife suspected
Chen was depressed. She had been watching a lot of televised
self-help and counseling programs and seemed to know the
symptoms. Chen’s colleagues and employer also found him
increasingly aloof and antisocial; some even asked him to “visit
Zaoyuan”—the area where Zhangqiu’s only mental hospi-
tal is located—effectively telling him to see a psychiatrist.
Yang “Officials’ Heartache”
Chen, however, focused his resentment on the superior who
had played a key role in his relocation. Chen described to me
how he had flattered his superior for years, bowing to qian
guize:
How much I did for him, only Heaven knows. . . . [I]
gifted him with the best things available to me. He himself
was so moved and said I am more than his brother. But
at crucial moments, he did nothing to benefit me; the one
who took my position has more powerful connections and
can benefit that bastard. If it were you, would you not be
angry?
Unlike Xiao, who knows qian guize contributed to his loss of
that training opportunity but is unable to express exactly why
he was undermined, Chen knows his marginalization resulted
from his superior’s interest in more powerful connections,
making Chen’s efforts to practice qian guize irrelevant. While
most public servants resented qian guize when they themselves
were suffering from these rules, such resentment was mitigated
once they benefited from qian guize. It is thus less workplace
hierarchy that triggers depression than the shock of these rules
turning against them. The positionality of middle-ranking offi-
cials—both sufferers and contributors of qian guize—equals
precarity, binds, and, frequently, defeat.
Ethical Contradictions and Psychological Distress
While the media emphasis on the biomedical definition of “de-
pression” is part of the discourse of the “psyche” in China,
conflicts between the psyche as the new “private” domain driven
by self-interest and the collective interest reflected in public
service permeated my informants’ analyses of their daily strug-
gles and distress. The alignment of public and private selves in
China is difficult today, as consumerism pushes people to desire
material gains, which is a significant temptation for officials,
who are now poorly paid compared to nouveau-riche entre-
preneurs. Here, I consider this shift in emphasis from collective
action to individual psyche.
I do not view the psyche as only a component of the indi-
vidual, immune to social pressures. Rather, I agree with Kipnis
(2012) that the psyche is a site of conflicts among contradictory
discourses, emotions, and urges and a target of the governing
actions of diverse institutions and social actors. In general, in
discussing their psychological state in the work environment,
officials I interviewed adopted a sociomoral understanding
of distress and of public-private dynamics, despite sometime
repeating and criticizing biomedical terms used by their em-
ployers. Many of my informants stated outright that they must
perform as shuangmian ren (two-faced people) to survive; they
claim to serve “the people” through their work but must attend
to their own personal interests because of the demands of qian
guize. Being two-faced helps them balance sacrifices (anxiety,
distress, humiliation) and gains. In this sense, they are masters
of themselves in the guise of public servants. In Zhangqiu,
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000
several informants pointed me to a news report that included a
letter from an official arrested on corruption charges. They felt
that the letter exemplified the treacherous nature of qian guize
and the necessity of being two-faced. In the letter, the official
advises his son, soon to be an official himself:10
First, don’t pursue the truth of things. Let intellectuals do
so. You should follow the principle, “Whatever benefits my-
self is true.” . . . Second, learn how to lie and be good at it.
You need to view lying . . . as a career, to the point where
you yourself believe your lies. An official is like a prostitute,
but sells his mouth.
The letter goes on to list other ways officials can succeed by
engaging in negative behaviors, such as focusing on currying
favors rather than performing actual work and prioritizing
short-term effects rather than positive values like gaining real
knowledge or critical thinking. It ends with a lesson:
Finally, treat pai ma pi [flattery] as an advanced art, not as
crude practices that might lead to you or someone else los-
ing face. Like mistresses, only a few of them successfully be-
friend rich men, while most become companions of the low-
liest men at nightclubs. The same can be said of pai ma pi.
Within an autocratic society, flattering one’s superior [effec-
tively] is the only way for promotion.
Several informants, discussing this letter, asked the same ques-
tion: given such norms, can anyone survive officialdom with-
out depression? Their contradictory roles provoke distress, rem-
iniscent of the notion of a “divided self” conceptualized by
Kleinman and colleagues (2011), who use the image of an owl
with one eye open and one eye shut as a metaphor for this
divided self. The open eye takes in all that is necessary to get
ahead in everyday life, while the shut eye protects an inner self.
However, when I raised this metaphor of the owl with one
informant in Zhangqiu, he was underwhelmed: “If this is true,
we have to blink every moment. You have to be cautious and
calculating whenever you’re at work to avoid pits and traps. At
some point, you feel so frustrated and so exhausted that you
want to end it all.”
If we agree with Michael Lambek (2010) that decisions made
in everyday life are guided by ethics and that ethical principles
are intrinsically ordinary—what he calls “ordinary ethics”—
Chinese officials experience continually shifting ethics, through
which they cannot sustain integrity. They end up in what Greg-
ory Bateson (1973) deems “double binds,” social relationships
that require permanent management of contradictions. The
double bind imposes irreconcilable (ethical) demands on the
subject in situations where the person has no meaningful way
to respond or escape. Double binds can produce anger that en-
dangers social harmony and so is often subconsciously con-
tained, giving rise to inner rage that is channeled unconsciously
10. http://www.xici.net/d131319164.htm, accessed July 18, 2015.
 000
or indirectly into everyday speech and acts. Constant manage-
ment of ethical contradictions leads to exhaustion, prevalent
among the officials I interviewed and manifest in apathy, cyn-
icism, and ambivalence toward their work lives and in psycho-
logical and physical suffering. Beyond ideological and semiotic
processes that shape bureaucratic life (Gal 2002), public-private
dynamics are also embodied and affective forces. When the
subjective perception of distinct domains of public and private
is violated in practice, it may trigger distress among officials who
have difficulty assuaging the rub between their public and pri-
vate selves.
The majority of those I interviewed indicated that in re-
sponse to these conditions, they kill time to get by (hun rizi).
Many try to detach themselves from workplace politics and
focus on their private lives through yangsheng (nurturing life).
Some officials actually thrive within bureaucratic culture. The
director of the local public health bureau proudly told me that
he is a third-generation politician and that the skill of dealing
with contradictions is in his blood: “Growing up, I saw how my
parents and grandparents engage qian guize. It is a part of my
being.” Another way of smoothly navigating an environment
characterized by qian guize is to act as a participant-observer.
A middle-ranking official at a science park in Zhangqiu viewed
qian guize as a scientific study:
Like your anthropological research, the practice of qian guize
requires skills, sharp observation, embodied learning, and—
above all—xin ling shen hui [being receptive in your heart
and understanding leaders’ inclinations with your spirit] . . . .
Leaders see you are loyal; loyalty is more important than
ability. They’ll trust you and include you in their circle; you
become an insider, not far from promotion.
Besides a work environment governed by hidden rules and
contradictions, the government’s iron-handed anticorruption
campaign, which has ramped up dramatically since 2012, has
likely put officials in a constant state of anxiety and stress.11
Indeed, since the 18th National Congress of the Communist
Part of China in November 2012, about 30% of officials who
committed suicide had been accused of corruption by the party’s
disciplinary committees (Beijing Youth Newspaper 2015). Still,
the pressure experienced by officials comes mainly from their
routine bureaucratic practices. The situation is summed up in a
folk saying that circulated among officials in Zhangqiu: “With-
out a strong stomach [courage], you will be scared to death;
without a strong body, you may die from exhaustion; without
the ability to resist wine, you may drink yourself to death;
11. Those accused of corruption may be penalized through shuanggui,
or dual designation (of time and location for interrogation)—extralegal
procedures overseen by the party’s disciplinary committees, who detain and
interrogate party members (Chu 2011; Sapio 2008). Psychological manipula-
tion and physical torture, including sleep deprivation, simulated drowning,
and beatings are reportedly common during shuanggui. To avoid this sce-
nario, some officials choose to end their lives; according to Chinese law,
death ends a corruption investigation and can be attributed to “depression.”
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Current Anthropology Volume 59, Number 5, October 2018
without a strong personality, you may worry to death; without
a strong heart, you may die of frustration.” The bitter tone
captures the dissonance between officials’ views of depression
as a cause of suicide and that of the government/media. The
government tells a story that diverts attention from the prob-
lems of the bureaucracy and toward individual mental illness,
narrowing the discussion of officials’ suicides to psychomedical
terms and, through psychologization, deploying therapeutic
resources to treat individual problems that are actually social
issues in the name of “social harmony.”
Historicizing Psychologization and Stigmatizing
“Officials’ Heartache”
The Chinese psychiatrists I interviewed affirmed the mode of
therapeutic governance I have identified in this research and
its historical roots. For them, media representations of depres-
sion as the cause of officials’ suicides are consistent with the
state’s interest in constructing “a harmonious society.”12 Cut
out of investigations into the suicides, they were not surprised
by lay diagnoses of depression. Under Mao, psychiatry was
viewed suspiciously as a pseudoscience and as dispensable—
bad thoughts could be eradicated through ideological reorien-
tation and through medication (Munro 2002). Psychiatrists still
play an ambivalent role in China today: both complicit with the
state and critical of informal diagnosis, which, to some extent,
undermines their status as medical experts. In summer 2013,
I had an extensive conversation with several psychiatrists in a
Beijing mental hospital regarding a report on an official’s sui-
cide. One of them commented:
If they [officials] really suffer depression, they [investigation
teams] would offer more information, at least which hospital
made the diagnosis. . . . It’s hard to diagnose someone dead
in terms of mental illness; diagnoses based on the medicine
they found sound arbitrary. . . . Our remarks on social causes
of mental illness may hint at a problematic bureaucracy. This
will open a whole can of worms. We are useless.
The most senior psychiatrist continued:
Well, this is harmony. Maintaining harmony means dif-
ferent things: for those who are crazy, we need to diagnose
them and put them in hospital; it also means we keep quiet
when others made the diagnosis. This explains we are not
paid enough; others take over our job. [Laughs.]
Harmony (hexie) is a popular slogan that covers almost ev-
erything the Chinese government does, from promoting hap-
piness to preventing crimes, but people have different under-
standings of it. A third psychiatrist involved in the above
conversation further explained hexie as having “no actual sub-
stance. It simply harmonizes anything deviant from the norms.
12. A harmonious society, as envisioned by Hu Jintao and Wen Jiabao
in 2004, is people centered and sustainable. Its key features include de-
mocracy, the rule of law, equity, justice, sincerity, amity, and vitality.
Yang “Officials’ Heartache”
Its heavy use only shows the ubiquitous lack of harmony in
society.”
The government promotes harmony to break down social
barriers and narrow social stratification intensified by privat-
ization. The reiteration by the state of its goal of achieving
harmony silences dissenting voices and appeases anger or social
unrest. Whether an official commits suicide out of despair at his
failure to be promoted or out of guilt due to corruption, fo-
cusing on individual mental health diverts attention from wider
contexts. Indeed, one effect of psychologization is a confusion
of cause and effect. Since structural forces within the bureau-
cracy may cause psychological distress, focusing on individuals’
psychological issues will not achieve redress.
An additional consequence of the government’s approach
to suicide is that it reinforces the stigma of mental illness,
heightening its association with personal weakness. Quite a few
psychiatrists in Beijing pointed out that media reports of sui-
cides have resulted in a rise in clinic visits from family members
or confidants acting as proxies for people hoping to get care
while remaining anonymous. Corrigan and Watson (2002)
point out that stigmatization has two dimensions: public stigma,
which encompasses the reaction of the general population to
people exhibiting mental distress, and self-stigma, which is the
prejudice people exhibiting this distress turn against themselves.
Public stigma and self-stigma are often interrelated; both can
constitute modes of control. In his study of epilepsy, Kleinman
(1995) argues that Chinese society’s concern with social control
intensifies the effects of the illness; social control works through
stigma. To avoid stigma, families conceal diagnoses and se-
quester epileptic members at home. Likewise, many officials
who experience distress at work fear public condemnation and
take measures to hide their “illness” (see also Yang 2017b). As
mentioned, some in Zhangqiu visit guniang. Meanwhile, their
problems continue to worsen.
During my 2013 conversation with the psychiatrists in Bei-
jing, the most senior among them mentioned the difficulty of
treating officials who equate depression with weakness. He
cited the example of a senior official from Hebei Province who
insisted that he suffered only from insomnia and headache to
avoid the stigma of depression: “He refused to take any medi-
cine for depression; his wife begged me to write all the anti-
depression medicine for ‘insomnia or headache’ so he could
take it.” Another of his “patients,” a woman in her seventies,
tried to claim her son’s symptoms as her own in order to get
a diagnosis and prescriptions for the son. The son, a high-
ranking municipal official, considered exposing his “mental
illness” too risky. Such self-stigma, according to this psychia-
trist, may appear to promote social harmony, but it increases
pressure on the sufferer.
Some officials, however, manipulate the stigma of depression
to their own advantage, a maneuver that both reveals and re-
inforces the contradictions within therapeutic governance. A
deputy director at the transportation bureau in Zhangqiu, hav-
ing failed to be promoted and resenting qian guize, tried to
leave the public sector to become a lawyer. Having failed to
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000
secure a 6-month leave to prepare for the bar exam, he went
to the local mental hospital complaining of insomnia, anxiety,
and depression. With a diagnosis of depression, he obtained his
leave and is now a successful lawyer. He described the diag-
nostic procedures as “easy”: “The doctor wrote the diagnosis
without asking me why I couldn’t sleep. . . . Within 5 minutes,
he had sent me to their pharmacy.” This lawyer’s experience
illustrates both the biomedical understanding of depression
and the politicization of depression. Similarly, in 2005, the fa-
mous former CCTV anchor Cui Yongyuan publicly confessed
to suffering from depression, driving home the message that
it is a real disease that requires medical treatment. In 2014, he
blogged, “Damned, the frequent association of depression with
corrupt officials has ruined the good reputation of this disease”
(https://www.yangfenzi.com/shehui/43728.html). This entry both
reflects Cui’s biomedical understanding of depression and crit-
icizes the government’s political use of biomedical depression as
a strategy to downplay its own culpability in bureaucratic cor-
ruption.
Conclusion
This analysis of the phenomenon of guan xinbing in China
contributes to our understanding of therapeutic governance
by incorporating culture and ethnography into this concept
and by specifying the unique Chinese approach to therapeutic
governance: a devolved exercise of power manifest in mass ad-
herence to the political project of “social harmony” and stigma,
invoking informal diagnosis, and drawing on both Western
and local healing practices. In China today, everyone can be
an expert now, can “diagnose” freely, and can trade in psycho-
logical terms they hear on streets or on TV. This widespread
distribution of diagnostic responsibility and the strategic de-
ployment of psychology’s cultural authority for sociopolitical
purposes is nurtured by the government and serves its interests.
This research contributes to the study of therapeutic gov-
ernance by focusing on those subject to psy power. This ap-
proach reveals more nuanced techniques of psychologization
than studies focusing on experts and expertise, for example,
in the case of managing officials’ suicides: pathologization (of
their deaths), depoliticization (of bureaucratic politics), repo-
liticization (of depression), and deprofessionalization (of medi-
cal experts), as well as homogenization and reduction (of offi-
cials’ experiences and subjectivities). It exposes deeper causes
and more complicated historical and cultural contexts that
trigger guan xinbing. While the analysis focuses on qian guize
as the key bureaucratic cultural practice leading to officials’
“heartache,” Chinese economic growth exacerbates their de-
pression. Officials do not enjoy the same economic and social
privileges as they did before the reform era, which may inten-
sify their psychological stress and contribute to their double
binds. The reductive biomedical approach to guan xinbing turns
politics into a matter of mental health. Here the politics being
obscured include widespread corruption caused by, for exam-
ple, qian guize rather than the rule of law, and the state’s ab-
 000
dication of responsibility for reforming social structures and
the bureaucracy. The adoption of psychologizing modes of
knowledge and therapeutic forms of relationship allows the
government to cultivate certain subjectivities, psychologically
conscious but politically detached. Such subjectivities serve the
state interest in downplaying moral and political concerns
about bureaucratic corruption and highlighting social har-
mony. This ethnographic approach highlights the way biomed-
icine, economy, and politics inflect and fold onto one another,
a process involving concatenation of multiple and convoluted
powers and conflicts.
Crucial to this mode of therapeutic governance is psychol-
ogization—in the case of officials’ heartache, psychologization
of depression. As a popular cultural idiom, depression is un-
derstood multiply in China: as an illness, a lived experience,
an ideological construct, and an object of medicalization and
self-management. In officials’ suicides, depression, beyond an
economic liability (Rose and Abi-Rached 2013), is discussed by
public servants as an illness of power and injustice. For them,
it is a response to social and political convolutions in Chinese
officialdom, to the overwhelming but subtle workings of qian
guize, to the double bind imposed by irreconcilable (ethical)
demands, and to difficulties of sustaining the illusion of har-
mony within an autocratic bureaucracy. Chinese public ser-
vants are not just “victims” of a hierarchy dominated by am-
biguous qian guize but also part and parcel of that system. Many
become depressed due to insecurity and uncertainty about their
prospects, given their perception of how corrupt the system is.
This mode of governing raises important questions about the
relationship between (post)socialism, psychology, and therapy.
Psychologization forwards multiple government interests, off-
setting some of the negative consequences of China’s economic
restructuring by emphasizing people’s mental health, partly fill-
ing the emotional and psychological “gap” created by the de-
cline of communism and the market economy, legitimating the
harmonious society, a key “socialist” project, and providing a
rationale for the party’s continued existence by being the peo-
ple’s “guardian” and offering them psychological “care.” How-
ever, Chinese officials’ suicides partly reveal the cost of both
psychologization and the social harmony project.
Psychologization, as a new phenomenon connected to in-
creasing influence from the West, intersects with traditional
Chinese modes of autocracy and with tensions between the
appearance of serving the public good and particularistic loy-
alties. As both a process and government rhetoric, psycholo-
gization serves diverse sociopolitical purposes. The flexibility
and adaptability of psychology have rendered it a subtle and
powerful political technology that can transform issues requir-
ing complex sociopolitical resolution into personal issues or
pathology requiring “scientific” cures (see Taussig 1980; Furedi
2004; Lock and Nguyen 2010).
At the heart of “depression” and suicides among this un-
derstudied group of officials in China lie contradictions. The
current situation requires public servants to integrate a lin-
gering communal sense of self with an emergent sense of self
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Current Anthropology Volume 59, Number 5, October 2018
based on individualistic values. A person caught in this di-
lemma, who claims to serve the public, may nonetheless quickly
lose faith in communism and resort to maximizing personal
gain. The management of such ethical contradictions and slip-
page generates moral confusion and physical and psychological
suffering. To complicate matters, the government, which since
2009 has deployed mental health care to handle officials’ sui-
cides (Wang 2015), provides no effective support for public
servants suffering from psychological distress. To the extent
that widespread social inequalities, authoritarian governance,
and demands for obsequious behaviors are factors contribut-
ing to psychological distress, the most effective intervention in
mental health would be the reduction of these factors and as-
sociated contradictory practices. Under these circumstances,
it is important to ask how this bureaucracy might transform to
allow people to grow within it rather than forcing them into
constant double binds.
Acknowledgments
Pieces of the argument and narratives in this article were pre-
sented at the 2013 annual meetings of the American Anthro-
pological Association in Chicago and the Department of An-
thropology at the University of Victoria and at the Weatherhead
East Asia Institute at Columbia University. I thank Daromir
Rudnyckyj and Nick Bartlett for the invitation and their de-
tailed, insightful, and penetrating comments. I also appreciate
the comments and insights from the audience at these events.
I thank Marguerite Pigeon, Lesley Butt, Janet Dixon Keller, Erin
Martineau, Janice Mastumura, Carl Ratner, Pam Stern, and
Louise Sundararajan for their encouragement, insightful com-
ments, and editorial improvements. I also want to thank Zhi-
peng Gao, Byron Good, Elsa Fan, Anru Lee, Priscilla Song,
and Li Zhang for conversation and inspiration. Current An-
thropology Editor Mark Aldenderfer and three anonymous
reviewers provided helpful insights and guidelines for the
final revision of this article. Errors remain my own. Research
for this article was funded by a multiyear research grant from
the Social Sciences and Humanities of Research Council of
Canada.
Comments
Andrew B. Kipnis
Humanities Building, New Asia College, Chinese University of Hong
Kong, Room 410, Shatin, New Territories, Hong Kong (andrew
.kipnis@anu.edu.au). 27 IX 17
Jie Yang gives us an article that is insightful on at least two
counts: it shows how discourses about depression and psycho-
logical illness are abused for political purposes in the People’s
Republic of China, and it shows the types of social pressures
county-level officials in China endure. Everything that I know
Yang “Officials’ Heartache”
about these two topics supports her conclusions. The Chinese
Communist Party’s notorious system of detention and inter-
rogation—shuanggui—creates a legal environment in which
party officials receive even fewer protections of their human
rights than ordinary citizens in China do. In another Shandong
municipality, the anthropologist Li Geng (Li 2015) found that
the unpredictability and pressures of official life make local of-
ficials secretly consult fortune-tellers at far higher rates than
the public at large. And at least two political scientists have
detailed the sorts of qian guize that exist in other local govern-
ment settings in China (Hillman 2010, 2014; Smith 2009).
In a sense, the case Jie Yang gives us here is the perfect one for
an analysis that utilizes the theoretical language of “psycholo-
gization” and “therapeutic governance.” The purpose of psy-
chologizing discourse is to elide the social and political causes
of conflict. The abuse of psychology is so thorough in this case
that there is not even a need to consult actual practicing psy-
chiatrists or psychologists. But the extent to which this case fits
the theoretical language deployed in the article also makes me
want to interrogate the presumptions of this theoretical lan-
guage. The gist of this theoretical language is not just that
discourses about psychological illness can be abused for social
and political purposes but that they inherently and inevitably
lead to a form of false consciousness in which the “real” social
and political causes of psychological distress are ignored. As
Yang puts it, according to Foucault, “the form and etiology of
madness must not be sought in either the body or the psyche
but in the history of their discursive construction” (emphasis
my own).
So this theoretical language would reach the same conclu-
sions even in a more moderate case, such as the recent public
health campaigns in Australia, which encourage the popula-
tion, especially men, to attend to potential signs of depression,
anxiety, or other mental illnesses. One such campaign (run by
the nongovernmental organization beyondblue) features star
male athletes encouraging other men to talk about their emo-
tions, to listen to their friends who wish to talk about their
emotions, and to not be shy about seeing mental health pro-
fessionals. It also includes star athletes who discuss their own
depression or other mental illness. The campaign suggests the
following etiology of male suicide in Australia: norms of mas-
culinity label the discussion of negative emotions as a type
of weakness; these norms cause many men to bottle up their
feelings; as a consequence, their emotional problems become
worse and cases of depression go undiagnosed and untreated,
which in turn leads to suicide. Australia has a public health
system in which some—or, in many cases, most—of the costs
of seeing psychiatrists and psychologists, as well as filling pre-
scriptions for psycho-pharmaceuticals, are covered. The pur-
poses of the campaign are to destigmatize mental illness and
to lobby for even greater percentages of the costs of treat-
ment to be supported publicly. Whether Australian men who
sometimes experience negative emotions, such as myself, would
be better off if we spent more time discussing and analyzing
our feelings and consulting mental health professionals—
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000
or whether we would be better off focusing our efforts on po-
litical protests and social strategizing—is not a question that I
can answer. But if I were to analyze this case, I would resist
using a form of theory that can only answer the question in one
way.
The theoretical tension here can also be seen in recent de-
bates about Actor Network Theory and posthumanism, which
question whether and when nonhuman agents can be said to
exist (see, e.g., Gregory 2014; Kipnis 2015; Martin 2014). Should
“social” anthropology be a discipline that sees and analyzes only
the social/human/political causes of human dilemmas? Might
biological structures of the brain and body, whether shaped by
early childhood interactions, environmental toxins, or epige-
netic factors be considered? In Foucault’s terms, can the bodily,
psychic, and discursive construction of madness be considered
together?
But such questions take us far away from Jie Yang’s arti-
cle, which shows all too clearly how the Chinese Communist
Party’s desire to construct “political harmony” leads to the abuse
of psychological discourse in China. To her credit, Yang is
careful to specify the ways in which her case differs from many
others analyzed by anthropologists with the theoretical lan-
guage of psychologization and therapeutic governance. To me,
what is particular about Yang’s case is that it fits the theory
better than most.
Junko Kitanaka
Department of Human Sciences, Faculty of Letters, Keio University,
2-15-45 Mita, Minato-ku, Tokyo 108-8345, Japan (kitanaka@flet
.keio.ac.jp). 29 X 17
Jie Yang’s article is a welcome contribution to the anthropol-
ogy of psychiatry with a focus on depression and suicide. Ever
since Arthur Kleinman published his monumental Social Ori-
gins of Distress and Disease: Depression, Neurasthenia, and
Pain in Modern China in 1986, drawing parallels to Brown
and Harris’s (1978) classic on the social nature of depression
in the United Kingdom, anthropologists have repeatedly dem-
onstrated that depression is a thoroughly political, historical, and
social product (Kleinman and Good 1985). Anthropological
inquiries into local experiences of depression have grown enor-
mously, particularly since the 1990s, when the World Health
Organization proclaimed depression to be a “global burden”
and an illness of productivity, and the rise of Prozac seemed
to be promoting a neurochemical, cerebral understanding of
personhood fit for the neoliberal order. By contrast, anthro-
pologists have continued to find that depression and suicide
remain versatile and locally heterogeneous in places like Ar-
gentina (Brotherton 2016, Lakoff 2006), Brazil (Béhague 2015),
Canada (Stevenson 2014), Chile (Han 2012), Finland (Funa-
hashi 2013), France (Rechtman 2000), Greece (Davis 2012),
India (Ecks 2013), Iran (Behrouzan 2016), Italy (Giordano 2014;
Molé 2012), Japan (Borovoy 2008; Fisch 2018; Kitanaka 2012),
 000
Mexico (Duncan 2017), Morocco (Pandolfo 2017), Russia (Rai-
khel 2016), and the United States (Garcia 2010, Martin 2007).
They demonstrate the fact that to understand depression and
suicide, individuals and their immediate social and, particu-
larly, political environment cannot be separated. Illuminating
how “depression” in place of neurasthenia is now being dis-
seminated as a popular category for everyday distress in (post)
communist China, Yang has written a brilliant work that shows
a surprising twist from the time of Kleinman’s book.
In the 1980s, Kleinman showed that the psychiatric label of
“neurasthenia” was being used by Chinese laypeople as an id-
iom of distress, both collective and personal, for reflecting on
the historicity of the predicament in which people could not
freely express themselves under the communist regime. This
was certainly a politicized use of psychiatry and one that also
revealed humanistic and grassroots potential. China has since
seen rising interest in things psychological: Li Zhang (2014,
2017), for instance, has investigated how lay Chinese are cre-
atively embracing psychological techniques of self-exploration
like counseling, self-help seminars, and encounter groups. While
many initially approach psychology as a practical tool for self-
advancement in the neoliberal market economy, some come to
appreciate it as a genuine “care of the self,” a way of deepening
self-introspection and reflecting on the meanings of their lives
amid social upheaval. While Zhang’s work shows the creative
energy generated by popular reinterpretations of psychiatry/
psychology in China, Yang’s work is rooted in the other line of
anthropological inquiry that dissects how psychiatry can be used
as a state apparatus of “human engineering” for instilling a
certain kind of subjectivity desirable for a particular political/
economic structure. What Yang has shown here is indeed a
much darker side of the psychiatrization of everyday distress, in
which a popularized psychiatric label of “depression” is adopted
and abused by the communist state as a tool for concealing
structural injustices and blaming suicidal bureaucrats for indi-
vidual weaknesses in an effort to maintain collective “harmony.”
While this is a nightmarish scenario of medicalization under
the (post)communist regime, the striking fact is that psychia-
trists are almost completely absent from this process, remaining
silent even about the dubious nature of the “depression” diag-
nosis. One wonders if the current abuse of psychiatrization could
be a symptom of a transitional period; as people are beginning to
actually seek psychiatric care, perhaps, the state may no longer
be able to arbitrary impose a false label in its (unscientific but
official) “postmortem diagnosis” in this brutally manipulative
manner.
Indeed, one of the important findings from anthropological
investigations into the global rise of depression over the last
decade is the fact that this does not necessarily lead to mono-
lithic biomedicalization or psychologization (as was often ini-
tially assumed in the United States) but has instead proven to
generate fertile ground on which to discuss the “social” nature
of depression and suicide. Molé (2012) has shown how de-
pression in the workplace in Italy has led to concern about
harassment and the improvement of work conditions; other
European countries have also seen rising interest in the burden
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Current Anthropology Volume 59, Number 5, October 2018
of psychological labor and the toll it takes on workers, trig-
gering debates about how much the public (state/corporate)
should intrude into the private realm, or how to evaluate/
protect the health of a worker’s “mind.” In the case of Japan,
the worker’s movement since the 1990s has successfully fended
off the assertion that depression is a biological anomaly to
be located within workers’ individual brain and instead estab-
lished that it can be a product of work stress, for which the state
and corporations are held accountable. Their success has also
invited a new level of psychiatric surveillance into the previ-
ously private realm of workers’ mental health, however, with
the rise of “stress checks” nationwide. Notably, the Japanese
scales for measuring psychological stress in the workplace have
already been translated into Chinese and adopted in Taiwan,
generating a “social” understanding of depression in Asia more
broadly (Kitanaka 2012). Given these global changes, particu-
larly in Asia and Europe, and given that so many laypeople
interviewed by Yang seem aware of the thinly disguised polit-
ical manipulation of a scientific label, I wonder if the demor-
alization Yang centers on is a prelude to broader discussions
of depression as a problem of labor. I eagerly await further in-
vestigations to find out whether the underlying popular anger
toward corruption and the public’s suspicion about what really
lies underneath the upward trend in so-called depression-
triggered suicide might not soon help generate a more “social”
and politicized understanding of depression. And if so, then I
wonder what kind of affective mobilization may be possible,
particularly as more and more people begin to engage psychi-
atric modes of the care of the self, and what sorts of global
politics may emerge out of the Chinese reflections (with their
socialist background) on whether depression and suicide are
merely an impediment to work or a product of work itself.
David A. Palmer
Department of Sociology, University of Hong Kong, Pokfulam Road,
Hong Kong (palmer19@hku.hk). 12 XI 17
The poignant ethnographic examples in Jie Yang’s article res-
onate with my own experience living in a socialist work unit
(danwei) in Sichuan province—a training college for cadres in
the petroleum industry from oil fields around China—in 1993–
1995, at a time when market reforms were only beginning and
most resources, including things as simple as a doctor’s ap-
pointment or train tickets, could only be obtained through bu-
reaucratic channels rather than on the free market and by play-
ing the games of qian guize, deeply enmeshed with the culture
of guanxi (managing connections). As a result, officials wielded
far more power over peoples’ lives than they did in the following
decades. Lower-level cadres often confessed to me their insom-
nia, headaches, and general unhappiness and attributed these to
the stress of managing complex relationships with their superiors
and other people with access to resources. Perhaps more than
now, university-educated cadres saw themselves as a margin-
alized intellectual elite with a deep sense of moral responsibility
Yang “Officials’ Heartache”
to the nation but whose ideals were violated on a daily basis in
their own work relations, leading to a deep sense of cynicism
and apathy. But in those days, psychologization had not set in.
Terms such as depression (yiyuzhen) were not yet current.
Mental illness was still completely stigmatized. There was no
“pop psychology” by which people diagnosed each other, nor
did the state deploy psychological discourses and techniques as
a rationality of governance. There were many forms of escape
from the pressure of qian guize. Many pursued cultural hobbies
such as writing calligraphy, composing poetry, and reading
classical novels, identifying with the tragic fate of the Chinese
scholar-gentleman whose noble virtues fail to change a world
that remains caught up in political plots and machinations. An
intense drinking culture allowed them to momentarily forget
their sufferings and to engage in bittersweet commiseration
with friends over meals and even with coworkers at banquets—
the same people with whom they engaged in games dictated by
hidden rules. Another escape was the market economy, still a
new realm of experience in those days. Consumption—and
even moonshining through sideline businesses—opened
spaces of freedom (people had no debt; they had not yet started
buying property). There was a genuine sense of excitement and
happiness associated with the almost endless possibilities
afforded by the market reforms. For many, this helped to offset
the daily humiliations of office politics. They dreamed. Many
plunged into fanatical English learning; even when they knew
they had slim hopes of moving or studying abroad, the English
language itself was a world of escape. Others plunged into one
or another of the various cultural “fevers” of the time.
Two decades later, in the new era of Xi Jinping, the danwei
system of socialist work units has long been largely dismantled,
but it remains in place for civil servants, who still need to play
the qian guize of officialdom. But the outlets of escape have
changed. The cultural pursuits of the intellectual seem to be
less prevalent, replaced by cultural lifestyle consumption. The
market economy and going overseas (chuguo) are easily ac-
cessible and do not present the same novelty or excitement.
More professionalized technologies of management and in-
creasingly stringent systems of bureaucratic assessment and
control, coupled with anticorruption campaigns, ostensibly re-
duce the scope of qian guize but also provide new weapons
for games and manipulation. The game still needs to be played,
but the risks are higher.
And now these stresses have a name: yiyuzheng (depression),
a term that has become ubiquitous. The Western category of
“depression,” associated with processes of psychologization,
medicalization, and neoliberal governmentality, has become
appropriated into the norms and techniques of socialist author-
itarianism—failure to adapt to the collective is a mental illness—
and integrated with traditional values of self-cultivation—the
gentleman is responsible for keeping his inner serenity while
adeptly aligning himself to multiple and shifting contexts and
relationships. Yiyuzheng thus serves as a term for the symptoms
of the triple stress on Chinese people today, stemming from the
norms of market-based individualism, authoritarian collectiv-
ism, and traditional self-cultivation.
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000
Medicalization has not gone as far as in the West, however,
since, as Jie Yang describes, the medical authority of profes-
sional psychiatrists is ignored. The state, media, and common
people feel no compunctions about ascribing psychological
interpretations and diagnoses. This raises three questions. First,
the article highlights the contrast with medicalization in the
West, which privileges expert knowledge. But it seems that
what we are seeing in China is the rise of discourses and prac-
tices of “pop psychology”—something that is widespread in
the West as well. How does pop psychology relate to expert
knowledge in the West? And to what extent is the emerging
Chinese configuration similar or different? Second, given the
rise of pop psychology in China and the tendency toward
therapeutic self-reliance, this article raises the question of the
popular acquisition of psychological knowledge. For example,
according to Iskra (forthcoming), training programs in psy-
chotherapy, offered by private operators and leading to certi-
fication as a psychotherapist, are increasingly popular in large
metropolitan areas. Most participants, however, take these
courses not in order to become practicing psychotherapists but
simply for their own self-development. Such programs exist
among a burgeoning market of self-care workshops and prac-
tices, ranging from success gurus to body-mind-spirit work-
shops. To what extent do such practices influence, or are influ-
enced by, the prevalent psychologizing therapeutic discourses?
Third, how do such popular practices articulate with the tech-
nologies of “therapeutic governance?” Yang Jie evokes the state’s
self-appointed role as a caregiver, but in the cases described
in the article, there is very little concrete “care” provided; the
care is largely discursive, in the form of sympathy for the “de-
pressed” suicide victims. The specific practices of therapeutic
governance—and how they articulate the state and popular
movements—are another field for future investigations. Over-
all, this article is a valuable contribution to the medical and
political anthropology of China and to studies of the psycho-
boom, bureaucratic politics, and corruption in China.
Yinong Zhang
Institute of Anthropology, Shanghai University, 99 Shangda Road,
Shanghai 200444, China (yz36edu@gmail.com). 24 X 17
Nearly a century ago, Malinowski welcomed his pupil Fei
Xiaotong’s new book Peasant Life in China as “a landmark in
the development of anthropological fieldwork and theory,”
bringing both a great nation/civilization (as opposed to sav-
ages) and “how live Chinese minds work in reality” (as op-
posed to history) into the research scope of anthropologists of
the time, who later proclaimed a “Chinese phase in social an-
thropology” (Freedman 1963). While Malinowski and others
saw China as a means to push the frontier of anthropology as
a discipline, the post-1980s revival/reform of anthropology in
China reintegrated the discipline into the world anthropology
with a different mission—a nativization of “an anthropology
 000
with Chinese characteristics” (Harrell 2001). Deng Xiaoping’s
reform and open door policy not only ended the devastation of
the Cultural Revolution (1966–1976) and led to the Chinese
economic boom starting in the 1990s, but it also brought China
into a whole new phase of “present reality.” One significant
“unintended consequence,” following Robert Merton, of this
epic act of social engineering is the psychoboom manifested
in a wide variety of things, ranging from decollectivization and
the growing emphasis on the self to the radical increase in (or
perhaps exposure to) depression and the suicide rate (Merton
1976; Yan 2009; Wu 2010).
This new “present reality” begs for the study of a “deep
China” (Kleinman et al. 2011). Yang’s thought-provoking
article has touched upon a pressure point of contemporary
Chinese society, namely, the widespread phenomenon of psy-
chologically related personal/social problems, mental illness,
and—most of all—state intrusion into this domain, that is,
“therapeutical governance.” This fascinating ethnography on a
specific group of middle-to-low-level government officials—a
large body of the Chinese bureaucratic system and an under-
studied group—again explores the question of the “state” in the
Chinese context. On the one hand, these officials physically
make up a (major) part of the “state” at the bottom of the bu-
reaucratic pyramid. On the other hand, they appear to be victims
of a repressive system (or “state”) that is apparently separated
from themselves. While the concept of “therapeutic governance”
is not entirely new, what makes it intriguing is the paradoxical
nature of the repressor and the repressed that has been coined in
these “double bind,” depressed officials, what Yang describes as
“part and parcel of that system.”
To explain this complex phenomenon, Yang further intro-
duced the indigenous Chinese concept of quan gui ze, or “hid-
den laws,” that has dominated political and social life through-
out Chinese history. Given how powerfully influential these
hidden rules have been in Chinese life, the phenomenon of quan
gui ze has been well documented in the large amount of studies
on guanxi (managing relations), the art of gift practice, and the
general political economy in a Chinese cultural ecology (Osburg
2013; Yan 1996; Yang 1994). Yang departs from previous stud-
ies at two points. First, he does this by blurring the boundary
between the “losers” and “winners” in this game, noting that
“even if you are in power, you still have to obey others who hold
greater power than you.” The logic of going along to get along
further challenges the binary assumption of state versus society/
people, thus shedding new light in the studies of political an-
thropology and anthropology of state as to how power has been
executed (i.e., the anticorruption campaign) in an authoritarian
society like China. Second, Yang raises a seeming contradiction
between a rising social demand for psychological experts/ex-
pertise and the marginalization of those experts and their ex-
pertise. This leads to another valuable contribution to the study
of medical anthropology, namely, the medicalization of the
socially rich and politically charged phenomenon of depression
and suicide for the sake of state governance while at the same
time delegitimizing the psychological experts/expertise through
social stigmatization of the phenomenon. This contradiction
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Current Anthropology Volume 59, Number 5, October 2018
also reaffirms the power of “hidden laws” that is at once re-
pressive and enticing.
The paradoxical nature of contemporary China makes a good
interpretation only more questionable. For example, hidden
rules are believed to have played an important role in Chinese
social dynamics throughout history. If so, why is it only now
that these hidden rules have started to make people sick? In
other words, is suicide or depression as a social phenomenon
completely new in Chinese society? Malinowski clearly sees
the study of the present reality (anthropology) and study of the
past (history) as complementary and believes they “must be
used concurrently.” However, this only answers how, not why,
to paraphrase Evans-Pritchard’s classical question of Azande’s
granary collapse. Azande knew the natural cause of the granary
collapse was termites. The question was why it happened at this
time and why it fell on these people (Evans-Pritchard 1937).
To answer the questions of how and why, perhaps we should
try to look beyond the lineal metaphor of past and present, of
anthropology and history.
Reply
China’s mental health epidemic is inseparable from the coun-
try’s economic restructuring and privatization starting in the
1980s. Amid shrinking state employment and social welfare,
the socialist-collectivist ethos has gradually been replaced by
market-oriented individualism. In this context, multiple social
factors, including corruption and economic polarization, have
triggered a wide range of mental problems. One major response
of the Chinese government to this mental health crisis has been
“therapeutic governance”: the government now draws on psy-
chological discourse and techniques to foster flexible and psy-
chologically healthy subjects able to contribute to political
stability and economic development. Therapeutic governance
is implemented through varied forms and mechanisms, many
at arm’s length, including psychotherapy, psychiatric hospital
care, peixun (training) sessions, TV therapy, self-help, and so-
cial services, as well as subliminal public discourse.
This article offers a case study of such governance and its
specific mechanisms. It examines responses to the increasing
rate of suicide among Chinese government officials especially
since 2013, alongside intensifying anticorruption campaigns.
Responses include both discursive manipulation and concrete
psychological support (e.g., through counseling hotlines and
sessions offered by the National Center for the Psychological
Health of Public Servants of the Institute of Psychology, Chi-
nese Academy of Sciences in Beijing; Fang, Yun, and Zhang
2011). Due to stigma, however, few officials access these outlets
of formal support, and therefore, for the most part, discursive
manipulations are the main response.
Diverging from Western therapeutic governance, which em-
phasizes psychological expertise, the Chinese mode of managing
distress among officials highlights informal diagnosis by non-
Yang “Officials’ Heartache”
experts. This mode of therapeutic governance links therapeutic
practice with state interests but not in a heavy-handed way.
Rather, this is disavowed state power that encourages mass in-
formal diagnosis and individual self-management. In this article
I draw on Western literature on psychologization and thera-
peutic governance, which can be read as leading to a false con-
sciousness that elides the social causes of distress. However, I
emphasize the unique uptake of this governance in China that
enmeshes psychologization to indigenous cultural practices, for
example, respect for the dead as a means of muting discussion of
suicides and familial stigmatization. Such unique tactics rein-
force more than false consciousness but government control as
well as subject positions that suit state interests.
While this mode of governance decenters psychological ex-
pertise, I do not mean to argue that psychological expertise is
unimportant in China; in other modes of intervention—for
example, management of mass unemployment—psychother-
apy plays a key role (see Yang 2015), and within the recent
psychoboom, psychologists have assumed cultural authority.
They can be found at reemployment (job) centers, disaster sites,
and mega events like the 2008 Olympic Games, offering ser-
vices to the public. But in the case of officials’ suicides, often
attributed to “depression,” practicing psychiatrists or psychol-
ogists are not consulted. Given the rising cultural authority of
psychology, such elision is doubly jarring. In the context of
what has become since 2004 the ubiquitous Chinese discourse
of constructing a harmonious society, we can view this move
to bypass psychological experts, who may reveal the sociopo-
litical etiology of officials’ depression and suicides, as a tactic
promoting political stability.
Depression has become the most prevalent mental disorder
in China, affecting more than 90 million people (Zhang 2016)
and resulting in about US$6.6 billion annually in lost workdays
and other financial burdens (Kaiman 2013). Depression is gen-
erally understood in China as a private medical condition.
This is partly due to the dominant biomedical treatment model
in Chinese hospitals. Recent (government) efforts to destigma-
tize depression and treat mental illness as disease rather than
“social and ideological pathology” as in Mao’s era, has rein-
forced this perception. Indeed, the narrow popular definition
can be viewed as a result of the transitional period in which
(psychological) governing and the neoliberal underpinnings of
society emphasize individualism. To understand depression as
predominantly social would require diversification of treatment
models and wide accessibility of psychotherapy.
The psychologization discussed in the article is incomplete.
Depression in China is locally inflected, and many government
officials I interviewed see depression as a labor issue, contrast-
ing with the government and media representation of depres-
sion as biomedical. There is widespread distrust in government
reports, but many in China only vent their discontent online.
Such online activism is nevertheless more cathartic than trans-
formative and has not led to structural change. In the future,
if depression comes to be viewed as a product of labor directly
affecting productivity, gross domestic product, or China’s status
as the “world’s factory,” the government may resort to phar-
Current Anthropology
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000
maceutical treatment as a quick fix. This could reinforce the
current biomedical treatment model. However, if a biomedical
approach fails to reduce the cost of depression, discourses of
depression could diversify as the government would be forced to
address both psychopharmacology and psychotherapy. Likely,
a varied set of definitions of depression and treatment models
will eventually gain traction in Chinese society, at which point
it will be harder for the state to abuse the depression label in
the way I capture in this article.
Overall, we can view psychologization in China as an ex-
pression of pop psychology, which is informed by psychological
expertise but can diverge from it through popular misunder-
standing and abuse. In China, people are currently acquiring,
repurposing, and deploying new psychological knowledge via
various popular practices. In this sense, they align with people’s
uptake of pop psychology in the United States. Perhaps they
accept nonexpert diagnoses of depression among officials be-
cause they too have been encouraged to rely on their own di-
agnostic capacity. In the case of officials’ suicide, depression is
invoked as a biomedical term by media and investigation teams,
but the “diagnosis” is not based on expert psychiatric judgment.
What is particularly manipulated here is the emphasis on de-
pression as an individual, private disease, and the linear causal
relationship between depression and suicide. The general lack
of evidence in diagnoses of officials who are already dead defies
psychological expertise. But officials’ suicides also show the
unique articulations of pop psychology, cultural values, and
therapeutic governance in China and their consequences. Un-
like a psychiatric diagnosis of depression—which implies that
the official was in pain, the family is mourning, and the gov-
ernment owes compensation for stress—diagnoses from non-
expert government agents can mean that the official “failed,”
that the family is “complicit,” and that the government solves
a “problem.”
One major component of pop psychology in China encom-
passes widespread self-help genres. They are partly informed by
Western literature and partly by indigenous Chinese positive
thinking steeped in Buddhism, Confucianism, and Daoism (see
Yang 2017a). Today, there are at least three major trends of
psychological self-help in China: first, online and broadcast
counseling, such as Xinli Fangtan (Psychology Talk Show), on
China Central Television; second, problem-oriented genres
offering pragmatic advice to resolve issues like anxiety, anger,
and procrastination; and finally, growth-oriented genres that
advocate positive messages regarding life and happiness. The
latter form is called xinling chengzhang, heart-spirit growth,
which turns away from pathology in favor of nurturing posi-
tive potential. Many in China, especially members of the urban
middle class, now treat self-help as a resource for self-care and
growth (see Wang 2014). However, the nurture of positive
thinking and happiness also contributes to the political project
of social harmony. The case of officials’ heartache nevertheless
foregrounds the manipulative, pathologizing aspect of psychol-
ogy, which is co-opted in the name of state goals. The over-
emphasis on positive thinking has caused some people in China
to turn against self-help. Online bloggers deem self-help
 000
reductive and argue that it immunizes people against social
critique and actually causes more depressive symptoms (see Yang
2017b).
Meanwhile, as a transhistorical Chinese practice, qian guize,
or hidden rules, have become more salient in recent years, and
are now seen (by public servants) as a source of workplace psy-
chopathology. Three factors support this greater salience. First,
while the phenomenon may have existed throughout Chinese
history, the term was only coined in the late 1990s by a Chinese
journalist turned historian, Wu Si. This coinage has reignited
interest in understanding and conceptualizing the phenome-
non. Second, qian guize are highlighted in the context of eco-
nomic restructuring and privatization that engender new mecha-
nisms and practices of inequality. Third, while it is hard to
compare mental distress across historical periods, in China
today new terminologies and new diagnostic categories and
procedures have been adopted to discuss and even pathologize
feelings and practices arising from the prevalent practice of
hidden rules. The very notion of stress or yali only entered Chi-
nese psychological discourse around 2000. The exact sources
of stress people have experienced amid widespread socioeco-
nomic dislocation may be hard to pinpoint. The illusiveness
and prevalence of qian guize as powerful rules pervading mul-
tiple social domains in China render them an (imagined) lump-
sum source of injustice and distress.
—Jie Yang
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